Head & neck cancer treatment and diagnosis

Head & neck cancer

There are many types of head and neck cancer including on the lips, mouth, nose, salivary glands, sinuses, larynx (voice box), throat and trachea. They account for approximately 4% of cancers in the U.S. Head and neck cancer is more common in men and people over 50 years old. It can be treated with an early diagnosis and treatment can mean a positive outcome for many.

Chapter 1

Diagnostics

Head and neck cancer is often diagnosed with imaging scans, such as MRI, CT and PET, and pathology tests such as endoscopy and biopsy, although your doctor may use other tests to identify the problem. You may also have other advanced tests to find out more about your head and neck cancer, where it’s located and which treatments are likely to be most effective. Some of these tests are also used to assess how well your treatment is working.

It can be hard to diagnose head and neck cancer as there are often mild symptoms which can be linked to other less severe conditions such as a cold or sore throat. However, most head and neck cancers can be easily detected through an examination.

Find your nearest GenesisCare center to find out what diagnostic tests and scans are available in your local area. Whatever your outcome, our expert team will support you throughout your treatment journey.

We specialize in the latest technologies to treat head and neck cancer that are proven to be effective. Our teams of expert oncologists continually evaluate the latest head and neck treatments so we can offer the most up-to-date options to every patient without delay.

At our centers we offer three main treatments for head and neck cancers which are radiation therapy, surgery and chemotherapy. Some patients may receive all three treatments. Our team will determine the most appropriate treatment for your situation, depending on the stage and location of your head and neck cancer and will work with you to agree a treatment plan which is tailored to your condition, treatment history and personal preferences.

Chapter 2

Surgery

We work with expert teams of surgeons who are specially trained in the removal of cancerous and benign (non-cancerous) tumors in the head and neck. The lymph nodes may also be removed if it is suspected that the cancer has spread. Some people may also require reconstructive surgery and speech therapy after surgery as it can affect appearance and the ability to chew, talk and swallow. There are different procedures used for head and neck surgery and your surgeon will recommend the most appropriate one for you depending on the type of cancer you have and how advanced it is.

Glossectomy (removal of the tongue)

There are two types of glossectomy which are used to treat cancer of the tongue. A partial glossectomy is for smaller cancers and only removes part – less than a third – of the tongue. A total glossectomy is for larger cancers and removes the entire tongue.

Laryngectomy (removal of the voice box)

The voice box or larynx may need to be removed during surgery to take out the cancer. This is called a laryngectomy and is required when surgery to remove large tumors of the tongue or oropharynx involves removing tissue which is needed to swallow normally. This is very rare but causes a risk of food entering the windpipe and reaching the lungs which can lead to pneumonia. When the voice box is removed, the windpipe is attached to a hole (stoma) made in the skin in the front of the neck. This is called a tracheostomy or trach. It allows you to breathe and cough through the stoma, instead of through the mouth or nose.

Laser surgery

Laser surgery involves an endoscope with a high-intensity laser on the tip being inserted down the throat. The tumor is vaporized or cut out using the laser.

Mandibulectomy (removal of the jaw bone)

If a tumor has grown into the jaw bone, your surgeon may perform a mandibulectomy, also known as a mandibular resection. This involves removing all or part of the jaw bone (mandible). If the cancer hasn’t spread to the jaw bone, it may not need to be cut all the way through and the surgeon will remove only a part or piece of the jaw bone. This is called a partial-thickness mandibular resection or marginal mandibulectomy.

Maxillectomy

A maxillectomy or partial maxillectomy is performed if the cancer has grown into the hard palate (front part of the roof of the mouth). All or part of the involved bone (maxilla) is removed. A special denture, or prosthesis, may be used to fill the hole in the roof of the mouth following surgery.

Mohs micrographic surgery (for some cancers of the lip)

Mohs surgery, also called micrographic surgery, removes tumors on the lip in thin slices. Straight after its removal, each slice is looked at under a microscope to see if there are cancer cells. Slices continue to be removed and examined until there are no cancer cells. This technique limits the amount of normal tissue removed with the tumor and any change in appearance caused by the surgery.

Neck dissection

Some head and neck cancers can spread to the lymph nodes in the neck. The lymph nodes which contain cancer are removed by a procedure called a neck dissection or lymph node dissection which is performed at the same time as the surgery to remove the main tumor.

There are various types of neck dissection procedures depending on how much tissue is removed from the neck. Only a few lymph nodes are removed in a partial or selective neck dissection. In a modified radical neck dissection, most lymph nodes on one side of the neck between the jaw bone and collarbone, and some muscle and nerve tissue, are removed. Nearly all nodes on one side, as well as muscles, nerves and veins are removed in a radical neck dissection.

Transoral robotic surgery (TORS)

During transoral robotic surgery, the surgeon uses a computer-enhanced system to guide the surgical tools to remove mouth and throat cancers. By using a robotic system, the surgeon has the ability to make more precise movements in small spaces and to work around corners. This type of surgery usually leads to a quicker recovery and fewer complications.

Chapter 3

Radiation therapy

At GenesisCare we specialize in advanced radiation therapy techniques that are designed to be effective and minimize the side effects you’ll experience.

Our latest-generation machines are built to deliver highly targeted radiation beams. The accuracy of these treatments, together with the expertise of our teams, means that we can often complete a course of radiation therapy in a shorter amount of time - so you can spend more time doing the things you love.

The type of head and neck treatment your radiation oncologist recommends will depend on your diagnosis, if the cancer has spread to other parts of your body, your general health and personal preferences.

Radiation therapy for head and neck cancer

At GenesisCare our head and neck cancer treatments include external beam radiation therapy (EBRT), where radiation is delivered from outside the body, and internal radiation therapy (IRT), where the radiation dose is given via a source implanted within the body.

Intensity-modulated radiation therapy (IMRT)

IMRT is an advanced external beam radiation therapy technique where the beams of radiation are precisely shaped to exactly match your tumor and damage to adjacent healthy tissues is limited.

Brachytherapy

Brachytherapy is an internal radiation therapy that delivers radioactive pellets to the tumor site through small plastic tubes called catheters or an implant. Brachytherapy may be used in conjunction with external radiation for early stage tumors of the lips or mouth. This is usually done in one session and the radioactive pellets can either be removed after 10 to 20 minutes (HDR brachytherapy) or stay in the tumor site until they diminish (LDR brachytherapy).

Chapter 4

Medical oncology

At GenesisCare, we offer various drug therapies and a wide range of the latest anti-cancer drugs for head and neck treatment, including chemotherapy and targeted therapy.

Chemotherapy for head and neck cancer

Chemotherapy refers to drugs that destroy cancer cells. Our expert teams may recommend chemotherapy before or after other treatments, or on its own. It can be combined with radiation therapy (chemoradiation) before or after surgery.

The type of chemotherapy you’ll receive will also depend on how advanced your head and neck cancer is. If you have head and neck cancer that has spread to other parts of your body, chemotherapy can help control its growth, relieve symptoms and improve your head and neck cancer prognosis.

Targeted therapy for head and neck cancer

As researchers know more about head and neck cancer, they have developed new treatments that can specifically target it. We use targeted therapy to seek and attack cellular activity that the cancer depends on to survive and grow. They are used depending on the specific genetic make up of your cancer. Types of targeted therapy for head and neck cancer include:

  • Cetuximab – a monoclonal antibody which targets a protein on the surface of the cells in the oral cavity and can be an effective head and neck cancer treatment. By interfering with the protein, the cells can no longer grow and divide, slowing or stopping the cancer’s growth

Immunotherapy for head and neck cancer

Immunotherapy helps your body’s own immune system to recognize and fight the cancer and can be used to treat head and neck cancer. Checkpoint inhibitors are an effective immunotherapy against some head and neck cancers and they work by blocking the signals that stop the immune system from attacking the head and neck cancer cells.

Chapter 4

Why choose GenesisCare?

People choose GenesisCare so they can access the latest technologies, effective treatments and personalized care that’s tailored to them without delay.

Cancer treatment and care is constantly evolving and we offer the world’s latest evidence-based treatments that have been shown to benefit patients. By working together closely, our multidisciplinary teams of oncologists, surgeons, radiation therapists and other healthcare specialists provide care that’s focused on you, not just your cancer.

We know that for many people, cancer is a life-changing experience and our goal is to help you through it in the most positive way possible. That’s why as well as offering exceptional cancer treatments, we also provide you with support and resources for your cancer journey - including advice about nutrition and exercise, expert help for managing side effects and information on local support groups.

Designing better care

Our centers are conveniently located throughout the United States, and each location has a dedicated Office Financial Counselor on hand to help you with your paperwork and answer your questions. We accept most insurance plans as well as Medicare Part B, which covers physician services, including radiation therapy.