Head and neck cancer is a term used to describe a range of malignant tumors that appear in or around the throat, larynx, nose, sinuses, and mouth. Over the recent years, the management of these tumors has involved increasingly complex, combined-modality programs requiring specialists from various disciplines, including medical oncologists, radiation oncologists, surgical oncologists, radiologists, otolaryngologists (ear, nose, and throat doctors), plastic surgeons, maxillofacial prosthodontists, dentists, physical therapists, speech therapists, nurses, dietitians and social workers. Together, they form a multidisciplinary team to care for each patient before and after treatment begins.

In this issue of cancer update, we will review some of the new exciting advances in the evaluation and treatment of these cancers, including the use of functional imaging to improve staging, high precision radiation techniques to reduce therapy-induced side effects, combined modality approaches to improve treatment outcomes and novel molecular targeted therapies such as cetuximab. Often, curative treatment of these cancers also involves radical surgical resection that leaves behind significant anatomical defects. The role of plastic surgeons and speech therapists in restoring anatomy, function and cosmesis will also be addressed in this issue.

While the use of aggressive therapy such as combined chemoradiation has resulted in superior outcomes in the management of patients with head and neck cancers, these improved outcomes are at the cost of increased acute and late toxicities. These include acute local effects such as mucositis, dysphagia, odynophagia, and xerostomia as well as long-term endocrine disturbances such as hypothyroidism and hypopituitarism. Thus, supportive care is also an important area of focus for clinicians who care for head and neck cancer patients and some of these issues will also be discussed in this issue of cancer update.

With these improvements in imaging, surgical procedures, radiation techniques and novel therapies, “state of art” in head and neck treatment is now being redefined.

Dr Lim Thye Soon
Editor