Head and Neck Cancer Treatment
How Is Head and Neck Cancer Treated?
Diagnosis and treatment of a patient with head and neck cancer varies with the type, stage, and location of the cancer, as well as the patient’s age and overall state of health.
The goal of treatment is to remove the cancer, while sparing healthy tissue and reducing side effects. The ultimate goal is to enable the patient to resume normal activities and daily life after treatment of the cancer.
Because the head and neck are delicate and complex parts of the body and affect how we look, talk, breathe, and eat, a diagnosis and treatment plan will involve multiple specialists. Each patient’s plan of care will include treatment, rehabilitation, and follow-up care.
The multidisciplinary care of a patient with head and neck cancer is usually managed by one of the following head and neck specialists who serves as the primary caregiver for the patient during cancer treatment and coordinates the participation of other specialists. Other members of the medical team may include oral surgeons, dentists, and plastic surgeons, as well as nurses, social workers, speech and swallowing experts, and patient navigators.
- A head and neck surgical oncologist is a specialist trained in surgical conditions of the head and neck who performs surgery in the head and neck region. In addition, the head and neck surgical oncologist works together with a reconstructive surgeon to restore the function and appearance of the head and neck.
- A medical oncologist is a physician who treats cancer with chemotherapy (cancer-killing) drugs.
- A radiation oncologist is a doctor who specializes in the application of radiation therapy to kill cancerous tissue.
The goal of treatment is not only to remove cancerous tissue, but to also maintain quality of life and restore normal function and appearance. Treatment of most head and neck cancers involves one or more of the following procedures:
Surgery and Minimally Invasive Procedures
Often, surgery plays a major role in the management of head and neck cancers. The surgical oncologist removes tumors while preserving surrounding tissues. If the patient has a very large or complex tumor, the procedure may involve a team of two or more specialists operating at the same time.
Before surgery, radiation therapy and/or chemotherapy may be used to shrink the tumor. These therapies may also follow surgery to destroy any remaining cancer cells.
Physicians at BMC are pioneers in the development of minimally invasive surgeries and treatments for head and neck cancer. These innovative techniques reduce or eliminate surgical incisions, expose patients to less risk, lower post-operative pain, and shorten recovery time. One of these state-of-the-art practices is transoral robotic surgery (TORS).
BMC was the first organization to perform TORS in New England. This procedure utilizes the da Vinci robot to remove tumors that are extremely difficult to reach using traditional methods. This FDA-approved surgery spares patients from a large incision through their chin and throat to reach the tumor. Recovery time is shortened, and speech, swallowing, and other quality of life activities are preserved.
BMC also offers laser treatment. CO2 lasers were developed in the 1970s. The use of lasers for treatment of head and neck malignancies has continued to improve the outcomes of patients suffering from head and neck cancer. The procedure is minimally invasive and very effective.
Other state-of-the-art, minimally invasive surgical techniques in use at BMC include
- Endoscopic parathyroid surgery
- Endoscopic resection of nasopharyngeal, sinus, and skull base tumors using BrainLab image guidance
- Endoscopic transoral laryngeal surgery
Reconstructive surgery is another specialty at BMC. These practices include microvascular reconstruction—the transfer of tissue from one part of the body to another to restore function, as well as outward appearance. Other reconstructive techniques combine surgery with an oral surgeon and an ears, nose, and throat (ENT) surgeon collaborating with a prosthodontist to ensure the most appropriate dental rehabilitation. The goal of all of these is to restore a patient’s face to as close to its pre-cancer appearance as possible.
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Integrative medicine practices have been shown to reduce cancer-related symptoms such as pain, anxiety, nausea, and fatigue. The Program for Integrative Medicine and Health Care Disparities in the Department of Family Medicine at BMC combines conventional medical treatments with evidence-based complementary therapies. Free therapeutic massage to decrease preoperative anxiety and postoperative pain in cancer patients undergoing surgical procedures is available. In the Moakley Building, where BMC conducts much of its cancer care, a registered yoga instructor holds free biweekly yoga classes, and a licensed acupuncturist offers free acupuncture to cancer patients. Participants in these sessions have gained notable clinical benefits, reporting decreases in pain, depression, anxiety, nausea, and fatigue. Services to individual patients complement group activities. Consultations that focus on stress management, nutrition, and coordination of complementary therapies are also available.