Head and Neck Cancer Treatments

Head and neck cancer is often curable when detected early. Treatment varies depending on the type and location of the tumor, whether it has spread, and the patient’s general health and preferences.

For example, patients with oropharyngeal cancer caused by the human papillomavirus (HPV-positive OPC) may have better outcomes than those with HPV-negative tumors. Therefore, they may do well with less-intense treatment.

At UT Southwestern Medical Center’s Harold C. Simmons Comprehensive Cancer Center, patients have every treatment option available to them, delivered by the most experienced head and neck cancer specialists in Dallas.

Surgery for Head and Neck Cancer

Surgery is often the first treatment for head and neck cancers. The goal is to remove all of the cancerous tumor.

The major surgeries we perform include:

• Glossectomy: Removal of all or part the tongue
• Mandibulectomy: Removal of all or part of the jaw
• Maxillectomy: Removal of all or part of the facial bones that make up the hard palate, nose, and floor of the eye
• Pharyngectomy: Removal of all or part of the pharynx, the part of the throat behind the nose and mouth that connects to the esophagus
• Laryngectomy: Removal or all or part of the larynx (voice box)
• Parotidectomy: Removal of the parotid gland, the largest of the salivary glands
• Submandibular gland excision: Removal of the submandibular gland, the second largest of the main salivary glands
• Neck dissection: Removal of the lymph nodes in the neck
• Thyroidectomy: Removal of the thyroid gland, which is located at the base of the front of the neck and produces hormones
• Wide local excision of skin cancers: Removal of the cancerous tissue along with some healthy skin and tissue around it
• Sentinel node biopsy: Removal of a lymph node to determine if it is cancerous
• Local or regional tissue transfer: Reconstruction of head and neck defects using nearby tissue or tissue from an adjacent region
• Free tissue transfer: Microvascular reconstruction of head and neck defects using tissue from another part of the body; the arteries and veins of this tissue are connected to arteries and veins in the neck under a microscope

UT Southwestern’s team of specialists can also perform reconstructive surgery if bones or other structures are affected by the tumor. In many cases, we can perform reconstructive surgery at the same time as the cancer surgery.

Minimally invasive surgical options include:

• Transoral robotic surgery (TORS): Performed with the aid of a robotic arm that is operated by a surgeon, TORS provides access to small and often difficult-to-reach areas of the mouth and throat, without any external incisions.
• Endoscopic laser surgery: Surgeons can remove tumors using a laser attached to an endoscope (a thin, flexible tube with a tiny camera) inserted through the mouth or nose.

A new technology developed by UT Southwestern head and neck cancer surgeon Baran Sumer, M.D., and his team of researchers might soon be available to help with the surgical removal of cancer. The pH Nanosensor is an injection that highlights cancerous areas on a screen so surgeons know exactly where to operate. UT Southwestern is one of three medical centers – and the lead site – participating in a Phase 2 clinical trial of the technology.

Potential side effects of surgery for head and neck cancer include:

• Impaired ability to talk, chew, or swallow
• Swollen face and neck, which usually improves within a few weeks
• Lymph collection in the tissues (if lymph nodes were removed), which may cause long-term swelling
• Numbness in part of the neck and throat
• Shoulder and neck weakness

Radiation Therapy for Head and Neck Cancer

Targeted radiation therapy is often given to head and neck cancer patients as part of a multidisciplinary treatment regimen. Targeted therapy helps preserve structures vital to eating, swallowing, speaking, and hearing.

Stereotactic radiation therapy uses multiple angles to safely and precisely deliver a more potent dose than can be given with standard radiation therapy. UT Southwestern helped perfect this type of radiation, and only experts with advanced training such as those at UT Southwestern perform the procedure on head and neck cancer patients.

Radiation oncologists at UT Southwestern were the first in the world to conduct a formal study treating cancer of the larynx (voice box) with the CyberKnife, an advanced robotic, radiosurgical tool that can offer some patients improved voice recovery after treatment.

Our surgeons are also skilled at using the Gamma Knife for precise, noninvasive brain and skull-base surgery.

Side effects of radiation therapy include:

• Mouth irritation, redness, or sores in the mouth
• Dry mouth
• Difficulty swallowing
• Nausea
• Loss of taste
• Jaw stiffness
• Earache

Some patients may experience swelling or sagging of the skin under the chin, and the skin’s texture may change.

Medical Treatment for Head and Neck Cancer

For some head and neck cancer patients, chemotherapy – the use of cancer-killing drugs – is the best course of treatment before or after surgery and/or radiation therapy.

Targeted Biological Therapy and Immunotherapy for Head and Neck Cancer

We provide:

• Targeted biological therapy, which pinpoints and disrupts the mechanisms in the cells that help cancer grow
• Immunotherapy, which aims to improve the immune system’s ability to fight cancer

We offer the latest immunotherapy drugs, a particular benefit for patients with thyroid cancer.