Reclaiming the voice: Let’s talk about holistic care in head, neck cancer
Resource person: Dr Ben Yap Beng Khiong, Consultant Clinical Oncologist at OncoCare Cancer Centre Malaysia
Cancer’s impact to identity, dignity
For patients, a diagnosis of head and neck cancer goes beyond medical treatment. It affects daily activities many take for granted, such as speaking, eating, swallowing, and breathing. Losing the ability to enjoy meals, converse with loved ones, or participate socially can lead to withdrawal, isolation, and difficulty continuing to work.
The effects can be profound. Many patients feel they have lost part of their identity, especially if they can no longer speak clearly or enjoy food as before. This often results in embarrassment, social withdrawal, depression, and strained family relationships, though many families rally to provide vital support.
These emotional burdens show the importance of holistic care beyond tumor removal. Cancer treatment is not only about survival but also about supporting patients through their journey, helping them rediscover their sense of self and reclaim the simple joys that give life meaning.
A multidisciplinary approach is essential, involving oncologists, speech therapists, dietitians, physiotherapists, and psychologists. Small milestones—such as sharing a meal with family or speaking clearly again—play a major role in restoring confidence, self-worth, and well-being.
Emotional and social support are equally critical. Families, peer groups, and survivor communities offer encouragement that can greatly influence recovery. From experience, patients with strong support networks recover more positively, as they feel less alone.
In Malaysia, head and neck cancers make up around 6% of all newly diagnosed cases and 8% of cancer-related deaths. Among men, nasopharyngeal cancer, which develops behind the nose and above the soft palate, is the fifth [1] most common, with over 1,600 cases reported in 2022. Although less common in women (1.5% of all female cancers), the impact of these cancers extends far beyond statistics.
Cancer care goes far beyond removing or controlling the tumor. The real goal, apart from curing the disease, is restoring the patient’s dignity and improving quality of life, ensuring they can communicate effectively, consume food, and regain confidence in themselves.
Nasopharyngeal cancer most common in Malaysia
Head and neck cancer refers to cancers that begin in the mouth, throat, voice box, nose, sinuses, or salivary glands. In Malaysia, nasopharyngeal cancer is the most common, followed by cancers of the oral cavity, larynx, and oropharynx (back of the throat, tonsils, and base of the tongue).
Nasopharyngeal cancer occurs far more often in Malaysia and neighboring countries than in the West, where it is relatively rare. Risk factors include Epstein-Barr virus (EBV) infection, family history, diets high in preserved foods such as salted fish, and lifestyle habits such as smoking, alcohol use, and betel quid chewing. Human papillomavirus (HPV) infection is also linked to cancers of the oral cavity and oropharynx.
HPV-related head and neck cancers are increasingly recognized, especially among younger, non-smoking individuals. Symptoms may include a persistent sore throat, ear pain, difficulty swallowing, hoarseness, or a neck lump (swollen lymph node).
Overcoming stigma and misconceptions
Despite medical advances, stigma surrounding head and neck cancers remains a major challenge. Some patients delay seeking treatment out of fear of being judged or because they believe their diagnosis offers little hope. Others worry that treatment will inevitably lead to severe disfigurement or permanent loss of vital functions such as speaking and swallowing.
In reality, modern therapies—including precision radiotherapy, chemo-immunotherapy, and organ-preserving surgical techniques—have advanced significantly, allowing many patients to maintain their appearance, voice, and ability to eat close to normal. Still, these fears often hold people back from seeking help, and when treatment is delayed, its effectiveness may be reduced.
Humanizing cancer helps break stigma and encourages more people to seek screening and treatment. Early detection saves lives and preserves dignity.
New treatments from precision radiotherapy to immunotherapy
In recent years, significant technological advances have improved treatment for head and neck cancers.
Techniques such as intensity-modulated radiotherapy (IMRT) allow tumors to be targeted with precision while sparing healthy tissues such as the salivary glands and hearing structures, reducing side effects like dry mouth and hearing loss. In advanced cases, newer systemic therapies, including targeted drugs and immunotherapy, have enhanced both survival rates and quality of life.
These advances not only give patients hope but also help preserve vital functions—such as speaking and eating—allowing them to live more comfortably, which is essential for recovery and dignity.
HPV-associated head and neck cancers generally have a better prognosis and respond well to treatment; therefore, aggressive and disfiguring surgery should be avoided whenever possible.
From fear to advocacy
One patient with advanced tongue cancer under Dr Ben Yap’s care overcame initial fear and hopelessness through strong family support and a combination of therapies, ultimately achieving a remarkable recovery. The patient underwent chemo-immunotherapy prior to surgery and radiotherapy. Only a small portion of the tongue was resected, allowing most of its function to be preserved. “Not only did he recover, but he eventually returned to work,” Dr Ben Yap recounts. “His story will inspire many others to come forward earlier for screening and treatment, ” Dr Yap recounted.
Awareness, early detection save lives
The lessons from survivors carry a vital message: cancer is not the end of the story. With timely diagnosis, advanced treatment, and holistic care, patients can reclaim their lives.
Younger adults are urged to receive the HPV vaccine, which greatly reduces the risk of HPV-associated head and neck cancers. Quitting smoking also remains crucial, as it is a major risk factor for non-HPV-related cancers.
As Malaysia fights cancer, open dialogue and community education encourage earlier treatment and foster a society that supports patients with dignity and understanding.
Reference:
[1] https://gco.iarc.who.int/media/globocan/factsheets/populations/458-malaysia-fact-sheet.pdf
Editor’s note:The opinions expressed in contributed articles are those of the authors and do not necessarily reflect the views of HCA
Category: Education
