Description
Cancer of head and neck includes several parts but not brain cancer or cancer of the eye.The cancer can start inside the sinuses, behind the nose,in the mouth including tongue,gums and roof of the mouth and back of the mouth and even throat. In rare cases in the glands that makes saliva of the mouth.
Today our guest speaker is going to discuss his cases with us that are related to head and neck cancer.
Résumé
- Head and neck cancers, while collectively named, encompass cancers located in specific areas like the oral cavity, nasal cavity, larynx, and nasopharynx. Excluded are cancers of the eye, brain, and thyroid, as these warrant separate classifications. The incidence of head and neck cancers is highest in India, making it the most common cancer in the country and the sixth most common worldwide.
- Tobacco use, in any form, remains the single most important risk factor for developing head and neck cancers. Alarmingly, there's a growing trend of younger adults (20-40 years old) being diagnosed, primarily due to increased tobacco consumption. This shift is concerning as these cancers traditionally affect older populations.
- A 44-year-old female patient presented with a neck filling, nasal congestion, and epistaxis, leading to a diagnosis of nasopharyngeal carcinoma. Imaging (MRI) revealed a nasopharyngeal mass and bilateral retropharyngeal nodes, confirming the need for a biopsy.
- Nasopharyngeal carcinomas have distinct pathological types: keratinizing (Type 1) and non-keratinizing (Type 2). Type 2, the tissue type in this case, is endemic to certain regions and has a higher risk of distant metastasis.
- Radiation therapy is the primary treatment for nasopharyngeal carcinoma, often combined with concurrent chemotherapy (typically cisplatin). Adjuvant chemotherapy may follow in locally advanced cases. Metastatic disease management depends on the extent of metastasis and patient performance status.
- Radiative planning involves defining target volumes based on the disease stage. The gross disease receives the highest dose, while prophylactic nodal volumes receive a lower dose. Careful planning is crucial to avoid damaging critical structures.
- While cisplatin-based regimens are commonly used, the best chemotherapy regimen varies depending on the cancer's stage and characteristics. Cetuximab and fluorouracil are also utilized in certain protocols.
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