Head and Neck Cancer Treatment in India

Head and neck cancer is a type of cancer that begins in the tissues of the head and neck region, including the mouth, throat, sinuses, salivary glands, and larynx. These cancers, which are primarily diagnosed as squamous cell carcinomas, develop from the thin, flat squamous cells that line the surfaces of these structures.

According to the most recent statistics, HNC accounts for around 26% of all cancer cases in men and 8% in women. The chance of having HNC is estimated to be 1 in 33 for men and 1 in 107 for women. This comprises cancers of the oral cavity (mouth), pharynx (throat), larynx (voice box), paranasal sinuses, nasal cavity, and salivary glands. These types of cancer can spread to the lymph nodes of the neck.  The chances of diagnosis are influenced by age, gender, and certain risk factors such as tobacco use, alcohol intake, and HPV infection.

What are the Different Types of Head and Neck Cancer?

Head and neck cancers are a wide range of tumors that begin in various areas of the head and neck and are named after the specific area or type of cell affected. Recognizing the many types of head and neck cancer is essential for early identification, accurate diagnosis, and personalized treatment.

• Oral Cancer: Oral cancer affects areas such as the lips, tongue, and gums, and refers to a group of cancers that occur within the oral cavity. Cancers of the lips, teeth, gums, tongue, inner lining of the lips and cheeks, area under the tongue, roof of the mouth, and the little area behind wisdom teeth are all included.
• Oropharyngeal Cancer: Tonsil cancer is a type of oropharyngeal cancer that occurs in the middle of the throat (oropharynx). It differentiates itself from other head and neck cancers by its location in the throat.
• Hypopharyngeal Cancer: This type of cancer develops in the lower area of the throat (hypopharynx) and is located behind the voice box. Cancer cells are commonly discovered in the tissues of the lower throat.
• Laryngeal Cancer: Affecting the voice box (larynx), laryngeal cancer can take the shape of squamous cell carcinoma (SCC) or other, less prevalent forms, such as cancers of the salivary glands or those emerging from muscle, cartilage, or other structural tissues.
• Nasopharyngeal Cancer: Nasopharyngeal cancer is a rare cancer that develops in the top region of the throat (nasopharynx) behind the nose.
• Salivary Gland Cancer: Cancer cells originate in the salivary glands, which are responsible for creating saliva. These glands can be found right beneath the tongue, on the sides of the face in front of the ears, and under the jawbone.
• Nasal Cavity and Paranasal Sinus Cancer: Cancer of the nasal cavity or the empty spaces around the nose (paranasal sinuses) requires particular treatment.
• Skin Cancer of the Head and Neck: Head and neck skin cancers, such as melanoma, basal cell cancer, and squamous cell cancer, require specific treatment options because they involve cancer cells in the skin’s surface tissue.
• Melanoma of the Head and Neck: Melanoma of the head and neck region arises from melanocytes, the cells that provide skin pigment, requiring special attention due to their particular characteristics and potential for aggressive behavior.
• Sarcoma of the Head and Neck: Sarcomas of the head and neck are defined by cancer cells located in soft tissue structures such as muscles, connective tissues, arteries, joints, and fat.
• Head and Neck Cancer of Unknown Primary Site: When cancer shows as a lump in the neck without an identifiable primary site, further investigation is required to determine the origin. This type emphasizes the significance of a thorough diagnostic evaluation.

What are the Symptoms of Head and Neck Cancer?

Head and neck cancer can present with a variety of symptoms. The symptoms of head and neck cancer might vary depending on where the tumor is located. Some most common symptoms of head and cancer are:

• Persistent sore throat
• Hoarseness or voice changes
• Pain when chewing or swallowing
• Lump in throat, mouth, or neck
• Persistent earaches or infections
• Nosebleeds, bloody saliva, or phlegm
• Mouth or tongue sore that doesn’t heal
• Difficulty swallowing
• Change in voice or new hoarseness
• Unusual bleeding or pain in the mouth, throat, or nose

What are the Causes of Head and Neck Cancer?

A wide range of causes contribute to the development of head and neck cancer, such as:

• Tobacco and alcohol: Tobacco, in various forms such as cigarettes, cigars, pipes, and smokeless products, is a leading cause of head and neck cancer. When paired with alcohol consumption, the risk increases.
• Human Papillomavirus (HPV): HPV is linked to approximately 70% of oropharyngeal cancers, which affect sites such as the tonsils and base of the tongue.
• Ultraviolet (UV) Radiation: Overexposure to ultraviolet (UV) rays, whether from sunlight, tanning beds, or sunlamps, has been identified as a risk factor for lip cancer.
• Occupational Exposures: Certain occupations, such as construction, textile, pottery, logging, and food processing, expose people to chemicals such as wood dust, formaldehyde, asbestos, and nickel. Occupational exposures in these environments enhance the risk of nasopharyngeal cancer, linking the workplace to cancer development.
• Epstein-Barr Virus (EBV) Infection: Infection with the Epstein-Barr virus (EBV), which is known to cause infectious mononucleosis and other disorders, has been associated with an increased risk of cancers in the nasal region, behind the nose, and salivary glands.
• Radiation Treatments: Previous radiation treatments to the head and neck, while intended to be curative, might paradoxically become a causative factor for recurrent head and neck cancers.
• Age and Gender: Head and neck cancers are more common in people over the age of 50, emphasizing age as a risk factor.
• Genetic Changes: The modification of DNA within cells in the head and neck area is at the root of head and neck cancer beginning. These genetic alterations cause abnormal cell growth by disrupting the normal cell life cycle.

What is the Diagnosis of Head and Neck Cancer in India?

Head and neck cancer is diagnosed in India using a systematic method that includes thorough clinical examinations, specific diagnostics, and modern imaging techniques. Some of the diagnostic techniques used for head and cancer surgery in India are:

• Clinical Exams: The diagnostic process begins with a thorough clinical evaluation of the head and neck region. Doctors carefully examine the oral and nasal cavities, as well as the neck, throat, and tongue. Manual palpation is used to detect any unusual lumps or swelling in the neck, lips, gums, and cheeks.
• Imaging Tests: Cutting-edge imaging is essential in identifying the complexities of head and neck cancers. X-rays, CT scans, MRIs, and PET scans produce detailed images of the interior structures, assisting in the evaluation of the cancer’s size, location, and possible spread.
• Lab Tests: Blood samples may be collected for lab testing to investigate problems such as viral infections (HPV or EBV) and biomarker testing. Molecular testing examines proteins that are particular to various head and neck cancers, providing useful information for treatment planning.
• Biopsy Procedures: A biopsy is an essential component of confirming a cancer diagnosis. Tissue samples are extracted for microscopic inspection using several biopsy procedures, including fine needle aspiration and core needle biopsy.
• Specialized Tests: Endoscopies, which are classified according to the location being examined, provide important visual information. Additional tests may be carried out to look into specific viral connections, such as HPV in oropharyngeal malignancies and EBV in nasopharyngeal cancers.

What are the Different Stages of Head and Neck Cancer?

Using the TNM approach, head and neck cancer staging comprises determining tumor size (T), lymph node involvement (N), and metastasis (M). Treatment plans are influenced by the stages, which vary from I to IV. There are staging differences between head and neck cancer types, with special concerns for HPV-positive oropharyngeal tumors.

What are the Different Treatment Options for Head and Neck Cancer in India?

Head and neck cancer treatment in India options are tailored to the exact type, stage, and individual health factors. The primary treatments are:

• Surgery: Surgeons try to remove tumors and surrounding tissue, as well as lymph nodes if necessary. Reconstructive surgery helps to reduce functional impact. Different types of surgeries are performed to treat head and neck cancer in India, such as:
  • Laryngectomy
  • Free Flap Reconstruction
  • Parapharyngeal Mass Excision
  • Thyroidectomy with Neck Dissection Surgery
  • Right Radical Maxillectomy with Reconstruction
  • Partial Glossectomy with Reconstruction
  • Wide Excision with Nasal Reconstruction Surgery
  • Craniofacial Resection Surgery
• Radiation Therapy: Using high-energy X-rays, radiation therapy can be used alone or in combination with other treatments. Its purpose is to destroy remaining cancer cells and reduce symptoms.
• Chemotherapy: A single medicine or a combination of drugs is commonly used to treat advanced-stage head and neck cancers.
• Targeted Therapy: Drugs like Cetuximab address some head and neck cancers by targeting specific cancer-related cells, and are often prescribed when combined with other treatments.
• Immunotherapy: Drugs that boost the immune system’s ability to fight cancer, such as Pembrolizumab and Nivolumab, are used to treat recurrent or metastatic head and neck cancers.
• Clinical Trials: Investigational medicines and therapies are included in ongoing clinical trials, which provide access to cutting-edge advancements.

What is the Success Rate of Head and Neck Cancer Treatment in India?

India has an established Head and Neck Cancer Treatment Unit with a significant success rate of 70-85%. The Oncology Care Unit takes a comprehensive approach, bringing together a multidisciplinary team of highly skilled doctors under one roof. The hospitals in India are outfitted with cutting-edge medical technology and infrastructure, ensuring that patients suffering from head and neck cancer receive the best possible care. The success rate demonstrates the successful outcomes of the treatments, which include surgeries and innovative therapies, highlighting India’s dedication to providing world-class oncological care.

What is the Cost of Head and Neck Cancer Treatment in India?

The cost of head and neck cancer treatment in India is relatively low, ranging from around $2,500 to $20,000 on average. This cost includes all components of treatment, such as surgery, radiation therapy, chemotherapy, and other medical procedures. When compared to many Western countries, India’s healthcare system provides high-quality treatment alternatives for a fraction of the cost. India is an appealing destination for persons seeking effective and cost-effective head and neck cancer treatment because of its affordability, as well as the availability of cutting-edge facilities and experienced doctors.

Top Doctors for Head and Cancer Treatment in India

India has a large number of top doctors who specialize in head and neck cancer treatment. These doctors have received recognition for their skills and for offering comprehensive and cutting-edge care. With a focus on multidisciplinary techniques, these top oncologists use the most recent developments in cancer to ensure the best possible patient outcomes. These doctors and nurses contribute considerably to India’s recognition as a hub for head and neck cancer treatment because of their talent, experience, and dedication to patient well-being.

• Sandeep Batra – Max Super Specialty Hospital Saket, New Delhi
• Ankur Bahl – Fortis Memorial Research Institute, New Delhi
• Praveen Kumar Garg – Indraprastha Apollo Hospitals, New Delhi
• Hari Goyal – Artemis Hospital, Gurgaon
• Niranjan Naik – Fortis Memorial Research Institute, New Delhi
• Sameer Kaul – Indraprastha Apollo Hospitals, New Delhi
• Kamal Verma – Artemis Hospital, Gurgaon
• Suman Karanth Gupta – Medanta-the Medicity, Gurgaon

Best Hospitals for Head and Cancer Treatment in India

Some of the best hospitals for head and neck cancer treatment in India are known for their cutting-edge technology and outstanding medical care. These hospitals emphasize a multidisciplinary approach, providing full services for the diagnosis, treatment, and management of head and neck cancers. These hospitals, with a focus on patient-centered care and the most recent developments in oncology, play an important role in India’s position as an excellent option for cancer treatment.

• Medanta The Medicity, Gurugram
• Apollo Cancer Hospital, Chennai
• Indraprastha Apollo Hospital, New Delhi
• Fortis Memorial Research Institute, Gurugram
• Artemis Hospital, Gurugram
• BLK-Max Super Speciality Hospital, New Delhi
• Yashoda Hospitals, Hyderabad
• Max Super Speciality Hospital, Saket, New Delhi
• Nanavati Max Super Speciality Hospital, Mumbai