Head & Neck Cancer

Treatment Options for Head & Neck Cancer 

There are many different kinds of head and neck cancer, and each has its own specific biology, location, and treatment approach. That’s why specialist care is essential. 

At Siteman, we go beyond identifying where your cancer is located. We study how it behaves at the molecular level to build a plan that is right for your cancer and right for your life. 

Treatment plans often include a combination of: 

• Surgery with minimally invasive and robotic technology 
• Radiation therapy with IMRT, Proton Beam, and SBRT 
• Drug therapy with chemotherapy, immunotherapy, and targeted therapy 

Your team at Siteman is built around you. Surgeons, radiation oncologists, and medical oncologists collaborate on your care. And specialists in speech therapy, swallowing rehabilitation, reconstructive surgery, and physical therapy support your recovery before, during, and after treatment, so you return to your life as fully as possible. 

Is Surgery an Option for Head and Neck Cancer?

Yes. Surgery is an excellent option for many patients with head and neck cancer. WashU Medicine surgeons at Siteman have developed new procedures for removing tumors and lymph nodes that are available here and at only a handful of other cancer centers in the country. This level of surgical expertise is rare, and it matters for your outcome. 

Patients come to Siteman from across the country for our reputation in transoral robotic surgery, transoral laser microsurgery, and scarless thyroidectomy. These minimally invasive approaches mean less scarring, faster recovery, and increased ability to protect how you breathe, talk, and swallow. 

When Is Radiation Therapy Used for Head and Neck Cancer?

Radiation therapy is an essential treatment for many patients with head and neck cancer, especially those whose tumor location or size makes surgery difficult or impossible. In some cases, radiation alone can eliminate head and neck cancer without surgery. 

Radiation uses focused energy to destroy cancer cells by damaging their DNA. It can be used with chemotherapy to treat advanced disease, or on its own to eliminate cancer completely. Because the head and neck contain many sensitive structures, Siteman’s radiation oncologists use highly specialized techniques to protect healthy tissue while delivering a powerful dose to the tumor. 

Types of radiation therapy 

Intensity Modulated Radiation Therapy (IMRT) maps radiation doses to the precise three-dimensional shape of your tumor. Physicians can control exactly how much radiation enters each beam and can adjust it in real time. This protects healthy tissue around the tumor—especially important for the complex anatomy of the head and neck. 

Proton Beam Therapy uses targeted protons to attack cancer with unmatched precision. Unlike conventional radiation that passes through the body, proton beams stop at the tumor, delivering their full energy there and sparing surrounding tissue from exposure. Siteman’s S. Lee Kling Proton Therapy Center was the first in the St. Louis region to offer this technology. 

Stereotactic Body Radiation Therapy (SBRT) is used for patients whose cancer has returned or spread. Multiple radiation beams converge precisely on the tumor from different angles, delivering a concentrated dose while protecting surrounding tissue. SBRT can also be used in areas that have previously received radiation. This makes SBRT an important option for recurrent disease. 

How Does Drug Therapy Treat Head and Neck Cancer?

Drug therapy is an important option for patients whose cancer cannot be fully addressed with surgery alone, has returned after treatment, or has spread to other parts of the body. At Siteman, WashU Medicine medical oncologists lead this work, using the most current evidence to guide every decision. 

Most drug therapy is delivered through an IV so it can travel through the bloodstream and reach cancer cells throughout the body. Siteman offers three primary types of drug therapy for head and neck cancer: chemotherapy, immunotherapy, and targeted therapy.  

Types of drug therapy 

Chemotherapy uses drugs to destroy cancer cells directly. The most common chemotherapy for head and neck cancer is cisplatin, typically given in cycles over several weeks. 

Immunotherapy activates your body’s own immune system to identify and attack cancer cells. These medicines have become a standard treatment for patients with advanced or recurrent head and neck cancers. Pembrolizumab is one of the most commonly used immunotherapy drugs for the disease. Immunotherapy typically causes fewer side effects than chemotherapy and can lead to lasting results for some patients. 

Targeted therapy medicines are designed to attack specific features of cancer cells like proteins or genetic changes that allow them to survive and multiply. By blocking these specific targets, targeted therapy causes cancer cells to stop growing and, over time, to die. 

Clinical Trials: New Treatments, Here First 

Many patients at Siteman have access to breakthrough treatments through clinical trials. This research is studying medicines, combinations, and approaches not yet available at most cancer centers.  

When you come here, your care team will review your diagnosis and identify every trial that may open new options for your care.