Head and Neck Cancer

Mouth cancer

Tongue cancer

1. Chemotherapy

Indications:

Locally advanced head and neck squamous cell carcinoma (HNSCC) as part of concurrent chemoradiation.

Palliative treatment in recurrent/metastatic disease.

Neoadjuvant or adjuvant therapy in selected high-risk cases.

Expertise:

Administering agents like cisplatin (standard), carboplatin (for less fit patients), or cetuximab-based regimens.

Use of combination regimens like taxanes (docetaxel, paclitaxel), fluorouracil, or platinum-based therapies in advanced disease.

Managing toxicities such as nephrotoxicity, ototoxicity, mucositis, and hematological side effects.

2. Immunotherapy

Indications:

Recurrent or metastatic HNSCC with progression after platinum-based chemotherapy.

Expertise:

Administering immune checkpoint inhibitors like pembrolizumab (first-line for PD-L1 positive tumors) or nivolumab.

Monitoring for and managing immune-related adverse events (e.g., pneumonitis, colitis, thyroid dysfunction).

Evaluating treatment response using RECIST criteria and maintaining quality of life in palliative settings.

3. Radical Radiotherapy

Indications:

Definitive treatment of localized HNSCC (e.g., oropharynx, larynx, hypopharynx).

Post-operative radiotherapy for salivary gland malignancies with adverse pathological features (e.g., positive margins, perineural invasion).

Expertise:

Use of advanced techniques like IMRT, VMAT, and image-guided radiotherapy (IGRT) for precise delivery.

Application of adaptive radiotherapy strategies for tumor volume changes during treatment.

Managing acute toxicities like mucositis, xerostomia, and dermatitis, and addressing long-term side effects (e.g., fibrosis, swallowing dysfunction).

4. Concurrent Chemoradiotherapy

Indications:

Locally advanced HNSCC (e.g., oropharyngeal, nasopharyngeal).

Expertise:

Concurrent use of high-dose cisplatin with radiotherapy to enhance radiosensitivity.

Managing the synergistic toxicities of chemoradiotherapy, including severe mucositis, dysphagia, and weight loss.

Monitoring and ensuring adequate supportive care (e.g., feeding tube placement, hydration).

5. Adjuvant Radiotherapy

Indications:

Post-surgical cases with adverse features like extracapsular spread, positive margins, or perineural invasion.

Expertise:

Use of post-operative concurrent chemoradiotherapy for high-risk HNSCC.

Tailoring radiation fields to surgical bed and nodal areas at risk while sparing critical organs (e.g., parotid glands, spinal cord).

6. Palliative Radiotherapy

Indications:

Symptom relief in advanced or metastatic head and neck cancers (e.g., pain, bleeding, airway obstruction).

Expertise:

Administering short-course or hypo-fractionated regimens (e.g., 20 Gy in 5 fractions) for symptom relief.

Emergency radiotherapy for airway compromise or bleeding tumors.

Coordination with palliative care teams for holistic symptom management.

Additional Experience:

Salivary Gland Cancers:

Managing rare malignancies (e.g., adenoid cystic carcinoma, mucoepidermoid carcinoma) with post-operative radiotherapy or chemoradiation.

Applying systemic therapies for metastatic or high-risk cases, including targeted agents in clinical trials.

Multidisciplinary Tumor Boards:

Collaboration with surgeons, pathologists, and speech therapists for integrated care.

Supportive Care:

Proactive management of treatment-related toxicities, including dental care, swallowing therapy, and nutritional support.

Clinical Trials:

Participation in trials evaluating novel immunotherapy, chemotherapy, or combination strategies for head and neck cancers.

This range of expertise ensures high-quality, individualized care for head and neck cancer patients, addressing both curative and palliative needs.

FAQ

Coming!

What treatments are available for head and neck cancer in Liverpool?
Treatment options for head and neck cancer depend on the type, stage, and location of the cancer. Available treatments may include chemotherapy, immunotherapy, radiotherapy, concurrent chemoradiotherapy, surgery, targeted therapies, or a combination of these approaches. Treatment plans are tailored to each patient following multidisciplinary team discussion.
When is chemotherapy used for head and neck cancer?
Chemotherapy is commonly used alongside radiotherapy for locally advanced head and neck cancers. It may also be offered before surgery, after surgery, or as palliative treatment for recurrent or metastatic disease. Commonly used medications include cisplatin, carboplatin, taxanes, and fluorouracil-based regimens.
What is immunotherapy for head and neck cancer?
Immunotherapy helps the body's immune system recognise and attack cancer cells. It is often used for recurrent or metastatic head and neck cancers, particularly when cancer has progressed after platinum-based chemotherapy. Treatments may include pembrolizumab or nivolumab depending on the individual patient's cancer characteristics.
How effective is immunotherapy for head and neck cancer?
Immunotherapy can provide durable responses for selected patients, particularly those with PD-L1 positive tumours. While not suitable for every patient, it has significantly improved treatment outcomes for many individuals with recurrent or metastatic head and neck cancer.
What is concurrent chemoradiotherapy?
Concurrent chemoradiotherapy combines chemotherapy and radiotherapy given at the same time. This approach is commonly used for patients with locally advanced head and neck cancers because chemotherapy can increase the effectiveness of radiotherapy and improve cancer control.
What types of radiotherapy are available for head and neck cancer?
Modern radiotherapy techniques include Intensity-Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), and Image-Guided Radiotherapy (IGRT). These advanced treatments allow highly precise delivery of radiation while reducing exposure to surrounding healthy tissues.
What is radical radiotherapy?
Radical radiotherapy is treatment given with curative intent. It is often used as a primary treatment for cancers of the throat, voice box, oral cavity, or nasopharynx and may be used instead of surgery in selected patients.
What is adjuvant radiotherapy?
Adjuvant radiotherapy is radiotherapy given after surgery to reduce the risk of cancer recurrence. It may be recommended when surgical pathology identifies high-risk features such as positive margins, extracapsular spread, or perineural invasion.
When is palliative radiotherapy used?
Palliative radiotherapy is used to relieve symptoms caused by advanced cancer, including pain, bleeding, swallowing difficulties, or airway obstruction. Treatment is designed to improve quality of life while minimising treatment burden.
What treatments are available for recurrent or metastatic head and neck cancer?
Patients with recurrent or metastatic disease may be considered for chemotherapy, immunotherapy, targeted therapies, palliative radiotherapy, or clinical trials. Treatment decisions are individualised based on previous treatments, performance status, and molecular characteristics of the cancer.
Can I access clinical trials for head and neck cancer?
Some patients may be eligible for clinical trials investigating new immunotherapy treatments, targeted therapies, novel chemotherapy combinations, or precision medicine approaches. Clinical trials can provide access to innovative treatments that are not yet widely available.
Are there treatments available for salivary gland cancers?
Yes. Salivary gland cancers may be treated with surgery, post-operative radiotherapy, chemoradiotherapy, and, in selected cases, targeted therapies or clinical trial treatments. Management depends on the type and stage of the tumour.
How is supportive care provided during treatment?
Comprehensive supportive care is an essential part of treatment. Patients may have access to nutritional support, swallowing therapy, speech and language therapy, dental assessment, pain management, physiotherapy, and psychological support throughout their cancer journey.
Can I get a second opinion for head and neck cancer treatment?
Yes. Private consultations are available for patients seeking a second opinion regarding diagnosis, treatment recommendations, immunotherapy options, radiotherapy planning, clinical trials, or recurrent cancer management.
How do I book a private head and neck cancer consultation?
Patients can arrange a private consultation to discuss diagnosis, treatment options, clinical trial opportunities, immunotherapy, radiotherapy, chemotherapy, and personalised treatment recommendations from an experienced multidisciplinary cancer team.