As an ENT and Head Neck surgeon, I started writing with the aim of spreading awareness. Knowing about prevention gives all of us extra powers.
Key takeaway:
Head- neck cancer treatment needs early diagnosis and management for good results. Know what to look for in your hospital. Ask the right questions before you decide. In this post, I discuss the type of facilities, treatment options a Head neck cancer treatment center will have at a minimum. I also mention the kind of care cancer management requires.
Head Neck cancer treatment overview: How to choose your hospital for cancer treatment?
Head neck cancer is more common in men. Those above fifty years, with a history of smoking, alcoholism, radiation exposure. The risk factors are also things that make recurrence a problem.
Many continue to smoke even after laryngeal cancer surgery through their tracheostomy wound. Substance abuse needs to stop.
Cancer treatment has a lot of scary stories going around. But what you need to remember is, that early diagnosis and treatment helps you fight most of the cancers.
With good cancer treatment, life expectancy increases. For head neck cancer, the mainstay of treatments is surgery, radiotherapy, and chemotherapy. Nowadays Proton treatment is also under evaluation. The last one is available at Apollo Chennai.
Diagnostic set up at the hospital
Diagnostic setup needs the basics of Computed tomography and Magnetic resonance imaging. A PET scan is very helpful too. The in-house pathology department helps to come to a diagnosis as well as management.
What is the role of intraoperative diagnosis and frozen section?
Sometimes surgical margins look free of disease, but under the microscope, the margins are often breached. When this happens postoperatively, we go for radiation or chemotherapy as required.
Depending on the site and grade of the tumor, the gross disease-free margin varies. In the head neck since the area under surgery is often limited with several vital structures, the free margin is even more challenging. The facility of getting a frozen section biopsy report is a boon.
Some diseases may not be suitable for a frozen section biopsy. But the opportunity to confirm a tissue, extent of disease, pathology, resection margins are vital to a successful surgery. In this study, over an 18 month period, 240 cases when analyzed by five consultant histopathologists. the results showed an accuracy of 98.7%. There were only 3 cases with error in diagnosis.
What is the best place for Head -neck Cancer treatment in India?
In the case of or squamous cell cancer, radiation therapy can give excellent results often equivalent to surgery in the early stages.
For later stages, the bulk of the disease makes it difficult for radiation therapy alone to battle the diseases.
This is where a good center with experienced professionals, advanced imaging, providing staging grading facilities help. But often the cost of all this, makes treatment options unreachable for the masses.
Some Government Medical colleges give excellent care when it comes to Head -Neck cancer. All the Medical colleges in the metros like Delhi and Kolkata have excellent facilities and faculty for managing Head -Neck cancer .
At Safdarjung Hospital in New Delhi, where I was trained, it happened like this
The imaging was reviewed as a team.
Management protocols were discussed amongst teachers and students.
Preoperative counseling about lifestyle and the need for regular follow-up and possible need of post-op RT or CT explained. The extent of surgery explained and informed consent taken.
Postoperative lifestyle changes, physiotherapy, and supportive care explained and started before discharge.
Why do you need to follow up at a cancer /tumor clinic?
The surgical wound healing, reconstruction if any and catching relapse/early recurrence.
What really helps if facilities are available in house at the hospital and the manpower to handle the workload. In Kolkata, most of the Medical Colleges are equipped to manage most head neck cancers.
When it comes to private players Apollo hospital has an excellent setup. But TATA Medical Centre has a good method of offering good payment packages, which help many plans for the expenses for their surgery.
Many of my patients, two of my relatives and a friend underwent treatment at the facility and all of them were very happy with the entire process from diagnostic workup to postoperative management.
The best part is they have a setup for relatives to stay ( at a cost), close to the hospital.
This is especially useful when the patient is undergoing outpatient or daycare chemotherapy or radiation therapy and lives outstation
When it comes to illness and disease like cancer, we need to balance the comfort of the patient, making it easy and transparent and balancing the cost of medicine and technology.
Until India, as a country makes this a part of the Ayushman Bharat healthcare plan the Socialistic healthcare schemes may become unsustainable.
Free often leads to total erosion of resources. What we also need is stopping the production, sale, and use of all addictive cancer-causing substances. Because that may be the most important step to make health for all possible.
Effect of alcohol on ear, nose, and mouth
Reference: 1. Garrett K L, McNeal J E, Cohen R J. Intraoperative lymph node staging of prostate cancer: the case against. ANZ J Surgery 200373263–266. [PubMed] [Google Scholar]
2. Hung W ‐ K I, Chan M C M, Chong S F. et al Sentinel node biopsy in breast cancer: report of 50 cases using combined isotope and blue dye mapping. Annals of the College of Surgeons of Hong Kong 2002653–57.
3. Intraoperative diagnosis using the frozen section technique.C A Evans, S K Suvarna.J Clin Pathol. 2006 Mar; 59(3): 334. PMCID: PMC1860336
I really did not know about this disease,helpful post indeed.
Glad you found this helpful Jyotirmoy