​What kinds of symptoms do patients experience before receiving treatment?

Patients often present with abnormal growth or lumps located on the head, neck, or face. This could be due to various reasons, including benign (non-cancerous) or malignant (cancerous) tumors, cysts, lipomas, or other abnormal tissue growths. The size of the tumor or mass can limit vision, speaking, breathing, or ability to swallow

​What is the impact on patients’ lives of living with these conditions?

These tumors can have a profound impact on the lives of patients, affecting both their physical and emotional well-being. There is significant facial disfigurement, difficulty eating drinking, speaking, pain and discomfort and social isolation.

What cultural or regional factors affect the treatment of these conditions?

Patients often face late diagnoses, few treatment options, and lack of specialized doctors in Cambodia. Cambodian preference is often to first visit traditional medicine practitioners or spiritual healers, delaying their eventual diagnosis. Often, patients try health products and medication advertised online. They may experience depression, anxiety, and low self-esteem due to changes in their appearance and the challenges they face in daily life. They face low awareness of disease and screening measures, inadequate treatment facilities and heavy financial costs. They are unable to get a job, are socially ostracized, and end up hidden at home or begging on the streets, and dying a painful death.

What does the treatment process look like?

Patients usually present themselves in an advanced stage of a tumor or mass. After histology confirms a diagnosis, a surgical incision is made in the facial area overlying the tumor. The precise location and size of the incision depend on the tumor's characteristics and location. The surgeon carefully dissects the tissues around the tumor to expose it. The tumor is then removed along with a margin of healthy tissue to ensure complete removal and reduce the risk of recurrence. The surgeon may use various techniques depending on the nature of the tumor. Depending on the size and location of the tumor and the extent of tissue removal, facial reconstruction may be required to restore the patient's appearance and function. This could involve techniques such as skin grafts, local flaps, or microsurgical techniques to rebuild facial structures. Complex surgeries as described often take 6-8 hours.

What is the impact of this treatment on the patient’s life?

Patients can regain a better appearance and functional abilities, such as speech and swallowing. They may experience improved communication and acceptance from society as a whole despite their disfigurement.

What potential side effects or risks come with this treatment?

Patients may experience complications of surgery, depending on the extent of the tumor or mass. This may include bleeding, infection, or rejection of skin grafts.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

This treatment is not generally available to Cambodians as it is challenging to navigate the limited options for care in the country. CSC offers these complex surgeries when surgeons visit to teach local Khmer surgeons. Patients may travel up to 8 hours to reach CSC during this time and may stay at the hospital for several weeks. This puts a strain on families who already have limited resources.

What are the alternatives to this treatment?

Cambodian preference is to first visit traditional medicine practitioners or spiritual healers, delaying their eventual diagnosis. Patients with money and resources may choose to go to Thailand to receive treatment, often at a higher cost. Based on the type of tumor and the location, if a patient has functional limitations for facial, head, or neck tumors, surgery is usually the best option. Chemotherapy and radiation are not available or very limited in rural areas and it is very costly.