Distant Metastasis

Deciding on a Treatment Plan

In considering the treatment of distant metastases from a head and neck cancer, you should have an in-depth discussion with a specialist who deals with this disease. You should discuss the various options and consider the possibility of entering into a clinical trial at an academic cancer center.

There are three general therapeutic options to consider:

In the case of distant metastases, it is also worth mentioning a fourth option: active observation. This might be recommended if you are not having symptoms related to the metastasis and if the best possible treatment is more likely to cause side effects than offer a long-term benefit to you. If this is chosen, you will probably get serial imaging studies to see if the metastasis is getting bigger or spreading more. If the balance between side effects versus possible benefits changes, your doctor might then recommend treatment.

Surgery might be recommended if there is a single focus of metastasis in one part of the body. Other criteria in which surgery might be recommended are if the primary tumor has been completely removed, the spread to a distant site is very limited and the tumor can be completely removed with the surgery.

Radiation can be considered under similar criteria as surgery. It is especially common to treat spread of cancer to spinal bones that is causing significant pain.

Still the most common treatment method for distant metastasis is chemotherapy and/or biologic therapy. A cancer that has spread to a distant site has gotten within the blood, and there are probably tumor cells throughout your body. By giving a drug that circulates throughout the body, the hope is that it will stop the deposit and growth of tumor cells in other parts of the body as well. The exact agents that are used depend on a number of factors; you should discuss this with your oncologist.

A number of experimental therapies can also be considered. These should only be done after an extensive discussion with your cancer specialist and weighing the possibilities of more standard treatment options. Experimental therapies done in well-designed clinical trials at an academic medical center are the best ones to try.

Many people ask about alternative therapy as well. These might include mind over body, herbal remedies and eastern medical therapies. In general, as long as the alternative therapy does not get in the way of treatments that have been proven to be effective (or at least have some proven possible effectiveness through scientific studies), there is no reason not to try them. You should not be afraid to speak to your cancer doctor about these options. He or she might even know of a clinical trial to test these approaches in a scientific way.


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