Head neck cancer is an important health problem with considerable high morbidity and mortality. Early detection and timely treatment result in an improved prognosis. Creating awareness among clinicians and the general public is important to achieve control of head neck cancer thus reducing its disease burden.
July 27th is celebrated as world head neck cancer day. It was announced during the opening ceremony of the combined meeting of the International Federation of Head Neck Oncology Society (IFHNOS) 5th world congress and American Head Neck Society (AHNS) on 27th July 2014 in New York while celebrating the 100th anniversary of the Head Neck program at Memorial Sloan Kettering Cancer Centre (MSKCC). The meeting was attended by more than 3200 delegates from 90 countries and was the largest gathering of head neck cancer specialists in history. I was fortunate enough to witness this historic moment when this important step was taken. A petition to make 27 July as world head neck cancer day was circulated online and was signed by more than 3000 people. Union for International Cancer Control (UICC) also supports this campaign to create awareness about this cancer which is largely a preventable disease.
India has a high disease burden of head neck cancers. Oral cancer which is the most common cancer in males and the 4th most common cancer in females in our country is a type of head neck cancer. Other cancers which come under the category of Head Neck cancers are cancers of the voice box, oropharynx, hypopharynx, nasopharynx, thyroid and parathyroid, neck, maxilla, nose and paranasal sinuses, ear, parotid and other salivary glands.
The principal cause of Head neck cancer is the consumption of tobacco and alcohol. Tobacco can be smoked in the form of cigarettes and bidi or chewed in the form of gutka, pan, pan masala etc. Supari or areca nut is another agent responsible for oral cancer and is often taken along with tobacco. Tobacco when consumed in any form is dangerous. Importantly, there is no safe level of tobacco. Human Papillomavirus infection is another preventable cause of oropharyngeal cancer and is responsible for a recent increase in the incidence of head neck cancers in the western population. Though It is more prevalent in western countries, anyone who has developed oropharyngeal cancer in the absence of tobacco or alcohol consumption must be investigated for the presence of HPV infection.
Head and neck cancer can be cured if detected early and treated adequately in a timely manner. Multidisciplinary management by site-specific oncologists has shown the best outcomes. Surgery remains the cornerstone of treatment for the majority of the Head Neck sites. However, radiation therapy with or without chemotherapy plays an important role, especially in advanced stages. Often a combined modality treatment is required when the tumour is stage III or IV. Chemotherapy alone or immunotherapy is needed in advanced, unresectable or metastatic disease.
Head neck cancer in our country poses significant health and economic burden as it is increasingly affecting our youth. More and more young people are becoming victims of this deadly disease thus affecting the most productive years of their lives. Indian males develop head neck cancer one or two decades earlier when compared to a western population where it is typically the disease of the elderly. This is because of the early initiation of habits of tobacco and alcohol consumption seen in our country.
We must raise awareness and put an end to this tobacco-related cancer epidemic. Let us spread the word and join the campaign against this preventable disease.
Dr. Shilpi Sharma | Consultant – Head & Neck Surgery – Oncology, Oncology, Surgical Oncology | Narayana Superspeciality Hospital, Gurugram