Head and neck cancers are complicated diseases that require the caliber of specialized expertise found through Froedtert & the Medical College of Wisconsin. With advanced diagnostics and a full menu of treatment options from radiation therapy to medical oncology to oncology and reconstructive surgery, we have unrivaled physician capabilities and clinical tools to help our patients fight cancer and win.
The Head and Neck Cancer Program offers all available treatment options, such as:
- Surgery, including minimally invasive approaches such as transoral robotic surgery (TORS) and transoral laser microsurgery (TLM), which utilize various specialized instruments, lasers, and endoscopes to remove tumors while preserving normal surrounding tissues.
- Radiation therapy, including IMRT, TomoTherapy© and Gamma Knife
- Medical oncology, including targeted agents and new, cutting edge drugs from the latest clinical trials
- Reconstructive surgery, including microvascular free tissue transfer techniques
Head and Neck Cancer Treatment - Video FAQ
Stuart Wong, MD, medical oncologist, explains that care is individualized for head and neck cancer patients.
We have a philosophy for caring for our patients. And, if I have to say it's one thing, it would be that we try to individualize the care for our patients — that we listen to them and try to create a treatment plan that is specific for them.
Let me give you an example. I have some patients where their primary motivation is to do everything in their power to have the highest chance for cure. Whereas, I will have some patients where cure is important, but they want to come out of their therapy with the best possible quality of life and to preserve the functions that are important for their everyday life.
An example would be musicians who need to be able to feel their instrument. They need to be able to hear. Some patients are in the middle of the most productive point in their lives, and they need to preserve the functions that allow them to re-enter the workspace and function normally. We can individualize their care for their specific goals, and we pride ourselves on that.
Becky Massey, MD, head and neck surgical oncologist, explains head and neck cancer treatment.
Head and neck cancer treatment includes a combination of surgery, radiation and chemotherapy. We try to limit the amount of treatment that patients get, so that we can cure their cancer while limiting the side effects of any of the treatments.
Head and neck cancer surgery is often used in patients who have cancer that is localized to their head and neck area. Head and neck cancer surgery can be done a number of ways. There has been a lot of progress in the last several years in treatments for head and neck cancer via surgery.
Surgery can be done through the mouth or through incisions in the neck. Those incisions can be camouflaged in skin creases, so patients can have a cure of their cancer and often look and function normally.
Stuart Wong, MD, medical oncologist, explains that survival outcomes for head and neck cancer vary.
Survival for head and neck cancer varies. It depends on a number of different issues. The primary issue is the type of cancer that it is and the anatomic location. One scenario that perhaps gives you the best idea of the best outcome for patients are those patients with HPV-associated cancer where their disease is diagnosed very early. For those patients, the overall survival may be 85% at five years, and that's really an outstanding outcome.
For patients with advanced or metastatic head and neck cancer, the survival for these patients has changed dramatically. Part of this is driven by new therapies — primarily immunotherapies. It was unheard of, say five or 10 years ago, for patients to live beyond five years. Now we're seeing, with these new therapies, patients that achieve remission status that is durable and lasts a long time. For some patients, this treatment allows them to continue years and years and years. This may be the exception rather than the rule, but it is a phenomenal change for our patients.
Aditya Shreenivas, MD, MS, medical oncologist, explains the challenges and importance of controlling head and neck cancer pain.
Management of head and neck cancer pain can be extremely challenging. We focus on this and make sure that patients derive benefit from appropriate strategies. We have a multidisciplinary group that works together. We develop personalized pain plans for patients, which depend on their prior exposure to certain pain medications, their comorbid conditions and their allergies to certain pain medications. Once we address all of these things, we devise a personalized pain plan for each patient.
We are also exploring innovative strategies in clinical trials to use less habit-forming pain agents. Oftentimes, patients are reluctant to take pain medication because they're afraid that they would get addicted to it, so we are exploring less habit-forming medications in this setting.
We're also working with our collaborators here and outside to develop a real-time pain monitoring application on mobile. Essentially, patients are able to record and report their pain in a real-time setting.
Sometimes, when you see patients in clinic they report a certain pain level, but their pain level at home is completely different. We don't really know how bad their pain is at home. In order to get the best evaluation of pain at home, we developed real-time pain monitoring via a mobile application. We evaluate pain levels at home and address it in a real-time setting appropriately and adequately.
Stuart Wong, MD, medical oncologist, explains head and neck cancer patients have a number of effects from radiation therapy and chemotherapy.
Because head and neck cancer patients have a number of specific side effects related to the radiation and the chemotherapy that have to do with hearing or swallowing, we have a team of experts that help to treat those problems and prevent them. Probably the key issue is knowing that these problems can exist and identifying them early and trying to prevent them from getting worse.
Stuart Wong, MD, medical oncologist, describes the abundance of new information leading to medicine and treatment changing quite a bit.
Medicine has changed so much over the last few years and the last decade, and treatment is very specialized. It is not possible for an oncologist to know everything. So much new information has occurred, that we need "super specialists."
For instance, we have specialized surgeons, radiation oncologists, neuroradiologists and medical oncologists. These are all the people who make up our multidisciplinary team. On top of that, we have a number of support personnel who deal with medical problems related to supportive care — hearing specialists, speech specialists, rehab specialists and psychology support specialists. These are all of the team members that make up our multidisciplinary team, and it is an important component in giving the patients their best possible outcome.
Michael Stadler, MD, head and neck surgical oncologist, lists the ways head and neck cutaneous melanoma is treated.
The treatment of head and neck cutaneous melanoma follows the same basic principles of melanoma treatment throughout the rest of the body. This includes the primary surgical management of removing the melanoma itself.
Surgery is often followed by additional therapies, such as radiation therapy and systemic therapy. One of the most common systemic therapies that we use is immunotherapy.
Michael Stadler, MD, head and neck surgical oncologist, discusses advances in treating cutaneous melanoma of the head, neck and scalp.
We have had many advances in the treatment of cutaneous melanoma of the head and neck and scalp regions. Surgical principles have remained fairly constant. We have learned more and more about how much skin we have to remove as it relates to the melanoma, as well as some of the reconstructive principles that we utilize today.
Some of the more advanced areas that we have learned about and use today relate to radiation therapy and our ability to treat areas in a more focused manner, as well as systemic therapies and that mainly relates to immunotherapy.
Thanks to our multidisciplinary approach, patients receive treatment opinions from a team of head and neck cancer specialists who use their combined expertise to shape the best possible treatment plan. Experts from head and neck surgery, radiation oncology, medical oncology, radiology, pathology, oral surgery, speech language pathology and other areas are involved in each case as appropriate. With input from so many clinical leaders, no aspect of patient care is left to chance and all of the latest treatment options are considered.
The Right Treatments at the Right Time
The right medicines, the right combinations of treatment approaches and the right sequence of treatment steps matter greatly in fighting head, neck and skull base cancers. All of these care aspects factor into every plan of care. For each patient, team members work together with a goal of finding the best treatment with the least impact on quality of life. Our academic medical center setting allows us to offer the latest, proven approaches to eliminating cancer while working innovatively to preserve head and neck tissue, structure and function.
Pretreatment Care and Patient Support
Innovative treatment goes hand in hand with a full menu of support options and resources for patients and their families. Before, during and after a course of treatment, our staff guide patients and families through decisions to be made, realistic expectations about potential lifestyle changes and many different resources for support of all kinds. From pretreatment counseling to appointments with oral surgeons, registered dietitians, speech-language pathologists and other specialists, patients get expert help in navigating all aspects of their diagnosis.
Nutrition During and After Treatment - Video FAQ
Makayla Konop, RD, clinical dietitian, explains how head and neck cancer patients can have nutrition issues.
Head and neck cancer patients face a lot of different nutrition issues based on their cancer type and their treatment. The location of your cancer can cause mechanical difficulties which can harm your ability to chew and swallow your food. During treatment, you may have pain or discomfort with swallowing. This can also impact your nutrition plan for head and neck cancer.
Whether it's one or both of these issues, there is a high risk for nutritional deficiency, and that is what our team monitors very closely throughout your cancer journey.
Makayla Konop, RD, clinical dietitian, describes how personalized interventions are built into each head and neck cancer patient's care plan.
We make sure that every head and neck cancer patient gets the best possible nutrition, and we start by doing this with a pre-screening every time you come into clinic. That allows us to see what type of nutritional risk is possible. Based on that, we develop personalized interventions that we implement directly in your care plan.
For example, somebody with throat cancer can have a lot of nutrition concerns — one of which being what you can and cannot eat based on the side effects and symptoms of your treatment. We work with them on what specific foods are appropriate for them and then that implements right into their care plan.
Makayla Konop, RD, clinical dietitian, explains how the team creates personalized meal and nutrition plans for head and neck cancer patients.
We try to make the meal plan and the nutrition plan very patient-centered and very personalized to your current lifestyle. We like to meet you and make sure that anything we recommend is something you can sustain in your lifestyle.
Makayla Konop, RD, clinical dietitian, talks about the most common questions she gets from head and neck cancer patients.
The big question is "Is there anything I can't have, that I absolutely have to avoid in my diet?"
We do our best to keep your diet as liberal as possible with as many of the things that you like to eat in your diet. We avoid limiting your diet unless it's absolutely necessary.
Makayla Konop, RD, clinical dietitian, explains how the nutrition team collaborates with the rest of the head and neck cancer care team.
Our nutrition team is in constant collaboration with all other members of the care team. That allows us to anticipate some of the upcoming challenges and focus on real-time changes to the nutrition plan to provide you with the most consistent and thorough care.
Knowing that the head and neck cancer population is at higher risk for nutritional deficiencies, our team is ready to help you through any of those obstacles that come along.
Lindsey Nye, MS, CCC, SLP, speech language pathologist, explains how long a feeding tube is used for head and neck cancer patients.
Typically, if you need a feeding tube, you will have it for as long as you need it. For a lot of people, this is just for the extent of treatment. As soon as treatment is done and they're feeling better, we can get them back to swallowing again. Then the tube can come out.
For others, if they feel like it's needed, it can stay in longer and for as long as they need it.
Lindsey Nye, MS, CCC, SLP, speech language pathologist, describes when a feeding tube may be needed for a head and neck cancer patient during and after treatment.
A speech therapist can help determine if somebody needs a feeding tube, and it's typically something that we use as a little extra help. It is usually used when somebody is unable to get enough nutrition by eating. Swallowing has become more challenging, more difficult, and they feel like they cannot eat enough.
We work with our patients to make sure that they never stop eating throughout the treatment process. We want them to keep swallowing, and a feeding tube would only be used in addition to what they are able to eat by mouth.
Not every head and neck cancer patient will need a feeding tube. Typically, only a very small percentage of people that go through treatment will end up getting one. It is more common with surgery, but it is something that is usually decided between the entire team and the patient when they feel like it is necessary to help them to get proper nutrition throughout their treatment.
If it is decided to get a feeding tube, the person that receives that feeding tube will have it for as long as they need it. For a lot of people, this is just for the extent of treatment. As soon as treatment is done and they are feeling better, we can get them back to swallowing again that tube can come out. For others, if they feel like it is needed, it can stay in longer and for as long as they need.
Virtual Visits Are Available
Safe and convenient virtual visits by video let you get the care you need via a mobile device, tablet or computer wherever you are. We’ll gather your medical records for you and get our experts’ input so we can offer treatment options without an in-person visit. To schedule a virtual visit, call 1-866-680-0505.
Cancer and the COVID-19 Vaccine
There is currently no data that suggests current or former cancer patients should avoid getting the COVID-19 vaccine. Cancer can weaken your immune system, so we recommend that most patients get the vaccine as soon as possible.