Radiation Oncology

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Radiation Therapy for Head and Neck Tumors

Head and neck cancers include carcinomas arising in the oral cavity, pharynx and larynx (voice box). As a group these cancers share several distinctive features: Almost all (with the notable exception of nasopharynx) are strongly associated with tobacco. Cigarette smoking greatly increases one's risk of pharyngeal and laryngeal cancer and chewing tobacco is strongly associated with oral cavity cancers (cancer of the mouth and gums). The large majority of head and neck cancers are squamous cell carcinomas, arising from the squamous epithelium that lines the upper aerodigestive tract.

Signs and symptoms of head and neck cancer can be variable but complaints of chronic sore throat, ear pain, difficulty swallowing, hoarseness, or feeling a lump in the neck, are most common. If your primary doctor is concerned about the possibility of cancer, he will refer you to a specialist (an otolaryngologist) who will examine the throat with a scope. This procedure, called a laryngoscopy, allows the entire pharynx and larynx to be clearly visualized and biopsies to be performed. If cancer is detected appropriate staging must be performed. Stage is determined by the size of the tumor, whether it invades other structures and the presence of lymph nodes. A CT scan of the head and neck is usually obtained to adequately assess these features.

Treatment of head and neck cancer depends on the stage and site of the tumor. In general surgery, radiation, chemotherapy or a combination are recommended for treatment of head and neck tumors. Surgery is often the treatment of choice for small tumors which can be resected without causing great morbidity. Radiation may be recommended after surgery if there is concern that the tumor may not have been entirely resected or that the lymph node bearing areas in the neck harbor cancer.

For large tumors radiation is often the treatment of choice. Radiotherapy for head and neck cancer usually consists of seven weeks of daily treatments aimed at the cancer and surrounding lymph nodes. Patients may experience side effects including dry mouth, changes in taste and sore throat (more info). Chemotherapy is prescribed by a medical oncologist and recent studies have shown a benefit to dosing chemotherapy in many types of unresectable head and neck tumors.