Head and Neck Cancer

The South Eastern Health and Social Care Trust provide a Specialist Head and Neck Cancer Service for patients diagnosed with oral (mouth) and oropharyngeal (part of the throat just behind the mouth) cancer.

Head and Neck cancers are treated by a large and experienced multidisciplinary team including:

• Plastic Surgeons
• Maxillofacial Surgeons
• Specialist Nurses
• Nurses
• Oncologists
• Anaesthetists
• Specialist Radiographers
• Speech and Language Therapist
• Dietitian
• Physiotherapist
• Restorative Dentist
• Pathologist
• Psychology and Counselling Service

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• Types of Cancer

  About 90% of head and neck cancers are of a type called squamous cell carcinoma. Squamous cells line the mouth, nose and throat.

  There are many different areas that cancer can occur in the mouth (oral cavity) and the area just behind the mouth (oropharynx).

  Mouth cancer can develop on the:

  • Lip
  • Roof of the mouth (hard palate)
  • Floor of the mouth
  • Inside the cheek (buccal mucosa)
  • Tongue
  • Areas behind the wisdom teeth (retromolar)
  • Gum

  Oropharynx is the area behind the mouth and cancers can develop on the soft part of the roof of the mouth (soft palate), base or back of the tongue and the tonsils.

  Head and Neck cancers can also develop from other types of cells:

  • Lymphomas develop from the cells of the lymphatic system
  • Adenocarcinomas develop from cells that form the lining of glands in the body
  • Sarcomas develop from the cells which make up muscles, cartilage or blood vessels

  The head and neck multidisciplinary team have agreed clinical guidelines which indicate referral of suspect head and neck cancer symptoms.

  Symptoms for referral usually include:

  • An ulcer which does not heal in two weeks
  • A red patch in your mouth
  • A white patch in your mouth
  • An unexplained loose tooth
  • Any unexplained lumps or swelling in your mouth that persists for more than two –three weeks
  • Pain when eating, talking, swallowing or chewing
  • Any lump in your neck
  • Hoarseness persisting for more than six weeks

  Signs and symptoms differ with every patient and some people may have these symptoms but not have cancer.

  Patients with a biopsy proven cancer will be given a date and time to attend one of our Head and Neck Outpatient Clinics, which are held in both the Ulster Hospital and the Royal Victoria Hospital.

  If a patient is referred as urgent, they should receive an appointment quickly to see a Consultant who specialises in managing head and neck cancer.

• Multidisciplinary Team

  To effectively treat cancer, a number of specialists need to work together in order to gain an accurate diagnosis and to decide the best treatment plan for patients. These specialists work together in what is known as a multidisciplinary team.

  The Head and Neck Multidisciplinary Team (MDT) meet weekly in the Royal Victoria Hospital to discuss patients who have a confirmed head and neck cancer. The purpose of the MDT is to ensure that patients are offered the most appropriate treatment.

  The decision of the team will be discussed at the patient’s next clinic appointment.  Patients’ will be involved in the final decision regarding their treatment.  The patient’s GP will also be informed of the treatment plan.

• Treatment

  Treatments offered to patients with head and neck cancer depends on:

  • Where the cancer is in the head and neck area
  • The stage of the cancer
  • Type of cancer
  • Size of the cancer
  • Individual’s general health

  This will be discussed in detail with every patient by one of our medical team, once a diagnosis has been made and results of appropriate investigations available.  Your Head and Neck Clinical Nurse Specialist can provide you with information, support and advice about your treatment options.

  The main treatments for head and neck cancer are:

  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Specialist Palliative Care or a combination of the above

  Before patients undergo any treatment, they must give consent for the treatment to proceed. This is an important process to ensure that patients understand the nature of their treatment and the risks involved.

• Health Education

  Smoking

  If you are a smoker, it is important to try to give up. Smoking is the main cause of head and neck cancers.

  Stopping smoking may lower the risk of your cancer coming back after treatment.   It will reduce your risk of developing a second cancer in the head and neck area.

  Continuing to smoke can reduce the effectiveness of your current treatment and worsen the side effects.

  Giving up smoking can be very difficult, but there is lots of support available to help.

  Alcohol

  Alcohol taken regularly or excessively is another main risk factor for head and neck cancer. Continuing to drink alcohol puts you at risk of developing another cancer. It also makes treatment and recovery more difficult.

  It can be difficult to stop smoking and taking alcohol and you may need help. Patients can discuss this with the doctors, nurses or GP.

• Follow up after treatment

  After treatment has finished, patients will be asked to come to the hospital for check-ups. Check-ups are a good opportunity for patients to discuss any worries or problems they may have. Patients should go to their GP or Specialist Doctor or contact their Clinical Nurse Specialist for advice if they have a symptom.