Other Cancer Treatments and Programs

Programs and Services

Other Cancer Treatments and Programs

Salivary and Parotid Gland Tumors

The parotid gland is the largest salivary gland, located in the cheek near the ear. Other major salivary glands include the submandibular and sublingual glands, and tumors can develop in all three. Salivary gland tumors may be cancerous or benign. If they’re cancerous, it’s important to determine if the cancer has spread from another area of the body. Diagnosing a salivary gland tumor often starts with a needle biopsy, the case is usually reviewed by the Otolaryngology Tumor Board, and a treatment approach is developed.

While most tumors of the salivary glands are not cancerous, they almost always need to be removed surgically. Because tumors in the parotid gland are often closely entwined with the facial nerve, operating on the parotid gland requires meticulous surgery to avoid damaging that nerve. Our surgeons have advanced training and experience treating even the most complicated cases.

Benign and Malignant Neck Tumors

As with other tumors, neck tumors may be cancerous or benign. Most often, they develop in the neck after spreading from another area of the body, such as the lymph nodes, the tonsils or the tongue. Determining whether the tumor is cancerous or not and where it may have originated are two of the most important things we do. Armed with that knowledge, we can develop a treatment plan that aggressively treats the tumor while avoiding nearby areas that don’t need treatment.

A variety of conditions and diseases can cause neck tumors, whether cancerous or benign. Tumors can develop in almost any structure in the neck. In some cases, people have congenital neck tumors — tumors they were born with that are discovered in adulthood. These tumors can generally be treated surgically. Regardless of the cause, our team has the skills, tools, knowledge and expertise to treat these tumors successfully.

Lip and Oral Cavity Cancer

The most common form of cancer in the oral cavity, which includes the lips, is squamous cell carcinoma. In its early stages, oral cavity cancer is highly curable. At Froedtert & The Medical College of Wisconsin, we treat all types of oral cavity cancer, including the most complicated cases. Patients benefit from our well-coordinated multidisciplinary approach to care from a team of medical and dental specialists who work closely together to treat oral cavity cancer, which often requires surgery. The team also includes speech pathologists and other specialists critical to care, before, during and after treatment.

Patients having surgery on the oral cavity may need dental work done at the same time, and they will meet with an oral surgeon in advance. These patients may also need reconstructive or plastic surgery to rebuild the bones or tissues of the mouth. Reconstructive surgeries, including microvascular reconstructive surgery, are also performed by a plastic surgeon or a head and neck surgeon.

Cancer of the Larynx (Voice Box)

With laryngeal cancer or cancer of the larynx (voice box), we work to preserve the larynx whenever possible using proven methods of successfully treating the cancer without damaging or removing the voice box. We have aggressively treated laryngeal cancer with the right combinations of chemotherapy and radiation therapy, while preserving the voice box and the patient’s quality of life. Surgery is still a vitally important tool in the fight against cancer, and we offer a spectrum of surgical procedures – including minimally invasive laser procedures, such as transoral laser microsurgery (TLM), and partial or total voice box removal or laryngectomy. We work closely with all laryngeal cancer patients to make sure they make the most informed decision about their treatment options. Additionally, our team of speech-language pathologists are experts in rehabilitation after treatment of laryngeal cancer, and can provide a variety of options to help the patient return to a functional and perhaps near normal voice.

Cancer of the Pharynx (Throat)

The pharynx is made up of three parts: the nasopharynx, the upper part behind the nose; the oropharynx or middle part which includes the tonsils, soft palate and base of the tongue; and the hypopharynx or lower part. Cancer can occur in all three parts. As with cancer of the larynx, we take an organ preservation approach to treating cancer of the pharynx, using combinations of chemotherapy and radiation therapy, depending on the patient’s condition. Minimally invasive laser procedures may also be used in treatment.

Team members are skilled in looking beyond treatment to anticipate potential problems as early as possible and make referrals to appropriate specialists to shorten treatment and speed recovery.

Support Tools, Screenings and Resources

At Froedtert & The Medical College of Wisconsin, we offer the area’s only support group dedicated to head, neck and skull base cancer patients and their families. Any head and neck cancer patient may attend at any stage of treatment and recovery. The Head and Neck Cancer Support Group meets monthly in the Cancer Center Conference Room.

We also offer the area’s only newsletter exclusively for head, neck and skull base cancer patients and their families. The Heads Up newsletter is published quarterly by the Department of Otolaryngology and Communication Sciences. Past issues can be found online. Because we have such a high volume of head and neck cancer patients, the newsletter is an excellent way to stay in touch with patients and offer advice, insight, tips and resources.

Because smoking and tobacco use are the most important risk factors in developing head, neck and skull base cancers, we offer resources to help smokers quit. Support is key to kicking the habit for most people, so we offer tips and resources to help smokers find that support and change their behavior.

Screenings and wellness programs are an important way to educate patients and their families about risks and ways to stay healthy. Froedtert & The Medical College of Wisconsin offer several screening and wellness programs through Small Stones, our health resource center.

Another valuable resource is Dr. Bruce Campbell’s health blog, Reflections in a Head Mirror on froedtert.com. His insightful thoughts and compassionate stories inform and inspire cancer patients and their families.

Second Opinions

Everyone with a cancer diagnosis deserves a second opinion for reassurance that their diagnosis is accurate, and to be sure they know the treatment options available to them. So much vital function goes on in some very small spaces in the head and neck. Treating these complicated cancers successfully while preserving quality of life is important to our patients and to us. If you or someone you know has been told they need treatment for head, neck or skull base cancer, contact us for a second opinion.

Cancer Genetics Screening Program

Because genetics can play an important role in diagnosing certain diseases and for families with strong histories of cancer, our Cancer Genetics Screening Program provides genetic counseling and testing. As part of the Cancer Center, the program provides personalized counseling regarding cancer risk, cancer genetics, genetic testing, early detection, improved cancer management and possible risk reduction to people who may be at risk for certain diseases due to a personal or family history of a genetic condition.

Rehabilitation Services

Head and neck cancer patients often face complicated treatments. The clinical care team coordinates services and creates an individualized care plan for each patient. This team approach to head and neck cancer treatment leads to better outcomes and improves the quality of life of our patients.

The speech-language pathologist (SLP) is a specially trained member of the clinical care team who provides ongoing assessment of communication skills and swallowing function as well as rehabilitative therapies. If indicated, a comprehensive treatment plan is implemented to preserve or improve function. Pre-treatment counseling, preventative exercise, and direct therapy intervention are designed to meet the individual needs of the patient. Special tests are sometimes required to help with the planning process and include:

Swallow study: An X-ray of swallowing used to identify the cause of a swallowing problem and to help find possible solutions.
Fiberoptic Endoscopic Evaluation of Swallowing (FEES): Allows for direct examination of swallowing function by passing a laryngoscope through the nose and observing the throat during the swallow.
Videostroboscopy: A diagnostic procedure used to view the larynx and vocal cord motion by inserting an endoscope through your mouth or nose.

Therapy programs for voice and swallowing disorders often require specialized programs or techniques that improve a patient’s ability to carryover new skills at home. Independent home programs are a necessary part of treatment and accelerate the rate of progress.

Surface Electromyography (sEMG): A record of electrical activity from a muscle or group of muscles obtained through electrodes applied to the skin. This noninvasive procedure provides valuable biofeedback in the treatment of swallowing.
Trismus Management: Limited mouth opening (trismus) is associated with cancer treatments and is treated with a passive jaw rehabilitation system called TheraBite.

Author: Joan Cotter Pike

Date: Nov. 15, 2007