Head and Neck Cancers We Treat

Types of head and neck cancers

Squamous cell carcinoma

Squamous cell carcinoma is the most common cancer of the mouth, throat, voice box and sinuses. This cancer often grows where it started and can grow into nearby areas, including the jawbones, eye and brain.

These cancers can spread to one or both sides of the neck, and to the lungs and other parts of the body. Squamous cell cancers can show up as a lump or mass in the neck, and your physician will look for where they started (often in the mouth or throat) using imaging tests and biopsies.

Adenocarcinoma and other salivary gland cancers

Adenocarcinomas are cancers that start in the glands that line your organs. They can show up in different parts of the body, including the glands that make saliva.

There are many other head and neck cancers, including adenoid cystic carcinoma, mucoepidermoid carcinoma and others.

Thyroid cancer

The most common thyroid cancer is papillary thyroid cancer. Most papillary thyroid cancers respond well to treatment. We also treat follicular, medullary and anaplastic thyroid cancers.

Skin cancer

We treat skin cancers in the sun-exposed areas of the head and neck. The most common skin cancers are basal cell carcinoma, squamous cell carcinoma and melanoma. We also treat rarer forms of skin cancer.

Sarcoma

Sarcomas can start in bone or soft tissues like blood vessels or fat. We treat sarcomas that occur in the head and neck.

Lymphoma

Lymphomas can sometimes show up as a mass in the neck or a lump in other parts of the head and neck. A biopsy is required to determine the type of lymphoma and the best treatment options.

Symptoms

Symptoms of head and neck cancers can include:

• A mass or swelling in the face or neck
• A painful area in the mouth or throat
• Changes in voice
• Ear pain
• Difficulty swallowing (which can lead to weight loss)

Having these symptoms does not necessarily mean you have cancer; they can be caused by other conditions.

If you have symptoms of head and neck cancer, several tests can help make a diagnosis.

Diagnosis

Head and neck examination

A physician will carefully examine your mouth, throat, voice box, nose, ears and neck. This often includes the use of specialized equipment called a fibre-optic telescope. The fibre-optic telescope is passed through the nose into the throat and voice box. This helps the physician look closely at these areas.

Ultrasound

Ultrasounds are available in our clinics to evaluate head and neck masses. They are also used to perform ultrasound-guided needle biopsies, as needed.

Computed tomography (CT) scans

CT scans take detailed pictures of the inside of the body using X-rays from different angles. They are used to assess the head and neck area and the lungs of many patients with head and neck cancer. Other areas of the body may also require CT imaging, depending on the circumstances.

Magnetic resonance imaging (MRI)

MRIs are sometimes needed to see more detail, especially for cancers that involve the base of the tongue, some parts of the throat or the sinuses, or cancers that are close to the eye or brain.

Biopsy

A biopsy is a procedure to take a tissue sample for examination in a laboratory. If there are signs of cancer, a biopsy is often needed to make a definite diagnosis.

If the area is easily visible and accessible, a biopsy can often be done with local anesthesia and ultrasound guidance in our otolaryngology clinic during your first visit. If the area to be biopsied is more difficult to reach, you may need general anesthesia.

Treatment

If you have been diagnosed with head and neck cancer, your Cancer care team will discuss your treatment options with you. We will help you weigh the benefits of each option against the possible risks and side effects.

Treatment options depend on the cancer type and the stage of your disease.

The most common treatment for head and neck cancers is surgery. Radiation therapy, chemotherapy or targeted therapy may also be recommended.

Surgery

Surgery is the primary treatment for many head and neck cancers, including cancers of the mouth, some throat or voice box cancers, and most thyroid and skin cancers. In some cases, a physician may recommend radiation or a combination of radiation and chemotherapy before you have surgery.

The complexity of surgery varies greatly depending on the location and size of the tumour. Our highly specialized surgeons, nurses and interprofessional care team work together to achieve the best possible results.

Note that there are other types of cancer, such as nasopharyngeal cancer, that are treated primarily with radiation or a combination of radiation and chemotherapy. For these cancers, surgery may be recommended if the cancer does not respond to the treatment or if it returns.

Radiation therapy

People who have advanced head and neck cancers often need radiation therapy as part of their treatment. You may receive radiation therapy before or after surgery. The surgeons at Sinai Health work closely with radiation oncologists to plan and optimize treatment.

Medical oncology

Medical oncology focuses on treating cancer with medications that affect the whole body, such as chemotherapy.

If you receive chemotherapy for head and neck cancers, it is often used in combination with radiation therapy. Drugs that boost the immune system (immunotherapy) are not currently mainstream therapies for head and neck cancer.

Targeted therapy

Targeted therapy uses medications that target the proteins and genes that cause cancer to grow. The aim is to block the growth and spread of cancer cells and limit damage to healthy cells. In some cases, targeted therapy may be given alone or with chemotherapy.

The treatment for some thyroid cancers is radioactive iodine along with thyroid hormone suppression therapy.