Head and Neck Cancer

 

Head and Neck Cancer is a collection of cancers of different disease sites mainly associated with the upper airway and upper digestive tract. These sites include the oral cavity (mouth), oropharynx (throat), salivary glands, sinuses, nasal cavity, larynx (voicebox), thyroid gland, and the neck. Approximately 35,000 men and women will be diagnosed with cancer of the oral cavity and pharynx this year. Although these cancers are categorized together, different disease sites exhibit different behavior.

Cancers of the head and neck are directly related to tobacco use and alcohol consumption. There also is an association between the HPV virus and oropharynx cancers as well as the Epstein-Barr virus and nasopharynx cancer.

The natural history of head and neck cancer is interesting. These cancers develop at a primary site and then usually spread to draining lymph nodes in the neck. These cancers can stay in the head and neck region for long periods of time before they spread to other parts of the body. This aspect of head and neck cancer allows for effective use of local treatments such as surgery and radiation therapy.

Treatment

Treatment for head and neck cancers is decided on an individual basis using a multidisciplinary approach. Surgery or radiation therapy alone can be used for early cancers, while a combination of radiation therapy, surgery, and chemotherapy can be used for more advanced tumors.

Special attention is given to quality of life issues while planning treatment. Very important and sensitive functions are performed in the head and neck region. These include swallowing, speaking, taste, as well as mouth and throat lubrication. These functions can be impacted by both the cancers and treatments.
Conventional radiation therapy to the head and neck typically results in a permanent dry mouth, a condition called xerostomia. Fortunately, with the development of IMRT (intensity-modulated radiation therapy), the occurrence and level of xerostomia has dramatically improved. All of our centers have IMRT capability, as well as experience using this type of radiation to treat head and neck cancers.

A multidisciplinary approach to head and neck cancer is very important. Also important are support services such as nutritionists and social workers, who are available in all of our centers. We also work closely with dental specialists familiar with radiation therapy in order to avoid dental problems during and after treatment.