Cancer is a multifaceted illness that remains a persistent threat to humanity and is one of the leading causes of death globally. While discussions around cervical, breast, and lung cancers are a mainstay, it is imperative to recognize the prevalence of head and neck cancer (HNC), the seventh most common cancer in the world.

In India, HNC causes over 1,25,000 deaths annually, accounting for a significant 30 percent of all cancer cases. Unfortunately, traditional treatments, such as surgery, chemotherapy, and radiation therapy, are highly invasive with multiple side effects, including facial disfigurement and chronic pain, which not only compromise treatment adherence but also reduces a patient’s quality of life.

As the healthcare and pharmaceutical industries stand poised on the edge of discovery, crucial innovations entail developing patient-focused and patient-friendly treatment modalities for HNC. The purpose of innovation must transcend survival metrics and refocus to elevate the quality of life after treatment.

Building the Foundation
As the industry innovates newer HNC treatments, a significant roadblock surfaces – a lack of disease awareness among patients, leading to late-stage diagnoses. As per the National Cancer Registry Program Report (2020), 60% of the diagnosed patients were at the locally advanced stage, resulting in limited treatment options, increased resistance, and substantially lower survival rates. Additionally, a staggering 59% of the diagnosed patients discontinue treatment due to side effects.

Therefore, there is a pressing need to factor in disease awareness to facilitate timely diagnosis and treatment, with an emphasis on the burden of side effects and patient tolerability in research for advanced treatment methodologies to mitigate the burden of this illness.

A Patient-Centric Approach
Globally, the need for less invasive, multi-modal treatments has been recognized and research to develop innovative treatment modalities is currently underway, such as:

Targeted Therapies: Therapies, such as monoclonal antibodies, have shown survival benefits in locally advanced and recurrent HNC cases. Research shows that targeted therapy with cetuximab combined with platinum-5-FU chemotherapy improves overall responses and survival rates compared to administering chemotherapy independently.

Biosimilars: While targeted therapies mark the progress made in HNC treatment, the cost of drugs limits accessibility. For instance, cetuximab is available to only two percent of eligible patients for treatment in India. Biosimilars have the potential to revolutionize the landscape of HNC treatment. They enhance access to life-saving therapies with comparable efficacy and affordability for the masses. In a historical breakthrough, cetuximab is the first biosimilar that received approval from the Drug Controller General of India for treating head and neck cancer in India.

Proton Therapy: Conventional therapy requires the delivery of high-dose radiation, which puts organs close to the tumour at risk. Proton therapy, however, is a unique, high-precision radiation therapy that delivers high doses of radiation to the affected area while minimizing the damage done to healthy tissues, thus reducing long-term side effects.

While advancements focus on treatment modalities, research on integrating AI in HNC diagnostics to identify disease patterns and enhance diagnostic accuracy is ongoing. However, disease and treatment awareness needs to be improved. So, it is critical to roll out targeted awareness campaigns to underscore the role of these treatments in amplifying curative outcomes.

Democratizing Access to Treatments
HNC is a socio-economically patterned disease, with India contributing to nearly 60% percent of the cases globally. The disparity is evident as the illness disproportionately affects poorer communities due to prevalent tobacco and alcohol use. The high prevalence, the steep costs of treatments and the rural-urban healthcare divide can further hinder equitable access to HNC care. However, the Pradhan Mantri Jan Arogya Yojana is a ray of hope, offering a solution by protecting beneficiaries from exorbitant costs of cancer treatment.

While we celebrate such efforts and the strides made in HNC treatments, it’s crucial to acknowledge the journey needs intensified focus on improved access, health schemes, patient-centric research, and innovation. A collaborative effort among key stakeholders, including the government, healthcare sector, and pharmaceutical companies, will bolster the HNC care infrastructure in the country and enable us to fight this growing pandemic.

This article was first published in the CNBC TV18 on 30^th April 2024