By: Rita Gill, Member, Research Information Outreach Team

Head and neck cancers can persist in various forms including salivary glands, sinuses, and even the muscles and nerves within the head and neck region. However, more than 90% of head and neck cancers begin in the mucosal surfaces of the head and neck which is known as squamous cell carcinoma – commonly referred to as head and neck squamous cell carcinoma (HNSCC). The most common types of HNSCC includes the larynx, the oral cavity, and the oropharynx.

Figure 1. The various different regions of head and neck cancer, with the most common highlighted in red. Photo is courtesy of Terese Winslow (with adaptations).

Did you know there are things you can do to protect yourself from head and neck cancers?!

In fact, alcohol and tobacco are both major contributors to head and neck cancers. Over 85% of patients diagnosed with these cancers have a history of either tobacco use (smoking or chewing tobacco) or alcohol consumption, with heavy long-term users of both resulting in an approximate 40 times greater risk in developing HNSCC. Avoiding both alcohol consumption and tobacco use can greatly reduce your risk of developing HNSCC!

Another risk factor is infection of human papillomavirus (HPV), particularly HPV type 16. The majority of oropharynx cancers (such as those of the tonsils or soft palate) are linked to HPV, especially in younger patients. Talk to your health care provider about the HPV vaccine to reduce your risk of contracting the virus, or if you need treatment support. One common medication for HPV is Gardasil 9, which has been approved for use in clinics and pharmacies across Canada. Gardasil 9 protects against several strains of HPV (types 16, 18, 31, 33, 45, 52 and 58), and can reduce your risk in developing oropharyngeal cancer, among other types of cancers. Although oropharyngeal cancer is a very serious illness, it is important to know that its symptoms can also be easily mistaken for more common, but less-serious conditions. These symptoms include mouth sores, a sore throat, or pain during swallowing. Always seek out a healthcare provider for any new and worsening symptoms you may be experiencing.

Though the prognosis of head and neck cancer varies depending on many factors, including the size or presence of metastasis, patients diagnosed during the early stages, compared to most advanced stages, have a better chance at a more positive outcome. This shows how important it is to be examined by a doctor if you believe you are at risk.

Treatment for HNSCC typically includes surgery and radiation therapy. These can be used alone or together, and sometimes in combination with chemotherapy. There are also exciting new studies being conducted by researchers to provide a more personalized treatment, also referred to as targeted therapies, for patients diagnosed with HNSCC. A group of researchers within the Princess Margaret Cancer Research Tower in Toronto, Ontario have discovered that HNSCC patient-derived xenograft models can be used. Patient-derived xenograft models involve taking a piece of tumour from the patient and implanting it within immunocompromised preclinical models. This can be used as a prognostic indicator and to explore personalized treatment options. Dr. Christina Karamboulas and her team at The Princess Margaret found that patients can be categorized into high risk or low risk categories based on the time it takes for the tumour to engraft (attach successfully) after implantation into preclinical models. High risk patients with tumours which rapidly engraft into these models, are associated with an overall lower survival rate and a higher chance of disease relapse. This important information can help healthcare providers to recommend more aggressive treatment options for patients who truly need it. What’s more, by comparing the rapidly engrafting tumours with non-engrafters, there is a possibility of discovering new biomarkers for prognostics!

Figure 2. Graphical abstract displaying the work done by Dr. Karamboulas and her team, taken from her publication in Cell reports (see below for citation). This work showed the correlation of HNSCC patient-derived xenograft in preclinical models with patient outcomes. It also showed the potential ways in which this model can help create a more personalized treatment plan for patients, and potentially generate new biomarkers for better prognosis in the future.

If you would like to learn more about head and neck cancers, check out the following sites for additional readings on the topic:

Head and Neck Cancers – NCI

Overview of Head and Neck Tumors – Ear, Nose, and Throat Disorders – Merck Manuals Professional Edition

Head and Neck Cancer: Symptoms, Causes & Treatment (

Head and Neck Cancers | CDC

Finally, to read more on research featured in this article, please see the following citation:

Karamboulas, C et al., “Patient-derived xenografts for prognostication and personalized treatment for head and neck squamous cell carcinoma.” Cell Reports 25.5 (2018): 1318-1331.

About Rita Gill:

Rita completed her undergraduate degree in Biochemistry at Brock University, followed by her graduate studies at the University of Toronto, where she looked at the use of mesenchymal stromal cells and their derivative as a potential anti-inflammatory agent. She is currently employed as a researcher in a translational oncology lab at Princess Margaret Cancer Centre.


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