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Head and Neck Cancers

For patients with a diagnosis of cancer of the head or neck, the priorities are always the same:  getting the very best treatment that affords the best outcome possible -- and finding hope in the process. 
 
City of Hope is recognized worldwide for its compassionate patient care, innovative science and translational research, which rapidly turns laboratory breakthroughs into promising new therapies. We’re a forward-thinking cancer center model devoted to rapidly transforming scientific discoveries into better treatments and improved prevention strategies.  And more importantly, we’ve been delivering hope to cancer patients for 100 years.
 
What sets City of Hope apart from other cancer treatment centers?

From diagnosis through treatment and follow up, City of Hope offers a truly comprehensive approach to treating head and neck cancers. Our renowned head and neck surgeons specialize in the complex procedures often necessary to eradicate these tumors while preserving vital structures and function. We offer ultra-sophisticated radiotherapy techniques, such as helical TomoTherapy, and we employ the latest chemotherapy protocols and devise promising experimental therapies through our drug development research programs. These combined attributes allow us to provide powerful therapeutic options to patients fighting such cancers as salivary gland cancer.

Through our Head and Neck Cancer Program, patients at City of Hope receive treatment from a coordinated, multidisciplinary team of surgeons, oncologists, endocrinologists, radiation oncologists, nurses, supportive care specialists and others, ensuring the highest possible standard of care.
 
City of Hope’s Head and Neck Cancers Program offers the latest treatments for:
 
 
 
If you have been diagnosed with a head or neck cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online Schedule a Call Back form.
 
 
 

About Head and Neck Cancers

If you or a loved one has been diagnosed with a cancer of the head or neck, City of Hope is here to help. Our world-renowned, multi-disciplinary team of head and neck cancer experts provides comprehensive, personalized care tailored to each patient’s individual needs in order to deliver the best possible outcomes.

Head and neck cancers are categorized by where they originate.  Squamous cell carcinomas are found in the squamous cells that line the moist, mucosal surfaces inside the head and neck, such as the inside of the mouth, nose and throat.  Other areas that make up this category of cancers are:
 
  • Oral cavity – includes the lips, front two-thirds of the tongue, gums, lining inside the cheeks and lips, floor (bottom) of the mouth under the tongue, hard palate (bony top of the mouth) and the small area of the gum behind the wisdom teeth.
  • Pharynx – the approximately five-inch-long hollow tube that starts behind the nose and leads to the esophagus, consisting of three parts: the nasopharynx (the upper part of the pharynx, behind the nose); the oropharynx (the middle part of the pharynx, including the soft palate [the back of the mouth], the base of the tongue, and the tonsils); and the hypopharynx (the lower part of the pharynx).
  • Larynx – also called the voicebox, this is a short passageway formed by cartilage in the lowest part of the pharynx. The larynx contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the larynx to prevent food from entering the air passages.
  • Paranasal sinuses and nasal cavity –small hollow spaces in the bones of the head surrounding the nasal cavity. The nasal cavity is the hollow space inside the nose.
  • Salivary glands – glands found in the floor of the mouth and near the jawbone that that produce saliva.
 

Symptoms and Risk Factors of Head and Neck Cancers

Symptoms of Head and Neck Cancers
 
Head and neck cancer symptoms vary from person to person, but in the early stages the cancers often do not produce symptoms. However, as the cancer grows, common symptoms may include:
 
  • breathing trouble, such as shortness of breath
  • difficulty swallowing
  • nosebleed or coughing up blood
  • a hoarse voice
  • an ulcer or lump
  • weight loss with no known cause

It is important to note that experiencing these symptoms does not necessarily indicate that cancer is involved; other health problems can cause many of these same symptoms. Nonetheless, early detection and treatment is crucial with any illness – especially cancer – so it’s important to see a doctor right away if you experience any of the above symptoms.
 
Risk Factors of Head and Neck Cancers
 
Many head and neck cancers are caused by long-term exposure to known risk factors such as tobacco, alcohol, the sun, ultra-violet light, radiation and cancer-causing agents in the workplace. These cancers generally are considered preventable.

Factors known to increase the risk of developing head and neck cancer include:
 
  • Tobacco and alcohol - People who use tobacco (including cigarettes, cigars, pipes and smokeless tobacco) or drink alcohol excessively are at much greater risk for developing head and neck cancers. An estimated 85 percent of head and neck cancers are linked to tobacco use. A smoker's risk of developing cancer of the larynx (voice box) or hypopharynx (the entrance to the esophagus) is as much as 35 times higher than the risk for a nonsmoker. Heavy use of alcohol raises the risk of those cancers two to five times. Those who smoke and drink heavily may raise their risk to 100 times that of nonusers. Though men are considerably more likely than women to develop a head or neck cancer because of their greater use of tobacco and alcohol, the rates of head and neck cancers found in women have been rising for several years.
  • Precancers - Not all precancers progress to cancer, but some do. Heavy smoking and drinking can cause genetic damage to squamous cells - which form a thin outer layer over structures in the head and neck - leading to the development of precancerous lesions. In many cases, people with precancers who stop heavy use of alcohol and tobacco can reverse this process.
  • Prolonged exposure to sunlight, ultraviolet light and radiation - People who have spent a substantial amount of time in the sun – or who use tanning beds or booths (ultraviolet light) – are at greater risk for skin cancers of the head and neck region. In addition, extensive radiation of the head or neck from diagnostic X-rays or radiation therapy increases the risk for cancer of the skin, salivary glands and thyroid, in particular.
  • Other possible risks - Other risk factors for head and neck cancer may include poor oral hygiene; exposure to occupational inhalants, such as asbestos or wood dust; a diet low in vegetables and fruits; gastroesophageal reflux disease; infection with the human papillomavirus (HPV) or Epstein-Barr virus; and a weakened immune system.
    
Making certain lifestyle changes can significantly lower your risk of developing a head or neck cancer.  By quitting smoking, you can substantially reduce the risk – even if you have smoked for many years. Moreover, those who already have a head and neck cancer and quit using tobacco can greatly reduce the risk of developing a second tumor. People who are exposed to toxic fumes and dust in the workplace or in other environments can reduce the risk of head and neck cancer by wearing protective face masks. Workplaces equipped with air-filtration systems minimize employees' exposure to harmful fumes and dust.

It is important to note that some head and neck cancers, such as parathyroid cancer, are not associated with any preventable risk factor, and some people who develop head and neck cancers have no known risk factors.
 
 
If you have been diagnosed with a head or neck cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.
 
 

Treatment of Head and Neck Cancers

Just like each patient, each type of head and neck cancer is unique. Thus, we customize your treatment specifically to your cancer type. City of Hope brings together world-class experts in oncology, lung diseases and surgery, radiation oncology and other medical specialties to provide the highest standard of personalized care for our patients. The course of treatment is based on the type and stage of tumor and each patient's general medical condition – with every effort made to minimize negative side effects and preserve quality of life.

Current treatment options include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these treatments. City of Hope surgeons are continually refining their techniques to treat cancer effectively while decreasing the physical impact of cancer surgery. Members of our head and neck cancer team come from a variety of disciplines and include head and neck surgeons, radiation oncologists, medical oncologists, diagnostic radiologists, pathologists, speech language pathologists, social workers and nurse practitioners. These team members meet on a weekly basis at a multidisciplinary Tumor Board conference to discuss every head and neck cancer patient to determine the best course of treatment based on each patient’s specific situation.
 
Revolutionary Treatments
Transoral laser microsurgery and transoral robotic surgery have revolutionized our ability to surgically treat head and neck cancers.
 
Transoral laser microsurgery (TLM)
 
With transoral laser microsurgery (TLM), a procedure widely used for tumors of the throat and larynx (voice box), the surgeon inserts a thin endoscope through the mouth, and a specially designed microscope enables the surgeon to see the tumor and surrounding tissue during the surgery. Highly specialized carbon dioxide (CO2) laser beams are used instead of a scalpel to cut through tissue. 
 
TLM offers several important benefits:
  • Unlike other types of lasers, the CO2 laser beam generates minimal heat energy, thus minimizing damage to normal structures around the tumor such as important nerves, blood vessels and muscles that are important for speech and swallowing.
  • Because it is performed directly through the mouth, TLM does not leave a visible scar.
  • TLM offers an individualized approach to treatment. Different types of laser systems are used depending on the specific type of procedure being performed.  For example, one type employs a robotic adapter to create precise incisions. Another system designed specifically for larynx and vocal-cord surgery uses a computer program to drive a “joystick” on an operating microscope. The flexible, fiber-optic CO2 laser reaches areas in the throat that otherwise could not be reached and performs a 360-degree resection around tumors in ways that were previously impossible. Another type of laser is designed to minimize blood loss for surgeries in which the risk of bleeding is high.

Transoral robotic surgery (TORS)

Transoral robotic surgery (TORS) is a minimally invasive procedure used to treat both benign and cancerous lesions of the throat, including the oropharynx, larynx and hypopharynx. To perform TORS, physicians use a guided endoscope that helps create a high-resolution 3D image of the back of the mouth and throat -- a difficult area to reach with conventional tools. Two robotically guided instruments that act as a surgeon’s arms cut the tumor away from surrounding tissue.

Key benefits of TORS:
 
  • It is performed through the mouth without the need for skin incisions or extensive dissection, so it leaves no visible scars.
  • The procedure results in less blood loss and faster healing than conventional open surgery.
  • There is minimal swelling.
  • A temporary tracheostomy usually is not needed.
  • There is less impact on the patient’s ability to speak and swallow.
  • It can significantly decrease the overall dose of radiation needed for head and neck cancer patients, limiting the adverse effects of radiation therapy
 
General anesthesia is used for TLM and TORS. Your City of Hope doctor will help you decide if these treatments are right for you.
 

The surgical removal of head and neck cancer may result in a range of physical defects and functional deficits. Our head and neck surgery team includes facial plastic and reconstructive surgeons who employ the latest surgical techniques to ensure optimal functional and cosmetic outcomes.
 

For head and neck cancer patients requiring radiation treatment, City of Hope radiation oncologists use state-of-the-art techniques including helical TomoTherapy which combines spiral CT scanning and intensity modulated radiation therapy to more accurately and precisely treat tumors while sparing normal surrounding tissues. Our surgeons, radiation oncologists and medical oncologists are actively involved in ongoing research to ensure that the best practices are being employed to achieve the best outcomes for our patients.
 

If you have been diagnosed with a head or neck cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.

Head and Neck Cancer Team

Support this program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.

For more information on supporting this specific program, please contact us below.

Kimberly Wah
Director
Phone: 213-241-7275
Email: kwah@coh.org

 
 

Head and Neck Cancers

Head and Neck Cancers

For patients with a diagnosis of cancer of the head or neck, the priorities are always the same:  getting the very best treatment that affords the best outcome possible -- and finding hope in the process. 
 
City of Hope is recognized worldwide for its compassionate patient care, innovative science and translational research, which rapidly turns laboratory breakthroughs into promising new therapies. We’re a forward-thinking cancer center model devoted to rapidly transforming scientific discoveries into better treatments and improved prevention strategies.  And more importantly, we’ve been delivering hope to cancer patients for 100 years.
 
What sets City of Hope apart from other cancer treatment centers?

From diagnosis through treatment and follow up, City of Hope offers a truly comprehensive approach to treating head and neck cancers. Our renowned head and neck surgeons specialize in the complex procedures often necessary to eradicate these tumors while preserving vital structures and function. We offer ultra-sophisticated radiotherapy techniques, such as helical TomoTherapy, and we employ the latest chemotherapy protocols and devise promising experimental therapies through our drug development research programs. These combined attributes allow us to provide powerful therapeutic options to patients fighting such cancers as salivary gland cancer.

Through our Head and Neck Cancer Program, patients at City of Hope receive treatment from a coordinated, multidisciplinary team of surgeons, oncologists, endocrinologists, radiation oncologists, nurses, supportive care specialists and others, ensuring the highest possible standard of care.
 
City of Hope’s Head and Neck Cancers Program offers the latest treatments for:
 
 
 
If you have been diagnosed with a head or neck cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online Schedule a Call Back form.
 
 
 

About Head and Neck Cancers

About Head and Neck Cancers

If you or a loved one has been diagnosed with a cancer of the head or neck, City of Hope is here to help. Our world-renowned, multi-disciplinary team of head and neck cancer experts provides comprehensive, personalized care tailored to each patient’s individual needs in order to deliver the best possible outcomes.

Head and neck cancers are categorized by where they originate.  Squamous cell carcinomas are found in the squamous cells that line the moist, mucosal surfaces inside the head and neck, such as the inside of the mouth, nose and throat.  Other areas that make up this category of cancers are:
 
  • Oral cavity – includes the lips, front two-thirds of the tongue, gums, lining inside the cheeks and lips, floor (bottom) of the mouth under the tongue, hard palate (bony top of the mouth) and the small area of the gum behind the wisdom teeth.
  • Pharynx – the approximately five-inch-long hollow tube that starts behind the nose and leads to the esophagus, consisting of three parts: the nasopharynx (the upper part of the pharynx, behind the nose); the oropharynx (the middle part of the pharynx, including the soft palate [the back of the mouth], the base of the tongue, and the tonsils); and the hypopharynx (the lower part of the pharynx).
  • Larynx – also called the voicebox, this is a short passageway formed by cartilage in the lowest part of the pharynx. The larynx contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the larynx to prevent food from entering the air passages.
  • Paranasal sinuses and nasal cavity –small hollow spaces in the bones of the head surrounding the nasal cavity. The nasal cavity is the hollow space inside the nose.
  • Salivary glands – glands found in the floor of the mouth and near the jawbone that that produce saliva.
 

Symptoms/Risk Factors

Symptoms and Risk Factors of Head and Neck Cancers

Symptoms of Head and Neck Cancers
 
Head and neck cancer symptoms vary from person to person, but in the early stages the cancers often do not produce symptoms. However, as the cancer grows, common symptoms may include:
 
  • breathing trouble, such as shortness of breath
  • difficulty swallowing
  • nosebleed or coughing up blood
  • a hoarse voice
  • an ulcer or lump
  • weight loss with no known cause

It is important to note that experiencing these symptoms does not necessarily indicate that cancer is involved; other health problems can cause many of these same symptoms. Nonetheless, early detection and treatment is crucial with any illness – especially cancer – so it’s important to see a doctor right away if you experience any of the above symptoms.
 
Risk Factors of Head and Neck Cancers
 
Many head and neck cancers are caused by long-term exposure to known risk factors such as tobacco, alcohol, the sun, ultra-violet light, radiation and cancer-causing agents in the workplace. These cancers generally are considered preventable.

Factors known to increase the risk of developing head and neck cancer include:
 
  • Tobacco and alcohol - People who use tobacco (including cigarettes, cigars, pipes and smokeless tobacco) or drink alcohol excessively are at much greater risk for developing head and neck cancers. An estimated 85 percent of head and neck cancers are linked to tobacco use. A smoker's risk of developing cancer of the larynx (voice box) or hypopharynx (the entrance to the esophagus) is as much as 35 times higher than the risk for a nonsmoker. Heavy use of alcohol raises the risk of those cancers two to five times. Those who smoke and drink heavily may raise their risk to 100 times that of nonusers. Though men are considerably more likely than women to develop a head or neck cancer because of their greater use of tobacco and alcohol, the rates of head and neck cancers found in women have been rising for several years.
  • Precancers - Not all precancers progress to cancer, but some do. Heavy smoking and drinking can cause genetic damage to squamous cells - which form a thin outer layer over structures in the head and neck - leading to the development of precancerous lesions. In many cases, people with precancers who stop heavy use of alcohol and tobacco can reverse this process.
  • Prolonged exposure to sunlight, ultraviolet light and radiation - People who have spent a substantial amount of time in the sun – or who use tanning beds or booths (ultraviolet light) – are at greater risk for skin cancers of the head and neck region. In addition, extensive radiation of the head or neck from diagnostic X-rays or radiation therapy increases the risk for cancer of the skin, salivary glands and thyroid, in particular.
  • Other possible risks - Other risk factors for head and neck cancer may include poor oral hygiene; exposure to occupational inhalants, such as asbestos or wood dust; a diet low in vegetables and fruits; gastroesophageal reflux disease; infection with the human papillomavirus (HPV) or Epstein-Barr virus; and a weakened immune system.
    
Making certain lifestyle changes can significantly lower your risk of developing a head or neck cancer.  By quitting smoking, you can substantially reduce the risk – even if you have smoked for many years. Moreover, those who already have a head and neck cancer and quit using tobacco can greatly reduce the risk of developing a second tumor. People who are exposed to toxic fumes and dust in the workplace or in other environments can reduce the risk of head and neck cancer by wearing protective face masks. Workplaces equipped with air-filtration systems minimize employees' exposure to harmful fumes and dust.

It is important to note that some head and neck cancers, such as parathyroid cancer, are not associated with any preventable risk factor, and some people who develop head and neck cancers have no known risk factors.
 
 
If you have been diagnosed with a head or neck cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.
 
 

Our Treatment Approach

Treatment of Head and Neck Cancers

Just like each patient, each type of head and neck cancer is unique. Thus, we customize your treatment specifically to your cancer type. City of Hope brings together world-class experts in oncology, lung diseases and surgery, radiation oncology and other medical specialties to provide the highest standard of personalized care for our patients. The course of treatment is based on the type and stage of tumor and each patient's general medical condition – with every effort made to minimize negative side effects and preserve quality of life.

Current treatment options include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these treatments. City of Hope surgeons are continually refining their techniques to treat cancer effectively while decreasing the physical impact of cancer surgery. Members of our head and neck cancer team come from a variety of disciplines and include head and neck surgeons, radiation oncologists, medical oncologists, diagnostic radiologists, pathologists, speech language pathologists, social workers and nurse practitioners. These team members meet on a weekly basis at a multidisciplinary Tumor Board conference to discuss every head and neck cancer patient to determine the best course of treatment based on each patient’s specific situation.
 
Revolutionary Treatments
Transoral laser microsurgery and transoral robotic surgery have revolutionized our ability to surgically treat head and neck cancers.
 
Transoral laser microsurgery (TLM)
 
With transoral laser microsurgery (TLM), a procedure widely used for tumors of the throat and larynx (voice box), the surgeon inserts a thin endoscope through the mouth, and a specially designed microscope enables the surgeon to see the tumor and surrounding tissue during the surgery. Highly specialized carbon dioxide (CO2) laser beams are used instead of a scalpel to cut through tissue. 
 
TLM offers several important benefits:
  • Unlike other types of lasers, the CO2 laser beam generates minimal heat energy, thus minimizing damage to normal structures around the tumor such as important nerves, blood vessels and muscles that are important for speech and swallowing.
  • Because it is performed directly through the mouth, TLM does not leave a visible scar.
  • TLM offers an individualized approach to treatment. Different types of laser systems are used depending on the specific type of procedure being performed.  For example, one type employs a robotic adapter to create precise incisions. Another system designed specifically for larynx and vocal-cord surgery uses a computer program to drive a “joystick” on an operating microscope. The flexible, fiber-optic CO2 laser reaches areas in the throat that otherwise could not be reached and performs a 360-degree resection around tumors in ways that were previously impossible. Another type of laser is designed to minimize blood loss for surgeries in which the risk of bleeding is high.

Transoral robotic surgery (TORS)

Transoral robotic surgery (TORS) is a minimally invasive procedure used to treat both benign and cancerous lesions of the throat, including the oropharynx, larynx and hypopharynx. To perform TORS, physicians use a guided endoscope that helps create a high-resolution 3D image of the back of the mouth and throat -- a difficult area to reach with conventional tools. Two robotically guided instruments that act as a surgeon’s arms cut the tumor away from surrounding tissue.

Key benefits of TORS:
 
  • It is performed through the mouth without the need for skin incisions or extensive dissection, so it leaves no visible scars.
  • The procedure results in less blood loss and faster healing than conventional open surgery.
  • There is minimal swelling.
  • A temporary tracheostomy usually is not needed.
  • There is less impact on the patient’s ability to speak and swallow.
  • It can significantly decrease the overall dose of radiation needed for head and neck cancer patients, limiting the adverse effects of radiation therapy
 
General anesthesia is used for TLM and TORS. Your City of Hope doctor will help you decide if these treatments are right for you.
 

The surgical removal of head and neck cancer may result in a range of physical defects and functional deficits. Our head and neck surgery team includes facial plastic and reconstructive surgeons who employ the latest surgical techniques to ensure optimal functional and cosmetic outcomes.
 

For head and neck cancer patients requiring radiation treatment, City of Hope radiation oncologists use state-of-the-art techniques including helical TomoTherapy which combines spiral CT scanning and intensity modulated radiation therapy to more accurately and precisely treat tumors while sparing normal surrounding tissues. Our surgeons, radiation oncologists and medical oncologists are actively involved in ongoing research to ensure that the best practices are being employed to achieve the best outcomes for our patients.
 

If you have been diagnosed with a head or neck cancer, we’re here to help. City of Hope is committed to making the process of becoming a patient here as easy as possible. Call 800-826-HOPE (4673) or complete the online appointment form.

Head and Neck Cancer Team

Head and Neck Cancer Team

Support This Program

Support this program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.

For more information on supporting this specific program, please contact us below.

Kimberly Wah
Director
Phone: 213-241-7275
Email: kwah@coh.org

 
 
Quick Links
Ask the Experts - Head and Neck Cancers
With Cancer, Expertise Matters

 
Cancer patients need to have confidence in their treatment plans by exploring all possible options. Often that means they should get a second opinion.  For these four patients, getting a second opinion from experts at City of Hope was life-saving.
Clinical Trials
Our aggressive pursuit to discover better ways to help patients now – not years from now – places us among the leaders worldwide in the administration of clinical trials.
 
Ranked as one of  "America’s Best Hospitals" in cancer by U.S. News & World Report, City of Hope is a pioneer in the fields of hematopoietic cell transplantation and genetics. Designated as a comprehensive cancer center, the highest honor bestowed by the National Cancer Institute, City of Hope's research and treatment protocols advance care throughout the nation.