Cancer that arises in the head or neck region (in the nasal cavity, sinuses, lips, mouth, salivary glands, throat, or larynx [voice box]) is termed as head neck cancer.
Head and neck cancer refers to a group of biologically similar cancers originating from the upper aerodigestive tract, including the lip, oral cavity (mouth), nasal cavity, sinuses, pharynx, and larynx. 90% of head and neck cancers are squamous cell carcinomas (SCCHN), originating from the mucosal lining (epithelium) of these regions. Head and neck cancers often spread to the lymph nodes of the neck, and this is often the first (and sometimes only) manifestation of the disease at the time of diagnosis. Head and neck cancer is strongly associated with certain environmental and lifestyle risk factors, including tobacco smoking, alcohol consumption, UV light and occupational exposures, and certain strains of viruses, such as the sexually transmitted human papillomavirus. These cancers are frequently aggressive in their biologic behavior; patients with these types of cancer often develop a second primary tumor. Head and neck cancer is highly curable if detected early, usually with some form of surgery although chemotherapy and radiation therapy may also play an important role.
What Causes Head Neck Cancer?
We know that cancers are not infectious – cancer of the head or neck cannot be caught from someone like a cold or cough. However, we do not know very much about what does cause cancer.
There are some things, however, that we know do to increase the chance of developing cancer of the head and neck, including:
- Smoking tobacco
- Chewing tobacco, betel, pan, or gutkha
- Heavy consumption of alcohol
- A poor diet
In some cancers, there appears to be a link with specific causative factors. For example, cancer of the nasopharynx has been linked to the Epstein-Barr virus (EBV), a very common virus that also causes glandular fever. EBV does not cause cancer on its own, and it is not known why it is associated with cancer in some people and only with an infection in others.
We also know that cancer of the head and neck is more common in men than in women and is more common in people over 55 years old than in younger people.
Symptoms of Head and Neck cancer:
The most common symptoms of a cancer of the head and neck include:
- An ulcer in the mouth that doesn’t heal within a few weeks
- Difficulty in swallowing, or pain when chewing or swallowing
- Trouble with speaking or breathing, such as a hoarse voice or persistent noisy breathing
- A constant sore throat and earache affecting one side
- A swelling or lump in the mouth or neck.
Less common symptoms include:
- A numb feeling in the mouth or on the lips
- An unexplained loose tooth
- A persistent blocked nose or nosebleeds
- Ringing in the ear or difficulty hearing
- Pain in the face or upper jaw
- Pre-cancerous changes in the lining of the mouth or on the tongue, which can appear as persistent white patches (leukoplakia) or red patches (erythroplakia) – they are usually painless but can sometimes be sore and may bleed.
Although these symptoms can be caused by conditions other than cancer, it’s important that they are always checked out by your doctor or dentist, particularly if they persist.
Head Neck Cancer Treatment:
It is important to work closely with your doctor to decide which treatment plan is right for you.
- Surgery
- Radiation therapy
- Chemotherapy
- Biologic therapy
Surgery: Surgery is performed to remove the tumor. Surgery to remove the tumor may involve the removal of the cancer and some of the healthy tissue and structures around it to provide a margin of safety.
Radiation therapy: Radiation therapy is a treatment involving the use of high-energy sources to destroy cancer cells. Sometimes patients may need both surgery and radiation therapy or a combination of radiation therapy with chemotherapy.
Radiation may come from a machine outside of the body (external beam radiation therapy), or it can come from radioactive materials placed directly into or near the area where the cancer cells are found (internal radiation therapy, or brachytherapy).
Chemotherapy: Chemotherapy is an anticancer drug that is given into a vein or taken by mouth. Chemotherapy is sometimes given to shrink the cancer before surgery or radiation treatment. For more advanced tumors, it’s been added to the options of radiation and/or surgery to improve the outcome of local treatment and to kill any microscopic cancer cells that may have traveled to distant sites and escaped detection.
Biologic therapy: Biologic therapy is a kind of therapy designed to affect cancer cell growth. Biologic therapy is not chemotherapy. Depending on the type of cancer being treated, biologic therapies may be added to other cancer therapies. ERBITUX® (cetuximab) is a biologic therapy.
ERBITUX is a monoclonal antibody that has been designed to bind and block structures that are often present on cancer cells. These structures are calledepidermal growth factor receptors, or EGFRs. While EGFRs are often present on cancer cells, they are also present on some normal cells.
The goal of biologic therapy is to kill the cancer cell, or cause it to die, while minimizing damage to the healthy cell. Depending on the type of the cancer being treated, biologic therapies may be added to other cancer therapies.
What kinds of cancers are considered cancers of the head and neck?
Most head and neck cancers begin in the cells that line the mucosal surfaces in the head and neck area, e.g., mouth, nose, and throat. Mucosal surfaces are moist tissues lining hollow organs and cavities of the body open to the environment. Normal mucosal cells look like scales (squamous) under the microscope, so head and neck cancers are often referred to assquamous cell carcinomas. Some head and neck cancers begin in other types of cells. For example, cancers that begin in glandular cells are called adenocarcinomas.
Cancers of the head and neck are further identified by the area in which they begin:
- Oral cavity– The oral cavity includes the lips, the front two-thirds of the tongue, the gingiva (gums), the buccal mucosa (lining inside the cheeks and lips), the floor (bottom) of the mouth under the tongue, the hard palate (bony top of the mouth), and the small area behind the wisdom teeth.
- Salivary glands– The salivary glands produce saliva, the fluid that keeps mucosal surfaces in the mouth and throat moist. There are many salivary glands; the major ones are in the floor of the mouth, and near the jawbone.
- Paranasal sinuses and nasal cavity– The paranasal sinuses are small hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.
- Pharynx: The pharynx is a hollow tube about 5 inches
long that starts behind the nose and leads to the esophagus (the tube that goes to the stomach) and the trachea (the tube that goes to the lungs). The pharynx has three parts:
- Nasopharynx-The nasopharynx, the upper part of the pharynx, is behind the nose.
- Oropharynx– The oropharynx is the middle part of the pharynx. The oropharynx includes the soft palate (the back of the mouth), the base of the tongue, and the tonsils.
- Hypopharynx– The hypopharynx is the lower part of the pharynx.
- Larynx– The larynx, also called the voicebox, is a short passageway formed by cartilage just below the pharynx in the neck. The larynx contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the larynx to prevent food from entering the air passages.
- Lymph nodes in the upper part of the neck– Sometimes, squamous cancer cells are found in the lymph nodes of the upper neck when there is no evidence of cancer in other parts of the head and neck. When this happens, the cancer is called metastatic squamous neck cancer with unknown (occult) primary.
Cancers of the brain, eye, and thyroid as well as those of the scalp, skin, muscles, and bones of the head and neck are not usually grouped with cancers of the head and neck.
After Head Neck Cancer treatment surgery:
Some people can have surgery as a day patient, particularly when this involves just an examination under anaesthetic or a biopsy. If your surgery is more complicated, you will need to stay in hospital for several days or up to a few weeks. Your stay in hospital will depend on the extent of the surgery and whether or not you have had a skin flap or tissue graft.
After your head neck cancer surgery you’ll be encouraged to start moving around as soon as possible. This is an essential part of your recovery and, even if you have to stay in bed, it’s important to do regular leg movements and deep breathing exercises.
A physiotherapist will explain these to you.
If you have extensive surgery, you may spend some time in intensive care immediately after the operation. This is a ward where you will be closely checked and given intensive nursing care for as long as necessary to help you recover.
Cost of Head neck cancer treatment Surgery in India
- The cost of the operation varies a great deal. Different countries have different rates. The operation needs an expert surgeon and the cost of the surgery will depend a lot on the surgeon’s fees. The more experienced he is, the higher his charges will be. This operation also needs hospital stay of four to five days. The charges will depend on the hospital also. The operating room charges, the recovery room charges, the anesthetics charges, medicines, check ups, pre and post consultations all cost money.
- Most health insurance companies cover the head neck cancer treatment surgery. However, this has to be discussed in advance. Head neck cancer is considered a health related operation and hence there is insurance cover for it.
- India is the most favorable destination when it comes to weight loss surgery at low cost without compromising the quality.
Head and Neck Cancer Surgery in India under specialized medical care
International patients can get Head and Neck cancer surgery in India under expert cancer surgeons at best cancer centers. Expert surgeons of India have the expertise and many years of experience in performing complex Head and Neck cancer surgery in India and have hands on experience with the latest technological devices used to perform the most sophisticated surgeries. Indian hospitals have its recognition not only in India but also at abroad countries for the world-class standards healthcare service that it provides to the patients. Indian hospitals are standardized and integrated world-class healthcare service provider that offer excellent service, patient care, and scientific knowledge.
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Head and neck cancer surgery is done to treat the patients having severe problems related to cancer at parts of head and neck. Surgery is an important part of the treatment of head and neck cancers and aims to remove them completely. The part of your mouth or throat that the doctor may remove depends on where the tumour is. Very small cancers can often be treated with a simple surgical operation under local or general anaesthetic, or with laser surgery, with no need to stay in hospital overnight. If the cancer is larger, surgery will often involve a hospital stay and an operation under general anaesthetic. Sometimes Head and Neck cancer surgery may involve more than one part of your head and neck, and may cause scarring on your face or neck. Laser surgery may sometimes be used to remove small tumours in the mouth and the pharynx. This may be combined with a light-sensitive drug (sometimes called a photosensitising agent) in treatment known as photodynamic therapy (PDT) A type of surgery called micrographic surgery or Mohs’ surgery is sometimes used for cancers of the lip. The surgeon removes the cancer in thin layers, and the tissue that has been removed is examined under a microscope during the surgery. The surgeon will continue to remove more layers until no cancer cells are seen in the tissue. This technique makes sure that all the cancer cells are removed, but that only the minimum of healthy tissue is removed. The success of Head and Neck cancer surgery in India is acclaimed by many abroad patients as they get the best possible result. Indian hospitals offer premium service for patients wishing to benefit from the high quality of Indian medical services and modern medical options. Medical tourism in India operates a specialized department to assist international patients during the entire course of their stay in the hospital. Medical tourism in India offers other services such as hotel or room accommodation assistance, free consultation through the internet, liaison services, special diets and food preferences and transportation services.
