Head and Neck (HN) Cancer on rising trends in India: Experts

Second only to lung cancer in men and ranking third after breast and lung cancers in women, head and neck cancers have become more common in the cancer incidences in India. Head and neck cancer includes a range of cancers originating in the mouth, neck, throat, nose, sinuses, ear, voice box, salivary glands, thyroid gland, and skin. Symptoms vary by location; oral cancers often present as painful ulcers that don’t heal within 2-3 weeks, while voice box cancers typically cause changes in voice.

Common symptoms include non-healing mouth ulcers, spontaneous tooth loosening, painful swallowing, voice changes, difficulty swallowing food, breathing difficulties, neck lumps, and bleeding from the nose or mouth. Early detection and treatment are crucial for better outcomes.

Dr. Shikhar Sawhney, Consultant, Head & Neck Cancer, Amrita Hospital, Faridabadsaid, “The epidemiology and incidence of head and neck (HN) cancer differ between India and the West. Oral cancers are more prevalent in India, earning it the title “Oral Cancer Capital of the World.” It is the second most common cancer in India, unlike in the West, where better tobacco control has reduced its incidence. Conversely, HPV-related oropharyngeal cancer has surged in the West, reaching epidemic proportions, while in India, it remains a minority at 5-10%. There is a strong likelihood that HPV related cancers, just like the west, will rise in India as well in the coming decade or so. Globally, cancer rates are rising due to unhealthy lifestyles, increased longevity, and better medical facilities. In India, the highest surge is predicted to be seen in oral cancers, particularly among males.”

The incidence of different cancers varies across India due to local practices and carcinogen exposure. Oral cancers are more prevalent in states like Uttar Pradesh, Bihar, Gujarat, and Maharashtra due to high tobacco use. Pharyngeal cancers are disproportionately high in northeastern states. In rural Andhra Pradesh, a unique smoking method called reverse smoking leads to higher rates of palatal cancers. These regional differences highlight the impact of lifestyle and environmental factors on cancer incidence across the country.

“Since 90% of HN cancers are lifestyle-related, limiting exposure to the said causes will go a long way to prevent these cancers. Cancer is curable, if detected early. It does not only significantly improve cure rates, it also decreases the side effects and toxicity of cancer directed treatment immensely”, said Dr. Subhramania Iyer, HoD, Head & Neck Cancer, Amrita Hospital.

Dr. Rishabh Kumar, Senior Consultant, Radiation Oncology, said, “There are three main cancer treatment options: surgery, radiotherapy, and chemotherapy. The choice of treatment depends on the cancer’s site, stage, and the patient’s overall health”.