Globally, head and neck cancer (HNC) is the seventh most common cancer and developing countries like India are witnessing an increase in its incidence.In India, head and neck cancer is the second most common cancer, especially lip and mouth cancer. . When we say head and neck cancer, we club cancers of the head and neck region into several anatomical subsites – lips, tongue, mouth, other parts of the pharynx (oropharynx, nasopharynx, hypopharynx), sinuses. , nasal cavity, salivary glands and larynx (voice box) and different HNC types may have a similar natural course of history and their pattern of spread to adjacent sites and lymph nodes.
In an interview with HT Lifestyle, Dr Yash Mathur, Head Neck Surgical Oncologist, HCG Cancer Center, Mumbai, shared, “The multiple subsites of the disease location make many of its manifestations easily visible or palpable on clinical examination, which allows for easy detection but symptoms that are not alarming. is misdiagnosed for harmful diseases and can mislead patients due to ignorance. In India, head and neck cancers are mostly diagnosed at advanced stages and hence early detection is important.”
According to him, in the absence of good and affordable health facilities, people tend to neglect and often report their signs and symptoms late. While advising to seek medical attention for some symptoms associated with HNC, he highlighted some common symptoms depending on the site of HNC –
- Oral cancer: Unexplained swelling or growth in the jaw, swelling of the lips, loose teeth, red or white spots in the mouth, such as on the gums, tongue or inside of the cheek, that does not heal for more than 15 days, gradual decrease in opening the mouth, changes in speech, unusual bleeding from the mouth or gums .
- Throat/pharynx cancer: a sore throat that refuses to go away after 2 weeks, difficulty or pain in swallowing; Pain in the throat, persistent cough that refuses to stop; Pain or ringing in the ears; Sudden trouble in hearing; Voice change or hoarseness. Difficulty in swallowing and earache.
- Nasopharynx Cancer: enlarged or blocked sinuses that refuse to heal; chronic sinus infections that are resistant to antibiotics; Frequent/multiple episodes of nosebleeds, frequent headaches, eye swelling or other problems, pain in upper teeth.
- Voicebox/larynx cancer: Shortness of breath, voice change or hoarseness, pain in swallowing, earache. Persistent cough after swallowing liquids.
- Erythrocyte Cancer: Pain in the ear area, chin, jawbone or under the neck that is persistent; Lump or swelling somewhere in the neck near the jawbone, facial paralysis, saliva running from the corner of the mouth to one side, inability to smile fully, inability to hold air in the mouth, partial closure of the eyelids or radiating pain in the throat, in front of the ear, behind the ear.
He revealed, “The gold standard for HNC is diagnosis by tissue biopsy, some under local and some even require general anesthesia. The extent of spread can be detected through imaging such as abdominal scan or contrast enhanced MRI, CT scan. Delayed diagnosis in HNC often leads to illiteracy. , is blamed on poverty but there is also a lack of trained HNC oncologists and cancer diagnosis and treatment centers that make it difficult to diagnose and treat patients accordingly. The head and neck hold important, complex and delicate parts for our appearance, social interaction, speech and facial expression. . HNC can cause deformities, functional problems, and affect the patient’s quality of life.”
Dr. Yash recommends that once HNC is deemed curable due to rapidly changing guidelines in the field of oncology, patients may be treated with surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, or a combination of these therapies, depending on stage and structure. He said, “Apart from these factors, a person’s age and overall health and other related diseases also determine the course of treatment. Pain management and palliative care are other ways to improve a patient’s quality of life when cancer cannot be cured. Early detection helps to achieve better treatment results, etiology such as tobacco and alcohol are the main cause of cardiorespiratory, liver, other related diseases of neurological origin that complicate cancer treatment plans. “
Advanced stages of HNC can be difficult to manage but the onset can be prevented and Dr Yash Mathur emphasizes that most HNCs are common and oral cancer is the most preventable cancer, which can be achieved with a proactive approach. He said, “HNC is a form of cancer that is caused by our lifestyle choices and addiction to betel nut chewing, tobacco and alcohol consumption, poor oral hygiene. With lifestyle tweaks, it can be assumed that HNC can be prevented. In the Indian subcontinent, the world capital of HNC, the focus should be on prevention or at least, early detection. This can start with tobacco users planning ways to quit or reduce smoking and regular checkups with their doctors and tobacco cessation specialists. Oral self-examination should be practiced by highly intelligent individuals who have a history of addiction and have now given up the habit. Vaccination to prevent head and neck cancer caused by HPV reduces its incidence. Making people aware of the symptoms of HNC through health education and mass screening.
He emphasized, “A diet rich in green and yellow vegetables and fish is known to provide protection against HNC. HNC, regardless of its prevalence, exhibits easily detectable symptoms and can be treated effectively, especially in its early stages. If we Working together, incidence and mortality can be reduced. Choosing a smoke-free lifestyle, seeking medical attention for potential symptoms, regular screening, strengthening health literacy, building a strong affordable cancer care system with head and neck oncologists, pathologists, surgeons and radiologists all contribute to care. can go a long way in reducing the gap.”