Surgery is a common treatment for oropharyngeal cancer. Cancers of the oropharynx often spread to the lymph nodes in the neck. Depending on the stage and exact location of the cancer, it may be necessary to remove these lymph nodes by an operation called a neck or lymph node dissection. There are several types of neck dissection procedures, and they differ in how much tissue is removed from the neck.
- Partial or Selective Neck Dissection - Only a few lymph nodes are removed.
- Modified Radical Neck Dissection - Most lymph nodes on one side of the neck between the jaw bone and collarbone and some muscle and nerve tissue are removed.
- Radical Neck Dissection - Nearly all nodes on one side and muscles, nerves and veins are removed.
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Radiation Therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Side Effects Management
It helps to learn more about the side effects from your treatment(s) before you begin, so you will know what to expect. When you know more, you can work with your health care team to manage your quality of life during and after treatment.
There are effective and readily available medications to address traditional side effects from cancer treatment (such as nausea, diarrhea, constipation and mouth sores.) Also, as newer 'targeted therapies' become available, they tend to leave people with fewer traditional side effects.
Keep in mind that everyone reacts differently to treatment and experiences side effects differently. There are coping mechanisms and strategies that can help.
Side Effects from Oropharyngeal Treatments
The most common side effects of any neck dissection are numbness of the ear, weakness when raising the arm above the head, and weakness of the lower lip. These side effects are caused by injury during the operation to certain nerves that supply these areas.
After a selective neck dissection, weakness of the arm and lower lip usually go away after a few months. But if either nerve is removed as part of a radical neck dissection or because of involvement with tumor, the weakness will be permanent.
Cancers of the head and neck are treated by operations that remove part of the facial bone structure. The changes are visible, so they can be devastating. Recent advances in facial prostheses are now giving patients the ability to have a more normal look and also improving vocal clarity (another side effect of surgical treatments.)
Side effects of external radiation therapy may include skin changes, nausea and vomiting, diarrhea, fatigue, painful sores in the mouth and throat and dry mouth or thick saliva. Most side effects of radiation are temporary, but some rare serious side effects can be permanent. In some cases, radiation to the chest can also cause lung damage, which may lead to problems breathing and shortness of breathe.
Chemotherapy has different side effects depending on the type and dose of drugs given and the length of time they are taken. These side effects can include hair loss, mouth sores, loss of appetite, nausea and vomiting, diarrhea, increased chance of infections (due to low white blood cell counts), easy bruising or bleeding (due to low blood platelet counts) and fatigue (due to low red blood cell counts).