Head neck cancer in Bangladesh

Bangladesh is advancing fast in the horizon of head, neck and thyroid diseases. Cancer specialties of these regions are becoming much more important as head, neck and thyroid cancer incidences are increasing day by day. Cancers of the head and neck region constitute 5% of all cancers. 95% of them are curable by treatment if detected earlier.

Head and neck region cancers include cancers of the lip, oral cavity, tongue, pharynx, larynx, nose with para-nasal sinuses, salivary glands and the neck.

The risk factors of developing these cancers are consumption of betel quid, betel nut, jarda, gul, bidi, cigarettes, viral infection, poor oral hygiene, exposure to radiation, industrial fumes, alcohol, chemicals etc.

The symptoms are according to the primary site of origin. These are difficulty in taking food, change of voice, respiratory distress, nasal obstruction, bleeding from the nose, swelling in the neck and pain in the different sites of head and neck which starts from above the chest to up to the top of the head.

Thyroid gland is situated in the neck and secretes thyroid hormones which are essential for life. 3% of all cancers occur in the thyroid gland. 95% thyroid cancers have good prognosis after surgery. Thyroid cancers spread quickly in the lymph nodes, lungs and bones. The major challenge for thyroid surgery is saving the recurrent laryngeal nerve which controls the voice and preservation of parathyroid glands which maintains the blood calcium level.

India has about 30 regional cancer centers where cancer surgeons, radiation and medical oncologists are appointed. Patients get complete treatment from there. They have many good govt. and private cancer hospitals. Bangladesh should adopt the same strategy. More cancer surgeons should be trained. Our cancer treatment is mainly dependent on radiotherapy and chemotherapy both in govt. and private sectors. Few numbers of head neck cancer surgeons are present in our country. So our patients are not getting proper treatment.

Cancer destroys the tissue, gradually the person and ultimately the whole family. We are fighting against cancer every day and this fight is difficult and relentless. But we must not lose hope. For cancer treatment, multi disciplinary approach is necessary. The main treatment modality is surgery. Radiotherapy is also helpful in some cases.

E-mail: dr.abu_hanif@yahoo.com