Treatment for head and neck cancers depends on several factors, including the type of cancer, its size and stage, its location and your overall health. For many head and neck cancers, combining two or three types of treatment may be most effective. Treatment for head and neck cancers requires a multidisciplinary approach, including a surgeon, a radiation oncologist and a medical oncologist. Often, organ preservation with radiation treatment can get rid of a tumor without invasive procedures such as surgery.
Radiation therapy involves delivering focused radiation to treat cancer cells by destroying their ability to multiply. Surrounding healthy tissue is also affected by radiation and may have some damage. However, healthy normal cells are better able to heal from radiation injury, compared to cancer cells, because they have maintained the ability to repair radiation-induced damage.
For head and neck cancer, radiation often allows organ-sparing treatment that can give patients equal cure rates with better swallowing and/or voice function with equal cure rates
as compared to surgically removing a tumor. In some cases, radiation will be combined with surgery, chemotherapy or both.
Surgery is an important curative approach to treatment. From biopsy to evaluating the nose, mouth and throat with a flexible endoscopic camera, your surgeon can fully assess whether the tumor has spread. If surgery will be part of your treatment, your surgeon can remove the tumor with a rim of normal tissue. Depending upon the tumor location and how advanced it is,
the surgeon may also surgically remove lymph nodes in the neck. The lymph nodes, part of the normal immune system, are a common path for spread in some tumors. Ask your doctors the likelihood of the lymph nodes being involved and whether you need surgery or radiation for the lymph nodes in the neck.
In some cases, surgery is combined with radiation. If radiation is the main treatment, some surgery may be helpful afterwards but is determined on a case-by-case basis. If surgery is the main treatment, radiation may be helpful after surgery if more advanced disease is found.
While surgery and radiation focus directly on treating the tumor, medication is often recommended to improve cure rates. A medical oncologist will evaluate you and determine what medications may be most helpful in accomplishing those goals. Two of the main categories of systemic therapy (treatment that is injected into a person's blood system) are:
- Chemotherapy has the ability to destroy cancer cells by different methods. Often, one to three different types of drugs may be combined to get the best outcome. The dose and schedule for treatment varies, but chemotherapy is usually delivered during radiation therapy. In some cases, chemotherapy may be helpful before radiation treatment. This type of treatment is called neoadjuvant chemotherapy.
- Targeted therapy involves focusing anti-cancer treatment on certain molecules, such as the epidermal growth factor receptor (EGFR). It can be used with radiation therapy as well.
Ask your medical oncologist whether these drugs may be helpful for you.