Head and Neck Cancer Surgery

Even if you follow an active and healthy lifestyle, you may be at risk for developing head and neck cancer. Head and neck cancers account for 3% to 5% of all cancer diagnoses each year with 50,000 new cases annually. In many cases, the cellular changes that lead to these cancers start in the mucosal surfaces such as the mouth, the nose, or the throat. The cells in these areas are known as squamous cells and are often the starting point for many carcinomas.

As with cancers that start in other areas of the body, cancers in the head and neck can spread and lead to serious and life-threatening complications. The overall outlook for patients who have cancers in these areas of the body is best for those who receive thorough and prompt treatment for cancers that are caught early.

Suncoast ENT Surgical Specialists brings you our expertise in diagnosing and treating head and neck cancer. Our board-certified Otolaryngologist/Head and Neck Surgeons serve the greater Tampa Bay community.

A vast percentage of head and neck cancers are caused by the consumption of alcohol and tobacco, and this is especially true of larynx and oral cavity cancers. Some 85% of cancers of the head and neck are related directly to tobacco use. What’s more, exposure to UVA and UVB from the sun, HPV (human papilloma virus), and radiation can also lead to these cancers.

The good news is that lifestyle changes can eliminate many of these factors. Avoiding alcohol, quitting smoking, and giving up smokeless tobacco can greatly reduce the risk of developing these types of cancers. Anyone who has these risk factors should be screened for head and neck cancer regularly so that any potential problems can be caught early on. The earlier the cancer is found, the more effective the treatment.

The symptoms of head and neck cancer are generally easy to detect, which means that people who seek medical treatment for their symptoms have a good chance at being diagnosed early. Actual symptoms that are experienced will vary according to the type of cancer, but they can include:

Changes in the voice, including hoarseness
Trouble swallowing
New or changing growths on the skin or in the mouth
One or more lumps in the neck
Blood in the saliva
Earaches

It should be noted that a number of conditions can cause these symptoms and that they are not always indicative of cancer. Patients who experience these symptoms should seek prompt medical care.

Patients who experience any of the aforementioned symptoms may be required to undergo a procedure known as an endoscopy (where the mouth and throat are viewed up-close through a camera), blood and urine tests, and a physical examination. If a mass is detected, or even if cancer is suspected, a biopsy may be performed in order to view the affected cells in a laboratory.

If a cancer diagnosis is made, physicians will next work to determine how far the cancer has progressed and whether it has spread anywhere else in the body. To do this, physicians use a variety of imaging procedures including x-ray, MRI, and CAT scan. These scans will help physicians determine the best course of treatment for their patients based upon their individual needs.

Head and neck cancers can be treated in a variety of ways, and the treatment that is chosen is based on factors such as the patient’s overall health, as well as the size and the location of the cancer. Oftentimes, the first step is surgery to remove as much of the cancer as possible. The surgeon also removes all of the suspected cancerous areas as well as some of the healthy areas around the tissue to ensure eradication. Next, patients may be candidates for chemotherapy, during which a targeted medication kills off cancer cells through repeated administration over a set period of time. Finally, during radiation therapy, physicians use highly-concentrated x-rays to destroy cancer cells at their source. Individual treatment plans will vary.

Patients who have been diagnosed with head and neck cancer should discuss all of the various treatment options with their doctors as the treatments used to eradicate the cancer can have a tremendous effect on the way individuals look, eat, speak, or even breathe. By making important life changes now, such as avoiding alcohol and quitting smoking, individuals can prevent their cancers from coming back and mitigate the risks associated with developing other diseases, as well.

Treating Head and Neck Cancers

Suncoast ENT Surgical Specialists brings you our expertise in diagnosing and treating head and neck cancer. Our board-certified Otolaryngologist/Head and Neck Surgeons will be at your side. We treat:

Laryngeal Cancer

Laryngeal cancer affects the larynx, or voice box. The larynx is comprised of three parts: the supraglottis, the glottis, and the subglottis. The glottis is where the vocal cords are housed while the supraglottis and subglottis reside above and below the glottis respectively. Laryngeal cancer occurs when cancer cells develop in the larynx. It can occur in any part of the larynx, but it usually starts in the squamous cells within the glottis. Without proper treatment, the cancer spreads to other surrounding tissues.

One of the most common symptoms of laryngeal cancer is changes in voice because it commonly affects the vocal cords first. Many people with laryngeal cancer in the glottis experience hoarseness that lasts more than two weeks. If the cancer does not initially affect the glottis, hoarseness only occurs in the late stages.

Other symptoms of laryngeal cancer are:

Difficulty swallowing
Feeling of a lump in the throat
Shortness of breath
Cough
Chest infection
Halitosis
Ear pain
Weight loss

There are many different factors that can increase the chance of developing laryngeal cancer, including:

Tobacco use
Heavy alcohol use
Poor eating habits
Weak immune system
Common acid reflux
Exposure to dangerous substances and chemicals, such as paint fumes.

Men are twice as likely to get diagnosed, and most people who develop laryngeal cancer are between 50 and 70 years old.

Anyone who has these risk factors should be screened for laryngeal cancer regularly so that any potential problems can be caught early on. The earlier cancer is found, the more effective the treatment.

If a patient experiences the aforementioned symptoms for a long period of time, they should visit Suncoast ENT Surgical Specialists for an examination. The doctor begins with an external examination of the throat to check for any lumps. The next step is to use an endoscope to examine the inside of the throat. An endoscope is a long tube that has a light and camera at the end. If the doctor does spot some abnormal tissue, a small sample is taken for a biopsy and examined under a microscope to check for cancerous cells.

If the doctor determines there are cancerous cells within the larynx, treatment will follow. Common treatments for laryngeal cancer are:

Radiation treatments
Chemotherapy
Partial laryngectomy
Total laryngectomy

Treatment depends on many factors, including the severity of the cancer. Luckily, regardless of the treatment, the patient won’t lose the ability to speak. However, due to the removal of tissue, parts of the larynx or even parts of the neck muscles, their voice may change.

A total laryngectomy may be required for the most severe cases of laryngeal cancer. A laryngectomy is a surgical procedure to remove the larynx and create a new path for breathing.

Skin Cancer

Skin, the largest organ in the human body, is made up of two layers. The outer layer of skin cells is called the epidermis and it is comprised of three types of cells:

Squamous cells: flat, scaly cells on the surface of the skin
Basal cells: round cells
Melanocytes: cells that give the skin pigment and protect it from damage

The inner layer of skin is called the dermis. The dermis contains the skin’s blood vessels, sweat glands, and nerves.

Skin cancer is when cancerous (malignant) cells are found in the outer layer of skin. There are three major types of skin cancer:

About 70% skin cancer diagnoses are basal cell carcinoma which looks like a small raised bump that may have a pearl-like appearance. Basal cell carcinoma is most frequently found in areas of excessive sun exposure, such as the nose. This cancer spreads to the surrounding areas of skin, but not to the rest of the body.

Accounting for 20% of skin cancer, squamous cell carcinomas are also usually found in the skin in parts of the body that are frequently exposed to the sun. Both basal cell and squamous cell carcinomas can be found on the nose, forehead, hands and upper lip. A squamous cell carcinoma usually looks like a firm red bump that doesn’t heal. Squamous cells are dangerous because they can spread to the lymph nodes, which in turn can spread the cancer to the rest of your body.

Melanoma: Less common, but more dangerous, melanoma is a skin cancer that shows up in the coloring of the skin. They appear as moles or other types of lesions in the skin. A melanoma will have an irregular shape, irregular borders, or a variety of colors to the spot. Melanomas are the most dangerous types of skin cancers because they can spread to the lymph nodes and to other parts of the body if left untreated. Thankfully, melanomas are easily treated when they are discovered early and treated right away.

A few factors increase the chance of developing skin cancer, including:

Long-term exposure to the sun
Fair, light colored skin
Blonde or red hair with freckles
Living in southern climates
Having moles
Using tanning devices
History of severe sunburns
Family history of skin cancer
Presence of non-healing lesions or nodules in the skin

Most skin cancers occur in parts of the body that receive the most sun and UV radiation. If you have lesions or moles on your skin, you should have them examined by a doctor. Finding skin cancer early gives you the best chance of curing skin cancer.

The most crucial thing you can do to reduce your risk of skin cancer is to reduce your exposure to direct sunlight and UV radiation.

While the word “cancer” is cause for concern, most skin cancers can be treated successfully if they are caught in the early stages. By being aware of your skin and having a doctor look at changes in your skin, you may be able to save your life.

If you notice any changes to your skin, contact Suncoast ENT Surgical Specialists for an examination. Any spots on the skin can usually be dealt with on the spot at our office. Local anesthetic is used, and the doctor will examine the suspicious tissue under a microscope for an immediate diagnosis. This procedure is called a biopsy.

If melanoma is found, a patient’s lymph nodes (located in the underarms) may also be tested for cancer, to see if the melanoma has spread. This procedure is called a sentinel lymph node biopsy. Melanoma treatment may include chemotherapy and immune system drugs if the melanoma has progressed. Radiation therapy may also be chosen to treat skin cancer, depending on the situation.

Throat Cancer

Throat cancer is an overall term that is used to describe any form of cancer that develops in or around the throat (pharyngeal cancer). This term can also be applied to cancers that form on or in the voice box (laryngeal cancer).

The throat and the voice box work together. The voice box is situated right underneath the throat. The majority of throat cancers stem from the same type of cells. Different terminology is used to describe different throat cancers based on the part of the throat where the cancer began.

Cancer that originates in the area of the throat just behind the nose is called nasopharyngeal cancer.
Cancer that originates in the area of the throat that is just behind the mouth including the area of the tonsils is referred to as Oropharyngeal cancer.
Cancer that originates in the lower section of the throat in the area above the esophagus and the windpipe is called Hypopharyngeal cancer.
Cancer that originates in the vocal cords is called Glottic cancer.
Cancer that originates in the top part of the larynx or in the epiglottis (a small piece of cartilage designed to prevent food from entering the windpipe) is referred to as Supraglottic cancer.
Cancer that originates in the lower part of the voice box in the area below the vocal cords is called Subglottic cancer.

Diagnostic testing for throat cancer may include:

Use of an endoscope or laryngoscope to get a better look at the throat and vocal cords
A biopsy to remove a sample of tissue from the throat for testing. Biopsies are usually recommended if an endoscopy or laryngoscopy reveals abnormalities in the throat
Imaging tests, such as x-rays, CT scans, MRIs, and PET’s, which help doctors determine cancer growth and the areas affected.

When throat cancer is detected, doctors may recommend one of the following or a combination of the following therapies:

Surgery

Minimally invasive endoscopic surgery: allows doctors to remove entire tumors throughout the mouth without causing large incisions and without affecting a person’s ability to speak or to swallow.
Trans-Oral Laser Microsurgery (TLM): is a procedure that uses a hollow core fiber that is very flexible. CO2 laser energy is transmitted through the fiber. This technique allows surgeons to access parts of the throat and to perform 360-degree resections around tumors in a way that was not previously possible.
Transoral Robotic Surgery (TORS): uses specialized surgical instruments, advanced computer technology, and state-of-the-art 3-D dimensional imaging to perform precision surgeries in the neck and throat.
Supracricoid Partial Laryngectomy: During this procedure, vocal cords and thyroid cartilage are removed. Other structures that are needed to swallow food and to speak are spared.

Chemotherapy

The main objective of chemotherapy is to shrink the tumor or kill remaining cancer cells after surgery or radiation treatment has been performed. Chemotherapy may be combined with radiation therapy for patients who have large tumors or those who cannot physically tolerate surgery.

Radiation Therapy

When coupled with proton therapy and the skill of a well-trained doctor, intensity modulated radiotherapy allows healthy tissue around cancer tumors to be spared during the radiation process.

Brachytherapy: Small radioactive seeds are inserted next to the body in close proximity to the tumor
3D-Conformal Radiation Therapy: Radiation beams are given that are the exact shape and size of the tumor
Intensity Modulated Radiotherapy: A specialized form of treatment tailored to the shape and size of the tumor.

Mouth Cancer

Oral cancer looks like a growth or sore in the mouth that does not heal or go away. Oral cancer includes the lips, tongue, cheeks, floor of the mouth, hard and soft palates, sinuses, and throat. It can be life threatening if not diagnosed and treated in the early stages.

The most common symptoms of oral cancer include:

Lumps, bumps or swelling of the lips, gums or other areas of the mouth
Rough spots, crusts or lesions inside the mouth
A white, red or speckled coating of colored patches in the mouth
Unexplained bleeding in the mouth
Unexplained numbness, or pain any area of the face, mouth, or neck
Persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks
A feeling that something is caught in the back of the throat
Difficulty chewing or swallowing, speaking or moving the jaw or tongue
Hoarseness or a change in voice
Chronic sore throat
Ear pain
A change in the way your teeth or dentures fit
A dramatic weight loss

Contact your doctor immediately if you notice any of these signs or symptoms so you can receive treatment quickly.

Risk factors for the development of mouth cancer include:

Smoking cigarettes, cigars, or pipes
Use of smokeless tobacco such as dip, snuff, or chewing tobacco products
Alcohol consumption
Family history of mouth or other types of cancer
Excessive sun exposure at a young age
Certain HPV (Human papillomavirus) strains

To reduce risk of mouth cancer, do not smoke or use tobacco products and limit alcohol consumption. In addition to physician visits each year, you should also see a dental provider who also performs a complete oral examination.

Your doctor or dentist performs an oral cancer screening during your regular exam. Your doctor feels for lumps, bumps and unusual tissue in your mouth, neck, head and face. Your physician also looks for discolored skin in your mouth and examines any sores for suspicious looking symptoms.

If you have unusual tissue or sores in your mouth, your doctor may test the area using a biopsy. If mouth cancer is diagnosed early, it is much easier to deal with because the cancer has not had a chance to spread. Treatment will vary depending on the location and development of the cancer.

Thyroid Cancer

Thyroid cancer occurs when abnormal cells begin growing in your thyroid gland. Your thyroid gland is located in the front of your neck and is shaped like a butterfly. The thyroid gland makes the hormones that regulate how your body uses energy, and that help your body work normally.

Thyroid cancer is not a very common type of cancer. Because thyroid cancer is most often diagnosed in the early stages, the prognosis is good for most patients. However, thyroid cancer can come back, sometimes a long time after a patient goes into remission.

The symptoms of thyroid cancer include:

A lump or swelling in the neck. This is the most common symptom.
Pain in your neck sometimes accompanied by pain in your ears.
Trouble swallowing.
A frequent cough that is not the result of a cold.
Trouble breathing or have constant wheezing.
A hoarse voice.

Thyroid cancer does not always produce symptoms that are obvious to the patient. Some people are diagnosed after their doctor finds a lump or nodule in their neck during a routine physical exam or wellness visit.

The most common risk factors for thyroid cancer are:

A personal or family history of thyroid disease or thyroid cancer
A medical history of receiving radiation treatments to the neck, head, or chest during childhood
Exposure to high levels of radiation, i.e. a nuclear power accident
A family medical history of conditions such as multiple endocrine neoplasia (MEN) 2a, MEN 2b, or familial medullary thyroid carcinoma (FMTC)
Inherited medication conditions such as Gardner’s syndrome and familial polyposis
Asian heritage

Women are more likely to be diagnosed with thyroid cancer. Most cases of thyroid cancer occur in patients between the ages of 22 and 50.

If you have a lump in your neck that could possibly be cancerous, your doctor may perform a biopsy on your thyroid gland to determine if there are cancer cells present. When the results of a biopsy aren’t clear, your doctor may decide that you need surgery to remove all or part of your thyroid gland in order to test it for cancer.

Treatment for thyroid cancer begins with surgery to remove the cancerous part of the thyroid. When one part (lobe) is removed, the procedure is called a lobectomy. Your doctor may also remove lymph nodes during surgery. After surgery, any remaining thyroid tissue is destroyed with radioactive iodine. Since you typically begin radioactive iodine treatment several weeks post-surgery, you may experience hypothyroidism symptoms during the waiting period.

Thyroid-stimulating hormone (TSH) suppression therapy is used to reduce the TSH in your body. TSH suppression therapy may help prevent any remaining cancer cells from growing. When thyroid cancer is diagnosed at an advanced stage, then chemotherapy or radiation therapy may be a part of initial treatment.

After you have undergone thyroid cancer treatment, your doctor may have you take thyroid hormone medication that will replace the hormones your body can no longer make. You will be on this medication for life. You’ll also need to schedule follow-ups with your doctor every six to twelve months. If you notice any new lumps in your neck or have difficulty breathing or swallowing, be sure to call your doctor to schedule an appointment right away.

Sinus Cancer

Sinus cancer, also known as sino nasal cancer or nose cancer, occurs when an abnormal malignant growth develops in an individual’s nasal or sinus cavities. The nasal cavity is located just under the upper bridge of the nose. The sinus cavities are located in the lower forehead in the area between the eyes and the upper part of the cheeks. The most common location of sinus cancer is in the maxillary sinus or cheeks.

The most common form of cancer that occurs in the nasal region is squamous cell carcinoma. Other types of cancer that can occur in this region include:

Esthesioneuroblastoma
Sarcoma
Malignant melanoma
Lymphoma
Undifferentiated carcinoma
Adenocarcinoma

In some cases, sinus and nasal cancers may metastasize, or spread, to the lymph nodes of the neck or other nearby regions before symptoms occur.

The viral infection HPV is one cause of sinus cancer (sino nasal cancer), and HPV is known to cause benign sinus tumors. Known as inverted papillomas, the HPV-related tumors can sometimes develop into squamous cell carcinoma.

In the beginning stages, sinus and nasal cancers have symptoms that are similar to those that occur during infections, such as:

Sinus pressure
Headaches
Runny nose
Swelling in the eyes
Runny nasal discharge
Congestion

While the symptoms of cancer and infection are similar, one of the main differences is that an infection will improve significantly after a few weeks. However, cancer symptoms do not subside. But even persistent symptoms can signal other nose and sinus related medical conditions.

As the nose or sinus cancer grows, patients may experience some additional symptoms:

Extreme fatigue
Lumps in the neck
Loosening of teeth
Bulging in one or both eyes
Pain or pressure in the ears
Loss of smell
Swelling or lumps on the face
Recurrent nosebleeds
Difficulty opening the mouth
Unexplained weight loss
Numbness or tingling in the face
Soreness or lumps in the nose
Swelling or lumps in the roof of the mouth
Changes in vision and blurriness
Pain or numbness in the upper teeth
Bloody nasal discharge
Forehead or cheek pain

Nose and sinus cancer (sino nasal cancer) symptoms vary widely based on the specific type of cancer, where it is located and the stage of growth. In addition, because the nasal cavity and sinuses have different types of tissue and cells, different forms of cancer can develop.

Unfortunately, initial symptoms of cancer are often misdiagnosed. Thus, nasal and sinus cancer (sino nasal cancer) is not typically detected in the early stages. Once detected, treatment typically involves a combination of radiation therapy, surgery, and chemotherapy.

The most important factors in developing a treatment plan are the type of cancer, its location and the stage of growth. Medical professionals also consider your general health and personal treatment preferences.

Treatment options for cancer of the paranasal sinuses or nasal cavity include:

Surgery
Chemotherapy
Targeted therapy
Radiation therapy
Palliative treatment

Trinity, FL

Brooksville, FL

Head and Neck Cancer Surgery

Treating Head and Neck Cancers

Laryngeal Cancer

Skin Cancer

Throat Cancer

Diagnostic testing for throat cancer may include:

Surgery

Chemotherapy

Radiation Therapy

Mouth Cancer

Thyroid Cancer

Sinus Cancer