A wide variety of tumors can occur in the head and neck. Commonly affected areas include the thyroid gland, salivary glands, throat, and lymph nodes. These tumors can affect patients of all ages and while many are benign, some are malignant and life threatening. Both Dr. Kirsch and Dr. Fraley have superior training and years of experience to help them diagnose and treat concerning symptoms or findings. Our doctors are able to perform any additional work-up, such as biopsies or CT scans, and begin treatment of your condition. Many cancers of the head and neck require a multidisciplinary approach involving oncologists, radiation oncologists, and endocrinologists. Our physicians have experience working with other providers in Conway and the surrounding areas to provide you with the best possible outcome.
Below you will find a list and information on some of the more common head and neck conditions we treat. If you or your doctor have any concerns for a tumor or growth of the head and neck region, call us today at 501-932-7600 for an appointment.
Each year more than 55,000 Americans are diagnosed with cancer of the head and neck - and approximately 13,000 will die from it. Over 90% of these are squamous cell carcinoma and arise from the mucosal lining of the mouth and throat. Commonly affected areas include the mouth, tongue base, tonsils, and voice box (larynx). The vast majority of squamous cell carcinomas of the head and neck are the result of tobacco use and alcohol - meaning they are preventable. In recent years, an increasing number of cancers are seen in non-smokers and are caused by the Human Papilloma Virus (HPV), the same virus responsible for most cervical cancers and genital warts. These, too, may be preventable in the future due to the introduction of vaccines for HPV such as Gardasil.
The symptoms of head and neck cancer will vary depending on the location of the tumor. Cancers in the mouth and tonsils often present as a persistent ulcer or sore throat. Cancers of the tongue base or larynx often present with a persistent sore throat, lumpy feeling in the throat, or trouble swallowing. Cancers of the larynx often present with persistent hoarseness. Head and neck cancers can also present with a firm, enlarging mass in the neck due to spread to local lymph nodes. Unfortunately, all of the above symptoms can also occur with other benign conditions. Generally, if you have any of the above listed symptoms that continue for a few weeks despite medical treatment, you should be seen by an ear, nose, and throat specialist.
The first step in treatment of head and neck cancer is a clear diagnosis. This involves a thorough head and neck exam including a laryngoscopy, or endoscopic exam of the throat and voice box. This can be done at the time of your appointment. A biopsy of the area can then be performed. If a lymph node or neck mass needs biopsy, a fine needle aspiration is usually performed. This is where a small needle is inserted into the lesion and a small number of cells are aspirated to be examined by a pathologist. This technique allows a rapid diagnosis without needing surgery or risking spreading the cancer. A CT scan, MRI, or PET scan is then often performed to determine the stage of the cancer.
After diagnosis and staging, your cancer can be treated. Early mouth and throat cancers can be treated either with surgery or radiation alone. More advanced cancers may require some combination of surgery, radiation, or chemotherapy. Our physicians will review your diagnosis with you, go over treatment options, and recommend a specific course of treatment. If surgery is part of your treatment, Dr. Kirsch and Dr. Fraley are the best trained and most experienced head and neck surgeons in Conway. If you need any referrals to outside physicians, such as oncologists or radiation doctors, our office will make these appointments for you. Additionally, if we feel you would be better served at tertiary treatment center, such as UAMS, we can make those referrals as well.
The thyroid gland sits at the bottom of the neck and produces thyroid hormone, which controls the body's overall metabolism. Several common disorders of the thyroid gland can occur, incuding functional (over- or underactivity) or structural (nodules, goiter, or cancer). The most common functional disorder of the thyroid gland is hypothyroidism, or an underfunctioning gland. This is typically diagnosed with blood tests and treated with thyroid hormone supplementation. Conversely, an overactive gland is much less common and is often the result of an overactive ("hot") nodule or Grave's disease. These can either be treated with radioactive iodine or surgery.
A thyroid nodule is an abnormal growth within the thyroid gland. There can be either one or multiple nodules in the gland. Overall, nodules are fairly common and can affect 5-10% of the population. Many are found incidentally while getting other tests, such as MRIs of the spine or CT scans of the chest. Some are large enough to be felt or seen on the neck. Most nodules are benign and do not require any treatment other than periodic follow-up. Larger nodules warrant biopsies (often fine needle aspirations) to rule out cancer. A goiter is an enlarged thyroid gland, either with or without nodules. If the gland is only mild or moderately enlarged without causing any symptoms, then no treatment is necessary. However, larger goiters or those that cause symptoms, such as trouble swallowing or breathing, should be removed.
The parathyroid glands are a set of 4 pea-sized glands that sit behind the thyroid gland and help regulate calcium levels. If these become overfunctioning, they can cause excessively high calcium levels in your blood. This is normally identified on routine bloodwork by your primary doctor. If severe, symptoms can include kidney stones, unexplained abdominal pain, or mood changes. Additionally, since the calcium is being stripped from your bones, it can cause osteoporosis or bone fractures. The mainstay of treatment for overfunctioning parathyroid glands is removal of the offending gland.
Dr. Kirsch and Dr. Fraley both specialize in the management of thyroid disorders. They can help determine which nodules need biopsies or additional work-up. For those not needing surgery, they can follow the thyroid over time with labs and ultrasound imaging to assess for changes or new problems. In the event that your thyroid is suspicious for cancer, continuously growing, or causing bothersome symptoms, you may need part of all of your thyroid removed. Dr. Kirsch and Dr. Fraley have years of experience performing thyroid surgery and perform the majority in Conway with excellent outcomes.
Lymph nodules are numerous small structures in the neck that function to treat infections and drain excess fluid from tissues. Everybody has lymph nodes in their neck and throughout their bodies. Depending on where they are located and how thin you are, your normal lymph nodes may or may not be easily felt. Lymph nodes in the neck usually become enlarged and tender with infections such as a cold, tonsillitis, or bad tooth. Persistently enlarged or hard, nontender lymph nodes can be a sign of cancer. As a general rule, most persistently enlarged lymph nodes in children are due to an infection, whereas those in adults are due to cancer.
Dr. Kirsch and Dr. Fraley both specialize in the management of enlarged lymph nodes of the neck. After performing a history and exam, they can determine if any additional work-up, such as bloodwork, a biopsy, or CT scan, is necessary. Sometimes, a little reassurance to the patient is all that is needed. If a biopsy is warranted, a fine needle aspiration biopsy is usually performed. Certain types of cancer, such as lymphoma, can not be diagnosed with fine needle biopsies and might need to be surgically removed, which can be performed by our doctors.
Information adapted from the American Academy of Otolaryngology - Head and Neck Surgery