Head & Neck Cancer Treatment

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• QAre there clinical trials for head and neck cancer?

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  A Dr. William D. Knopf, MD , Cardiology (Cardiovascular Disease), answered on behalf of Piedmont Heart Institute

  Clinical trials are research studies conducted with people who volunteer to take part. Participation in clinical trials is an option for many patients with head and neck cancers.
  Treatment trials are designed to find more effective cancer treatments and better ways to use current treatments. In some studies, all patients receive the new treatment. In others, doctors compare different therapies by giving the new treatment to one group of patients and standard therapy to another group. Doctors are studying new types and schedules for delivering radiation therapy, new anticancer drugs, new drug combinations, and new ways of combining treatments. They are also studying ways to treat head and neck cancers using biological therapy (a type of treatment that stimulates the immune system to fight cancer) by itself or in combination with anticancer drugs or radiation therapy.
  Scientists are also conducting clinical trials to find better ways to reduce the side effects of chemotherapy and radiation therapy for head and neck cancers. These clinical trials, called supportive care trials, explore ways to improve the comfort and quality of life of cancer patients and cancer survivors.lliam
  This answer is based on the source infromation from the the National Cancer Institute.
• QWhat health professionals treat head and neck cancers?

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  A Riverside Cancer Care Center answered

  Patients with head and neck cancers are best treated by a team of specialists. The specialists vary, depending on the location and extent of the cancer. The medical team may include oral surgeons; ear, nose, and throat surgeons (also called otolaryngologists); pathologists; medical oncologists; radiation oncologists; prosthodontists; dentists; plastic surgeons; dietitians; social workers; nurses; physical therapists; and speech-language pathologists (sometimes called speech therapists).

  This answer is based on source information from the National Cancer Institute.

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• QWhat is facial reconstruction "free flap" surgery?

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  A Intermountain Healthcare answered

  Free flap surgery to the face may address defects of both form and function. "Free flap" implies that tissue is being harvest from a remote site on the body in a manner in which the blood vessels keeping that tissue alive are still attached to it. These blood vessels are then cut. Because the tissue will not survive without blood supply, the flap vessels are sewn into recipient vessels (arteries and veins already present in the neck or face region) to re-establish flow in and out of the flap.
  
  A free flap may be used to help reconstruct a structure (such as the nose or the cheek). It may also be a functional flap (such as a gracilis or serratus muscle) in cases of facial paralysis. In these cases, a nerve to the muscle must also be left attached then connected to the motor nerve (facial nerve) of the face.

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• QWhat reconstruction occurs following treatment for head and neck cancer?

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  A Intermountain Healthcare answered

  Reconstruction following treatment of head and neck cancer may require transfer of tissues from another area of the body to the defect.   Below are some common reconstructions and the tissue required to reconstruct them:

  • Mandible - commonly reconstructed with a vascularize bone flap from the leg (fibula) but also reconstructed with vascularized bone flaps from the hip or forearm or with bone grafting alone (depending upon the appropriateness of the defect)
  • Tongue - based upon the size of the defect and the donor tissue, this may require skin grafting, tissue transfer from within the mouth, or transfer for tissue from the forearm (radial forearm flap) or thigh (anterolateral thigh flap)
  • Oropharynx and/or superior segment of the esophagus - this is commonly reconstructed with transfer of tissue from the thigh or the forearm (if reconstructing a portion of the esophagus, the flap of tissue is tubed so that the skin is the inside of the tube to allow for passage of a food bolus from the mouth to the stomach)

  Other areas may require reconstruction, such as the lining of the mouth, the facial nerve, or other areas of face.

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• QWhat type of doctors treat head and neck cancers?

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  A Dr. W. Chad Spanos, MD , Oral & Maxillofacial Surgery, answered on behalf of Sanford Health

  Head and neck cancers are complicated – and treatment is complex too, with some specialists focusing on the cancer and others on speech problems, for instance. Check out this video with Dr. Chad Spanos, an ear, nose and throat medical oncologist, to see why the type of medical center you choose may make a difference to survival.
• QHow are head and neck cancers treated?

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  A Riverside Cancer Care Center answered

  The treatment plan for an individual patient depends on a number of factors, including the exact location of the tumor, the stage of the cancer, and the person's age and general health.

  Surgery: The surgeon may remove the cancer and some of the healthy tissue around it. Lymph nodes in the neck may also be removed (lymph node dissection), if the doctor suspects that the cancer has spread. Surgery may be followed by radiation treatment.

  Head and neck surgery often changes the patient's ability to chew, swallow, or talk. The patient may look different after surgery, and the face and neck may be swollen. The swelling usually goes away within a few weeks. However, lymph node dissection can slow the flow of lymph, which may collect in the tissues; this swelling may last for a long time. After a laryngectomy (surgery to remove the larynx), parts of the neck and throat may feel numb because nerves have been cut. If lymph nodes in the neck were removed, the shoulder and neck may be weak and stiff.

  Radiation therapy: This treatment involves the use of high-energy x-rays to kill cancer cells. Radiation may come from a machine outside the body. It can also come from radioactive materials placed directly into or near the area where the cancer cells are found. In addition to its desired effect on cancer cells, radiation therapy often causes unwanted effects. Patients who receive radiation to the head and neck may experience redness, irritation, and sores in the mouth; a dry mouth or thickened saliva; difficulty in swallowing; changes in taste; or nausea.

  Chemotherapy: This treatment is used to kill cancer cells throughout the body. The side effects of chemotherapy depend on the drugs that are given. In general, anticancer drugs affect rapidly growing cells, including blood cells that fight infection, cells that line the mouth and the digestive tract, and cells in hair follicles. As a result, patients may have side effects such as lower resistance to infection, sores in the mouth and on the lips, loss of appetite, nausea, vomiting, diarrhea, and hair loss.

  This answer is based on source information from National Cancer Institute.

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• QDo all types of head and neck cancer require surgery?

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  A Dr. Brett A. Miles, MD , Ear, Nose & Throat (Otolaryngology), answered on behalf of The Mount Sinai Health System

  No. Many patients with head and neck surgery are treated non-surgically, depending on the location and stage of the cancer. Head and neck cancer requires detailed evaluation and treatment planning and may involve surgery, radiation therapy, and chemotherapy. Patients with head and neck cancer should be evaluated and treated by a multidiciplinary head and neck cancer team at large medical centers which have significant experience in this area to provide the best outcomes in terms of cure and function. 

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• QWhat clinical trials are underway for head and neck cancers?

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  A Dr. John H. Lee, MD , Ear, Nose & Throat (Otolaryngology), answered on behalf of Sanford Health

  

  There are several intriguing clinical trials underway for head and neck cancers.
  Watch this video featuring Dr. John Lee of Sanford Health to learn about some innovative and promising ideas for treating head and neck cancers.
• QHow are head and neck cancers caused by human papillomavirus (HPV) treated?

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  A Dr. John H. Lee, MD , Ear, Nose & Throat (Otolaryngology), answered on behalf of Sanford Health

  Head and neck cancers related to the HPV virus are more curable than those caused by smoking. In this video, Dr. John Lee from Sanford Health discusses therapies that boost the immune response to the virus.

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• QIs robotic surgery for head and neck cancers worth the expense?

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  A Dr. Eric M. Genden, MD , Ear, Nose & Throat (Otolaryngology), answered on behalf of The Mount Sinai Health System

  

  Is robotic surgery cost effective? In this video, Eric Genden, MD, chairman of the department of otolaryngology at The Mount Sinai Medical Center, explains why expensive robotic surgery may actually be saving money.