Head Neck Cancer Treatment at World Class Hospitals in India

Head and Neck Cancers make up almost 30% of cancers among Indians. The major culprits are chewing tobacco, betel nut, paan, smoking cigarettes and consuming excessive alcohol. Another risk factor is an infection with the HPV which increases the risk of throat cancer.

The most common type of cancer in the head and neck is squamous cell carcinoma, which arises from the cells that line the inside of the nose, mouth and throat. Squamous cell cancer is often associated with a history of smoking or exposure to the human papilloma virus (HPV). Other less common types of head and neck cancers include salivary gland tumors, lymphomas, and sarcomas. Methods of prevention include avoidance of exposure to alcohol and tobacco products as well as vaccination of children and young adults against HPV.

Cancers spread in four main ways. The first is direct extension from the primary site to adjacent areas. The second is spread through the lymphatic channels to lymph nodes. The third is spread along nerves (perineural spread) to other areas of the head and neck. The fourth is spread through the blood vessels to distant sites in the body. In head and neck cancer, a spread to the lymph nodes in the neck is relatively common.

Symptoms that should not be ignored to rule out Head & Neck Cancer:

• A sore in the mouth that has not healed for more than 3 weeks
• Persistent change of voice
• Difficulty in chewing and swallowing
• A lump in the neck
• Bleeding, pain or numbness in the nose or mouth
• Difficulty in opening the mouth
• Facial, neck or ear pain

Common Types of Head & Neck Cancers.

• Oral cavity (mouth):- 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.
• Pharynx (throat):- 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 :
  1. Nasopharynx:- The nasopharynx, the upper part of the pharynx, is behind the nose.
  2. 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.
  3. Hypopharynx:- The hypopharynx is the lower part of the pharynx.
• Para nasal sinuses (small hollow spaces around the nose lined with cells that secrete mucus) : – 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. nasal cavity (airway just behind the nose)
• Larynx (“Adam’s apple” or voice box) : – 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.
• Salivary glands (parotid, submanidular, sublingual 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.

Most Advanced Head & Neck Cancer Treatment options available in India

1. Surgery

During surgery, the goal is to remove the cancerous tumor and some surrounding healthy tissue during an operation. Types of surgery for head and neck cancer include:

• Laser Technology: This may be used to treat an early-stage tumor, especially if it was found in the larynx.
• Excision. This is an operation to remove the cancerous tumor and some surrounding healthy tissue, known as a margin.
• Lymph Node Dissection or Neck Dissection: If the doctor suspects the cancer has spread, the doctor may remove lymph nodes in the neck. This may cause stiffness in the shoulders afterward. This may be done at the same time as an excision.
• Reconstructive (Plastic) Surgery: If cancer surgery requires major tissue removal, such as removing the jaw, skin, pharynx, or tongue, reconstructive or plastic surgery may be done to replace the missing tissue. This type of operation helps restore a person’s appearance and the function of the affected area.

2. Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time. It can be the main treatment for head and neck cancer, or it can be used after surgery to destroy small areas of cancer that cannot be removed surgically.

The most common type of radiation therapy is called external-beam radiation therapy, which is radiation given from a machine outside the body. A specific type of external-beam radiation therapy is intensity-modulated radiation therapy (IMRT). IMRT uses advanced technology to accurately direct the beams of radiation at the tumor. This helps reduce damage to nearby healthy cells, potentially causing fewer side effects.

3. Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by ending the cancer cells’ ability to grow and divide.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs given at the same time.

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