Treatment Modalities: Head and Neck Cancer

Head and Neck Cancer

Many cancers of the head and neck can be cured, especially those that are found early. Treatment varies according to the type, severity, and location of the disease, and may include surgery, radiation therapy, or chemotherapy. In most patients, treatment modalities are combined or given concurrently to maximize the chances of curing the cancer.

Though curing head and neck cancer is the physician’s primary goal, preserving quality of life, including appearance and ability to function is also an integral part of treatment. Today, advances in surgical techniques, reconstruction, and nonsurgical treatment methods mean that nearly every patient can attain these quality-of-life goals.

Radiation therapy given together with chemotherapy is a standard of care for patients with locally advanced head and neck cancer. In select situations, such as oral cavity tumors, the patient will undergo surgery followed by radiation therapy and/or chemotherapy.

At our facility, we use a three-dimensional method of delivering external beam radiation called intensity-modulated radiation therapy (IMRT) to deliver radiation therapy to tumors with great precision. Using this technique, we can “mold” the dose of radiation to the tumor, making it possible to use higher, more effective doses, while sparing healthy areas of the head and neck, thus reducing the side effects. We also do a daily CT scan for image guided radiation therapy (IGRT) to localize the tumor daily as it shrinks and changes in size. These advanced IMRT and IGRT techniques help preserve patients’ ability to speak and swallow normally.

At our facility, we have dieticians and nurses who specialize in cancer care available to our patients on a daily basis and also have a head and neck cancer support group and a head and cancer tumor board, in which surgeons, oncologists, radiologists and pathologists consult with each other regarding optimal patient treatment.

Radiation to the head and neck, although often very effective, has many uncomfortable side effects, most of which resolve within a few months after treatment. Patients who receive radiation to the head and neck may experience redness, irritation, and sores in the mouth; a dry mouth or thickened saliva; difficulty in swallowing; changes in taste; or nausea. Other problems that may occur during treatment are loss of taste, which may decrease appetite and effect nutirition, and earaches. Patients may also notice some swelling or drooping of the skin under the chin and changes in the texture of the skin. The jaw may feel stiff and patients may not be able to open their mouth as wide as before treatment.

Patients should report any side effects to their doctor or nurse and ask how to manage these effects.