Head and Neck Cancer
with Eva Zinreich, MD
How many weeks of radiation are usually required?
Cancers of the head and neck account for more than 55,000 cases each year. “Head and neck” cancer includes any area above the collarbone, except the brain. Some common sites include the oral cavity, soft palate, the nose and paranasal sinuses, the larynx (voice box), the salivary glands and the thyroid gland. The lymph nodes of the upper part of the neck may also be affected.
At GBMC, head and neck cancers are treated at the Milton J. Dance, Jr. Head & Neck Rehabilitation Center. According to Eva Zinreich, MD, Radiation Oncologist at the Dance Center, treatment options vary, based on the stage (extent) of the cancer. Cancer stages range between I and IV, with IV being the most serious. Imaging studies including PET/CT scan are used to guide the biopsy of the abnormality and gather information that is used to define the extent of the cancer and determine optimal therapy.
At GBMC, a team of head and neck cancer experts meets weekly to discuss treatment options for each individual patient. Common team members include radiation oncologists, medical oncologists, surgeons, dentists, speech language pathologists, social workers, nutritionists and nurses. “Each week, every team member is there to discuss treatment options and follow the patient’s progress,” says Dr. Zinreich.
Treatment options of head and neck cancer include surgery, radiation therapy, chemotherapy or a combination. “Stage I and II head and neck cancers are usually treated with either surgery or radiation therapy with no need for systemic treatment,” says Dr. Zinreich. Chemotherapy is often referred to as systemic treatment because it is used to treat cancer outside the main location and enhances the radiation effect locally.
“Cancers in stages III and IV require multimodality treatment such as surgery followed by both radiation therapy and chemotherapy,” says Dr. Zinreich. Thanks to the latest advancements in multimodality treatment, surgery can often be reserved for uncontrolled cancer only, which may help with organ preservation.
Typically, radiation is administered to head and neck cancer patients using external-beam radiation therapy, where high-powered x-rays are used to kill the cancer cells. Because external-beam radiation can also damage the surrounding tissues, computer-guided imaging such as intensity modulated radiation therapy (IMRT) may be used to help pinpoint the exact location for aiming the dose and protecting some organs. Although radioactive seed implants (known as brachytherapy) are sometimes used in head and neck cancers, external-beam radiation is much more common.
According to Dr. Zinreich, undergoing treatment for head and neck cancer can be an intensive process, but one with generally good results. “It is common for external-beam radiation therapy to be administered twice a day for five and a half weeks with chemotherapy also being given during the first and last weeks of treatment,” she says. “Then six to eight weeks later, we use a PET scan to see how well the cancer cells have responded.”
Sometimes, further treatment such as surgery on the lymph nodes or neck dissection may be needed. But overall, says Dr. Zinriech, patients usually recover from treatment within six to nine months and go on to live healthy, active lives.
Since she began treating patients at the Dance Center in 1999, Dr. Zinreich has seen excellent six-year survival rates for many of her patients. She’s proud to be a part of that success. “GBMC is one of the best hospitals for treating head and neck cancers. Our individual attention to each patient and the use of the most up-to-date treatment modalities help us cure cancer and give patients a good quality of life,” she says.
