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India has the highest incidence of Head & Neck cancer in the world. These cancers constitute about 40 – 50% of all cancers in India. 70% of them are tobacco related and hence are totally preventable.

They occur in the most exposed and sensitive region of the body and they afflict vital organs like voice box, tongue, lining of oral cavity, pharynx, nose, eyes and ears. On an average about 1.5 lakh patients are diagnosed with head and neck cancers every year. Most of these cancers are curable if detected early.

Signs and symptoms

  • White patch, sore or ulcer in mouth.
  • Difficulty or pain during swallowing
  • Change of voice
  • One sided throat pain
  • Unexplained earache
  • Chronic cough
  • Difficulty in breathing
  • Lump in the neck
  • Bleeding/ discharge from ear, nose or mouth

Diagnosis

All that is required to diagnose head and neck cancer is good light, an alert mind, an eye for detail and sensitive fingers.

Majority of them can be diagnosed by simple clinical examinations alone. Biopsy is performed on OPD basis to obtain histological confirmation. Lumps can be diagnosed by simple fine needle aspiration cytology.

Treatment options

Head and neck is the most exposed region of the body usually associated with image, at the same time it is also the most functional region involving vision, smell, hearing, taste, swallowing and last but not the least the speech. Therefore the treatment must balanced aesthesis, function and control of cancer. Modern cancer treatment aims at maximum functional preservation and optimum cancer control.

Surgery and radiation alone are both effective in early stages, however both surgery and radiation therapy are required to treat advanced cancers. Unfortunately majority of the cases are advanced. In recent times, chemotherapy is used to potentiate the efficacy of radiation therapy.

With newer advancements, functional and reconstructive surgery is now performed resulting in preservation of vital functions thereby improving the quality of life. Jaw preserving surgery, voice preservation, speech restoration and state-of art micro vascular reconstruction are few of them. Reaching deep seated tumors and sparing the vital structures around it, was always a great challenge to the radiation therapist. Fortunately with newer technology such as the  TrueBeam STx, targeted radiation can be delivered to all head and neck cancers within shortest period of time, sparing vital functions.

Dr R. P Deo, Head & Neck Onco Surgeon, BGS Global Hospitals

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