Head and Neck Cancer

PEOPLE WHO DRINK ALCOHOL AND SMOKE ARE AT RISK FOR GETTING THIS CANCER. It can present as a soreness of the cheeks, the tongue or throat. A biopsy is needed to confirm the presence of this cancer. The treatment is dictated by the size of the primary cancer, its location, and what organs are involved. Surgery by itself, or combined with radiation, may be used. In the past, surgery was the main-stay treatment. But, because new chemotherapy agents are very effective the need for surgery is decreased. Modern treatment programs, in an attempt to decrease the morbidity rate and spare vital organs of the head and neck, now give chemotherapy as the first line of defense and by doing so hope to decrease the need for surgery. With the addition of radiation, complete remission can frequently be achieved. These cancers are: Cancers of the Tongue. Cancers of the Larynx Cancers of the Hypo Pharynx Cancers of the Salivary Glands Cancer of the tongue, if the cancer is small, is treated with surgery only. As the size gets larger, radiation therapy may be added. If the cancer is very large, then the approach changes. Chemotherapy is given before either surgery or radiation. If a remission is achieved with chemotherapy, then radiation therapy may be all that is needed to cure the problem. It is most desirable to retain as much function of the tongue as possible, and operating on the tongue causes significant functional disability, i.e. difficulty swallowing, difficulty talking, etc. As the chemotherapy drugs for this disease improve, radiation and chemotherapy may be all that is needed to cure this disease. Cancers of the larynx are treated with either radiation therapy alone or with pre-radiation therapy chemotherapy. Surgery is only used if chemotherapy and radiation therapy can not get the cancer to remit. It is important to retain all or mostly all of the function of the larynx in trying to treat this cancer. Cancers of the hypo pharynx are difficult to treat without causing significant morbidity. If the patient is willing I use chemotherapy first, then, if the cancer does not remit, radiation therapy and surgery. This is the most opportune way of treating this cancer. Surgeons, a radiation therapist and a medical oncologist need to carefully plan together on setting up a treatment plan for this tumor. Cancers of the salivary glands are usually treated with surgery. Radiation therapy and chemotherapy are used as back up. These cancers are usually localized and are frequently cured with surgery. The chemotherapy drugs commonly used to treat these cancers are taxol, Taxotere, the Platinum compounds, Flourouracil, Etopocide, and Herceptin. The Topoisomerases inhibitors are new additions to the list and their functions are still being clarified.