Head and Neck Cancer

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Questions to Ask Your Doctor about Head and Neck Cancer
(Free Handout)

Treatment

• Lip
  For early disease, either surgery or radiation is the mainstays. The choice of one over the other depends on the size and location of the disease. Given the infrequency of spread to the lymph nodes, elective treatment of the neck is not necessarily required. In advanced disease (Stages 3 and 4), a combination of surgery and postoperative radiation is often required.

• Alveolar Ridge and Retromolar Trigone
  In early disease (Stages 1 and 2) surgery or radiation alone with elective neck treatment (secondary to the tendency for regional nodal spread) is most often utilized. For advanced stages, multimodality therapy with surgery and postoperative radiation is often used.

• Floor of Mouth
  Treatment of early disease (Stage 1 and 2) involves surgical resection. However, either surgery or radiation as single modalities of therapy may be utilized. In early disease, the treatment of the neck is controversial; some opt for elective neck treatment in clinically negative necks, while others take a wait-and-see approach, with treatment reserved for those who show development of disease. For advanced disease (Stages 3 and 4), combined modality treatment with surgery and radiation is recommended. Elective treatment of the neck is required in all cases of advanced disease.

• Tongue
  Use of either surgery or radiation in early stage disease yields comparable outcomes. In advanced disease, as in other oral cavity cancers, combined modality therapy with surgery and radiation is utilized.
  
  
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• Hard Palate
  For both early and advanced disease, surgery is used for primary therapy. Radiation has a role in advanced disease, depending upon the closeness or involvement of surgical margins by tumor, evidence of nerve involvement or the presence of lymph node metastases.

• Buccal Mucosa
  Small lesions (T1 or T2) can be handled equally well by either surgery or radiation. For patients with small lesions and clinically negative necks, observation can be performed rather than treatment of the neck. For more advanced lesions, treatment of the neck is advisable. In advanced cancers, treatment most often consists of surgery followed by postoperative radiation.

See oral cancer for more information.

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