ABSTRACT
The management of cancer of the head and neck has a reputation for being difficult, for the reasons summarized in Box 16.1. Many of the apparent difficulties can be resolved by realizing that the management of head and neck cancer follows the same basic principles that apply to the management of any tumour. Good communication between specialists is a fundamental prerequisite; no individual specialist is omniscient. Surgical and radiotherapeutic techniques are evolving rapidly, new drugs are being introduced for the prevention and treatment of the disease, and the limitations of the past are no guide to the possibilities of the present. Decision-making often involves careful appraisal of competing options: the welfare of the patient is the paramount concern. The defence of turf or the maintenance of reputation should be of no consequence. The key decision-maker should be the patient; it is, after all, the patients who, once they have been properly informed of the risks and advantages of the various options, are in the best position to make decisions that are right for them, as individuals. In order for patients to be adequately assessed and informed it is essential that there be a multidisciplinary team characterized not just by technical competence, but also by open communication.
