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Most head and neck (H&N) of cancers are seen in the older patients, commonly those who smoke and drink.  There is new trend noted of human papilloma virus related cancers seen in the younger patients with oropharyngeal (throat) cancers.  The common symptoms H&N cancers are a lump in the mouth, throat, discomfort or pain, occasional bleeding with blood noticed in the saliva or enlarged neck lymph nodes.  They are diagnosed after a careful H&N examination including using a flexible endoscope through the nostril to inspect the different sites in the region.  Biopsies are nearly always needed.  Sometimes a fine needle aspiration cytology (FNAC) can be done especially for the enlarged node(s) in the neck.  Survival depends primarily on the stage of the disease and reliable treatment.  The majority of cases should be discussed in the H&N tumour boards though in some the appropriate treatment is obvious  based on international guideline commonly the National Comprehensive Cancer  Network (NCCN) guidelines.

In general, in early stage disease (stages 1 & 2) the treatment is by surgery removing the primary tumours.  Radiation therapy is however the treatment of choice for tumours of the voice box as the intent is to cure but also to preserve speech.  We achieve control of the disease in a significant number (up to 90% in early laryngeal cancers).  Even in some patients that have failed radiation therapy we are able to do salvage surgery conserving the larynx (Figs 1, 2, 3, 4 and 5).  In the advanced stages (3 & 4) the treatment usually consists of surgery followed by postoperative radiation with or without chemotherapy.  Immunotherapy or photodynamic therapy may be used for recurrent unresectable tumours.



About Doctor

Prof Soo is a senior surgical oncologist specialising in Head & Neck oncology and complex abdominal and soft tissue tumours. In caring for each patient, he brings more than 40 years of experience in the public sector of treating and managing both local and international patients who presented with cancers of all stages and from all walks of life.