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Head & Neck Disease Management Group
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Bio Medical Waste Report For Shalimar Bagh

Month Red Autoclave(Infected Plastic Waste) Yellow- Incineration(AnatomicalWaste & Soiled Waste) Blue Autoclave (Glass- Bottles) Black Cytotoxic- Incineration( Cytotoxic Contaminated Items) White- Sharp Total Bags Total Weight(In KG's)
  No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's)    
Apr-17 924 2963.50 954 2994.10 239 1017.30 103 279.20 1645 606.40 3865 7861.00
May-17 1175 4624.12 1028 3498.40 276 1524.34 87 195.01 1803 823.85 4369 10665.71
Jun-17 1060 4511.45 902 2886.66 293 1324.05 76 194.00 2057 1100.69 4388 10016.85
Jul-17                     0 0.00
Aug-17                     0 0.00
Sep-17                     0 0.00
Oct-17                     0 0.00
Nov-17                     0 0.00
Dec-17                     0 0.00
Jan-18                     0 0.00
Feb-18                     0 0.00
Mar-18                     0 0.00
YTD 3159 12099.065 2884 9379.155 808 3865.69 266 668.705 5505 2530.94 12622 28543.555
Home >> Our Specialities >> Head & Neck

Head & Neck

In Head and neck DMG (disease management group) at Max institute of cancer care, we have a dedicated and expert team of doctors who deals with head and neck cancers. Head and neck cancer comprises of a wide range of tumors that can develop in several areas of the head and neck, including the mouth, throat, larynx (voice box), nose, sinuses, thyroid and salivary glands. Our team includes head and neck surgeons, radiation oncologists, medical oncologists, plastic and reconstructive surgeons, Maxillofacial surgeon, radiologists, pathologists, speech and swallowing therapists, nuclear medicine and nutritionist. This team only take care of head and neck cancer patients as their requirement are different and specific in comparison to other tumours.

We sit together in head and neck tumour board and discuss each case in detail to ensure that we can provide best treatment to the patient keeping in mind of specific requirement of each patient. We also meet regularly to analyse our results to improve patient care.

Having experts from all of these disciplines ensures that your treatment plan is coordinated and comprehensive not just in the treatment phase but even after the treatment is over for a much better recovery and rehabilitation for a fruitful life ahead.

What is HEAD AND NECK CANCER?

  • Oral (Mouth) Cancer
  • Laryngeal Cancer
  • Pharyngeal (Throat) Cancer
  • Thyroid Cancer
  • Nasal Cavity & Paranasal Sinus Cancers
  • Parathyroid Tumors
  • Salivary Gland Tumours
  • Skin cancers
  • swelling in the neck
  • a non-healing ulcer in the mouth
  • a red or white patch in the mouth that doesn't go away
  • persistent hoarseness or a change in the voice
  • persistent pain in the neck, throat, or ears
  • blood in the sputum
  • difficulty chewing, swallowing, or moving the jaws or tongue
  • numbness in the tongue or other areas
  • loosening of teeth
  • frequent nosebleeds, ongoing nasal congestion, or chronic sinus infections that do not respond to treatment

Risk involved

  • Tobacco and Alcohol Use
  • HPV infection
  • may be genetic

Prevention

  • Lifestyle changes- e.g. Cessation of smoking and tobacco chewing
  • Periodic check up in case of symptoms

Doctors may ask the patient for many tests to find or diagnose cancer. They also do tests to see if cancer has spread to another body parts from where it started.

For almost all types of cancer, a biopsy is one of the only sure ways for the doctor to learn if an area of the body has cancer. In a biopsy, the doctor takes a tiny sample of tissue for testing in a laboratory; if in case a biopsy is not possible, then the doctor may suggest other tests so that diagnosis can be made.

If a patient has symptoms of head and neck cancer, the doctor will take a complete medical history, including signs and symptoms, in addition to this the following tests may be required to diagnose head and neck cancer:

  • Physical examination During a physical examination, if the doctor feels for any lumps on the neck, lips, gums, and cheeks, then the doctor will also examine the nose, mouth, throat, and tongue for abnormalities, by generally using a light and a mirror for a clearer view.
  • Endoscopy: An endoscopy allows the doctor to look the inner body with a thin, lighted, flexible tube known an endoscope. The examination has various names depending on the part of the body which is examined, such as laryngoscopy to see the larynx, pharyngoscopy to see the pharynx, or nasopharyngoscopy to see the nasopharynx. When these procedures are mixed, they are sometimes attributed to a panendoscopy.
  • Biopsy : A biopsy is a procedure in which the small amount of tissue is removed for the examination under a microscope, post that analysis of tissues is done by a pathologist..
  • Molecular testing of the tumor. The doctor may ask for running laboratory tests on a tumor sample to analyze specific genes, proteins, and various factors that are unique to the tumor. The basis on the results of these tests, it will help the doctor to decide whether your treatment options include a sort of treatment known as targeted therapy.
  • X-ray/barium swallows: An x-ray is an approach to build a picture of the structures that are inside the body, by using a tiny amount of radiation. A barium swallow may be needed to describe abnormalities along with the swallowing passage.
  • Panoramic radiograph : This test is done to detect cancer or evaluate the teeth before radiation therapy or chemotherapy. This is often called a Panorex. It is a rotating, panoramic, x-ray of the upper and lower jawbones.
  • Ultrasound: An ultrasound uses the sound waves to generate a picture of internal organs. It is an important test in evaluation of thyroid carcinoma.
  • Computed tomography (CT or CAT) scan : A CT scan constructs a 3-dimensional image of the inner body using x-rays that are taken from various angles; a computer combines these images into an intricate, cross-sectional view that shows any abnormalities or tumors.
  • Magnetic resonance imaging (MRI): An MRI uses magnetic fields, not x-rays, to produce specific images of the body, mainly the images of soft tissue, like the tonsils and tongue. MRI may also be used to measure the size of a tumor and neck node status.
  • Positron emission tomography (PET) or PET-CT scan A PET scan is usually combined with a CT scan which is known as a PET-CT scan. A PET scan is a way to produce pictures of organs and tissues that are inside the body. A little amount of radioactive sugar stuff is injected into the patient’s body. This sugar substance is taken up by a cell that uses most of the energy. As cancer tends to use the energy very actively, it soaks up more of the radioactive substance. Post that scanner detects this substance to produced images of the inner body.
    PET CT scan can detect if cancer spreads to other organs in the body.

Once the diagnostic tests are done, the doctor will evaluate all of the results with the patient. If the patient is suspected of cancer, all these reports help the doctor describe the type of cancer. All the process of diagnosis is known as staging.

Numerous cancers of the head and neck can be cured, mostly if they are found at an early stage. While removing cancer is the principal goal of the treatment, conserving the function of the adjacent nerves, organs, and tissues are also very important. When planning treatment, doctors contemplate how treatment might affect a patient’s standard of living, for instance how a patient feels, looks, talks, eats, and breathes.

Generally, the major treatment options are surgery, radiation therapy, chemotherapy, and targeted therapy. Surgery or radiation therapy by themselves or a mix of these treatments can be part of a patient’s treatment plan. Treatment alternatives and guidance depends on several factors, which include:

  • The category and stage of head and neck cancer
  • Viable side effects
  • Preference of patient and overall health

Patients care plan may also involve treatment for symptoms and side effects, which is a key part of cancer care. One can take time to learn about all of the treatment options and be sure to ask questions about things that are not clear. In addition to this feel free to talk to the doctor about the goals of every treatment and what all can be expected while getting treatment.

  • Surgery is one of the main stay of treatment of head and neck cancers. MICC has expert team of surgeons who has experience to remove tumours completely and preserving the normal structures. Our aim in surgery is to give maximum result with minimum morbidity.
  • Our head and neck surgeons are expert in doing surgeries for all head and neck subsites.
  • Buccal mucosa (cheek) cancers- We take out tumour completely and if feasible, try to preserve the normal structures around the tumour, e.g. preservation of lower jaw bone (mandible) by preserving it completely or partial removal of bone(marginal mandibulectomy)
  • Tongue cancers- aim is adequate tumour removal and preservation of voice and swallowing
  • Larynx (voice box) carcinoma- Try to give voice back to the patient even after total laryngectomy (complete voice box removal) by inserting voice prosthesis. Also early stage tumours can be removed completely with Transoral Laser surgery with good preservation of voice.
  • Oropharynx (throat cancers)- usually these tumours treated with radiotherapy and chemotherapy but early stage tumour and recurrent tumours can be removed with Transoral robotic surgery (TORS) with good results in MICC.
  • Thyroid cancers- We have well trained doctors for thyroid surgery and they work in coordination with nuclear medicine and endocrinology department. We have full facility of post operative adjuvant radioactive iodine therapy. We also do intra operative nerve monitoring.
  • Parathyroid tumours- our emphasis of removal of parathyroid adenomas with focused approach with minimal invasive technique with good cosmetic effect. We have facility of intra operative PTH sampling and frozen section.
  • Skull base tumous – we have trained surgeons in endoscopic skull base tumour removal along with expert team of neurosurgery.
  • Salivary gland tumour- our aim to remove salivary gland tumour removal with preservation of cranial nerves. We have facility of intra operative nerve monitoring.
  • Reconstructive surgery- Reconstructive surgery is now a days an integral part of any head and neck cancer unit. If in case cancer surgery needs major tissue removal, for instance removing the jaw, skin, pharynx, or tongue, so, reconstructive or plastic surgery may be done to restore the missing tissue. This sort of operation helps restore a patient’s looks and the function of the affected area.Good reconstruction is required for good functional outcome in terms of speech and swallowing and good cosmetic outcome. We have the facility of complex microvascular free flap reconstruction.
WHY TO CHOOSE MICC FOR HEAD AND NECK SURGERY?
  • We treat a good number of head and neck patients in MICC. We have expert and experienced surgeons who are capable of doing all kind of complex head and neck surgeries. We have cutting edge technology e.g. Transoral robotic surgery and Transoral Laser surgery.
  • We have experienced team of anesthetists who look after the patients during surgery. We have experienced nursing staff and physiotherapists who are trained to look after specifically head and neck post operative patients.
  • We audit our results regularly for patient satisfaction not only in terms of surgery but also overall stay in hospital and try to improve each time.

The aim of radiation therapy is to use beams of radiation to kill cancer cell with as little risk as possible to normal cells. Radiation treatment, like surgery,is a local treatment .It affect the cancer cells only in a specific areas of the body. Radiation therapy can be used before surgery to shrink a tumor called as neoadjuvant Radiation. Radiation therapy may be used after surgery to stop growth of cancer cells that may remain called as adjuvant Radiation. Radiation therapy can be used at the time of surgery known as Intraoperative Radiation (IORT).

The source of radiation may be from a machine outside the body also called as EBRT or External Beam Radiation therapy or from radioactive material placed as close as possible to the cancer cells (Brachytherapy).

EBRT is usually given during outpatient visits to a hospital .In this, a machine directs the high energy rays at the tumor and a small margin of normal tissue surrounding it. The type of machine used for radiation therapy at MAX cancer centre is called as a Linear Accelerator, True Beam STX . It has the facility for IMRT (Intensity Modulated Radiation Therapy), IGRT (Image Guided Radiation Therapy),SRS (Stereotactic Radiation Therapy), SBRT(Stereotactic Body Radiation Therapy).

Intensity-modulated radiation therapy (IMRT) and Image Guided Radiation Therapy (IGRT) for head and neck cancers or carcinomas refers to a new approach that uses computer based optimization process to carefully create a gradient or a dose fall-off between the target tissues and the surrounding normal tissues at risk. This fall of dose saves he surrounding normal structures effectively. Therefore these techniques and technology offers the prospect of increasing the locoregional control probability while decreasing the complication and side effects rate.

Image guided radiotherapy is classically defined as radiation therapy that is delivered only after verification of position of structures of interest by performing either an X-Ray or CT based image. The same are done by an imaging system mounted on the linear accelerator itself.

True beam STX is an advanced radiotherapy system to deliver more powerful cancer treatments with pinpoint accuracy and precision. It uniquely integrates advanced imaging and motion management technologies within a sophisticated new architecture that makes it possible to deliver treatments more quickly while monitoring and compensating for tumor motion.

While technology always opens the doors it is always a skilful doctors who can get inside it. To make the best skills available to our patients, we at Max have super-specialised “Head and Neck Disease Management Group” which is composed of individuals who are skilled in management of head and neck cancers from all disciplines of surgery, radiation therapy, chemotherapy, speech and swallowing rehabilitation, plastic surgery, physiotherapy, nutrition and dietetics, dentistry and implantology.

Medicines form an important armamentarium in the fight against head neck cancers. It's used primarily in the following scenarios

  • Concurrent partner to radiotherapy to increase the efficacy
  • Neoadjuvant modality- To make inoperable tumours operable by reducing the size
  • to control Metastatic ( cancer which has spread beyond the site of origin) or locally advanced tumour not amenable to surgery or radiotherapy.

The medicines include

  • chemotherapy drugs - these can be intravenous or oral. Examples are paclitaxel or cisplatin etc.
  • monoclonal antibodies - these are new class of drugs which are more specific in their actions and include immunotherapy drugs and other types of drugs. Examples include Cetuximab Nimotuzumab or Nivolumab

At MICC we are equipped to admister all types of chemotherapies or monoclonal antibodies as per latest international protocols at our state of art and the largest Day care facility or as an Indoor patient.

  • Speech and swallowing
    We have experienced speech and swallowing therapists who are integral part of head and neck team to help all the patients who underwent head and neck surgery, radiation therapy or chemotherapy. They do it with individualistic approach as requirement for each head and neck patient is different according to therapy and surgery is done.
    They also help in restoration of speech in post laryngectomy patients ( tracheoesophageal speech , Esophageal speech)
  • Physiotherapy –
    Physiotherapists are part of head and neck team who work with patient for early rehabilitation in terms of early mobilization after surgery.
  • Pain management
    We have specialist palliative care and pain management doctors who can help in decrease your pain during and after treatment.
  • Nutritionists –
    We have a team of dieticians who take care of each patient’s specific diet according to his/her treatment and comorbidities.

Head & Neck

Head & Neck At

Team That Cares

Dr. Harit Chaturvedi_new_0 - Max Hospital
Chairman – Cancer Care, Director & Chief Consultant - Surgical Oncology
Cancer Care / Oncology
Dr. A. K. Anand - Max Hospital
Senior Director - Radiation Oncology
Cancer Care / Oncology
Dr. Ranga Rao - Max Hospital
Senior Director- Medical Oncology
Cancer Care / Oncology
Dr Vineeta Goel - Max Hospital
Associate Director - Radiation Oncology
Cancer Care / Oncology
Gagan Saini - Max Hospital
Associate Director – Radiation Oncology
Cancer Care / Oncology
Sowrabh Arora - Max Hospital
Principal Consultant - Surgical Oncology (Head and Neck Oncology)
Cancer Care / Oncology
Dr. Devavrat Arya - Max Saket
Senior Consultant
Cancer Care / Oncology
Picture1-2 - Max Hospital
Senior Consultant – Medical Oncology
Cancer Care / Oncology
Shubham Garg - Max Hospital
Senior Consultant
Cancer Care / Oncology
Dr Vikas Goswami
Senior Consultant – Medical Oncology
Cancer Care / Oncology
Dr. Jyotika Jain -
Senior Consultant
Cancer Care / Oncology
Dr. Rajat Saha - Max Hospital
Senior Consultant – Medical Oncology
Cancer Care / Oncology
Dr. Saurabh Gupta - Max Smart
Consultant - Surgical Oncology
Cancer Care / Oncology
Dr. Vineet Govinda Gupta
Associate Consultant
Cancer Care / Oncology

Real People, Real Stories

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WHAT WE DO

  • HN cancers constitute 25% of the annual registrations at Max Institute of Cancer Care (MICC) .
  • The DMG comprises of major oncology specialists (Surgical, Radiation and Medical oncology), effectively supported by other ancillary and rehabilitative services, providing effective, evidence based care for HN cancer.
  • Multi disciplinary Joint Clinics to suit the individual treatment decision are held to evaluate the newly diagnosed patients. The plans are evidence based adhering to international guidelines.
  • Our Specialized Services include Skull Base surgery, Robotic surgery, Laser surgery ,Micro vascular reconstruction and rehabilitative care.
  • We provide a strong backup of oncosurgical ICU care as well as specialized intensivists and nursing support.
  • We provide patient-centred care with dedicated staff to support the patient and families psychological and social needs

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