Treatment of head and neck cancers
The choice of treatment depends not only on the location and extent of the disease, but also on your general condition. We aim to treat local diseases mainly with a curative target. Treatment options include surgery or radiation therapy, to which we can combine simultaneous chemotherapy if needed. We can also use combinations of all these treatments.
In addition to the best possible disease control, the aim of the treatments is to maintain the best possible functional and cosmetic outcome. The progression of metastatic disease can be controlled with the help of drug treatments.
The most common head and neck area cancers treated with surgical options are cancers of the oral cavity, such as the mucous membrane of the tongue or gums, cancers of the nasal cavity and paranasal sinuses, and oropharyngeal cancers not related to papillomavirus infection in patients who have smoked for a long time. The scope of surgery depends on the local extent of the disease. In extensive surgeries, we often correct tissue deficiencies with different types of flaps. If necessary, we can secure your airways with a tracheostomy and your nutrition either with a gastrostoma installed through the abdominal wall or with a nasogastric tube.
After the operation, we will monitor your recovery first in the intensive care unit if necessary, and then on the surgical inpatient ward. If, after the surgery, we detect factors suggestive of a high risk of recurrence in your disease, we recommend radiation therapy with simultaneous chemotherapy to ensure the best treatment result.
We can use radiation therapy alone as a curative treatment or after the surgery to prevent local cancer recurrence.
The most common head and neck cancers treated with radiation therapy alone are oropharyngeal cancers associated with papillomavirus infection, lower pharyngeal cancers, nasopharyngeal cancers, and many laryngeal cancers. If we cannot cure the cancer with the treatments, we use radiation therapy as a symptomatic treatment.
In treatment aiming to cure the disease, we usually provide radiation therapy on weekdays five days a week for a total of approximately seven weeks. If necessary, we combine radiation therapy with simultaneous chemotherapy, which we usually administer intravenously once a week.
Before starting radiation therapy, we assess the health of your mouth and teeth at the Oral and Maxillofacial Diseases Unit. If necessary, we will remove teeth that are in poor condition. Before starting radiation therapy, we will install a gastrostoma if necessary to ensure your nutrition intake.
As a basis for planning the target area of radiation therapy, we perform computed tomography imaging of the neck area and, if necessary, we also perform other imaging examinations. The physician will determine the target area of radiation therapy based on the simulation for the planned treatment. The radiation therapy plan is drawn up by a physicist experienced in radiation therapy. The repeatability of the position during radiation therapy is ensured by the help of a special mask, which is designed to keep your head and shoulders in an unchanged position during the radiation therapy.
Typical adverse effects of head and neck radiation therapy include dryness, irritation and ulceration of mucous membranes, pain, and changes in sense of taste. Mucosal symptoms may predispose you to infections and make it difficult for you to eat. Typically, the discomfort is most severe towards the end of the radiation therapy period. After the end of radiation therapy, mucosal breakdowns and pain usually resolve within a few weeks. Changes in the sense of taste and dryness of the mouth may take up to months to resolve, and in some cases, these adverse effects may be permanent. Chemotherapy given simultaneously alongside radiation therapy may complicate acute local symptoms and cause nausea, increased kidney values, and changes in blood counts.
During radiation therapy, it is especially important to take care of good oral hygiene, adequate nutrition and, if necessary, regular use of pain medication.
During the radiation therapy period, you will meet daily with radiographers working on the radiotherapy machine and, if necessary, with the physician responsible for your treatment. During the period of radiation therapy, you will also have access to the services of a pain nurse and clinical dietician.