Medically Reviewed by Virginia L. Clyburn-Ipock, MD

Head and neck cancers are some of the most frequent cancers we treat in this region. Learn the symptoms and how new developments in Radiation Therapy technology improve patient quality of life from McLeod Radiation Oncologist Virginia Clyburn-Ipock,MD

Here are the key points from Dr. Clyburn-Ipock’s comments:

Cancer that we frequently treat in this region is cancer of the head and neck. The majority of head and neck cancers are secondary to cigarette smoking. Recently, data have shown that often head and neck cancers in younger patients that don’t smoke are secondary to HPV, the Human Papillomavirus, which is the same virus that causes most types of cervical cancer.

Head and neck cancers encompass cancers within the head and neck region, but not including the brain. Most of these cancers are squamous cell carcinomas. Cancers of the head and neck involve sites in the oral cavity, which include the tongue, gums, floor of mouth, cheeks, lips and hard palate. Also included are tumors of the oropharynx — the tonsil, base of tongue and soft palate. Cancers of the voice box also known as the larynx are included in this group of cancers too. Less common sites of head and neck cancers are the nasopharynx and hypopharynx.

These tumors, while they may be large when diagnosed, have actually been shown to respond well to radiation and chemotherapy. Additionally, these patients actually have improved expected outcomes, when compared to those patients whose head and neck cancers are secondary to smoking.

When treating head and neck cancers we utilize IMRT, Intensity Modulated Radiation Therapy. This allows us to deliver a very conformal dose of radiation to the areas we want to target and decrease significantly delivery of radiation to nearby sensitive normal structures and organs.

Unfortunately, when we treat head and neck cancers, there are many sensitive structures in this area of the body. Often, when we treat head and neck cancers with radiation, patients will have many side effects.

Common side effects during the course of treatment include:

• Skin reddening
• Breakdown of the skin
• Dry mouth because the salivary glands are very sensitive to radiation; this can be a short-term and long-term side effect.
• Difficulty swallowing or pain with swallowing. When patients are undergoing treatment we provide medications to help with swallowing but this can also be a long-term problem that they have to face. In these cases, patients may undergo dilation of the esophagus, where the physician goes down with a balloon to open up the esophagus, making it easier for the patient to swallow.

Radiation and chemotherapy can actually cure certain head and neck cancers. Or chemotherapy and radiation may be used in the adjuvant setting after the patient has undergone an operation to remove the cancer. Radiation alone or in conjunction with chemotherapy in the postoperative setting can decrease the risk of the tumor coming back.

When treating head and neck cancer, the most important thing that I will tell patients to do is quit smoking. In patients that have had a head or neck cancer, if they continue to smoke, they risk developing a secondary cancer, which can be as high as 20%. One in five patients can also develop a second tumor — a completely different cancer than the head or neck tumor that they’ve previously had — if they continue to smoke.

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