Head and Neck Cancers

Head and neck cancers are tumors affecting various areas around the head, neck and throat. Some of the cancers commonly treated at Indiana University Health Melvin and Bren Simon Cancer Center include:

  • Oral cavity (mouth, lips, gums, cheeks, tongue, palate and mouth floor)
  • Pharynx or throat including the oropharynx (behind the mouth), nasopharynx (behind the nasal passage) and hypopharynx (behind the voice box)
  • Larynx (voice box)
  • Thyroid and parathyroid (glands on the throat below the Adam’s apple)
  • Salivary glands
  • Skin of the head and neck, including melanoma (malignant skin tumors)
  • Nasal cavity and paranasal sinuses (spaces in the bones of the face that are connected to the nasal cavity)
  • Skull base
  • Ear and temporal bone (portion of skull beside the ear)
  • Eye
  • Neck

Symptoms of head and neck cancers vary based on the site of the cancer. Some common symptoms include:

  • Sores in the mouth or throat that last four weeks or longer
  • Hoarseness
  • Difficulty swallowing
  • Lumps or bumps on the neck
  • Sores on the head or neck that don’t improve

Tobacco is implicated in about 85 percent of head and neck cancers, particularly when tobacco is used with alcohol. HPV (human papilloma virus) can also be a cause of cancers of the throat. HPV-related cancers can affect even healthy people who don’t have other risk factors.

Tumors of the head and neck can present particular challenges for treatment because the areas to be treated can have an impact on speech, swallowing and hearing. Early diagnosis is critical to improve outcomes and reduce side effects from treatment. Medical teams at IU Health Melvin and Bren Simon Cancer Center devote particular care to helping you maintain these vital functions.

Head and Neck Cancer Diagnosis

Physicians at IU Health Simon Cancer Center use a full range of diagnostic tools to determine your particular treatment needs. Diagnostic tools include:

  • Clinical examination, which can reveal lumps or other abnormalities.
  • Blood testing, which detects substances in the blood that may indicate the presence of cancer.
  • Biopsy, which is the removal of cells or tissue for examination under a microscope.
  • CT, MRI and PET scans, which take detailed internal pictures of the head and neck, allowing visual examination of tumors.
  • Fiber optic laryngoscopy or nasopharygoscopy, which use a lighted tube to examine the:
    • Larynx (voice box)
    • Nose or pharynx (extending from behind the nose to the top of the windpipe)
    • Esophagus (tube leading from the mouth to the stomach)

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Head and Neck Cancer Treatment

Our head and neck cancer team is made up of a multidisciplinary group of physicians and practitioners who specialize in diagnosis and management of malignancies of the head and neck. We use all major surgical, radiation and chemotherapy techniques, and are able to determine the best treatment plan for each individual patient. Our goal is to optimize the likelihood of cancer cure, while minimizing the side effects of treatment.  
 
Within our surgical group, we have fellowship trained head and neck surgeons who specialize in advanced techniques used for removing cancers from the face, mouth, throat, voice box, thyroid, salivary glands, and skull base. These same surgeons, along with members of the head and neck reconstructive team, can repair tissue affected by surgery to minimize impact on speech, swallowing, and cosmetic appearance.

Treatment of head and neck cancers is unique for each patient. Particular treatments recommended by our multidisciplinary team depend on the location and extent of cancerous tissue. Your treatment may include one or more of the following:

  • Surgical excision, which removes the cancer, and sometimes surrounding tissues and lymph nodes to prevent recurrence of the cancer.
  • Reconstruction, which reshapes or rebuilds a part of the head or neck area changed in surgery.
  • Chemotherapy, which is a series of drug treatments to kill cancer cells.
  • Radiotherapy, which destroys cancer cells and shrinks tumors.
  • Chemoradiation, in which chemotherapy and radiotherapy are used at the same time.
  • Chemoprevention, the use of chemotherapy to prevent a second cancer.
  • Dentistry, which is used to maintain and improve the function of the mouth during and after treatment.

Our physicians are experts in the use of transoral laser and microsurgery to remove small tumors in the throat. We use da Vinci robotic surgery to remove tumors with less invasive surgery and fewer surgical side effects, and proton beam radiation therapy to treat head and neck tumors in sensitive areas near important structures such as the base of the skull and optic nerves.

Radiation therapy treatments can include:

  • Computed Tomography (CT) Simulation. A radiation planning process using a CT scan to define tumor targets and internal anatomy in three dimensions to enable the radiation oncologist to precisely target the tumor while saving normal tissues.
  • Four-Dimensional CT Simulation. A CT simulation which also visualizes internal anatomy changes (such as changes in tumor location with the breathing cycle) allowing the radiation oncologist to target the tumor more accurately and further spare normal tissues.
  • Image Guided Radiation Therapy (IGRT). Uses precise radiographic imaging to more precisely target tumors while sparing normal tissues.
  • Cone-Beam Computed Tomography (CBCT). An IGRT technique that uses a limited CT scan prior to treatment to target internal anatomy in three dimensions.
  • Three-dimensional conformal radiotherapy. Guided by a computer-generated three-dimensional picture of the tumor, allowing the highest possible dose of radiation while sparing the normal tissue as much as possible.
  • Intensity Modulated Radiation Therapy (IMRT). Advanced radiation delivery that allows delivery of radiation to areas surrounded or in close proximity to radiation sensitive tissues by using a computerized optimization algorithm.
  • Stereotactic Body Radiation Therapy (SBRT). Special equipment is used to precisely deliver a large radiation dose to a tumor and not to normal tissue.
  • Proton Beam Radiation. Particle radiation that can be used to treat tumors in close proximity to critical radiation sensitive tissues.
  • Endobronchial High Dose Rate Brachytherapy (HDR). Treatment performed in conjunction with a pulmonologist for obstructing tumors in the main airways by delivering local radiation from inside the body in close proximity to the tumor.

After surgery, if your speech is affected, a speech therapist will help you recover your ability to speak naturally.

In addition to excellent medical care, we offer supportive care through the CompleteLife Program. This program is available to support and educate you by tending to your emotional, social and spiritual needs.

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Head and Neck Cancer Specialists

Head and Neck Cancer Surgery

Joseph Brigance, M.D.
Gary Dunnington, MD.
Michael G. Moore, M.D.
Hadley Ritter, MD.

Radiation Oncology

Robert B. Barriger, M.D.
Peter Johnstone. M.D.
Mark Langer, M.D.

Head and Neck Reconstructive Surgery

Michael G. Moore, M.D.
Joseph Brigance, M.D.
Taha Shipchandler, M.D.
William Wooden, M.D.
Juan Socas, M.D. 

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Head and Neck Cancer Research

Indiana University is a participating center for a study called "Observational Study of Swallowing Function after Treatment of Laryngeal Cancer." Dr. Bevan Yueh, at the University of Minnesota, directs this study overall, and Dr. Michael Moore directs the portion of the research done at IU Health Simon Cancer Center.
 
Information about cancer research can be found here.

Clinical Trials

Clinical trials at IU Health Simon Cancer Center make the latest treatments available to you. If you qualify, you may be enrolled in one or more of our current trials, which focus on improving the treatment of metastatic cancer (cancer that has spread from the original site), and on improving long-term outcomes after receiving treatment for larynx cancer.

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