Head and neck cancers are any cancers in the structures above your collarbones other than your brain and spinal cord. Cancers start when a normal cell begins to grow too fast, get out of control, and spread to other structures.

Head and neck cancers can start in:

• The lining of your mouth (oral cavity)
• Throat (pharynx)
• Voice box (larynx) 
• Nose (nasal cavity)
• Sinuses (paranasal sinus)
• Salivary glands
• Head and neck muscles (sarcoma)

Infections are a common cause of head and neck cancer. These include human papillomavirus (HPV) and Epstein-Barr virus (EBV). Lifestyle habits like smoking and drinking alcohol also contribute.

The skin of our scalp and neck gets lots of sunshine, so skin cancers, including melanoma, are common there. We work with our skin cancer team to treat skin cancer of the head and neck.

At Carilion, our head and neck cancer team also treats thyroid cancer. Carilion’s brain and spinal cord cancer team cares for nervous system cancers.

We often treat head and neck cancers with a mix of surgery, radiation therapy, and cancer medicines.

Because of their location, treatments for these cancers can have lasting effects. You may need experts in:

• Swallowing
• Speech
• Dental care
• Reconstructive surgery

Your care team may be especially large. We all work together to develop a plan just for you.

Pretreatment care

Our rehabilitation team takes a proactive approach to your health. Before your treatments, our head and neck cancer experts assess how your care may affect you. They might suggest things you can do to prevent some common side effects of treatment.

They're nationally known for their excellent care before, during, and after cancer treatment.

Pretreatment care includes:

• Hospital dentists: Cancer care to the head and neck can damage your teeth. Our dental care experts can protect your dental health before, during, and after treatment.
• Social work: The most complex cancer cases require many visits with many experts. Our social workers can help you negotiate the financial effects of lost work, frequent doctor’s visits, and travel expenses.
• Resources to help you quit smoking: Tobacco use increases your risk of head and neck cancer. Quitting helps your healing and recovery.

Cancer surgery

Surgery is one of the main ways we treat head and neck cancer. Cancer surgeries include:

• Endoscopic surgery: We place a long, thin tool with a camera and tiny surgical instruments down your nose or throat. At Carilion, we have many years of experience in endoscopic surgery.
• Trans-oral robotic surgery: We can use a robotic arm to help guide special surgical tools. It allows less invasive surgeries for cancers in the back of your throat or mouth.
• Mohs surgery: We can use this precise technique to remove lip and skin cancer with minimal scarring. 
• Lymph node removal: We remove nearby lymph nodes with signs of cancer. This helps keep your cancer from spreading.
• Plastic and reconstructive surgery: We may need to rebuild some parts of your mouth, jaw, nose, or throat. Surgery rebuilds these structures so they can look and work like they should. Our skilled plastic surgeons work to help you feel and look like you again.

Radiation therapy

Radiation uses high-energy rays to target and kill cancer cells. We aim the radiation at the cancer cells to stop their growth and shrink the tumor. Sophisticated machinery, scanners, and molding devices target the cancer, not the healthy cells.

Radiation therapy includes:

• External beam radiation therapy: We use a machine outside your body to deliver a beam focused on your tumor and nearby lymph nodes. It’s the most common way we use radiation therapy for head and neck cancers.
• Intensity-modulated radiation therapy: This is an advanced form of external beam radiation. It shapes the radiation dose to match the tumor. This helps protect nearby healthy tissue, such as the salivary glands, which is especially helpful for head and neck cancer.
• Internal radiation therapy or brachytherapy: We can also place a radioactive source right into or near the cancer. We may use brachytherapy if your cancer returns after other treatments.
• Radioactive iodine therapy: We use radioactive iodine therapy to treat thyroid cancer. We can place it into a vein, or you can swallow a radioactive pill or liquid.

Clinical trials

Clinical trials are another way to fight cancer. We usually compare a new medicine or protocol to the current best therapy in a trial. Your care team may ask you to consider a trial when studying a new and exciting way to treat cancer.

These studies are voluntary; you'll talk to your care team before enrolling. A trial can be a first treatment option or an option if your treatment stops working.

Rehabilitation 

Cancer treatment can cause many physical side effects and problems that can get in the way of daily living. To manage these, we offer prehab and rehabilitation services to many of our head and neck cancer patients.

Cancer rehabilitation services for head and neck cancers may include:

• Oral rehabilitation: Our hospital dentistry team can provide specialized oral prosthetics. These replace structures removed during cancer surgery.
• Nutritional support: Our registered dieticians can help plan for your caloric needs. Sometimes people with head and neck cancers have trouble swallowing. So, they may need a feeding tube.
• Lymphedema therapist: These experts help manage fluid build-up caused by cancer treatment. It’s common to get facial swelling during cancer treatment. They help reduce the swelling and control pain.
• Speech therapist: Our speech therapists can help you if you have trouble talking. They also understand the mouth and jaw muscles and can help with swallowing.