Head and neck cancer can be found in the lip, mouth, inside the nose, paranasal sinuses, pharynx, and larynx
It is the sixth leading cancer by incidence worldwide, with 500,000 new cases a year. Head & Neck cancer is strongly associated with certain environmental and lifestyle risk factors, including tobacco smoking, alcohol consumption, UV light, particular chemicals used in certain workplaces, and certain strains of viruses, such as human papillomavirus. Head & Neck Cancer can often spread to the lymph nodes of the neck, and this can be the first (and sometimes only) sign of the disease at the time of diagnosis. Head and neck cancer is usually treated with either surgery, chemotherapy, radiotherapy or a combination.
The principle aims of surgery is to clear the disease and, where required, reconstruct the resulting defect. Where the disease is centered around the voice box , this is often treated with a laser and this allows surgeons to remove disease without external incisions . There follows a rehabilitative phase where the patients are seen by Allied Health Professionals, i.e., Speech and Language Therapists who assist with speech and swallowing; Dietitians who ensure that nutritional intake and hydration is adequate and prevent weight loss as all of these have a major impact on healing and recovery. Throughout the cancer journey patients’ are supported by a Head and Neck Clinical Nurse Specialist who acts as Key Worker coordinating their care.
The aim of chemotherapy is to reduce the size of the tumour. Chemotherapy can be given prior to radiotherapy or in conjunction with radiotherapy as a first line treatment. When given in conjunction with radiotherapy, chemotherapy is generally given as two five day cycles , with a two week break between each cycle. It may also be given in a smaller cycle immediately prior to or at the same time as radiotherapy. It can also be given as a secondary treatment, following surgery, to make sure that the surgical area is completely free of cancerous cells; a “belt and braces” approach.
This form of treatment can be used alone or after surgery or in conjunction with Chemotherapy. The treatment is usually over a six week period, five days a week and each session usually lasts about 30 minutes. It is used extensively in oropharyngeal cancer. It involves lying on a bed with a mask on, so that the radiation can be delivered to the correct area.
As with surgery, both Chemotherapy and/or Radiotherapy treatment may result in dietary and swallowing difficulties so there is close monitoring by Speech Therapists and Dietitians both during, and after completion of treatment, to help with side effects. The C.N.S. remains a Key Worker throughout cancer journey supporting all aspects of patients care.