"Oral cancer is preventable and early detection helps in better outcomes."


 

Diagnosis

 

Head and Neck Cancer diagnosis is confirmed only after detailed physical examination, and diagnostic tests by the team of highly trained head and neck cancer specialists.


Diagnosis of mouth cancer includes
  • Clinical examination
    Your doctor will examine all the head and neck areas to look for any mucosal abnormality, lumps, skin changes and swelling. Your doctor will also check for the lymph nodes in the neck.
  • Determining the extent of the cancer
    After clinical examination, your doctor may introduce a small flexible camera through nose or mouth to determine the complete extent of the cancer.
  • Biospy
    If a doubtful lesion is identified, then your doctor may remove a small portion of cancer tissue and send for laboratory testing.
  • Imaging
    There are various imaging modalities to know the exact extent of the cancer and spread if any. These may include computed tomography(CT) scan, Magnetic Resonance Imaging(MRI) and positron emission tomography (PET) scans, among others. Your doctor will decide which tests are necessary based on your condition.
Diagnostic advantage at APCC
  • India’s first digital PETCT
  • Narrow band imaging (NBI)

    Ours is one of the few centres in the country which is equipped with NBI. It is an optical image enhancing technology that allows a detailed inspection of vascular patterns, providing the ability to predict cancer in real time endoscopy. It is used to diagnose and treat early upper aerodigestive tract cancers even more precisely and reliably. NBI is also a very accurate technology for follow-up. -We are also equipped with advanced high precision olympusVisera II Elite 300 endoscope and portable STORZ TELE PACK endoscope for our OP and IP services

Treatment

 

Treatment choice depends on the following 3 factors:


  • general health of the patient
  • site and size of cancer
  • whether the cancer has spread to other parts of the body or not
Early Oral cancers

These can be treated with a single modality treatment such as surgery alone or radiotherapy alone.


Advanced Oral cancers

Advanced Oral cancers will require a combined modality treatment which includes surgery and radiotherapy with or without chemotherapy.


Surgery

This includes the following:


  • Resection
  • Neck dissection
  • Reconstruction

Resection


This involves removal of the entire tumour with a cuff of surrounding healthy tissue to obtain negative margins.


Neck Dissection


This involves the removal of lymphnodes from the neck which may be involved by the cancer.


Reconstruction


Many times, cancer surgery may involve removal of jaw bones, skin, tongue and surrounding tissues. These missing structures will be replaced via reconstructive surgery to restore form and function.


Surgery at APCC
  • We are specialized in treating residual or recurrent tumours.
  • We are equipped with cutting edge surgical technology.
  • We are experienced in Complex reconstructive surgeries like microvascular free flaps using Zeiss Tivato 700 microscope to restore esthetics and function. It is done by the same team of experts who are extensively trained in resection as well as reconstruction.
  • Virtual surgical planning and 3D printing.
Proton therapy and Radiotherapy

Apollo Proton Cancer Centre is equipped with facilities and expertise for both Proton therapy as well as radiotherapy.


Radiotherapy and proton therapy are usually administered after surgery in patients with cancer of the tongue, cheek or gums. In this situation, the role of proton therapy / radiotherapy is to prevent cancer cells from re-growing, thus improving the chance of the patient remaining disease free.


Cells that form the lining of the oral cavity are shed daily. When exposed to radiation, they are not replenished at the usual rate, thus resulting in raw areas in the lining of the mouth, i.e. cheeks, lips, palate. Since this region is very richly endowed with nerve endings these raw areas are painful. Radiotherapy can result in inflammation of the cheek lining, thick saliva, weight loss, swallowing difficulties. Modern radiotherapy techniques aim to reduce these side effects of radiotherapy.


Proton therapy, administered over 6-7 weeks helps reduce the dose to all neighbouring critical structures. This results in substantially decreasing the risk of early side effects and late consequences of treatment. During the period of treatment less dose to critical structures equates with reduction in the risk of blisters in the mouth and throat, less requirement of strong pain killers, less chance of weight loss, tube feeding, hospital admission or treatment interruption.


In the long run, patients undergoing proton therapy for tonsil / base tongue cancer have been noted to be able to have a much better chance of resuming their normal life. The same benefit is likely to accrue in patients with oral cancer. In addition, proton therapy is known to reduce the risk of having a second cancer. This is especially important in the case of adolescents and young adults undergoing radiotherapy for oral cancers.


At APCC, proton therapy is administered using the latest pencil beam scanning technology on an IBA Proteus Plus. The sophisticated treatment unit comprises 2 gantries that can rotate around the patient and deliver proton therapy from multiple angles and a specialised treatment couch that is capable of moving and rotating to position the patient accurately for treatment. The treatment unit is equipped with various forms of imaging, X-rays, Cone beam CT and surface imaging to ensure accurate delivery of radiotherapy.


In addition to proton therapy, patients may receive treatment for oral cancer on the RadixactTomotherapy unit, using helical tomotherapy. This advanced image guided radiotherapy technique is based on photons or X-rays, with a high degree of modulation to reduce dose to normal structures.


At APCC, all head neck proton and radiation treatments are carried out under the care of head neck specialised expert doctors who are supported by a team of medical physicists and radiotherapy technologists. At APCC, the treating team is supported by a group of services that help in the holistic management of head neck cancer patients.


APCC Advantage
  • We at Apollo Proton cancer centerhave dedicated team of experts who are highly trained in various disciplines of head and neck cancers
  • We are equipped with cutting edge technology with state of the art equipments.
  • We aim at providing personalized and comprehensive cancer care through multidisciplinary approach
  • We not only treat the cancer, we also aim to maintain the function and esthetics with improved quality of life.
  • Multidisciplinary tumor board: All our patients undergo a multidisciplinary treatment planning approach in which experts in different specialties review and discuss the case and treatment options of a patient before initiating the treatment
Dental implants

Following reconstruction of our jaw bone, dental implants are used along with the prosthesis to restore function and esthetics of the mouth.


What are dental implants?

These are metal screws which are designed to replicate the tooth root.


How is it different from removable dentures and bridges?

Unlike removable dentures and bridges which rest on the gums, Implants are drilled into the bone to replicate the tooth root. These implants are made of biocompatible metals such as titanium. They fuse to the bone by a mechanism called osseointegration. Once the implant is in place, the prosthodontist attaches a crown over the implant which restores the form and function.


Chemotherapy

Ancillary services Pathology, Radiology.


Radiological assessment for staging tumour and response assessment is critical considering tendency of these cancers having submucosal spread. Also pathological confirmation of tumour, grading and post-surgical histopathology evaluation is important is deciding adjuvant therapy.


Winning Over Cancer

Dr. Naveen Hedne, Senior Consultant & Lead - Surgical Oncology talks about managing head & neck cancers during COVID-19. He said head & neck cancers can be easily identified & one should not ignore its symptoms, He further added that APCC is well equipped and ready to treat patients during the pandemic situation.

FOR APPOINTMENT

Mr. Param Gandhi from Surat, Gujarat talks about the Proton Therapy for his father at Apollo Proton Cancer Centre. He also talks about the standard of care and treatment journey while conveying his heartfelt gratitude to Dr. Ghosh, Dr.Sapna, Dr Naveen, Dr.Vidyadharan, Dr.Pradeep and the entire team of Head & Neck Cancer Management for their excellent guidance & support. Wishing Param & his family good health always.

FOR APPOINTMENT

Mr. Kishore Jain from Mumbai talks to us about his brother-in-law who was diagnosed with oral cancer and the treatment he underwent at Apollo Proton Cancer Centre. He thanks Dr.Sapna Nangia, Dr.T.Raja, Dr.Naveen, Dr. S. Vidyadharan and the entire team for their extensive help and making him feel optimistic during the treatment period. He is happy to see his brother-in-law who has recovered and is looking fit & healthy today.

FOR APPOINTMENT

Ms.Pooja from Delhi speaks to us about her family member who was diagnosed with head & neck cancer in February, this was when COVID - 19 was picking up in India. She describes how Dr. Sapna Nangia (Director - Head Neck & Breast, Department of Radiation Oncology) gave her hope by explaining about Proton Therapy at Apollo Proton Cancer Centre.

While the treatment is still going on, she wants to thank the entire team at APCC for taking care of her travel formalities during this challenging time.

FOR APPOINTMENT

Other Head & Neck Cancers