Head and neck cancers


Treating head and neck cancers

Page last updated: February 2024

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Head and neck cancers may be treated in different ways, depending on the type, location and stage of the cancer, your general health and what is important to you.

The key treatments for head and neck cancers are:

  • surgery
  • radiation therapy
  • chemotherapy
  • immunotherapy
  • targeted therapy

You may have one or more treatments, and may be able to have new treatments through clinical trials.

Treatment will be tailored to your situation. For complex head and neck cancer, treatment options should be discussed at a meeting of the multidisciplinary team (MDT) in a specialised centre.

Preparing for treatment

It is important to look after your health before treatment begins. This will help you cope with side effects and can improve treatment outcomes. 

  • Stop smoking – aim to quit before starting treatment. See your doctor or call the Quitline on 13 7848.
  • Begin or continue an exercise program – exercise will help build up your strength for recovery.
  • Improve your diet and nutrition – a dietitian can suggest ways to get the right nutrition before, during and after treatment, which will help maintain your weight and muscle mass, improve your strength and energy levels, and may mean the treatment works better. 
  • Avoid alcohol – alcohol irritates mouth sores from the cancer or treatment.
  • See a dentist – treatments for head and neck cancer can affect your mouth, gums and teeth. Your specialist may refer you to a dentist or oral medicine specialist who understands the treatments you will be having. You will need a full check-up and an oral health care plan covering any dental work you need and how to care for your mouth.  
  • Consider the costs – there can be extra costs during cancer treatment. Your health care providers should talk to you about how much you’ll pay for tests, treatments, medicines and hospital care. This is called informed financial consent.

 

Your guide to best cancer care

A lot can happen in a hurry when you’re diagnosed with cancer. The  guide to best cancer care for head and neck cancer can help you make sense of what should happen.

It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.

Read the guide

Surgery

The aim of surgery is to completely remove the cancer and preserve the functions of the head and neck area, such as breathing, swallowing and talking.

The surgeon will cut out the cancer and a margin of healthy tissue, which is checked by a pathologist to make sure all the cancer cells have been removed. Often some lymph nodes will also be removed.

Thinking about having surgery to your head and neck area can be frightening. Talking to your treatment team can help you understand what will happen. You can also ask to see a social worker or psychologist for emotional support before or after the surgery.

Removing lymph nodes

How the surgery is done

Reconstructive surgery

Surgery for oral cancer

Surgery for pharyngeal cancer 

Surgery for laryngeal cancer

Surgery for nasal or paranasal sinus cancer

Surgery for salivary gland cancer

 

What to expect after surgery

How you feel after surgery will vary greatly depending on your age, general health, how large an area is affected and whether you also have reconstructive surgery.

Your surgeon can give you a better idea of what to expect after the operation.

Staying in hospital

Side effects

Radiation therapy

Radiation therapy uses a controlled dose of radiation to kill or damage cancer cells. For head and neck cancer, it is most often given with external beam radiation therapy (EBRT).

A technique called intensity modulated radiation therapy (IMRT) targets the radiation precisely to the cancer, which reduces treatment time and causes as little harm as possible to nearby healthy tissue.

  • As the main treatment – for some pharyngeal and laryngeal cancers, radiation therapy will be the main treatment, with the aim of destroying the cancer while maintaining normal speech, swallowing and breathing. Sometimes chemotherapy will also be used to make the radiation work better (chemoradiation). Radiation treatment usually is given daily for 7 weeks for mucosal head and neck cancers, but this may vary from person to person.
  • After surgery – radiation therapy is often used after surgery for head and neck cancers (adjuvant treatment). The aim is to destroy any remaining cancer cells and reduce the chance of the cancer coming back. You will probably start radiation therapy as soon as your wounds have healed and you’ve recovered your strength, which should be within 6 weeks. Adjuvant radiation therapy is sometimes given together with chemotherapy (chemoradiation). This is usually given for about 6–7 weeks, but may vary person to person.

Before radiation therapy, you meet with a radiation oncologist to work out whether radiation therapy is right for you. You will have a planning session with a CT scan to show the exact area that needs the radiation. 

Radiation therapy is carefully planned to make sure enough radiation reaches the cancer, while as little as possible reaches healthy organs and tissues.

During treatment sessions, you will lie on a table under a machine called a linear accelerator, which precisely delivers the radiation.

The treatment is painless and is usually given Monday to Friday for 6–7 weeks. You usually won’t need to stay in hospital.

You wear be fitted for a plastic mask called an immobilisation mask, which you will wear for 10–20 minutes at each session. It helps you keep still and makes sure the radiation is targeted at the same area at each treatment session.

You can see and breathe easily, but it may feel strange and confined at first.

Tell the radiation therapists if you have claustrophobia or the mask makes you feel uncomfortable – you can talk to someone or may be offered medicine to help you relax.

"I had never seen a mask like this and I had never heard about its purpose. A combination of listening to music, light sedation and support from a psychologist helped a great deal." JULIE

Side effects of radiation therapy

 

Chemotherapy

Chemotherapy is the use of drugs to kill or slow the growth of cancer cells. The aim is to destroy cancer cells while causing the least possible damage to healthy cells.

You will usually receive chemotherapy by injection into a vein (intravenously), although it is occasionally given as tablets. How often you have chemotherapy sessions will depend on the treatment plan.

Chemotherapy may be given for a range of reasons:

  • in combination with radiation therapy (chemoradiation), to increase the effects of radiation
  • before surgery or radiation therapy (neoadjuvant chemotherapy), to shrink a tumour
  • after surgery (adjuvant chemotherapy), along with radiation therapy, to reduce the risk of the cancer returning
  • as palliative treatment to relieve symptoms such as pain.

Side effects of chemotherapy



Other drug therapies

Head and neck cancer that has advanced is often treated with other drug therapies that reach cancer cells throughout the body (systemic therapies). T

his may include targeted therapy and immunotherapy, which work in different ways to chemotherapy.

They can be combined with other treatments such as chemotherapy or radiation therapy.

Targeted therapy

Immunotherapy

New targeted therapy and immunotherapy drugs are being studied in clinical trials. Talk with your doctor about the latest developments and whether a clinical trial would be an option for you.

Learn more

Palliative treatment

In some cases of very advanced head and neck cancer, the medical team may talk to you about palliative treatment. This aims to improve your quality of life by managing the symptoms without trying to cure the disease.

When used as palliative treatment, radiation therapy, chemotherapy or other drug therapies can help manage pain and other symptoms, and may also slow the spread of the cancer.

Understanding Head and Neck Cancers

Download our Understanding Head and Neck Cancers booklet to learn more.

Download now  Order for free

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