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Head, neck screening awareness planned by Cindy Abole Public Relations Actor Yul Brynner had it. So did baseball legend Babe Ruth and Civil War general and former U.S. president Ulysses S. Grant. These famous legends were diagnosed with some form of head and neck cancer which eventually cost them their lives.  Each year, more than 70,000 Americans are diagnosed with head and neck cancers. More than 15,000 will die. In 1993 and 1997, South Carolina had the highest oral cancer death rate in the fifty states, exceeded only by the District of Columbia. According to the South Carolina Cancer Registry, there are approximately 444 new cases of head and neck cancer annually. About 100 people die from the disease annually. Last spring, the South Carolina Chapter of the Yul Brynner Head and Neck Cancer Foundation (YBF) recognized the need for greater patient education and public awareness by  supporting the state's first observance of National Head and Neck Cancer Awareness Week. This year's awareness is slated for April 23 - 27. New for this year is a collaborative head and neck screening day set for Friday, April 27. This year's efforts will involve screenings for oral, pharyngeal and laryngeal cancers at various clinical sites sponsored by MUSC, East Cooper Regional Medical Center, Trident Health System and Roper-CareAlliance.  “I feel very fortunate to be able to participate in this program in South Carolina,” said Terry Day, M.D., associate professor of otolaryngology-head and neck surgery and director of the Division of Head and Neck Oncologic Surgery at MUSC. Most head and neck cancers are the result of tobacco and alcohol abuse. Smokers are six times more likely than non-smokers to develop these types of cancers. About 90 percent of head and neck cancers are curable with early diagnosis. The cure rate drops to only 25 percent for patients who present a late-stage diagnosis, which can often result in disfiguring scars from surgery or the possible loss of organ systems like the tongue or voice box. Day and other otolaryngologists helped to establish the national program in 1997 growing from only three sites in the U.S. to more than 100 sites, internationally. It is endorsed by the American Cancer Society, American Academy of Otolaryngology-Head and Neck Surgery, American Speech-Language-Hearing Association and Support for People with Oral and Head and Neck Cancer group and the Society of Otorhinolaryngology and Head-Neck Nurses. The foundation's mission provides year-round support to head and neck cancer patients and survivors; patient education for treatment and prevention and ongoing research support in head and neck cancer oncology.  Recently, Day, his colleagues and other South Carolina experts collaborated to submit a grant to develop a state model for prevention and early detection of oral cancer in South Carolina. This collaboration , the South Carolina Partnership for Oral Cancer Prevention, is comprised of individuals from state government, universities, organizations, agencies and health professionals and is led by MUSC.  The grant was submitted in response to a national initiative sponsored by the NIH/National Cancer Institute and National Institute of Dental and Craniofacial Research. Funded grant awardees will be notified in June 2001 and Day hopes to be funded. “We expect to learn a lot about South Carolina's strengths and deficiencies in head and neck cancer awareness and education,” Day said. The first phase of the program focuses on the knowledge, opinions and practices in relation to oral cancer by the general public, health care professionals and oral cancer patients.  Other MUSC researchers joining in the initiative include Frank Groves, M.D., MUSC Department of Biometry and Epidemiology; Susan Reed, DDS., DPH., Department of Stomatology, CDM; Brenda Nickerson, MSN, Hollings Cancer Center. The University of South Carolina and Clemson University, S.C. Department of Health and Environmental Control, S.C. Central Cancer Registry, Richland Memorial and Greenville Hospital Cancer programs and health care professionals are also involved in this partnership.  “If the grant is funded, we will have the opportunity to conduct a statewide needs assessment about oral cancer for South Carolina,” said Reed, an oral epidemiologist and co-investigator for the grant. “We look forward to the opportunity for the partnership to develop a state model to address the needs of South Carolina in an organized fashion of improved detection, prevention and treatment of oral cancer.”  To celebrate local awareness, proclamations from South Carolina Gov. Jim Hodges, city and town mayors will recognize next week's celebrations. YBF members and cancer survivors will also visit Lowcountry public schools to share personal stories and encourage prevention. On April 24, a YBF survivor banquet and silent auction fund-raiser will be held at the Embassy Suites Historic Charleston. During the head and neck cancer screening on April 27, specialists will perform a 15-minute, non-invasive exam of the head and neck area of the body.  To obtain further information about the YBF call 792-6624 or visit their Web site at <http://www.ybfsc.org>.  To schedule an appointment at the MUSC screening sites at Hollings Cancer Center and Rutledge Tower ENT Area, call Health Connections at 792-1414. What happens during a head and neck cancer screening? Head and neck cancer screening is a painless exam that takes about 15 minutes without any invasive procedures or medication. The exam involves a visual and bimanual inspection of the head/neck region, ears, nose, mouth, throat and neck. A brief history will be taken in the form of a questionnaire which takes less than 5 minutes.  To schedule an appointment for the April 27 head and neck cancer screening, call MUSC Health Connections, 792-1414.  Be aware of Oral Cavity and Laryngeal Cancer signs/symptoms: non-healing ulcers in the mouth  loosening of teeth  trouble opening the mouth  weight loss  difficulty swallowing  pain when swallowing  a sensation of having a constant “lump in the throat”  bloody cough  persistent sore throat  hoarseness  neck mass A cancer survivor's story Many people know him for his work as a world-reknowned ophthalmologist and researcher but David Apple knows that he is first a survivor. Dr. David Apple Apple, director of MUSC's Center for Research and Ocular Therapeutics and Biodevices, was ending a business trip in Germany, when he first noticed a lump on the left side of his neck in June 1999.  “If I were not a doctor, I wouldn't have thought a thing about it,” said Apple, an M.D. who holds the Pawek-Valloton Chair of Biomedical Engineering. “It was rubbing my neck in just the right spot that probably helped save my life.” A pathology report confirmed his worst fears. He was diagnosed with a stage III or IV cancer on the base of the tongue with a metastasis to a lymph node in the neck—the one he felt. Although this form of cancer is usually connected with excessive tobacco and alcohol use, Apple is a rare exception. His non-use of these products is a stark reminder that anyone can be susceptible. The good news is that it was caught early enough to be treated.  Apple met with head and neck specialist Khanh-Gien G. Hoang, M.D., Ph.D., associate professor of Otolaryngology and Communicative Sciences. Hoang successfully performed a surgical dissection of the neck lymph nodes to remove the tumor. His surgery was followed by intense chemotherapy and radiation treatments. Like most cancer patients, he experienced the usual side effects of radiation: dry mouth, difficulty swallowing and even some loss in appetite. He continues to suffer from persistent and often severe nerve pain around the neck and jaw area spreading to his upper shoulders. “I knew what the course of treatment would be: surgery, chemotherapy and radiation,” Apple said. “There were no surprises.” Reflecting, Apple believes he may have suffered from symptoms caused by the tumor even three or four years prior to its discovery. “I just remember feeling very fatigued and not feeling well. That's usually the result of what tumors can do, even prior to their discovery.” Already at the peak of his career in his research, the cancer surgery and treatments affected his life for one and one-half-years. Today, he sees both Hoang and head and neck oncology surgeon Terry Day, M.D., for follow-up care. Yet, the experience hasn't encouraged him to sit out and retire.  “I like research too much,” Apple said, with a twinkle in his eye. “And I want to continue teaching people, whether it is about ocular cataracts , laser surgery or about cancer, I believe I have become a good specimen—a good example for people to listen to what I have to say.” As part of next week's Yul Brynner Head and Neck Cancer Awareness (YBF) in Charleston, Apple will visit Moultrie Middle School to talk about his own experiences with students. He will be a speaker at the YBF survivor's banquet at the Embassy Suites Historic Charleston on April 24. “Once I found out that I had cancer, I didn't fear the future,” Apple said. “I felt I had already done a lot in my life of 57 years. His advice to newly diagnosed patients: “Don't be afraid. Try to commit yourself to the most maximum therapy available. Do all you can to treat the disease, even if the therapy causes suffering later. It's well worth it.” And how has his experience changed him as both a medical professional and cancer survivor? “It has made me focus on getting my work and message out there,” Apple said, citing his decision to cut back from numerous administrative duties in the department to focus more on his research efforts and other academic pursuits. “The experience has helped me to learn that every hour of every day in life counts.”