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ENT, HEAD AND NECK CANCER (ONCOLOGY)
“Oncology”
is
the
branch
of
medicine
that
deals
with
tumour
or
cancer.
A
“tumour”
can
be
malignant
(cancerous) or benign (non-cancerous).
Therefore,
ENT
Oncology
deals
with
tumours
in
the
ear,
nose,
mouth,
throat
and
the
head,
salivary
glands,
neck (including voice box/larynx and thyroid) regions.
The
number
1
head
and
neck
cancer
in
Malaysia
is
nasopharyngeal
cancer
(NPC)
.
Other
common
cancers
include oral cavity cancers (eg. tongue, floor of mouth, buccal region).
Based
on
the
2006
Malaysian
Cancer
Registry,
the
commonest
Head
&
Neck Cancers (by frequency) were:
1.
Nasopharyngeal Cancer (NPC) (981 cases)
2.
Thyroid Cancer (891)
3.
Oral Cancer (428)
4.
Laryngeal Cancer (216)
5.
Salivary Gland Cancer (142)
6.
Pharyngeal Cancer (113)
7.
Sinonasal Cancer (113)
The
commonest
histological
type
of
ENT,
head
and
neck
cancer
is
squamous
cell
cancer
(SCC).
Though
cancer
can
arise
in
anyone
(unfortunately),
tobacco
smoking,
excessive
alcohol
intake,
betel
nut
chewing
are major risk factors for cancers in the ENT, head and neck regions.
ENT,
head
and
neck
cancer
symptoms
largely
depend
on
the
location
on
the
tumor
or
the
involved
organ
in
the spread (medical term “metastasis”) of the cancer. Symptoms can include but not limited to:
•
non-healing and/or painless ulcer in the mouth
•
bleeding ulcer
•
persistent red or whitish patch in the mouth
•
progressive/persistent hoarse voice
•
progressive/persistent pain or difficulty swallowing
•
nose/ear bleeds and blockage, especially if one sided and persistent despite treatment
•
progressively enlarging mass/lump in the neck
•
skin lesions or moles that change color or increase in size
Early
detection
while
the
cancer
is
still
in
its
early
stage
offers
the
best
chance
of
cure.
A
full
video
endoscopic
examination
of
the
upper
aerodigestive
tract
via
flexible
nasopharyngolaryngoscope
(FNPLS)
is
usually
warranted.
Narrow
Band
Imaging
(NBI)
endoscopy
also
offers
an
extra
advantage
in
the
early
detection of cancer lesion.
Occasionally,
endoscopic
examination
of
the
bronchus
(bronchoscopy)
and
esophagus
(esophagoscopy)
may
be
needed.
If
a
sweliing
is
present
eg.
in
the
salivary
glands,
neck
lymph
nodes,
thyroid
gland,
a
Fine
Needle
Aspiration
Cytology
(FNAC)
is
also
commonly
performed
to
assess
the
nature
of
the
swelling.
Diagnosis
is
usually
made
after
a
biopsy
of
the
tumour
with
a
histopathological
report
to
confirm
the
cancerous
nature
of
the
tumour.
Further
investigations
can
include
CT
scans
and/or
MRI
of
the
relevant
regions
to
delineate
the
extent
of
the
local
tumour.
It
is
also
important
to
exclude
spread/metastasis
to
nearby lymph nodes (eg. cervical/neck lymph nodes) and distant sites (eg.lung, liver, verterbra)
Treatment
is
very
much
tailored
to
the
extent
of
local
cancer
disease
and
the
stage
of
spread
of
the
disease
to
the
rest
of
the
body.
Treatment
can
be
in
the
form
of
surgery,
radiotherapy,
chemotherapy,
either
as
a
sole modality or combined approaches, depending on the type of cancer
Cancer of the right salivary (parotid) gland
Another case of cancer involving the neck
lymph nodes - just before surgery
A normal endoscopic view of the
area behind the nose
(nasopharynx) - a common area
where the nasopharyngeal cancer
(NPC) begins.
This is how nasopharyngeal cancer/carcinoma
(NPC) looks like under the microscope.
This is how a nasopharyngeal mass can look
like on the nasal video endoscope
Vincent’s S.C.A.N.S
Ear, Nose and Throat (ENT), Head and Neck Surgery
Specialist Clinic
Copyright Vincent Specialist Solutions Sdn Bhd 2016. All rights reserved
Last update: 10/1/13
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D
R.
V
INCENT
T
AN
Consultant Ear, Nose and Throat, Head and Neck Surgeon,
MD (UKM), MS ORL-HNS (UKM), DOHNS RCS Edinburgh (UK), MRCS Edinburgh (UK), Postgrad. Cert.in Allergy (UK), A.M. (Mal),
Fellowship in Rhinology (Singapore)
Fellowship in Head and Neck Oncology & Surgery (Amsterdam)
+603-3377 7864
+6012-3760 728
ENTdrvincenttan@gmail.com
