Head and Neck Cancer Treatment in India

Head and neck cancers include several types. To list a few are the cancers of your mouth, throat, and other neck and head parts. A persistent sore throat is one of the most common symptoms you’ll ever come across. These cancer types are preventable if you avoid consuming tobacco, limit your alcohol intake, and get your HPV vaccine on time. The mainstay for head and cancer treatment usually comprises surgeries followed by adjuvant radiation therapies and other supportive therapies. The head and neck cancer treatment usually requires a multidisciplinary approach, including the collective efforts of several departments, such as surgical, medical, radiation oncology, radiology, pathology, and other allied services.

Understanding Head and Neck Cancer

Head and neck cancer is a broader term that includes several types starting in the head and neck regions. Mostly, they start in the squamous cells of your mouth, voice box, throat and oral cavity. Medically, they are called head and neck squamous cell carcinoma (HNSCC).

Common Types of Head and Neck Cancers

Cancers of your throat, mouth, and other related structures fall under head and neck cancer types:

• Oral Cancer: This category includes cancers of your gums, lips, tongue, cheeks, and lips.
• Salivary Gland Cancer: This category includes cancer affecting your salivary glands. 
• Nasal Cavity and Paranasal Sinus Cancer: This category includes cancers forming hollow areas deep within your nasal cavity or those around the hollow bone spaces of your paranasal sinuses.
• Nasopharyngeal Cancer: This category includes cancers of your nasopharynx 
• Oropharyngeal Cancer: This category includes cancers of the middle of your throat or oropharynx, including your tonsil region and tongue base.
• Laryngeal Cancer: This category includes cancers of your larynx containing your vocal boxes.

Symptoms and Early Signs

You need to understand and determine the early signs and symptoms of your head and neck cancers. Symptoms are subject to experiences that an individual reports, such as feeling tired or nauseated. Early signs and symptoms could also be dependent on several life stages like pregnancy, infections and other underlying health concerns.

Symptoms to Watch Out For

1. Mouth and Throat: A lump present in your neck or a sore in your mouth could be early signs. These signs are persistent for a longer duration and do not heal as quickly as you expect them to. Other symptoms may include loose teeth, hoarse voice, painful swallowing and bleeding in the mouth.
2. Nose and Sinuses: A stuffy nose and nosebleeds are common signs of head and neck cancers. Watch out if you are frequently suffering from sinus infections that do not respond well to your treatment.
3. Others: Difficult breathing, ear pain, and an unexplained loss of weight are included among the other signs and symptoms of your head and neck cancers.

Early Signs and Importance of Recognition

Early detection of your head and neck cancers is crucial and supportive in improving your treatment outcomes. These early detections help you in increasing your survival rates. Common early signs are inclusive of:

• Persistent Sore Throat: A sore throat that takes time to heal or does not resolve.
• Unexplained Weight Loss: If you are losing your weight without undergoing any strict changes or alterations to your diet.
• Voice Hoarseness: Persistent voice hoarseness or changes to your voice quality.
• Lumps or Swelling: Lumps or swelling in your face or neck, particularly if they persist for a longer time.
• Pain in the Ear or Hearing Loss: Pain in your ears or losing your ability to hear.
• Nasal Blockage or Nosebleeds: Frequent nasal blockages or nosebleeds.
• Difficult Swallowing: Painful or difficult swallowing or a constant feeling of having something stuck in your throat.
• Loose Teeth: Having loose teeth or dentures.

Risk Factors for Head and Neck Cancer

The key risk factors for causing head and neck cancers are:

1. Use of Tobacco: Both smoking and smokeless tobacco put you at great risk of head and neck cancer.
2. Alcohol Consumption: Drinking alcohol puts you at risk of head and neck cancer risk.
3. Tobacco and Alcohol Together: The combined effects of the two produce a substantial risk of head and neck cancer.
4. HPV 16 and HPV 18 Infections: HPV, or Human Papilloma Virus, has a strong link with head and neck cancer, too.
5. Age and Gender: Head and neck cancers are mostly seen in patients over 40 years of age.
6. Betel Quid and Gutka: People continuously chewing gutka or betel quid are at an increased risk of thyroid and salivary gland cancers.
7. Ultraviolent Light: People spending more time in the sun are more prone to skin and lip cancers.

Other Risk Factors: Epstein-Barr Virus, weakening immune system, genetics, long-term exposure to cancer-causing substances and radiation, salt-cured foods, and poor oral hygiene are among the other risk factors.

Diagnostic Procedures

Early and accurate diagnosis of head and neck cancers is crucial for initiating the treatment early. Hospitals across India are equipped with all essential facilities and state-of-the-art technologies and software for handling such emergencies.

Key Diagnostic Tests

• Physical Examination: Your head and neck cancer will usually start with the physical assessment of your head and neck region. While performing your physical examination, your surgeon will assess your nasal cavities, mouth, neck and throat. They may even assess your lips, neck, cheeks, and gums.
• Endoscopy: In this endoscopy procedure, a thin and lighted tube is passed through your nasal cavity, voice box, and throat.
• Imaging Tests:

X-rays, CT scans, PET Scans, and MRI Tests: These tests are used to detect the tumours deep inside your body.

• Lab Tests: Your otolaryngologists will even ask you to undergo HPV tests to determine the presence of HPV viruses causing cancerous growth.
• Biopsy: A biopsy is a procedure performed to confirm whether your tumour is cancerous or not. To determine this, your otolaryngologists will remove a small part of your tumour tissue and send it to the pathologist for confirmation.

Each of these comprehensive tests is performed at different cancer stages to support your otolaryngologists with the determination of the best treatment regime for you.

Head and Neck Cancer Treatment in India

India is equipped with multiple private and governmental hospitals for treating several types of head and neck cancers. The treatment of different cancer types depends on their locations and stages. Your health condition too is important in determining what type of treatment should you undergo. The usual treatments performed for head and neck cancers in India include:

Surgical Procedures

Whenever possible, your surgeon will ask you to undergo a surgical removal of cancerous growth in your head and neck. This may even involve removing a part of the surrounding healthy tissue.

1. Flexible Robotic Surgery: With flexible robotic surgery, your surgeon will be able to reach the hard-to-access areas of your mouth and throat. This surgery comes under the minimally invasive option using a flexible scope.
2. Vocal Cord Stripping: Your surgeon performs a vocal cord stripping to remove your vocal cord’s outer layers. It is usually done to obtain a biopsy of the sample. It is also a better option for treating stage 0 of your head and neck cancers related to vocal cords. It may or may not impact your speech.
3. Laser Surgery: In this surgery, your doctor will use an endoscope equipped with a high-intensity laser on its tip. This endoscope goes straight down your throat to either cut or vaporise your tumour there.
4. Cordectomy: Cordectomy is a procedure where your entire vocal cord is removed. It is mainly used to treat glottic cancer. It is a small cancer located on your surface tissues. You may experience a change in your speech after undergoing this surgical correction.
5. Laryngectomy: In this procedure, a part or entire portion of your larynx is removed.
   • Partial Laryngectomy: This is usually done for small cancers where there is no need to remove your entire larynx.
   • Total Laryngectomy: This is usually done to remove your entire larynx. This procedure involves the removal of your entire larynx. It is also known as tracheostomy.

Radiation Therapy

Currently, radiation therapy is a type of cancer treatment option in India involving the use of high-energy beam particles. These beams, on reaching your tumour, destroy the cancerous growth, thereby damaging their cellular DNA.

• Proton Therapy: Radiation containing proton beams is used in this therapy. Unlike photons, these protons do not penetrate deep within your tumours. Hence, they are most likely to cause minimal side effects.
• Intensity-Modulated Radiation Therapy (IMRT): This therapy is a combination of approaches of a metallic device called a collimator with that of a highly advanced computer program. Such tools shape the radiation beam reaching its target according to its exact dimensions.
• Image-guided intensity-modulated Radiation Therapy (IG-IMRT): This therapy uses imaging tests like MRIs, CTs, and PETs. These imaging techniques, when combined with special computing software, optimize the real-time radiation delivery to the exact treatment site.
• Adaptive Radiotherapy: In adaptive radiotherapies, your surgeon will revisit your treatment plan to keep them modifying as many times as they see changes in the precisions of radiation.
• Stereotactic Body Radiotherapy (SBRT): SBRT, in combination with IGRT or some more advanced techniques, is highly effective in delivering high radiation doses to your affected site. It minimizes the dosing to the surrounding healthy tissues.
• Brachytherapy: This therapy involves placing radioactive material inside your body. This material is then sealed within a seed, pellet, or capsule with the support of a catheter or a needle. This radiation damages the DNA of the nearby cells, too.

Systemic Therapies

• Chemotherapy:

Chemotherapy treatment uses powerful chemotherapeutic drugs to attack cancerous cells. Cisplatin is the most commonly recommended chemotherapeutic drug.

• Targeted Therapy: 

Targeted therapies are tailored treatments to the specific differences in the genes found within individual tumours. A technique called genomic testing identifies such genetic changes. This technique is also referred to as molecular profiling or tumour sequencing.

• Immunotherapy:

Certain drugs empower your immune system to recognise and fight cancerous cells. These therapies, called immunotherapies, are recommended for advanced stages. There are two FDA-approved drugs for using this therapy for head and neck cancers called nivolumab and pembrolizumab.

Current Protocols and Guidelines

There is an India-specific guideline available for head and neck cancer management. These guidelines emphasize early diagnosis of cancers and a multidisciplinary approach. It also integrates palliative care.

It highlights how important the standardized diagnostic protocols are. It also talks about advancements in surgical techniques, such as robotic surgeries and other personalized treatment plans.

Advanced Cancer Treatment For Throat Cancer in India

The top cancer care hospitals across India are equipped with the best tools and techniques for improving precision and reducing surgical complications.

Here are the advanced treatment options available for head and neck cancer:

1. Immunotherapy:
   • Immunotherapy for head and neck cancer involves the use of Dostarlimab, Nivolumab, and Pembrolizumab immunomodulators. This therapy triggers an individual’s immune system to kill the cancerous cells.
2. Precision Medicine:
   • Precision medicine is an emerging therapeutic approach for head and neck cancers. It is a promising approach based on the patient characteristics and tumour profiles of individual patients. It leverages the advancements in molecular biology, genomics, and bioinformatics for identifying specific genetic mutations.
3. Concurrent Chemoradiotherapy (CTRT):
   • Definitive concurrent chemoradiotherapy (CTRT) is standard care for inoperable locoregionally advanced stages of head and neck cancer. In this therapy, cisplatin is the most common chemotherapeutic drug used in conjunction with radiation therapy.
4. Advanced Radiation Therapies:
   • Advanced Radiation Therapies include procedures such as IMRT, Proton therapy, IGRT, adaptive radiotherapy, and brachytherapy.

Key Considerations

• Multidisciplinary Approach: Head and neck cancer treatment involves a comprehensive multidisciplinary approach. It is inclusive of your surgeon, family doctor, clinicians, physiotherapists, dietitians, and speech therapists.
• Clinical Trials and Research: Participation in several clinical trials offers you easy access to several innovative treatments that may not be widely available.
• Genomic Testing and Personalized Treatment: These therapies are gaining popularity. Both techniques analyze the genetic makeup of your tumour. This helps your doctor identify specific mutations responsible for driving the growth and spread of cancers.

Such advanced treatment options continuously evolve the landscape of head and neck cancer management across India. It majorly focuses on its precision, effectiveness, and quality of life.

Best Doctors for Head and Neck Cancers in India

Surgical Oncologists

1. Dr. Harit Chaturvedi
   Hospital: Max Super Speciality Hospital
   Location: Saket, New Delhi
2. Dr. S P Bhanot
   Hospital: Bhanot Hospital
   Location: Gurgaon
3. Dr. Surender Kumar Dabas
   Hospital: BLK-Max Super Speciality Hospital
   Location: New Delhi
4. Dr. Anil K D’Cruz
   Hospital: Apollo Cancer Centre
   Location: Mumbai
   Dr. Vedant Kabra
   Hospital: Fortis Memorial Research Institute
   Location: Gurgaon
5. Dr. Ravi Chander Veligeti
   Hospital: Medicover Cancer Hospital
   Location: Hitech City, Hyderabad
6. Dr. Rakesh Reddy Jillela
   Hospital: Dharamshila Narayana Superspeciality Hospital
   Location: Delhi

Radiation Oncologists

1. Dr. Kaustav Talapatra
   Hospital: Nanavati Max Super Speciality Hospital
   Location: Mumbai
2. Dr. Kannan S
   Hospital: Apollo Specialty Cancer Hospital
   Location: Chennai
3. Dr. Aniruddha Vidyadhar Kulkarni
   Hospital: Nanavati Max Super Speciality Hospital
   Location: Mumbai
4. Dr. S. Jayalakshmi
   Hospital: Artemis Hospital
   Location: Gurgaon

To know more about the top, read the Best Throat Cancer Doctors in India

Best Hospitals for Head and Neck Cancer in India

1. Max Hospital, New Delhi
2. Kokilaben Dhirubhai Ambani Hospital, Mumbai
3. Tata Memorial Hospital, Mumbai
4. Artemis Hospital, Gurugram
5. SIMS Hospital, Chennai
6. Yashoda Hospitals, Hyderabad
7. HCG Cancer Centre, Bengaluru
8. Nanavati Max Super Speciality Hospital, Mumbai
9. Fortis Memorial Research Institute (FMRI), Gurugram
10. Indraprastha Apollo Hospital, New Delhi
11. Apollo Proton Cancer Centre, Chennai
12. Max Super Specialty Hospital, Saket, New Delhi
13. Medanta – The Medicity, Gurugram
14. Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad
15. Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), Delhi
16. Mazumdar Shaw Cancer Center, Bengaluru

These are some of the best hospitals for head and neck cancer treatment in India.

Rehabilitation and Post-Treatment Care

Rehabilitation and post-treatment care for head and neck cancers emphasises restoring function and managing complications. It helps significantly in improving the quality of a patient’s life. This rehabilitation procedure includes speech therapy, physical therapy, nutritional support, and psychological support. Sometimes, your surgeon may even recommend reconstructive surgeries and prosthetics to address the physical changes caused by head and neck cancers.

Key Aspects of Recovery

• Physical Therapy: It is instrumental in addressing issues such as muscle stiffness and weakness often caused by surgery, chemotherapy, and radiation. It involves exercising to improve the range of motion, posture, and strength.
• Speech Therapy: It is quite beneficial for patients finding it difficult to speak and swallow.
• Nutritional Support: It addresses the nutritional deficiencies to help the patients maintain or regain their weight and energy levels.
• Occupational Therapy: It supports patients by adapting changes in their daily activities such as bathing, dressing, and eating.
• Psychological Support: It supports the patients in addressing their emotional and psychological challenges related to their diagnosis and treatments.
• Reconstructive Therapy and Prosthetics: It is used in repairing and reconstructing tissues damaged by cancers. Artificial devices such as facial prosthetics and dentures are used to replace teeth or alleviate facial deformities.

Preventive Measures and Risk Reduction

Not all stages of head and neck cancers are preventable so that lifestyle alterations can bring about a significant risk reduction.

• Avoiding Tobacco: Both smoking and chewing tobacco are at increased risk of causing head and neck cancers.
• Limiting Intake of Alcohol: Like tobacco, alcohol too is a carcinogen, especially when you combine it with tobacco.
• HPV Vaccination: The HPV vaccine is both safe and effective for preventing you from developing HPV-related oropharyngeal cancer.
• Safe Sexual Practices: Reduce exposure to HPV.
• Regular Screenings: High-risk individuals should continuously go for regular cancer screenings to detect their cancer risks early.

Healthy Diet: All you need to support your immunity and overall health functioning is a diet rich in both fruits and vegetables.

Why Choose India for Head and Neck Cancer Treatment?

India offers a wide range of attractive options for treating your head and neck cancers. The treatment options and centres available across India are affordable and equipped with state-of-the-art technology and medical support. Moreover, they have skilled professionals. Patients from across the world find India a convenient head and neck cancer treatment location for:

Affordability in the healthcare system includes lower hospitalisation fees, travel costs, medication costs, and accommodation costs.

Hospitals in Mumbai, such as Tata Memorial Hospital and HN Reliance Foundation Hospital, are popular for their advanced cancer treatments. They are equipped with state-of-the-art technology, such as robotic-assisted surgery options and precision radiation therapies.

The cancer care centres in Mumbai prioritise personalised treatment plans that incorporate cutting-edge technology therapies such as targeted therapies and immunotherapies.

Indian hospitals are increasing their focus on improving patients’ quality with advanced reconstructive therapies for addressing both the form and functioning of the damaged parts.

India is leading in the research and development of several treatments and technologies for treating head and neck cancers. It includes exploring the scope of digital health technologies, precision medicines, and several other collaborations between oncologists and other key professionals.

Taking the First Step Toward Recovery

Taking your first step towards recovery of head and neck cancer in India involves a multidisciplinary approach. It includes surgery, radiation, and chemotherapy, depending on its location and the stage. Early detection with prompt intervention and treatment is essential in improving the quality of a patient’s life. Rehabilitation and support services may also be beneficial for your long-term recovery and well-being.