Head And Neck Cancer

Head and Neck Cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the neck. Most begin in the moist tissues that line the mouth, nose and throat. Symptoms include:

  • A lump or sore that does not heat
  • A sore throat that does not go away
  • Trouble swallowing
  • A change or hoarseness in the voice

Using tobacco or alcohol increases your risk. In fact, 85 percent of head and neck cancers are linked to tobacco use, including smoking and smokeless tobacco. If found early, these cancers are often curable. Treatments may include surgery, radiation therapy, chemotherapy or a combination. Treatments can affect eating, speaking or even breathing, so patients may need rehabilitation.

Symptoms & Signs

People with head and neck cancer often experience the following symptoms or signs. Sometimes, people with head and neck cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer.

Swelling or sore that does not heal; this is the most common symptom

Red or white patch in the mouth

Lump, bump, or mass in the head or neck area, with or without pain

Pain or difficulty chewing, swallowing, or moving the jaw or tongue

Ear and/or jaw pain

Blood in the saliva or phlegm, which is mucus discharged in mouth from respiratory passages

Loosening of teeth

Persistent sore throat

Foul mouth odor not explained by hygiene

Hoarseness or change in voice

Nasal obstruction or persistent nasal congestion

Frequent nose bleeds and/or unusual nasal discharge

Difficulty breathing

Double vision

Numbness or weakness of a body part in the head and neck region

Treatment Options of Head & Neck Cancer

Surgery, Radiation Therapy and Chemotherapy are the three modalities of treatment of H & N Cancer. Surgery and/ or Radiotherapy are the primary modalities while Chemotherapy is used as adjunct/adjuvant treatment. The treatment plan varies from patient to patient depending on a number of factors like the stage of the tumour, location of the tumour, patient’s age, general condition, occupation of the patient etc.Surgery: The goal of treatment when surgery is the main option is cure, which is possible when we can remove the tumour with good margin all around and also remove the lymph nodes.
Wide Excision: Depending on the afflicted area Wide Excision may include a surrounding structure also. For e.g., in some cases, a rim or segment of the jaw bone may be removed so that there is no compromise on getting a microscopic clean margin.
While the Oncosurgeon is totally focused on getting the tumour out, he/ she would have a plan for reconstruction which is often discussed with an Aesthetic Surgeon and the patient, in advance.You may discuss with your surgeon the loss of tissue expected and the plan for reconstruction. He/She would use line diagrams to explain the whole process to you. In tongue cancer, whenever a wide margin is taken, the treating team works to ensure that the remaining tongue remains mobile and as functional as possible. When surgery is inevitable-Partial Laryngectomy is performed in suitable cases. This helps us preserve the voice to a great extent. However, if total Laryngectomy has to be performed and other options are not suitable,there are methods to implant a prosthetic device or use an external device for the purpose of speech. The earlier we intervene better it is, in terms of disease control and for rehabilitation.The surgery will have some effect on your appearance,speech, swallowing etc, but depending on the area of surgery, generally these symptoms settle down. Sometimes, it helps to meet someone who has undergone a similar process/surgery.
Neck Dissection – H & N Cancers generally spread to neck glands. Even if the neck glands are not involved, these might have to be removed for control of cancer. Today,wherever possible, a modified neck dissection is done so that the appearance and shoulder function are well preserved. It, however, causes some swelling of the face which comes down in 2-3 months, more so in patients undergoing post surgery radiation therapy. Radiation Therapy entails use of high energy X-Rays to kill cancer cells. The source of radiation may be from a machine outside the body (external beam radiotherapy) or from radioactive materials inserted into the involved organ(Brachytherapy).
Chemo-Radiation: Many locally advanced H & N Cancers are treated with combination of Radiation and Chemotherapy. This treatment takes advantage of both the modalities of treatment for improving cure rates and conserving the organ affected by the disease. It gives hope of conserving larynx to allow patient to have near normal speech and swallowing.

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