Information about Head and Neck Cancers

Cancer is when a broad group of diseased cells found in the thousands of cells that make up the human body are in a growth state. If these growth cells have accumulated in a specific area, they are referred to as tumors. Uncontrollable growth cells will eventually disrupt the natural balance of the body and unless preventative measures are not taken or if treatment is not given consequently this will affect the functionality of the body thus inevitably lead to death.

When many of my patients have found out that I am a Head & Neck Surgeon they have responded by telling me about their neck ailments such as a stiff neck, aches/pains in the neck area and herniated neck problems.  However Head & Neck Surgery is actually a totally different field in medicine.  The neck, acts as a bridge, it is part of the skeletal system that functions as the carrier of the head and just as importantly it is an area where vital organs located.  The location of these precious vital organs is exactly where our field of medical surgical expertise as Head & Neck Surgeons is crucial.  An example of a situation whereby this type of surgery would be needed is where the Thyroid gland is located, which is the cause of the Goiter illness, the part of our Larynx (Throat), which enables us to make sounds.

As Head & Neck Surgeons we do not attend to illnesses linked to the Spinal Column/Cord.  The Medical definition of Head and Neck encompasses the areas located between the membrane (Dura) that surrounds the brain (this membrane in actual fact also surrounds the spinal cord, which goes all the way down to the waist) and the membrane (Pleura) that surrounds the lungs. These areas of formations are where our medical expertise of Head & Neck Surgery is entered into:

• Facial Skin
• Nose
• Mouth
• Salivary Glands
• Throat
• Pharynx
• Tongue
• Thyroid Gland
• Bones these are just a few of the areas that come to mind

Cancer can develop in every part of our body.  If the cancer has originated in the head and neck region it is called a Head & Neck Cancer.  Cancers that originate in the head and neck region are one of the five most common cancers seen in human beings, which can lead to death.

Throat Cancers and Thyroid Cancers are the most common types of cancers found in area of the head and neck.  All type of tissues in this region such as Facial Skin cancers, Salivary Gland tumors, in short, all types of tissues found in this region are susceptible to developing cancer.

The specific area where the cancer is located will determine the type of symptom it will show. Symptoms of Throat Cancer could appear as shortness of breath, a loss or hoarseness of the voice. With Thyroid Cancer the symptoms are usually a swelling of the neck and a growth such as a lump. An ulceration in the mouth, a wound on the lip that will not heal, Facial Skin growths with crusts or with discoloration, an insidious runny nose may all be signs of probable cancer.

Today we are extensive knowledgeable about what are the underlying causes of cancer development. Smoking can be said to play a primary role in the development of Throat Cancer. Radiation is known to have significant effects in the development of Thyroid Cancer. After the Chernobyl disaster we have seen significant increases in the numbers of cases of Thyroid Cancers in the Ukraine and Belarus regions. The knowledge that certain habits or practices, such as smoking, can devastatingly harm the health of the human body, could inevitably lead to cancer.

If detected and treated at an early stage the probability of finding a cure is very high. These days, early stage patients’ of head and neck cancers who received treatment have shown a 90% five-year survival rate post treatment.

In the medical world Cancer treatments are referred to as being Multidisciplinary. This is because so many different areas of expertise must work together. The Head and Neck Surgeon will orchestrate cases of head and neck cancers. Treatments may include, mainly surgery, radiotherapy (radiation), more rarely chemotherapy (drug treatment), and sometimes a combination of these treatment may be administered.

The majority of head and neck cancer patients with initial symptoms of an Ear-Nose-Throat (ENT) will go to a specialist physician. The physician will from this moment on will address the situation he is faced with and plan a course of action. This action plan will most probably include using diagnostic tools, general precautions, preparations for the treatment and communicating with the rest of the team involved.

Initially in most cases when the physician suspects that the tissue may be cancerous, their first course of action will be to request that a small piece of the tissue (biopsy) is sent for diagnosis. Ensuing this an endoscopic examination will also be administered and according to the diagnosed results the physician will determine if it is necessary to move onto the next phase of treatment/s.

In the first stage, the diagnoses of the disease is followed by the second stage where further examinations and tests will determine the type of the cancer and at what phase the disease is at so that treatment can be determined accordingly.

At the mention of an Endoscopic Examination, for most people, the type of examination that comes to mind is that the physician will look at the esophagus-stomach and intestines.  However the meaning of endoscopic is to “look inside”.  Today, thanks due opportunities given to us by advanced technology, we have the ability to go into very thin channels and even perform surgery.

The procedure is carried out by the physician using a small camera attached to a thin long tube that can get visual views of nasal and throat areas, which are impossible to reach without the endoscopic procedure.

During the majority of Head & Neck Endoscopic examinations for the most part the patient is seated and usually there is no need for anesthetic application.  When there is a need for a nasal endoscopic examination, the procedure is simple, via the nose, to the nasal cavity located behind the nose by which the physician can gain visual vital information.   Endoscopic examination of the lower throat, pharynx and larynx are achieved by requesting the patient stick their tongue out and entry via the throat gives the physician a visual view of the area/s.

On detection of the presence of Head and Neck cancer, in addition endoscopy, there may be a need for bronchoscopy and esophagoscopy (lower respiratory tract and endoscopic examination of the esophagus) to be scheduled.  Bronchoscopy and esophagoscopy procedures are carried out under either sedation, numbing of the area, or anesthesia, being put to sleep.

As well as indentifying the location of the origin of the cancerous tissue it is also vital to see if the cancer has spread to adjacent organs; in short if the prevalence of cancer is found in that area further investigations, tests may be required.

In some cases besides the original cancer of the head and neck there may possibly be additional cancers that exist.  Due to these possibilities, patients may require furthermore test for diagnosis and more endoscopic examinations.

Unfortunately the answer to this question is ‘No’.  Depending on the nature of the cancer the physician will need to further review the disease.  Additional blood tests may be necessary.  These blood tests are required as check-ups in order for the doctor to follow the patients’ present situation; as yet no cancer-specific blood tests are available.

There are many other complementary tests / check processes that may be required in order to get a full picture of the patients’ situation.  These may often include X-rays, computed tomography, ultrasound, MRI, scintigraphy, PET. The results from these further tests will be reviewed and examined by the specialists and physician giving them knowledge of any remote chance of or prevalence of metastases.

At this stage, the data and results would be consulted among the physicians in order to decide which course of action to take. In light of their medical knowledge and their experiences on the preferences of patients’, the physicians will put forward a big plan as to the type of treatment.

Living with the diagnosis of Cancer is like finding yourself on a painfully long and winding path ahead.  During this period of treatment, all those involved in the life of the patient, including family, close friends, the medical team and the patient themselves will aim to hopefully pass this period with the least of bit of stress and discomfort aiding if possible in ridding the Cancer.  Firstly, in order to complete this enormous path ahead you need to be in the hands of a thoroughly experienced and knowledgeable team.

In most Head and Neck cancer treatments, predominantly, the cancer would involve removal of the cancer by surgery.  As for example, in the case of facial skin cancer treatment, the diseased tissue would be removed surgically and then optimally the repair process will follow. However, radiation therapy for head and neck cancers constitutes another effective alternative option. Today, the share of radiation therapy in the treatment of laryngeal cancer is witnessing a gradual increase. Sometimes one single host method (surgery, radiation therapy or drug treatment) may be sufficient in treating the cancer, but sometimes more effective treatments can be required, thus this may include multiple or joint methods of treatment.

In the treatment process, in case of adverse developments and after care requirements the patient will be co-coordinated to a comprehensive infrastructure of support services and after care follow-ups. This requires a thoroughly good planning process for during, after care treatment solutions and follow-up treatments.

I would advise that this is not necessary, as we have very highly advanced and successful treatments available for cancer patients in our country. Today, technologically modern advanced treatments are available at centers where the physicians are highly qualified and trained comparable to the most highly successful research centers of the world. Additionally, together with the course of treatment, the process of healing is usually more beneficial for the patient to be in their own environment, their home and their own surrounding.

The patient must be made fully aware that certain values will be beneficial during and after treatment. These are – having inner peace with oneself, courage and faith, being made aware by their nearest and dearest that they are of utmost importance. If, the patient believes that certain applications will be beneficial to them, only then on approval by the physician, once it is established that they will not harm the patient can these alternative applications or medicines be considered.

Today, alternative medical practice for the treatment of cancer, although not yet in a place of medical scientific proof, accepted by some scientists is one of the reasons I have written the additional above note.