Surgical treatment and chemoradiotherapy

In case of early-stage carcinomas confined in the primary site or without cervical lymph node metastasis, surgical removal or radiotherapy are recommended. In case of carcinomas that invaded the primary site or spread to the cervical lymph nodes, functional preservation surgery or chemoradiotherapy are suitable. Since these kinds of cancers are in the head and neck, close to vital organs and involving important functions like eating, speaking, and breathing, it is hard to secure sufficient margin for safety when removing the carcinomoas. Therefore it is essential to select an appropriate surgical approach and have functional and cosmetic reconstruction. AMC’s highly experienced head and neck cancer team in the department of otolaryngology and cooperation with the department of plastic surgery for reconstruction minimize the duration of anesthesia and voice and swallowing rehabilitation as well as motor rehabilitation of the shoulder. In some cases, laryngeal microscopic surgery and transoral robotic surgery are used. After surgery, radiotherapy may be added, and sometimes concurrent chemoradiotherapy is conducted without surgery.

1) Thyroid cancer

For thyroid cancer, surgery is the primary and first treatment and radioactive isotope therapy is additionally performed in certain situations. Surgery is divided into partial thyroidectomy and total thyroidectomy; and if the carcinoma spread to the cervical lymph nodes or it is suspected, neck dissection is also performed. Postoperative complications mostly occur right after surgery (bleeding, difficulty in breathing, infection, hypoparathyroism, and vocal cords paralysis). If total thyroidectomy is performed, thyroid hormone is no longer produced, so patients should take thyroid hormone medicine for life, but it is a pill that is easy to take like vitamin. If partial thyroidectomy is performed, most patients do not need to take thyroid hormone medicine, but do need to take medicine in some cases.

2) Oral cancer, oropharyngeal cancer, and laryngeal cancer

Different treatment is chosen depending on the disease status, also known as disease stage. A malign tumor is treated with surgical treatment, radiotherapy, and chemotherapy (drug therapy). In case of carcinomas confined in the primary site or without cervical lymph node metastasis, surgical removal or radiotherapy are recommended. In case of carcinomas that invaded the primary site or spread to the cervical lymph nodes, functional preservation surgery or chemoradiotherapy are suitable. AMC Head and Neck Cancer Center holds a meeting every Wednesday in the afternoon where medical professionals of the departments of oncology, radiation oncology, radiology, and plastic surgery discuss and find the optimal treatment for each patient.

3) Salivary gland cancer

In case of salivary gland cancer, thorough examinations and surgical removal of a carcinoma should be done as soon as possible. A treatment plan is developed based on tumor size and degree of metastasis, and if the tumor did not directly invade into the main brain nerves like facial nerves, the brain nerves should be preserved. Surgery is the primary and first treatment for removable carcinomas, and radiotherapy or chemotherapy is performed for unremovable carcinomas.