Continued from previous page.

Cutting-edge technologies for head and neck cancer treatment

At NCCS, the treatment for head and neck cancer involves a judicious combination of surgery, radiotherapy and chemotherapy as determined by a multidisciplinary team. Patients have access to cutting-edge technologies such as minimally invasive robotic surgery, as well as highly targeted radiation therapy and chemotherapy.

“Every decision is made by a panel of 10 to 15 oncologists, all sub-specialised in their own fields. This fact can be reassuring for patients. It actually removes the need to seek a second opinion, as the individualised treatment, tailored both to the patient and the cancer, is based on the consensus of a large panel of sub-specialists, including surgical, radiation and medical oncologists,” says Clinical Associate Professor Tan H​iang Khoon​, Senio​​​r Consultant, Division of Surgery & Surgical Oncology, National Cancer Centre Singapore (NCCS), a member of the SingHealth​ group.​

At various stages, dentists, therapists, dietitians and social workers can also be part of the management team.

NCCS is currently leading a multinational phase 3 trial to investigate one of the roles of a targeted chemotherapy agent nimotuzumab. As many as 19 centres from 11 countries are participating in this trial that is the first head and neck cancer trial of its kind in the Asia-Pacific region. “That truly puts NCCS at the forefront of head and neck cancer treatment,” says Clin Assoc Prof Tan.

Here’s an overview of the main types of head and neck cancer (including throat cancer):

  1. Squamous cell carcinoma: Most head and neck cancers such as oral cancer, laryngeal (voice box) cancer and pharyngeal (throat) cancer fall in this category.​

    • Oral cancer can begin in the lips, gums, behind the molars or wisdom teeth, inside the mouth and cheeks, as well as the tongue. Many oral cancers are discovered during routine dental checks.

    • Laryngeal cancer (cancer of the voice box): The second most common type of head and neck cancer, it occurs in the larynx (or the “voice box”), which is located at the top of the trachea (or “windpipe”). Most cases of this cancer occur in men.

    • Pharyngeal cancer (throat cancer): Throat cancer occurs in the pharynx, which is the hollow tube in the neck that starts behind the nose and finishes at the top of the oesophagus. Hollywood actor Michael Douglas suffered from throat cancer.

  2. Nasopharyngeal cancer (nose cancer):

  3. Also known as nose cancer, this type of head and neck cancer affects the nasopharynx region, which is the upper part of the throat behind the nose. It is linked to the Epstein-Barr virus. Singapore has one of the highest incidences of nasopharyngeal carcinomas in the world.

  4. Thyroid carcinoma:

    The incidence of this type of head and neck cancer has tripled in the last three decades. Doctors are still researching the causes of this increase.

  5. Salivary glands carcinoma:

    This is a rare type of cancer. US Senator and 2008 Republican presidential nominee John McCain is a survivor of salivary gland carcinoma.

  6. Skin cancer and sarcomas arising from the head and neck region:

    This type of cancer is more common in the Caucasian population and is linked to excessive sun exposure.

See previous page for the symptoms and risk factors of head and neck cancer​.​

​Ref: K21