Head and Neck Cancer

Definition
Cancers that are known collectively as ‘head and neck cancers’ usually begin in the squamous cells that line the moist, mucosal surfaces inside your head or neck — for example, inside your mouth, nose, and throat. Head and neck cancers also can begin in the salivary glands, but salivary gland cancers are relatively uncommon. Most head and neck cancers are biologically similar. About 90 percent are squamous cell carcinomas, so they are called head and neck squamous cell carcinomas (HNSCC).

General information
HNSCC is the sixth leading cancer by incidence worldwide. A half million new cases are diagnosed each year, and two-thirds of them occur in industrialized nations. HNSCC develops most frequently in men between the ages of 50 and 70. The five-year survival rate for HNSCC patients is 40-50 percent. HNSCC is frequently aggressive and patients with these types of cancer are at a higher risk of developing another cancer in the head and neck area.

Alcohol and tobacco use (including chewing tobacco) are the two most important risk factors for head and neck cancers, especially cancers of the oral cavity, oropharynx, hypopharynx, and larynx. At least 75 percent of head and neck cancers are caused by tobacco and alcohol use. People who use both tobacco and alcohol are at greater risk of developing these cancers than people who use one or the other.

In addition to alcohol and tobacco use, other causes of head and neck cancer include ultraviolet light, chemicals used in certain workplaces, and viruses, such as the human papillomavirus.

Common symptoms of head and neck cancer include a lump or sore that does not heal, a sore throat that does not go away, difficulty swallowing, and a change or hoarseness in the voice. Symptoms may differ according to the part of the head or neck that is cancerous.

Tests used to diagnose head and neck cancers vary according to symptoms but may include biopsy, endoscopy, blood or urine tests, x-rays, CT scans, MRIs, and PET scans. Treatment depends on the location of the tumor, the stage of the cancer, and the patient’s age and general health. Treatment options include surgery, radiation therapy, and chemotherapy.

Depending on the location of your cancer and the type of treatment employed, rehabilitation may include physical therapy, dietary counseling, speech therapy, and/or learning how to care for a stoma after a laryngectomy. Some patients may need reconstructive surgery.

Social Security Administration POMS: DI 23022.190  — Head and Neck Cancers
To establish disability under the Social Security Administration (SSA) with your diagnosis of HNSCC, you will need a pathology report and an operative report – the two preferred methods for documentation. In the absence of these reports, a physician’s opinion indicating the cancer is inoperable or unresectable, based on described objective findings, may be acceptable. Head and neck carcinomas that are inoperable, unresectable, or with distant metastases, meet Social Security Medical Listing 13.02 with A or D criteria.

Head and neck cancer also is listed under the SSA’s Compassionate Allowance Program, which was launched in 2008 to expedite certain disability claims. Applying for disability benefits under the Compassionate Allowance Program requires the same procedure every applicant must follow when applying for SSA disability benefits; however, you will be notified if your condition is being considered as a compassionate allowance.

Your representative may be able to help expedite your disability claim if you have a head or neck cancer.