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Treatments for Stage 3 to 4 Neck Tumors

Neck cancers are a group of cancers that includ cancer of the throat or trachea, cancers of the larynx (the voicebox) and pharynx (the area where the nasal tubes connect with the throat). Thyroid tumors and cancers of the skin, muscles and bones are categorized separately. If a cancer is stage III or IV, it's already quite advanced and may be difficult to treat; nonetheless, prompt and aggressive treatment can still achieve success.

  1. Stage III and IV

    • Doctors often assign a "stage" to a cancer to indicate how far it has spread at the time of diagnosis. While the staging system is different for each type of neck cancer, in general, stage III means the cancer has grown to a point where it's more difficult to treat or has spread to nearby lymph nodes, while stage IV means the cancer has either invaded surrounding tissues, colonized lymph nodes or metastasized (spread to different organs in the body). Stage IV cancers are the most difficult to treat successfully. The survival rate--and the chances of success--vary depending on the primary site (the place where the tumor originated).

    Surgery

    • Stage III or IV tumors have often invaded lymph nodes or other tissues, so while surgery is still one of the main treatment options it can be a complex procedure, typically involving removal not only of the primary tumor but of regional lymph nodes as well. Depending on the location of the tumor, treatment may involve oral surgeons, ear, nose and throat surgeons and plastic surgeons to restore appearance and function following surgery. Since the surgery can sometimes cause damage to nerves in the area, parts of your neck and throat may feel numb afterwards; many patients experience problems with swelling or have difficulty in chewing or talking for some time after the procedure. Restoring function after surgery may call for speech therapy.

    Radiotherapy

    • Radiation is usually administered post- rather than preoperatively, since irradiated tissues don't heal or recover as well after surgery. Radiation can help kill any cancer cells that escaped the knife and treat cases where the cancer has already invaded multiple lymph nodes.

    Chemotherapy

    • Chemotherapy isn't a preferred approach for these kinds of cancers, but it may help relieve pain or shrink tumors in cases where other approaches are unsuccessful or where the cancer has invaded other organs. Some studies have found that chemotherapy combined with other treatments improves survival. Cisplatin, fluorouracil, bleomycin and methotrexate are commonly used drugs. Chemotherapy will often achieve a short-lived improvement--three months, on average.

    Considerations

    • The side effects of each treatment are an important consideration in choosing the right approach. Chemotherapy can cause serious side effects like nausea and vomiting, hair loss, immunosuppression and the risk of infection; radiotherapy can damage salivary glands and thus increase the chance of dental problems, although newer techniques like IMRT can help minimize this risk. While surgery can cause difficulty in swallowing and talking, surgeons have developed a variety of methods to overcome these problems and therapy can help you restore function after the procedure. Even though stage III and IV cancers are more difficult to treat than localized tumors, there are still options that can help manage, control or cure head and neck cancer. As always, none of the above is intended as medical advice; if you have questions about your health, the best person to consult is your doctor.

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