Lawrence Chow / ENT Doctor
Post Oral Cancer Surgery: Key Recovery Points and Life Guide
What do patients need to know and pay attention to after completing oral cancer surgery?
Hospital Observation Post-Surgery
If the patient’s surgery requires skin or tissue transplantation, the patient needs to stay in the hospital for several weeks for observation to ensure there is no rejection or infection.
Early Mobilization Post-Surgery
To prevent blood clots, doctors will encourage patients to get out of bed and move as soon as possible after surgery. If unable to get out of bed, patients should try to move their legs as much as possible, which is crucial for recovery. Additionally, to prevent chest infections, patients need to perform deep breathing exercises as taught by the physiotherapist.
Dietary Arrangements Post-Surgery
After oral and throat surgery, patients may not be able to eat normally for some time. Before resuming normal eating, patients will receive intravenous injections to supplement body fluids and nutrients. Some patients may need a nasogastric tube to input high-calorie, high-protein liquids to help maintain energy and speed up recovery. For patients with severe conditions, they may need to rely on a gastric tube for feeding in the future, and the amount to be input daily will be discussed with a nutritionist.
Temporary Tracheostomy Post-Surgery
Surgery on the mouth and throat can sometimes cause swelling of the tissues around the throat, leading to breathing difficulties. Doctors will create a temporary tracheostomy in the lower front of the neck to assist with breathing. Once the swelling subsides, the tracheostomy can be removed. However, for patients who have had their vocal cords removed due to cancer or have undergone a total laryngectomy, the tracheostomy will be permanent.
Temporary Drainage Tubes Post-Surgery
Immediately after the removal of an oral cancer tumor, patients may be unable to get out of bed to use the toilet. Doctors will insert a thin tube into the patient’s bladder to drain urine into a collection bag. Additionally, a thin tube will be connected to the surgical site to drain fluids from the wound to aid in faster healing. These are temporary and can be removed once the wound heals or the patient can get out of bed on their own.
Pain Management Post-Surgery
After oral cancer surgery, patients may feel numbness in the mouth and face. Removal of neck lymph nodes can also cause stiffness in the neck and shoulders. It is normal to feel pain or discomfort in the first few days after surgery, and doctors can prescribe painkillers to help manage the pain.
Recovery of Speech Functions Post-Surgery
Speech functions involve the coordination of multiple organs (larynx, nose, mouth, tongue, teeth, lips, and soft palate). Once oral cancer is present, regardless of the treatment method used, it will affect the functioning of these related organs, sometimes temporarily and sometimes permanently. If the vocal cords are removed or a total laryngectomy is performed, the patient will no longer be able to speak naturally and will need to undergo speech therapy to learn new methods of vocalization.
For any ear, nose, and throat issues, please contact ENT Head and Neck Surgery Centre (Tel: 3100 0555) for a detailed consultation with our ENT specialists (phone 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Oral Cancer Surgery Pre- and Post-Operative Guide: Considerations for Appearance Alterations and Transplant Surgery
The primary treatments for oral cancer are surgery and radiotherapy, sometimes supplemented with other therapies to reduce the risk of recurrence. However, surgical resection of oral cancer may raise concerns about changes in appearance. What should patients consider before surgery? Will the surgery cause disfigurement? Is transplant surgery necessary?
Pre-Surgery Considerations for Oral Cancer Patients:
- Dental Check-Up Before Treatment
During oral cancer treatment, the mouth may become sensitive, painful, and prone to infection. A dentist will assess the patient’s dental health and provide guidance on protecting teeth and gums. Therefore, patients are advised to undergo a comprehensive dental examination to address any dental issues beforehand. The treating dentist should have extensive experience in oral and throat cancers.
- Immediate Smoking Cessation
Patients who smoke must quit immediately. Continued smoking increases treatment side effects and the risk of cancer recurrence or metastasis.
- Why Remove Lymph Nodes If Tests Show No Spread?
Lymph nodes may contain trace amounts of cancer cells undetectable during initial tests. To ensure complete cancer removal, surgeons may remove lymph nodes on one or both sides of the neck. Before surgery, doctors will explain the procedure, the affected area, the extent of resection, and potential short- or long-term impacts. Patients will also learn about necessary rehabilitation, such as speech therapy.
Will Oral Cancer Surgery Cause Disfigurement?
Depending on the tumor’s location and the resection extent, scars on the face or neck may be unavoidable. If disfigurement is significant, doctors may recommend reconstructive surgery. Potential transplant or reconstruction methods include:
- Skin Grafting:Skin from the patient’s arm or chest may be used to cover excised facial areas.
- Bone Grafting:If the jawbone is affected and partially removed, bone grafts from the patient’s body may be used.
- Reconstructive Surgery:Advanced techniques can restore cheekbones post-resection, often with minimal visible changes.
- Artificial Bone Implants:Synthetic bone substitutes can replace resected facial bones, eliminating the need for grafts. Modern implants are highly customized, functional, and aesthetically natural.
Understanding the scope of surgery and its potential consequences is critical before undergoing oral cancer treatment. If you suspect oral cancer or require consultation, please contact ENT Head and Neck Surgery Centre (Tel: 3100 0555). Our ENT specialists have extensive experience in treating oral and throat cancers and will help tailor a suitable treatment plan.
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Oral Cancer and Throat Cancer: Treatment Options and Key Decision-Making
What are the treatment methods for oral and throat cancers?
- Surgery
- Radiotherapy
- Chemotherapy
- Photodynamic Therapy (PDT)
- Immunotherapy (Biological Therapies)
The choice of treatment depends on the cancer’s stage. For early-stage cancers, radiotherapy alone may suffice, but combined approaches (e.g., surgery with radiotherapy) are often used to remove cancerous cells and reduce recurrence.
How are oral and throat cancers staged?
Staging uses the TNM system (T, N, M) with numerical indicators (1–4):
- T: Describes tumor size and local spread.
- N: Indicates spread to nearby lymph nodes.
- M: Reflects distant metastasis.
- Stage 1: Small tumor, no spread.
- Stages 2–3: Spread to adjacent tissues.
- Stage 4: Metastasis to distant organs.
Lower numbers indicate less spread; higher numbers signify advanced disease.
What does the cancer stage signify?
Staging reflects tumor characteristics (size, microscopic features) and spread patterns, aiding doctors and patients in understanding disease progression and selecting optimal treatments.
How is the treatment method determined?
Treatments for oral/throat cancers may impact swallowing, breathing, and speech. Therefore, a multidisciplinary team—including ENT specialists, dentists, oncologists, radiologists, nurses, nutritionists, rehabilitation therapists, and speech therapists—collaborates to tailor a plan based on factors like age, overall health, tumor size, and metastasis.
What happens if I decline the recommended treatment?
Doctors respect patient autonomy and will not proceed without consent. Patients are encouraged to openly discuss concerns or reservations with their physician. Doctors will explain potential outcomes of refusing treatment and may suggest alternative options. Seeking a second opinion is advisable if it does not delay care.
How do I choose between multiple treatment options?
For example, surgery and radiotherapy may both be effective. Patients should compare the procedures, risks, and side effects of each option before deciding.
For questions about treatment, contact ENT Head and Neck Surgery Centre . Our ENT specialists have extensive experience in managing oral and throat cancers (Tel: 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Oral Cancer Diagnosis: A Comprehensive Guide to Key Examination Methods
Facing oral cancer, early diagnosis is the key to overcoming the disease. This article will detail a range of advanced examination methods, including nasal endoscopy, biopsy, fine needle aspiration cytology, microcytoscopy, X-ray, CT scan, magnetic resonance imaging (MRI), bone scan, and ultrasound or positron emission tomography (PET scan). These methods not only help doctors accurately assess the condition but also provide patients with the most suitable treatment plans. We will explain the principles, procedures, and applicable scenarios of these examinations one by one, helping you feel less confused when facing oral cancer.
Common diagnostic methods for oral cancer are briefly described as follows:
Nasal Endoscopy
The doctor will use a nasal endoscope to examine the patient’s oral cavity. The endoscope is equipped with a mirror and light, which reflects strong light into the patient’s mouth, allowing the doctor to clearly see any ulcers or masses in the patient’s oral cavity and throat.
Biopsy
The doctor will take a small amount of soft tissue from the suspected cancerous area and send it for laboratory testing. By examining these cell slices under a microscope, the presence of cancer cells can be determined.
Fine Needle Aspiration Cytology
The doctor uses a thin needle and syringe to extract cell samples from the mass in the patient’s oral cavity for testing. Fine needle aspiration cytology is a relatively simple and quick examination method, and the patient can leave immediately after the procedure.
Microcytoscopy
If a patient has precancerous cells and frequently undergoes biopsies, the doctor may recommend microcytoscopy as an alternative. The doctor applies a small amount of blue dye to the abnormal cells and then observes them under a microscope. This examination is painless, with only slight discomfort.
X-ray
X-rays of the face, neck, oral cavity, jaw, and lungs are taken to determine if the cancer cells have spread.
CT Scan and Magnetic Resonance Imaging (MRI or NMR)
CT scans or MRI can reveal details that X-rays or other examinations cannot. Both methods are quick and painless. However, patients with cardiac monitors, pacemakers, or any surgical clips cannot undergo MRI because the strong magnetic field can interfere with these devices.
Bone Scan
A bone scan can check if cancer cells have spread to the cheekbones near the oral cavity.
Ultrasound or Positron Emission Tomography (PET Scan)
Ultrasound or positron emission tomography (PET scan).
Before each examination, the ENT specialist will explain the reasons for the test, the procedure, and any potential risks to the patient. To accurately assess the patient’s condition and determine the appropriate treatment, the patient may need to undergo one or a combination of the above examinations.
For any ENT issues, please immediately contact ENT Head and Neck Surgery Centre for detailed evaluation by our ENT specialists (Tel: 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Understanding Oral Cancer: Causes, Symptoms, and High-Risk Groups
What is Oral Cancer?
The oral cavity includes the lips, gums, tongue, floor of the mouth, hard and soft palate, uvula, tonsils, inner cheeks, pharynx, hypopharynx, salivary glands, and parotid glands. Cancerous cells can develop in any of these areas, forming oral cancer.
What Are the Causes and Symptoms of Oral Cancer?
Who is More Susceptible to Oral and Throat Cancer? How to Determine if Swollen Neck Lymph Nodes Signal Cancer?
What Causes Oral and Throat Cancer?
Like many cancers, the exact causes of oral and throat cancer are unclear. However, individuals who smoke or consume alcohol excessively have a higher risk. Pipe or cigar smokers also face increased risks of tongue and cheek cancers. In regions where betel nut chewing is common or diets lack fresh fruits and vegetables, the incidence of oral and throat cancers is similarly elevated.
Who is More Likely to Develop Oral and Throat Cancer?
- Smokers and heavy alcohol consumers
- Elderly males
- Individuals with diets low in fresh fruits and vegetables
- Note:Oral and throat cancers are not hereditary.
What Are the Symptoms of Oral and Throat Cancer?
- Ulcers or lumps in the mouth, throat, head, or neck
- Pain while eating or speaking
- Noisy breathing, slurred speech, or hoarseness
- Numbness in the mouth or lips
- Sudden loosening of teeth
- Persistent nasal congestion or nosebleeds
- Sore throat
- Ear pain
- Swelling or lumps in the mouth or neck
- Pain in the face or upper jaw
These are the most common symptoms of oral and throat cancer. Symptoms vary depending on the tumor’s location. For example, tongue cancer may cause slurred speech, while hypopharyngeal cancer can lead to hoarseness. Smokers and heavy drinkers may develop painless white or red patches in the mouth or on the tongue, which may bleed—a potential early sign of oral cancer.
Are Swollen Neck Lymph Nodes a Precursor to Oral Cancer?
It is not definitive. A thorough oral, throat, and neck examination is required for confirmation. While swollen neck lymph nodes are a common symptom of oral and throat cancers, they can also result from viral infections. The lymphatic system acts as the body’s defense against infections. Lymph nodes, distributed in the neck, armpits, and groin, produce white blood cells to combat pathogens. Swollen lymph nodes due to infections typically resolve with antibiotics. However, if a painless lump persists for 3–4 weeks, it may indicate cancer, as oral tumors often spread to neck lymph nodes.
How to Determine if Swollen Neck Lymph Nodes Signal Cancer?
Virus-related lymph node swelling usually subsides with antibiotics. If a painless lump persists for 3–4 weeks, seek immediate medical attention. The mouth and neck are interconnected, so oral tumors frequently metastasize to neck lymph nodes.
For any ear, nose, or throat concerns, contact ENT Head and Neck Surgery Centre for detailed evaluation by our ENT specialists (Tel: 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Sinus Cancer: What Warning Signs to Be Aware Of ?
Case Studies
“Mr. Zhong, 45 years old: Suffered from long-term nasal congestion and recurrent unilateral nosebleeds, initially misdiagnosed as sinusitis. Later, he developed facial numbness and blurred vision. Nasal endoscopy and biopsy confirmed sinus cancer. He underwent tumor resection followed by radiation therapy and remains under ongoing monitoring.”
“Mr. Li, 35 years old: Experienced nasal congestion and runny nose for six months, dismissed as rhinitis. Subsequent facial numbness and vision decline led to medical evaluation, which revealed a sinus tumor. Biopsy confirmed sinus cancer.”
What is Sinus Cancer?
Sinus cancer develops in the nasal cavity or paranasal sinuses (e.g., frontal, ethmoid, sphenoid, or maxillary sinuses). Maxillary sinus cancer is the most common type, including squamous cell carcinoma and adenocarcinoma. Due to the sinuses’ concealed location and early symptoms resembling rhinitis, diagnosis is often delayed. By the time of detection, tumors may have invaded surrounding structures (e.g., orbits or skull base).
Common Symptoms and Complications
Early symptoms are subtle and may include unilateral nasal congestion or runny nose. As the disease progresses, symptoms may involve:
- Nasal symptoms: Persistent congestion, purulent discharge, blood-tinged mucus, nosebleeds, reduced sense of smell.
- Facial symptoms: Swelling, pain (e.g., cheek protrusion in maxillary sinus cancer).
- Ocular symptoms: Vision decline, bulging eyes, double vision due to tumor pressure on optic nerves or orbital invasion.
- Intracranial symptoms: Headaches, dizziness, or seizures if the skull base is compromised.
- Complications: Untreated sinus cancer can lead to facial deformity, vision loss, cervical lymph node metastasis, intracranial infections, meningitis, or life-threatening conditions.
Risk Factors
- Chronic inflammation: Long-term sinusitis or nasal polyps may trigger mucosal hyperplasia.
- Smoking: Harmful chemicals in smoke irritate sinus linings.
- Occupational exposure: Dust from industries like leather or woodworking.
- Viral infections: EB virus links to sinus cancer.
- Other factors: Immunodeficiency or family cancer history.
Diagnosis
- Initial exam: Nasal endoscopy to detect abnormalities.
- Imaging: CT or MRI to map tumor extent.
- Biopsy: Confirm cancer type via tissue sampling.
- Staging: PET scan to check for metastasis.
Treatment Options
- Surgery: Primary treatment for tumor removal and sinus function restoration (e.g., endoscopic or open surgery).
- Radiation therapy: Controls tumor growth post-surgery or for inoperable cases.
- Chemotherapy: For advanced or recurrent cases, often combined with radiation.
- Targeted therapy and immunotherapy: For late-stage patients (e.g., anti-EGFR drugs).
- Rehabilitation: Post-surgical facial reconstruction and recovery support.
Early detection is critical for effective treatment. Please immediately contact ENT Head and Neck Surgery Centre for detailed evaluation by our ENT specialists (Tel: 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Lip Cancer: Learn All About This “Silent Lip Killer”!
Case Study:
“Mr. Li, a 60-year-old long-term smoker, noticed a ‘recurrent small ulcer with scabbing’ on his lower lip over the past six months. Self-applied ointments were ineffective. The ulcer gradually enlarged, developing a cauliflower-like surface with mild pain and numbness. After examination, he was diagnosed with ‘lower lip squamous cell carcinoma.’ The treatment team formulated a plan involving surgical resection, radiotherapy, and lip reconstruction, successfully restoring his appearance and function.”
What is Lip Cancer?
Lip cancer (carcinoma of the lip) is a malignant tumor arising from the mucosa of the vermilion border. Over 90% are squamous cell carcinomas, while adenocarcinomas are rare. According to international cancer classification standards, lip cancer is distinct from oral cancer but is still categorized under head and neck tumors. It commonly occurs at the junction of the middle and outer third of the lower lip. The male-to-female incidence ratio is approximately 7:1, with peak prevalence between ages 50–70.
What Are the Symptoms of Lip Cancer?
Lip cancer progresses relatively slowly with late metastasis. However, delayed treatment can severely impact appearance and function. Common symptoms include:
- Early Stage:Small hard nodules, herpetic-like scabs, localized mucosal thickening, or leukoplakia, often mistaken for common ulcers or angular cheilitis.
- Progressive Stage:Ulcers expand into crater-like or cauliflower-shaped masses with bleeding, foul odor, and tingling, pain, or numbness around the lips or oral skin. Invasion of muscles or bones may cause difficulty opening the mouth or loose teeth.
- Late Stage:Metastasis to cervical lymph nodes or distant organs (lungs, liver, bones), posing life-threatening risks.
What Causes Lip Cancer?
The exact etiology remains unclear, but risk factors include:
- Chronic Irritation:Smoking, alcohol abuse, betel nut chewing, or foreign object biting causing repeated mucosal damage.
- UV Exposure:Outdoor workers with insufficient lip pigmentation face higher cancer risk due to prolonged sun exposure.
- Chemical Exposure:Long-term contact with substances like asphalt.
- Precancerous Lesions:Untreated leukoplakia, verrucous hyperplasia, or chronic ulcers.
- HPV Infection:Some cases correlate with human papillomavirus (HPV).
How is Lip Cancer Diagnosed?
- Physical examination of the lips and cervical lymph nodes, along with lifestyle inquiries (smoking, sun exposure).
- Biopsy of the lesion for pathological analysis to confirm cancer type and differentiation.
- CT/MRI to assess tumor depth and lymph node involvement.
- PET-CT to detect distant metastasis.
- TNM Staging:Based on tumor size (T), lymph node metastasis (N), and distant metastasis (M) to guide treatment planning.
What Are the Treatment Options for Lip Cancer?
- Surgery:Early cases undergo wide local excision (≥1 cm margins) with direct closure or local flaps. Advanced cases require neck lymph node dissection and possible partial jawbone resection, followed by reconstructive surgery using adjacent tissue or free flaps.
- Radiotherapy:External beam radiation for postoperative adjuvant therapy or inoperable patients, often using proton therapy for precision. Brachytherapy places radioactive sources directly on the lip to minimize tissue damage.
- Chemotherapy:For advanced or metastatic cases.
- Targeted & Immunotherapy:Agents targeting specific mutations (e.g., EGFR) or PD-1/PD-L1 inhibitors to improve survival in advanced stages.
Early detection is critical for effective treatment. If a lip ulcer persists for over 2 weeks, immediately contact ENT Head and Neck Surgery Centre for detailed evaluation by our ENT specialists (Tel: 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
ocal Cord Cancer: When the Voice Becomes Hoarse, Be Alert to This Early Sign
Case Study
“Mr. Jia, 56 years old, experienced breathing difficulties and hoarseness for two years, with symptoms worsening recently. Upon seeking medical help, a laryngoscopy revealed a cauliflower-like growth on his left vocal cord. A PET-CT scan showed abnormally high metabolic activity, leading to a diagnosis of squamous cell carcinoma of the vocal cord. This case highlights the importance of timely medical evaluation for persistent hoarseness to rule out malignancy.”
What is Vocal Cord Cancer?
Vocal cord cancer is a malignant tumor affecting the vocal cords—key structures for sound production. It accounts for over 60% of laryngeal cancers. The majority (96%–98%) are squamous cell carcinomas. Early-stage tumors are often localized but highly invasive, potentially destroying laryngeal cartilage or spreading to neck lymph nodes.
Common Symptoms and Risks
- Hoarseness:The most typical early symptom. Seek evaluation if it persists beyond two weeks.
- Throat discomfort:Sensation of a foreign object, pain, coughing, or difficulty swallowing. Late stages may involve blood in sputum or coughing up blood.
- Breathing difficulties:Tumor obstruction of the airway can become life-threatening.
- Spread risk:Early tumors are localized, but advanced stages may invade surrounding tissues, damage laryngeal function, spread to neck lymph nodes, or metastasize to distant organs (e.g., lungs, liver), complicating treatment.
Causes of Vocal Cord Cancer
- Smoking and alcohol:Smokers face a 10-fold higher risk. Combined with alcohol, the risk escalates.
- HPV infection:Some cases are linked to human papillomavirus (HPV).
- Environmental factors:Long-term exposure to industrial dust, air pollution, or occupational carcinogens.
- Demographics:Most common in males aged 50–70.
Diagnostic Methods
- Laryngoscopy:Fiber-optic laryngoscopy detects mucosal abnormalities. Narrow Band Imaging (NBI) enhances early detection.
- CT/MRI:Assesses tumor extent and cartilage involvement.
- PET-CT:Detects distant metastasis and aids staging.
- Biopsy:Confirms cancer type via tissue analysis.
Treatment Options
Surgery
- Laser minimally invasive surgery:For early-stage tumors. Preserves function but may affect voice.
- Partial laryngectomy:Preserves partial laryngeal function for localized tumors.
- Total laryngectomy:Required for advanced/recurrent cases. Requires a tracheostomy.
Radiation Therapy
- Advantages:Preserves vocal function; suitable for elderly or comorbid patients.
- Drawbacks:May cause throat pain, swallowing difficulties.
Combined Therapies
- Radiation + Chemotherapy:Shrinks tumors pre-surgery in advanced cases.
- Targeted + Immunotherapy:Emerging treatments targeting genetic mutations or boosting immune response.
Early detection and treatment are critical. If you experience prolonged hoarseness, seek immediate medical attention. High-risk individuals should undergo regular screenings. For ENT concerns, contact ENT Head and Neck Surgery Centre or call 3100 0555 for expert consultation.
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
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