I want to say ‘thank you’ to all the doctors and nurses; I’m grateful for everything they’ve done. They have a special place in my heart." Jackie Garcia, head and neck cancer survivor
If you’ve been diagnosed with a head and neck cancer, talk to us about treatment options. At City of Hope, our dedicated team of experts take a patient-centered approach to diagnosing and treating this group of cancers, including tumors and cancers of the:
- oral cavity (including lips, mouth and tongue)
- throat (pharynx, including nasopharynx, oropharynx and hypopharynx)
- voicebox (larynx)
- paranasal sinuses and nasal cavity
- salivary, thyroid and parathyroid glands
- skin, muscle and bone in the head/neck region
Request a consultation
If you have been diagnosed with a head and neck cancer, are at a high risk for developing this disease or are looking for a second opinion consultation about your treatment, you may request an appointment online or contact us at 800-826-4673 (HOPE). Please visit Making Your First Appointment for more information.
Our multidisciplinary staff pursues an integrated approach to treating head and neck cancers by combining the latest research findings with outstanding patient care. This includes using advanced technologies and specialized techniques such as:
- Innovative, minimally invasive surgical approaches that reduce discomfort, blood loss and recovery time
- Transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) using orally inserted therapy tools, eliminating the need for external incisions, scarring and other complications
- Plastic and reconstructive surgery procedures that can restore appearance and function, often performed in the same operation as the cancer removal surgery
- Highly precise radiation delivery that uses advanced imaging technology to guide radiation dose and focus, increasing its cancer-fighting effectiveness while minimizing exposure in normal tissues
- Individually customized chemotherapy and targeted therapy regimens
- Comprehensive rehabilitation program to help restore normal functions (eating, speaking, swallowing) after treatment
Additionally, City of Hope patients have access to our extensive team of supportive care experts, who will help you and your caregivers achieve and maintain a better quality of life during and after your cancer treatment.
City of Hope is a nationally recognized leader in the research and treatment of head and neck cancers. We are one of the few facilities designated a comprehensive cancer center by the National Cancer Institute, and for over a decade, U.S. News & World Report has named City of Hope one of the top cancer hospitals in America.
Our physicians have been consistently named "America's Top Doctors" by Castle Connolly and are active participants in the National Comprehensive Cancer Network, which sets evidence-based best practices for detecting, evaluating and treating head and neck cancers nationwide.
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What are head and neck cancers?
Head and neck cancers are a group of diseases involved abnormal, uncontrolled cell growth in head and neck tissues. These include:
- Oral cavity: including the lips, gums, cheek lining, hard palate, front two-thirds of the tongue and floor of mouth underneath the tongue
- Pharynx: the tube that starts from behind the nose and ending at the esophagus; it may classified further based on location — including the nasopharynx (the upper part behind the nose), oropharynx (the middle part, including the soft palate, base of tongue and tonsils) and hypopharynx (the lower part leading into the esophagus).
- Larynx: Also known as the voicebox, the larynx is a tube that connects the base of the pharynx to the bronchus and lungs. It contains the vocal cords, which control air output for speaking, and epiglottis, which prevents food matter from going into the larynx during swallowing.
- Nasal cavity and paranasal sinuses: hollow spaces within and around the nose
- Salivary (parotid) glands: glands near the jawbone that produce saliva
What risk factors are linked to head and neck cancers?
Factors that can elevate head and neck cancer risk include:
- Alcohol: heavy alcohol use, especially over a long time
- Tobacco: tobacco use, particularly smokeless tobacco (also known as “chewing tobacco” or “snuff”)
- Frequent or regular consumption of paan (betel quid), mate or preserved foods
- Human papillomavirus (HPV) or Epstein-Barr virus infection
- Radiation exposure to the head and neck region
- Occupational/industrial exposures to substances linked with head and neck cancer, including wood and metal dusts, synthetic fibers, asbestos and formaldehyde
- Poor oral health
- Family history of head and neck cancers
- Gender: head and neck cancers are twice as common in men
- Ethnicity: Asians, particularly Chinese, have a higher risk of developing nasopharyngeal cancer
What are the symptoms of head and neck cancers?
Head and neck cancer symptoms vary depending on the area affected, and may include:
- Unusual pain in the mouth, neck or throat, particularly when swallowing
- Lump or swelling in the head or neck area
- Change in head or neck appearance, particularly any differences that develop between the left and right sides
- Difficulty breathing, chewing, swallowing or speaking
- Persistent bleeding through the nose or in the mouth
- Red or white patch on the gums or inner cheek
- Chronic sinus blockages or infections
- Numbness or paralysis with facial muscles
Although these symptoms can be caused by other conditions, you should check with your doctor to get a definitive diagnosis.
- Throat Pain: When is it something more serious?
- Head and Neck Cancers: Get the Stats
- Head and Neck Cancers Q&A: HPV-linked disease has better outcomes
Sources: National Cancer Institute and American Cancer Society
Diagnosing head and neck cancers
Precise head and neck cancer tests are crucial for treatment planning, and City of Hope is equipped with state-of-the-art technologies and specialized staff to ensure an accurate, comprehensive diagnosis of head and neck cancer.
Highlights of our screening and diagnosis services include:
- Advanced imaging technology to better locate tumors and determine treatment response
- Genomic and molecular profiling of the cancer, which can lead to more effective, less toxic treatments
How are head and neck cancers detected?
Your doctor may use the following tests to look for head and neck cancer:
- Physical exam
- Head and neck exam: This comprehensive examination includes looking and feeling the head and neck area for suspicious lumps and using thin, flexible tubes to examine the oral, nose and/or throat cavities for signs of cancer. Depending on the procedure used, the patient may be given a localized numbing agent or placed under general anesthesia.
- Biopsy: Examination of suspicious tissue — depending on its location. This may involve scraping the targeted area, using a fine needle to extract a sample or surgically removing a small piece of tissue.
- CT or CAT (computed tomography) scan: This test involves taking a series of X-ray images to form a computer-generated image, which determines tumor size, location and spread. Special dyes may be used to enhance this scan.
- MRI (magnetic resonance imaging) scan: This procedure uses radio waves and strong magnets to produce detailed images of the body’s tissues, including head and neck tumors.
- HPV testing: Throat cancer patients may be tested for human papillomavirus infection, since presence or absence of the virus can guide treatment planning for better outcomes.
- Genomic testing: The cancerous tissue is tested to see if it exhibits certain genetic mutations or molecular markers, which can be used to help determine disease progression, optimal treatments or identify risk for other cancers.
Based on the results of these tests, the cancer is then staged according to its size, number of lymph nodes affected and whether it has spread to nearby or distant organs. Generally, cancer caught in earlier stages will have better outcomes than those caught in advanced or metastasized stages.
What are the current screening guidelines for head and neck cancers?
There are currently no screening guidelines for head and neck cancers, since no screenings have been shown to lower risk of dying for people of average risk. However, your physician may recommend more vigorous monitoring if you are at a high risk of developing this disease, which includes:
- HPV or Epstein-Barr infection
- Family history of head and neck cancers
- Prolonged use of tobacco products, particularly smokeless tobacco
Treatment options for head and neck cancers
I am privileged to have an awesome team of experts that are with me … we look at everything, we consider everything, and at the end of the day we want to be sure we can stamp the City of Hope name on that treatment plan that we are prescribing and be proud of it." Ellie Maghami, M.D., The Norman and Sadie Lee Professor in Head and Neck Cancer
Head and neck cancers are particularly unique and complex, requiring a personalized treatment plan for optimal clinical, quality-of-life and cosmetic outcomes. At City of Hope, our multidisciplinary team of medical experts across different fields —- including surgery, radiation oncology, medical oncology, pathology and supportive care medicine — will review your individual case and determine the best course of therapy based on the latest evidence-based guidelines and groundbreaking research.
Our physicians are also active members in many collaborations and cooperative groups, participating in numerous clinical trials for detecting, treating and preventing head and neck cancers. This dedication to research also ensures our patients have access to the most promising and leading-edge of cancer therapies.
Learn more about our head and neck cancer treatment options below:
For early stage or locally advanced head and neck cancers, surgical removal of cancerous tissue is the primary treatment. The type of surgery varies depending on the type, size and location of the cancer.
City of Hope offers the latest advances in head and neck surgery, meaning you can achieve outcomes not possible elsewhere. This includes our surgeons’ experience and innovative approaches to cancer removal, technology for minimally invasive procedures and specialized reconstruction to preserve quality-of-life functions.
When possible, minimally invasive surgeries — which use smaller incisions compared to a traditional open procedure — will be performed. This can significantly reduce discomfort, blood loss, hospital stay and recovery time while maintaining optimal outcomes.
Highlights of our head and neck cancer surgery include:
- Transoral robotically assisted surgery and transoral laser microsurgery, minimally invasive procedures that guide surgical instruments through your mouth and throat cavities and remove the cancer without extra incisions.
- Immediate reconstruction following cancer removal surgery – usually within the same operation – to restore appearance and maintain normalcy in everyday functions such as breathing, speaking, chewing and swallowing.
Experience in surgically addressing complex cases of head and neck cancers, including:
- locally advanced cancers
- large or disfiguring tumors
- tumors at or near vital organs or structures
- other health conditions that can complicate head and neck surgery
- Head and Neck Cancer Treatment: Where technology is about the patient
- After surgery, a renewed childhood for fourth-grader with cancer in jaw
Radiation therapy uses high-energy X-rays or other forms of radiation to kill cancer cells. It is typically delivered externally using beams of energy focused on the tumor site.
Radiation can treat tumors that cannot be removed by surgery (sometimes shrinking them enough to be operable) and can be used to relieve pain and other cancer symptoms. It may also be used after surgery to kill any remaining cancer cells at the tumor site to reduce likelihood of recurrence.
City of Hope is a leader in image-driven radiation planning, using advanced imaging technologies — such as computed tomography, magnetic resonance imaging and positron emission tomography scans — to determine tumor size and location and “sculpt” radiation delivery to the cancerous areas. This ensures radiation is accurately delivered to the tumor site, while minimizing exposure to nearby normal tissues.
Drug therapy may be given to patients to fight head and neck cancer cells throughout the body by killing the cancer cells or stopping their growth and spread. These drugs include:
- Chemotherapy, which targets rapidly dividing cells, including cancer cells
- Targeted therapy, which selectively attacks cancer cells based on specific characteristics
- Immunotherapy, which stimulates the patient’s own immune system to recognize and attack cancer cells
The drug or drug combination used depends on the type and stage of head and neck cancer, previous treatments used, the patient’s health and overall treatment goals. This personalized medicine approach may be further enhanced by molecular or genetic testing of your cancer, which can help identify treatments that are more effective and/or less toxic.
City of Hope patients may also be eligible for new, promising drugs through our clinical trials program.
City of Hope’s renowned physicians and researchers utilize the latest in technology and innovation to treat cancer, coupled with our enduring belief in providing unparalleled compassionate care.
Otolaryngology/Head and Neck Surgery
Research and clinical trials for head and neck cancers
At City of Hope, head and neck cancer clinicians and researchers collaborate extensively to develop and evaluate new therapies for better survival and quality-of-life outcomes. Our patients have access to a wide variety of clinical trials, including new chemotherapy and targeted therapies, novel surgical techniques, innovative radiation approaches and new prevention strategies.
These trials give current patients access to promising, leading-edge therapies and improve overall care for future patients worldwide. Visit our clinical trials page to learn more about current studies and their eligibility criteria.
Our current head and neck cancer clinical trials include:
- 14145: Phase II Randomized Trial of Transoral Surgical Resection Followed by Low-dose or Standard-dose IMRT in Resectable p16+ Locally Advanced Oropharynx Cancer
- 14255: STAT3 Signaling During Chemo-Radiation for Squamous Cell Carcinoma of the Head and Neck
- 14340: A Phase II, Randomized, Open-Label, Multi-Center, Global Study of MEDI4736 Monotherapy, Tremelimumab Monotherapy, and MEDI4736 in Combination with Tremelimumab in Patients with Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck (SCCHN)
- 14258: Randomized Phase II and Phase III Studies of Individualized Treatment for Nasopharyngeal Carcinoma Based on Biomarker Epstein Barr Virus (EBV) Deoxyribonucleic Acid (DNA)
- 09188: A Multi-Histology Phase II Study of 5-Fluoro-2'-Deoxycytidine with Tetrahydrouridine (FdCyd+THU)
City of Hope is a recognized leader in thyroid cancer research. We offer access to numerous clinical trials and new therapies that are not readily available elsewhere. Our latest research includes developing more precise surgical and radiation techniques for better tumor removal, identifying drugs that can better fight the cancer throughout the body and boosting quality of life for our patients and survivors.
Our current head and neck clinical trials include:
14145: Phase II Randomized Trial of Transoral Surgical Resection Followed by Low-dose or Standard-dose IMRT in Resectable p16+ Locally Advanced Oropharynx Cancer
14255: STAT3 Signaling During Chemo-Radiation for Squamous Cell Carcinoma of the Head and Neck
14340: A Phase II, Randomized, Open-Label, Multi-Center, Global Study of MEDI4736 Monotherapy, Tremelimumab Monotherapy, and MEDI4736 in Combination with Tremelimumab in Patients with Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck (SCCHN)
14258: Randomized Phase II and Phase III Studies of Individualized Treatment for Nasopharyngeal Carcinoma Based on Biomarker Epstein Barr Virus (EBV) Deoxyribonucleic Acid (DNA)
09188: A Multi-Histology Phase II Study of 5-Fluoro-2'-Deoxycytidine with Tetrahydrouridine (FdCyd+THU)
Living with a head and neck cancer
Once I was done with treatments, I was hiking and getting back on track as soon as I was able." Kurt Deetz, head and neck cancer survivor
When you come to City of Hope, you automatically gain access to an unparalleled array of support services to help you and your loved ones take each step during and after your head and neck cancer treatment.
We can help with all of the following concerns, and more:
- Managing symptoms and side effects, such as pain, nausea and fatigue
- Rehabilitating your ability to speak, chew and swallow after therapy
- Adjusting to dietary changes
- Handling emotional, social and spiritual issues
- Coping with stress
- Navigating the health care system
- Maintaining a healthy lifestyle with expert nutrition and physical activity guidance
- Building caregiver skills
- Improving communications with family, partners and loved ones
- Restoring normalcy in your family, job or school routine
- Healing arts workshops to restore the body and mind
- Returning to wellness after active treatment
For more information about the supportive care programs we offer, please contact the Sheri & Les Biller Patient and Family Resource Center at 626-218-CARE (2273).