Lips, mouth, larynx… “Red throat”, a campaign to raise awareness of the first signs of ENT cancer

Le professeur Renaud Garrel lors d'une consultation consécutive à un traitement de cancer ORL. Midi Libre – JEAN MICHEL MART

In France, each year, 15,000 new patients discover that they have ENT cancer, often ignoring the first signs of the disease. The national "Rouge gorge" raises awareness: "Don'don't wait until you are in the red zone".

Eating spicy ? No, but drinking, smoking, yes, especially cannabis, "a joint is the equivalent of&rsquo ;a pack of cigarettes", warns Dr. Cupissol, oncologist. Not to mention the devastating effects of the papillomavirus.

The first national campaign to raise awareness of the risks and first signs of throat cancer, "Rouge gorge", from April 2 to 5, wants to send the right messages, at the end of &quot ;Blue March", on colon cancer screening, well before "Pink October", on breast cancer screening, two meetings established in the landscape of health prevention .

"This is a national first, ten years after the first "Make sense" screening campaign, at the’ initiative of Europe, which made "pschitt". The French ENT society, the French head and neck cancer society and the cancer centers found it a shame to let the message get out but it's a difficult campaign", notes Dr Didier Cupissol, medical oncologist just retired from ICM Val d’Aurelle, in Montpellier, today president of Gefluc France and Occitanie.

Beyond the figures, 15,000 new cases each year in France, 1,500 in Occitanie, the association, which raises awareness of cancer in the professional environment, wants to alert the general public to these harmless signs that ;rsquo;we must not let this pass.

Pr Renaud Garrel: “We absolutely must relaunch the HPV vaccination campaign”

Renaud Garrel is head of the oncology and laryngology medical team at Montpellier University Hospital. His message is insistent, to reduce cancers of the ENT sphere, and in particular of the central part of the pharynx (oropharynx), which has increased by + 157% in twenty years, "we absolutely must relaunch the vaccination campaign& quot; against papillomavirus.

"The vaccine prevents 100% the risk of throat cancer, but also penile cancer in men and uterine cancer in women", specifies Renaud Garrel. 

In France, at the end of 2021, 45.8% of 15-year-old girls and 6% of boys of the same age had received at least one dose of the vaccine, according to Inserm.< /p>

"We must not leave it lying around"

"We need to make people aware of this symptomatology around the mouth and throat. Functional discomfort, a hoarse voice that takes time to treat, a cold sore that doesn't disappear after three weeks… hellip; you must consult very quickly", advises Didier Cupissol.

"Pain in the tongue or throat, red or white spot in the mouth, painful swallowing, hoarseness, lump in the neck, stuffy nose or discharge of blood from the nose" must lead to consultation, complete the campaign messages.

Thierry Roux, 53, knows the cost of letting things drag on too much. A loss of voice attributed to a cold, a first appointment with an ENT who does not diagnose "nothing cancerous", the nurse finds himself eight months later with the alarming result of a biopsy: "The two vocal cords affected, and a tumor that has spread to the bones.

One year after 35 radiotherapy sessions and 3 cycles of chemotherapy, he is "lucky that everything is gone", the treatment protocol which kept his vocal cords intact."The care is still very heavy, and it’s psychologically very violent", warns the tired nurse, who still regrets the time lost&nbsp ;: "Don't leave it lying around!"

"After a laryngectomy, few people return to normal life and activity"

"If we start things early, surgery, today largely robotic, can be enough, and life gets back to normal fairly quickly" , adds Didier Cupissol, who also reports on progress in radiotherapy assisted by artificial intelligence, and immunotherapy protocols. But "after a laryngectomy, few people return to normal life and activity. There are major disturbances, we talk in burps…"

The doctor will speak in some businesses in the region this week, with key messages and awareness films. He is hopeful of involving dentists soon, "there is nothing official".

This Thursday, April 4, the French ENT society is organizing a webinar on the subject.

Like his colleague Renaud Garrel, ENT surgeon at Montpellier University Hospital, he also insists on the interest of vaccination against papillomavirus: " Countries that vaccinated more than 25 years ago have seen HPV infections disappear. There was Australia, and certain American states. California has seen these cancers disappear.

Oropharyngeal cancers: +157% in 20 years

ENT cancers develop “in the lips, mouth, pharynx (nasopharynx, oropharynx, hypopharynx), larynx or even the nasal cavity, sinuses or salivary glands”, specifies Gefluc in the awareness campaign which starts this week.

In France, the number of new cases of throat cancer (lips, mouth, pharynx and larynx) projected in 2017 is 15 264. 10,932 of the new cases are diagnosed in men, 4,332 cases in women. While the number of throat cancers is decreasing among men, it is increasing among women. This trend is particularly linked to the evolution of smoking, on the rise among women.

On oropharynx cancers alone, the figure is 3,000 new cases per year in 2023, identical to that of new cases of cervical cancers, indicates Professor Renaud Garrel. "Half of oropharyngeal cancers are linked to the papillomavirus", specifies the doctor. But if'"there is a trend towards a decrease in the incidence of cervical cancer, by -20%, there is an increase of 157% in oropharynx cancer over 20 years' quot;. 

Throat cancers occur most often between the ages of 50 and 64, but some of them, such as HPV-induced oropharyngeal cancers, appear in younger patients, in good general health and not consuming alcohol or tobacco. Cases of HPV-induced throat cancer are increasing and affect both men and women. These cancers tend to be diagnosed in two age groups: 30 to 40 years old and 60 to 70 years old.

In Occitanie, 1,500 new cases of the aero-digestive tract are recorded each year, 70% in men, but the incidence is increasing in women.

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