Cancer of the mouth and head and neck region is on the rise due to chewing tobacco and smoking. Usually there is a delay in diagnosis because the patient comes late, or symptoms appear at a late stage or patient is not aware of the symptoms. The delay in diagnosis results in late detection of cancer cases. Studies confirm that survival or cancer cure rate depends on the stage of the disease, early diagnosis and treatment. Despite advances in surgical techniques, radiation techniques and chemotherapy, the overall survival rate is 60%. Those who survive often have to endure major functional, cosmetic, and psychological burden due to inability to speak, swallow, breathe and chew.75% of all head and neck cancer begin in the oral cavity. Early detection of cancer greatly increases the cure rate.
What does the head and neck oncology surgeon do?
A detailed examination of the head and neck region including the mouth from inside is done. The neck is examined for any swelling.
A flexible endoscopy is done to examine the nose, behind the nose, voice box and the food passage. This endoscopy is done under local anesthesia in sitting position and takes 5-10 minutes to perform. The patient can go home after 15 minutes.
At RTTICS, the endoscopes are attached to a special filter called Narrow Band imaging, which enables the surgeon to diagnose cancer without biopsy. This is a great advancement in techniques when comparing the previous ones where the surgeon and patient had to wait for 5 days to get biopsy results.
To diagnose swelling in the neck, a needle is introduced to make a diagnosis which is available within 48-72 hours.
- Swelling in the neck not responding to antibiotics
- Sore throat >6weeks duration
- Hoarseness of more than 3 weeks duration (and or in association with thyroid swelling)
- Lump sensation in throat of 2-3 weeks duration
- Difficulty in swallowing of more than one week
- Ulcers in the mouth of more than 3 weeks duration
- White patches (leukoplakia) in the mouth
- Pain in the ear with difficulty in swallowing
- Paralysis of nerves of the face
- Swelling of the eye
Suspicion should be particularly for patients who are smokers and over the age of 40 years
Dr. Dev Shuvendu Roy
MS, DLO, FRCS, FRCS (ENT), EB Facial Plastic Surgery
Consultant – ENT Surgeon
RTIICS, Kolkata
