Nuclear Oncology

The three main types of treatment for managing head and neck cancer are radiation, surgery and chemotherapy. The primary treatments are surgery or radiation, or a combination of both, chemotherapy is often used as an adjunct or adjuvant. The optimal combination of the three treatment modalities for a patient with head and neck cancer depends on the site and stage (stage) of disease.

In general, patients with head and neck cancer in early stages (especially cancers limited to the site of origin) are treated with a single modality, either radiation therapy or surgery. Patients with more widespread cancer is often treated with concurrent chemotherapy and radiotherapy. Sometimes, depending on the clinical scenario, patients are treated with surgery followed by postoperative radiotherapy and chemotherapy.

If the plan of treatment is radiation therapy alone for primary cancer, is also given radiotherapy to the neck. Furthermore, it may be necessary to remove the lymph nodes of the neck if the condition in the neck nodes is relatively large or if the cancer in the neck nodes has not been fully removed upon completion of the course of radiotherapy.

Surgery is another treatment that may be necessary before or after radiation therapy. In general, if indicated, surgical removal of primary tumor, radiotherapy is given later, if needed. However, sometimes the cancer is large or can not be removed completely at first. The radiation is then given first to try to shrink the tumor, and surgery follows radiotherapy.

Recent studies indicate that chemotherapy given at the same time as radiotherapy is more effective if given before radiotherapy. Therefore, the schedule of radiation therapy often includes chemotherapy if the cancer is advanced (advanced stage III or IV). The drugs are often given together with radiation therapy are cisplatin (Platinol) and Cetuximab (Erbitux). Sometimes, other drugs may include fluorouracil (5-FU, Adrucil), carboplatin (Paraplatin) and paclitaxel (Taxol). This is an incomplete list of chemotherapy drugs and your doctor may choose others. Chemotherapy can be administered in various ways, such as a low daily dose, a moderate dose every week, or a relatively high dose every three to four weeks.