HEAD & NECK SURGERY
Head & Neck Cancer

Head and neck cancer is a general term used to describe a vast range of cancerous tumors located within the head and neck area.

There are many places within this region where cancer may develop, including the voice box (larynx), mouth, tongue, lips, throat (pharynx), back of the nose (nasopharynx), nasal cavities and sinuses, and salivary glands, amongst others. Risk factors for this type of cancer are smoking tobacco, drinking alcohol, and two closely related viruses named human papillomavirus (HPV) type 16 and 18. The average age of diagnosis is 60 years, but over the years, an increase in head and neck cancer is being seen in younger patients.  It is a serious form of cancer, but the prognosis varies quite a bit with tumor location. Overall, head and neck cancer is very treatable when caught early.

Dr. Wreesmann is a fellowship-trained head and neck surgeon with over 10 years experience in diagnosing and treating cancers and precancerous lesions of the head and neck area. First and foremost, he is mindful of the stress and anxiety you may feel when visiting our clinic with a suspicion of cancer, or just having learned of your new diagnosis. His vast experience enables him to differentiate between growths or lumps that are suspicious for cancer, and ones that are innocent, and help set your mind at ease as quickly as possible. Dr. Wreesmann works closely with specialist pathologists and radiologists to arrive at the most optimal diagnosis.

Our team is committed to providing the most effective treatment, while helping maintain your quality of life. In order to do so, we work closely with nutritionists, dieticians, speech and language therapists, physiotherapists, endocrinologists, dermatologists, dentists, maxillofacial surgeons, neurologists, respiratory physicians, infectious disease specialists and family practitioners. Should you or your referring clinician suspect you may have head and neck cancer, our team will make sure to see you within a few days, and perform the necessary investigations within two weeks. 

 

During your consultation for (a suspicion of) head and neck cancer, examination may include one or more of the following:

Intraoral inspection-this is an examination to assess your mouth, back of the mouth and tongue. Sometimes we will examine your tongue with a gloved finger to assess for any lumps, to feel the aspect base of your tongue and evaluate your tonsils. In case you suffer from a high gag reflex, we may use a numbing spray for the back of the tongue and throat. 

Flexible endoscopy-this involves inserting a small camera into your nasal cavity to inspect your nasal cavities, the back of your nose, your throat and voice box. The endoscope we use is a thin, flexible tube with a tiny, built-in camera at the tip of it. During the examination you will be asked to make certain sounds, which helps us assess your vocal cords better. Flexible endoscopy is done awake, but at your request a local anesthetic (numbing) spray can be used. 

Palpation of (feeling) the neck-we will feel your neck to assess for any swelling, evaluate your lymph nodes, salivary glands and thyroid.

Ultrasound of the neck- a specialized radiologist will carry out an ultrasound of your neck. They will put some gel over the skin of your neck and pass a probe over the area. All structures of your neck will be visible on a monitor. 

Imaging-in some cases you may need a CT or MRI scan to investigate your tumor further. This will be done within the shortest time frame possible. Our specialized radiologists will study your tumor from a radiologic perspective and create a report on which we base our diagnosis. You will receive an appointment for your scan, and an appointment soon after to discuss the results. 

Examination and/or endoscopy under anesthesia with biopsies-in order to get a definitive diagnosis it is usually necessary to take a biopsy of the suspicious area. In some cases, biopsies can be taken under a local anesthetic in our clinic, but in others this will be done through an examination under anesthesia. In some cases, the suspicious area is located in a place which may only be accessible for biopsy through an endoscopy. This procedure is always done under general anesthesia in a hospital setting. Endoscopy involves inserting a rigid, hollow metal tube carefully into the mouth and throat. This enables us to view all structures that are normally hidden. We can visualize the extent of your tumor, and at the same time take biopsies without causing you discomfort. You should be able to go home the same day after a few hours of observation. More information can be found in our patient information folder. The tissue biopsies are sent to our specialized pathologist, who will study your tissue and cells and create a report upon which we base our diagnosis. The results will be discussed with you in a separate appointment.