Tests, Treatments and Therapies for Head and Neck Cancer at the University of Colorado Cancer Center

Staging & Detection Tests

The following tests and procedures may be used to find and classify (or “stage”) head and neck cancer:

• Barium swallow (Upper GI Series) – A series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken.
• Biopsy – The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.
• Bronchoscopy – An exam to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.
• CT Scan (computed tomography) – An X-ray procedure that creates detailed, highly accurate cross-sectional body images.
• Endoscopy – An exam to look at organs and tissues inside the body to check for abnormal areas. An endoscope (a thin, lighted tube) is inserted through an incision (cut) in the skin or opening in the body, such as the mouth. Tissue samples and lymph nodes may be taken for biopsy.
• Esophagoscopy – An exam to look inside the esophagus to check for abnormal areas. An esophagoscope (a thin, lighted tube) is inserted through the mouth or nose and down the throat into the esophagus. Tissue samples may be taken for biopsy.
• Exfoliative cytology – A procedure to collect cells from the lip or oral cavity. A piece of cotton, a brush or a small wooden stick is used to gently scrape cells from the lips, tongue, mouth or throat. The cells are viewed under a microscope to find out if they are abnormal.
• Laryngoscopy – A procedure in which the doctor examines the larynx (voice box) with a mirror or with a laryngoscope (a thin, lighted tube).
• MRI scan  (magnetic resonance imaging ) – An imaging technique that provides detailed images of body structures. It uses a magnetic field instead of the X-rays used in a CT scan.
• PET scan (positron emission tomography) – An imaging test used to light up cancer in different parts of the body. A short-lived radioactive substance is injected prior to the scan. Cancerous tissue will absorb more of the substance, and appear brighter than normal tissue on the PET images. Other non-cancerous tissues, such as areas of inflammation, may also “light up.”
• Physical exam – An examination in which the doctor will feel for swollen lymph nodes in the neck, look down the throat with a small, long-handled mirror to check for abnormal areas and check the lips and oral cavity for abnormal areas.
• Serum tumor marker test – Your blood sample is checked to measure the amounts of certain substances released into the blood by organs, tissues or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers.
• Ultrasound – An exam in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
• X-rays – An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Treatments & Therapy

Treatment for head and neck cancer varies greatly from person to person. Your medical team may use any combination of surgery, chemotherapy, radiation, targeted therapy or new immunotherapy to treat or control your cancer.

Surgery

Surgery may be part of an overall treatment plan or may be used for treating recurrence or new tumors. A specially-trained head and neck surgical oncologist removes a tumor and some tissue around it. The surgeon also may remove some nearby lymph nodes.

Surgery may employ the use of lasers to do precise surgery and remove cancer or precancerous growths or to relieve symptoms of cancer. Laser surgery is used most often to treat cancers on the surface of the body or the lining of internal organs.

Radiation Therapy (“Radiotherapy”)

Radiation therapy involves using X-rays and other types of medical radiation. Aimed at specific parts of the body, it is used to kill cancer cells, prevent cancer cells from developing or recurring, and improve many of the symptoms caused by cancer. It can be used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”).

Chemotherapy

Chemotherapy involves using drugs proven to slow down, damage or kill cancer cells. This may involve single drugs or combinations of drugs taken intravenously or by mouth. Chemotherapy is often applied in three or four week cycles. Your medical team may also prescribe other drugs to reduce or eliminate chemotherapy’s side effects.

Anti-Cancer Drug Therapy

Single drugs or combinations of drugs taken through intravenous injections or as tablets/capsules prescribed to a patient to help fight the cancer itself or the side effects from chemotherapy. Patients may take the drugs in repeating patterns, called “cycles”, that usually last three to four weeks.

Targeted Therapy

Targeted therapies are anti-cancer drugs or other substances that directly interfere with cancer growth and progression on a molecular level. They may be taken (with few side effects) on their own or in combination with standard chemotherapy. Many new targeted therapies, including vaccines and gene therapies, are currently in development.

Clinical Trials

Your medical team may also recommend that you participate in a clinical trial. The University of Colorado Hospital conducts hundreds of clinical trials in an ongoing effort to discover and deliver more effective treatments. They may offer access to drugs, vaccines and new kinds of treatment years before they are widely available.

Other therapies being tested through clinical trials:

Angiogenesis Inhibitors

Angiogenesis inhibitors are substances that may prevent the formation of blood vessels. In anti-cancer therapy, an angiogenesis inhibitor prevents the growth of blood vessels to keep them from “feeding” a cancerous tumor.

Biologic therapy (biotherapy or immunotherapy)

These are treatments that join with the patient’s immune system to fight cancer. Substances – some made by the body, some made in a laboratory – help boost, direct or restore the body’s natural defenses against cancer.