Head and neck cancer

Head and neck cancer is the term used to describe a range of cancers that begin in the head and neck region. This can include cancers that arise in the mucosal lining of the mouth, lip, throat, nose and sinuses, as well as skin cancers that start in the head and neck area.

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Types of head and neck cancer

Skin cancers are the most common type of cancer in the head and neck region. Head and neck squamous cell carcinoma (HNSCC) is the most common type of cancer arising from the mucosal lining. Other types of head and neck cancers include adenocarcinoma, mucosal melanoma, parotid tumours, lymphomas and sarcomas.

What causes head and neck cancers?

There are a number of things that can increase a person’s risk of developing a head and neck cancer, but smoking and alcohol consumption are the main risk factors. Other risk factors include increasing age, sun exposure (for head and neck skin cancer), poor oral hygiene and viruses including the human papillomavirus (HPV).

How is head and neck cancer diagnosed?

The diagnosis of head and neck cancer typically begins with a clinical examination and some form of medical imaging, such as a CT scan.  If a suspicious lump is identified, a fine needle aspiration (FNA) will be undertaken. During this procedure, a needle is inserted into the suspicious lump and a sample of cells are removed for testing under a microscope. This can help to confirm if a lump is cancerous and can also provide information on the type of cancer and how aggressive it is.

How is head and neck cancer treated?

Treatment for head and neck cancer depends on the type of cancer, its location and stage. Dr Ch’ng collaborates with other specialists to tailor the management of head and neck cancer for each patient. Following diagnosis, Dr Ch’ng will discuss head and neck cancer cases at a head and neck multidisciplinary team meeting with other surgeons, radiation oncologists, medical oncologists, dentists, speech pathologists, nutritionists, and specialist clinical nurses. The team will review the patient’s diagnosis, staging, general health and social circumstances, and the available treatment options, to recommend an optimal management plan.

Early stage head and neck cancer

If a head and neck cancer is diagnosed early, is small and has not spread to nearby tissue or lymph nodes, surgery or radiotherapy may be the only treatment that is required. Both approaches have similar outcomes (although no randomised clinical trial has ever compared the two). However, surgery has some practical advantages:

  • It is a single treatment
  • It has a relatively quick recovery
  • Patients can make a good recovery with limited impact on their ongoing health and functioning (depending on the site of the cancer)
  • Pathologists can test the tumour to confirm staging and whether cells have spread into the healthy tissue around it.

Advanced head and neck cancer

Most head and neck cancer (>60%) is diagnosed after it has spread to nearby tissue or lymph nodes (stage III), or other parts of the body (stage IV).

Advanced head and neck cancer will usually require a combination of treatments, including surgery, radiotherapy and/or medical therapy (chemotherapy, immunotherapy and targeted therapy).

Some head and neck cancers are better suited to surgery than others. For example, tumours in the lip and mouth may be easier to access than tumours in the throat. As such, the approach to the treatment of advanced head and neck cancer will depend on the size and location of the cancer and may include:

  • surgery, followed by radiotherapy with or without medical therapy
  • medical therapy, followed by surgery and radiotherapy
  • medical therapy and radiation at the same time.

Advances in surgical techniques, including transoral robotic surgery (TORS) and transoral laser microsurgery mean that surgery may have an expanding role in the management of some head and neck cancers, including pharyngeal and laryngeal tumours.

Dr Ch’ng remains at the forefront of these advances and manages head and neck cancers according to latest treatment guidelines and techniques.

Get in touch

If you’d like to know more about our head and neck, plastic or skin cancer surgical services, or if you have a question for Dr Ch’ng, we’d love to hear from you.

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