OP097: Management of the obese patient with head and neck cancer

Abstract

The incidence of head and neck cancer (HNC) is rising in the United Kingdom (UK). The increase in diagnosis rates has been especially notable amongst young and middle aged adults, with evidence demonstrating the expanding role of Human Papilloma Virus. Equally, strong evidence demonstrates the general population of the UK is becoming ever more obese. Although some studies have shown HNC risk to be reduced amongst those who are overweight or obese, it seems likely that as our population continues to grow, the incidence of HNC amongst obese patients will also rise. We discuss the difficulties in the surgical and medical oncological management of the obese HNC patient. A brief review of the literature with regards to HNC and obesity is presented. Local data and case studies are presented. From our experience difficulties have arisen at all stages of the management pathway. Dilemmas with regard to diagnosis and treatment planning, including free-flap selection and design are highlighted. Anaesthetic, intra-operative and post-operative complications have also been encountered and are discussed. Difficulties which may be met in the Oncological treatment of the obese patient are also discussed. Most of the clinical difficulties encountered have related to body habitus, although complications due to associated medical problems were experienced. Significant complications and difficulties have been experienced during the management of obese patients in our unit. We present our cases with a view to highlighting the challenges the obese patient presents to the HNC multidisciplinary team. Although future strategies to help overcome such issues are suggested, the authors welcome input from colleagues with regard to the conundrums this patient group present.