|Image 1 : Throat Cancer Patien|
Treatment falls into two categories: treatment to fight the cancer and treatment to relieve the symptoms of the disease and the side effects of the treatment (supportive care). Depending on the type of cancer and how far it has spread, you may be treated with one or a combination of therapies.
Revolutionary new technologies in robotics and laser surgery have ushered in a new era of surgery for throat cancer. That is the most advanced equipment and technology to perform advanced surgeries such as the following:
- Minimally invasive or endoscopic surgery: This new technique allows surgeons to remove whole tumors through the mouth, without incisions and little or no change in speech and swallowing function.
- Transoral Laser Microsurgery (TLM): A flexible, hollow-core fiber transmits CO2 laser energy, enabling surgeons to reach otherwise unreachable areas and to perform a 360-degree resection around tumors in ways that were previously not possible.
- Transoral Robotic Surgery (TORS): Robotic-assisted surgery offers the advantages of computer technology, specialized surgical instruments and advanced three-dimensional imaging.
- Supracricoid Partial Laryngectomy: The supraglottis, vocal cords and thyroid cartilage are removed, while other structures that are needed to swallow and produce speech are spared.
2. Radiation therapy
Radiation therapy involves the use of a high-energy beam to kill cancer cells. Radiation therapy uses high-energy beams from sources such as X-rays and protons to deliver radiation to the cancer cells, causing them to die.
- Radiation can be used instead of surgery for many stage I and II cancers, because surgery and radiation have equivalent survival rates in these tumors. In stage II cancers, tumor location determines the best treatment. The treatment that will have the fewest side effects is usually chosen.
- Stage III and IV cancers are most often treated with both surgery and radiation. The radiation is typically given after surgery. Radiation after surgery kills any remaining cancer cells.
- External radiation is given by precisely targeting a beam at the tumor. The beam goes through the healthy skin and overlying tissues to reach the tumor. These treatments are given at the cancer center. Treatments are usually given once a day, five days a week, for about six weeks. Each treatment takes only a few minutes. Giving radiation this way keeps the doses small and helps protect healthy tissues. Some cancer centers are experimenting with giving radiation twice a day to see if it increases survival rates.
- Unfortunately, radiation affects healthy cells as well as cancer cells. Damage to healthy cells accounts for the side effects of radiation therapy. These include sore throat, dry mouth, cracked and peeling lips, and a sunburn-like effect on the skin. It can cause problems with eating, swallowing, and speaking. The patient may also feel very tired during, and for some time after, these treatments. External beam radiation can also affect the thyroid gland in the neck, causing the level of thyroid hormone to be low. This can be treated.
- Internal radiation therapy (brachytherapy) can avoid these side effects in some cases. This involves implanting tiny radioactive "seeds" directly into the tumor or in the surrounding tissue. The seeds emit radiation that destroys tumor cells. This treatment takes several days and the patient will have to stay in the hospital during the treatment. It is less commonly used for oral cancers than external radiation therapy.
Chemotherapy may be used to shrink a tumor before surgery or kill lingering cancer cells after surgery and/or radiation treatment. A combination of chemotherapy and radiation therapy may be used as a primary treatment for patients with larger tumors or those who cannot tolerate surgery.
4. Targeted drug therapy
Targeted drugs treat throat cancer by taking advantage of specific defects in cancer cells that fuel the cells' growth. Cetuximab (Erbitux) is one targeted therapy approved for treating throat cancer in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of throat cancer cells.
Other targeted drugs are being studied in clinical trials. Targeted drugs can be used in combination with chemotherapy or radiation therapy.
5. Rehabilitation after treatment
Treatment for throat cancer often causes complications that may require working with specialists to regain the ability to swallow, eat solid foods and talk. During and after throat cancer treatment, your doctor may have you seek help for:
- The care of a surgical opening in your throat (stoma) if you had a tracheotomy
- Eating difficulties
- Swallowing difficulties
- Stiffness and pain in your neck
- Speech problems
Your doctor can discuss the potential side effects and complications of your treatments with you.
Treatment of recurrent tumors, like that of primary tumors, varies by size and location of the recurrent tumor. The treatment given previously is also taken into account. For instance, sometimes further surgery can be done. If a site of recurrence was already treated by external radiation therapy may be difficult to treat a second time with external radiation. Often chemotherapy may be tried if a recurrence is inoperable, or further radiation with curative intent is not feasible.
Weight loss is a common effect in people with head and neck cancers. Discomfort from the tumor itself, as well as the effects of treatment on the chewing and swallowing structures and the digestive tract, often prevents eating.
Medications will be offered to treat some of the side effects of therapy, such as nausea, dry mouth, mouth sores, and heartburn.
The patient will probably see a speech therapist during and for some time after treatment. The speech therapist helps the patient learn to cope with the changes in the mouth and throat after treatment so that he or she can eat, swallow, and talk.