The best treatment for head and neck cancers is guided by a team of specialists. At the University of Chicago Medical Center, our expert cancer team includes surgeons, medical and radiation oncologists, physical and speech therapists, and other experts who provide compassionate, coordinated care. 

Our multidisciplinary team is nationally recognized for outstanding treatment outcomes. For example, 62 percent of our patients with stage III and IV head and neck cancer survive three years or more, compared with the national average of 20 to 30 percent. But, just as important, our team is recognized by patients and their families for our extraordinary dedication to helping patients maintain the best possible quality of life during and after treatment.

Head and neck cancers can affect the:

• Sinuses

• Mouth

• Tongue

• Tonsils

• Pharynx (throat)

• Larynx (voice box)

• Upper esophagus

• Salivary glands

• Thyroid

More than ever before, new medical advances mean there are better and more treatment options for patients facing this challenging disease. Many patients are able to recover from their cancer and return to their normal lives, thanks to a combination of expertise, innovation, and support.

Why Choose Us for Head and Neck Cancer Care?

Better Survival Rates

Patients with head and neck cancer who come to the University of Chicago Medical Center live longer than patients treated elsewhere. For example, 62 percent of our patients with stage III and IV head and neck cancer survive three years or more, compared with the national average of 20 to 30 percent.

More Experience with Complex Cases

Our head and neck cancer program is one of the busiest in the area, seeing hundreds of patients each week. This means that our cohesive team of experts has experience treating a range of cases, including the most complex cancers.

Our doctors are pioneers in using a combination radiation-chemotherapy treatment that can control locally advanced head and neck cancers in the majority of patients and preserve critical functions such as speech and swallowing. A recent study conducted at the University of Chicago found that this combined therapy controls cancer in more than 85 percent of patients with advanced disease, with 62 percent of patients surviving long term.

Internationally Recognized Experts

Our treatment team is made up of internationally respected experts from every area of head and neck cancer care and research. Members of our multidisciplinary team often serve on national and international boards to develop guidelines for care, and frequently lead multi-institutional studies of new treatment approaches.

Less Invasive Diagnosis and Treatment

We offer minimally invasive techniques to diagnose and treat several types of head and neck cancer. For instance, our doctors offer a less invasive way to check the esophagus for cancer called transnasal esophagoscopy. This procedure can be done in the office setting without general anesthesia.

When surgery is the best option for patients, our surgeons can perform organ-sparing techniques that maximize the chances of functional recovery. In addition, our surgeons have developed innovative surgical approaches that can access difficult to reach areas, (such as the skull base or carotid artery). Restoration of bone and soft tissue in the head and neck is often accomplished with a technique called microvascular free flap reconstruction. These methods help to rebuild tissues in the head and neck such as the jawbone and pharynx. Many times, a patient’s appearance and speech and swallowing functions can be preserved.

When Preventing Cancer Is the Focus

The University of Chicago is home to a new high-risk oral cancer clinic, which provides patients with access to ongoing clinical trials to test new ways to detect oral cancer early on.

Research into New Alternatives for Treatment

Our doctors and scientists are committed to advancing treatment of head and neck cancer through research. Currently, researchers are testing the latest targeted therapies such as drugs that react against the cancer’s growth factors.

As recognized experts in this field, our team has led several multi-institutional clinical studies, including a large, international phase III trial looking at the benefit of chemotherapy prior to concurrent chemotherapy and radiotherapy for locoregionally advanced head and neck cancer. At any given time, our team is actively conducting clinical and basic science research into nearly every aspect of this disease.

Head and Neck Cancer Treatment

Head and neck cancers may grow quickly. The earlier that a cancer is diagnosed, the more likely the treatment will be successful.

At the University of Chicago Medical Center, our physicians strive to provide head and neck cancer treatment that is effective and gives the patient the best chance of preserving speech, taste, and swallowing function. In most cases, effective treatment does not require radical surgery.

Matching the appropriate treatment to the right patient is vitally important in cancer care. For head and neck cancer, treatment may involve an intensive combination of radiation and chemotherapy. Or it may center on surgery, followed by radiation and chemotherapy. University of Chicago experts from surgery, medical oncology and radiation oncology work together as a team to develop the best treatment plan for each patient.

Head and neck cancer treatment options are determined by the stage of the cancer, the location of the tumor, and other factors. Here, treatment is typically provided as outlined in the following table:

Cancer Stage	Treatment
Stage I	Surgery or radiation therapy
Stage II (cancer has not spread to lymph nodes)	Therapy depends upon the location of the tumor, and may include surgery, radiation therapy or chemotherapy, or a combined approach.
Stages III and IV	A combined radiation therapy and chemotherapy approach is typically the first line of treatment. In other cases, surgery is performed first, followed by chemoradiation.

Chemotherapy Plus Radiation: A “One-Two” Punch

Doctors at the University of Chicago Medical Center are leaders in developing a new treatment regimen that helps certain patients with head and neck cancer avoid surgery. This combined therapy approach harnesses the power of chemotherapy and radiation therapy to work in tandem to shrink tumors. Our experts have published studies on the success of this approach, and report that it controls cancer in more than 85 percent of patients with advanced disease, with 60 percent of patients surviving long term.

A sample combined therapy approach may involve five, 14-day treatment cycles. For the first five days of the treatment cycle, the patient will receive multiple chemotherapy drugs and twice-daily radiation therapy treatments during a hospital stay. Then, the patient returns home for nine days. Patients who previously had surgery may be treated with four, 14-day cycles of treatment.

Any patient with any type of head and neck cancer with lymph node involvement may be a candidate for this approach.

Precise Radiation Therapy Treatments

At the University of Chicago Medical Center, our radiation oncologists are internationally recognized for their expertise, and use sophisticated methods and machines to deliver precise treatments that target tumors while sparing healthy tissue. We were one of the first hospitals in the nation to offer intensity modulated radiation therapy (IMRT) to treat head and neck cancer. With IMRT, the radiation beam is accurately shaped to follow the contours of the tumor. The beam's intensity is controlled in relation to its location on the tumor and its proximity to healthy tissues and critical structures such as the salivary glands or the optic nerve.  

Our team uses image-guided radiation therapy (IGRT) to ensure that treatments are set up the right way, every time. Before each treatment, our specialists confirm the exact tumor position and make any needed adjustments before treatment begins. Here, our experts have refined IGRT by developing a 3-D imaging system to improve treatment planning. An added benefit of this system is faster treatment sessions since less time is required for set-up at each visit.

When Surgery Is the Solution

For many patients with early-stage head and neck cancer, surgery is the best option for a successful outcome in terms of survival and preservation of function. Endoscopic laser resection is one of the many techniques used to address early stage lesions. This minimally invasive approach uses sophisticated thin instruments equipped with a laser that enables the surgeon to remove tumors with pinpoint precision.

When patients have advanced disease, our expert surgeons work with radiation and medical oncologists to develop the best treatment plan.

When Reconstruction Is Needed

Our cancer experts are skilled at using organ-sparing and reconstructive techniques to maintain a patient’s physical appearance and function during or after treatment. Patients are often referred to the University of Chicago for complex wounds that have developed as a complication of prior treatment. Examples include soft-tissue wounds, aspiration (inhalation of material into the lungs), and osteoradionecrosis (bone death caused by radiation). Our head and neck surgeons team with our plastic surgeons to transfer new tissue to help heal wounds, relieve pain, and give hope.

Many Options for Recurrent Disease

For patients with recurrent disease, options often include surgery in addition to radiation, and experimental therapies. Our doctors can provide innovative approaches and state-of-the-art reconstructions for patients with recurrent cancer.  Our treatments can provide pain relief, wound rehabilitation and hope for survival.  Patients with recurrent head and neck cancers are often referred after being told “nothing can be done.”  Our team believes that there is always something that can be done to support the patients and their families.

The University of Chicago Medical Center is one of the leaders in re-irradiation—a second treatment with full-dose radiotherapy—combining radiation with chemotherapy and novel molecularly targeted agents. In addition, we have a very active program using novel drugs in patients with metastatic disease.

Rehabilitation and Support for Head and Neck Cancer

Rehabilitation during and after treatment is an important part of the care plan, since many patients may find their speech, swallowing, or other functions become more difficult. The goals of rehabilitation are different for each patient. At the University of Chicago, patients work with speech pathologists, therapists, dietitians, and other experts to improve their chances of making a full recovery.

Nutrition

As a result of both the cancer and treatment, patients may experience difficulty maintaining their usual diet.  There is growing evidence that good nutritional habits help patients recover from chemotherapy and radiation therapy.  If it is safe, it is best for patients to continue to eat by mouth during treatment.  If a feeding tube is required, it is good to continue to eat some things orally.

The dietitians on the cancer team know that during treatment, patients may find that food tastes different, appetite may be poor, and it may take a long time to eat certain foods.  Patients may be unsure about what they should eat and might feel anxious about swallowing.  Our dietitians can answer questions and recommend types of foods and ways to prepare food that help patients:

• Maintain optimal body weight
• Improve nutritional intake during and after hospitalization
• Help patients gain control and better cope with treatment
• Resume normal activities more quickly after treatment is completed

Swallow Function

Cancer of the head and neck can cause difficulty swallowing. Treatments for cancer such as surgery, radiation and chemotherapy may also cause swallowing problems. At the University of Chicago Medical Center, specially trained speech pathologists work one-on-one with head and neck cancer patients to create customized plans to maintain optimal swallowing function during and after treatment. Therapies include mouth, neck and swallowing exercises to improve muscle coordination. Some patients may require enteral tube feeding to ensure proper nutritional support. Our goal is to help you resume the most natural diet in a safe way.

Speech Therapy

Head and neck cancer treatment often affects speech. Here, our speech pathologists work with patients to address speech problems during and after treatment. Our specialists provide detailed exercises to help patients communicate effectively. Speech therapy may continue after cancer treatments have concluded.

Coordinated Care with Dental Professionals

Treatment for head and neck cancer affects the mouth, salivary glands and teeth. It's critical for patients to maintain proper dental care before, during and after treatment. Dental problems should be addressed as early as possible--often before radiation treatment--to ensure that dental and gum problems do not lead to infection, jaw damage or other health problems. Our team will work with you and your dentist to ensure proper dental care. If your dentist is not experienced in caring for patients with head and neck cancer, our team can recommend dental professionals to meet your needs.

Support

Support plays a major role in the treatment for head and neck cancer. Patients are encouraged to share their feelings and accept support and encouragement from the treatment team, family members, and friends.  At the University of Chicago, an outpatient support group meets each month so that patients can share common concerns and learn from each others’ experiences. And when behavior changes such as smoking cessation are needed, our team can develop a plan to help patients protect their health in the future.