Advanced Malignancy in the Young Marijuana Smoker

Abstract

Head and neck cancer is a devastating malignancy that afflicts approximately 53,500 Americans annually (1). This disease generally begins in the mucosal lining of the upper aerodigestive tract and is most commonly seen in the larynx, oral cavity, and oral and hypopharynx. It is a relatively slow growing tumor that remains localized for varying lengths of time and then metastasizes to regional lymphatics. Distant spread outside the head and neck is uncommon in the early cases; and it is not uncommon to find patients with lesions existing one year or longer, and attaining considerable size without metastasis below the clavicles. The majority of these tumors are squamous cell carcinomas by histology. Early tumors can be successfully treated by conservative surgery or irradiation therapy. Advanced cancers necessitate wide-field resection often with the addition of postoperative radiation therapy. Although this aggressive approach produces acceptable therapeutic results, it leaves many patients with impaired physiologic functioning and a disordered appearance.