Our Approach to Head and Neck Cancer

The treatment of head and neck cancers has a dual focus: eliminating the cancer and providing the latest reconstructive procedures to restore patients’ appearance and ability to communicate and swallow. Siteman Cancer Center physicians have developed a number of leading-edge transoral endoscopic and transoral robotic minimally invasive surgeries. With transoral surgery, reconstruction can often be avoided.  Advanced reconstructive procedures, including tongue, facial soft-tissue, and skull-base reconstruction for larger defects or open surgery can often be done during the same procedure when the tumor is removed. Siteman’s head and neck cancer program can provide these broad-based treatments because of its strong multidisciplinary approach provided in a timely manner for patients anxious about their potential diagnosis. The team includes specialists in otolaryngology, radiation oncology, medical oncology, radiology, pathology, prosthodontics, oral surgery, speech therapy, audiology, psychology and dietetics. For head and neck cancer patients who come to Siteman, a multidisciplinary tumor board meets weekly to discuss testing and treatments.

Head and Neck Multidisciplinary Clinic

In July 2015, the Head and Neck Multidisciplinary (HNM) Clinic opened, in which otolaryngology, medical oncology and radiation oncology all see patients at the same time in the same place. After the different disciplines see the patient, they confer and return to the patient to discuss treatment options. You leave with that information, which can be very important if you came a long distances for this consultation. Experienced nurse coordinators, having gathered all previous medical information and testing prior to the visit, spend time with you, answering your questions and putting you in touch with resources that may help during this stressful time. These nurses can offer patient literature on your condition, surgery, radiation therapy, chemotherapy, and other related issues. As a unique feature of your care, Siteman also offers the services of a palliative care specialist who can help you fit treatment into your own special circumstances, if needed. Some of the head and neck cancers treated include:

Oropharyngeal Cancer:

The oropharynx is a middle part of the throat that includes the base of the tongue, the tonsils, the soft palate, and the walls of the pharynx. Oropharyngeal cancers can be divided into two types, HPV-positive, which are related to human papillomavirus infection, and HPV-negative cancers, which are usually linked to alcohol or tobacco use. Clinicians at Siteman have seen a spike in HPV-positive head and neck cancers in younger patients. Over the last sixteen years, the incidence in the U.S. has gone up 225 percent.

Hypopharyngeal Cancer:

This is a disease in which malignant cells grow in the hypopharynx, the area where the larynx and esophagus meet. This type of cancer is rare. Only about 2,500 cases are seen in the US each year.

Laryngeal Cancer:

Also known as cancer of the larynx or voice box, these are mostly squamous cell carcinomas, and most originate in the glottis, the vocal cords.

Lip and Oral Cavity Cancer:

These cancers originate in the mouth, most often the floor of the mouth, the jaw, the front of the tongue and the lips.

Nasopharyngeal Cancer:

These cancers occur in the uppermost region of throat behind the nose where the nasal passages and auditory tubes join the remainder of the upper respiratory tract.

Paranasal Sinus and Nasal Cavity Cancer:

These cancers form in the sinuses and nose.

Salivary Gland Cancer:

Cancer forms in tissues of salivary glands, including the parotid, submandibular, and sublingual glands and other minor glands located throughout the palate, nasal and oral cavity. Salivary gland cancer is rare, with 2 percent of head and neck tumors forming in the salivary glands, the majority in the parotid gland.

Head and Neck Sarcomas:

Approximately 15-20 percent of sarcomas occur within the head and mandible (jaw); the paranasal sinuses and neck are the most frequent sites of origin. Unlike the development of squamous cell carcinoma, the development of sarcomas is unrelated to smoking and alcohol use. In the head and neck, the most common sarcomas in adults are osteosarcoma, angiosarcoma, malignant fibrous histiocytoma, and fibrosarcoma. Types of treatment used for head and neck cancer depend on the stage at which it is diagnosed, generally stages I through IV. Staging is helpful in treatment planning. Washington University surgeons and oncologists at the Siteman Cancer Center treat more than 750 head and neck cancer patients a year, and are internationally recognized for their expertise. Siteman cancer physicians are actively involved in clinical trials that investigate new treatment regimens, and other approaches to cure. Having your cancer treated at Siteman gives you access to new therapies that are as good as – or potentially better than – current standard therapies available elsewhere.