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Radiation Therapy

There are two types of radiation used for head and neck cancer. External-beam radiation therapy is given from a machine outside the body. Internal radiation therapy (brachytherapy) is given using implants.

Side effects:

  • Head and Neck Lymphedema
    • This is swelling caused by extra lymph fluid that builds up in tissues. It can occur from tissue damage after radiation therapy. This can affect speech and swallowing function. Head and neck lymphedema is treated with manual lymphatic drainage and, in some cases, compression bandages. If you feel or notice any swelling, let your health care team know immediately.
  • Trismus
    • This is when your mouth doesn’t fully open. It can be caused by tissue damage from radiation. Trismus is treated with exercise therapy and devices to help stretch your mouth opening.

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Chemotherapy

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. There are many different chemotherapy drugs that doctors can use against head and neck cancer. The most commonly used drugs include:

  • Cisplatin (Platinol®)
  • Carboplatin(Paraplatin®, Onxol®)
  • Fluorouracil (Adrucil®)
  • Methotrexate (Rheumatrex®, Trexall®)
  • Paclitaxel (Taxol®)
  • Docetaxel (Docefrez®, Taxotere®)

Your doctor may recommend chemotherapy along with your radiation therapy to increase the tumor’s sensitivity to treatment. The combination of radiation plus chemotherapy is called chemoradiation.

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Targeted Therapy

Targeted therapy is a type of cancer treatment that targets a specific error (mutation) that is helping the cancer grow, divide, and spread. In head and neck cancer, drugs that block EGFR like Cetuximab (Erbitux®) can help stop or slow tumor growth. These drugs may be used alone or combined with radiation therapy. For more advanced cancers, doctors may prescribe a combination of the targeted therapy and standard chemotherapy drugs.

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Immunotherapy

Immunotherapy is a treatment that helps your immune system fight the cancer better. Two immunotherapy drugs, known as checkpoint inhibitors, are approved for head and neck cancer:

  • Pembrolizumab (Keytruda®)
  • Nivolumab (Opdivo®)

These drugs may be used alone or in combination with chemotherapy.

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