Head and neck cancer in Africa

Sameera Dalvie

doi:10.4102/sajo.v3i0.67

Abstract

Management is a combination of surgery, chemotherapy and radiotherapy. Published guidelines are available for the developed world, but there are no official guidelines for Africa. Aim: The aim of the survey was to describe diagnosis and management of head and neck cancer in Africa. Setting: This study was undertaken by a clinical oncologist employed by the state sector in South Africa. Methods: An online, cross-sectional electronic survey was mailed to oncologists and surgeons, working in the field of head and neck cancer in Africa. The survey was open from August 2016 to January 2017. Questions were posed about diagnosis and management. Results: Thirty-nine respondents from different locations in Africa responded. All the respondents practised in urban centres in their respective countries. Sixty-three per cent identified as oncologists. The remainder identified as surgeons. A third of the respondents see more than 200 head and neck patients per year. Access to diagnostic tools as well as therapy resources was limited. Forty per cent of the patients were assessed in a multidisciplinary clinic. Surgery and adjuvant radiotherapy are important modes of therapy, in the setting of locally advanced disease. Two-dimensional radiotherapy and clinical mark-up were utilised by 47% and 34% of respondents, respectively. A substantial proportion of patients with curative disease were treated palliatively. Conclusion: Trainers from well-established centres in Africa need to develop coordinated training programmes to facilitate the establishment of multidisciplinary teams. This will aid in the development of local, relevant protocols.

Highlights

Head and neck cancer is the sixth most common cancer globally
Two-dimensional radiotherapy and clinical mark-up were utilised by 47% and 34% of respondents, respectively
Trainers from well-established centres in Africa need to develop coordinated training programmes to facilitate the establishment of multidisciplinary teams

Summary

Introduction

Head and neck cancer is the sixth most common cancer globally. Therapy is complex. Head and neck cancer is the collective term for a group of tumours that arise in the head and neck area. It defines a heterogeneous group of cancers. Therapy is often individualised, as it must be tailored to the patient, tumour and available resources.[1] There are published guidelines in the developed world for diagnosis and management.[2,3,4] These guidelines are accepted as gold standard therapy. Presentation at an advanced stage of disease is well documented in the literature.[6,7,8] An online survey was undertaken to describe the diagnosis and management of head and neck cancer in African countries

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Conclusion