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Head & Neck Cancer

Diseases Description

Nasopharyngeal Cancer

Head & Neck Cancer Surgery in DelhiMeaning: Nasopharynx is a very small area of the Head & Neck area in between our eyes and above the nasal cavity. Due to its proximity to vital nerves and subsites like eyes, visual pathway nerves,. Nasopharyngeal Cancer is a Cancer that starts in the nasopharynx, the upper part of the throat behind the nose and near the base of skul.

Line of Treatment:

CyberKnife: CyberKnife can be used as boost to small critical area close to the eyes or other vital areas to decrease the dose going to the vital areas and subsequent side effects. CyberKnife is also indicated for post primary therapy residual and recurrent disease or Neck node residual or Recurrent disease

Alternate: It is a difficult area to treat and needs precision and excellence. These patients generally present as primary Nasopharynx Mass along with Neck nodes, These patients require Radiotherapy to primary site and Neck nodes along with Chemotherapy. Therefore Linear Accelerator based precision Radiotherapy is required.

Paranasal Sinus and Nasal Cavity Cancer

Meaning: "Paranasal" means near the nose. The paranasal sinuses are hollow, air-filled spaces in the bones around the nose. Paranasal Sinus and Nasal CavityCancer is a disease in which malignant (Cancer) cells form in the tissues of the paranasal sinuses and nasal cavity.

Line of Treatment:
CyberKnife: CyberKnife again is indicated for localized boost, residual or recurrent settings.
Alternate: Surgery is very difficult in view of gross disfigurement. Patients need Radiotherapy in settings of inoperability, post operative cases with residual disease or to decrease the chances of post surgery recurrences.

Lip and Oral Cavity Cancer

Meaning: Lip and Oral Cavity (Tongue/ Floor of Mouth/ Palate/ Gums/Cheek/ Teeth) is one of the important sub site of Head & Neck and is of vital importance as it forms the inlet for our body and responsible for all our nutrition/ taste/ phonation, etc. Lip and Oral Cavity Cancer is a disease in which Cancer (malignant) cells are found in the tissues of the lip or mouth. The oral cavity includes the front two thirds of the tongue, the upper and lower gums (the gingiva), the lining of the inside of the cheeks and lips (the buccal mucosa), the bottom (floor) of the mouth under the tongue, the bony top of the mouth (the hard palate), and the small area behind the wisdom teeth (the retromolar trigone).

Line of Treatment:

CyberKnife: CyberKnife can be indicated in cases where it can be used as an additional boost to deliver higher dose to the primary lesion for more effective response from Radiation at no additional side effects. It can also be used for post treatment small residual/ recurrent diseases and also for recurrence in Neck as isolated Nodal Disease

Alternate: Surgery is one of the important modality of treatment for early stages. But generally due to disfigurement and difficulty in repair of post of defect, now there is a trend of organ preservation wherever possible. In most of the cases linear accelerator based Radiotherapy will be required along with Chemotherapy.. 

Oropharyngeal Cancer

Meaning: Oropharynx is an area that connects Oral Cavity to the upper part of the Neck and forms a small pouch carrying important subsites of Head & Neck. Oropharyngeal Cancer is a disease in which malignant cells form in the tissue of oropharynx.

Line of Treatment:
CyberKnife: CyberKnife can be used as boost to small critical area close to the eyes or other vital areas to decrease the dose going to the vital areas and subsequent side effects. CyberKnife is also indicated for post primary therapy residual and recurrent disease or Neck node residual or recurrent disease. 

Alternate: Surgery is generally difficult in this site and these patients generally need concurrent Chemotherapy and Radiotherapy.  These patients require Radiotherapy to primary site and Neck nodes along with Chemotherapy. Therefore Linear Accelerator based precision Radiotherapy is required.

Laryngeal Cancer

Meaning: Larynx or the Voice Box is one of the most important site of Head & Neck area and helps in phonation. These Cancers generally present early due to early change in voice, apart from other common generalized Cancer symptoms. Cancer that forms in tissues of the larynx (area of the throat that contains the vocal cords and is used for breathing, swallowing, and talking). Most laryngeal Cancers are squamous cell carcinomas (Cancer that begins in flat cells lining the larynx).

Line of Treatment:

CyberKnife: CyberKnife is indicated in cases of post treatment recurrence/ Neck Nodal Recurrence or Post Primary Treatment Residual disease.

Alternate: Surgery/ Radiotherapy and Chemotherapy are indicated for treatment. This is a specialised area which requires the coordinated expertise of ear, nose and throat (ENT) surgeons (otolaryngologists) and oncologist.

Hypopharyngeal Cancer

Meaning: Hypopharyngeal area of Head & Neck is a small area which forms a common junction of the food pipe and wind pipe in the body. Smoking, like lung Cancer, can cause Hypopharyngeal Cancer because it contains carcinogens that alter the DNA or RNA in a dividing cell. Chewing tobacco can have the same effects as smoking and is also linked to Hypopharyngeal Cancer. Heavy alcohol use is linked to Hypopharyngeal Cancer as well.

Line of Treatment:

CyberKnife: CyberKnife can be useful in Small Recurrent Disease, Post Chemotherapy and Radiotherapy Residual disease and Neck Nodal Recurrence.

Alternate: Cancers of this site are common and needs multi disciplinary approach of treatment. Surgery is difficult in such cases and generally combined use of Radiotherapy and Chemotherapy is indicated. Majority of the cases will need fractionated Linear Accelerator based Radiotherapy.

Metastatic Squamous Neck Cancer with Occult Primary

Meaning: There can be situations where patient present with Neck Nodes, but no primary focus of the disease in Head & Neck region even after through investigations from all possible modalities. Metastatic Squamous cells are thin, flat cells found in tissues that form the surface of the skin and the lining of body cavities such as the mouth, hollow organs such as the uterus and blood vessels, and the lining of the respiratory (breathing) and digestive tracts. Some organs with squamous cells are the esophagus, lungs, kidneys, and uterus. Cancer can begin in squamous cells anywhere in the body and metastasize (spread) through the blood or lymph system to other parts of the body.

Line of Treatment:

CyberKnife:  As it requires a wider area to be treated, localized radiation in the form of CyberKnife may not be indicated in the first place.

Alternate: It is treated with Chemotherapy and Radiotherapy.. However, as a boost to Conventional Therapies, for residual disease or for isolated small recurrences long after primary therapy, it may be used. 

Parathyroid Cancer

Meaning: Parathyroid Cancer is a malignant (Cancerous) growth in a parathyroid gland. This Cancer are primarily caused by hypercalcemia (high levels of calcium in the blood), and may affect various parts of the body. People who had head or neck radiation may also be at increased risk. Such radiation exposure, however, is more often connected with thyroid Cancer.

Line of Treatment:

CyberKnife: CyberKnife as boost or for residual or recurrent cases may be indicated. 

Alternate:Surgery is preferred modality for Thyroid Cancers. Chemotherapy and Radiotherapy is indicated in some subtypes. Generally Conventional Radiotherapy is preferred in view of larger fields. Incase of nodal recurrences or gross large disease,