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A heads up on head and neck disorders

Some of the common causes behind these disorders include smoking and consuming alcohol

Enlargement of lymph nodes is a common disorder of the neck. PHOTO: ISTOCK
Enlargement of lymph nodes is a common disorder of the neck. PHOTO: ISTOCK

Going through cancer can be one of the most gruelling ordeals in life. Empathising with this, Prof Christopher Goh steered himself to specialise in treating patients with head and neck conditions in an illustrious career that has spanned more than two decades. 

He says: “I have always felt a strong sense of empathy for my patients, of whom many consider their fight against cancer to be one of the most debilitating events in their life. I believe that helping my patients through their journey with this devastating disease is my life's calling.” 

Today, he is an ear, nose and throat (ENT) consultant at Novena ENT - Head & Neck Surgery Specialist Centre, where he treats patients with head and neck tumours and disorders, such as thyroid and salivary gland tumours and nasopharyngeal cancer 

Before his move to private practice, Prof Goh headed the Otolaryngology department at Singapore General Hospital from 2005 to 2012 and served as President of the Society of Otolaryngology - Head & Neck Surgery Singapore from 2007 to 2009. 

Prof Christopher Goh is an ear, nose and throat (ENT) consultant at Novena ENT - Head & Neck Surgery Specialist Centre. PHOTO: NOVENA ENT

Causes of head and neck cancers 

According to Prof Goh, one of the main causes of head and neck cancer can be traced to smoking and consuming alcohol. Carcinogens found in tobacco smoke and alcohol causedamage to the cells lining the upper aerodigestive tract, which has respiratory and digestive functions. He explains: “These carcinogens initiate cancer by causing genetic changes to these cells which cause them to divide uncontrollably and spread into surrounding tissues.” 

Another cause is the Human Papillomavirus (HPV), which is linked to throat cancers predominantly in the tonsils and the back of the tongue. HPV, which can be sexually transmitted, also causes cervical cancer. Chewing on betel nut and poor dental hygiene can also increase one’s tendency of getting head and neck cancers. 

An example of a relatively common head and neck cancer is nasopharyngeal cancer. It is most prevalent among males of south-eastern Chinese descent, especially those from the Cantonese dialect group. The condition can be linked to the consumption of salted fish and preserved vegetables, and the Epstein Barr Virus, a type of herpes virus that is spread through saliva.  

One of the more frequent cases that Prof Goh sees is thyroid cancer, which commonly occurs in women in their thirties to fifties. Symptoms of thyroid cancer typically include the presence of a thyroid nodule, which is a lump on the lower central part of the neck, enlarged lymph nodes in the neck and hoarseness of voice. 

Thyroid nodules are best evaluated by ultrasound coupled with fine needle aspiration biopsy. With the guidance of ultrasound, a thin needle is inserted into the area of interest and cells are aspirated for evaluation under the microscope. 

A cutting-edge method of detecting malignant tumours is through the PET-MRI imaging system, which performs positron-emission tomography (PET) and magnetic resonance imaging (MRI) scans at the same time. He says: “PET-MRI scans couple PET scans, which uses radiotracer tagged to glucose to show activity in the body at the cellular level with MRI scans, which gives more detailed soft tissue definition.” 

Other head and neck disorders 

Another common disorder in the neck are enlargement of lymph nodes.This can be due to infection, cancer or autoimmune disorders. Prof Goh advised to look out for red flags such as persistent unexplained fever, night sweating, loss of weight, difficulty in swallowing, hoarseness and the presence of persistent ulcers in the mouth. These symptoms could indicate the presence of cancer as a cause of the enlarged lymph nodes.  

White patches in the mouth, which are known as leukoplakia, can be caused by chronic irritation or pre-cancerous conditions. He adds: “Mouth ulcers which do not heal after two to four weeks or bleed upon contact can be an indication of a cancer and needs to be investigated.”

For more information, visit or 6898-6898 (Novena) to make an appointment with the specialists. 

This article provides general information only and is not a substitute for medical advice. Please consult medical or healthcare professionals for advice on health-related matters.