Head and neck cancer includes a wide variety of tumours that can develop in this area of the body: from the oral cavity, the paranasal sinuses, the pharynx, the cervical spine, the larynx or the salivary and thyroid glands.
Despite the fact that head and neck tumours represent only 6% to 8% of all cancer cases, this pathology has a great impact on patients because of its high incidence on quality of life and because it affects the most visible part of the body. The affected region is responsible for functions as important as speech, breathing and swallowing, so the loss or deterioration of these functions has a major impact on the patient’s life.
This type of tumour can be considered to have a primarily environmental or external aetiology. The main risk factors are:
Drinking alcohol increases the risk of laryngeal cancer by a factor of 5 compared to the general population. The risk increases if it is associated with tobacco consumption. It also increases the risk in the oropharynx, hypopharynx and oral cavity.
Smoking increases the risk of tumours in the oral cavity, oropharynx, hypopharynx and larynx. The duration and extent of tobacco use is directly related to risk.
Head and neck tumours account for only 6-8% of all cancer cases.
Drinking alcohol and smoking tobacco increase the risk of developing head and neck tumours.
Head and neck cancer has a 95% early cure rate.
Persistent ulceration inside the mouth, discomfort or difficulty in swallowing that lasts over time, hoarseness, or the appearance of lumps in the neck are some of the symptoms that could alert us to the presence of a possible tumour.
Tumours affecting the auditory nerve, on the other hand, usually manifest through tinnitus (persistent ringing), deafness and vertigo. If any of these symptoms are detected, it is advisable to see a doctor immediately.
There are no effective programmes for the early detection of head and neck cancer. Close follow-up is recommended for people with known risk factors, such as heavy smokers and drinkers. A simple examination by ENT specialists in maxillo-facial surgery can diagnose tumours in their early stages, often when the patient is asymptomatic.
The treatment of head and neck cancer is based on three different and complementary specialities: ENT surgery, radiation oncology and medical oncology.
Depending on the stage of the disease and the type of tumour, either one or another, or a combination of them, is used. Generally, in early stages, treatment usually involves surgery or radiotherapy. In advanced stages, however, all three specialities are usually combined.
In terms of surgery, tumour removal through the mouth, using lasers, endoscopy and, recently, the Da Vinci robot, is increasingly used today, avoiding external scarring and damage to structures not affected by the tumour.
With these surgical techniques, it is possible to cure the tumour while still having the three treatment methods within reach, as in general, once radiotherapy is used, this technique can no longer be used again.
As for chemotherapy, there is now a development of immunotherapy, which is not based on destroying tumour cells with chemotherapy drugs that also damage healthy cells, but rather is based on the body controlling the tumour cells itself.
The IVO Ear, Nose & Throat Service is a national and international benchmark thanks to its experience and its use of modern diagnostic and therapeutic techniques in the treatment of all types of head and neck tumours, from the simplest to the most complex.
As a specialty hospital, the centre is highly specialised in technical and human support for the treatment of oncological diseases, which is why it treats many complicated cases that may have been diagnosed in other centres. The specialists at the IVO also carry out operations on advanced skin tumours, as well as all types of reconstructions.
The IVO ENT Service has become super-specialised in reconstructive surgery: operations with pedicled flaps and microvascularised flaps in head and neck tumours.
Reconstructive surgery involves obtaining healthy tissue from different parts of the body and transplanting it in affected areas. In the case of pedicled flaps, the tissue is taken from the regions around the head and neck, while in the case of microvascularised flaps, the tissue is taken from the fibula or the hip for reconstructions of the jaw. The forearm tissue is used for reconstructions of the tongue, oral cavity, pharynx and/or larynx. Tissue from the abdomen is used when a larger amount of material is required. These flaps require sophisticated microsurgical techniques to suture the arteries and veins, which are usually only a few millimetres long, to vessels in the neck to guarantee their viability.
These reconstructive techniques, which aim to restore such important parts for the patient as the lips, nose, ears, face, tongue or throat, entail a shorter recovery time after surgery, and patients are able to eat and breathe naturally in less time than they would if the operation were not performed. In other words, patients have a shorter and more comfortable hospital stay.
The reconstructive surgery performed at the IVO aims to shorten operating times. To this end, surgery is performed with two simultaneous teams. One team resects the cancer and the other obtains the tissue that will reconstruct the defect created. This shortens the operation time to an average of 8-10 hours.
The advantages of this type of procedure for the patient are undeniable, as it involves less anaesthesia, less exposure of the tissues to infection, less need for blood transfusions and a shorter hospital stay.
Another of the super-specialised activities that the IVO's ENT Service performs is what is known as Salvage Surgery. This involves operating on patients who have already been previously treated for a tumour and who have either not responded to the treatment administered or have suffered a relapse.
These patients have an uncertain future and, for the most part, their only chance is extremely complex surgery.
The IVO is one of the few hospitals in which this type of treatment is performed, attending to an average of 100-130 patients per year, most of whom are referred from other hospitals, both within the Valencian Community and other autonomous communities.
The ENT Service of the IVO specialises in reconstructive surgery for head and neck tumours
The Service's team of professionals accompanies cancer patients throughout the whole disease process.
A clinical trial is a research study carried out on people with the aim of learning more about how the body reacts to certain treatments. These trials generally seek to find drugs that are more effective than the current best therapeutic option for patients, or that have similar efficacy but a better toxicity profile.
Bearing in mind that almost all currently available treatments are the result of clinical research, the importance of clinical trials is obvious.
The IVO has a clinical trials unit for all types of tumours and participates in phase 1-3 studies as well as other types of studies.
Whether you receive the news of an initial diagnosis of cancer or a relapse, coping with cancer can be emotionally overwhelming. Each person has their own way of coping with a head and neck cancer diagnosis, but there are some recommendations that can help you through this process: