Cancer in the ear is mostly infrequent. Usually, onset of the cancer occurs on the skin in the outer ear. Out of 100, nearly 5 skin cancer are advances as an ear cancer, in which, the internal ear cancer is defined to be a rare one.
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The middle ear is a small cavity comprising of three tiny bones that transmit the vibrations from eardrum to inner ear. The ear is enveloped by a bone called the temporal bone, which encloses the ear canal, middle ear and inner ear.
Temporal bone is located at the sides and bottom of the skull. One portion of the temporal bone is known as the mastoid bone. The mastoid bone found at the back of the ear and occurs as a lump. The exterior region of the mastoid bone appears as hard and solid and the bone interior to it is shaped like a honeycomb.
The small cavities are filled with air and has inner ear with nerves regulating the face and tongue movement. People suffering from long term ear infections are highly prone to the cancer in the middle year.
Different treatment options
The treatment for ear cancer relies on the following factors:
- The site of the cancer in the ear.
- The kind of cancer that have occurred.
- The size of the cancer.
- The stage of the cancer.
- And the normal health condition of the patient.
Provided that the cancer in the ear is detected in the initial stage, the treatment is not highly complex and requires only simple methods to cure them. But if the tumor is large, then it requires an extensive treatment and restoring is very complicated. The following are the various treatments available to treat ear cancer;
The removal of the tumor along with a minimum of 5 mm of healthy unaffected tissue around a growing tumor is called clear margin, it will prevent the recurrence of ear cancer. The surgical procedure removes the ear canal, a segment or a whole temporal bone, the middle and the inner ear. The mastoiddectomy or temporal bone resection is a technique where the temporal bone found at the sides of the skull is removed.
The facial nerves that pass the side of the face, over the salivary gland, and also the lymph nodes in the neck should be removed by the physician along with the affected ear region. The portions that were dissected include the sleeve area of the outer ear as well as the middle ear.
Whereas, in radical temporal bone resection surgery, the whole of the temporal bone along with the portion that is exposed to the cancer are removed. After the removal, repairing of the temporal bone is necessary.
Radiation therapy utilizes intensive rays to kill cancer cells. In some cases the cancer on the outer flap of the ear (pinna) is small, then radiotherapy is the only option for treatment. It is also given as post-operative treatment where the clear margin cannot be removed by the physician. This therapy reduces the risk of cancer recurrence, later following the removal of the tumor cells. The secondary effects of the radiotherapy are;
- Skin redness of the ear
- Painful or sensitive and tender ear
- Inflammation all over the ear
The physicians may prescribe some antibiotics and steroids to arrest the progress of the complications.
Chemotherapy is another approach that assists in treating ear cancer. Although chemotherapy is not the only method to cure cancer in the ear, physicians still opt for it, as the other treatment does not suit the patient to get relieved from the symptoms like pain.
In this approach, anticancer drugs (fluorouracil and cisplatin) are used to kill cancer cells and hence they are called as cytotoxic. Researchers may use chemotherapy along with radiation therapy either pre- surgery or post-surgery to heal ear cancer.
More research is required to know the effectiveness and exact time to start the chemotherapy. The frequently used drug in treatment of cancer is Fluorouracil, also called as FU or 5FU. The other common drug, cisplatin is available to cure several kinds of cancer as it actively kills the cells that undergo rapid mitosis.
4. Follow up with patient
It is necessary to have regular checkups in post-surgery stage. The physicians will inspect the patient for any undesirable secondary effects, after the treatment. Through periodical follow-ups, the effects of the treatment can be prevented by constantly observing the symptoms.
If any such symptoms appear, it can be treated at the earliest and can reduce the risk of the effects. The recurrence of the cancer can be detected by the physicians and treated before it develops to other parts of the ear.
The physicians will inspect the ear and the general health of the patient. The patient can ask any questions and share the concerns with the physician during his/her regular checkups. Usually the schedule for the consultation varies depending on the patient’s situation.
Reviewed by Afsaneh Khetrapal BSc (Hons)