Head & Neck Cancer Treatment, a Surgeon’s Perspective – Dr Suneel Kaushik

 

Dr Suneel Kaushik Komanduri, Consultant Surgical Oncologist, at Balco Medical Centre in Raipur, Chhattisgarh, speaks to us about the symptoms, causes and treatment modalities for head and neck cancer. 

What are head and neck cancers? What causes these?

Head and neck cancers arise from the moist pink lining which forms the inner layer of the oral cavity, larynx, pharynx, nose and the paranasal sinuses which we call as mucosa.

Tobacco is the most important risk factor contributing to head and neck cancers. This includes smoking of tobacco in the form of cigarettes, cigars or beedis, or in smokeless form like chewing tobacco, zarda, khaini etc. Chewing of paan and betel quid also increases the risk of cancer. 

Apart from these, infections like human papilloma (HPV) also lead to cancer. 

Certain occupational hazards like working in textile industry, construction industry, ceramic industry etc increases the risk of nasopharyngeal and laryngeal diseases. 

How can I check if I have head and neck cancer?

Those at high risk of developing oral cancer, especially those who have a long history of tobacco abuse and a long history of paan chewing, must check their mouth, tongue, teeth and gums for any usual appearances on a regular basis. 

They can also undergo a physical examination by a dentist or a general physician. 

Any non-healing ulcers, loose and painful teeth, bad breath, or neck swellings on either side of the neck can be symptoms of head and neck cancer and should be checked-up. 

 

How are head and neck cancers treated?

The most common treatment modes for head and neck cancer include surgical ablation of the tumour, radiotherapy and chemotherapy. 

They are used in various combinations depending upon the site  of the disease, the clinical stage, the extent that the disease spread, patient’s general health condition and several other factors. 

Usually, a combination of these modalities are used, referred to as a multimodality treatment or approach. 

What are the most advanced treatments available for head and neck cancer?

Surgery and Radiation are the curative modalities for treatment of head and neck cancers. Robotic surgery can be used for lesions that are located in interior sites but this is available only at selected centres in our country.  The data to support a survival benefit with robotic surgeries is still limited.

Advanced radiation techniques like Proton therapy have been found to be useful for deep-seated and recurrent cancers of head and neck region.

Immunotherapy is found to be effective in 20 to 25% of patients in the majority of the studies conducted till now. 

Can head and neck cancer recur after treatment?

Any type of cancer can recur after treatment. This depends on several factors like the stage at diagnosis, the quality of the treatment received and how well the patient has responded to the treatment. 

Generally, it is advised that the patient present himself for regular follow-up every three months for the first two years after completion of treatment. 

What can we expect after surgery for head and neck cancers?

If the patient has undergone mutilating surgeries for head and neck cancer, he may suffer from trouble with swallowing and with speaking. They may also suffer from low immunity and will need to prevent further infections.

The patient can undertake swallow and speech therapy to help them with a range of motions to enable better swallowing and speech. 

Each and every unit treating head and neck cancers across the country will provide rehabilitation services to help the patient enjoy a better quality of life after treatment. 

The patient will require a lot of support from their family in order to face the social, emotional and financial consequences of head and neck cancers. 

If you would like to consult an oncologist, visit our website to schedule a call.