Close

Treatment Types

Your loved one’s cancer care team will use the information from the diagnosis—namely, the specific type of cancer and the disease stage—to select the best treatment options. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers, which are based on the best evidence to date from research, also provide guidance for the selection of the best treatment options.1Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 18, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org. You and the patient should ask questions to understand the benefits, risks and side effects associated with the suggested treatment plan.

There are typically three types of therapeutic treatments for head and neck cancer: surgery, radiation therapy or chemotherapy (or a combination of these therapies).1, Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 18, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

Surgeons performing surgeryTreatment type: surgery

If your loved one’s cancer care team selects cancer removal surgery, which is very likely, then it may be the only treatment needed. Surgery can be curative.Surgery can also be combined with other therapies. For example, the cancer care team can perform surgery as the primary treatment, and later, the cancer care team can perform radiation therapy.

The treatment goals for surgery include removing as much of the tumor as possible and keeping the nearby anatomic structures intact.2Shah JP, Lydiatt W. Treatment of cancer of the head and neck. CA Cancer J Clin. 1995;45:352-368. Extensive head and neck surgery sometimes necessitates the removal of bones, such as part of the jaw, or even entire structures, such as the external ear.2, Shah JP, Lydiatt W. Treatment of cancer of the head and neck. CA Cancer J Clin. 1995;45:352-368.3Yu P. Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck. 2004 Sep;26(9):759-69. Your doctor is required to clearly state what will happen during your surgery so you’ll know what to expect. A concern many patients have is whether a surgical procedure will impact their appearance or ability to eat or speak.4Gaziano JE. Evaluation and management of oropharyngeal Dysphagia in head and neck cancer. Cancer Control. 2002 Sep-Oct;9(5):400-9. Your health care team will use many strategies to retain both form and function, but that may require rehabilitation for several months after treatment.

10397479Treatment type: radiation therapy

If radiation therapy is used to treat early-stage head and neck cancer, it can be the only treatment necessary and can often be curative. Radiation therapy may also be used sequentially (i.e., after surgery) or concurrently with chemotherapy (combined, the therapies are known as chemoradiation).

Radiation therapy uses high-energy rays that disrupt the DNA of targeted cells and induces cell death, which then decreases the size of the tumor.5Lichter AS, Lawrence TS. Recent advances in radiation oncology. N Engl J Med. 1995;332(6):371-9. To optimally deliver the high-energy rays to the site of the tumor yet protect surrounding tissues, radiation planning is performed before the radiation procedure. Imaging of the tumor site is mapped while the patient is positioned in the same manner as the upcoming treatment.6Vissink A, Burlage FR, Spjkervet FKL, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003;14(3):213-225. Then, during radiation therapy treatment, the person is carefully positioned in the same place while the beams deliver radiation therapy to the tumor.

Radiation therapy can have the following side effects:

  • Inflammation of the membranes lining the mouth (mucositis); approximately 50 percent of patients who are administered radiation therapy develop this symptom at the time of treatment, and it can cause pain and interfere with eating and/or swallowing7, Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695-1709.8Forastiere A, Koch W, Trotti A, Sidransky D. Head and Neck Cancer. N Engl J Med. 2001;345(26):1890-1900.
  • Alteration in taste7, Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695-1709.8Forastiere A, Koch W, Trotti A, Sidransky D. Head and Neck Cancer. N Engl J Med. 2001;345(26):1890-1900.
  • Decreased salivation7, Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695-1709.8Forastiere A, Koch W, Trotti A, Sidransky D. Head and Neck Cancer. N Engl J Med. 2001;345(26):1890-1900.
  • Changes in voice (e.g., hoarseness)7Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695-1709.
  • Difficulty opening the mouth (trismus)6Vissink A, Burlage FR, Spjkervet FKL, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003;14(3):213-225.
  • Cavities, which are likely due to decreased salivation6Vissink A, Burlage FR, Spjkervet FKL, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003;14(3):213-225.
  • Fatigue, experienced by 70 to 80 percent of patients9, Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC. Fatigue in cancer patients. Br J Cancer. 1993 Aug;68(2):220-4.10, Vogelzang NJ, Breitbart W, Cella D, et al. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol. 1997 Jul;34(3 Suppl 2):4-12.11, Henry DH, Viswanathan HN, Elkin EP, Traina S, Wade S, Cella D. Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S. Support Care Cancer. 2008 Jul;16(7):791-801.12Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12 Suppl 1:4-10.

drop in intravenous (IV) drip.Treatment type: chemoradiation therapy

If the cancer care team selects chemoradiation therapy, they may use it sequentially (following surgery) or as a primary treatment for patients with more advanced head and neck cancer. This type of therapy uses both chemotherapy and radiation therapy at the same time.

Chemoradiation therapy can have the following side effects:

  • Inflammation of the membranes lining the mouth, or mucositis; this symptom can interfere with eating and swallowing4Gaziano JE. Evaluation and management of oropharyngeal Dysphagia in head and neck cancer. Cancer Control. 2002 Sep-Oct;9(5):400-9.
  • Decreased salivation13Wendt TG, Grabenbauer GG, Rödel CM, et al. Simultaneous radiochemotherapy versus radiotherapy alone in advanced head and neck cancer: a randomized multicenter study. J Clin Oncol. 1998 Apr;16(4):1318-24.
  • Fatigue, reported by 70 to 80 percent of patients9, Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC. Fatigue in cancer patients. Br J Cancer. 1993 Aug;68(2):220-4.10, Vogelzang NJ, Breitbart W, Cella D, et al. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol. 1997 Jul;34(3 Suppl 2):4-12.11, Henry DH, Viswanathan HN, Elkin EP, Traina S, Wade S, Cella D. Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S. Support Care Cancer. 2008 Jul;16(7):791-801.12Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12 Suppl 1:4-10.
  • Nausea and/or vomiting14Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-353.

Female Scientific Research Team With Clear Solution In LaboratorTreatment type: clinical trials

If your loved one has very advanced head and neck cancer, the cancer care team may recommend participating in a clinical trial.1Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 18, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org. A clinical trial would enable your loved one to use therapies that are in development for the treatment of cancer.

Obviously, you want to get the cancer out of you, but it’s important not to just jump on the first options out there.Tony L. (oral cancer survivor)

References

1 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 18, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

2 Shah JP, Lydiatt W. Treatment of cancer of the head and neck. CA Cancer J Clin. 1995;45:352-368.

3 Yu P. Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck. 2004 Sep;26(9):759-69.

4 Gaziano JE. Evaluation and management of oropharyngeal Dysphagia in head and neck cancer. Cancer Control. 2002 Sep-Oct;9(5):400-9.

5 Lichter AS, Lawrence TS. Recent advances in radiation oncology. N Engl J Med. 1995;332(6):371-9.

6 Vissink A, Burlage FR, Spjkervet FKL, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003;14(3):213-225.

7 Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695-1709.

8 Forastiere A, Koch W, Trotti A, Sidransky D. Head and Neck Cancer. N Engl J Med. 2001;345(26):1890-1900.

9 Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC. Fatigue in cancer patients. Br J Cancer. 1993 Aug;68(2):220-4.

10 Vogelzang NJ, Breitbart W, Cella D, et al. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol. 1997 Jul;34(3 Suppl 2):4-12.

11 Henry DH, Viswanathan HN, Elkin EP, Traina S, Wade S, Cella D. Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S. Support Care Cancer. 2008 Jul;16(7):791-801.

12 Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12 Suppl 1:4-10.

13 Wendt TG, Grabenbauer GG, Rödel CM, et al. Simultaneous radiochemotherapy versus radiotherapy alone in advanced head and neck cancer: a randomized multicenter study. J Clin Oncol. 1998 Apr;16(4):1318-24.

14 Doyle C,Kushi LH,Byers T, et al.2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society.Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin.2006;56:323-353.