Why Choose Cedars Sinai Marina del Rey Hospital for Head and Neck Cancer Treatment?
With over 50 years of experience in providing healthcare to the community of Los Angeles, our hospital is equipped with state-of-the-art technology by virtue of which our skillful and talented surgeons can perform a wide range of procedures for head and neck cancer. Thereby, you will experience minimal postoperative risks, as well as a fast recovery. If you choose to undergo treatment for head and neck cancer at Cedars Sinai Marina del Rey Hospital, you will receive the healthcare you need in a warm and compassionate environment, as we place great emphasis on the comfort and wellbeing of our patients.
As the name implies, head and neck cancer develops on one of the organs or tissues in this area of the body, namely the sinuses, mouth, salivary gland, pharynx, and larynx. It is worthy of note that malignant diseases that affect the brain, the eye, the esophagus, and the thyroid gland, as well as the scalp, skin, muscles, and bones of the head and neck, are not classified as head and neck cancers.
Cancer of the head and neck usually spread to the lymph nodes in the nearby areas, which typically occurs within six months to three years. Head and neck cancer begins in the squamous cells that line the moist surfaces inside the head and neck, such as the inside of the mouth, nose, or throat. In the United States, head and neck cancers account for approximately 4% of all malignant diseases. By the end of 2021, over 65,000 people will have been diagnosed with head and neck cancer, whereas 14,500 individuals will have lost their lives to these malignant diseases.
The treatment you will receive for head and neck cancer will highly depend on the location of your malignant disease, whether it has spread to adjacent parts of the body, your general health, your age, as well as your preferences. When found in the early stages, head and neck cancer can be successfully treated with surgery. The specialists who are involved in the care of head and neck cancer patients form a multidisciplinary team comprised of professionals such as:
While the main purpose of the treatment is to completely resect the malignant tumors, preserving the function of the adjacent nerves, organs and tissues are also very important. The process of designing the most effective treatment approach for people with head and neck cancer places great emphasis on how it may affect the quality of life of the patient, such as the way they feel, look, talk, eat and breathe. The following are the most common types of surgery used for the treatment of head and neck cancer:
- laser technology: this treatment is particularly useful for patients whose cancer is in the early stages, as it can completely remove the malignant tumors, and is often employed for laryngeal cancer
- excision: this type of surgery has the purpose of removing the malignant tumor and the surrounding tissues that may have been affected by cancer and it is performed to treat all kinds of head and neck cancers
- lymph node dissection or neck dissection: if the doctor suspects that cancer has spread to the lymph nodes, they may remove them from the neck, a procedure which may be performed along with excision
- reconstructive surgery: also known as plastic surgery, reconstructive surgery in the case of head and neck cancer patients has the goal of restoring the appearance and function of the organs and tissues damaged by cancer
Radiotherapy may be used before or after the surgery to reduce the size of the malignant tumor as much as possible. It can be of multiple types, such as:
- external-beam radiation therapy: this radiotherapy involves radiation given from a machine outside the body to the areas of the body affected by cancer and one of the most novel and effective type of external-beam radiation therapy is intensity-modulated radiation therapy, which uses state-of-the-art technology to precisely direct the beams of radiation at the tumor, thereby reducing damage to nearby healthy tissues and causing fewer side effects
- proton therapy: as another type of external-beam radiation therapy, this is a very new type of treatment for head and neck cancer that uses protons instead of X-rays and is currently not the standard treatment for these malignant diseases
Whether it comes in the form of a pill or injection, chemotherapy is another effective treatment for people with head and neck cancer. It works by delivering certain medication through the bloodstream to the areas of the body affected by cancer to destroy the malignant cells and prevent their further growth. Some of the most common drugs used for chemotherapy in head and neck cancer patients are:
Targeted therapy may also be useful in the treatment of head and neck cancer. It entails blocking the growth and spread of malignant cells while reducing damage to healthy cells. As the name implies, it targets specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. There are currently 2 types of targeted therapy for head and neck cancer that has proven to be quite efficient in keeping the disease under control, namely:
- EGFR inhibitors: it targets a tumor protein known as epidermal growth factor receptor and was found to block and stop or slow the growth of various types of head and neck cancers
- tumor-agnostic therapy: the drug larotrectinib is used for this type of targeted therapy, which focuses on specific genetic change in NTRK genes and while this kind of genetic change is uncommon, it was found to be present in certain head and neck cancers
Finally, immunotherapy is another treatment for head and neck cancer. At the moment, pembrolizumab and nivolumab are the drugs approved by the U.S. Food and Drug Administration for the treatment of head and neck cancer.
Cancer of the head and neck is categorized by the area in which it occurs. Accordingly, there are 5 types of head and neck cancer:
- oral cavity: this cancer damages the lips, the front two-thirds of the tongue, the gums, the lining inside the cheeks and lips, the floor of the mouth under the tongue, the hard palate, and the small area of the gum behind the wisdom teeth
- pharynx: the pharynx is a hollow tube of approximately 5 inches that starts behind the nose and leads to the esophagus and has 3 portions that can be affected by cancer, namely the nasopharynx, the upper part of the pharynx behind the nose, the oropharynx, the middle part of the pharynx that includes the soft palate, the base of the tongue and the tonsils, and the hypopharynx, which is the lower part of the pharynx
- larynx: commonly known as the voicebox, the larynx is a short passageway made of cartilage that is located just below the pharynx in the neck and contains the vocal cords
- paranasal sinuses and nasal cavity: the paranasal sinuses are tiny hollow spaces in the bones of the head surrounding the nose, whereas the nasal cavity is the hollow space inside the nose
- salivary glands: responsible for producing saliva, the salivary glands are on the floor of the mouth and near the jawbone
Symptoms of Head and Neck Cancer
Because head and neck cancer can affect so many areas of the body, there are numerous symptoms that can accompany it, the most common being:
- swelling or a sore that does not heal
- a red or white patch in the mouth
- a lump, bump, or mass in the head or neck area
- persistent sore throat
- foul mouth odor not explained by hygiene
- hoarseness or change in voice
- nasal obstruction or persistent nasal congestion
- frequent nose bleeds or unusual nasal discharge
- difficulty breathing
- double vision
- numbness or weakness of a body part in the head and neck region
- pain or difficulty chewing, swallowing, or moving the jaw or tongue
- jaw pain
- blood in the saliva or phlegm
- loosening of teeth
- dentures that no longer fit
- unexplained weight loss
- ear pain or infection
Diagnosis of Head and Neck Cancer
There are numerous accurate diagnostic tests and exams available for detecting head and neck cancer, such as:
- Physical exam: The doctor will examine your lips, nose, tongue, gums, throat, neck, or cheeks for any signs of abnormality, such as the presence of a lump, with the help of a light and a mirror to allow for a clearer view.
- Blood and urine tests: There are certain blood and urine tests that will help your physician determine whether you may have head and neck cancer or another, more common health problem.
- Endoscopy: As a very useful test in detecting the presence of head and neck cancer, endoscopy uses a medical tool known as an endoscope, which is a thin, flexible and long tube equipped with a camera that is inserted through the nose into the throat and down the esophagus of the patient so that the doctor can examine the inside of the head and neck for abnormalities while the patient is lightly sedated. The test has different names that depend on the area of the body that is examined, such as laryngoscopy to evaluate the larynx, pharyngoscopy to view the pharynx, or nasopharyngoscopy to assess the nasopharynx. When these procedures are used in conjunction, they are referred to as a panendoscopy.
- Biopsy: A biopsy entails the collection of a small portion of tissue from the area that is believed to be affected by cancer, which is subsequently sent to a laboratory to be examined by a pathologist. A pathologist is a medical professional who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose a wide range of diseases. For the diagnosis of head and neck cancer, fine needle aspiration may be used, which is a type of biopsy. During this procedure, cells are collected with the aid of a thin needle inserted directly into the tumor or lymph node.
- Molecular testing of the tumor: This test involves conducting laboratory tests on a tumor sample to pinpoint specific genes, proteins, and other factors unique to the tumor, which will subsequently help your doctor recommend the most effective treatment for your head and neck cancer.
- Barium swallow: After you swallow a liquid that contains barium, you will undergo X-rays, which will show whether a tumor is present along your larynx or pharynx. Because barium coats the lining of the esophagus, stomach, and intestines, a potential tumor will be visible on X-rays. Alternatively, you may be recommended to undergo regular X-rays, without a barium swallow, which may also be helpful in determining whether a tumor is present in your head or neck area.
- Panoramic radiograph: A panoramic radiograph is a rotating X-ray of the upper and lower jawbones whose purpose is to detect cancer or evaluate the teeth before radiotherapy or chemotherapy. It is often referred to as Panorex.
- Ultrasound: This test uses sound waves to provide the doctor with clear images from the inside of your head or neck, which will help the medical professional identify the presence of a potentially malignant tumor.
- CT scan: By using X-rays, computed tomography is a very useful test in detecting head and neck cancer, as it provides the doctor with clear images of the inside of your body. It can also show the size of the tumor, if it is present, as well as whether it has spread to other parts of the body.
- MRI scan: Similarly to a CT scan, this test also offers the doctor clear, high-quality images from the inside of your body and can determine whether the malignant tumor has spread to adjacent parts of the body. However, unlike a computed tomography, it uses magnetic resonance imaging.
- Bone scan: During this exam, a radioactive substance will be injected into one of your veins, which will subsequently collect in the areas of the bone. The physician will be able to see any potential abnormalities by using a special camera. While healthy bones appear light on the camera, those that have been damaged by cancer will stand out.
- PET scan: Lastly, positron emission tomography may be employed for the diagnosis of head and neck cancer. It is usually combined with computed tomography for the best results. This test allows the doctor to see the inside of your body and detect a potentially malignant tumor in your head or neck. Before the procedure, a small amount of radioactive sugar may be injected into one of your veins to provide the physician with clearer images.
The exact cause of head and neck cancer has not been found yet. Nevertheless, medical researchers have found several risk factors that contribute to the development of these malignant diseases, such as:
- smoking: tobacco use, which includes smoking cigarettes, pipes or cigars, as well as chewing tobacco, was found to increase the likelihood of developing cancer of the mouth and throat, as tobacco smoke is very irritant to the lining of these organs
- alcohol: frequent and heavy alcohol consumption is linked to a greater risk of head and neck cancer, as alcoholic beverages can also be very irritant to the lining of the mouth and throat
- prolonged exposure to the sun: exposure to the sun without wearing sunscreen can lead to the development of cancer of the lips, as well as of the skin of the head and neck, over the years
- human papillomavirus (HPV): according to medical studies, carrying the human papillomavirus is a risk factor for head and neck cancer
- Epstein-Barr virus (EBV): nasopharyngeal cancer can develop following exposure to the Epstein-Barr virus, the virus that causes mononucleosis
- gender: men are 2 to 3 times more susceptible to developing head and neck cancer than women
- age: people over the age of 40 are at a higher risk of coming to struggle with head and neck cancer
- poor oral and dental hygiene: neglecting the care of the mouth and teeth can increase the risk of head and neck cancer
- environmental or occupational toxic exposure: the inhalation of asbestos, paint fumes, wood dust, or various chemicals may lead to the development of throat cancer within several decades of the first exposure
- marijuana use: according to medical research, the frequent use of marijuana increases the risk of developing head and neck cancer
- unhealthy diet: a diet poor in vitamins A and B may heighten the risk of coming to struggle with head and neck cancer
- gastroesophageal reflux disease and laryngopharyngeal reflux disease: both conditions were found to increase the risk of developing throat cancer, as stomach acid is very irritant to the lining of the larynx
- weak immune system: people with a poor immune system are more prone to developing head and neck cancer
- radiation exposure: salivary gland cancer risk was found to increase with frequent exposure to radiation
- a personal history of head and neck cancer: if you have already had head or neck cancer in the past, you are more susceptible to developing it again in the future
In the regrettable event that you struggle with head and neck cancer, you may want to try alternative treatment approaches in addition to standard therapy. There are numerous alternative therapies for people with cancer, regardless of the location of the disease in the body, the most effective being:
- acupuncture: during acupuncture, the practitioner inserts tiny needles into your skin at precise points, which can alleviate nausea caused by chemotherapy, as well as the pain associated with head and neck cancer
- exercise: engaging in gentle exercise promotes the alleviation of fatigue and stress in cancer patients, increases their sleep quality, and also improves their overall health and quality of life
- aromatherapy: this alternative treatment uses fragrant oils to offer a calming and relaxing sensation upon inhalation and also relieves nausea, stress, and pain in cancer patients
- hypnosis: as a deep state of concentration, hypnosis involves a therapist talking in a gentle voice and helping you relax, focusing on relieving your stress and pain caused by cancer
- massage: massage was found to alleviate pain in cancer patients and during it, the practitioner kneads your skin, muscles, and tendons to relieve muscle tension and stress and promote relaxation
- relaxation techniques: as a way to focus your attention on calming your mind and relaxing your muscles, relaxation techniques can be very effective in relieving pain and stress in cancer patients
- music therapy: during this alternative therapy, you may listen to music, play various instruments, sing songs or write lyrics, which can help you get rid of stress and anxiety, symptoms that are often associated with cancer
- yoga: this ancient practice combines stretching exercises with deep breathing and during a session, you place your body in various poses that require bending, twisting, and stretching, which will help you relax and get rid of stress, as well as pain and discomfort
While there are some risk factors for head and neck cancer that you cannot avoid, there are others that you can, which will reduce your chances of developing one of these malignant diseases. The factors, which focus on lifestyle, that you can avoid in order to lower your risk of head and neck cancer include:
- quitting smoking
- drinking alcohol in moderation
- maintaining a good oral hygiene
- wearing adequate protective equipment if you work with toxic agents
- limiting your marijuana use
- including more foods with vitamins A and B in your diet
- seeking treatment for gastroesophageal reflux disease or laryngopharyngeal reflux disease
- boosting your immune system by eating a balanced diet and engaging in exercise on a regular basis