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).