Cancer occurs when cells in the body become abnormal and multiply without control or order. These cells form a growth of tissue called a tumor. A tumor can be benign or malignant. A benign tumor is not cancerous and usually can be removed without growing back. A malignant tumor is cancerous and can invade and damage the body’s healthy tissues and organs.

Head and neck cancer is a term used to describe a range of malignant (cancerous) tumors that can appear in or around the throat, larynx, nose, sinuses, and mouth.

Most head and neck cancers are squamous cell carcinomas, meaning they begin in the flat, squamous cells that make up the thin, surface layer (called the epithelium) of the structures in the head and neck. Directly beneath this lining, some areas of the head and neck have a layer of moist tissue, called the mucosa. If a cancer is limited to the squamous layer of cells, it is called carcinoma in situ. If the cancer has grown beyond this cell layer and moved into deeper tissue, then it is called invasive squamous cell carcinoma. If the cancer starts in the mucosa, the tumor will be classified as an adenocarcinoma, adenoid cystic carcinoma, or mucoepidermoid carcinoma; each is a rare type of cancer.

There are five main types of head and neck cancer, named by the part of the body where they begin. For more information on each type, select a name below.

Laryngeal and Hypopharyngeal Cancer

Nasal Cavity and Paranasal Sinus Cancer

Nasopharyngeal Cancer

Oral and Oropharyngeal Cancer

Salivary Gland Cancer

Other types of cancer may be located in this area of the body, but they are addressed separately on this website. Please see Cancer.Net's Guide to Thyroid Cancer, Guide to Parathyroid Cancer, and Guide to Brain Tumors for information on those specific diseases.

Statistics

Head and neck cancer accounts for about 3% to 5% of all cancers in the United States. In 2008, an estimated 47,560 people (34,990 men and 12,570 women) will develop head and neck cancer, and an estimated 11,260 deaths (8,120 men and 3,140 women) will occur.

Cancer statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer in the United States each year, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with head and neck cancer.

Statistics adapted from the American Cancer Society’s publication, Cancer Facts & Figures 2008.

To learn about the cancer terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: Basic Oncology Terms.

A risk factor is anything that increases a person’s chance of developing cancer. There are risk factors that can be controlled, such as smoking, and risk factors that cannot be controlled, such as age and family history. Although risk factors can influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop the disease, while others with no known risk factors do. However, knowing your risk factors and communicating them to your doctor may help you make more informed lifestyle and health-care choices.

Two risk factors greatly increase the risk of head and neck cancer:

• Use of tobacco (including cigarettes, cigars, pipes, chewing tobacco, and snuff) is the single, largest risk factor for head and neck cancer
  
  
• Frequent and heavy consumption of alcohol

Eighty-five percent (85%) of head and neck cancer is linked to tobacco use. Using alcohol and tobacco together increases this risk even more. Recent research suggests that people who have used marijuana may be at higher risk for head and neck cancer.

Other factors that can raise a person’s risk of developing head and neck cancer include:

Prolonged sun exposure. This is especially linked to cancer in the lip area (as well as skin cancer of the head and neck and other chronically sun-exposed areas such as the hands).

Human papillomavirus (HPV). Research indicates that infection with this virus is a risk factor for head and neck cancer. HPV is passed from person to person during sexual intercourse. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of head and neck cancers.

Epstein-Barr virus (EBV). Exposure to EBV, which is more commonly known as the virus that causes mononucleosis, plays a role in causing nasopharyngeal cancer to develop.

Gender. Men are two to three times more likely than women to develop head and neck cancer. However, the rate of head and neck cancer in women has been rising for several decades.

Age. People over 40 are at higher risk for head and neck cancer.

Race. Black people are more likely than white people to develop certain types of cancer of the head and neck.

Poor oral hygiene. Poor oral hygiene has been suggested to increase the risk of head and neck cancer.

Environmental/occupational inhalants. Exposure to asbestos, wood dust, paint fumes, and certain chemicals may increase a person’s risk of head and neck cancer.

Poor nutrition. A diet low in A and B vitamins can raise a person’s risk of head and neck cancer.

Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD). Reflux of stomach acid into the upper airway and throat may lead to head and neck cancer.

Weakened immune system. A weakened immune system can raise a person’s risk of head and neck cancer.

Exposure to secondhand smoke. Exposure to secondhand smoke may be a risk factor for head and neck cancer.

Prevention

Although some of the risk factors of head and neck cancer cannot be changed, such as age, several can be avoided by making lifestyle changes. Stopping the use of all tobacco products is the most important thing a person can do, even for people who have been smoking for many years. Some other activities that can reduce the risk of head and neck cancer:

• Avoiding alcohol
  
  
• Avoiding marijuana (discuss marijuana as a risk factor with your doctor)
  
  
• Using sunscreen regularly, including lip balm with an adequate solar protection factor (SPF)
  
  
• Reduce your risk of HPV infection by limiting the number of sex partners, because having many partners increases the risk of HPV infection. Using a condom cannot fully protect you from HPV during sex.
  
  
• Maintaining proper care of dentures. Poorly fitting dentures can trap tobacco and alcohol’s cancer-causing substances. Denture wearers should have their dentures evaluated by a dentist at least every five years to ensure a good fit. Dentures should be removed every night and be cleaned and rinsed thoroughly every day.

People with head and neck cancer often experience the following symptoms. Sometimes, people with head and neck cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

• Swelling or sore that does not heal (the most common symptom)
  
  
• Red or white patch in the mouth
  
  
• Painless lump or mass in the neck
  
  
• Mass or bump in the head and neck area
  
  
• Persistent sore throat
  
  
• Foul or fetid mouth odor not explained by hygiene
  
  
• Hoarseness or change in voice
  
  
• Nasal obstruction or persistent nasal congestion
  
  
• Frequent nose bleeds and/or unusual nasal discharge
  
  
• Difficulty breathing
  
  
• Double vision
  
  
• Numbness or weakness of a body part in the head and neck region
  
  
• Pain or difficulty chewing, swallowing, or moving the jaws or tongue
  
  
• Ear and/or jaw pain
  
  
• Blood in the saliva or phlegm
  
  
• Loosening of teeth
  
  
• Dentures that no longer fit
  
  
• Unexplained weight loss
  
  
• Fatigue

People who notice any warning signs should consult a doctor and/or dentist right away. When detected early, cancers of the head and neck have a much better chance of cure.

Because many of these symptoms can be caused by other, noncancerous health conditions as well, it is important to receive regular health and dental screenings; this is particularly important for those people who routinely drink alcohol or currently use tobacco products or have used them in the past.

In fact, people who use alcohol and tobacco should receive a general screening examination at least once a year. This is a simple, quick procedure in which the doctor looks in the nose, mouth, and throat for abnormalities and feels for lumps in the neck. If anything unusual is found, then the doctor will recommend a more extensive examination using one or more of the diagnostic procedures mentioned below.

People who notice any warning signs should consult a doctor and/or dentist right away. When detected early, cancers of the head and neck have a much better chance of cure.

Because many of these symptoms can be caused by other, noncancerous health conditions as well, it is important to receive regular health and dental screenings; this is particularly important for those people who routinely drink alcohol or currently use tobacco products or have used them in the past.

In fact, people who use alcohol and tobacco should receive a general screening examination at least once a year. This is a simple, quick procedure in which the doctor looks in the nose, mouth, and throat for abnormalities and feels for lumps in the neck. If anything unusual is found, then the doctor will recommend a more extensive examination using one or more of the diagnostic procedures mentioned below. Smokers should also be enrolled in lung cancer screening programs.

Doctors use many tests to diagnose cancer and determine if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:

• Age and medical condition
• The type of cancer suspected
• Severity of symptoms
• Previous test results

If a person has symptoms and signs of head and neck cancer, the doctor will take a complete medical history, noting all symptoms and risk factors. The doctor may perform any of several types of tests that can help to make a definite diagnosis and determine the stage of the cancer (how far it has progressed).

The following tests may be used to diagnose head and neck cancer:

Physical examination/blood and urine tests. During a physical examination, the doctor feels for any lumps on the neck, lips, gums, and cheeks. Also, the doctor will inspect the nose, mouth, throat, and tongue for abnormalities, often using a light and a mirror for a clearer view. Blood and urine tests may be performed to help diagnose cancer. Testing for viral infections, including HPV, may also be done.

Endoscopy. This test allows the doctor to see inside the body. A thin, flexible tube with an attached light and view lens is inserted through the mouth or nose to examine the head and neck areas. The examination has different names depending on the area of the body that is examined, such as laryngoscopy (larynx), pharyngoscopy (pharynx), or a nasopharyngoscopy (nasopharynx). It is performed using an anesthetic spray to numb the area or general anesthesia to make the patient more comfortable. If tissue looks suspicious, the doctor will take a biopsy.

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed from the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease).

Fine needle aspiration. In this type of biopsy, cells are withdrawn using a thin needle inserted directly into the tumor. The cells are examined under a microscope for cancer cells (called cytologic examination).

X-ray. An x-ray is a picture of the inside of the body. A barium swallow may be required for identifying abnormalities along the swallowing passage. A special type of barium swallow called a modified barium swallow may be needed to evaluate difficulties. A dentist may also take x-rays of the teeth and mandible and maxilla, including a panorex (panoramic view). Signs of cancer may be followed up with a computed tomography (CT) scan.

Panorex. This is a rotating, or panoramic, x-ray of the upper and lower jawbones to detect cancer, or to evaluate teeth before radiation therapy or chemotherapy.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body, especially images of soft tissue, such as the tonsils and base of the tongue. A contrast medium may be injected into a patient’s vein to create a clearer picture.

Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs.

Bone scan. A bone scan uses a radioactive tracer to look at the inside of the bones. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears gray to the camera, and areas of injury, such as those caused by cancer, appear dark. This test may be done to see if cancer has spread to the bones.

Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a patient’s body and absorbed by the organs or tissues being studied. This substance gives off energy that is detected by a scanner, which produces the images.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: Newly Diagnosed.

To learn more about what to expect during common diagnostic tests, read Cancer.Net: Tests and Procedures.

Staging is a way of describing cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer’s stage, so staging may not be complete until the doctor performs a biopsy. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis (chance of recovery). There are different stage descriptions for different types of cancer.

One tool that doctors use to describe the stage is the TNM system. This system uses three criteria to judge the stage of the cancer: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to other parts of the body. The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:

• How large is the primary tumor and where is it located? (Tumor, T)
  
  
• Has the tumor spread to the lymph nodes? (Node, N)
  
  
• Has the cancer metastasized to other parts of the body? (Metastasis, M)

There is a different staging system for each type of head and neck cancer; detailed information about staging for each head and neck cancer can be found in the specific cancer type section. (see Overview.)

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Sixth Edition (2002) published by Springer-Verlag New York, www.springer-ny.com.

The treatment of head and neck cancer depends on the size and location of the tumor, whether the cancer has spread, and the person’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan.

This section outlines treatments that are the standard of care (the best treatments available) for this specific type of cancer. Patients are also encouraged to consider clinical trials when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. For more information, visit the Clinical Trials section.

Many cancers of the head and neck can be cured, especially if they are found early.

Although curing the cancer is the primary goal of treatment, preserving the function of the nearby nerves, organs, and tissues is also very important. When they plan treatment, doctors consider how treatment might affect a person’s quality of life, such as how a person feels, looks, talks, eats, and breathes.

Head and neck cancer specialists often form a multidisciplinary team to care for each patient, and an evaluation should be done before any treatment begins. The team may include medical and radiation oncologists; surgeons; otolaryngologists (ear, nose, and throat doctors); plastic surgeons; maxillofacial prosthodontists (specialists who perform restorative surgery in the head and neck areas); dentists; physical therapists; speech pathologists; audiologists; psychiatrists; nurses; dietitians; and social workers. It is imperative that a comprehensive treatment plan is established prior to the start of therapy, and people may need to be seen by multiple specialists before a treatment plan is fully developed. 

In addition, this evaluation may include testing for HPV infection. As outlined in the Risk Factors section, HPV has been linked to a higher risk of head and neck cancer. Whether a person has HPV can also be a factor in determining which treatments are likely to be most effective, in some cases.

There are three main treatment options for head and neck cancer: surgery, radiation therapy, and chemotherapy. One of these therapies, or a combination of them, may be used to treat the cancer.

Surgery

During surgery, the doctor performs an operation to remove the cancerous tumor and some of the healthy tissue around it (called a margin). The goal of surgery is to remove all of the tumor and leave negative margins (no trace of cancer in the healthy tissue). Laser technology may be used to treat early-stage tumors, especially in larynx cancer. If the doctor suspects that the cancer has spread, then the doctor may remove lymph nodes in the neck, possibly causing stiffness in the shoulders afterward. Sometimes, it is not possible to completely remove the cancer; additional treatments might be necessary.

Depending on the location, stage, and the type of the cancer, some people may need more than one operation to remove the cancer and to help restore the appearance and function of the tissues affected. If the surgery requires major tissue removal (for example, removing the jaw, skin, pharynx, or tongue), reconstructive or plastic surgery may be used to replace the missing tissue. A prosthodontist may be able to make an artificial dental or facial part to restore the ability to swallow and speak. A speech pathologist may then be needed to help the patient relearn how to swallow and communicate using new techniques or special equipment.

Sometimes, surgery is followed by radiation treatment and/or chemotherapy to destroy cancer cells that cannot be removed during surgery.

Side effects of surgery depend on the type and location of the surgery, and may include:

• Swelling of the mouth and throat area, making it difficult to breathe. Some patients may receive a temporary tracheostomy (a hole in the windpipe) to make breathing easier.
  
  
• Temporary or permanent loss of normal voice or impaired speech.
  
  
• Difficulty chewing or swallowing. A tube may be inserted in the stomach for feeding purposes.
  
  
• Facial disfigurement. Reconstructive surgery may be required to maintain appearance or body functions, such as chewing, swallowing, or breathing.
  
  
• Hearing loss
  
  
• Decreased functioning of the thyroid gland, especially after a total laryngectomy (the removal of the larynx) and/or radiation therapy

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body.

A new method of external-beam radiation therapy, known as intensity modulated radiation therapy (IMRT), allows for more effective doses of radiation therapy to be delivered while reducing the damage to healthy cells and causing fewer side effects.

Radiation therapy can be the main treatment for head and neck cancer, or used after surgery to destroy small pockets of cancer that cannot be removed surgically.

Before beginning radiation treatment for any head and neck cancer, patients should receive a thorough examination from an oncologic dentist (a dentist experienced in treating people with head and neck cancer). Since radiation therapy can cause tooth decay, damaged teeth may need to be removed. Often, tooth decay can be prevented with proper treatment from a dentist before beginning treatment. People should also receive an evaluation from a speech pathologist who has experience treating people with head and neck cancer. Since radiation therapy can cause throat swelling and scarring, voice and swallowing are often affected.

Radiation therapy to the head and neck may cause the following side effects:

• Redness or skin irritation to the treated area
  
  
• Swelling
  
  
• Dry mouth or thickened saliva, from damage to salivary glands
  
  
• Bone pain
  
  
• Nausea
  
  
• Fatigue
  
  
• Mouth sores and/or sore throat
  
  
• Dental problems (usually preventable)
  
  
• Painful or difficulty swallowing (short and long-term)
  
  
• Changes in voice because of swelling or scarring
  
  
• Loss of appetite, due to a change in sense of taste
  
  
• Hearing loss, due to buildup of fluid in the middle ear
  
  
• Buildup of earwax that dries out because of the radiation therapy’s effect on the ear canal
  
  
• Fibrosis (scarring)

Radiation therapy also may cause a condition called hypothyroidism, in which the thyroid gland (located in the neck) slows down and causes the patient to feel tired and sluggish. Every patient who receives radiation therapy to the neck area should have his or her thyroid checked regularly.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions through Cancer.Net’s Drug Information Resources, which provides links to searchable drug databases.

Targeted therapy

Targeted therapy is a treatment that targets faulty genes or proteins that contribute to cancer growth and development. Targeted therapies against a tumor protein called epidermal growth factor receptor (EGFR) may be used.

Radiation therapy also may cause a condition called hypothyroidism, in which the thyroid gland (located in the neck) slows down and causes the patient to feel tired and sluggish. Every patient who receives radiation therapy to the neck area should have his or her thyroid checked regularly.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given orally (by mouth); given intravenously (in a vein); injected either into a muscle, under the skin, or directly into the cancerous tumor; or applied onto the surface of the skin.

Chemotherapy can be used in the initial treatment either neoadjuvant (before) or adjuvant (after) surgery, radiation therapy, or both.

Many combined treatments (chemotherapy and radiation therapy) are performed as part of a clinical trial, which are research studies to find new treatments.

Each drug or combination of drugs can cause specific side effects, and some can be permanent. In general, chemotherapy may cause the following side effects:

• Fatigue
  
  
• Nausea
  
  
• Vomiting
  
  
• Hair loss
  
  
• Dry mouth
  
  
• Loss of appetite, due to a change in sense of taste
  
  
• Weakened immune system
  
  
• Diarrhea and/or constipation
  
  
• Open sores in the mouth; this condition coupled with a low immunity can lead to infections

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications you’ve been prescribed, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions through Cancer.Net’s Drug Information Resources, which provides links to searchable drug databases.

Doctors and scientists are always looking for better ways to treat patients with head and neck cancer. A clinical trial is a way to test a new treatment to prove that it is safe, effective, and possibly better than a standard treatment. Patients who participate in clinical trials are among the first to receive new treatments, such as new chemotherapy, before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that this is the only way to make progress in treating head and neck cancer, such as finding new drugs. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with head and neck cancer.

To join a clinical trial, patients must complete a learning process known as informed consent. During informed consent, the doctor should list all of the patient’s options, so the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different than the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment. Learn more about clinical trials, including patient safety, phases of a clinical trial, deciding to participate in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.

Cancer and its treatment can cause a variety of side effects. However, doctors have made major strides in recent years in reducing pain, nausea and vomiting, and other physical side effects of cancer treatments. Many treatments used today are less intensive but as effective as treatments used in the past. Doctors also have many ways to provide relief to patients when such side effects do occur.

Fear of treatment side effects is common after a diagnosis of cancer, but it may be helpful to know that preventing and controlling side effects is a major focus of your health-care team. Before treatment begins, talk with your doctor about possible side effects of the specific treatments you will be receiving. The specific side effects that can occur depend on a variety of factors, including the type of cancer, its location, the individual treatment plan (including the length and dosage of treatment), and the person’s overall health.

Ask your doctor which side effects are most likely to happen (and which are not), when side effects are likely to occur, and how they will be addressed by the health-care team if they do happen. Also, be sure to communicate with the doctor about side effects you experience during and after treatment. For more information on the most common side effects of cancer and different treatments, along with ways to prevent or control them, visit Cancer.Net’s section on Managing Side Effects, based on ASCO’s curriculum.

After treatment for head and neck cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. If radiation therapy was used, your doctor may recommend regular thyroid gland checkups, through blood tests.

Rehabilitation is a major part of follow-up care after head and neck cancer treatment. People may receive physical therapy to maintain movement and the range of movements, and speech therapy to regain skills, such as talking and swallowing. Proper evaluation and treatment may often prevent long-term speech and swallowing problems. Supportive care to manage symptoms and maintain nutrition during and after treatment may be recommended. Some people may need to learn new ways to eat or to eat foods prepared differently.

People may look different, feel tired, and be unable to talk or eat the way they used to. Many people experience depression. The health-care team can help people adjust and connect them with support services.

People recovering from head and neck cancer are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about Healthy Living After Cancer.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: After Treatment.

Research for head and neck cancer is ongoing. The following advances may still be under investigation in clinical trials and may not be approved or available at this current time. Always discuss all diagnostic and treatment options with your doctor.

Combined therapies. Most research for head and neck cancers focuses on combining different types of treatments to improve the effectiveness and the patient’s quality of life.

Radiofrequency thermal ablation (RFA). Used on a localized tumor that cannot be removed by surgery, RFA is a minimally invasive treatment option that applies heat to the tumor.

Gene therapy. Gene therapy is a targeted, nontoxic form of treatment that uses biologic gene manipulation to change bits of genetic code in a person’s cells. Although gene therapy is relatively new, it appears to show promising potential for treating head and neck cancer.

Photodynamic therapy. In photodynamic therapy, a light-sensitive substance is injected into the tumor that stays longer in cancer cells than in normal cells. A laser is directed at the tumor, which destroys the cancer cells. Photodynamic therapy is currently used to relieve swallowing problems for a brief period; it is not a curative therapy.

Proton radiation therapy. Proton radiation therapy can be used as a boost (part of treatment) to reduce normal tissue toxicity. It can be used as part of the treatment for some skull-base tumors (for example, nasopharynx, chordoma [a rare tumor that usually occurs in the spine and base of the skull], chondrosarcoma [a cartilage-based tumor]) to further limit the radiation dose to normal structures, such as the optic nerves and brainstem.

HPV. Research continues regarding the link between HPV and head and neck cancers, both in terms of why this virus raises the risk for the disease and why it may affect treatment results in some cases. Investigation is also underway about whether the HPV vaccine, currently used to prevent cervical cancer, is effective in preventing head and neck cancers as well.

In addition, there are many valuable, ongoing investigations of new chemotherapy drugs and multi-modality studies (where more than one treatment approach is used).

Regular communication with your doctor is important in making informed decisions about your health care. Consider asking the following questions of your doctor:

• What is the exact type of head and neck cancer that I have?
  
  
• Can you explain my pathology report to me?
  
  
• Is it important to determine if I have HPV? Why?
  
  
• What are the treatment options?
  
  
• What clinical trials are open to me?
  
  
• What treatment do you recommend? Why?
  
  
• What are the possible side effects of this treatment, both in the short term and the long term?
  
  
• How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?
  
  
• If surgery is needed, will it be necessary to have a reconstruction done to replace lost tissue (mandible)?
  
  
• If surgery is needed, will there be a need for a neck dissection (removing lymph nodes)? If so, what type of dissection will be done? What does this mean?
  
  
• Should I get an additional consultation or second opinion?
  
  
• Can you recommend an oncologic dentist?
  
  
• Should I see a speech pathologist prior to treatment?
  
  
• What follow-up tests will I need, and how often will I need them?
  
  
• What support services are available to me? To my family?

Support for People with Oral, Head, and Neck Cancer, Inc.
P.O. Box 53
Locust Valley, NY  11560-0053
Toll Free: 800-322-0978
www.spohnc.org

The Oral Cancer Foundation
3419 Via Lido, #215
Newport Beach, CA  92663
Phone: 949-646-8000
www.oralcancerfoundation.org

View all of Cancer.Net's Patient Information Resources.