You may have surgery, radiation, or chemotherapy to treat head, neck, and oral cancer. Your treatment will be tailored to you based on the type of cancer you have, its size, location, whether it has spread, and your overall health.
If you have early-stage cancer with a tumor that is smaller than 2 cm and hasn’t spread to nearby tissue or lymph nodes (stage I and II), you’ll probably have surgery or radiation therapy alone.
If you have advanced-stage cancer (stage III, IVA and IVB), your care will be more complex. These stages include larger tumors and cancer cells that have spread to nearby tissue and lymph nodes. Our goal is to preserve your organ while destroying the cancer and managing symptoms. You will likely have a combination of surgery, radiation, and chemotherapy.
If you have late-stage cancer that has spread to distant organs like your lungs (stage IVC), you might also receive experimental therapies to control the disease and prolong your life.
Support for You
You will meet with different people on your care team to understand the possible effects of your surgery, to make decisions about your treatment plan, and to get support before and after your procedure. This might include a speech pathologist, a dentist, a reconstructive surgeon, and a social worker. You might also meet with our palliative care specialists to help you manage side effects from your treatment.
Many people who have head, neck, or oral cancer will have surgery to remove the primary tumor.
Unfortunately, because of the tumor locations, these surgeries have the potential to change the form or function of structures in the head and neck. It’s critical to have operations done by surgical oncologists and reconstructive surgeons with special training in treating cancers in the delicate tissues of your mouth, throat, and sinuses. Our surgeons are experts in this area.
We will always partner with a reconstructive surgeon to ensure you have the best possible functional and cosmetic outcome.
Our surgeons specialize in minimally invasive surgery, using it whenever possible. Instead of making an incision in your skin, we use an endoscope—a long flexible tube with a light and camera inside—to remove the tumor from the inside whenever possible. This approach usually results in less blood loss, less pain and pain medication, and speedier recovery times.
If your doctor suspects you have cancer in your lymph nodes, they’ll remove one or more nodes during your operation for a pathologist to examine under a microscope. We’ll use this information to determine what additional treatment you might need.
If your tumor is caught early when it is small, your only treatment might be radiation therapy. Or, you might have radiation therapy after surgery (adjuvant) to destroy cancer cells that may have been left behind.
Radiation therapy causes cancer cells to break or die by targeting the DNA with high-energy particles, such as X-rays, gamma rays, electron beams, or protons. Radiation oncology specialists direct these particles to the tumor site from outside of your body to precisely target cancer cells, often sparing nearby tissue. You might hear this called external beam radiation therapy.
We use a type of radiation therapy called intensity-modulated radiation therapy for head, neck, and oral cancers. This advanced technology lets us accurately direct the radiation beams at your tumor, sparing nearby healthy tissue.
You’ll have radiation therapy on a schedule your radiation oncologist sets--daily, weekly, every other day, or a single treatment.
Because radiation can cause tooth decay, it’s important that an oncologic dentist do an exam before you have this treatment.
We use three types of medications to treat head, neck, and oral cancers:
Chemotherapy medications are given to stop cancer growth and spread. For cancer that is not metastatic, or has not spread to other parts of the body, chemotherapy can help prevent cancer from recurring by causing rapidly dividing cancer cells to become damaged and die.
Chemotherapy is a “systemic” medicine that interferes with fast-dividing cells in your body. This is why it can cause side effects like hair loss. It is most commonly given through an IV in our infusion center.
Chemotherapy drugs are designed to kill cancer cells and are generally given in cycles of a few weeks, with a period of treatment followed by a period of rest.
You might have chemotherapy in combination with radiation therapy, called chemoradiation.
Some head, neck, and oral cancers have specific genes, proteins, or tissue environments that we can target with drugs. These targeted therapies can stop cancer from growing with a different, usually more limited, side effect profile than chemotherapy.
Your doctor may run tests to look for these genetic issues so we can match you with the most effective treatment. You might also qualify for a clinical trial of a new therapy based on test results.
Some head, neck, and oral cancers can be targeted with the following drugs:
- EGFR inhibitors, which target a tumor protein called epidermal growth factor receptor and slow down tumor growth.
- Tumor-agnostic therapy, which focuses on a genetic change in the NTRK genes. You might have this therapy if you have metastatic disease that can’t be removed with surgery and that has gotten worse with other treatments.
Immunotherapy uses the power of your own immune system to fight cancer. Several immunotherapy drugs are approved for treating head, neck, and oral cancers. One immunotherapy, called a checkpoint inhibitor, “takes the brakes off” of your immune system, allowing it to recognize and kill invading cancer cells. There are several FDA-approved immunotherapies for head and neck cancers, and our physicians and researchers are working to find more with our clinical trials program. You can speak to your doctor about whether immunotherapy is for you.
You may qualify to participate in a clinical trial, which is a research study to learn more about promising new treatments or supportive care therapies. The hope is to improve the quality of life and survivorship of colorectal cancer patients. Columbia Cancer offers several clinical trials for patients with head, neck and oral cancers. You can talk to your care team about whether a clinical trial is an option for you.