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Overview
What is Head & Neck Cancer?
Head and neck cancer includes cancers that arise in areas such as the mouth, throat, nose, sinuses, and salivary glands. Most of these cancers begin in the inner lining of these structures.
What Causes It?
- Tobacco use (smoking or chewing)
- Human papillomavirus (HPV) infection
- Alcohol consumption
- Exposure to harmful chemicals or radiation
- Poor oral hygiene
Who is at Risk?
- People with HPV infection
- Smokers and tobacco users
- Age over 50 years
- Heavy alcohol users
- Poor nutrition or oral hygiene
Symptoms
- Lump in neck or mouth
- Persistent sore throat
- Hoarseness or voice change
- Difficulty swallowing
- Unexplained weight loss
- Change in taste
Diagnosis
- Physical examination
- Imaging (CT, MRI, PET scan)
- Biopsy (tissue sample test)
Treatment Options
- Surgery
- Radiation therapy
- Immunotherapy (uses immune system to kill cancer cells)
- Chemotherapy (uses medicines to kill or control cancer)
- Targeted therapy (attacks cancer cells to control the disease)
Types of Surgeries for Head & Neck Cancer
Flexible robotic surgery: Uses a flexible scope to reach hard-to-access areas in the mouth and throat.
Laser surgery: Uses a thin tube with a laser to reach the tumour through the throat and remove or destroy it.
Laryngectomy: Surgeon removes the entire larynx (voice box) or parts of it.
Pharyngectomy: Surgeon removes parts of the throat where cancer cells are located.
Reconstructive microsurgery: Rebuilds affected areas (like the nose, tongue, or throat) using tissue from other parts of the body.
Benefits of Head and Neck Cancer Surgery
- More precise surgery
- Faster recovery
- Better ability to speak and swallow
- Improved chances of recovery and survival
Procedure Details
Step-by-Step Overview
- Patient is given general anaesthesia
- Tumour is accessed through the mouth (transoral/endoscopic/robotic)
- Cancer and surrounding margin are removed
- Neck dissection if cancer has spread
- Tissue repair or reconstruction if required
- Surgical site closed or allowed to heal
Risks & Complications
Common Risks
- Pain or swelling
- Temporary difficulty swallowing
- Mild bleeding
- Infection
- Severe pain
Rare but Serious Complications
- Slow wound healing
- Pain or nerve-related problems (like numbness or weakness)
- Serious infection in the bloodstream (fungal infection)
Hospital Stay & Recovery
Instructions on the Day of Procedure
- Do not eat or drink before surgery
- Arrive early at hospital
- Remove jewellery/dentures
- Bring medical records
Post-Procedure Monitoring
- Do not drive, work, or use machinery for 24 hours after anaesthesia
- Avoid alcohol or sedatives for 24 hours
- Start with light food and drinks, then return to normal diet if tolerated
- Contact your doctor if you feel unwell or have any concerns
Recovery Timeline
- Hospital stay: 1–2 days
- Gradual increase in activities: after 2–3 weeks
Benefits and Outcomes
Benefits
- Early recovery
- Lower risk of infections
- Improvement in swallowing
Expected Results
- Removal of tumour
- Improved quality of life
- Reduced symptoms
Quality of Life
- Better speech preservation
- Improvement in depression
- Reduced discomfort
Lifestyle & Prevention
Activity Restrictions
- Avoid heavy lifting for 2–3 weeks
- Gradually resume normal activity
- Light walking early
- Avoid strenuous activity
Wound Care / Precautions
- Maintain oral hygiene
- Follow doctor's cleaning instructions
- Watch for signs of infection
Diet
- Start with liquids, soft foods and normal diet
- Avoid spicy or hard foods initially
Long-Term Care
- Regular follow-ups
- Speech/swallow therapy if needed
Preventing Recurrence
- Avoid alcohol
- Minimise tobacco
- Maintain oral hygiene
Follow-Up Schedule
- 1st year: every 1–3 months
- 2nd year: every 2–6 months
- 3–5 years: every 4–8 months
- After 5 years: every 12 months
Myths vs Facts
Surgery permanently worsens quality of life.
Most patients report good long-term quality of life, with recovery and adaptation over time.
Patients cannot return to normal daily activities after surgery.
Many patients are able to resume daily activities and maintain independence after recovery.
Speech and swallowing problems are always severe and permanent.
While some difficulties may occur, many patients improve significantly over time, especially with rehabilitation.
Reconstruction leads to poor long-term outcomes.
Microvascular reconstruction helps restore function and appearance, supporting better long-term outcomes.
Frequently Asked Questions
How long does it take to recover after surgery?
Recovery time varies, but most patients gradually improve over a few weeks, with full recovery taking longer depending on the surgery.
When can I start eating after surgery?
You may start with liquids or soft foods and slowly return to a normal diet as swallowing improves.
Will I be able to move around after surgery?
Yes, you will be encouraged to start gentle movement early to help recovery and prevent complications.
How is pain managed after surgery?
Pain is managed using a combination of medications and supportive care to keep you comfortable.
References
- 1. Head and neck cancers. Available from https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet/
- 2. Head and Neck Cancer. Diagnosis. Available from https://www.mayoclinic.org/diseases-conditions/head-and-neck-cancers/diagnosis-treatment/drc-20558359/
- 3. Surgery for Head and Neck Cancer. Available from https://www.cancercenter.com/cancer-types/head-and-neck-cancer/treatments/surgery/
- 4. Ablative head and neck surgery. Available from https://www.clevelandclinicabudhabi.ae/en/health-library/health-resources/treatments-and-procedures/ablative-head-and-neck-surgery/
- 5. What you need to know about neck surgery. Available from https://www.healthline.com/health/neck-surgery#surgery-risks/
- 6. Ganga K, McMullen C. State-of-the-art management for challenging complications in head and neck surgery. Plast Aesthet Res. 2023;10:69.
- 7. Preparing for surgery. Available from https://www.uclahealth.org/medical-services/head-neck-surgery/patient-resources/preparing-surgery/
- 8. List MA, Knackstedt M, Liu L, et al. Enhanced recovery after surgery, current, and future considerations in head and neck cancer. Laryngoscope Investig Otolaryngol. 2023;8(5):1240–1256.
- 9. Kainulainen S, Koivusalo AM, Roine RP, et al. Long-term quality of life after surgery of head and neck cancer with microvascular reconstruction. Oral Maxillofac Surg. 2020;24(1):11–17.
- 10. Eating and drinking after head and neck cancer surgery. Available from https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/eating-and-drinking-after-head-and-neck-cancer-treatment/
- 11. Hashim D, Genden E, Posner M, et al. Head and neck cancer prevention. Ann Oncol. 2019;30(5):744–756.
- 12. Surveillance education. Available from https://www.ahns.info/survivorship_intro/surveillance-education/