Frequently asked questions

Not always. Depending on the site and stage of the tumour, treatment may be surgery, radiotherapy, chemotherapy or a combination, in an order decided for each person. Prof. Hafız explains which options apply to you and why.

Preserving speech and swallowing is one of the main goals when an operation is planned. What can be preserved depends on where the tumour is and how far it has spread; this is discussed openly before you decide.

The nerves that move the vocal cords run directly behind the thyroid. Prof. Hafız uses nerve monitoring during the operation to identify and protect them. A temporary weakness of the voice can occur and usually recovers; a lasting change is uncommon.

After removal of the whole gland, yes, for life, with the dose adjusted by blood tests. After removal of one half, many people do not need tablets; this is checked afterwards.

The incision is placed low in the front of the neck, along a natural skin crease, and usually fades to a thin line over the following months.

Many laryngeal cancers, especially when found early, can be removed while preserving the voice box. When the whole larynx must be removed, speech can be restored with a voice prosthesis or other methods, and Prof. Hafız discusses this with you before the operation.

An operation in which the tumour is removed through the mouth, under a microscope, with a laser, leaving no cut in the neck. It is used for suitable early tumours.

For some tumours radiotherapy alone or combined with chemotherapy is an alternative to surgery. The choice depends on the stage and site of the tumour, on your general health and on your wishes.

For small tumours, eating and speech usually return close to normal after healing. For larger ones, rebuilding the tongue or floor of the mouth with tissue from elsewhere is planned so that swallowing and speech are preserved as far as possible, and therapy afterwards helps.

Often, yes. Teeth in poor condition are treated before surgery or radiotherapy, and a dental assessment is part of the plan when the jaw or teeth are involved.

Some patches (leukoplakia and erythroplakia) are precancerous. They should be examined, often biopsied, and followed closely.

Most tumours of the parotid gland are benign, but they grow and can change over time, so they are usually removed. A needle biopsy and imaging give a good idea beforehand; the final answer comes from the pathologist.

The nerve that moves the face runs through the parotid gland. It is identified and protected during the operation, with nerve monitoring when appropriate. A temporary weakness can occur and usually recovers.

Usually not. The remaining salivary glands normally produce enough saliva after one gland is removed.

Not always. Many neck lumps are enlarged lymph nodes from an infection, cysts or benign tumours. A lump that lasts for more than a few weeks, grows, or is hard and does not hurt should be examined, particularly in adults.

A selective neck dissection removes the groups (levels) of lymph nodes most likely to be involved and spares the others as well as the muscle, vein and nerve of the neck. A comprehensive dissection removes more levels and, when the cancer involves them, some of those structures as well.

The nerve to the shoulder muscle runs through the area. It is preserved whenever the cancer allows, and physiotherapy helps shoulder movement recover afterwards.

For suitable early tumours, guidelines (NICE NG36) list laser surgery among the standard treatments; its effect on voice and swallowing depends on the tumour. The choice depends on the site and size of the tumour and on how well it can be exposed through the mouth.

The operation is performed entirely through the mouth, so no cut is made in the skin of the neck.

The voice is hoarse while the area heals and usually improves over a few weeks. The final quality depends on how much of the vocal cord had to be removed; voice therapy can help.

Commonly the forearm, the thigh or the lower leg (the fibula, when bone is needed). The choice depends on what has to be rebuilt: lining, bulk, bone or skin.

The joined vessels can clot in the first days, which is why the flap is checked frequently after the operation. If a problem is found early, it can often be corrected.

The donor site usually heals over a few weeks and is chosen to preserve function as far as possible. Some numbness and a scar remain; the arm or leg usually returns to normal use with time.