HEAD & NECK CANCER
Cancer in the Head and Neck region has unique challenges both in its treatment and in the post-operative phase. The treatment of Head and Neck Cancer may temporarily or permanently affect the normal function of anatomical structures that are involved in breathing, vision, hearing, swallowing and speech. It can also involve a permanent change in a patient’s appearance which may affect their interaction with the society that surrounds them. When a patient has completed their treatment, oral rehabilitation with dentures or implants may be required to restore their teeth to a balanced functional occlusion (bite).
The most common type of Head and Neck Cancer is Squamous Cell Carcinoma. This type of cancer can affect most of the Head and Neck region. Cancers are commonly located on the skin of the face and neck, tongue, floor of mouth, retromolar area, tonsil, upper and lower jaw. Other types of cancers that affect the Head and Neck region include salivary gland cancers and metastatic cancers from other regions of the body. Oral Cavity Cancer is commonly associated with smoking and excessive alcohol consumption, whereas Skin cancer is associated with prolonged UV exposure in susceptible individuals.
The diagnosis of your cancer will usually involve imaging (including CT scans, MRI scan and a PET scan) and a biopsy which is may be performed under local anaesthetic in an outpatient setting.
All cases of Head and Neck Cancer in the Hunter Region are referred to the Head and Neck Cancer MDT (multidisciplinary team) meeting, which is held weekly. During the meeting, all relevant aspects of a patient’s history is discussed, and a treatment course is recommended. The advantage of an MDT meeting is that the case is discussed with a range of health professionals and allied health practitioners, including surgeons, radiologists, radiation and medical oncologists, speech pathologists and dieticians, with each providing their expertise and experience to the discussion.
If surgery is recommended, the treatment will usually involve:
Wide local excision of the primary lesion:
This involves removal of the lesion with the goal of a clear margin – this means that an area around the tumour is also removed to ensure that there is no residual microscopic tumour trace left after excision.
This involves the removal of lymph nodes that are in the drainage pathway of the affected area.
This addresses the defect after removal of the primary lesion. The extent and complexity of reconstruction is determined by factors including the size and location of the defect.
A tracheostomy (a breathing tube placed in the airway through an incision in the neck) may be used to protect your airway during your initial recovery. This is removed when the team decides that it is safe to do so.
After you have recovered from surgery, you may require further treatment in the form of radiotherapy or chemotherapy. This will be discussed with you as part of your post-operative management.
Dr Tan-Gore is involved in each aspect of your treatment, from the pre-operative assessment and MDT discussion to your treatment and post-operative care in hospital. She is also involved in your follow up care and you should expect regular appointments so that she can continue to monitor your progress and address any concerns you may have.