Treatment for mouth, head and neck cancer
The treatment you have will depend on your age, your general health and the type of cancer. Your doctor will also explain to you if your treatment can cure or control the cancer.
Some of the treatments used for mouth, head and neck cancers are:
You may need one or two of these treatments or a combination.
- Dental check-up: Before you begin your treatment, your doctor may advise you to have a dental check-up. This is very important as your treatment may cause your mouth to become sore.
- Smoking and drinking: Your doctor might advise you not to smoke and drink alcohol at this time. Smoking and alcohol can cause your treatment to become less effective or increase the side-effects. If you would like to give up smoking, speak to your doctor, nurse or pharmacist. The National Smokers' Quitline is available for advice, support and information at Freefone 1800 201 203 (Monday–Sunday 8am–10pm).
Surgery is one of the main treatments for mouth, head and neck cancers. The aim of surgery is to remove the cancer cells. If the cancer is found early, surgery can often cure it. Depending on where the tumour is found, your surgeon may need to remove skin, muscle or bone along with your cancer. This can be replaced by skin or muscle or prosthesis. Your doctor will explain what to expect after surgery and if any scarring will happen.
Surgery may also affect how you eat or drink or how you look. A plastic surgeon might also work with your surgeon to reconstruct the affected area to give you the best possible function and appearance. This is called reconstructive surgery.
Depending on your surgery, you may need to stay in hospital for several days or even weeks. For the first few days after surgery, you might need to stay in the intensive care unit. It is normal to be attached to tubes and drips after your surgery for a few days. These include a drip to give you fluids, a tube going from your nose to your stomach (nasogastric tube) to feed you or a PEG tube going from the wall of your tummy directly into your stomach.
You may have a tube draining urine from your bladder (catheter) and some small tubes to drain any excess blood from your wound. For some patients swelling and bruising around the mouth or throat can make breathing difficult. Your surgeon may need to make an opening in your neck into your windpipe so that you can breathe easier. This is called a tracheostomy or stoma. After surgery, a team of health professionals will care for you and visit you regularly. This includes a dietitian, physiotherapist, social worker and speech and language therapist.
Radiotherapy is the use of high-energy rays to kill or shrink the cancer cells. Radiotherapy can be used alone or with other treatments like surgery or chemotherapy. If given after surgery, it can destroy any cancer cells left behind. There are two main ways to give radiotherapy: external beam radiation and internal radiation.
External beam radiation aims high-energy X-rays at a cancer to cure or control it. These X-rays come from a machine called a linear accelerator. The treatment does not hurt but you must lie very still during it. For most mouth, head and neck cancers, a ‘mask’ is needed. These masks are moulded from plastic to the shape of your face and make sure your head keeps still during treatment.
Internal radiotherapy involves giving radiotherapy from within your body. Usually an implant containing a source of radiation is put directly into the tumour and left in place for several days. It will release radiation and kill the cancer cells. Internal radiotherapy is also known as brachytherapy. The implant is usually put in under general anaesthetic.
See the booklet Understanding Radiotherapy, which you can download from our "Important cancer information booklets" list on the right hand side of this page, for more details about the types of radiotherapy and possible side-effects.
Chemotherapy is the use of drugs to cure or control cancer. Chemotherapy drugs can be given on their own or with each other. Chemotherapy can also be given before or after radiotherapy and surgery. The drugs are either injected into the bloodstream or given in tablet form. Your doctor will decide the type and dose of your chemotherapy based on the size and location of the tumour, if it has spread, and your general health. Some drugs used for mouth, head and neck cancer are carboplatin and Taxol. See the booklet Understanding Chemotherapy, which you can download from our "Important cancer information booklets" list on the right hand side of this page, for more information about chemotherapy.
Biological therapies are drugs that block the growth of cancer cells by interfering with molecules needed for the cancer to grow. Unlike chemotherapy, biological therapy can tell the difference between cancer cells and normal cells. Biological therapy can be given on its own or with chemotherapy drugs.
A commonly used biological therapy for mouth, head and neck cancer is cetuximab (Erbitux).
Advanced cancer is when the cancer has spread to other parts of your body. If this happens, your doctor will discuss the best treatment option for you with a team of healthcare professionals. Your doctor may refer you to specialist palliative care doctors and nurses.
Palliative care is treatment and care given if you are seriously ill. The aim of the care is not to cure the disease but to relieve your symptoms and make sure you have the best quality of life possible. Patients with mouth, head and neck cancers often have difficult symptoms and the palliative care team can help you to manage these better.
The type of side-effects you get will depend on the type of treatment, the dose, the duration and your own general health. Many treatments may cause fatigue. Your doctor will discuss any likely side-effects before treatment.
- Surgery: Surgery may affect how you eat or drink or how you look. If you have swelling and bruising around your mouth, you may need a temporary airway called a tracheostomy so you can breathe easily.
- Radiotherapy: Some common side-effects are sore skin, tiredness (fatigue), loss of taste, loss of appetite, feeling sick (nausea), hair loss in the treated area, bad breath, dry mouth, sore mouth, pain on swallowing and jaw stiffness. For patients receiving internal radiation, the skin or tissue around the implant can become swollen and sore.
- Chemotherapy: The side-effects of chemotherapy depend on the individual drug. They may cause nausea, vomiting, diarrhoea, loss of appetite or hair loss.
- Targeted therapies: These may cause flu-like symptoms when given at first. But in general they cause very few side-effects.
- Photodynamic therapy: This will cause you to become highly sensitive to light for about 2 weeks. Other temporary side-effects are some pain, swelling of the treated area, difficulty in swallowing and bleeding.
All of the above side-effects usually improve once your treatment is over. A team of health professionals such as the doctor, nurse, dietitian, physiotherapist, social worker and speech and language therapist will help ease any side-effects.
For more about coping with side-effects, see the booklets Understanding Chemotherapy, Understanding Radiotherapy, Coping with Fatigue, Diet and Cancer and Understanding Cancer and Complementary Therapies, all available to download under the "Important cancer information booklets" list on the right hand side of this page.
If a treatment looks like it might be helpful, it is given to patients in research studies called clinical trials. Trials may be taking place at the hospital you are attending. If you are interested in taking part, talk to your doctor. He or she can tell you if the trial would suit you or not.