TUMORS OF THE MOUTH, TONGUE, THROAT AND LARYNX
Tumors of the head and neck are treated by the Ear, Nose, and Throat Specialist, also referred to as an Otolaryngologist—Head and Neck Surgeon. Tumors can occur anywhere that is lined with mucous membranes, the moist pink lining inside our noses, mouths, and throats. Some common locations for head and neck cancer include the oral cavity (mouth), tongue, tonsils, and pharynx (throat). Tumors in this region can be benign or malignant (cancerous). The most common cancers of the head and neck are called squamous cell carcinomas. These are usually (but not always) associated with heavy tobacco and alcohol intake. More recently, an association with the human papilloma virus (HPV) has been established. This is the same virus that has been linked to cervical cancer in women.
Symptoms of head and neck cancer vary, depending on the location and size of the tumor. The symptoms might include a sore throat, difficulty with or painful swallowing or talking, coughing up blood, ear pain, or shortness of breath. Subtle cancers may not cause any discomfort, but an abnormal growth is noted in the throat during the exam. Sometimes, a neck mass is the first sign of a mouth or throat cancer.
If you have been diagnosed with a cancer of the oral cavity or pharynx, it is important to determine the type and severity (stage) of the tumor. The staging will guide your physician at Suburban Ear, Nose, and Throat as to the most appropriate therapy. To confirm the diagnosis, a biopsy will be required. If the tumor easily visualized in the office, the biopsy can be done with some local anesthesia. Tumors that are difficult to reach will usually require general anesthesia to obtain a biopsy. During the biopsy procedure, we will also closely inspect the remainder of the throat, larynx (voice box), trachea (windpipe), and the esophagus because there is a 2-3% chance of having a second tumor in one of these areas. Staging of the tumor will also involve some imaging such as a CT scan, an MRI, or a PET scan. On occasion, special swallowing x-rays will also be obtained.
Once the stage of the tumor is understood, all treatment options will be discussed. In general, there are three forms of therapy for head and neck cancer. Surgery is performed by the Ear, Nose, and Throat Specialist, radiation therapy is administered under the care of a radiation oncologist, and chemotherapy is provided by a medical oncologist.
Early stage (I and II) cancers will often only require one form of treatment, either surgery OR radiation therapy. For advanced stage (III and IV) cancers, two or often three forms of cancer therapy will be recommended. The sequence of administration of treatment depends on the specifics of your tumor. For example, sometimes surgery is followed by radiation therapy, or in many cases, chemotherapy and radiation therapy are given at the same time, followed by surgery.
If your treatment plan involves surgery, the type of surgery performed by your Ear, Nose and Throat specialist will depend on the particulars of your tumor. The spectrum of surgery extends from a minor biopsy to removal of a portion of the tongue, mouth, or pharynx. If a large defect is created by the surgery, some reconstruction may be required with a tissue graft. In addition, if the tumor has spread into the lymph nodes in your neck, a neck dissection (removal of the neck lymph nodes) might be recommended for one or both sides of your neck. The details of this operation are discussed elsewhere on our website.
Patients with head and neck cancer can be complicated, and for this reason, multiple health care providers may be involved in their care. In addition to the above mentioned specialists, this may include your Primary Care Physician, Gastroenterologist, Speech Pathologist, and others. This is called a "multi-disciplinary" approach to cancer treatment.
As your healthcare provider, we at Suburban Ear, Nose, and Throat take great pride in helping you understand each step along the path of your individual cancer treatment. If you are diagnosed with head and neck cancer, we will develop a lifetime relationship of close follow-up and support. We go to great lengths to try to help you understand your plan of care. If at any time during your care you have questions or concerns, please call us at 847‐259‐2530.