Head & Neck Oncosurgery

Oral Cancer
Management

Expert diagnosis, staging & surgery — Dr. Bidhan Koirala

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Warning Signs — See a Doctor

  • Non-healing ulcer lasting more than 2 weeks
  • White patch (leukoplakia) or red patch (erythroplakia) inside mouth
  • Difficulty swallowing or persistent pain
  • Unexplained neck swelling or lumps
  • Loosening of teeth without dental cause
  • Numbness or bleeding in the mouth
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Risk Factors — Nepal / India Context

  • Tobacco chewing — gutkha, khaini, paan (highest risk)
  • Smoking — bidi carries higher risk than cigarette
  • Alcohol — synergistic effect with tobacco (multiplies risk)
  • Poor oral hygiene and sharp/broken teeth
  • HPV infection (selected cases)
  • Malnutrition and low immunity
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Staging — How It Is Done

T
Tumor Size &
Depth of Invasion
N
Lymph Node
Involvement
M
Distant
Metastasis
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Final staging (pTNM) is confirmed AFTER surgery using histopathology — not before. Clinical staging guides initial planning.

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Prognosis — Survival Rates

⬆ Early Stage (I–II)
Overall Survival 70–90%
Disease-Free 65–85%
⬇ Advanced Stage (III–IV)
Overall Survival 30–60%
Disease-Free 25–50%

Early diagnosis dramatically improves survival. Stage I treated early can achieve cure rates above 85%. Don't wait.

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Treatment Pathway

1
Biopsy
Tissue confirmation of cancer type and grade
2
Imaging & Staging
CT / MRI / PET scan for accurate clinical staging
3
Surgery
Wide local excision with safe margins
4
Neck Dissection
Removal of regional lymph nodes when indicated
5
Reconstruction
Restoring form, speech, and swallowing function
6
Radiotherapy / Chemotherapy
Adjuvant therapy when pathology indicates need
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Why a Head & Neck Oncosurgeon?

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Accurate StagingCorrect clinical and pathological staging guides every treatment decision.
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Complete Tumor RemovalSafe surgical margins reduce recurrence risk significantly.
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Expert Neck DissectionTrained in all levels of lymph node clearance with nerve preservation.
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Advanced ReconstructionFlap surgery preserves speech, swallowing, and appearance.
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Multidisciplinary CareCoordinated team with oncology, radiation, and rehabilitation.
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Improper initial treatment can worsen survival outcomes and significantly increase the risk of recurrence. First treatment must be right.

Book a Consultation
Dr. Bidhan Koirala — Head & Neck Oncosurgeon
कर्मण्येवाधिकारस्ते मा फलेषु कदाचन Act on time without fear — early treatment saves life.
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