Harry Folk speaks about successful throat cancer treatment received at St. Luke’s Cancer Center

It’s been nine years since Harry Folk of Palmer Township had a scare with throat cancer. He is able to talk about his journey, literally, thanks to the treatment he received at St. Luke’s. The treatment plan recommended by his cancer team not only removed his cancer, but preserved his voice and ability to swallow without difficulty.

Like so many other ordinary evenings, Harry was enjoying a quiet evening watching TV with his wife in May 2006. While rubbing his neck, he felt a lump. He had no pain in his neck or sore throat so he was not overly concerned. At his wife’s urging, however, he decided to have it checked out; he scheduled an appointment with his family doctor.

To Harry’s surprise, the doctor saw redness when he looked at his throat. He tested for strep and prescribed an antibiotic, which did nothing to clear up the redness or the lump. As a result, his physician referred him to David Yen, MD, an ears, nose and throat physician, who identified a mass at the base of Harry’s tongue. Through a biopsy, Dr. Yen confirmed the mass to be cancer of the oral pharynx. “You could have knocked my wife and me over with a feather,” Harry says.

Smoking and chewing tobacco increase the risk of head and neck cancers. Harry did smoke cigarettes for about five years, quitting in 1980. He also chewed smokeless tobacco for about 15 years, quitting in 1998.

The progression of cancer is classified by four stages identifying extent and severity. At the time of diagnosis, Harry’s cancer had already spread to the lymph node, which meant his disease advanced to stage IV. At this stage, the five-year survival rate of head and neck cancer is only 30 percent.

Knowing they needed to begin treatment as soon as possible, Dr. Yen presented Harry with his treatment options. Harry opted to treat the cancer aggressively by having both chemotherapy and radiation therapy concurrently. Dr. Yen aligned the treatment team consisting of St. Luke’s medical oncologist Subhash Proothi, MD and St. Luke’s radiation oncologist Nicholas Cardiges, MD. Treatment began in June 2006.

Dr. Cardiges explained that surgery was an option, but due to the tumor’s location at the base of the tongue close to the voice box, the voice box would need to be removed and, as a result, Harry would not be able to speak and would have difficulty swallowing.

Dr. Cardiges prescribed radiation treatment five days a week for seven weeks at St. Luke’s Cancer Center, Bethlehem. Harry received Intensity Modulated Radiation Therapy (IMRT), an advanced form of treatment that precisely targets the tumor while sparing surrounding healthy tissue. Because IMRT is so precise, the oncologist can administer higher, more effective doses of radiation with fewer side effects, according to Dr. Cardiges.

Meanwhile, Harry received three courses of Cisplatin, a chemotherapy medication. The cornerstone of treatment for throat cancer, Cisplatin is a platinum-compound chemotherapy drug that stops cancer cells from growing, causing them to die, Dr. Proothi says.

Chemotherapy drugs not only make radiation work better, but also are effective in attacking cancer cells that may have already escaped from the primary site and be in circulation ready to settle somewhere, Dr. Proothi says.

Dr. Cardiges says the combination of the two treatments is effective, but not easy. After a couple of weeks of radiation, Harry’s throat became very sore. He had dryness of the mouth and pain when swallowing. In fact, Harry says he did not eat solid foods from July 16^th until just before Labor Day weekend. Surviving on a liquid diet, he lost 25 pounds. The discomfort was well worth the benefits, however.

“The radiation melted away the tumor in the tonsil and right oral pharynx region,” Dr. Cardiges says. “He was cured. And now, after more than five years, the chance of recurrence is very low.”

As for Harry, he says the experience gave him an entirely different perspective on life, an insight into what’s important and what’s not.

And as for care at St. Luke’s, “I couldn’t be more pleased with my physicians, the treatment I had and the outcome,” he says. “I will always be grateful to them.”

About St. Luke’s Head and Neck Cancer Team Approach

The St. Luke’s University Health Network employs a team-approach to diagnose and treat head and neck cancers. This refers to any cancer of the mouth, throat, voice box, nose and sinuses.

At St. Luke’s, the Head and Neck Cancer Team meets routinely to review cases and consider treatment options, says medical oncologist Subhash Proothi, MD. The team includes surgeons, medical oncologists, radiation oncologists, otolaryngologists (ears, nose and throat), dentists, physical, occupational and speech therapists, oncology nurse navigators and dietitians.

The goal of treatment is to rid the patient of cancer with as few side effects as possible, explains radiation oncologist Nicholas Cardiges, MD. Years ago, cancer patients would receive radiation or chemotherapy separately. Today it is common for patients to receive treatment concurrently. As a result, the team works together to manage the patient’s overall care.

Risk Factors for Developing Head and Neck Cancers

“Historically, 90 percent of head and neck cancers occurred in smokers and heavy drinkers,” says otolaryngologist (ears, nose and throat physician) David Yen, MD. “What we’re finding now is that human papillomavirus (HPV) – the same virus that causes warts and cervical cancer – also plays a role in head and neck cancers. In fact, having a history of multiple sexual partners seriously increases the risk of head and neck cancers.”

Still, smoking and chewing tobacco remain the biggest risk factors.

Symptoms

Often head and neck cancers exhibit few or no symptoms until the disease reaches advanced stages. According to Dr. Yen, the most common symptom is a painless lump in the neck that lasts for three weeks, a month or more. Another common symptom is hoarseness or a persistent change in voice. “The key here is persistent voice change, not just hoarseness because you have a cold or yelled too much during an Eagles game,” he says.

A persistent sore throat or one that lasts a long time is a sign of head and neck cancer. Persistent ear pain is another frequent symptom.

Steps the Patient Can Take to Improve Outlook

Dr. Yen says there are four things someone with cancer can do to improve the likelihood that their treatment will be effective:

1. Control his or her attitude. If the patient doesn’t want to fight, there’s not much the care provider can do.
2. Eat a balanced diet.
3. Seek out treatment from experienced providers offering advanced treatment options.
4. Get outside support from spouse, children, friends or a faith community.

“Once you have cancer, you will need a lifetime of care,” Dr. Yen says. “It’s important that you know your care team well and you have faith in them.”