Head and Neck Cancer Diagnosis and Treatment

A doctor feeling a patient's thyroid gland.
We offer the latest treatments for head and neck cancer. They include robotic, minimally invasive and expert reconstructive surgeries.

At the OHSU Knight Cancer Institute, we tailor treatments to your specific needs and wishes. Our state-of-the-art care includes:

  • Oregon’s most experienced head and neck cancer doctors.
  • Doctors who work together, often combining cancer and reconstruction procedures into one surgery.
  • Leading-edge techniques such as robotic surgery, minimally invasive surgery and microvascular reconstruction.
  • The latest radiation therapy technology, including a sophisticated 3D imaging system to zero in on tumors and limit damage to healthy cells.
  • Targeted therapies that attack head and neck tumors at the molecular level.
  • A full slate of support and rehabilitation services.

Diagnosis

The OHSU Knight Cancer Institute provides the most advanced diagnostic procedures in the Northwest. This includes the latest imaging technology and sophisticated lab tests. We also aim to provide in-office or same-day results for many tests.

Diagnostic tests may include:

  • Ultrasound exam: Ultrasounds use sound waves to create images of the inside of your body. The images aren’t as detailed as an MRI or CT scan.
  • CT scan: A computed tomography, or CT, scan is similar to an X-ray but takes a series of images for cross-section and 3D views. CT scans can clearly show tumors and help your care team decide if surgery is a good option.
  • MRI scan: Magnetic resonance imaging, or MRI, scans use magnets and radio waves to take pictures inside the body. An MRI produces sharp, detailed images that can help detect cancerous cells in the head and neck.
  • PET scan: Positron emission tomography, or PET, scans require an injection of radioactive sugar. Cancer cells consume sugar faster than normal cells. A PET scan shows areas where the sugar is concentrated so doctors can see if cancer is present.
  • Barium swallow: Patients with cancer in the mouth or throat are at risk for cancer of the esophagus. Your care team may use this test to check. Patients drink a chalky liquid called barium that coats the walls of the throat and esophagus. This makes the area easier to see as a technician captures a series of X-rays.
  • Fine-needle aspiration biopsy: A thin needle is used to extract tissue that is then analyzed by a pathologist, a doctor who is an expert in identifying cancers and other diseases. The pathologist uses a microscope to look for cancer cells in the tissue.
  • Surgical biopsy: Tissue is removed in surgery to check for cancer.
  • Molecular testing: OHSU is a leader in next-generation sequencing to match cancers to targeted treatments. After a biopsy, we do detailed tests of the tumor to look for medications that can fight cancer at the molecular level.

Treatments

The OHSU Knight Cancer Institute’s doctors are trained in the latest treatments for all types of head and neck cancers.

Expertise: Our head and neck surgeons are experts in the latest surgical procedures, including minimally invasive techniques. They’re also national leaders in techniques to avoid important tissues of the head and neck, preserving your ability to speak, swallow and breathe normally.

Reconstruction: Our plastic surgeons can do expert reconstructive surgery, often at the same time the tumor is removed.

The main types of surgery for head and neck cancer are:

  • Transoral microsurgery: Our head and neck surgeons can sometimes remove cancer of the mouth, throat or voice box through the mouth using a microscope and tiny instruments or a laser.
  • Transoral robotic surgery: Our surgeons were the first in the Northwest to do transoral robotic surgery for cancer. This minimally invasive option results in shorter hospital stays and faster recovery for throat cancer patients.
  • Endoscopic skull base surgery: Since 2009, our surgeons have used a tube called an endoscope to remove nose and sinus cancers through the nostrils. This minimally invasive technique avoids incisions to the face and skull. It can result in fewer complications and quicker recovery. It also increases chances that nasal passages and sinuses work normally after surgery.
  • Neck dissection: When head or neck cancer spreads, it usually spreads to neck lymph nodes first. At the Knight Cancer Institute, our team is the most experienced in the region with a method to remove affected nodes without damaging muscles and nerves in the neck and shoulders.
  • Microvascular reconstruction: Our team provides the most experience in microvascular reconstruction in the region. This technique, used in reconstructive surgery, attaches tiny blood vessels to new tissue. This offers the most options for ideal results.

Chemotherapy, one of the most common treatments for cancer, uses medications to stop cancer cells from growing or reproducing.

Before surgery: Chemotherapy may be given before surgery to shrink the tumor.

Instead of surgery: Chemotherapy and radiation therapy may be used together (chemoradiation; see more below) instead of surgery, especially to preserve a patient’s ability to speak or swallow normally.

After surgery: Chemotherapy can be used after surgery to kill any remaining cancer cells circulating in your body or to relieve symptoms of advanced cancer.

Head and neck cancer patients are among those who benefit from an advanced form of therapy called immunotherapy. Your immune system keeps many diseases at bay, but cancer sneaks past the body’s defenses. Immunotherapy medications use your own biology to stop cancer cells from growing or spreading.

For head and neck cancers, immunotherapy medications may act on a specific protein in immune cells, boosting the system’s ability to find and destroy cancer.

Your care team may recommend targeted therapies, medications that can destroy cancer cells without affecting healthy cells as much. This can lessen side effects. Researchers have also found that targeted therapies can increase survival for some patients with advanced head and neck cancer.

Radiation therapy uses targeted beams of energy to kill cancer cells. It might be the only treatment for certain early-stage cancers. Like chemotherapy, radiation therapy may be used before surgery, in combination or after surgery.

We have Oregon’s most advanced radiation technology for treating head and neck cancers, including:

  • External beam radiation: Radiation therapy is delivered by a machine outside the body. The most advanced types use imaging software that allows your care team to adjust the radiation intensity. This helps reach as much of the tumor (or area where the tumor was removed) as possible while avoiding healthy tissue. We use the Novalis Tx, one of the most sophisticated systems available.
  • Brachytherapy: Tiny pieces of radioactive material are placed inside the body near the cancer. Brachytherapy may be permanent, with the material safely staying inside your body. Or the doctor may remove it after treatment.

Your care team may find that chemotherapy and radiation therapy would be more effective together. Chemoradiation can be helpful if cancer is difficult to reach with surgery or if surgery alone wouldn’t stop it. Chemoradiation is often preferred when:

  • The patient isn't healthy enough for surgery.
  • Surgery would cause serious side effects.
  • Surgery would result in the loss of an important part, such as the voice box.

Additional services

Your team will make sure you receive complete follow-up care. Our services include:

Voice and swallowing care: Because surgery may affect tissue such as the voice box, windpipe and neck muscles, we offer rehabilitation services at our Northwest Clinic for Voice and Swallowing.

Speech and physical therapy: Specialists at the OHSU Rehabilitation Clinic provide speech therapy, physical therapy and other services to help cancer patients maintain or restore function.

Support services: We offer wide-ranging resources to help you and your family during and after treatment. They include:

  • Cancer social workers who can help you and your family handle challenges around finances, transportation and other issues.
  • Nutrition services with dietitians who can provide support and education from diagnosis through follow-up care.
  • Survivorship programs to help you transition from active treatment to follow-up care.

For patients

Call 503-494-5355 to:

  • Request an appointment
  • Seek a second opinion
  • Ask questions

Location

Parking is free for patients and their visitors.

Center for Health & Healing Building 2
3485 S.W. Bond Avenue
Portland, Oregon 97239
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