Treatments

Throat Cancer Treatments

How is oropharyngeal cancer treated?

Treatment of oropharyngeal cancer depends on exact location (tonsil, base of tongue), extent of cancer in its primary location, presence of spread to the lymph nodes, and patient’s general medical condition.

Full extent of the cancer as assessed by clinical evaluation and imaging studies determines the stage of the cancer. Stage of the cancer can be a guide to prognosis (outlook for cure). Early stage cancers can often be treated by single modality such as surgery or radiation while more advanced stage tumors may require combination therapy.

At Northwestern Head and Neck Program, treatment is designed to best utilize the benefits of minimally invasive robotic surgery, focused radiation techniques, and recent advances in drug therapy to maximize the likelihood of cure while still preserving long-term quality of life.

Surgery for treating oropharynx cancers can be performed in a minimally invasive fashion at Northwestern Head and Neck Program. Both robotic surgery as well as microscope-assisted laser surgery are used to remove the cancer with minimal disturbance of the surrounding normal tissue. Simultaneously, the lymph nodes in the neck are commonly dissected to ensure that all cancer has been removed from the patients.

Surgical techniques and therapies for throat cancer treatment include:

• Primary tumor resection: Removal of the entire tumor and surrounding area of tissue.
• Maxillectomy: Removal of the tumor, including part or all of the hard palate (roof of the mouth), if bone is involved.
• Glossectomy: Removal of the tongue.
• Mohs' micrographic surgery: Removal of the tumor in "slices" to minimize amount of normal tissue removed (may be considered when the cancer involves the lip).
• Laryngectomy: Removal of a large tumor of the tongue or oropharynx, which may involve removing the larynx (voice box).
• Neck dissection: If cancer has spread to the lymph nodes in the neck, these lymph nodes may need to be removed as well.
• Radiation therapy: Treatment that uses high-energy rays that damage cancer cells and halts the spread of cancer. Radiation therapy is very localized, aimed at only the area where the cancer is present. Radiation therapy may be administered externally with a machine, or internally with radioactive materials.
• Chemotherapy: Medications that go throughout the entire body to kill cancer cells. Chemotherapy has the ability to interfere with the cancer cell's replication. Chemotherapy may be used in combination with surgery and radiation therapy.
• Targeted therapy: Drugs that target specific cancer cells are also an option and often cause less side effects than chemotherapy that kills both cancerous and noncancerous cells. One such example is cetuximab (Erbitux®) that targets epidermal growth factor receptors.

Nonsurgical approaches utilizing a combination of radiation and chemotherapy are appropriate in many patients depending on the location and extent of cancer. Patients receive radiation daily (Monday to Friday) for up to 7 weeks. Chemotherapy infusions are administered simultaneously once a week or less often during this time.