Head and Neck Cancer

Treatment of Head and Neck Cancer

Treatment for head and neck cancers ranges from surgery or radiation in the earliest stages to a combination of surgery, radiation and possibly chemotherapy in the later stages. Curing the cancer is the fundamental priority, and treatment may result in the removal of part of the facial and/or communication structures. For this reason the department at Barnes-Jewish Hospital is strongly oriented toward reconstruction.

Our philosophy is that since the treatment for these cancers may have wide-ranging effects on the organs of communication and swallowing, an equivalent, minimally invasive transoral laser microsurgery and functionally restorative reconstruction is needed. Following surgery, therapists help patients adjust to changes, and a smoking cessation and support group is available. Regular cancer checks are scheduled with the doctor for years after completion of treatment.

The multidisciplinary treatment approach is a major reason why the Department of Otolaryngology at Barnes-Jewish Hospital is named among the top 5 in the country by U.S. News and World Report's annual guide to "America's Best Hospitals." Another reason for this superior ranking is the department's efforts to continually document treatment and outcomes. A frank evaluation of treatments establishes the department's track record and sets the direction for future improvements. This only comes with the commitment to research that characterizes Washington University School of Medicine.

The Warning Signs

Knowing the warning signs of cancer is critical for early detection, especially for those who use tobacco. Symptoms of throat cancer include a change in voice quality such as hoarseness, difficulty swallowing, irritation and pain in the throat, coughing or spitting up blood, or the appearance of a lump in the neck or throat. Symptoms of mouth cancer may be bleeding or pain in the mouth, irritation around the gums, loosening of the teeth, a visible ulcer or a change in the way dentures fit.

Other Causes of Head and Neck Cancer

Head and neck cancers represent the sixth most common cancer worldwide and have long been associated with the use and abuse of tobacco and alcohol. However, the epidemiology of head and neck cancers is changing with an upsurge in oropharynx (tonsil and base of tongue) cancers striking young, healthy, non-smoking/drinking population. These oropharynx cancers are caused by the human papillomavirus (HPV) and the incidence has increased by 225%, from 0.8 per 100,000 in 1988, to 2.6 per 100,000 in 2004 despite decrease in tobacco consumption. The prognosis of HPV-related OPC is excellent, following transoral laser microsurgery. Washington University is one of the premier centers performing transoral laser microsurgery for head and neck cancer. There are over 700pts that have been treated using this technique here at Barnes-Jewish Hospital. The outcomes for this surgical technique has resulted in multiple peer reviewed manuscripts.

Sometimes the cause of cancer cannot be identified, but there are other risk factors known to increase the chance for the disease developing in the head and neck area. The head, face, and neck are common sites for skin cancer to develop because of their continual exposure to ultraviolet rays. Awareness of skin type, wearing protective headgear and clothing, using sun blocks containing an appropriate sun protection factor (SPF) and simply staying out of the sun are all ways of protecting against skin cancer. A visible abnormality -- a persistent growth that starts to change in size, shape or color, or to itch -- is an indication that cancer may be present on the skin.

Thyroid cancer, appearing as a lump in the throat, is another type that may have no obvious cause, but may be associated with a genetic abnormality or exposure to low levels of radiation in childhood. Tumors also occur in the nose and sinuses with sometimes subtle warning signs. A progressive obstruction of the nasal passages; bleeding from the nose; facial pain; eye disturbances such as double vision or blurring; new onset of hearing loss, especially one-sided; a visible lump or mass -- all of these can be signs that something is wrong.

If you have a personal health concern, contact your family physician or internist. If appropriate, your physician may then decide to refer you to a specialized clinic such as the Head and Neck Cancer Center at Washington University School of Medicine. If you have questions about the Head and Neck Oncology Division at the Washington University School of Medicine, please contact one of our specialists for more information.

Meet our Head and Neck Cancer Specialists

International Physician Observer Program in Head & Neck Surgery