Department of Oncology
Cancer has become a scary word today. The only way to deal with any cancer related problem is to educate you about it. Punjab is the cancer capital of the country, a survey conducted by Punjab government showed that Punjab has higher incidence of cancer than the rest of the country. There are at least 90 cancer patients for every 100,000 population in Punjab. Early stage detection of cancer can help the treatment in a lot of ways. With a team of dedicated doctors at Capitol, we take you through each level with utmost care with compassion. We ensure that you get the best cancer treatment in Punjab when you come to Capitol Hospital.
Capitol Hospital provides main types of treatment procedures when it comes to dealing with different types of cancers:
- Surgical Oncology: Surgical Oncology is the surgical management of cancer treatment. It is the precise local treatment where a surgeon may remove a portion of the tumor or obtain a specimen for diagnosis. It is the oldest type of cancer therapy which is concerned with removal of cancerous tissue from the body.
- Radiation Therapy: Radiation Therapy also known as Radiotherapy is the use of high-energy x-rays or other particles to kill cancer cells.
TrueBeam system, an advanced radiotherapy technology in cancer treatment with pinpoint accuracy and precision is used for Cancer treatment. Capitol Hospital is only one in this region to have this technology which can help in your Cancer treatment effectively. Owing to its pinpoint accuracy, the TrueBeam system can be used to treat many different types of tumors, like those in sensitive areas such as the abdomen, liver, lung, breast and head and neck without causing any damage to nearby tissues. Treatments focus powerful radiation on the tumor while minimizing exposure of surrounding healthy tissues.
- Medical Oncology (Chemotherapy) : Department of medical oncology at Capitol hospital is a comprehensively facilitated center involved in diagnoses and treatment of solid and Hematological malignancies. Chemotherapy is the use of drugs to kill cancer cells.
- Well Equipped day care Center delivers day based infusional chemotherapies to patients under all as pectic condition. Laminar air flow chamber and continuous monitoring. Drugs are dispensed by highly qualified nursing staff under the guidance of consultants.
What is Cancer?
In normal terminology, it is the uncontrolled growth of abnormal cells in the body. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues. Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemia, generally do not form solid tumors.
Types of Cancer
There are more than 200 different types of cancer characterized by abnormal cell growth. There are many different causes, ranging from radiation to chemicals to viruses; an individual has varying degrees of control over exposure to cancer-causing agents.
Cancers are divided into groups according to the type of cell they start from. This includes
- Carcinomas : Cancer that begins in the skin or in tissues that line or cover internal organs.
- Lymphomas & Myeloma: Cancers that begin in the cells of the immune system
- Leukaemias : Cancer that starts in blood forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and go into the blood
- Brain & Spinal cord cancers: These are known as central nervous system cancers
- Sarcomas : Cancer that begins in the connective or supportive tissues such as bone, cartilage, fat, muscle, or blood vessels
We will be explaining in detail some common types of cancers people have:
Head & Neck Cancer: These are of various types.
- Para nasal sinuses
- nasal pharynx
- oral cavity & oropharynx
- laryngopharynx & Hypo pharynx
Sinuses are cavities (spaces) or small tunnels. They are called paranasal because they’re around or near the nose.The nasal cavity opens into four types of sinuses, as displayed in the illustration.
Any of the cells that make up the mucosa can become cancer, and each type behaves or grows differently from the other.
- Squamous epithelial cells can become squamous cell carcinomas. This forms the most common type of cancer in the nasal cavity and paranasal sinuses. It makes up a little over half of cancers of these areas.
- Minor salivary gland cells can turn into adenocarcinomas, adenoid cystic carcinomas,and mucoepidermoid cancers. These also are common nasal and paranasal sinus cancers.
- Undifferentiated carcinoma is yet another type of cancer that can come from mucosa cells. This is a fast-growing cancer in which the cells look so abnormal that it’s hard to identify in what type of cell the cancer first started.
- Cells that give the skin its tan or brown color are called melanocytes. Melanoma is a type of cancer that starts in these cells. It has a tendency to grow and spread quickly. These cancers usually are found on sun-exposed areas of the skin but can form on the lining of the nasal cavity and sinuses or other areas inside the body.
- Esthesioneuroblastoma is a cancer that starts in the olfactory nerve (sense of smell). This cancer is also called olfactory neuroblastoma. It usually starts in the roof of the nasal cavity and involves a structure called the cribriform plate. These tumors can sometimes be mistaken for other types of tumors, like undifferentiated carcinoma or lymphoma.
- Lymphomas(cancers starting in immune system cells called lymphocytes) can occur in the nasal cavity and paranasal sinuses. One type of lymphoma seen in this area, T-cell/natural killer cell nasal-type lymphoma, was previously called lethal midline granuloma.
- Sarcomas are cancers of muscle, bone, cartilage, and fibrous cells that can start anywhere in the body, including the nasal cavity and paranasal sinuses.
Each of these types of cancer has a distinct behavior and outlook. They cannot all be treated in the same manner. Many of them rarely affect the nasal cavity and paranasal sinuses, so they’ve been hard to study. Due to this, doctors usually base their treatment decisions on their experience with similar cancers in other parts of the head and neck.
After your cancer is diagnosed and staged, your cancer care team along with doctors at Capitol Hospital will discuss with you about your treatment options. Choosing a treatment plan is an important decision, so it’s important to take time and think about all choices put forth.
Treatment for nasal cavity or paranasal sinus cancer may include:
- Radiation therapy
- Targeted therapy
- Palliative treatment
Depending on the stage of the cancer and your basic health and well-being, different treatment options may be used alone or in combination.
Pharynx is the medical name for the throat. The pharynx is in three parts. The nasopharynx is one of these parts. The nasopharynx connects the back of your nose to the back of your mouth. Cancer that develops in the nasopharynx is called nasopharyngeal cancer.
Some people with nasopharyngeal cancer have no symptoms at all. But it is important that you tell your doctor if you have any of the following symptoms for more than three weeks:
- a lump or growth anywhere in the neck area that does not go away after three weeks
- hearing loss – usually on one side only
- ringing in your ears (tinnitus)
- fluid collecting in your ear
- blocked or stuffy nose – particularly if it’s only blocked on one side
- blood stained discharge from your nose
- double vision
- numbness of the lower part of your face
- difficulty with swallowing
- changes in your voice, like hoarseness
Here at Capitol Hospital, a team of doctors and other professionals discuss the best treatment which is suited for you. We call it a multidisciplinary team (MDT).
The treatment you have depends on certain factors as:
- where your cancer is
- how far it has grown or spread (the stage)
- the type of cancer
- how abnormal the cells look under a microscope (the grade)
- your general health and level of fitness
The doctor will discuss your treatment, its benefits and the possible side effects with you.
Radiotherapy is the main treatment for nasopharyngeal cancer. You might have it on its own or with chemotherapy (chemoradiotherapy).
You might have chemotherapy if nasopharyngeal cancer has spread to:
- the lymph nodes in your neck
- other parts of your body, such as the lungs or bones
Having chemotherapy and radiotherapy at the same time is called chemoradiotherapy. The chemotherapy makes the cancer cells more sensitive to radiotherapy.
Surgery is not a common treatment for nasopharyngeal cancer. This is because the area is very difficult to get to and is surrounded by important nerves and blood vessels.
Oral Cavity and Oropharyngeal Cancer:
Oral cavity and oropharyngeal cancers start in the mouth or throat. Oral cavity cancer, or just oral cancer, as it is called is atype of cancer that starts in the mouth (also called the oralcavity). Oropharyngeal cancer starts in the oropharynx, which is the part of the throat just behind the mouth.
What is Oral Cavity?
The oral cavity includes the lips, the inside lining of the lips and cheeks (buccal mucosa), the teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, and the bony roof of the mouth (hard palate).
What is Oropharynx?
The oropharynx is the part of the throat just behind the mouth. It begins where the oral cavity stops. It includes the base of the tongue (the back third of the tongue), the soft palate (the back part of the roof of the mouth), the tonsils, and the side and back wall of the throat.
There are different kinds of risk factors. Some, such as your age or race, can’t be changed. Others may be related to personal choices such as smoking, drinking, or diet. Some factors influence risk more than others. Herein, we discuss the popular ones:
- Tobacco and alcohol:
Tobacco and alcohol consumption are among the strongest risk factors for oral cavity and oropharyngeal cancers.
- Betel quid and gutka:
Many people chew betel quid, which is made up of areca nut and lime wrapped in a betel leaf. Then, there is an entire population which also chews gutka, a mixture of betel quid and tobacco. People who chew betel quid or gutka have an increased risk of cancer of the mouth.
- Human papillomavirus (HPV):
Human papillomavirus (HPV) is a group of more than 150 types of viruses. They are called papillomavirusesbecause some of them cause a type of growth called a papilloma.
Oral and oropharyngeal cancers are more common in men than in women. This could be because men have been more likely to use tobacco and alcohol in the past.
Cancers of the oral cavity and oropharynx usually take many years to develop, so they are not common in young people. Most patients with these cancers are older than 55 when the cancers are first found.
Post cancer detection, your doctor will discuss treatment choices with you. Based on the stage and location of the tumor, the patient always has different types of doctors on the treatment team.
The main treatment options for people with oral and oropharyngeal cancers are:
- Radiation therapy
- Targeted therapy
- Palliative treatment
These may be used either alone or in combination, depending on the stage and location of the tumor. Generally, surgery is the first treatment for cancers of the oral cavity, and may be followed by radiation or combined chemotherapy and radiation. Oropharyngeal cancers are usually treated with a combination of chemotherapy and radiation.
Laryngeal and Hypopharyngeal cancer:
Laryngeal and hypopharyngeal cancers start in the lower part of the throat. Cancers that start in the larynx are termed aslaryngeal cancers. Cancers that start in the hypopharynx are called hypopharyngeal cancers.
Majorly all the cancers in the larynx or hypopharynx develop from thin, flat cells called squamous cells, which are in the epithelium, the innermost layer lining these 2 structures. Cancer that starts in this layer of cells is called squamous cell carcinoma or squamous cell cancer.
What is the larynx?
The larynx is the voice box. It’s one of the organs that help us speak. It contains vocal cords. It is located in the neck, above the opening of the trachea (windpipe). There, it helps keep food and fluids from entering the trachea.Cancer that starts in the larynx (laryngeal cancer) is treated based on which section it begins in.
What is the hypopharynx?
The hypopharynx is the part of the throat (pharynx) that lies beside and behind your larynx. The hypopharynx is the entrance into the esophagus (the tube that connects the throat to the stomach).
A risk factor can be anything that affects your chance of getting a disease like cancer. Different cancers have different risk factors associated with them.
Laryngeal and hypopharyngeal cancers are often grouped with other cancers of the mouth and throat (commonly called head and neck cancers). These cancers often have many of the same risk factors, which are listed below.
- Tobacco and Alcohol consumption:
Tobacco use is the most important risk factor for head and neck cancers (including cancers of the larynx and hypopharynx). The risk for these cancers is much higher in smokers than in non-smokers.
Moderate or heavy alcohol use (more than 1 drink a day) also increases the risk of these cancers, although not as much as smoking.People who use both tobacco and alcohol come into the highest risk of all categories. Combining these two habits doesn’t just add both risks together, it actually multiplies them.
- Poor nutrition:
Poor nutrition may increase the risk of getting head and neck cancer. The exact reason for this isn’t clear. Heavy drinkers often have vitamin deficiencies, which may help explain the role of alcohol in increasing risk of these cancers.
- Human papillomavirus infection:
Human papillomavirus (HPV) is a group of over 150 related viruses. They are called papilloma viruses because some of them cause a type of growth called a papilloma, more commonly known as a wart.Infection with certain types of HPV can also cause some forms of cancer, including cancers of the penis, cervix, vulva, vagina, anus, and throat.
- Genetic syndromes:
People with syndromes caused by inherited gene defects (mutations) have a very high risk of throat cancer, including cancer of the hypopharynx.
- Workplace exposures:
Long and intense exposures to wood dust, paint fumes and certain chemicals used in the metal working, petroleum, plastics and textile industries can increase the risk of laryngeal and hypopharyngeal cancers.
Treatment for laryngeal or hypopharyngeal cancer may include:
- Radiation therapy
- Targeted therapy
Depending on the stage of the cancer and your overall health, different treatment options may be used alone or in combination, as it will be discussed with you by your oncologist.