Potential treatments for HNC include chemotherapies, immunotherapies, gene-targeted therapies radiation and surgery. They are often used in combination. The treatment plan for an individual depends on the exact location of the tumour(s), the stage of the cancer, whether it is caused by HPV, and the person’s age and general health.
There are several different types of surgery that can be performed to remove head and neck cancers. The type of surgery depends on where the cancer is located, its spread and its size. The surgery can range from minimally invasive laser microsurgery done through the mouth to more invasive operations to remove cancerous tissue. Surgeries can require the insertion of breathing or eating tubes for periods of time during recovery.
Radiation therapy involves delivering electromagnetic radiation to kill the cancer cells.
Definitive radiation therapy is a curative treatment for certain localized head and neck cancers. The most common is external beam radiation, delivered from outside the body. This type of radiation therapy can also be combined with chemotherapy and/or surgery.
Adjuvant radiation therapy is the term for radiation treatments given after surgery to kill cancer cells that might not have been removed by the surgery. Sometimes, but rarely, it is given before surgery to shrink tumors. Chemotherapy can also be added during this radiation therapy to help make overall treatment more effective.
Common side effects of radiation are tiredness, a hoarse voice, skin irritation at the treated area, pain or difficulty swallowing, irritation in the throat and dry mouth and throat. Again, a feeding tube may be required during treatment.
Chemotherapy refers to drugs used to destroy or damage cancer cells. Most often, these drugs for head and neck cancer are given by a fluid into a vein through a needle (intravenous infusion).
Chemotherapy is often used to supplement surgery or radiation therapy. It makes them more effective by killing cancer cells that survive surgery or radiation. Chemotherapy is also sometimes used before surgery or radiation to reduce large cancers and make the surgery easier.
Common side effects of chemotherapy include nausea, loss of feeling in the fingers and toes, hearing loss and ringing in the ears, rashes, a higher risk of infections, as well as greater side effects from radiation if chemotherapy is given at the same time as radiation.
Targeted therapy is a treatment that has been specifically designed to act on a cancer tumour with certain characteristics (such as specific genes or proteins). It is normally only used and effective when those characteristics are present in the tumour. The presence of these exact biomarkers (genetic or protein) are found via specific testing on the tumour sample obtained during a biopsy (the removal of a small portion of the cancer tumour to determine its exact type and help determine the best course of treatment).
Targeted therapies can cause side effects like those seen with chemotherapy.
Immunotherapy is a relatively new type of cancer treatment that entices the body’s immune system to find and kill cancer cells. Immunotherapy has become the fourth major type of cancer treatment, the others being surgery, radiation and chemotherapy.
Immunotherapy can be used to treat head and neck cancers, either alone or in combination with other types of treatment.
Side effects include flu-like symptoms, and diarrhea, nausea, itching, rash, joint pain and feeling unusually tired or weak.