Head and Neck Cancers – Diagnosis and Treatment
Diagnosis
Checking the Head, Throat, and Neck
Doctors look and feel for any unusual spots, swelling, or lumps in the head, throat, or neck. They check for sores in places such as the roof of the mouth, tongue, and around the sinuses.
Sometimes, doctors use a small mirror and a bright light to see hard-to-reach areas. Tiny cameras called endoscopes help them see deep into the throat or nose.
This allows the doctor to find signs of cancer in areas like the pharynx, larynx, or salivary glands.
Taking Pictures Inside the Body
Imaging tests show the location, size, and spread of cancer cells. Common tools include:
- MRI Scans: Use magnets and radio waves to make detailed images of soft parts like the throat, mouth, or sinuses.
- CT Scans: Combine X-rays and computers to provide a clear picture of the head and neck area, including the lymph nodes and jaw.
- PET Scans: Use a special dye to highlight areas where cancer might have spread.
- X-rays and Ultrasound: Check areas like the jaw, teeth, or salivary glands for damage or changes.
These tests give information about areas the doctor can’t see or feel directly.
Taking Tissue or Cells for a Closer Look
Doctors perform a biopsy by removing a small piece of tissue or some cells for closer examination. There are several ways to do this:
- Surgical Biopsy: The doctor cuts out a bit of tissue from the mouth or throat, such as from a sore that doesn’t heal.
- Needle Biopsy: The doctor uses a thin needle to take cells from a lump, like in a swollen lymph node.
- Special Tools: Tools help gather cells from hard-to-reach spots inside the nose or pharynx.
Doctors order biopsies if they suspect possible throat cancer, oral cancer, or cancer in areas affected by risk factors like smoking or HPV.
Analyzing the Sample in the Lab
Laboratory specialists examine the tissue or cells under a microscope to look for cancer cells. They may perform:
- Standard Cancer Tests: To confirm if cancer is present.
- HPV Tests: To look for human papillomavirus, which can cause oropharyngeal cancers.
- Other Tests: That show how the cancer cells act and if they are aggressive.
These results help the doctor develop the best plan for treating the cancer, whether it is oropharyngeal, pharynx, or salivary gland cancer.
Treatment
Operations to Remove Tumors
Surgeons often start treatment for most head and neck cancers by removing the tumor and a small margin of healthy tissue. Removing some healthy tissue lowers the chance the cancer will return.
If cancer spreads into nearby structures or is in a location that makes surgery too risky, doctors may recommend other treatments first.
Some surgeries can change how a person eats or speaks. Specialized teams work with patients to lower these risks.
Reconstructive surgery rebuilds bone or tissue that doctors must remove. Rehabilitation specialists help patients with eating and speaking after surgery. Some common surgical procedures for head and neck cancer include:
- Removal of tumors from the mouth, throat, or sinuses
- Removing part of the jaw or facial bones if needed
- Transoral robotic surgery for small tumors
High-Energy Beam Treatment
Doctors use radiation therapy to target and destroy cancer cells with beams of energy. These beams can be X-rays, protons, or other types of radiation.
The treatment plan aims the beams at the cancer area while sparing as much healthy tissue as possible.
Doctors sometimes use radiation after surgery to kill any remaining cancer cells. They may also use it as the main treatment if surgery isn’t possible. Different forms of radiation therapy include:
| Radiation Type | Description |
|---|---|
| Standard external beam | Delivers X-rays from outside the body |
| Intensity-modulated (IMRT) | Aims beams from many angles to protect healthy tissue |
| Proton therapy | Uses proton particles for even more focused treatment |
Proton therapy and IMRT help limit side effects.
Medicines to Kill Cancer Cells
Doctors use chemotherapy drugs to target and destroy cancer cells, often giving them in cycles. For head and neck cancers, they sometimes combine chemo with radiation treatments. When combined, the medicines can make the radiation work better.
Doctors may use chemotherapy alone if the cancer has already spread. The most common side effects include tiredness, nausea, and hair loss. Doctors plan chemo carefully to try to limit these effects.
Precision-Targeted Medicines
Doctors use targeted therapy medicines to block signals that help cancer cells grow. These medicines differ from regular chemotherapy and are aimed at certain chemicals or genes inside cancer cells.
Doctors may use targeted therapies when the cancer returns or has spread to other parts of the body. By focusing on certain targets, these medicines can sometimes cause fewer side effects than chemotherapy.
Boosting the Body’s Immune Defenses
Immunotherapy helps the immune system find and attack cancer cells. Some cancer cells trick the immune system to avoid destruction. Immunotherapy medicines stop this.
Doctors often use immunotherapy when head and neck cancers do not respond to other treatments or when they have spread.
Patients may receive these medicines through an IV. Immunotherapy can cause side effects like tiredness or skin changes, but many people continue most of their normal activities during treatment.
Comfort and Symptom Relief
Palliative care helps patients feel better and manage pain and symptoms at any stage of cancer. It supports people alongside other treatments like surgery, radiation, or medication.
A team of doctors, nurses, counselors, and dietitians assists the patient and their family. The main goals are pain relief, managing other symptoms, and improving comfort and quality of life.
Managing Emotions and Finding Help
Get Information About Your Diagnosis
Understanding a cancer diagnosis can be hard. Patients should write down any questions about their condition and treatment to ask during appointments.
Bringing a friend or family member to appointments helps with remembering important information or getting a second perspective.
Learning about the illness and available treatments can help people feel more in control and confident in their decisions about cancer care.
Keep in Touch With Loved Ones
Staying close to friends and family improves well-being and quality of life. Loved ones often want to help but may not know how.
It may help to create a short list of ways they can assist, like helping around the home, running errands, or just being there to listen. Staying connected can also lower feelings of loneliness and stress during cancer treatment.
Reach Out for Emotional Support
Talking openly with someone experienced in helping people with cancer, such as a counselor, social worker, or support group leader, can be helpful.
Patients can ask their healthcare team for referrals to mental health experts or local and online support groups.
Organizations provide resources to connect patients with others who share similar experiences, which may improve overall health and emotional strength.
Support networks can include individual counseling, group meetings, or even online forums, depending on what feels most comfortable.
Getting Ready for Your Visit
Steps You Can Take Before Seeing Your Provider
Taking a few simple actions beforehand can help make your appointment go more smoothly.
- Follow any special instructions. Some tests or exams require you to avoid eating or drinking for several hours. Check about any restrictions when scheduling.
- Keep a symptom record. Write down all symptoms, even those that may not seem connected. Include the time when they started and whether they change or stay the same.
- Gather personal information. Note any recent stressful events, major life changes, or relevant medical history like genetic conditions. Family health history can be important, especially if anyone has had cancer or genetic diseases.
- List your medications. Bring a detailed list of all medications, vitamins, or supplements you use. Include how much and how often you take each.
- Bring someone with you. Having a family member or friend at your side can help remember details and ask questions you may forget.
- Prepare questions. Make a numbered list of things you want to ask. Start with your top three questions, then add others in order of importance.
Possible Topics for Questions
- What type of cancer is this?
- Do I need more tests, such as genetic testing or imaging?
- What are my choices for treatment, and what are their possible side effects?
- Do I need to consider any clinical trials?
- Is avoiding tobacco or alcohol important for my treatment or recovery?
- Could work conditions or previous exposures to things like chemicals, asbestos, or dust be a risk?
- Should I consider talking to a genetic counselor, or is the HPV vaccine recommended for me or my family?
| Question Topic | Why It Matters |
|---|---|
| Type and stage of cancer | Helps plan treatment |
| Additional tests | May confirm diagnosis |
| Treatment choices | Guides decisions |
| Side effects | Prepares for results |
| Support resources | Aids understanding |
| Follow-up planning | Ensures ongoing care |
What Your Healthcare Provider Might Ask
During the visit, your healthcare provider will ask questions to better understand your situation.
- When did your symptoms start?
- Do symptoms stay the same or do they come and go?
- Are the symptoms mild, moderate, or severe?
- Does anything make your symptoms better or worse?
- Do you have a personal or family history of cancer, tobacco use, exposure to chemicals at work, or any known genetic conditions?
If you prepare to answer these questions, your doctor can identify your risk factors, such as tobacco use or occupational exposures, and determine if you might benefit from genetic counseling or further testing.
You and your doctor can also discuss whether the HPV vaccine could help with prevention or if you or your family need genetic testing. These steps lead to a more focused conversation and help you get the most from your appointment.
