4 DISCUSSION
HNC is a multifactorial, multipath-driven disease so treatment of HNC
also needs to be multi-modal based on the stage as well as site of the
tumor (Marur et al. , 2008). Tumors diagnosed early can be managed
with surgery and radiation while as at intermediate & late stages
combined modality approach are required. Surgery bears a risk of
impaired function such as difficulty in swallowing, cosmetic deformity,
salivary glands, teeth & other mouth opening complications depending on
the extent of diseased tissue (Bozec et al. , 2018). Many of
chemotherapeutics drugs like platinum-based drugs and targeted therapies
using monoclonal antibodies like cetuximab (for EGFR), alone or in
combination with chemotherapeutic regimen are effective in treating HNC
to some extent. But they bear adverse side effects (hepatotoxicity,
cardiotoxicity and nephrotoxicity) apart from chemoresistance which they
acquire immediately within minimum period of time (Price et al. ,
2012). While Radiation therapy is frequently carried out as an adjunct
to chemotherapy or in concurrence with surgery (Marur et al. ,
2016), But it also has lethal threat to the thyroid gland, salivary
glands & pharyngeal constrictor muscles causing hypothyroidism,
xerostomia, dysphagia and chronic aspiration (Langendijk et al. ,
2008). Drawbacks of these therapies have pushed for clinical &
translational research for stronger chemotherapeutics with fewer
therapies related toxicities. So focus is on therapies that preserve
vital organ function and improve the quality of life of HNC patients.
Multiple molecular pathways involved in HNC tumorigenesis necessitate
the utilization of natural agents with numerous molecular targets. Their
use in combination with already existing therapies to reduce treatment
side effects has a great potential in the field of HNC chemoprevention.
Many studies are emphasizing on use of biologically dynamic active
compounds from natural sources to evolve as chemotherapeutic compound
with higher efficacy & lesser side effects (Kunnumakkara et al. ,
2017).