Head and Neck Cancer Treatment

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Types of Head and Neck Cancer and Related Conditions Treated

  • If detected early, most head and neck cancers can be cured with surgery or radiation therapy

    Cancers of the oral cavity (mouth)
  • Cancers of the pharynx (throat, including tonsils and base of the tongue)
  • Cancers of the larynx (voicebox)
  • Cancers of the paranasal sinuses and skull base
  • Dysplasia (or precancerous changes) of the oral cavity
  • Salivary gland tumors
  • Nasopharyngeal cancer
  • Ear and Temporal bone tumors
  • Thyroid and parathyroid
  • cancer, hyperparathyroidism,  thyroid nodules, and many non-cancerous thyroid and parathyroid conditions
  • Melanoma, Merkel cell cancer, squamous cell skin cancer, and other skin and lip cancers
  • Head and Neck problems from tumors from other disease sites (Metastases in neck lymph nodes)
  • Sarcomas of the Head and Neck
  • Complications of radiation treatment, surgery or head and neck injuries

Treatment Options for Head and Neck Cancer

Our approach usually allows for coordinated evaluation and consultation during a single visit

In America today several approaches are available to treat head and neck cancer.  The best method to treat the cancer depends upon its location, and its size.

All treatment recommendations for head and neck tumors should take into account not only cure of the cancer, but also preserving the patient’s quality of life. Sometimes more than one treatment will work equally well, so the patient should have an opportunity to meet with doctors from different specialties before treatment begins in order to decide which option suits them best.  This also allows the multidisciplinary team to make a treatment recommendation that takes into account the unique features of each patient’s disease and needs.  

At Fox Chase Cancer Center, our Head and Neck Cancer team often agrees upon recommendations during the first appointment and shares the treatment plan with our patients. Our approach usually allows for coordinated evaluation and consultation during a single visit. Some patients, however, do not require assistance from the entire team.

If detected when they are small, most head and neck cancers can be cured with either surgery or radiation therapy alone.

Both surgery and radiation may both be used as approaches to help preserve organs, whether the cancer is localized or advanced. More advanced cancers respond well to combinations of surgery, radiation therapy and chemotherapy, and many can be treated with two of the three. These “combined modality” treatments lead to higher cure rates while maintaining the patient's quality of life.

Surgery

Highly skilled
head and neck surgeons
offer patients a wealth of experience,
which includes
robotic surgery (TORS),
laser microsurgery,
and other techniques.

Many head and neck cancers can be cured with operations. Some of these procedures are short (sometimes even without hospitalization) but others take longer to perform and will involve staying in the hospital. Highly skilled head and neck surgeons, John A. Ridge, MD, PhD, Miriam N. Lango, MD, and Jeffrey Liu, MD, offer patients a wealth of experience, which includes robotic surgery (TORS), laser microsurgery, and other techniques. They will explain what will happen during and after the operation, and what to expect.

In addition, they have a wide array of support services, including expert Speech Language therapists and rehabilitation specialists devoted exclusively to recovery from cancer treatment, and they work closely experienced reconstructive surgeons when needed.

Transoral Laser Surgery

For the right cancer
(and the right patient)
even advanced cancers can be treated with only small scars

Surgeons  at Fox Chase Cancer Center are revolutionizing treatment by removing cancers of the oropharynx (throat, tonsils, and base of the tongue) and larynx (voicebox) using the Intuitive Surgical Robot or Transoral Laser Microsurgery .

For many patients this means less scarring, bleeding, swelling and fewer infections. Recovery after Transoral Robotic Surgery (TORS) and laser microsurgery is more rapid than from many other cancer treatments.

There are several benefits to TORS and to laser microsurgery:

  • Patients more often keep their ability to speak normally after microsurgery treatment of cancers of the larynx, or voicebox.
  • For some patients, it is not necessary to perform radical surgery. Often times, surgeons can reach the affected organ via the mouth. Surgeons do not need to use external incisions or cut through the jaw when using laser procedures or TORS.
  • For the right cancer (and the right patient) even advanced cancers can be treated with only small scars

Read more on Transoral Laser Surgery »

Reconstructive Surgery

Some cancers are so large that curing them with an operation will require head and neck surgeons Ridge, Lango, or Liu to perform larger procedures. When such treatment is necessary, Plastic and reconstructive surgeons Neal S. Topham, MD, Eric Chang, MD, and Sameer A. Patel, MD, as well as oral surgeons and prosthodontists at Fox Chase, specialize in reconstructive surgery and other techniques to achieve the best possible cosmetic and functional results.

While such procedures are complex, requiring  highly specialized teams, our safety record is unparalleled in the  Philadelphia area.

Read more about Reconstructive Surgery at Fox Chase »

 

Radiation Therapy

Trilogy Linear Accelerator with Cone Beam CT and Rapid Arc

For some patients, radiation treatment of their head and neck cancers gives equal or better results than surgery; it may be possible to avoid an operation entirely. In other instances, it can be a vital addition to surgical therapy.

Thomas Galloway, MD, and Aruna Turaka, MD, are Radiation Oncologists—specialists in radiation treatment for head and neck cancer. They are experts in the use of sophisticated radiation techniques: intensity-modulated radiation treatment (IMRT— a technique that allows the radiation oncologist more control of radiation delivery), image-guided radiation treatment (IGRT—a technique that allows radiation with smaller “margins”), stereotactic radiosurgery (SBRT with either a linear accelerator or the CyberKnife system—techniques that allow radiation treatment to small areas), and interstitial brachytherapy.

Technological advances in radiation delivery have improved cancer cure rates while decreasing side effects of treatment

The radiation process is complex and questions are encouraged.  Your radiation oncology team will be with you every step of the way.  The treatment process begins with a special CT scan, potentially an MRI fusion, and a PET/CT for treatment planning. This targeted approach improves the accuracy of the radiation by sparing the surrounding healthy tissues from radiation, and limiting treatment side effects. The radiation oncologist, in conjunction with internationally renowned Fox Chase Cancer Center physicists,  crafts a unique plan to treat each cancer.  The plan will undergo a rigorous process of verification, before radiation treatments begin. 

Technological advances in radiation delivery have improved cancer cure rates while decreasing side effects of treatment.

Chemoradiation

The CyberKnife Robotic Radiosurgery System at Fox Chase Buckingham

Chemoradiation (chemotherapy and radiation given at the same time) has enabled many patients to avoid surgery and improve cancer control for large cancers that cannot be removed without major side effects. This approach has made it possible for the Fox Chase Cancer Center Head and Neck team to provide curative therapy without radical surgery.

This treatment is complex. Patients undergoing such treatments benefit from the support of an experienced treatment team. Medical Oncologists Ranee Mehra, MD and Igor Astsaturov, MD, PhD work closely with the radiation oncologists, and are experts in organ preservation chemoradiation.  Kristen Kreamer, MSN,APRN-BC, works closely with the medical oncologists to provide supportive care during treatment.


Chemotherapy and targeted agents

Patients sometimes require ongoing treatment with chemotherapy or newer therapies that target specific functions at the molecular level.  Many of these treatments are being studied in clinical trials with the goal of advancing cancer care and to provide patients with access to the newest therapies.  At Philadelphia's Fox Chase Cancer Center, our team of nationally recognized medical oncologists, such as Igor Astsaturov, MD, PhD, and Ranee Mehra, MD, offer the newest, innovative clinical trials.   

[3/5/2014]

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Head and Nech Cancer Stories of Hope Patient Stories from Fox Chase Cancer Center

Head and Neck Patient Stories

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Blue Distinction

Blue Cross/Blue Shield
Fox Chase is a Blue Distinction Center for Head and Neck Cancer Treatment
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See National Cancer Institute information on Oral Cancer

See National Cancer Institute information on

The Head and Neck surgical team includes
Neal Topham, MD, John A. Ridge, MD,
and Miriam M. Lango, MD.

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Our Genetic Test Creates a "Blueprint" of Your Cancer

DNA sequencing means tumor-specific genetic alterations now can potentially be matched to precision drugs. Your own body can tell us which chemotherapy might be best for you. Fox Chase patients with advanced cancers can elect to have their tumors examined for a panel of genetic alterations,
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