KUALA LUMPUR, Oct 23 – Head and neck cancers, while often overshadowed by other types of cancer, could have a profound impact on patients’ lives.
They not only threaten survival but also challenge the patient’s self-identity, dignity and the ability to communicate with others.
The loss of speech, ability to swallow, changes to taste of food or even changes to facial features can deeply affect how individuals see themselves and how they connect with others socially.
In Malaysia, head and neck cancers make up around 6 per cent of all newly diagnosed cases and 8 per cent of cancer-related deaths.
Among men, nasopharyngeal cancer, which develops behind the nose and above the soft palate, is the fifth most common, with over 1,600 cases reported in 2022.
Although less common in women, (1.5 per cent of all female cancers), the impact of these cancers extends far beyond statistics.
“Cancer care goes far beyond removing or controlling the tumour,” says Dr Ben Yap Beng Khiong, consultant clinical oncologist at OncoCare Cancer Centre Malaysia.
“The real goal apart from cure from cancer is restoring the patient’s dignity and improving quality of life, ensuring they can communicate effectively, consume food and feel confident in themselves again.”
Understanding Head And Neck Cancers
Head and neck cancer refers to a group of cancers that begin in areas such as the mouth, throat, voice box, nose, sinuses, and salivary glands.
In Malaysia, nasopharyngeal cancer is most common and other head and neck cancers include those of the oral cavity, larynx, and oropharynx (back of the throat, tonsils and base of the tongue) cancers.
Nasopharyngeal cancer is far more common in Malaysia and neighbouring countries than in the West, where it is relatively rare. Contributing factors include Epstein-Barr virus (EBV) infections, family history, diets high in preserved foods such as salted fish, and lifestyle habits like smoking, alcohol consumption and betel quid chewing.
Additionally, infections such as human papillomavirus (HPV) are associated with cancers of the oral cavity and oropharynx. HPV-associated head and neck cancers are increasingly recognised, particularly among younger, non-smoking individuals.
These cancers may present with symptoms such as a persistent sore throat, ear pain, difficulty swallowing, hoarseness, or a neck lump (swollen or enlarged lymph node).
More Than A Medical Diagnosis
For patients, the diagnosis of head and neck cancers goes beyond medical treatment. It affects everyday activities that most take for granted, such as speaking, eating, swallowing and even breathing.
Losing the ability to enjoy meals, converse with loved ones, or participate socially can cause patients to withdraw and feel isolated, and in some cases, struggle to continue working.
“The effects can be very profound,” said Dr Yap. “Many patients feel as though they have lost part of their identity, especially if they can no longer speak clearly or enjoy food as before.
“This loss often leads to embarrassment, social withdrawal or even depression. It can also place strain on family relationships, although many families rise to the occasion and rally together to provide much-needed support.”
These emotional burdens highlight the importance of holistic care that goes beyond tumour removal.
Cancer treatment is not only about survival, but also about supporting patients as they walk through their cancer journey, rediscover their sense of self, and embrace the simple joys that give life meaning.
“We take a multidisciplinary approach, involving not just oncologists but also speech therapists, dietitians, physiotherapists and psychologists.
“Small steps, such as being able to enjoy a meal with family or speak clearly again, play an enormous role in restoring a patient’s confidence and sense of self and well-being,” Dr Yap said.
The integration of emotional and social support, along with empowering patients and their families with treatment information, is equally vital. Families, peer support groups, and survivor communities offer encouragement that can significantly influence recovery outcomes.
“I have personally seen how patients with strong emotional and social support recover more positively, as they feel less lonely,” said Dr Ben Yap.
Breaking Stigma And Misconceptions
Despite medical advances, stigma surrounding head and neck cancers remains a major challenge. Some patients delay seeking treatment because they fear being judged or believe their diagnosis leaves little room for hope, while others worry that treatment will inevitably result in severe disfigurement or the permanent loss of vital functions like speaking and swallowing.
In fact, modern therapies such as precision radiotherapy, chemo-immunotherapy and organ-preserving surgical techniques have advanced greatly, enabling many patients to keep their appearance, voice and ability to eat near to normality.
Yet, these fears can understandably hold people back from seeking help, and when treatment is delayed, it can become less effective.
Advances In Treatment: Precision And Hope
In recent years, significant technological advances have transformed treatment for head and neck cancers.
Techniques such as intensity-modulated radiotherapy (IMRT) allow tumours to be targeted with precision while sparing healthy tissues such as salivary glands and hearing apparatus, resulting in fewer side effects such as dry mouth and hearing loss.
In advanced cases, newer systemic therapies, including targeted drugs and immunotherapy, have improved survival rates and quality of life.
“These advances not only give patients hope but also allow them to keep the ability to speak, eat and live more comfortably, things that are important for recovery and dignity,” said Dr Yap.
HPV-associated head and neck cancers typically have a better prognosis and respond well to treatment; hence, aggressive and mutilating surgery should be avoided whenever possible.
From Fear To Advocacy
One patient with advanced tongue cancer under Dr Yap’s care overcame initial fear and hopelessness through strong family support and a combination of therapies, ultimately achieving a remarkable recovery.
The patient underwent chemo-immunotherapy prior to surgery and radiotherapy. Only a small portion of the tongue was resected, allowing most of its function to be preserved.
“Not only did he recover, but he eventually returned to work,” Dr Yap recounted. “His story will inspire many others to come forward earlier for screening and treatment.”
Awareness And Early Action
The lessons from survivors echo a vital message that cancer is not the end of the story. With timely diagnosis, advanced treatment and holistic care, patients can reclaim their lives.
“Humanising cancer helps break the stigma and encourages more people to seek screening and treatment,” said Dr Yap. “Early detection saves lives and preserves dignity.”
He encourages younger adults to receive the HPV vaccination, which significantly reduces the risk of HPV-associated head and neck cancers.
He also stressed the importance of quitting smoking, a major risk factor for non-HPV related head and neck cancers.
As Malaysia continues the fight against cancer, open conversations and community education are essential.
Breaking the silence not only encourages patients to seek help earlier, but also builds a society where every journey is met with dignity, understanding and support.
