Head and Neck Cancers

The South Eastern Health and Social Care Trust provides a Specialist Head and Neck Cancer Service for patients diagnosed with oral (mouth) cancer. Head and neck cancers are treated by a large and experienced multidisciplinary team including:

  • Plastic Surgeons
  • Maxillofacial Surgeons
  • Specialist Nurses
  • Nurses
  • Oncologists
  • Specialist Radiographers
  • Speech and Language Therapist
  • Dietitian
  • Psychology and Counselling Service and administrative staff.


Types of Cancers

About 90% of head and neck cancers are of a type called Squamous Cell Carcinoma. These start in the cells that form the lining of the mouth, nose, throat or ear, or the surface layer covering the tongue. There are many different areas that cancer can occur in the tissue and organs of the head and neck including:

  • Cancer of the tongue
  • Cancer of the roof of the mouth (palate)
  • Cancer of the floor of the mouth
  • Cancer of the gums
  • Cancer of the inner lining of the lips and cheeks
  • Other types of cancer

Other types

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
  • Melanomas start from cells called melanocytes, which give colour to the eyes and skin


Referral

Referrals to the Head and Neck Team in the South Eastern Health and Social Care Trust generally come from the School of Dentistry, Oral Surgery Clinics, General Dentist Practitioners or General Practitioners.

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

Unusual findings may 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 will be given a date and time to attend the Outpatient Clinic that takes place at the Royal Victoria Hospital (only our outpatient appointments take place here).

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 suspected or confirmed head and neck cancer. The purpose of the MDT is to ensure that patients are offered the most appropriate treatment.

The team is made of a range of specialists including;

  • Surgeons
  • Oncologists
  • Radiologists
  • Pathologists
  • Nurses
  • Radiographers.

The decision of the team will be discussed at the patient’s next clinic appointment. The patient’s GP will also be informed of the treatment plan.


Treatment

Treatments offered to patients with head and neck cancer will depend on individual cases and the stage of cancer. 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.

  • Surgery
  • Chemotherapy
  • Radiotherapy
  • Specialist Palliative Care

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 and continuing to smoke puts you at greater risk of developing a second cancer. It may also significantly reduce the effectiveness of your current treatment, worsen the side effects and increase the risk of your cancer coming back. Giving up smoking can be very difficult, especially at times of stress.

Alcohol

If you drink alcohol it is important to try to stop. Alcohol taken regularly or excessively is a main cause of 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 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.