Doctro Heo Dae-seog of Seoul National University

By Bae Ji-sook
Staff Reporter

Cancers of the head and neck are serious problems in Korea.

About 2,500 people are diagnosed with the illness every year, making it the eighth most common cancer here.

According to the U.S. National Cancer Institute, the disease affects the head or neck region - in the nasal cavity, sinuses, lips, mouth, salivary glands, throat or larynx (voice box).

The cancer develops in the squamous cells that line the mucosal surfaces in the head and neck, and often spreads to other organs such as the lymphatic glands.

The tumors are detected by computerized tomography and magnetic resonance imaging and, in some cases, positron emission tomography is used for detection.

The cancer shows different incidence among races. The nasopharyngeal cancer, a rare tumor arising from the epithelium of the nasopharynx, is dominant among Southeast Asian patients but the ratio is lower among Caucasians.

"We aren't really sure what causes the difference. Maybe it's just more of a statistical matter. We are trying to define its generation," said Heo Dae-seog, a doctor at Seoul National University.

In Korea, cancer on the tongue and oral areas are the most reported.

Though non-specific factors are dominant, a lump or sore on the mouth or neck which troubles eating, or a constant sore throat might be the first signs of the disease. Some sense change or hoarseness in their voice or find palpable mass around the areas.

"However, many of these symptoms may not be serious. Only when they are persistent and progressive, then you may suspect these symptoms are related to cancer," said Heo.

The doctor says that alcohol and smoking are the triggers of the disease. "You put all the harmful substances directly into the lungs and other parts of your body. The chemicals touch the organs in the head and neck areas directly," he said. "Men's prevalence rate is double that of women," he added.

The Epstein-Barr virus, often found among Southeast Asian patients, is also one of the causes. More recently, there have been reports that human papillomavirus, one of the biggest causes of cervical cancer, is also responsible for the disease, but Heo said that more studies were needed to support the theory.

The cancer is treated through three main methods: medication, radiation and chemotherapy. The selected treatment depends on how much the cancer has developed and to what extent it has spread throughout the body.

Since the disease involves a vast range of organs and areas of the body, Heo said the best solution was for several doctors in different fields ― oncologists, radiotherapy experts, surgeons and many more ― to collaborate on treating a single patient.

The method of treatment is also changing. The combination of radiotherapy and chemotherapy has been proven to be effective and is used as a preventative measure against relapses. These days, medicines are also effective against the disease, Heo said.

"These days we see the five-year-survival rate for patients at 50 to 60 percent," he said.

Preserving or restoring function and the "appearance" of the affected area has become more important than ever. Heo has been working on the restoration project since the 1980s.

He cites an episode with one of his patients dating back t two decades. "He was a very ordinary university student who found cancer on his tongue one day. We had to remove his tumor and also a considerable part of the speaking organ. The wound and scar were quite horrid at the time,'' he said.

"We took some skin off from his shoulders and put it on the scar left after surgery. Within a couple of months, the color of the area looked relatively comfortable. He is now healthy, married and has children. He can also speak well."

Heo added, "in the future, target molecule medicines to destroy cancer cells would be more adaptable to the problem area. "We will need more studies in the future for that," he said.

bjs@koreatimes.co.kr

Who is Huh Dae-seog? Huh Dae-seog is often referred to as one of the best doctors when it comes to head and neck cancer as well as lymph gland cancer. The graduate of Seoul National University is known for his friendliness and giving of detailed information to his patients. His conservative but also prudent treatment is highly credited among his peers and his patients. Heo is also a devout supporter of the hospice system, which refers to ceasing excessive treatment for patients suffering from terminal stage illnesses and providing them with religious or other meditative consolation so that they can have a peace of mind. "The most important value is the patient. It is of course very sad for family members to see the beloved one go away. However, keeping them under constant pain for so long is not really advisable," Heo said. "The hospice system is to let the patients get abundant painkillers and let them live a peaceful life for a couple of months. Let them meet people they wanted to meet and see, eat what they have wanted and do what they have always wanted to do instead of being stuck in a bed nearly unconscious," he said. Seoul National University came up with guidelines for the cessation of meaningless and excessive treatments in July and has been receiving relevant documents from the patients and their family members since then. More than 20 have been collected by far. Heo is also the chief director of the National Evidence-based Healthcare Collaborating Agency, a state-funded institute developing new medical techniques and services.