Head and Neck Cancer Surgery in Raipur

Head and neck cancer encompasses malignancies of the oral cavity, oropharynx, hypopharynx, larynx, nasopharynx, nasal cavity, salivary glands, and thyroid. One of the most prevalent cancer categories in India is caused by tobacco and areca nut use; these cancers carry a specific challenge: the anatomical region responsible for speech, swallowing, breathing and appearance is the same region that requires treatment. Every decision is shaped by oncological necessity and its functional consequences.

Surgery ranges from the relatively minor thyroid lobectomy or small oral cavity excision to among the most technically demanding oncological operations: resection of the jaw, floor of the mouth & tongue, and reconstruction with free tissue transfer and simultaneous neck dissection. The surgeon's goal is clear margins while preserving maximum function and appearance.

Surgery is primary for most resectable oral cavity cancers and thyroid malignancies, with a central role in laryngeal, salivary gland and skin cancers. For oropharyngeal and nasopharyngeal cancers, definitive chemoradiation is preferred in many cases, with surgery for residual or recurrent disease. Every individual's treatment is planned by our multidisciplinary tumour team. 

Why Choose Ramkrishna CARE Hospitals for Head and Neck Cancer Surgery in Raipur?

Successful head and neck cancer surgery requires precision, specialised expertise and coordinated multidisciplinary care, all of which are available at Ramkrishna CARE Hospitals:

• Dedicated head and neck surgical oncology team: Complex anatomy, low tolerance for imprecision and immediate visible functional consequences demand subspeciality training. Our surgical oncologists are formally trained in head and neck oncological surgery across the full range from minor excisions to major ablative and reconstructive procedures.
• Multidisciplinary tumour board: Every case is reviewed by surgical, radiation, and medical oncologists; radiologists; pathologists; speech therapists; and nutritional specialists before treatment is planned.
• PET-CT pre-operative staging: Integrated metabolic and anatomical staging identifying primary tumour extent, involved nodes and distant metastases before surgery. The uMI 550's 2.76 mm resolution and time-of-flight imaging detect small nodal metastases and early distant disease with greater sensitivity than CT, preventing futile surgery in patients with occult spread.
• Reconstructive surgery capability: Major ablative surgery requires reconstruction that restores functional anatomy. Microvascular free flap surgery (fibula, forearm or anterolateral thigh flap anastomosed to neck recipient vessels) fills surgical defects and recreates mandibular continuity. This requires surgical expertise and operating theatre infrastructure for prolonged procedures.
• Elekta Versa HD radiation: Postoperative, definitive and concurrent chemoradiation delivered on the Elekta Versa HD. IntelliBeam IMRT with HexaPOD positioning achieves tight dose conformality around complex head and neck anatomy, protecting salivary glands, spinal cord and mandible.
• Speech and swallowing rehabilitation: Our speech and language therapy team is involved from pre-operative assessment through post-treatment rehabilitation, including laryngeal exercises, swallowing strategies and voice restoration guidance after laryngectomy.
• Accessible from across Chhattisgarh: Patients from Bilaspur, Durg, Rajnandgaon and Bastar attend our centre for integrated specialist surgery, precision radiation and multidisciplinary rehabilitation.

Types of Head and Neck Cancers Treated

Different types of head & neck cancers are the following:

• Oral cavity cancer: Lips, buccal mucosa, floor of mouth, tongue and hard palate.
• Oropharyngeal cancer: Base of tongue, soft palate and tonsils. Increasingly HPV-related in younger non-tobacco users. In Ramkrishna TORS Traus oral robotic surgery is available for oropharyngeal cancer.
• Laryngeal cancer: Glottis, supraglottis & subglottis. Treatment options. - surgery/radiation/chemotherapy voice prostheses.   
• Hypopharyngeal cancer: Piriform sinuses, posterior pharyngeal wall and postcricoid region. Often presenting at an advanced stage and managed with surgery, chemoradiation or combined modality treatment
• Nasopharyngeal cancer: Distinct epidemiology linked to EBV. Primarily managed with concurrent chemoradiation and surgery for residual or recurrent disease
• Thyroid cancer: Papillary, follicular, medullary and anaplastic carcinomas. Surgery is the primary treatment of choice, radioactive iodine for differentiated thyroid cancer and targeted therapy for medullary and anaplastic diseases.
• Salivary gland tumours: Parotid, submandibular and sublingual gland tumours. Surgical excision is primary; facial nerve identification and preservation are the central technical priority in parotid surgery.
• Skin cancers: Cutaneous SCC and melanoma of the scalp, face, and neck treated with wide local excision with or without sentinel node biopsy and neck dissection.

Symptoms of Head and Neck Cancer

Signs and symptoms that indicate head and neck cancers are the following:

• A persistent sore or ulcer in the mouth, tongue or throat not healing within two to three weeks
• Hoarseness or a change in voice quality that persists for more than two to three weeks in an adult
• Difficulty or pain on swallowing, particularly if progressive
• A painless lump in the neck, possibly a metastatic lymph node or primary salivary gland tumour
• Blood in saliva or sputum or recurrent unexplained nosebleeds
• Persistent one-sided nasal blockage or discharge
• Unexplained ear pain, particularly when associated with throat symptoms
• Visible or palpable swelling of the face, jaw or neck.

Causes of Head and Neck Cancer

Tobacco in all forms is the dominant cause of oral cavity and laryngeal cancer in India, including cigarettes, bidis, hookahs, khaini, gutka and zarda, all of which expose mucosal surfaces to DNA-damaging carcinogens. Risk increases with duration and quantity. Other causes are:

• Areca nut: An independent carcinogen causing oral submucous fibrosis and directly promoting oral malignancy.
• Alcohol: Chronic heavy use acts synergistically with tobacco, multiplying oral and pharyngeal cancer risk.
• HPV: HPV-16 is causally linked to oropharyngeal cancers like base of tongue and tonsil, particularly in younger non-tobacco users.
• EBV: Causally linked to nasopharyngeal carcinoma, which has a distinct geographic and epidemiological pattern.

Risk Factors of Head and Neck Cancer

Tobacco is the most important modifiable risk factor. Other factors that increase risk of head and neck cancers are the following:

• Areca nut and pan masala with or without tobacco
• Heavy alcohol use, particularly in combination with tobacco
• Previous head and neck cancer-shared carcinogenic exposure creates risk for synchronous or second primary cancers.

Diagnosis Before Surgery

A thorough preoperative evaluation helps determine the exact location and extent of the tumour, ensuring safe surgery and the most effective treatment plan:

• Clinical examination and endoscopy: Systematic oral cavity and laryngeal examination. Fibreoptic nasolaryngoscopy visualises the nasopharynx, larynx & hypopharynx, confirming tumour extent and vocal cord mobility.
• Biopsy: Confirms cancer type and subtype. It includes FNAC for neck masses and parotid lesions and incisional or punch biopsy for mucosal lesions.
• CT and MRI: Define tumour depth, cortical bone invasion, perineural spread and cervical nodal extent that are critical determinants of surgical approach and resectability.
• PET-CT: Whole-body metabolic staging identifying occult nodes and distant metastases. The uMI 550's 2.76 mm resolution and time-of-flight imaging detect hepatic, pulmonary or skeletal spread that would alter treatment strategy that is essential before major ablative surgery.
• Panendoscopy: Direct laryngoscopy, oesophagoscopy and bronchoscopy to confirm tumour extent, exclude synchronous second primaries and plan the surgical approach
• Nutritional and functional assessment: Preoperative nutritional status, swallowing function and dental assessment before radiation, affecting both operative safety and treatment tolerability.

Treatments for Head and Neck Cancer

Treatment options are the following:

• Wide local excision: For early oral cavity cancers – transoral resection with normal tissue margins for most anterior lesions, without external incision.
• Composite resection: For oral cavity cancers invading the mandible – resection of the tumour with the mandibular segment, reconstructed using a fibula free flap to restore jaw continuity and mucosal lining
• Glossectomy: Partial or total tongue resection. Partial glossectomy preserves much speech and swallowing function, whereas total glossectomy requires reconstruction and intensive rehabilitation.
• Laryngectomy: Total laryngectomy for advanced unpreservable laryngeal cancer, including permanent tracheostomy with voice restoration via tracheo-oesophageal prosthesis. Partial laryngectomy preserves voice and airway in selected patients.
• Thyroidectomy: Hemithyroidectomy for unilateral or low-risk disease. Total thyroidectomy for bilateral disease or when radioactive iodine ablation is planned. Recurrent laryngeal nerve & parathyroid gland preservation are essential.
• Parotidectomy: Superficial or total parotidectomy. Facial nerve identification and preservation throughout the gland is the primary technical priority.
• Neck dissection: Selective, modified radical or radical removal of cervical lymph nodes that is performed simultaneously with primary resection or staged. Extent determined by the primary site and imaging evidence of nodal involvement
• Concurrent chemoradiation: Primary treatment for oropharyngeal, nasopharyngeal and organ-preservation laryngeal protocols that are delivered on the Elekta Versa HD with IMRT precision and concurrent cisplatin-based chemotherapy.
• Post-operative radiation or chemoradiation: For close margins, multiple positive nodes or adverse pathological features delivered on the Elekta Versa HD with IGRT-verified positioning and IMRT dose conformality.

When Should You See a Doctor?

Head and neck cancer is most often diagnosed late because early symptoms are normalised. See a specialist promptly for:

• Any white or red patch, or an oral ulcer not healing within two to three weeks
• Hoarseness lasting more than two to three weeks
• A neck mass present for more than two to three weeks, such as painless cervical lymphadenopathy in an adult, is malignant until proven otherwise.
• Any tobacco or areca nut user with a new change in oral mucosa. 

Conclusion

Head and neck cancer surgery requires a team that understands the anatomy, oncology and functional consequences of each decision and an infrastructure that delivers the full programme: PET CT staging, ablative and reconstructive surgery, adjuvant chemoradiation and speech, swallowing & nutritional rehabilitation.

At Ramkrishna CARE Hospitals, Raipur, PET-CT staging on the uMI 550, subspeciality head and neck surgery, precision radiation on the Elekta Versa HD and multidisciplinary rehabilitation are all within a single integrated programme coordinated by a tumour board reviewing every case before treatment begins.