Head and Neck Cancer Treatment: Terms You Need to Know
Rachel Zohn | March 5, 2018
If you or someone you love has been diagnosed with head and neck cancer, learning the medical terminology involved can be overwhelming. Read on for a helpful breakdown of definitions related to treatments and therapies for different forms of head and neck cancer.
Treatments for head and neck cancer
Chemotherapy is the use of medicines and drugs to treat cancer. Radiation therapy uses X-rays or radiation to treat cancer. Concurrent chemoradiation is a treatment that uses both chemotherapy and radiation therapy at the same time. Another type of therapy is called immunotherapy, which is the use of your body’s own immune system to help fight cancer. Targeted therapy uses drugs to identify and attack specific cancer cells, leaving normal cells unharmed.
Types of radiation: EBT, IMRT, and brachytherapy
Several different types of radiation may be used. External beam therapy (EBT) is radiation therapy that delivers a beam of high-energy x-rays or proton beams to the tumor site. Intensity-modulated radiation therapy (IMRT) is a high-precision radiotherapy that uses advanced software to plan a precise dose of radiation, based on tumor size, shape, and location. It delivers radiation in sculpted doses to match the shape of the tumor. Brachytherapy uses radiative implants, such as seeds or needles, which are inserted near the site of the tumor.
Types of surgery for head and neck cancer
There are many types of surgery that may be used to treat these cancers. Microsurgery is surgery that requires a high-powered microscope, and microvascular surgery is a type of microsurgery to repair blood vessels. An endoscope is a long, thin tube with a camera that a surgeon can use to examine hard to reach areas and remove tumors with a high-intensity laser. Transoral robotic surgery is the use of a surgical robot to remove a tumor from the mouth or throat. The robotic arm allows the surgeon to access areas that their hands couldn’t reach.
Removal surgeries for head and neck cancer
- Laryngectomy: removal of all or part of the larynx, or voice box
- Pharyngectomy: removal of all or part of the pharynx, or throat area behind the nose and mouth
- Cordectomy: removal of all or part of the vocal cords
- Glossectomy: the tongue
- Mandibulectomy: removal of all or part of the mandible, or lower jaw bone
- Rhinectomy: removal of all or part of the nose
- Maxillectomy: removal of all or part of the maxilla, or upper jawbone
Other surgical procedures: Neck dissection, vocal cord stripping, and tracheotomy
Neck dissection is surgery to remove the lymph nodes from the neck. Lymph nodes are small organs located within the lymphatic system, or channels within the body which carry white blood cells that fight infection. Vocal cord stripping is when the outer layers of tissue on the vocal cords are stripped away. A tracheotomy is performed to create a hole, or stoma, in the trachea, or windpipe, which is used as an alternate pathway for breathing.
Reconstructive surgery terms: Secondary intention, primary closure, and skin graft
Reconstructive surgery is a procedure to restore structure and function of the affected area following extensive surgery for cancer. If cancer removal leaves a wound that is left to heal on its own, it is called healing by secondary intention. Primary closure is when stitches, staples, or glue are used to close a wound. A skin graft may be used to cover the wound with a layer of skin from another part of the body; eventually, blood vessels will grow into the new skin to help it heal.
Flap surgery: A type of reconstructive surgery
Flap surgery uses a piece of tissue that is still attached by a major artery and vein to cover a wound. A local flap is tissue that is transferred from a nearby area. Free flap or free tissue transfer is tissue, such as skin, muscle or bone, which is taken from another area of the body and transplanted to the site that needs to be reconstructed. The flap’s blood supply is surgically reconnected to the blood vessels adjacent to the wound.
Complications of head and neck cancer treatment
Facial lymphedema is the swelling of the head and neck area and is a common complication follow surgery or treatment. Mucositis is a complication from radiation therapy or chemotherapy in which the lining of the digestive system becomes inflamed, causing sores in the mouth and throat. Neurotoxicity is damage to the nervous system caused by some treatments. Rampant dental decay and demineralization is the erosion of the tooth’s surface as a result of changes to the saliva following treatment.
Functional disabilities after treatment
Functional disabilities are limitations in ability, such as impairment to eating, speaking, or swallowing, following treatment or surgery. Dysarthria is impairment of speech, such as slurred speech or inability to pronounce words clearly. Dysphagia is difficulty swallowing. To assess these types of impairment, health care providers use the Karnofsky Performance Scale (KPS). It uses a score from 0 to 100 to convey a person’s ability to perform daily activities, with 100 indicating completely normal functions.
When it comes to treating head and neck cancer, there are many types of therapies, procedures, and surgeries that may be used. Learning the terminology early can help you better navigate your care, or the care of a loved one. Interested in learning more terms related to types of head and neck cancers and the diagnosis process? See Head and Neck Cancer Diagnosis: Terms You Need to Know.