By: Dr. Stefanie Horne, MD
Southwest Ohio ENT Specialists
Surgery, radiation therapy and chemotherapy are used to treat head and neck cancers. Some patients will require all three modalities, while others can be treated with just one or two. The head and neck cancer team (Head and Neck Tumor Board) meets every 2 weeks to discuss any new cancer patients and the treatment options. Patients are also followed by the Tumor Board throughout and after treatment. Tumor board involves all members of the treatment team (see below) as well as radiologists, nuclear medicine physicians and pathologists to assist in interpreting testing for staging and follow up. The tumor board will make treatment recommendations based on the consensus of the specialists. Many times, there is a clear best course of treatment which will be recommended. Sometimes, there are 2 equally effective treatment options, and you will decide what is best for you. Your physicians will help you navigate that decision.
Surgery: This is done by your Otolaryngologist (ENT surgeon). All patients will require some type of biopsy to diagnose the cancer and test it for tumor markers. Sometimes this can be done in the office, sometimes this requires going under anesthesia. Surgery can range from an exam under anesthesia to examine the upper airway and biopsy the tumor to extensive tumor resection with neck dissection and reconstruction. The recommendation for surgery as a part of your treatment depends on the location, size and stage of the cancer. Surgery can be done as primary treatment or to clear residual cancer after chemotherapy and radiation.
Radiation therapy: This is done by your Radiation Oncologist. Most head and neck cancer patients will require radiation, this is usually External Beam Radiation which targets the tumor cells and involved lymph nodes but spares the important surrounding structures. The beams are carefully planned by the Radiation Oncologist and their team. Treatment usually lasts 6 weeks and treatments are every Monday through Friday. Patients usually get 33-35 “treatments” that are short bursts of radiation similar to an x-ray but the beams are targeted at the cancer. Radiation therapy is sometimes done alone, sometimes it is in combination with chemotherapy (chemoradiation). Radiation alone or chemoradiation can be done as primary treatment or as an adjuvant to surgery once you have healed.
Chemotherapy: This is done by the Oncologist (or Hematologist/Oncologist). Many head and neck cancer patients will require chemotherapy to be given during the same time they are getting radiation. This combined treatment is called “chemoradiation.” Chemotherapy potentiates the radiation therapy (helps it work better) and prevents the spread of cancer outside the head and neck to other areas of the body. Chemotherapy is usually given every 1-2 weeks over the course of the 6 weeks of radiation therapy.
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