Head and Neck tumor
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Head and Neck tumor
The most common cancer in Indian men, largely linked to tobacco and betel nut chewing.
Head and Neck Radiation Therapy (RT)
- Definition: Radiotherapy used to treat cancers in the head and neck region, including the oral cavity, pharynx, larynx, salivary glands, nasal cavity, and sinuses.
- Purpose: Can be used curatively or palliatively, depending on the stage and extent of the disease.
Common Sites Treated
- Oral cavity (cheek, tongue, floor of mouth, gums, hard/soft palate)
- Pharynx (nasopharynx, oropharynx, hypopharynx)
- Larynx
- Salivary glands (parotid, submandibular, sublingual)
- Nasal cavity and paranasal sinuses
- Lymph nodes in the neck (regional lymphatic spread)
Common causes and Risk factors
Cause
Details
Tobacco Use (Smoking and Smokeless)
Most significant risk factor in India; includes gutkha, khaini, paan, bidis, cigarettes
Alcohol Consumption
Synergistic with tobacco; increases cancer risk, especially in the oral cavity and pharynx
Betel Quid (Areca Nut) Chewing
Common cultural practice; strongly linked to oral submucous fibrosis and oral cancer
Poor Oral Hygiene
Chronic irritation and infection may contribute to carcinogenesis
Human Papillomavirus (HPV)
Increasingly recognized in oropharyngeal cancers (especially in younger, non-smoking patients)
Occupational Exposures
Exposure to wood dust, asbestos, certain chemicals (e.g., in leather or textile industries)
Nutritional Deficiencies
Low intake of fruits, vegetables, and vitamins (especially A, C, and E)
Immunosuppression
HIV/AIDS or post-transplant patients may have increased risk
Genetic Susceptibility
Family history and certain polymorphisms may play a role
Treatment Duration
- Curative treatment (typically EBRT or VMAT/ IGRT/ IMRT) for head and neck cancers usually involves daily treatment (Monday through Friday) over 6–7 weeks.
- Postoperative radiation is often prescribed for patients who have had surgery to remove the tumor but are at high risk for recurrence (e.g., stage 2/3/4, close surgical margins, positive lymph nodes).
- Palliative radiation is shorter, often using hypofractionated regimens (e.g., 8 Gy x 1 or 20 Gy in 5 fractions).
Treatment Approach
- External beam radiotherapy (EBRT): The most common form of treatment, including IMRT, VMAT, or IGRT
- Chemoradiation: For definitive and certain advanced cases, chemoradiation may be used to enhance the efficacy of radiation.
- Nutritional support, Dental prophylaxis, Deaddiction support, Mouth opening exercises form important pillars for supportive care.
Side Effects
- Acute: Mucositis, dry mouth (xerostomia), dysphagia (difficulty swallowing), fatigue.
- Chronic: Long-term xerostomia, thyroid dysfunction, mandibular osteoradionecrosis, hearing loss (due to proximity to the ear).