Head and Neck Cancer Awareness Week is commonly observed in April. Harrington board-certified oncologist Dr. Christopher Seidler, Medical Director for The Cancer Center at Harrington, shares some academic insight into what accounts for six percent of all malignancies in the United States.
Head and neck cancer are fairly common tumors that arise anywhere in the head and neck region. There are over 40,000 cases per year in the United States. They include tumors from the oral cavity, voice box (larynx), back of throat (pharynx), nasal cavities and salivary glands. The three major risk factors include smoking and chewing tobacco, heavy alcohol consumption, and Human Papuloma virus (HPV).
There has been great progress in treating head and neck cancers of the last 10 years. Aggressive surgery is still the treatment of choice for most early stage patients with localized tumors. The exception is that stage 1-2 localized tumors of the larynx have a 90% or better cure rate with radiation alone.
Tri-Modality Treatment
In the past, many patients with more advanced tumors (stage III lymph nodes and stage IV bilateral) often faced disfiguring surgeries with partial removal of the face, jaw, and larynx.
Today, with modern Tri-Modality treatment (surgery, radiation, and chemotherapy together) we can cure the majority of patients and allow “organ” preservation. This requires a coordinated, specialized approach involving radiation therapy, medical oncology, and surgery. This is an intense out-patient, three -four months of highly intense chemo/radiation therapy and is a TEAM approach.
Most chemo therapy involves care at our center and at home with an infusion pump. This requires placements of an implantable IV port under the skin and an electronic infusion pump the size of a Sony Walkman.
Patients first have an initial surgical ENT evaluation and biopsy. When necessary an IV device is implanted. Most patients require a temporary feeding tube be placed into their stomach through the abdominal wall and receive tube feeds at home. Patients then receive nine weeks of intense out-patient chemotherapy followed by a one- month rest period and then seven-eight weeks of external beam radiation therapy with weekly concurrent chemotherapy.
Our dedicated nursing staff plays the key role in the front line with patients. Without their daily support and interaction with patients, this approach would not be possible. In addition, to meet our patients’ needs, we have a nutritionist, social worker, and psychologist on staff and on-site radiation, imaging, and dosimetry. While this is a high-dose therapy and challenging journey, thanks to outstanding care and technology, many patients have completed this program and are in remission with excellent long-term prognosis.
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