Quality of Life in Patients of Head and Neck Cancer During Covid 19.

The Indian Institute of head and neck oncology, a charitable Cancer Centre under the Indore Cancer foundation, continued to offer treatment during the Covid pandemic. 44 head and neck cancer patients who underwent surgery with adjuvant radiotherapy and 43 head and neck cancer patients who underwent only radiotherapy as the primary line of treatment from March 2020 to May 2021, were selected for the purpose of this study. Patients who underwent treatment for head and neck cancer either by radiotherapy or by surgery followed by post-operative radiotherapy were analysed to evaluate quality of life. Feedback was obtained using a QOL questionnaire. The results were analysed against numerical scores. Pain, appearance, speech, swallowing, chewing taste sensation etc. were analysed. Fear and psychological discomfort remained the overriding aspect.

Head and neck surgery during COVID-19.

Thirty-two Head and Neck cancer patients were operated by surgical team of the Indian Institute of Head and Neck Oncology (IIHNO) in a period ranging from May 2020 to the first week of December 2020. Surgical procedures ranged from surgery for tongue cancer, resection of cancers of the oral mucosa/cheek (with or without reconstruction), as well as surgery for paranasal cancers and thyroid cancers, with an average duration of 3 h for the procedures. This article reviews this experience during the peak of covid pandemic regarding the approaches adopted by the team of the IIHNO, a flagship project of the Indore Cancer Foundation, a public charitable trust.

Out Sourcing of Head and Neck Oncologic Surgery: Cost Considerations.

165 surgeries for head and neck cancer have been performed by a team of the Indian Institute of Head and Neck Oncology IIHNO in 1 year. Integration of private players was necessitated because of need to share available facilities without losing objective of reducing the cost. These surgeries were performed at a private hospital using their resources for the operation theatre and post-operative intensive care services, since the IIHNO does not as yet have an operation theatre facility. The pre-op facilities and post-operative care was done at IIHNO a charitable cancer center under the Indore Cancer Foundation a public charitable trust. Cost analysis of these procedures has been done and the system of integration of the two have been analysed.

Partnering with District Hospitals in India for Fight Against Cancer.

Cancer is a difficult disease to treat particularly in low socioeconomic strata. There are three major challenges: that of early detection, of affordability and easy accessibility to specialised health care. The complexity of health care delivery, lack of structured grassroots level training program for early cancer detection, the shortage of well-equipped hospitals compounds the challenge of detecting as well as treating cancer in village based India. We have tried to reach out to rural population, through district level anti-cancer programs. These included holding (1) free detection camps to find cancers early, (2) training of doctors at district level in early detection (3) wherever feasible, offer radical surgery at the district hospitals itself and (4) train doctors, nurses on relevant palliative care issues including home care of dying cancer patients. We believe that our experience of carrying out more than 200 free cancer detection camps and performing radical surgeries in an outreach program in several districts of central India and surrounding States have the practical potential of a national model for low cost cancer treatment.

Palliative Mastectomy Revisited.

Couple of decades ago, Palliative Mastectomy for locally advanced breast cancers was common, if not frequent surgical procedure in the surgical armamentarium. The advent of better understanding of tumor biology and better multidisciplinary management has certainly narrowed down its role. However there are situations where it is still a potent option. In the subset of patients where palliative mastectomy is to be performed, it is important to aim for clear surgical margins, with good clearance at the third dimension, i.e. the tumor base. Surgeons with adequate experience of breast cancer surgeries should perform the procedure to achieve intended palliation.

Attrition as one of the challenges of developing a palliative care centre: experience of the Indian Institute of Head and Neck Oncology, Indore, India.

Palliative care is an essential component of health care delivery. With respect to India, currently, despite rapid socio economic development, there are tremendous challenges in offering institutional palliative care due to several factors. A major factor has been an acute shortage of trained palliative care professionals. Another has been the fact that the majority of India's population is not covered by any health insurance. We describe the problems, including attrition faced by the Indian Institute of Head and Neck Oncology, in the central Indian state of Madhya Pradesh.

Overall treatment duration with multimodality treatment approach and outcome results in oral cavity carcinoma: A study from an institute from central India.

OBJECTIVE OF THE STUDY: To see the different age groups, gender, sites, disease stage, treatment outcome of various oral cavity sites carcinoma by combined modalities and the overall treatment duration. MATERIALS AND METHODS: A total of 212 oral cavity carcinoma patients (169 males and 43 females) with complete records (from September 2009 to December 2012) were analyzed for age, sex, histopathology, associated medical illnesses, various subsites with disease stage, various treatment modalities with the duration and follow-up records for disease control as well as disease failure at local, nodal, local + nodal, and distant metastasis. RESULTS: The most common site in oral cavity cancer was buccal mucosa 81 (38.20%). 149 (69%) patients reported were in advanced Stages III and IV of the disease. The majority of patients 149 (70.28%) were given chemotherapy + radiotherapy postoperatively (S-CRT group). The mean follow-up for all patients was 41 months (range = 21-59 months). In terms of overall disease control and metastases-free survival, the best results were (80%) for Stage I in all oral cavity sites. Irrespective of disease stage best results (59.57%) were in alveolar ridge subsite of oral cavity carcinoma. CONCLUSION: Challenges are still lie ahead in treating head and neck carcinoma, as in spite of using multimodality treatment approach and biological and molecular research, the overall survival percentage has not changed much. In India as oral cavity carcinoma is in increasing trend in younger individuals massive health promotion and awareness programs targeting the risk population along with financial support for those already affected are required.