Advances in Treating Head and Neck Cancers

Each year, approximately 50,000 Americans are diagnosed with “head and neck cancer,” not including skin cancers that occur in this region

Head and neck cancer can develop in the throat, larynx (voice box), nose, sinuses and mouth. The most common malignant tumor of the head and neck is squamous cell carcinoma.

Minimally Invasive Surgery

Surgery is the primary treatment for most cancers of the head and neck. Advances in surgical techniques, specifically minimally invasive surgical techniques, allow surgeons to remove many more tumors, while preserving structures involved in sensory and physical functioning, says Joseph McCain, M.D., chief of Oral and Maxillofacial Surgery at Baptist Health.

In many cases, surgery to remove the tumor is combined with reconstructive surgery to obtain a better outcome. Surgeons reconstruct bones and other structures, and use skin and muscle from a patient’s back or abdomen to replace part of the scalp, neck, tongue and throat. Dental and maxillofacial surgeons replace teeth lost during treatment with dental implants.

“Preserving a patient’s quality of life, including appearance and ability to function, is an important part of every treatment plan,” Dr. McCain said.

Dr. McCain and a team of Baptist Health specialists performed life-saving surgery on Neissa Azor, an eight-year old girl from Haiti. The team removed a complex facial tumor and reconstructed a large section of her craniofacial structure. Although the tumor was benign, Neissa’s tumor would have continued to grow and blocked her airway if left untreated.

Radiation Therapy and Chemotherapy

Radiation therapy alone or in combination with chemotherapy is standard treatment for many patients with head and neck cancers. These therapies may be used in combination to treat patients with more advanced disease, patients with inoperable cancers or those who are not good candidates for surgery.

Proton Therapy

Proton therapy, an advanced form of radiation therapy, allows for effective treatment of complicated head and neck tumors, while minimizing the radiation dose to vital tissue. Miami Cancer Institute at Baptist Health South Florida, opening later this year, will be the first in the region – and one of the few in the nation – to offer proton therapy.

“Proton therapy delivers high radiation doses to the tumor while sparing critical structures such as the optic nerves, eyes, brain stem and spinal cord,” said Dr. McCain. “Vital physical functions such as vision, smell, taste and swallowing remain intact when a patient is treated with proton therapy.” 

Genomics and Precision Medicine

Recent genomic sequencing studies have provided valuable insight into genetic abnormalities in head and neck squamous cell carcinoma. Genomics is one of the main components of precision medicine – a personalized approach to treating cancer based on a patient’s individual genetic makeup. It allows physicians to identify the genetic drivers that cause a patient’s cancer.

“Our ability to identify the genetic makeup of an individual patient’s tumor lends hope that a more precise, targeted attack against its specific biology is possible,” Dr. McCain said.

Risk Factors and Symptoms

Like all cancers, successful treatment of head and neck cancer depends on early detection. Knowing the risk factors and recognizing its signs can save your life. Risk factors for head and neck cancers include tobacco and excessive alcohol use, a history of pre-cancerous lesions and exposure to cancer-causing agents in the environment.

Some of the most common symptoms of head and neck cancer are:

• A lump or swelling in the neck
• A sore in the mouth that does not heal or bleeds easily
• A red, white or gray patch in the mouth
• Frequent nosebleeds, constant nasal congestion or chronic sinus infections
• Persistent sore throat
• Constant hoarseness or a change of voice
• Ongoing pain in the neck, throat or ears
• Blood in the sputum
• Difficulty chewing, swallowing, or moving the jaws or tongue
• Numbness in the tongue or other areas
• Loosening of teeth
• Dentures that no longer fit

Specialists from Baptist Health will discuss advances in the management of malignant tumors of the head and neck at the Fifth Annual Head and Neck Cancer Symposium on Saturday, April 30, at the Baptist Hospital Auditorium. Joseph McCain, M.D., chief of Oral and Maxillofacial Surgery at Baptist Health, is the symposium director.

Tags: cancer research, Miami Cancer Institute, surviving cancer