How to fight head and neck cancer

April 7-14 is celebrated as Global Head and Neck Cancer Awareness Week. In the wake of this, an oncologist tells us how we can be better prepared to fight this disease.

Head and neck cancer is the sixth most common cancer in the world. In central Asia, it is the most common one.

Smoking, consumption of alcohol, and chewing of tobacco are the main causes. Human Papilloma Virus (HPV) infection is also a risk factor.

Persistent mouth ulcers, painful ulcerative lesion on the lip, a hoarse voice, dysphagia, and lump in the throat are the major symptoms.

The disease can be diagnosed by clinical examination, CT scan, MRI, and biopsy. After the diagnosis and staging of the disease, head and neck cancer is treated through surgery, radiotherapy, and chemotherapy.

In the early stages, the disease is mainly treated by surgery. In certain clinical situations, radiotherapy is the treatment of choice. Bulky tumours are generally best treated with a combination of surgery and radiotherapy. More than 60% of head and neck cancers are advanced locoregional diseases. 

The use of radiotherapy with concurrent chemotherapy has been demonstrated to be associated with survival advantage over radiotherapy alone.

Although platinum-based chemotherapy is a preferred choice of treatment for fit patients, targeted therapies for platinum-unfit patients come with good survival advantages. 

Recently, targeted therapies and immune-oncology drugs have also shown promising results in relapsed cases. 

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That acute lower-back pain could be spinal arthritis

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.






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 For two years, a 34 year old man had been laid low with back pain and found no relief in physiotherapy, painkillers or traction.

The source of his trouble was bilateral sacroilitis, inflammation of the joint which connects the spine with the pelvis, a classical manifestation of ankylosing spondylitis, a form of arthritis that affects the spine.

The condition often remains misdiagnosed as 'simple' back pain for years, said experts."More cases of ankylosing spondylitis are now being diagnosed by physicians.Initially, these cases were missed. The incidence of ankylosing spondylitis is more in men than in women. The prevalence of ankylosing spondylitis in the population is 0.1% 0.9%," said an orthopaedic surgeon .
The disease is more commonly seen in young adults. "We see about 12-14 cases in a month mainly in the 20-40 age group. Patients are generally thin of build and mostly men," Sancheti said. The early signs are, low back pain, multiple joint pains, morning stiffness, reduced chest expansion, he said.

Sancheti hospital will be raising awareness in and around Pune about arthritis through lectures and camps between October 12 and October 20.

Rheumatologist Pravin Patil said, "Ankylosing spondylitis symptoms, especially in the early stages, can be very similar to common back problems.Many people put up with the pain for some time before seeking help. Also, widely available pain killers like Brufen, Combiflam and Voveran mask the symptoms of ankylosing spondylitis."

  "Ankylosing spondylitis is a disease of young adults. It is a systemic disease." Severe hip pain and stiffness are common complaints in patients suffering from it.



"I have been treating ankylosing spondylitis patients for several years. They are being diagnosed more commonly now. They come with severe hip pain and stiffness. Some need hip replacement surgery at around 25 and 40 years of age. The best exercise for them is swimming and yoga," said a joint replacement surgeon who plans to start a support group for such patients.

The disease has a strong family or genetic linkage because 90% carry the gene HLAB27.Smoking and tobacco chewing can cause acute flare ups, said  an orthopaedic surgeon .

"It is a chronic condition with episodes of acute flare ups. It affects the spine, peripheral joints mostly lower limb or weight-bearing joints. Early diagnosis can prevent joint fusion, reducing chronic pain and developing disabling postural deformities," 

   

Pharyngeal Cancer- risk factors,

• Age over 40
• Male sex
• Smoking
• Chewing tobacco
• Heavy alcohol use
• Oral lichen planus (a chronic autoimmune disease manifesting as lacy white patches in the mouth or throat)
• Human papillomavirus infection, especially in oropharyngeal cancers
• Epstein-Barr virus infection, especially in nasopharyngeal cancers
• Southern Chinese or South Asian ancestry, primarily in nasopharyngeal cancers
• Diet low in fruits and vegetables/antioxidants (oropharyngeal/hypopharyngeal)
• Plummer-Vinson syndrome (hypopharyngeal cancer)
• Drinking maté, a stimulant drink common in South America (oropharyngeal cancer)
• Leukoplakia (white patches in the mouth or throat) (oropharyngeal cancer)
• Erythroplakia (red patches in the mouth or throat) (oropharyngeal cancer)
• Chewing betel quid, a stimulant commonly used in parts of Asia (oropharyngeal cancer)