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Head & Neck CancersIf you’ve been recently diagnosed with cancer of the head and neck you and your family might be overwhelmed with questions and decisions to make. Your first decision is where to get treatment.
You want a place where you can get the most advanced treatment options available. A place where you are supported by a team of compassionate experts. A place where you are treated as a whole person.
MultiCare Regional Cancer Center is that place. We have the region’s best health care providers in the field on oncology. Our world-class treatment facility offers cutting edge technology in a welcoming and positive healing environment.
Learn about our treatment approach, our cancer care team or more about head and neck in the tabs below.
Cancer of the head and neck can occur in the nasal cavity, sinuses, lips, mouth, salivary glands, throat, or larynx (voice box).
Most oral cancers start in the lining of the lips or mouth where you have thin, flat cells called squamous cells. The oral cavity includes the following:
- The front two thirds of the tongue
- The gingiva (gums)
- The buccal mucosa (the lining of the inside of the cheeks)
- The floor (bottom) of the mouth under the tongue
- The hard palate (the roof of the mouth)
- The retromolar trigone (the small area behind the wisdom teeth)
Most laryngeal cancers also form in squamous cells, in three main parts of the larynx:
- Supraglottis: The upper part of the larynx above the vocal cords, including the epiglottis.
- Glottis: The middle part of the larynx where the vocal cords are located.
- Subglottis: The lower part of the larynx between the vocal cords and the trachea (windpipe).
Symptoms for these types of cancer include:
- Sore on your lip or in your mouth that bleeds easily and does not heal
- Lump or thickening on your lips, gums, cheek, or in your mouth
- White or red patch on your gums, your tongue, tonsils, or the lining of your mouth
- Sore throat that does not go away or a feeling that something is caught in your throat
- Unexplained difficulty chewing, swallowing, speaking, or moving your jaw or tongue
- Numbness or pain in your tongue or other areas of your lips or mouth
- Swelling in your jaw that makes your teeth loose or your dentures fit poorly
- Change or hoarseness in the voice
- Dry mouth (xerostomia)
- Ear pain
Causes & Risk Factors
Risk factors for lip and oral cavity cancer include the following:
- Using tobacco products
- Heavy alcohol use
- Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time
- Being male
- Being infected with human papillomavirus (HPV)
Some combinations, such as using tobacco and drinking alcohol, increase the risk more than using tobacco or drinking alcohol. The same is true for using marijuana if you have high-risk HPV infection.
Early Screening & Prevention
Researchers are studying how people can make changes in their lifestyles to reduce their risk for cancer. One lifestyle change that may reduce the risk for oral cancer is eating fruits and fiber-rich vegetables.
Take the following steps for prevention of these types of cancer:
- Don't use tobacco in any form
- Drink alcohol only in moderation
- Use sun protection on your lips, such as a lip balm that has sunscreen or a colored lipstick
- Get dental checkups twice a year so that signs of oral cancer can be detected early
Patients who have had these types of cancer have an increased risk of developing a second cancer in the head or neck. Frequent and careful follow-up is important. Clinical trials are studying the use of retinoid drugs to reduce the risk of a second head and neck cancer.
The following tests and procedures may be used:
- Physical Exam: Performed on the lips, oral cavity, throat and neck. A history of the patient's health habits and past illnesses and medical and dental treatments will also be taken.
- Endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through an incision (cut) in the skin or opening in the body, such as the mouth. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of disease.
- Laryngoscopy: A procedure in which the doctor examines the larynx (voice box) with a mirror or with a laryngoscope (a thin, lighted tube).
- X-rays: Performed on the head, neck, and chest
- Biopsy: To remove cells or tissues so they can be viewed under a microscope by a pathologist.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body.
- CT Scan: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles.
- Exfoliative Cytology: A procedure to collect cells from the lip or oral cavity.
- Barium Swallow: A series of x-rays of the esophagus and stomach.
- PET Scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
The process used to find out if cancer has spread within the oral cavity, throat or larynx or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage of the disease in order to plan treatment.
Treatment for oral, lip and throat cancer is usually provided by a team of doctors who are experts in treating head and neck cancers. The team may include a medical oncologist, a head and neck surgeon, an oral (maxillofacial) surgeon, or a radiation oncologist.
Surgery is a common treatment for all stages of cancers of the head and neck. The following surgical procedures may be used:
- Wide Local Excision: Removal of the cancer and some of the healthy tissue around it. If cancer has spread into bone, surgery may include removal of the involved bone tissue.
- Neck Dissection: Removal of lymph nodes and other tissues in the neck. This is done when cancer may have spread from the lip and oral cavity.
- Plastic Surgery: An operation that restores or improves the appearance of parts of the body. Dental implants, a skin graft, or other plastic surgery may be needed to repair parts of the mouth, throat, or neck after removal of large tumors.
- Cordectomy: Surgery to remove the vocal cords only.
- Supraglottic Laryngectomy: Surgery to remove the supraglottis only.
- Hemilaryngectomy: Surgery to remove half of the larynx (voice box). A hemilaryngectomy saves the voice.
- Partial Laryngectomy: Surgery to remove part of the larynx (voice box). A partial laryngectomy helps keep the patient's ability to talk.
- Total Laryngectomy: Surgery to remove the whole larynx. During this operation, a hole is made in the front of the neck to allow the patient to breathe. This is called a tracheostomy.
- Thyroidectomy: The removal of all or part of the thyroid gland.
- Laser Surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy:
- External radiation therapy uses a machine outside the body to send radiation toward the cancer.
- Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
For patients who smoke, radiation therapy works better when smoking is stopped before beginning treatment. It is also important for patients to have a dental exam before radiation therapy begins, so that existing problems can be treated.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
Because the lips, throat and oral cavity are important for breathing, eating, and talking, patients may need special help adjusting to the side effects of the cancer and its treatment. The medical oncologist may refer the patient to other health professionals with special training in the treatment of patients with head and neck cancer. These include the following:
- Head and neck surgeon
- Radiation oncologist
- Speech therapist
- Rehabilitation specialist
- Plastic surgeon
Learn about the various treatment options for lip and oral cancer by stage.
Learn about the various treatment options for laryngeal cancer by stage.