Head and neck cancer is a type of cancer that occurs in the broad head and neck region, which encompasses the base of the skull and the upper part of the esophagus. Excluding tumors that occur in the brain and eyes, it refers to malignant tumors that occur in about 30 areas, including the thyroid gland, nasal cavity, salivary glands, tongue, pharynx, hypopharynx, and larynx.

Eighty-five percent of head and neck cancer patients are associated with smoking. The risk of developing cancer increases by 15 to 20 times when smoking is combined with alcohol consumption. Gender-wise, men are reported to be more vulnerable to head and neck cancer than women.

HPV-related oropharyngeal cancer increases among young people

Head and neck cancers associated with the human papillomavirus (HPV), which is known to cause cervical cancer, are rapidly increasing worldwide. The incidence of head and neck cancer is rising among young people. In developed countries, including the U.S. and Europe, the incidence of oropharyngeal cancer caused by HPV is on the rise.

Although smoking-related head and neck cancer is decreasing due to a decline in the smoking population, HPV-related oropharyngeal cancer incidence is also increasing in Korea. As a result, safe sexual practices are recommended, and both women and men are advised to receive HPV vaccines.

Head and neck cancer often goes undetected in its early stages due to the absence of symptoms, leading to diagnosis at an advanced stage. The five-year survival rate is 50–60 percent, indicating a poor prognosis. However, if detected early, the cure rate exceeds 80 percent. As with other diseases, early detection is crucial.

Head and neck cancer can be diagnosed initially through laryngoscopy. If the endoscopy results are suspicious, a biopsy is performed, and if cancer is diagnosed, imaging tests are conducted to determine the extent of the cancer.

Multidisciplinary collaboration is essential for diagnosis and treatment

Head and neck cancer is treated with surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy, depending on the location and stage of the cancer. Due to the variety of locations and types, the diagnosis, treatment, and rehabilitation processes require the expertise of various medical departments. A multidisciplinary treatment system involving otolaryngology, oncology, radiation oncology, radiology, pathology, nuclear medicine, plastic surgery, dentistry, and ophthalmology is crucial.

Head and neck cancer surgery is highly complex due to the intricate network of nerves, blood vessels, and muscles in the area. Minimizing the loss of major functions such as eating, speaking, and breathing after surgery is also important. If the defect is large after tumor removal, reconstructive surgery may be necessary to transplant tissue from other parts of the body. This also requires advanced technology.

In the past, head and neck cancer surgery involved extensive resection due to poor prognosis. Postoperative complications, including dysphagia and voice disorders, were severe, and extensive scarring and facial deformities led to low patient satisfaction. Recently, the limitations of head and neck cancer surgery have been overcome with the introduction of robotic surgery, which minimizes damage and enables precise surgery.

Currently, robotic surgery is most actively used in oropharyngeal cancer (tonsil cancer and base of tongue cancer). In the case of tonsil cancer surgery, large-scale reconstructive surgery was previously required, and the surgery time was long. With the introduction of robotic surgery, tumors can be removed with precision, and surgery and recovery times have been significantly reduced.

Robotic oropharyngeal cancer surgery enables precise surgery through the narrow oral cavity using thin robotic arms. Compared to traditional surgical methods, it has the advantage of narrowing the surgical field and shortening the recovery period, thereby improving patients' quality of life after surgery.

On a tumorological level, it demonstrates equivalent treatment outcomes compared to conventional surgical methods and is now recognized as the standard treatment for oropharyngeal cancer. The greatest advantage is that the use of robots enables precise surgery, minimizing damage to normal tissue and preserving the ability to eat and speak after treatment.

After head and neck cancer surgery, difficulty swallowing may lead to aspiration pneumonia. Swallowing exercises and rehabilitation exercises should be performed concurrently to aid in functional recovery. After surgery, it is advisable to consume soft, easily digestible foods. If swallowing is difficult, foods can be chopped into smaller pieces or prepared using various cooking methods to make them easier to consume. If oral intake is impossible, enteral feeding via a tube inserted into the nose or stomach may be considered. Smoking and alcohol consumption are major risk factors for head and neck cancer recurrence, so quitting smoking and moderating alcohol intake are essential.

“Head and neck cancer often has no early symptoms, so regular health checkups are crucial for early detection,” said Professor Park Jun-ook of the Department of Otolaryngology at the Head and Neck Cancer Center of the Catholic University of Korea Seoul St. Mary's Hospital. “If you feel a lump in the neck or notice persistent ulcers in the tongue or mouth, it is essential to visit a hospital immediately.”