At Carle Cancer Center, the latest state-of-the-art treatments and technologies are available to our patients. It is important to remember that different cancers require different treatments based on a variety of factors. For this reason, your treatment plan will be designed to meet the needs and requirements of your specific form of cancer.
Physicians will create an individualized treatment plan for each patient. Treatment plans depend upon:
- Exact location of tumor
- Stage of cancer
- Patient's age
- General health of patient
Patients and physicians will confer to carefully consider treatment options, while considering how the treatment might change a patient's appearance, speech ability, and eating and breathing. There is much to consider, and each step will be carefully analyzed for the best interest of the patient.
Treatment options may include:
Surgery is often the first method used in diagnosing or treating cancer. It may be followed by other treatments such as chemotherapy or radiation therapy. Some surgical procedures are done in an outpatient setting, while others may require hospitalization. Surgeons use the latest techniques to treat tumors and reconstruct tissue while restoring function and appearance.
Our surgeons, oncologists and other physicians work as a team to obtain the best possible outcome for our patients. Surgery may be performed to achieve one or more of the following goals:
- Preventive surgery is performed to remove growths or tissues that are likely to develop into cancer.
- Diagnosis and Staging
- A biopsy may be performed to discover whether a growth is cancerous, and if so, how far the disease has progressed.
- Curative surgery aims to remove an entire tumor.
- Tumor Reduction
- Called "debulking," this surgery is performed to remove the majority of a tumor. Some cancer cells may remain and may be removed by other treatment methods.
- Palliative surgery does not treat cancer but rather alleviates pain and other complications that a cancer may cause.
Reconstructive surgery addresses body image concerns resulting from cancer or cancer treatment. Options may include facial reconstruction or scar revision.
- Microvasular reconstruction - Microvascular head and neck reconstruction is a technique for rebuilding the face and neck using blood vessels, bone and tissue, including muscle and skin from other parts of the body. The technique is one of the most advanced surgical options available for rehabilitating surgical defects that are caused by the removal of head and neck tumors.
- Neck dissection and reconstruction - Standard surgery for excision of cervical nodal metastases resulting from head and neck cancer.
- Tracheostomy - Surgically created hole through the front of your neck and into your windpipe.
- Laryngectomy - Removal of the larynx and separation of the airway from the mouth, nose and esophagus.
Chemotherapy for head and neck cancer can be given orally or intravenously. The most common method of administration is directly into the bloodstream. The drugs travel through the bloodstream to reach all parts of the body. Targeted therapy for head and neck cancer is often considered chemotherapy since it is given intravenously as with chemotherapy. Traditional chemotherapy generally kills both cancer cells but also some normal cells. Targeted therapy interferes with the growth, progression and spread of the cancer cells whiel limiting damage on the normal cells. Chemotherapy for head and neck cancer is often given at the same time as radiation because some chemotherapies are considered radiosensitizers which means they work with the radiation to improve the treatment outcome. Chemotherapy as well as targeted therapy are usually given in cycles. Periods of chemotherapy treatments are alternated with rest periods when no chemotherapy is given. Chemotherapy may be administered in a single day, over the course of a few days, once a week or even once a month. The frequency of chemotherapy depends largely on the type of cancer and type of drug or drugs being given. The length of time for chemotherapy is based on research evidence guidelines, response to treatment and side effects encountered. Depending on the cell type and stage of head and neck cancer, most individuals receive chemotherapy for three to six cycles. Occasionally chemotherapy is given before surgery to help decrease the size of the cancer and improve the outcome after surgery. This type of chemotherapy is called neoadjuvant.
Very few chemotherapy treatments require hospital admission. Some chemotherapy drugs come in an oral form and can be taken at home. By far the most common setting for chemotherapy administration is in a specialized chemotherapy infusion center which is staffed by specially-trained infusion nurses.
Common chemotherapy drugs given for head and neck cancer include: Cisplatin, Taxotere, 5FU, and Methotrexate. The targeted therapy for head and neck cancer is Erbitux.
Side effects from chemotherapy can be well controlled or may not occur for some patients. Common side effects may include: hair loss, constipation, diarrhea, fatigue, appetite changes, nausea or vomiting, numbness or tingling of the hands and feet. Eribitux can cause the following side effects: allergic reaction during or after administration and an acne-like rash.
Radiation oncology aims to reduce tumors by creating chemical changes within cancer cells. Because it is highly localized, radiation therapy produces limited side effects and is one of the most precise treatment options available. Radiation therapy may be delivered in one of the following forms:
The most common type of radiation therapy, external beam radiation therapy is designed to target a specific part of your body. The treatment machines aim high-powered beams inside the body at cancer cells to prevent them from dividing.
A form of external beam therapy, intensity-modulated radiation therapy (IMRT) breaks the radiation into thousands of thin beams to better target the cancer and minimize effects on surrounding tissue.
Image-guided radiation therapy (IGRT), one of the most cutting edge innovations in fighting cancer, combines imaging and treatment capabilities on a single machine.
IMRT and IGRT are used together to treat cancers of the head and neck. The treatments are very precise, and require extreme accuracy in positioning. Because the positioning is so important, we use special immobilization devices to keep your body in the same position. One of the devices used is called a mask. A mask is a custom made plastic shell that is worn over the face or face/neck and is fixed to the treatment table. Wearing a mask reduces the possibility of any movement while you are being treated.
The mask is made in our department. A staff member will position you on a procedure table and drape a warm sheet of plastic mesh over your head. The mesh has plenty of ventilation, so you will be able to see and breath normally. As the mask cools, it becomes hard. It will be used each day you come for treatment.
See below for a picture of a mask that covers your head and neck area.