Head and Neck Cancer Patients Who Don’t Drink or Smoke Have Worse Outcomes

Genetics could be playing a role in the subset of patients who neither smoke nor drink, and the researchers plan to pursue studies in this direction. In the meantime, otolaryngologists should still encourage patients to quite smoking, reduce drinking, and make healthy lifestyle choices, he said.

As an aside, Dr. Devaiah also pointed out that while the medical community knows that “there’s no therapeutic benefit to tobacco use at all,” there is still some uncertainty about the protective effects of moderate alcohol use. While a glass a day of wine has been indicated as being protective for heart disease, there could be increased risks when it comes to other health conditions. “We’re not sure what is really safe for alcohol consumption,” Dr. Devaiah said.

In fact, with smoking rates going down as reported by the American Cancer Society, there is now some suspicion that alcohol may play a larger role than previously believed. Some European data suggest there maybe an increased risk of head and neck cancer with increased alcohol use alone, Dr. Devaiah said.

Good Study, Questions Remain

Gady Har-El, MD, Professor of Otolaryngology and Neurosurgery at SUNY Health Science Center in Brooklyn, NY, who was not part of the Boston study group, said that this sort of study is important in trying to figure out what is going on with patients who lack traditional risk factors such as smoking and drinking.

“For the last 20 years we’ve been seeing more and more of them. They are young and we’re not sure exactly what’s gong on. This study was nice and done in such a way that it was trying to find some comorbidity—some other issue that may contribute to the occurrence of cancer in this subset of patients,” he said.

Another factor worth considering is whether human papilloma virus (HPV) plays a role in increasing the risk in this subset of patients. “There are a few studies now, both in Europe and the United States, that raise the question of transmission of oral papilloma virus in an oro-genital way. They talk about the indirect relation of human papilloma virus in oral cavity cancer and the uterine cervix, which is an interesting thing,” Dr. Har-El said.

If studies show there is such a connection, then the HPV vaccine could be useful for people at risk.

©2006 The Triological Society