"Proton therapy, administered over 6-7 weeks helps reduce the dose to all neighbouring critical structures."

Investigations

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Investigations done prior to the treatment of Oropharyngeal cancer include a set of routine blood tests to ascertain the functioning of vital organs, a biopsy to establish the diagnosis and ascertain the nature of the cancer. This biopsy is usually done endoscopically.


This is followed imaging for the local region as well as the whole body. At APCC this is in the form of a whole body digital FDG PET CT and a contrast enhanced MRI of the primary. Patients may undergo additional investigations for an association with the Human papilloma virus, the swallowing mechanism and the status of the heart.

Treatment

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The primary treatment of cancer of the oropharynx i.e tonsil or base tongue cancer, that is confined to the local site and neck is radiotherapy. Chemotherapy is administered along with radiation for most patients except those with very early stage radiation. Selected patients with early stage tonsillar cancer may undergo Trans Oral Robotic Surgery (TORS) instead of radiotherapy.

Proton therapy and Radiotherapy

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


The normal organs that are close to the tonsil and base tongue are the salivary glands, the lining of the cheek and throat, the voice box (larynx)the muscles associated with swallowing and the spinal cord. In certain situations, treatment may also be required adjacent to the inner ear.


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. There are a number of retrospective studies that have noted this; out experience at APCC has been similar.


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 nasopharyngeal 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.


Surgery

Commonly throat cancer is used for a group of cancers affecting the oropharynx (back of mouth) and hypopharynx (upper end of food pipe), this includes tonsil cancers and base of tongue cancers.


Traditional surgical approaches to these cancers affect critical function of speech and swallowing.


HPV (Virus) is being increasingly associated as causative agent for throat (tonsil) cancer, and these HPV associated cancers have a better outcome resulting in better long-time survival.


At APCC we discuss these cancer cases in a Multi-disciplinary team approach and provide a comprehensive treatment plan (Radiation (Proton/Photon) / surgery (trans oral robotic)) along with focus on functional rehabilitation (speech and swallowing).


Transoral Robotic Surgery

The transoral Robotic Surgery involves removal of cancers affecting the back of mouth and throat using a surgical robot. The Robotic arms are controlled by surgeon in a master (surgeon) slave (robot) engagement.


Robotic system provides high definition magnified vision to inaccessible area where human hand cannot reach comfortably, resulting in a quicker and easy recovery following cancer surgery.


  • Chemotherapy.
  • Ancillary services Pathology, Radiology.

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.

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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.

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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.

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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.

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Other Head & Neck Cancers

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