Introduction:

Cancer is a dreadful name. It is not just a killer, it comprises a lot of human stories- which comprises with fear, cry, depression, financial crisis, love, care, deep sorrow and happy moments of cure.

Cancer is the first or second leading cause of premature death (i.e., at ages 30-69 years) in 134 of

183 countries, and it ranks third or fourth in an additional 45 countries.1

Globally in 2020, every 6 deaths include 1 cancer patient and number of deaths by cancer was 1 crore. It may be increased to 1.5 crore by the next decade. Death of two-third cancer patients in the developing countries.2

In Bangladesh 114 person per lac has been suffering from various cancer. Approximately 20 lacs cancer patient in Bangladesh. Newly affected are 53 person per lac. 2 lacs affected in every year and about 1 lac died of cancer in every year.  In this country 12% death due to cancer. Daily death about 273 in Bangladesh. According to study, there is a definite risk of it to be doubled by upcoming three decades. 3

In human body, there are about 100 trillion cells. Uncontrolled and uncoordinated proliferation of cells makes cancer. About 200 different types of cancer may affect human being. 1 out of 2 people affected by cancer in his lifetime. Male are two times affected than female.

3 out of 5 ignore their symptoms of cancer.

There are at least 30 types of cancer that affects head and neck regions are called collectively Head- Neck Cancers.

Some common are as follows:

-  Oral cavity cancer

-  Laryngeal cancer

-  Thyroid cancer

-  Oropharyngeal cancer

-  Tongue cancer

-  Tonsillar cancer

-  Nasopharyngeal Cancer

-  Hypopharyngeal cancer

-  Sinonasal cancer

-  Parotid cancer

-  Cancer of Minor Salivary gland

-  Cancer involving ear

-  Skin cancer involving Head and Neck Region

-  Lymphoma involving Head and Neck Region

Head-Neck Cancer Burden:

There are 4 different types of head neck cancer out of top 10 cancer internationally. According to data, 33 head neck cancer patient out of 100 male cancer patient and 11-13 head neck cancer patient out of 100 female cancer patients. Head Neck cancer patients mostly affecting developing countries.

According to various statistics head-neck cancers are the leading cancer in Bangladesh. To understand the scenario some facts should be considered. In Bangladesh there is no complete cancer registry. For this reason, it is difficult to conclude accurately on highest burden of cancer type. There is a published report by National Institute of Cancer Researches and hospital (NICRH) (2015-2017) highest affected cancer was lung cancer (26.1%) in male and breast cancer (30.4%) in female and combinedly lung cancer 16.6%. In this report Head- Neck cancer components are shown separately. Top listed 10 cancer of male shows

4 are head- neck cancer. 2 out of 4 are fully categorized

as head- neck cancer and rest 2 out of 4 are partly categorized as head- neck cancer. Again, Top listed

10 cancer of female shows 3 are head- neck cancer. 1 out of 3 are fully categorized as head- neck cancer and rest 2 out of 3 are partly categorized as head- neck cancer. So, summation of all component of head- neck cancer of this list will go to near highest.

Moreover, most of thyroid cancers are not included in this report. As because for thyroid cancer after surgery Radioactive Iodine Ablation therapy is the treatment of choice. Only few thyroid cancers are reported to NIRCH for conventional radiotherapy and etc. International study shows almost half of the population harbors Thyroid disorders/ nodules. Almost 10% of thyroid nodule may affected by thyroid cancer. Differentiated Thyroid cancers are exclusively

treated by surgery and Radioactive Iodine Ablation therapy. Radioactive Iodine Ablation therapy is given by various institutes of nuclear medicine all over the country. So, Thyroid cancer patients are not reported to NICRH and not included their published report.

In a published report from National institute of nuclear medicine and applied sciences (NINMAS) shows about 2500 Thyroid cancer patients reported annually in all nuclear medicine Centre of Bangladesh. Again, all Thyroid cancer patient are not coming here as because all patient usually not required RAI therapy especially early differentiated thyroid cancer or not willing to take RAI Therapy in spite of offering and explaining about the necessity of it.

Very recently there is a ‘Evidence from population- based cancer registry’ report named “Distribution of Cancers in Bangladesh” published Epidemiology division of department of public health and informatics of BSMMU. The study was conducted from July 2023 to June 2024 at 4 unions of Hossainpur upazila, Kishoreganj. It aimed to find out the distribution of cancers among Bangladeshi population.

Sufferings of Head-Neck cancer patients in

Bangladesh

• Sufferings of Head - Neck cancer patient in

Bangladesh mostly due to 4 reasons

-   Advanced presentation

-   Insufficient treatment facilities

-   Absence of referral system

-   Absence of feasible, affordable, and cost- effective treatment

What Should we do?

Awareness builds up at all levels. Risk factor should be isolated and understandable to common population. Stop exposure from harmful risk factors. Cessation of all habits that may initiate cancer.

Preventive steps should be taken to avoid Head-Neck cancer. Educate the common population about Head- Neck cancer. Regular Screening program for early detection of Head-Neck Cancer. Early diagnosis may cure almost all head-neck cancers. Regular physician education is essential to keep them updated. Outcome of treatment regularly monitored and audited. Survived patients carefully and regularly followed up.

Some preventive measures are reflecting in the slogan of World Cancer Day.

“Close the care gap”-Slogan of World Cancer Day-

2022-2024

‘United by Unique’-United in our message, Unique in our stories- Slogan of World Cancer Day-2025-2027

Bangladesh with global partners in Head-Neck

Cancer

Bangladesh is a member of International Federation of Head and Neck Oncologic Societies (IFHNOS) and Asian Head Neck Societies (AHNS). World Head Neck Cancer Day (July 27) are celebrating every year in Bangladesh together with 55 Head-Neck Societies,

51 Countries and UICC.

Conclusion:

Head Neck Cancer is one of the top-ranking cancers in Bangladesh and Globally. It should be appropriately addressed in policy making level. Treatment facilities should be increased. Manpower should be appropriately trained. Dedicated personnel are required to face the challenge of increased head- neck cancer burden. Awareness program should be observed comprehensively and continuously.