S24 

Challenges in Managing Head and Neck Cancer During Pandemic: Experience of an Institution 

 
Muhamad Yusri Musa1, Jasmin Jalil1, Siti Hajariah Kamarrudin2, Gokula Kumar Appalanaido1  

 
Objectives: Head and neck cancers are not uncommon, they represent approximately eight percent of 

all malignancies according to the site and specifically, nasopharyngeal carcinoma is the fourth most 

common malignancy in Malaysia. The challenges in managing these tumours are often reflected by 

multimodality treatment which requires a multidisciplinary team and multicentre involvement. Head 

and neck cancers often require postoperative chemoradiotherapy to achieve a complete response. Before 

the pandemic, patients were already at risk of delayed treatment due to multiple factors mentioned and 

the lack of radiotherapy centres in the country. The outbreak of COVID-19 added significant challenges 

and treatment dilemmas caused by quarantines, hospitalisation, screening protocols, illnesses and 

lockdowns interfering with patients' movement.  

Method: Our centre received 144 newly diagnosed head and neck cancer patients during the period of 

March 2020 to August 2021. Standard treatment protocol for these patients includes uninterrupted 

chemoradiotherapy and multiple imaging scans and CT simulation.  

Results: Three patients infected by COVID-19 during the treatment with additional 13 patients faced 

interruptions and delayed management due to the quarantine order as close contacts. An average delay 

of 10 days was observed during the period. All patients managed to complete treatment planned for 

them despite the challenges mentioned, made possible by vigorous team efforts, repeated RTK 

screenings whenever indicated, extra man-hours and multiple reminders and advice. Subsequent follow-

ups and clinical surveillance will determine whether the treatment response and survival rate are 

affected by disruption in the treatment process.  

Conclusion: In conclusion, the COVID-19 pandemic has significantly caused difficulties in managing 

head and neck cancers in our centre. However, multiple solutions created managed to minimise the risk 

of incomplete treatment.  

 

Keywords: Head and neck cancer, chemoradiotherapy, pandemic 

 

___________________________________________________________________________ 

1Oncology and Radiological Sciences Cluster, Advanced Medical and Dental Institute (AMDI), 

Universiti Sains Malaysia, Bertam, Penang, Malaysia 

2Department of Nuclear Medicine, Radiotherapy and Oncology, School of Medical Science Universiti 

Sains Malaysia (HUSM), Kubang Kerian, Kelantan, Malaysia. 

 

Correspondence to:  

Muhamad Yusri Musa, ORL Specialist, Oncology and Radiological Cluster, AMDI, USM, Bertam, 

myusrim@usm.my    

__________________________________________________________________________________ 

 

DOI: http://dx.doi.org/10.31344/ijhhs.v6i0.414

mailto:myusrim@usm.my