Planning to Preserve Function and Appearance After Surgery for Head or Neck Cancer
Head and neck cancers include a range of conditions such as sinus cancer or cancers of the throat or voice box. What can make these tumors a unique challenge is that they are invariably located near areas where senses and critical functions take place.
That means treatment of a tumor, whether through surgery or radiology, can impact a patient's ability to hear, see, smell or taste. More than that, it can impair a patient’s ability to swallow or speak. Working with a medical team that keeps all of these potential impacts in mind – and plans to avoid loss of functionality whenever possible – is important.
But functionality isn't the only concern many head and neck cancer patients have. When treatments occur near the face, patients can be concerned about how they will look following surgeries.
Some head and neck cancers do require aggressive treatment; surgery to treat severe sinus cancer, for example, could necessitate removal of an eye. When aggressive surgical treatment is unavoidable, it's important to work with a team that includes an experienced reconstructive surgeon to help maintain appearance. That experience, combined with modern treatment methods, can achieve remarkable results.
Look for Experience and a Multidisciplinary Approach
Patients who are facing decisions about treating head or neck cancer should look for providers that offer an unbiased approach to treatment. Each specialty provider – such as a surgeon or a radiation oncologist – is trained in specific approaches and treatment methods. Without a balanced perspective, even medical providers can be somewhat biased in their approach.
For example, our MedStar Georgetown Cancer Institute team has met every week for over 20 years. Providers from a range of disciplines – for example, oncologists, surgeons and speech therapists – meet to discuss each active case, where treatment decisions are approached from a variety of perspectives. That's important not only for helping each patient make the best possible decision, but also for ensuring recovery is well planned.
Experience is also important when choosing a medical team. Our head and neck cancer surgery team alone brings over 50 collective years to the table. That experience helps us understand the long-term impact of any decision made to treat cancer today.
Talk to Your Providers About the Future
The landscape of head and neck cancer is changing. There has been a significant increase in the incidence of throat cancers that are the result of a prior infection with the human papilloma virus (HPV). These are often found in patients of middle age who do not have the classic throat cancer risk factors of chronic tobacco and alcohol use. The increased incidence of these tumors in otherwise healthy middle-aged patients is a major change in the field of head and neck cancer, but fortunately this new version of head and neck cancer has a high cure rate.
Not only are the cure rates for these types of cancer high, these younger patients often are healthier and do not present other illnesses or conditions that would further complicate their diagnosis and treatment. When determining the best course of treatment, medical teams and patients must balance the expectation of high survival rates with the possible long-term consequences of treatment on swallowing, on dental status and on other quality of life issues years after successful cancer treatment.
If both radiology and surgery are equally viable solutions, patients might choose radiation because they are afraid of surgery or there are more short-term disadvantages. However, radiation could lead to swallowing issues in 15 years, which might make surgery the better option in the long-term, for individual patients.
Though there are others, these are a few of the variables requiring consideration that make an experienced, multidisciplinary team approach essential to successful treatment and preservation of function for head and neck cancer patients.