Management of head and neck cancer in Britain

Plenty of room for improvement

Surgical and radiation oncologists will readily disagree over many aspects of cancer management but one point is widely accepted: patients with head and neck cancer probably present the greatest challenge of all. Apart from the obvious difficulty of assessing a range of treatment strategies for an unusually wide number of primary sites (larynx, pharynx, oral cavity, paranasal sinuses, etc)and the consequent difficulty in comparing outcomes, so many patients have to face devastating treatment consequences as the price of cure. What is more, although the incidence of head and neck cancer is rising,1 the relatively small number of patients—fewer than 5000 new cases a year in Britain—has slowed cooperative efforts in building worthwhile databases or, better still, mounting prospective clinical studies large enough to provide meaningful results.

The brief report by Edwards and colleagues in this week's issue provides a disturbing overview of current provision for the treatment of head and neck cancer in Britain (p 1589 …