Head & Neck Cancers-Prevention and Treatment

Head & Neck Cancers are the leading cause of morbidity and mortality among males in India in age group of 35-64 as per HBCR studies of ICMR from 2007-2011. Majority of these cancers are preventable, as definite risk factors are involved.

Risk factors:

Smoking & alcohol consumption are the two major risk factors responsible for 75% of Head & Neck Cancers. Smoking increases the risk factor by five to twenty five folds, whereas alcohol increases by two to six folds. Both the factors combined together increase the risk by fifteen to forty folds.

Chewing Tobacco, betel , snuff, slaked lime are also important risk factors for Oral Cancers. Oral sex leading to HPV infection is associated with oropharyngeal and tonsillar carcinoma. Genetic predisposition is quite common in younger population. Immunodeficiency syndromes increase the susceptibility of developing Head and Neck cancers.

Prevention:

Cessation of smoking and limiting alcohol consumption are the two most important strategies for preventing these cancers. Regular checkups and prompt treatment of premalignant conditions can lead to prevention of overt cancers. Diet plays important role in preventing these cancers. Fresh fruits and vegetables have protective effect.

Presentation:

The common symptoms that highlight that you may be suffering from Head and Neck Cancer are:

• Dysphagia- difficulty in swallowing
• Change in Voice- your vocal chords feel stressed
• Blood in sputum- there is blood coming out in your mucous and from your mouth during a cough
• Decreased mouth opening
• Pain in the ears
• Loose teeth- feeling that some of your teeth as falling off
• Ill fitting dentures
• Non healing cancers in the mouth
• Neck mass- increase in the mass in the neck

The investigations that are required to keep a check :

The following are the tests that are usually suggested by the doctors to diagnose your Head and Neck Cancers:

• FNAC from Neck mass
• Biopsy from ulcer/white patch/Growth
• Triple Endoscopy
• CT Scan, MRI/ PET scan(Optional)

The tests prescribed or recommended can vary from person to person.

Management of the Head and Neck Cancers:

Treatment essentially depends upon the stage of the disease. Premalignant disease in majority of cases are treated by surgery. Prognosis of HPV associated oral cancer is considered to be good. Stage I and II cancers can be managed by surgery or radiotherapy alone depending upon site/extent of the disease and performance status of the patient. Locally advanced cancers require multidisciplinary approach with combination of surgery, radiotherapy, chemotherapy and immunotherapy. Tumor board discussions, comprising of surgical/ medical/ radiation oncologist, prosthodontist, plastic / vascular surgeon and Rehabilitation team should always be done, before starting definitive treatment. Good functional outcome can be achieved by free flaps and reconstructive surgeries which were earlier unimaginable. With the advent of modern Radiotherapy techniques, like 3DCRT, IMRT, voice can be preserved in laryngeal cancers. It is best that you trust your doctor and based on the suggestions follow the line of treatment.