Tests, Treatments & Therapies for Head and Neck Cancer at the University of Colorado Cancer Center

At the University of Colorado Cancer Center, we use the most minimally invasive approach possible for both diagnosis and treatment of Head and Neck cancer. We recognize that both work-up and management requires a multidisciplinary approach with numerous specialists working closely together.

We use both standard treatments and those being tested in clinical trials. You might consider participating in a trial, which are designed to improve current treatments or get information on new treatments. If a new treatment is proven better than the standard treatment, the new treatment may become the standard treatment.

Staging and Detection Tests

Tests are only as good as the doctors who report and interpret them. That’s why our doctors-who work together as your care team-are the highest trained specialists in the state.

Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:

• Different types of scans
• Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)

Scans and other tests may also be used:

• In a “surveillance program” looking for any signs of relapse after treatment
• In a “screening program” to detect cancer early in individuals at high-risk
• To monitor responses to treatment

Tests

Physical Exam of affected area – An examination in which the doctor will do one or more of the following:

• feel for swollen lymph nodes in the neck
• look down the throat with a small, long-handled mirror to check for abnormal areas
• check the lips and oral cavity for abnormal areas

Biopsy – The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.

Endoscopy – An exam to look at organs and tissues inside the body to check for abnormal areas. An endoscope (a thin, lighted tube) is inserted through an incision (cut) in the skin or opening in the body, such as the mouth. Tissue samples and lymph nodes may be taken for biopsy.

Laryngoscopy – A procedure in which the doctor examines the larynx (voice box) with a mirror or with a laryngoscope (a thin, lighted tube)

Esophagoscopy – An exam to look inside the esophagus to check for abnormal areas. An esophagoscope (a thin, lighted tube) is inserted through the mouth or nose and down the throat into the esophagus. Tissue samples may be taken for biopsy.

Bronchoscopy – An exam to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.

CT Scan (CAT scan) – A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly.

Magnetic Resonance Imaging (MRI) – A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body.

Barium swallow (Upper GI Series) – A series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken.

X-rays of the head, neck, and chest – An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Exfoliative cytology – A procedure to collect cells from the lip or oral cavity. A piece of cotton, a brush or a small wooden stick is used to gently scrape cells from the lips, tongue, mouth or throat. The cells are viewed under a microscope to find out if they are abnormal.

Positron Emission Tomography (PET scan) – An imaging test used most often to detect cancer and to examine the effects of cancer therapy. Patients are injected with a radioactive substance before undergoing the scan. Cancerous tissue will accumulate more of the substance and appear brighter than normal tissue on the PET images.

Serum tumor marker test – Your blood sample is checked to measure the amounts of certain substances released into the blood by organs, tissues or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers.

Ultrasound – An exam in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

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Surgery

Operations and procedures to remove head and neck cancer are done by doctors who have specialized training, called surgical oncologists. In most cases, the surgeon removes a tumor and some tissue around it. The surgeon also may remove some nearby lymph nodes.

Surgery may be part of an overall treatment plan or may be used for treating recurrence or new tumors. 

Lasers – Laser light is of such high intensity and narrow beam that it can be used to do precise surgery to remove cancer or precancerous growths or to relieve symptoms of cancer. It is used most often to treat cancers on the surface of the body or the lining of internal organs.

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Radiation Therapy (“Radiotherapy”):

Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:

• Kill cancer cells
• Prevent cancer cells from developing or recurring
• Improve many of the symptoms caused by cancer

Radiation therapy can be:

• Used before surgery to make the operation easier (this is called “neoadjuvant” treatment)
• Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”)
• Almost as effective as surgery in people who are not fit enough for an operation
• Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”)

Chemotherapy and other drug-based treatments:

Anti-cancer drug treatments: Chemotherapy-and new “targeted therapies”-involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed.

View current cancer clinical trials available at UCCC.

Anti-cancer drug treatments may involve:

• Single drugs or combinations of drugs
• Intravenous injections or tablets/capsules
• Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
• Taking some drugs every day or only on a few days within the cycles
• Taking other medicines to reduce or eliminate side effects associated with chemotherapy
• Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
• Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials

Chemotherapy and targeted therapies can:

• Be given before surgery to make the operation easier
• Be given in combination with radiotherapy to make both treatments more effective
• Be given after surgery to reduce the chances of cancer coming back
• Successfully control advanced cancer and many cancer-related symptoms

Angiogenesis Inhibitors

Angiogenesis inhibitors are – substances that may prevent the formation of blood vessels. In anti-cancer therapy, an angiogenesis inhibitor prevents the growth of blood vessels from surrounding tissue to a solid tumor.

Biologic Therapy

Biologic therapy involves using a drug to stimulate your own immune system to fight cancer. An example is a vaccine.

Clinical Trials

The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:

• New drugs
• New combinations of therapies
• New treatment delivery methods

Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center-one of only 39 in the United States-your treatment will always include the latest and most comprehensive care options.

Learn more about clinical trials at UCCC