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Dr Ram specialises in head & neck cancers, skull base tumours, central nervous system (CNS) tumours and gastrointestinal cancers. Dealing with cancer can be a difficult and emotionally challenging situation. Dr Ram is a certified, highly skilled, and experienced oncology care provider. He offers comprehensive non-surgical treatment with radiotherapy, chemotherapy or immunotherapy depending on your own personal circumstances and always has his patients’ best interests and wellbeing at heart. Here is a brief overview of the cancers for which Dr Ram is an expert.
Including throat cancer, oral cancer, sino-nasal cancer, salivary gland tumours, larynx/pharyngeal cancers
Head and neck cancer is a general term for cancers that occur in the mouth, throat, voice box, sinus, salivary and thyroid glands. Often caused by a history of smoking or heavy drinking and poor oral hygiene, it is a reasonably uncommon cancer type in the UK. However, over the last 10 years, there has been an increase in the incidence of head and neck cancers in a younger group of patients caused by the human papillomavirus (HPV).
The most common signs or symptoms of head and neck cancer include a neck lump, an ulcer or a lump on the tongue, a loss of voice or difficulty with swallowing because of a tumour in the voice box or throat. These symptoms don’t mean you have head and neck cancer, but you should see a doctor if you have any concerns.
The commonest type of head and neck cancer is squamous cell cancer accounting for around 90% of head and cancer cancers, the other types of head and neck cancer include adenocarcinoma, adenoid cystic carcinoma, mucoepidermoid carcinoma, lymphomas and sarcomas.
Survival rates vary and depend on the histology, stage and co-morbidities. Patients with early-stage cancers have cure rates of more than 90% with either surgery or radiotherapy. For locally advanced tumours, the long-term cure rate can be around 50% with either combined surgery and radiotherapy or chemoradiotherapy. For more advanced tumours which have spread to other parts of the body such as lungs, bones, liver, etc, the treatment is palliative with chemotherapy, immunotherapy radiotherapy or occasionally surgery.
Skull base tumours are tumours close to skull bones or sinuses and include both benign tumours such as acoustic neuroma, meningioma, neuroma, pituitary adenomas, etc and primary malignant cancers( squamous cell cancer, adenocarcinoma, adenoid cystic cancer, chordoma, chondrosarcoma, etc) as well secondary cancer spread from elsewhere.
Most skull base tumours do not usually cause symptoms and symptoms may be due to the tumour – pressure on the brain tissue causing headaches, nausea, dizziness/seizures, compressing the optic nerves causing visual disturbances, involvement of pituitary gland causing hormonal imbalances, etc. The treatment varies depending on the histology and location of the tumour and could be either surgery, radiotherapy or a combination of both.
The benign tumours have a very good prognosis compared to the malignant cancers with >85% 10-year control rates. The malignant cancers in the skull base region have a varying prognosis depending on the type and location of cancer. The treatment for skull base tumours would be surgery, radiotherapy or a combination of both. Most benign tumours can be treated with highly targeted stereotactic radiosurgery.
Gastrointestinal cancers can arise from oesophagus (gullet), stomach, intestine, liver, pancreas, colon(large intestine), rectum and anus. The symptoms vary depending on the location of cancer: oesophagal cancer may have difficulty swallowing, gastric(stomach) cancer will notice ulcer-like symptoms (e.g., indigestion, loss of appetite, bloating and pain), Liver cancer and pancreatic cancer can cause abdominal pain, and colorectal cancer may cause changes in bowel function or rectal bleeding and weight loss.
Treatment is surgery for operable cancers and non-surgical treatment with radiotherapy, chemotherapy or combination prior to surgery for locally advanced cancers. In advanced gastrointestinal cancer, the aim is to palliate symptoms rather than cure and systemic treatments include chemotherapy, targeted therapy or immunotherapy.
Re-irradiation of recurrent cancers:
The second course of radiotherapy after an initial course of radiation is termed as Re-irradiation and can be considered for local recurrent cancer, lymph nodal recurrence and for second primary cancer developing in a previously irradiated location.
Re-irradiation can be delivered for head & neck cancer, brain tumours and gastrointestinal cancers with either standard IMRT radiotherapy, proton beam therapy or brachytherapy.
Dealing with cancer can be a difficult and emotionally challenging situation. Dr Ram always has your best interests and wellbeing at heart.
Whether you are seeking expert care or a second opinion make an enquiry or book an appointment today to see how Dr Ram can help.