Head & Neck Cancer Treatment

At MD Anderson, head and neck cancer patients are treated by a team of expert doctors. These specialists include medical oncologists, radiation oncologists and surgeons. They focus exclusively on cancers in the head and neck. This gives them incredible experience, skill and expertise to call on when caring for patients. They work together to develop a personalized and coordinated treatment plan designed just for you.

These treatments may include:

• Minimally invasive surgical procedures that offer shorter hospital stays and faster recovery times.
• Advanced radiation therapy techniques, such as proton therapy and volumetric modulated arc therapy (VMAT), which limit radiation exposure to healthy tissue near the tumor.
• Stereotactic body radiation therapy, a powerful and precise form of radiation that can be completed in just a few sessions.
• Immunotherapy, which recruits the body’s immune system in the fight against cancer.
• Targeted therapy, which slows or stops the growth of cancer on the cellular level.

Surgery

Surgery is a key treatment for many types of head and neck cancer. Surgeons may perform the procedure using live MRI images of the tumor site or with CT or MRI images taken just before the patient goes into the operating room.

Surgery for head and neck cancer may include:

Open surgery

During open surgery, incisions are made in the skin of the head and neck to expose the tumor. These incisions often can be hidden in the hair, skin creases, nose or mouth.

The tumor and the tissue it impacts are removed, with the surgeon taking care to protect important nerves and blood vessels. After the tumor is removed, the incision is closed. When needed, plastic surgeons rebuild the soft tissues and bone to optimize function and appearance. When muscles and nerves are affected, highly specialized plastic surgeons may provide facial reanimation and complex craniofacial reconstruction.

Minimally invasive surgery

Minimally invasive surgeries are performed without making an incision in the skin, or with only a few small incisions. Compared to open surgery, they typically require shorter hospital stays, have shorter recovery times and fewer complications. There are different types of minimally invasive surgery, including:

• Endoscopic surgery: An endoscope is a thin, flexible tube with a camera and surgical instruments at the end.
• Laser surgery: In laser surgery, doctors use lasers to kill or cut away cancerous tissue. Laser surgery for head and neck cancer is often performed with an endoscope.
• Robotic surgery: During these procedures, the surgeon uses robotic tools to access the tumor site. This lets the surgeon perform complex procedures in small spaces, like the throat, without making large incisions.

Radiation therapy

Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different types of radiation therapy. Doctors can use these to accurately target a tumor while minimizing side effects to healthy tissue.  

Learn more about radiation therapy.  

Types of external beam radiation include:

• Intensity modulated radiation therapy (IMRT) is a form of external beam radiation therapy that focuses multiple X-ray beams of different intensities and at different angles directly on the tumor. This delivers radiation to the tumor while limiting radiation exposure to healthy tissue. One form of IMRT is volumetric modulated arc therapy (VMAT), which uses a rotating treatment machine to deliver radiation at more angles.
• Proton therapy: Like IMRT, intensity modulated proton therapy uses multiple beams of different intensities. Instead of X-rays, these beams are made of positively charged particles (protons). Protons have no exit dose, meaning they do not impact tissue beyond the tumor. This may allow doctors to target tumors while limiting radiation exposure to healthy tissue, potentially reducing side effects. Learn more about proton therapy.
• Stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy, or stereotactic ablative body radiation (SABR) precisely targets tumors with very high levels of radiation in fewer doses and a shorter time than other types of radiation. SBRT achieves this by using several radiation beams of various intensities aimed at the tumor from different angles. Learn more about SBRT.

In addition, head and neck cancer can be treated with brachytherapy. Brachytherapy delivers radiation with small pieces of radioactive material (usually about the size of a grain of rice or small piece of wire). This material is placed on or inside the patient’s body, either inside the tumor or as close to the tumor site as possible. This allows doctors to deliver very high doses of radiation directly to the patient’s tumor, or to the tumor site after the tumor has been surgically removed. This may reduce radiation damage to healthy tissue. Learn more about brachytherapy.

Chemotherapy

Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.

Learn more about chemotherapy.

Hormone therapy

Different hormone levels can encourage the growth of certain cancers. Hormone therapy can be used to modify hormone levels in the patient’s body.

Targeted therapy

Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them. 

Learn more about targeted therapy.

Immunotherapy

The immune system finds and defends the body from infection and disease. Cancer is a complex disease that can evade and outsmart the immune system. Immunotherapy improves the immune system’s ability to eliminate cancer.

Immunotherapy can be used to treat some head and neck cancers and cancer that has spread, or metastasized, to other parts of the body.

Learn more about immunotherapy.

There are several types of immunotherapy. Currently, immune checkpoint inhibitors are approved to treat head and neck cancer. Immune checkpoint inhibitors stop the immune system from turning off before cancer is completely eliminated. Learn more about immune checkpoint inhibitors.

Cryoablation

Cryoablation, also known as cryotherapy or cryosurgery, uses cold to kill tumor cells. During the procedure, a special probe is inserted into the tumor and then cooled to temperatures well below freezing. A ball of ice forms at the tip of the probe, freezing and destroying cancerous tissue. Cryotherapy is not as invasive as surgery and can sometimes be performed as an outpatient procedure.

Learn more about cryoablation.

Active surveillance

Some head and neck cancers can be slow growing. In these cases, doctors may recommend active surveillance. This approach involves closely monitoring the disease without active treatment. Treatment begins only if the disease progresses to a pre-set point.

Clinical trials 

Clinical trials are a key component of MD Anderson's mission to end cancer. MD Anderson uses clinical trials to find better ways to prevent, diagnose and treat cancer. Doctors use these trials to learn more about how to fight cancer. Your doctors will recommend a clinical trial only if they believe it is the best treatment for you.

MD Anderson has one of the largest clinical trials programs in the world and offers trials for practically every type of head and neck cancer. These trials may offer new immunotherapy treatments, targeted therapy, radiation therapy and more.

Learn more about clinical trials.

Specialized care for head & neck cancer patients

Head and neck cancer and its treatments can impact patients' ability to eat, drink and speak, as well as their appearance. MD Anderson offers therapies and services to help head and neck cancer patients adjust to and overcome these challenges as much as possible.

Audiology and otology care: Audiologists at MD Anderson examine patients for the tumor’s impact on hearing and balance and provide care, if needed. Our otologists are medical doctors who specialize in diagnosing and treating diseases and conditions of the ear.

Speech therapy: MD Anderson speech pathologists and audiologists offer patients the most advanced techniques for restoring speech after head and neck cancer treatments.

Swallowing therapy: Experts in MD Anderson’s speech pathology and audiology group are dedicated to evaluating and treating patients who have or may develop difficulty drinking and swallowing after treatment. MD Anderson’s swallowing service is one of the leaders in this field and serves as a model for the management of patients treated for head and neck cancers.

Dental care: The teeth and jaw of head and neck cancer patients can be damaged by the disease and its treatments. MD Anderson dentists specialize in designing implants and performing procedures to help head and neck cancer patients restore appearance and function.

Survivorship: MD Anderson has a survivorship clinic dedicated to the needs of patients who have been successfully treated for head and neck cancer.

Regular follow-up and screenings are vital due to the risk of the cancer recurring, or coming back. Patients typically see their doctors every few months for the first few years after treatment, when the chance or recurrence is highest. After that period, patients can be seen less frequently, but will still need lifelong survivorship care to monitor for long-term effects of cancer and its treatments.

Head and neck patients are also strongly urged not to smoke or drink alcohol during and after treatment. Drinking and smoking can make treatments less successful and worsen side effects during treatment. They can also greatly increase the chance of the cancer returning or of the patient developing a second cancer.

Learn more about the treatments for: 

• Eye cancer
• Oral Cancer
• Parathyroid disease
• Pituitary tumors
• Retinoblastoma
• Salivary gland cancer 
• Skull base tumors
• Throat cancer
• Thyroid cancer

Some cases of head and neck cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.