Head & Neck Cancer

Head and neck cancer is an overall term to describe many different cancers that can affect a person’s face (including ears, nose, lips and scalp), mouth, jaw bones, tongue, throat, voice box, thyroid and salivary glands. Surgery is often used as the main treatment for head and neck cancer.

About head & neck cancer 

  • While many head and neck cancers start in the moist lining of the mouth, nose or throat, it is not just one type of cancer.

  • Cancers of the head and neck are named after the area of the head of neck where they begin (eg mouth cancer, throat cancer, salivary gland cancer, skin cancer).

  • Treatment for head and neck cancer can affect a person’s identity in profound ways – affecting speech, changing facial features and taking away some of the everyday functions we take for granted like eating, breathing, drinking and swallowing.

  • Smoking, alcohol and excessive sun exposure are still the most common causes of head and neck cancers.

  • We now understand that infection with the human papillomavirus (HPV) also causes head and neck cancers of the throat in young, otherwise healthy, non-smoking men and women.

Treatment for head & neck cancers

Combined with the complex anatomy involved, head and neck cancers can develop quickly. Treatment often requires complex care that includes surgery, radiotherapy, and chemotherapy. It also requires support from dieticians, speech pathologists, counsellors and physiotherapists during and after treatment. This approach is known as multidisciplinary care.

Choosing your surgeon and MDT

In head and neck cancer, there is a strong correlation between surgical experience, surgical volume and better outcomes for patients. Having access to a multidisciplinary team (MDT) and multidisciplinary care is important for all types of head and neck cancer. Many head and neck procedures can be done at smaller hospitals as day or overnight procedures and will be discussed at an MDT meeting as required. Chris O’Brien Lifehouse and Wollongong Hospital are both high volume MDTs for head and neck cancer where your treatment will be discussed and enacted.

Testing and diagnosis

Diagnosing a tumour as cancer is an important first step, however, Dr Wykes will need to gather a lot more information about any tumours or lesions to plan your treatment correctly. Our team will work with your GP or help you arrange any further diagnostic tests needed.

Staging

Staging is where we work out how far the cancer has spread. In Australia, we use the TNM staging system for head and neck cancers. While each type of head and neck cancer is staged a little differently, letters and numbers are used to describe how large the tumour is (T), the degree of nearby lymph node involvement (N) and whether the cancer has spread (metastasised) to other organs (M).

Generally, stages 1-2 refer to early head and neck cancer (small, primary cancer that has not spread) and stages 3-4 refer to advanced head and neck cancer. That is, larger cancer that has spread to nearby tissue (locally advanced), lymph nodes (regional spread of cancer) or other parts of the body (metastatic cancer).

Planning for surgery with Dr Wykes  

Many cancers of the mouth, jaw and throat, as well as advanced skin cancers, will require the cancer to be removed along with the lymph nodes in the neck. The type of surgery you need depends on the location and size of your tumours. The options may include:  

  • Endoscopic surgery – where small instruments with a light and camera attached are inserted through the mouth – usually used to assess and biopsy tumours.

  • Transoral surgery – surgery for mouth, tongue and jaw surgery where the cuts are made inside your mouth but not on your face. Often combined with open neck surgery.

  • Transoral laser surgery – where a microscope with a laser attached is used to remove early cancers or pre-cancerous lesions through the mouth.

  • Open surgery – where cuts are made in the skin of the head and neck to reach and remove larger cancers or those in difficult positions.

  • Microvascular reconstructive surgery – where tissue with its own blood supply is transplanted into the head and neck to replace skin, jaw, tongue or the lining of the mouth.

Each surgical method has its own advantages. While minimally invasive surgery, such as endoscopic and laser microsurgery, has many benefits (eg less scarring and faster recovery), these types of surgery are not always possible with head and neck cancers, especially if they are advanced. Often open surgery is the best option for being able to clearly see what is going on and ensure that all areas affected by cancer are removed.

Dr Wykes will discuss the surgery with you before recommending the method most suitable for your condition.

Will I need to have reconstructive surgery?  

Reconstructive surgery uses a combination of skin, muscle and bone to rebuild facial structures after surgery. It is often recommended as part of treatment for large cancers. Dr Wykes specialises in microvascular reconstructive surgery and will discuss your need to have any reconstructive surgery prior to treatment.