Delayed care is a critically important factor in the survival of patients with head and neck cancer, and the patients who most often experience these delays are African American, according to two new studies at the Medical University of South Carolina (MUSC) and Hollings Cancer Center. The study was published in JAMA Otolaryngology-Head & Neck Surgery.

MUSC Hollings Cancer Center researcher, MUSC Health otolaryngologist-head and neck surgeon. Just as some scientists work to understand cancer genetics or tumor biology in the hope of finding targets that can be modified with a new drug, we see care be modified delivery pathways in the same light.

Even just changing a few things can result in a higher survival rate of patients and racial discrimination in care around the country. Head and neck squamous cell carcinoma (HNSCC) affects the areas around the throat, voice box, nose, sinuses, and mouth.

The disease begins in the head and neck and begins to grow rapidly from tumor control, according to the American Society of Clinical Oncology. Squamous cell carcinoma refers to the origin of the tumor: flat cells that form the lining of both the mouth and the throat.

While HNSCC is considered rare, consisting of only 4% of all cancer cases each year, it has a high mortality rate. The American Cancer Society estimates that almost 14,000 patients will die from this disease in the US in 2018, and African Americans are even more likely to die from it.

Treatment for HNSCC varies depending on the stage at which the patient is diagnosed, but best practices have been tried and agreed upon by a team of doctors from across the United States. These findings, which form the basis for the National Comprehensive Cancer Network (NCCN) guidelines for treating this form of cancer, shaped the parameters of these two studies.

According to the NCCN treatment guidelines, patients undergoing surgery for HNSCC need to receive postoperative radiotherapy (PORT) within six weeks of their surgical procedure to maximize their chances of remission.

Patients who had a care in two different hospitals rather than continuous care at one hospital or academic medical center were more likely to experience delays as well. Those who met with radiation oncology before surgery had an 8.9-fold increase in timely PORT.

More research is still needed to determine the specific barriers to timely and equitable HNSCC care, and racial differences, as well as treatment delays in other aspects of cancer care, continue. Graboyes aims to enact real change that will benefit patients in South Carolina and across the country.

They hope that these data will be helpful for head-neck cancer providers and healthcare policymakers to understand the magnitude of the problem and spur coordinated action to address its root causes.