1. Correlations between Urologic and Head and Neck Cancers
John R Jacobs MD
Edson J Pontes MD
Karmanos Cancer Center
Wayne State University

2. Case Report 57 y/o male smoker (2PPD x42yr) construction worker
4/2004 Rt neck swelling dx metastatic squamous cell cancer UNK Primary
Treated with MND post op RT/CT
5/2006 Renal mass ID on routine CT of thorax for HN Ca
Laparoscopic Assisted Left Radical Nephrectomy
Clear cell (Furman Grade 3) 6.2 cm T1NxMo organ confined

4. Case Report (con) 12/2008 elevation PSA Prostate Biopsy negative
8/2009 Gross painless hematuria
8cm left lateral wall urinary bladder
Low grade non invasive papillary urothelial ca

5. Case Report (con)
3/2010 Surveillance cysto small recurrence bladder neck
10/2010 recurrence two areas
5/2011 Surveillance cysto pending

6. Question
Is it reasonable to prospectively screen head and neck cancer patients for urologic malignancies?

7. Hypothesis
There exists a significant number of patients with both head and neck and urologic malignancies because of similar risk factors

8. Background

9. Known Etiologic Factors for Head and Neck Cancer
Tobacco products
Alcohol
Betel nut usage
Aniline dyes
Woodworkers
Nickel refiners
Paint fumes
Petroleum industry chemicals
Human papillomavirus
Epstein barr virus (nasopharyngeal)

10. Known Etiologic Factors for Urologic Cancer
Tobacco
Aniline dyes
Rubber manufacturing
Textile printing
Cyclophosphamide or ifosfamide
Pelvic irradiation
Schistosomiasis
Chronic irritation (Foley)
Phenacetin

11. Common Etiologic Factors
Tobacco
Aniline dyes
Petroleum industry products

12. Methodology
SEER data base
Surveillance Epidemiology and End Results

13. Methodology Established in 1973
Covers roughly 26% of the USA population
Cancer incidence and survival from population based data bases
Both academic and community hospitals participate

14. Results

15. Participating Sites

16. Total Cases

17. Frequency by Years

18. Sex by Site

19. Site and Stage

20. Sequence

21. Conclusions

22. Majority of patients are male
Conclusions
Majority of patients are male

23. Conclusions Majority of patients are male
Distant disease at presentation is unusual

24. Conclusions Majority of patients are male
Distant disease at presentation is unusual
More undifferentiated cancers in urology

25. Conclusions Majority of patients are male
Distant disease at presentation is unusual
More undifferentiated cancers in urology
More regional disease in head and neck

26. 128,650 Head and Neck 237,509 Urologic ONLY 2462 with both
Total Cases
128,650 Head and Neck
237,509 Urologic
ONLY 2462 with both

27. Conclusion
Less than 1% of patients will have both head and neck and urologic cancers

28. Hypothesis
There exists a significant number of patients with both head and neck and urologic problems because 60 year males with a past history of tobacco usage are common in both groups

29. Unique patients seen at KCI

30. Conclusion
Less than 2% patients are see jointly between Head and Neck and Urology

31. Conclusion
Two busy surgeons who refer to each other see a number of patients in common

32. Conclusion
The incidence of joint problems in the head and neck and the urologic cancer population is too low to justify screening

33. Patient Characteristics H&N URO

34. Patient Characteristics H&N URO

35. Patient Characteristics H&N URO

36. Patient Characteristics

37. Patient Characteristics H&N URO