Concomitant irradiation & chemotherapy can help preserve the normal anatomic outline in locally advanced head and neck cancer without sacrificing treatment efficacy.
It seems that the latest outcomes of combined chemoradiation are comparable to those of radical surgery with further postoperative treatment.
True, chemoradiation requires focused expertise and is technology-dependent. As such, this option is found only in the larger Centers. True, the addition of terrific induction chemo may further improve organ preservation rates or, if preliminary trial results hold up, even survival.
Yes, well & good... but will function be preserved as well as anatomy? And… can Filipinos afford these cancer treatments? These are matters up for discussion, but not just amongst medical professionals.
Its obvious that doctors should get their acts together to organize Head and Neck cancer services at their institutions. The name of that game is multidisciplinary coordination, wherein radiotherapists, medical oncologists, subspecialty surgeons, and supportive services work to provide full options to the community. It would be a shame if a life-saving opportunity is lost by improperly timed interventions. The final decision is the patient's after all, and acceptance or rejection of risks, side effects, and costs is an exercise of their personal choice.
Evidence-based information from all participating specialties is invaluable in this regard. All patients deserve a multispecialty plan of action.