The management of head and neck cancer

The management of head and neck cancer has become increasingly complex with the use of modern diagnostic and treatment procedures. It is a challenging subspeciality within otorhinolaryngology. Patients present with diverse conditions which can involve any part of the head and neck region including the aerodigestive tract, lymph nodes, salivary glands, thyroid and parathyroids. The practitioner must be able to obtain a diagnosis and plan subsequent treatment with all available resources. This article will concentrate mainly on squamous cell carcinoma of the aerodigestive tract as it is most commonly seen. With centralization of cancer services to main teaching centres, trainees in general have less exposure to head and neck cancer. It is crucial that one is aware of best practice guidelines and different treatment modalities to maximize outcomes. The management of a head and neck cancer patient involves a multidisciplinary team approach. Team members are from medical and non-medical backgrounds as treatment and subsequent rehabilitation can be complex. The subspeciality of head and neck cancer is challenging due to the technical aspects of treatment and surgery is often mutilating with significant functional deficits postoperatively requiring intensive rehabilitation. Patients often present or develop significant co-morbidity and psychosocial problems. However, it is an enormously rewarding area as patients are grateful to clinicians for ameliorating an otherwise fatal condition.