Head & Neck Cancer Treatment in Lucknow
Expert Care at Lucknow Cancer Institute
Head and neck cancers include tumours of the oral cavity, throat, voice box, nose, sinuses and salivary glands. These cancers are among the most common in India, particularly affecting people who use tobacco and alcohol. Dr. Sidharth Pant provides comprehensive treatment using surgery, radiation therapy and chemotherapy in coordination with head and neck surgeons, with focus on cancer control and preservation of speech, swallowing and quality of life.
Head & Neck Cancer Statistics
Understanding the global and Indian burden of head and neck cancers
Global Burden
- 358,000 deaths annually (3.6% of all cancer deaths)
- Male-to-female ratio: 2:1 globally
- Peak age: 60-70 years worldwide
- Highest incidence: South Asia, Southeast Asia, Eastern Europe
- Lowest incidence: Western Africa, Northern Europe
Indian Scenario
- 70,000 deaths annually (8.5% of all cancer deaths)
- Highest incidence: Northeast India (Assam, Meghalaya, Mizoram)
- Lowest incidence: Southern states (Kerala, Tamil Nadu)
- Variation linked to tobacco and betel nut use patterns
- India accounts for disproportionately high share of global cases
Prevention Note
Head and neck cancer is largely preventable through tobacco cessation and early detection through screening. Regular dental check-ups can help detect precancerous changes early.
Common Sites & Types
Head and neck cancers can originate from different anatomical sites
Oral Cavity Cancer (40%)
- Tongue, floor of mouth, buccal mucosa (inside cheek)
- Gums, hard palate, lips
- Most common in tobacco chewers
Laryngeal Cancer (25%)
- Voice box cancer
- Presents with hoarseness, difficulty breathing
- Strongly linked to smoking
Pharyngeal Cancer (20%)
- Oropharynx (tonsil, base of tongue) – HPV-related
- Hypopharynx (lower throat)
- Nasopharynx (upper throat behind nose) – EBV-related
Other Types
- Nasopharyngeal Cancer (10%) – common in Southeast Asia
- Salivary Gland Cancer (5%) – diverse histological types
- Histology: Squamous cell carcinoma (>90% of cases)
What Causes Head & Neck Cancer?
Understanding risk factors is the first step in prevention
Tobacco Use
Strongest risk factor. Increases risk 5-25 times. Includes smoking and smokeless tobacco (gutkha, khaini, paan masala).
Alcohol Consumption
Independent risk factor. Synergistic effect with tobacco. Heavy drinkers have 6-fold increased risk.
Betel Nut Chewing
Causes oral submucous fibrosis (precancerous condition). High risk even without tobacco.
HPV Infection
HPV-16 and HPV-18 strains linked to oropharyngeal cancers. Better prognosis than tobacco-related cancers.
Prevention is Key
Most head and neck cancers are preventable. Tobacco cessation is the single most important preventive measure. Regular dental check-ups and HPV vaccination for adolescents can significantly reduce risk.
Recognize the Warning Signs
Early detection improves treatment outcomes significantly
Oral Cavity Symptoms
- Non-healing ulcer or sore in the mouth (>3 weeks)
- White or red patch (leukoplakia, erythroplakia)
- Persistent pain or numbness
- Lump or thickening in cheek
- Loosening of teeth without dental cause
Throat & Larynx Symptoms
- Persistent sore throat
- Difficulty or pain while swallowing
- Sensation of something stuck in throat
- Hoarseness lasting >2 weeks
- Voice change or loss
Nose & General Symptoms
- Persistent nasal congestion (one side)
- Nosebleeds
- Pain or numbness in face
- Painless lump in neck (lymph node)
- Unexplained weight loss
Emergency Note
Any neck lump, hoarseness >2 weeks, non-healing mouth ulcer >3 weeks, or difficulty swallowing requires immediate medical evaluation. Early consultation can save lives and preserve function.
Diagnostic Work-up
Comprehensive evaluation for accurate staging and treatment planning
Clinical Examination
Detailed oral cavity and neck examination, flexible endoscopy, palpation of neck lymph nodes, and assessment of function.
Tissue Diagnosis
Biopsy of primary lesion, fine needle aspiration (FNAC) of neck nodes, histopathology with immunohistochemistry, and HPV testing in oropharyngeal cancers.
Imaging Studies
Contrast-enhanced CT scan, MRI for soft tissue detail, PET-CT for staging, dental evaluation with orthopantomogram (OPG).
Multidisciplinary Tumor Board
All cases reviewed by team including medical oncologist, radiation oncologist, head-neck surgeon, pathologist, radiologist and nutritionist at Lucknow Cancer Institute.
Comprehensive Treatment Strategy
Personalized treatment based on stage, site, and patient factors
Early Stage (I-II)
- Surgery Alone: Tumour resection with adequate margins
- Radiation Therapy Alone: External beam radiation (66-70 Gy)
- Chemoradiation: Weekly cisplatin + radiation for high-risk cases
- IMRT techniques to minimize side effects
- Focus on organ preservation (voice, swallowing)
Locally Advanced (III-IVA)
- Standard Approach: Concurrent chemoradiation
- External beam radiation: 70 Gy in 35 fractions
- Weekly cisplatin: 40 mg/m² during radiation
- 60-70% cure rates with organ preservation
- Surgery-based approach for resectable tumours
Metastatic/Recurrent (IVB)
- First-Line Palliative Chemotherapy: Platinum-based doublet
- Immunotherapy: Pembrolizumab or nivolumab (PD-1 inhibitors)
- Targeted Therapy: Cetuximab (anti-EGFR antibody)
- Salvage surgery for localized recurrence
- Re-irradiation with stereotactic or IMRT techniques
Treatment Modalities
- Surgery: Resection with reconstruction
- Radiation Therapy: IMRT, SBRT
- Chemotherapy: Induction, concurrent, adjuvant
- Targeted Therapy: Cetuximab
- Immunotherapy: Checkpoint inhibitors
Managing Side Effects & Rehabilitation
Comprehensive supportive care throughout the treatment journey
Pre-Treatment Care
- Dental evaluation and extractions if needed
- Nutritional assessment and counseling
- PEG tube placement for high-risk patients
- Speech and swallowing baseline assessment
- Smoking and alcohol cessation counseling
During Treatment Care
- Mucositis (mouth sores) management
- Pain control with appropriate medications
- Nutritional support (oral supplements, tube feeding)
- Skin care in radiation field
- Infection prevention protocols
Post-Treatment Rehabilitation
- Speech & swallowing therapy
- Dental & oral care with fluoride applications
- Nutritional support and PEG tube management
- Psychosocial support and counseling
- Thyroid monitoring after neck radiation
Prognosis & Survival Rates
Early detection dramatically improves treatment outcomes
Success Story
Early detection dramatically improves outcomes. Stage I oral cancer has >80% cure rate with single-modality treatment. Regular screening and immediate evaluation of warning signs can save lives and preserve function.
Factors Affecting Prognosis
- Stage at diagnosis: Most important factor
- Primary site: Location of the tumour
- HPV status: Better prognosis in HPV-positive oropharyngeal cancers
- Performance status and nutrition: Patient's overall health
- Treatment compliance: Completing prescribed treatment
- Smoking cessation: Continuing tobacco reduces treatment effectiveness
Prevention & Early Detection
Proactive measures to reduce risk and detect cancer early
Primary Prevention
- Complete tobacco cessation (smoking and smokeless)
- Limit alcohol consumption
- Avoid betel nut and areca nut products
- HPV vaccination for adolescents
- Maintain good oral hygiene
- Balanced diet rich in fruits and vegetables
Secondary Prevention
- Monthly self-examination of mouth
- Annual oral cancer screening by dentist/doctor
- Immediate evaluation of warning signs
- High-risk individuals: screening every 6 months
- Regular dental check-ups every 6 months
- Awareness of early symptoms
Screening Recommendation
Anyone using tobacco or alcohol should undergo annual oral cavity examination by a healthcare professional. Early detection through regular screening significantly improves treatment outcomes and quality of life.
Frequently Asked Questions
Common questions about head and neck cancer treatment
Yes, especially when detected early. Stage I-II cancers have 70-90% cure rates. Even advanced cancers can be controlled with modern treatment including surgery, radiation, chemotherapy, and immunotherapy.
Most patients retain their voice. Total laryngectomy (voice box removal) is needed only in advanced laryngeal cancer; even then, voice rehabilitation options exist including voice prosthesis and esophageal speech.
Surgery requires 1-2 weeks hospitalization. Radiation is 6-7 weeks (daily Monday-Friday). Chemotherapy depends on stage - usually 2-3 months for adjuvant treatment. Follow-up continues for 5 years after treatment completion.
Most patients gradually return to normal eating. Swallowing therapy helps during recovery. Some patients need texture modifications long-term. Nutritional support is provided throughout treatment to maintain adequate nutrition.
Absolutely. Continuing tobacco reduces treatment effectiveness by 30-40% and increases recurrence risk by 2-3 times. Smoking cessation support is provided to all patients at our institute.
Immunotherapy (pembrolizumab, nivolumab) is now standard for recurrent/metastatic disease and shows promising results. It works by activating the body's immune system to fight cancer cells and can provide durable responses with fewer side effects than chemotherapy.