Radiation therapy combined with chemotherapy (chemoradiation) is the most common treatment. In most cases, surgery is only required if the tumor returns after chemoradiation therapy.
Radiation therapy, including intensity modulated radiation therapy, stops cancer cells from dividing and slows the growth of the tumor. Radiotherapy also destroys cancer cells and can shrink or eliminate tumors. Intensity modulated radiation therapy allows the use of more effective radiation doses with fewer side effects than conventional radiotherapy techniques.
Radiation therapy involves 5-6 weeks of daily treatments.
Chemotherapy is prescribed for different reasons:
- Together with radiotherapy as an alternative to surgery (called chemoradiation)
- After surgery to decrease the risk of the cancer returning
- To slow the growth of a tumor and control symptoms when the cancer cannot be cured (palliative treatment)
In most cases, surgery is only required if the tumor returns after chemoradiation therapy.
If the tumor is small, the surgeon can perform transoral laser microsurgery. The laser is on a small metal scope (tube). The patient is given anesthesia before the surgery begins. The laser is inserted into the mouth and the beam from the laser is used to excise the tumor, and one centimeter (2.5 inches) of tissue around it.
After the surgery, a small nasogastric feeding tube (NG tube) is inserted through a nostril and into the stomach because the patient cannot eat until the surgical area heals. Healing takes about two weeks. During this time, the patient will receive liquefied food through the NG tube. The patient can go home three to five days after surgery with the NG tube in the nostril.
Larger tumors require a traditional incision with a scalpel. Before the surgery begins the patient is given anesthesia. The surgeon makes an incision in the neck, under the chin, to locate and remove the tumor. The open area is then reconstructed and closed with a flap of skin or muscles from the arm or other part of the body.
If the lymph nodes in the neck are affected, a neck dissection may be needed to remove the nodes.