Head and Neck Cancers
Head and neck cancers can develop in the nose, oral cavity, pharynx, or larynx. The most common symptom is a lump in the neck, followed by non-healing mucosal lesions, which can cause pain, difficulty swallowing, hoarseness, or bleeding. The main risk factors are nicotine and alcohol consumption, as well as infection with high-risk HPV (human papillomaviruses). With timely diagnosis and appropriate treatment, many ENT tumours can be effectively treated today. We have extensive experience in the evaluation, treatment (especially head and neck oncologic surgery), and follow-up care of head and neck cancers, with all diagnostic and therapeutic modalities available at HalsGesichtsChirurgie Zürich and our collaboration partners.
Diagnostics
The evaluation of head and neck cancers is based on a thorough clinical and endoscopic examination, possibly combined with a biopsy under local anaesthesia. During endoscopy, a flexible endoscope can be used to examine the subregions of the pharynx and larynx. The endoscopy images can then be shown and explained to you on a screen. If a lymph node suspicious for metastasis is present in the neck, an ultrasound-guided fine-needle aspiration (FNA) can be performed directly during your initial consultation to collect cells, which is low-risk and takes only a few minutes. For the so-called staging (determining the stage of the disease), cross-sectional imaging is performed, such as a computed tomography (CT), magnetic resonance imaging (MRI), or a PET/CT. In cases where collecting a tissue sample under local anaesthesia is not possible, or a very precise examination of the tumour region and its surroundings is required, a panendoscopy is additionally performed. This is an examination under short anaesthesia, during which the upper airways and digestive tract are precisely examined and tissue samples can be collected.
Treatment
Head and neck cancers can be effectively treated if diagnosed early, with an individualized treatment plan tailored to each patient, determined at the so-called tumour board (a multi-disciplinary meeting with case discussion). The treatment modalities consist of surgery, radiation therapy (radiotherapy), or systemic therapy (medication), which in many cases are also combined. Surgery in almost all cases involves tumour resection and removal of the lymph nodes in the tumour’s drainage area, with reconstruction performed as needed to restore form and function, depending on the size and location of the resulting defect. In selected cases, instead of lymph node dissection, a so-called sentinel lymph node biopsy can be performed, or instead of conventional surgical resection of the primary tumour, a transoral robotic-assisted resection (TORS) with a surgical robot or a laser resection can be carried out.
Follow-up
Following therapy, close oncologic follow-up care is indicated. This includes recording of any symptoms and treatment consequences, performing a thorough examination including endoscopy and, if necessary, ultrasound, such as initiating rehabilitation measures (speech therapy, physiotherapy, etc.) if required. Most often, imaging studies (CT, MRI, or PET/CT) are also conducted as part of the follow-up.
