Going Back to the Office? The Colder Temperature Could Lead to Weight Gain


By Kenneth McLeod, Binghamton University, State University of New York

With millions of Americans vaccinated against COVID-19, many who have worked from home over the past year will be heading back into the office. Adjusting to new routines is challenging and can affect our health and fitness. We’ve been more sedentary or more active, gained weight or dropped pounds.

As part of my work as a biomedical engineer, I study how physical factors influence human metabolism. This includes height and weight, gravity – and air temperature. My research colleagues and I have found that living or working in a cool environment for extended periods can lower core body temperature. That decreases metabolic rate – how fast we burn calories – and commonly causes weight gain.

Maintaining core body temperature

Humans are homeotherms – that is, we maintain a relatively constant core body temperature. Specifically, we keep our body temperature in the range of 97 F to 101 F even in cool environments. Three different types of metabolic activity keep our body warm.

The first is basal metabolism. About two-thirds of the calories we burn each day fuel basic bodily functions, all of which generate heat: breathing, blood circulation, cell growth, brain function and food digestion. Any kind of physical movement also generates heat through chemical reactions that make muscles contract.

A third heat-generating process happens within specialized tissue called “brown fat.” It’s a leftover evolutionary adaptation that kept us from freezing during the ice ages. It kicks in when our core temperature drops to very low levels, but most people lose their brown fat as they age.

With increasing body temperature, our metabolic rate rises and we burn more calories. This generates more heat and further raises our body temperature, creating a positive feedback process which usually keeps our body temperature in the healthy range.

But this process is remarkably sensitive to temperature. For every 1-degree drop in body temperature, our metabolic rate can decrease by more than 7%. This means that the resting metabolic rate for someone at a body temperature of 101 F (the high end of normal) is up to 30% higher than if their temperature were 97 F (the low end). Increasing body temperature by four degrees can burn more calories during the course of the day than the average person burns as a result of all of their daily physical activity.

Body temperature versus physical exercise

This is why changing your physical environment can substantially alter the way your body works – and impacts both health and fitness. If you’re gaining weight and aren’t sure why, check the thermostat where you live or work.

Most offices tend to be kept near 70 F. That’s why so many of your co-workers are complaining of being cold, wearing sweaters or jackets, or using a space heater. This tends to be too cold for most women – and many men – who sit at a desk all day. But it’s more than uncomfortable; it’s not healthy.

The “correct” room temperature is where you are comfortable: not too hot, not too cold. That’s generally between 72 F and 81 F at moderate humidity, but may range as low as 65 F or up to 85 F.

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Working in a cold office slows your metabolism. In addition to making weight management challenging, sluggish metabolic rates are linked to lowered immune response, heart damage and increased risk of developing Type 2 diabetes.

If you don’t have control over the thermostat, you still have a few options besides wearing a coat all day. New technologies include a wearable personal device which changes your perception of warmth and cold; a passive exercise device that increases your metabolic rate by increasing cardiac output; and a “smart” version of the traditional space heater. However you achieve it, do your best to stay comfortably warm in your future workplace.The Conversation

Kenneth McLeod, Professor of Systems Science and Director, Clinical Science and Engineering Research Laboratory, Binghamton University, State University of New York

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Barriers to Care: Head and Neck Cancer

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Medically reviewed by Dr. Jennifer Grandis.

Head and neck cancer is a catch-all term that includes cancers of the lips, mouth, voice box, throat and salivary glands. When caught early, these cancers have a five-year survival rate of 70% to 90% with treatment. Unfortunately, most cases of head and neck cancer aren’t diagnosed until they’ve reached a later stage, making treatment much less effective.

If treatment works so well for early stage head and neck cancer, why aren’t more people diagnosed before their cancer advances? What’s stopping people from getting care sooner?

Uncertainty about head and neck cancer type, symptoms

“There are numerous types of tumors that are seen in the head and neck,” explained Dr. Eleni Rettig, a head and neck surgeon at Brigham and Women’s Hospital and Dana-Farber Cancer Institute at Harvard Medical School. The most common type of head and neck cancer is squamous cell carcinoma, where cancer develops in cells that make up the middle and outer layers of the skin, she said.

Because head and neck cancer includes several types of cancer, symptoms of these cancers are many and varied. And some of the most common ones, like a chronic sore throat or hoarse voice, can be misinterpreted as a sign of something else (like a cold).

Head and neck cancer and HPV

Risk factors for head and neck cancer include tobacco use, alcohol consumption and HPV infection. Caused by human papillomavirus, HPV infection is responsible for about 70% of head and neck cancer that affects the oropharynx — the back of the throat, including the base of the tongue and tonsils.

“If you have squamous cell carcinoma of the oropharynx, then it is important to know whether your tumor is caused by HPV,” Rettig said.

Head and neck cancer caused by HPV is becoming more prevalent. Experts aren’t sure why, although one theory is that more people are engaging in oral sex, which can spread the HPV virus.

Stigma surrounds HPV

HPV affects nearly every sexually active person at some point in their lives. About 85% of women and 91% of men will be infected with at least one type of HPV by age 45. But even though HPV infection is widespread, a lot of stigma surrounds it.

Because sexual contact is the main way HPV is transmitted, negative stereotypes may make people less likely to bring it up with their friends or healthcare providers. If a person is experiencing symptoms of head and neck cancer but isn’t aware of the connection to HPV, or doesn’t want to bring up their HPV status with their healthcare provider, it may take longer to get a cancer diagnosis.

Even after they learn they have head and neck cancer, some people are reluctant to talk about HPV. They may feel ashamed or embarrassed to ask questions about the role HPV plays in their cancer.

HPV vaccine hesitancy and misinformation

There is a vaccine that protects against HPV, including the strains of the virus that cause cancers of the oropharynx. The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccine for everyone up to age 26, as well as some adults up to age 45 who haven’t received the vaccine and may be at risk of new HPV infections.

In spite of CDC recommendations, some parents are reluctant to vaccinate their adolescent children against HPV. A 2019 study published in the journal Pediatrics found that parental hesitancy about the HPV vaccine went up from 50.4% in 2012 to 64% in 2018, even though more providers were recommending the vaccine to their adolescent patients.

Public health officials are working to strengthen HPV vaccination efforts on local, state and national levels to help prevent cancers caused by HPV.

Cancer disparities affect many Americans

Health disparities and inequalities can be another barrier to accessing head and neck cancer care. People who live in counties affected by persistent poverty are more likely to die of cancer than those who live in other counties, and low income is linked to poor survival rates of head and neck cancer.

Rural areas, which often have higher rates of poverty and limited access to health care, tend to have higher cancer mortality rates than urban and suburban areas. One study looking specifically at head and neck cancer found that patients living in rural counties were less likely to be diagnosed at a younger age than those in urban counties.

Racial and ethnic disparities also have a big impact on cancer care, as do those surrounding sexual orientation. In one analysis spanning 10 years, Black patients with oropharyngeal cancer had a significantly worse overall survival rate compared to patients of other races. And lesbian, gay and bisexual young people are more likely than their heterosexual peers to drink alcohol and smoke cigarettes, both of which can increase their risk of getting head and neck cancer.

Seeking specialized support

With so many types of head and neck cancer, it can be difficult for newly diagnosed patients to know where to go. Rettig suggests finding a medical practice that specializes in head and neck oncology. “Other specialists you may see include a speech-language pathologist, dietitian and physical therapist,” she said.

The importance of routine health care

Concerns about Covid-19 have caused some people to skip or delay medical care and dental care, which can lead to worsening symptoms or missed diagnoses. In the case of head and neck cancer, where early detection is key to improving survival rates, skipping an annual physical or appointment to get the HPV vaccine could mean a much worse outcome.

The bottom line? Don’t let fear prevent you from seeing your provider.

This resource was created with support from Merck.

I Didn’t Choose to Get Parkinson’s at 46, but I Can Choose How I’m Going to Live With It

As told to Alex Fulton

April is Parkinson’s Disease Awareness Month.

At 43, I felt like I’d really found my groove. After my recent divorce, I’d pulled myself back together and restarted my life. I was raising my teenage son. I got a promotion at my job as a social worker. I joined a hiking group. I ran my first 5K. It was a time of personal and professional growth, and I felt really good. Until I didn’t.

I first noticed something was wrong while training for my second 5K. Around the two-mile mark on my runs, my right foot would start cramping and twisting. I thought it was kind of weird, but since I don’t really like running anyway, I decided I’d just stick to walking after the 5K was done.

Then it started happening when I walked fast. I thought, “Maybe I just need to dial it back a little.” But my foot kept getting worse. I saw my doctor, who sent me to a back specialist. I got an MRI of my back and started physical therapy. Nothing helped. A physical therapist happened to notice I wasn’t swinging my right arm when I walked, but no one seemed concerned.

Months passed, and my right arm started giving me trouble. It felt weirdly heavy and awkward when I did things like use a computer mouse. I had to switch to an electric toothbrush because I couldn’t sustain the back-and-forth motion with my right hand.

At an exercise class one day, I mentioned my arm trouble to a friend who’s an occupational therapist. She suggested I see a neurologist, so I made an appointment. Next thing I knew, I was diagnosed with
Parkinson’s disease. I was 46 years old.

One of my first questions after my doctor said I had Parkinson’s was, “Aren’t I too young?” I knew about Michael J. Fox — but I didn’t think about him in that moment. It turns out, about 10 to 20% of those diagnosed with Parkinson’s are under 50 years old (out of roughly 60,000 new cases diagnosed in the U.S. annually) and this is called early-onset Parkinson’s.

The diagnosis — delivered flatly without any accompanying information other than instructions to keep exercising — absolutely floored me. I hadn’t made the connection between my foot and my arm and wasn’t expecting anything more than a pinched nerve or something equally benign.

I left that neurology appointment, got in my car, and cried. Then I called my mom, followed by my therapist. I went home and put on a brave face for my son.

My first step after my diagnosis was to find a different neurologist, a movement disorder specialist who put me on medication that helps control my symptoms. I expanded my exercise routine, adding things like yoga and pilates. Different forms of physical activity help me in different ways, so I try to mix it up.

My second step was to start a support group for women living with Parkinson’s disease. I wanted to surround myself with others who shared my experience. Since the type of group I was looking for didn’t exist in my home state of Massachusetts, I decided to create one. This is not a disease you want to face on your own.

Women tend to be caregivers. Whether it’s our children, grandchildren or partners, we are the ones doing the caring. How do you juggle that when you may not always be able to do everything you used to do? Can you ask for help? These are some of the issues our group talks about.

In many ways, my day-to-day life is the same now as it was before my diagnosis over three years ago. I’ve made it a goal to continue doing things that are important to me. I’m still working as a social worker, and I got another promotion to clinical director. I try to be mindful of when I need rest so I can continue to do those important things.

I also try to stay focused on the present because spending too much time worrying about my future can be scary. What kind of shape am I going to be in when my son graduates from college? Am I going to be able to hold my grandchild and babysit safely? How long am I going to be able to continue doing the job I love?

Parkinson’s has given me an appreciation for where I’m at now. I take opportunities as they come because I don’t know if I’ll be capable in the future. Putting things off isn’t an option. It has also helped me focus on what matters. I’ve committed myself to the stuff in my life that’s worth keeping and ejected everything else.

A lot of language used to describe people with Parkinson’s is that we are “victims” who are “suffering” with this terrible disease. Is it a terrible disease? Yes. I have an incurable, degenerative neurological condition. There is no treatment that will take this disease from my body. While I might not die from Parkinson’s (because it’s not considered a terminal disease), I will die with Parkinson’s. But that does not mean I’m a passive victim.

When people are diagnosed with cancer, they are said to fight, to battle. When they no longer have cancer, they’ve won, and when they die we say they’ve lost a long battle with cancer.

I’m a person living with Parkinson’s. I fight every day, not to be cured (though that would be nice), but to live a life that’s as fulfilling, meaningful and healthy as possible. I battle to maintain my functioning.

Do I suffer? Sometimes. This is a life-altering diagnosis, and my future is very uncertain. Sometimes I feel angry or sad, and that’s OK. I just try not to let those feelings take over.

But I believe suffering is the story we tell ourselves about our experience. I see suffering every day as a social worker, and my job is to try to help people move through that. I’m not suffering now.

I have Parkinson’s. I’ve made space for it in my head. It’s my companion. I don’t like it, but I’m not suffering. That can always change, but I prefer language that is empowering.

I didn’t choose to have Parkinson’s, but I can choose how I’m going to live with it.

Liz Brouillard is an Aware in Care Ambassador for the Parkinson’s Foundation.

Resources:
Parkinson’s Foundation Newly Diagnosed Program
The Michael J. Fox Foundation

Time to Say Goodbye to Some Insurers’ Waivers for Covid Treatment Fees

By Julie Appleby, Kaiser Health News

Just as other industries are rolling back some consumer-friendly changes made early in the pandemic — think empty middle seats on airplanes — so, too, are health insurers.

This story also ran on NBC News. It can be republished for free.

Many voluntarily waived all deductibles, copayments and other costs for insured patients who fell ill with covid-19 and needed hospital care, doctor visits, medications or other treatment.

Setting aside those fees was a good move from a public relations standpoint. The industry got credit for helping customers during tough times. And it had political and financial benefits for insurers, too.

But nothing lasts forever.

Starting at the end of last year — and continuing into the spring — a growing number of insurers are quietly ending those fee waivers for covid treatment on some or all policies.

When it comes to treatment, more and more consumers will find that the normal course of deductibles, copayments and coinsurance will apply,” said Sabrina Corlette, research professor and co-director of the Center on Health Insurance Reforms at Georgetown University.

Even so, “the good news is that vaccinations and most covid tests should still be free,” added Corlette.

That’s because federal law requires insurers to waive costs for covid testing and vaccination.

Guidance issued early in President Joe Biden’s term reinforced that Trump administration rule about waiving cost sharing for testing and said it applies even in situations in which an asymptomatic person wants a test before, say, visiting a relative.

But treatment is different.

Insurers voluntarily waived those costs, so they can decide when to reinstate them.

Indeed, the initial step not to charge treatment fees may have preempted any effort by the federal government to mandate it, said Cynthia Cox, a vice president at KFF and director for its program on the Affordable Care Act.

In a study released in November, researchers found about 88% of people covered by insurance plans — those bought by individuals and some group plans offered by employers — had policies that waived such payments at some point during the pandemic, said Cox, a co-author. But many of those waivers were expected to expire by the end of the year or early this year.

Some did.

Anthem, for example, stopped them at the end of January. UnitedHealth, another of the nation’s largest insurers, began rolling back waivers in the fall, finishing up by the end of March. Deductible-free inpatient treatment for covid through Aetna expired Feb. 28.

A few insurers continue to forgo patient cost sharing in some types of policies. Humana, for example, has left the cost-sharing waiver in place for Medicare Advantage members, but dropped it Jan. 1 for those in job-based group plans.

Not all are making the changes.

For example, Premera Blue Cross in Washington and Sharp Health Plan in California have extended treatment cost waivers through June. Kaiser Permanente said it is keeping its program in place for members diagnosed with covid and has not set an end date. Meanwhile, UPMC in Pittsburgh planned to continue to waive all copayments and deductibles for in-network treatment through April 20.

What It All Means

Waivers may result in little savings for people with mild cases of covid that are treated at home. But the savings for patients who fall seriously ill and wind up in the hospital could be substantial.

Emergency room visits and hospitalization are expensive, and many insured patients must pay a portion of those costs through annual deductibles before full coverage kicks in.

Deductibles have been on the rise for years. Single-coverage deductibles for people who work for large employers average $1,418, while those for employees of small firms average $2,295, according to a survey of employers by KFF. (KHN is an editorially independent program of KFF.)

Annual deductibles for Affordable Care Act plans are generally higher, depending on the plan type.

Both kinds of coverage also include copayments, which are flat-dollar amounts, and often coinsurance, which is a percentage of the cost of office visits, hospital stays and prescription drugs.

Ending the waivers for treatment “is a big deal if you get sick,” said Robert Laszewski, an insurance industry consultant in Maryland. “And then you find out you have to pay $5,000 out-of-pocket that your cousin didn’t two months ago.”

Costs and Benefits

Still, those patient fees represent only a slice of the overall cost of caring for a hospitalized patient with covid.

While it helped patients’ cash flow, insurers saw other kinds of benefits.

Still, those patient fees represent only a slice of the overall cost of caring for a hospitalized patient with covid.

While it helped patients’ cash flow, insurers saw other kinds of benefits.

For one thing, insurers recognized early on that patients — facing stay-at-home orders and other restrictions — were avoiding medical care in droves, driving down what insurers had to fork out for care.

I think they were realizing they would be reporting extraordinarily good profits because they could see utilization dropping like a rock,” said Laszewski. “Doctors, hospitals, restaurants and everyone else were in big trouble. So, it was good politics to waive copays and deductibles.”

Besides generating goodwill, insurers may benefit in another way.

Under the ACA, insurers are required to spend at least 80% of their premium revenue on direct health care, rather than on marketing and administration. (Large group plans must spend 85%.)

By waiving those fees, insurers’ own spending went up a bit, potentially helping offset some share of what are expected to be hefty rebates this summer. That’s because insurers whose spending on direct medical care falls short of the ACA’s threshold must issue rebates by Aug. 1 to the individuals or employers who purchased the plans.

A record $2.5 billion was rebated for policies in effect in 2019, with the average rebate per person coming in at about $219.

Knowing their spending was falling during the pandemic helped fuel decisions to waive patient copayments for treatment, since insurers knew “they would have to give this money back in one form or another because of the rebates,” Cox said.

It’s a mixed bag for consumers.

“If they completely offset the rebates through waiving cost sharing, then it strictly benefits only those with covid who needed significant treatment,” noted Cox. “But, if they issue rebates, there’s more broad distribution.”

Even with that, insurers can expect to send a lot back in rebates this fall.

In a report out this week, KFF estimated that insurers may owe $2.1 billion in rebates for last year’s policies, the second-highest amount issued under the ACA. Under the law, rebate amounts are based on three years of financial data and profits. Final numbers aren’t expected until later in the year.

The rebates “are likely driven in part by suppressed health care utilization during the COVID-19 pandemic,” the report says.

Still, economist Joe Antos at the American Enterprise Institute says waiving the copays and deductibles may boost goodwill in the public eye more than rebates. “It’s a community benefit they could get some credit for,” said Antos, whereas many policyholders who get a small rebate check may just cash it and “it doesn’t have an impact on how they think about anything.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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For one thing, insurers recognized early on that patients — facing stay-at-home orders and other restrictions — were avoiding medical care in droves, driving down what insurers had to fork out for care.

Being My Own Advocate Helped Me Defeat Tonsil Cancer

I knew there was something more to the lump I felt in my throat.

But it still took 2 1/2 months in 2007 and several visits to an ear, nose and throat specialist (ENT) to convince her to look harder and deeper at my symptoms. Even my father was convinced I was a hypochondriac, the same 5-year-old girl insisting on a Band-Aid for a freckle.

Eventually, the ENT did an endoscopy and found a finger-like growth in the back of my throat. After a biopsy the next morning, I heard the dreaded news: It was cancer. An otolaryngologist, a specialist in ear, nose and throat, as well as some areas of the head and neck, diagnosed me with squamous cell carcinoma of the left tonsil.

At the time I was diagnosed, I knew virtually nothing about head and neck cancer. I was 42, decades younger than most who get the same diagnosis, with no family history of the disease.

After surgery to remove the lump, I started a high dose of radiation treatment for seven weeks straight, and I no longer showed signs of cancer.

Christmas came and went, and although my radiation treatment was behind me, the new year brought the horrible news that my father had esophageal cancer. I went from being a patient to a caregiver. He died 18 months later, but my cancer battle continued.

To be considered in remission, I had to make it five years cancer-free. In 2011, during routine dental work, my oral surgeon noticed a suspicious patch resembling a burn mark on the back of my throat. He sent me to a different otolaryngologist who confirmed my cancer had returned, and this time it was on the left side of my tongue. The burn mark turned out to be radiation burn, but the otolaryngologist discovered the recurrent cancer during the examination.

Surgeons removed a small portion of the left side of my tongue, which left me with a slight speech impediment. All things considered, I managed that really well. I was still eating the food I usually did, I just had to be more mindful about my approach to chewing and swallowing.

At my 12-month checkup, I was still cancer free. Then came month 13: My cancer had returned to the base and majority of my remaining tongue. In 2013, I underwent a procedure where the muscle and nerves in my left forearm were harvested and used to build a new tongue.

I had a feeding tube and port surgically placed to get me through the upcoming chemotherapy and another seven-week course of radiation therapy. My chemotherapy days were grueling. I started at 7 a.m. and finished at 7 p.m., leaving the infusion center to run to the floor below for radiation treatment. On April 16, 2013, I proudly rang the bell signaling my last chemo treatment.

On a follow-up visit shortly after, my doctor told me there were very few treatment options left if my cancer returned.

It was imperative now for me to make the five-year milestone. (The clock reset every time my cancer returned.) If not, doctors told me I would not live much longer than 50. Even with that said, I never felt like I was dying or that there was an expiration date on my forehead. I didn’t dwell on it, I just kept up my regular routine, which included raising a flock of neglected chickens I rescued.

Eating was a huge hurdle for me. After my second tongue surgery, all of my nutrition came from the feeding tube. On the one hand, it was great to juice or blend a variety of nutritious food and just shoot it right in my tube, but I was mourning the act of eating food.

I slowly worked up to swallowing smoothies, milkshakes and eventually soups while my feeding tube was still in. After about four months, I felt like I was ready to sustain myself nutritionally without my tube, and I approached my medical team about removing it. They were worried it was months ahead of schedule, but I promised to return if I couldn’t manage it.

With the tube out, I started to experiment with transforming traditional soup recipes into drinkable form, which I kept up for a year until I could eat more solid food.

I was doing really well until 2016 when I noticed some of my teeth felt loose. I went to my dentist, who suggested I go back to my otolaryngologist. He consulted with a maxillofacial surgeon who determined that due to my past radiation treatment, my lower left jaw bone became necrotic. It had to be removed and replaced with the fibula from my right leg. That surgery resulted in my disability becoming more visible, and it caused my self-esteem to take a nosedive.

Luckily, a year later I heard the words the doctors told me I thought I would most likely never hear, “You are in remission.”

While in remission, I started to think about what it meant to me to live my best life. I am originally from the West Coast but had moved to Georgia in the early 1980s. I had always missed the ocean and decided remission meant returning to it. I planned a trip to the Gulf Coast to house hunt.

I spent Saturday with a real estate agent and Sunday walking on the beach where I prayed to God and my father. After walking for miles with tears rolling down my face, I asked for a sign. As I said amen, the water rushed up around my feet and when I looked down, there was a rock shaped like a heart.

I flew back to Georgia, sold most of my belongings, loaded up my dogs and hit the road. In May 2019, I settled in a charming little beach house just blocks from the ocean where I live today with my yellow lab Ozzy. I am now 55 and medically retired. Ozzy and I can be seen most days out walking on the beach.

For anyone facing head and neck cancer, my best advice is this: Be your own advocate. No one knows your body better than you. If something is wrong, keep pushing until your healthcare providers sit up and take notice. And once your battle is over, look for your own heart-shaped rock. Don’t be afraid to start over no matter how terrifying. It may not be the life you had before cancer, but you can’t stop now! Go live your best life.

This resource was created with support from Merck.

Información resumida: Qué debe saber sobre el cáncer de cabeza y cuello

La Dra. Sara Isabel Pai hizo la revisión médica de este documento.

El 4% de los casos de cáncer en Estados Unidos son de cabeza y cuello y se diagnostican con mayor frecuencia en personas que tienen más de 50 años. Aquí podrá encontrar los datos básicos.

¿Qué es el cáncer de cabeza y cuello?

Los cánceres de cabeza y cuello empiezan en las células que forman las fosas nasales, los senos paranasales, los labios, la boca, las glándulas salivales, la garganta o la laringe (también conocida como glotis).

¿En qué partes del cuerpo puede aparecer el cáncer de cabeza y cuello?

  • En la cavidad bucal: Los labios, las dos terceras partes frontales de la lengua, las encías, la mucosa interior de los cachetes y de los labios, el suelo (la parte inferior) de la boca debajo de la lengua y de la bóveda del paladar (el hueso que queda en la parte superior de la boca).
  • En la faringe: El área que empieza atrás de la nariz y termina en la parte superior de la tráquea y del esófago. El cáncer puede ocurrir en la nasofaringe (la parte superior de la garganta, atrás de la nariz), en la orofaringe (la parte media de la garganta, atrás de la boca) o en la hipofaringe (la parte inferior de la garganta).
  • En la laringe: En la glotis que participa en el proceso de respiración, que produce sonidos y que protege a sus pulmones cuando bebe líquidos.
  • En los senos paranasales y en las fosas nasales: Los senos paranasales son espacios pequeños huecos en los huesos del rostro que rodean a la nariz. La fosa nasal es el espacio hueco adentro de la nariz.
  • En las glándulas salivales: Los órganos que producen saliva y las glándulas salivales principales se encuentran en el piso de la boca y en la región de los cachetes.

¿Cuáles son los factores de riesgo del cáncer de cabeza y cuello?

Los dos factores de riesgo más importantes son fumar y abusar del alcohol. La gente que fuma y que consume alcohol tienen un mayor riesgo de desarrollar este tipo de cánceres que la gente que solo fuma o solo consume alcohol. Al menos el 75% de los casos de cáncer de cabeza y cuello son causados por fumar y consumir alcohol. El 25% restante de cánceres de cabeza y cuello ocurren por infecciones del virus del papiloma humano (Vph), especialmente de los tipos VPH16 y VPH18.

Otros factores de riesgo incluyen:

  • Enfermedad por reflujo gastroesofágico (Erge)
  • Masticar betel (paan) o gutka
  • Higiene o salud dental deficiente
  • Una dieta sin frutas ni vegetales
  • Un sistema inmunológico debilitado
  • Exposición a sustancias tóxicas en el lugar de trabajo
  • Tratamiento de radiación en el pecho o en la parte inferior del abdomen
  • Luz ultravioleta del sol o de camas de bronceado
  • Infecciones del virus de Epstein-Barr

¿Cuáles son los síntomas?

Los síntomas pueden incluir:

  • Un bulto en el cuello, quijada o boca
  • Una llaga en la boca que no sana
  • Un dolor de garganta o dolor en el cuello
  • Dificultad para tragar
  • Cambio de voz o ronquera
  • Una mancha blanca o roja en las encías, en la lengua o en la mucosa de la boca
  • Sangrado o dolor inusual en la boca y problemas o malestar cuando se ponen dentaduras postizas
  • Problemas para respirar o hablar
  • Infecciones sinusales crónicas que no responden a tratamientos con antibióticos
  • Hinchazón abajo del mentón o alrededor del cachete, sensación de adormecimiento o parálisis de los músculos en la cara, o dolor en la cara, en el mentón o en el cuello que no desaparece

¿Cómo se diagnostica el cáncer de cabeza y cuello?

El diagnóstico de cáncer de cabeza y cuello usualmente empieza con un examen físico realizado por su médico. Algunas pruebas de diagnóstico incluyen una examinación de la cabeza y cuello bajo anestesia, un ultrasonido, una tomografía por computadora (Tc) o una tomografía por emisión de positrones (Tep). Si se detecta alguna anomalía, una biopsia confirmará si existe la presencia de células anormales o cancerosas.

¿Cuáles son mis opciones de tratamiento?

El tratamiento depende de varios factores, incluyendo la ubicación exacta del tumor, la etapa del cáncer y su edad y salud general. Las opciones podrían incluir cirugías, terapias de radiación, quimioterapias, inmunoterapia o una combinación de dichos tratamientos.

¿Cómo puedo reducir el riesgo?

  • Hable con su médico sobre formas para reducir su consumo de tabaco o para dejar de fumar
  • Limitar el consumo de alcohol
  • Programar regularmente consultas dentales
  • Dar un mantenimiento adecuado a las dentaduras postizas para evitar que tabaco, alcohol y otras sustancias que causen cáncer se queden atoradas
  • Use protector solar cuando salga al aire libre, incluyendo en los labios y evite usar camas de bronceado
  • Tenga relaciones sexuales con protección y vacúnese para el Vph
  • Use una mascarilla facial de protección o tipos adicionales de equipos de protección personal si está expuesto a humos tóxicos y a polvo de madera

Este recurso se preparó con el apoyo de Merck.