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What essentials we need to know about head & neck cancer?

Head & neck cancer in India is ever increasing menace because of prevalent use of tobacco. let us start to what is cancer? And what are head neck cancer? Normally, cells grow and divide to form new cells in an orderly way. They perform their functions for a while, and then they die. Sometimes, however, cells do not die. Instead, they continue to divide and create new cells that the body does not need. The extra cells form a mass of tissue, called a growth or cancer. Their growth invades normal structures near the tumor and spreads to other parts of the body.(metastasis) .So the cancer arising in head & neck region include oral cavity (mouth cancer)which comprises of tongue, gums, inner side of cheek (buccal mucosa), palate. then the other area which is affected is larynx, also called the voicebox, then pharynx which 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).Other regions are nose and paranasal sinuses( hollow bones around the nose),salivary glands, thyroid etc. These cancers spread locally and to lymph glands in the neck.

The Most common cancer affecting the Indian population is cancer of the oral cavity of which tongue cancer is the highest in the world.

What are the causative factor for these cancers Tobacco (gutkha, paan, khaini, surti, beedi, cigarette) and alcohol use are the most important risk factors for head and neck cancers, particularly those of the oral cavity, oropharynx, hypopharynx, and larynx. There are an estimated 2.5 million cases of cancer in India at any given time. Nearly 800,000 cases were diagnosed in 2000 and there were 550,000 deaths due to cancer in that same year. Tobacco-related cancers account for almost one-third of all cancers in India—predominantly head and neck, lung, and esophageal cancers.

More than 5 million children in India are addicted to gutkha, a smokeless tobacco product that is a key driver behind the country’s soaring oral cancer rates.

Eighty-five percent of head and neck cancers are linked to tobacco use. People who use both tobacco and alcohol are at greater risk for developing these cancers than people who use either tobacco or alcohol alone. The other risk factors are poor oral hygiene and; Human papilloma virus (HPV) infection . There are certain stages before development of frank cancer which present as White patches (leukoplakia) in the mouth which does not get rubbed off or Red patches (Erythroplakia).

People who are at risk for head and neck cancers should come to us for check ups talk with their doctor about ways they can reduce their risk. They should also discuss how often to have checkups. So What are common symptoms of head and neck cancers? Symptoms of several head and neck cancer sites include a lump or sore that does not heal, a sore throat that does not go away, difficulty swallowing, and a change or hoarseness in the voice. The symptoms related to specific sites are Oral cavity. A white or red patch on the gums, tongue, or lining of the mouth; a swelling of the jaw that causes dentures to fit poorly or become uncomfortable; and unusual bleeding or pain in the mouth. Nasal cavity and sinuses. Sinuses that are blocked and do not clear, chronic sinus infections that do not respond to treatment with antibiotics, bleeding through the nose, frequent headaches, swelling or other trouble with the eyes, pain in the upper teeth, or problems with dentures. Pharynx Ear pain,Trouble breathing or speaking, frequent headaches, pain or ringing in the ears, or trouble hearing. Larynx. Pain when swallowing, or ear pain.

These symptoms may be caused by cancer or by other, less serious conditions. It is important to get checked with a specialist.How are head and neck cancers diagnosed? The specialist doctor (Head & Neck Surgeon) takes history &Physical examination then examines the affected following which endoscopy is done ,if anything is found suspicious tiny piece is taken for examination in the laboratory using microscope, if lesion is found then it needs to be found whether disease has spread from the site of origin the test which help in this are X-rays, CT (or CAT) scan is a series of detailed pictures of areas inside the head and neck created by a computer linked to an x-ray machine. Magnetic resonance imaging (or MRI), PET scan. After this patient is staged if disease is small confined then it is in stage I, if large but still confined to the site of origin- StageII, if spread to the lymph glands in the neck then Stage III, if spread to lungs, liver then patient is staged IVc.

Knowing the stage of the disease we plan the treatment which are best treated by a team of specialists. Thel team includes Head & Neck Oncologist ,pathologist ; medical oncologists; radiation oncologists; prosthodontists; dentists; plastic surgeons; dietitians; social workers; nurses; physical therapists; and speech-language pathologists (sometimes called speech therapists).The treatment plan is decided by joint meeting (TUMOR BOARD)of these specialist and blue print of the treatment is laid down in consultation with the patient. How are head and neck cancers treated?

If the in Stage I & II,surgery is done or managed by radiation only, for stage III surgery + radiotherapy is given, Stage IV only chemotherapy with symptom care.

The treatment plan for an individual patient depends on a number of factors, including the exact location of the tumor, the stage of the cancer, and the person’s age and general health. Surgery. Remove the cancer and some of the healthy tissue around it. Lymph nodes in the neck may also be removed (lymph node dissection), if the doctor suspects that the cancer has spread. Surgery may be followed by radiation treatment. Radiation therapy, also called radiotherapy. This treatment involves the use of high-energy beams to kill cancer cells. Radiation may come from a machine outside the body (external radiation therapy). Chemotherapy, also called anticancer drugs. This treatment is used to kill cancer cells throughout the body. Our motto is win against cancer by prevention, treatment and good rehabilitation.

At Dharamshila we are well equipped to tackle this cancer at whichever stage it comes, we are harping on prevention of these disease by conductive nationwide diagnostic and educative camps. In house we experienced and expert councillors for persons who want to leave tobacco but are not able to do so. We have educative brochures elucidating the harmful effects of tobacco consumption.

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