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Providence Cancer Institute
Providence Cancer Institute
Where bright minds and big hearts come together
At Providence, we see more than a patient with a head or neck cancer diagnosis. We see the life you’re fighting for – and we have for nearly 100 years. That’s how long we’ve been providing world-class cancer care across Southern California. Today, our commitment continues with nationally accredited cancer programs in Los Angeles and Orange County with a multidisciplinary patient focused approach.
Cancer navigators who provide individual support, compassionate care and coordination every step of your cancer journey.
Access to the most advanced technology and treatment options, including research, precision medicine, genetic counseling and clinical trials.
Your personalized treatment plan will depend on factors that are unique to you, from your specific diagnosis to your personal health and preferences. But one thing that most patients can count on is that it will take a multidisciplinary team, and that’s where Providence shines.
Your team may include multiple experts who specialize in very specific aspects of cancer care, such as cancer and reconstructive surgeons, radiation and medical oncologists, as well as nurses, dietitians, speech therapists, audiologists, dentists, and counselors, all collaborating on your care. Collaboration is the source of this approach and our staff the heart. One way is through regular collaborative multidisciplinary tumor conferences (tumor boards), where members of your team, with complimentary specialties gather to review your case as well as others, and to share clinical opinions, recommend treatments or strategies, suggest opportunities for clinical trials and optimize care coordination.
To help guide you through the whole process, we will also team you up with a cancer navigator. Your cancer navigator helps you with care coordination, answers your questions, refers you to helpful support services, and provides emotional support and more to help ease the stress of cancer treatment.
Treatment options and services may differ based on location including Providence Little Company of Mary and Providence Holy Cross where City of Hope partnerships have been established for cancer care. For more information, please contact the Patient Engagement Center or click on the selected location.
Head and neck cancer includes several types of cancer that begin in the head, neck or throat.
Oral Cavity: Oral cavity cancer, also called oral cancer or mouth cancer, starts in the mouth, lips, the cheeks, or the front of the tongue. These tumors can involve the mandible and can affect speech and swallowing.
Oropharynx: Oropharyngeal cancer starts in the middle part of the throat and includes the base of the tongue, soft palate and tonsils. Almost all these cancers are squamous cell. The incidence of these tumors is on the rise.
Nasal Cavity and Paranasal Sinuses: Nasal cavity cancers start inside the nose, while paranasal sinus cancers most often start in the maxillary sinuses in the cheeks and below the eyes on either side of the nose. Paranasal sinus tumors can also involve the skull base, the orbit, or nerves that given sensation to the face. A number of different cancers originate in this area, including squamous cell carcinoma, olfactory neuroblastoma, or adenoid cystic carcinoma.
Larynx: Laryngeal cancer begins in the larynx, or voice box. Almost all laryngeal cancers develop from squamous cells, which are thin, flat cells in the inner lining of the tissue. A tumor in this area can affect the voice, swallowing, or the airway.
Hypopharynx: Hypopharyngeal cancer affects the lower part of the throat. Like laryngeal cancer, it most often develops from squamous cells lining the throat.
Nasopharynx: Nasopharyngeal cancer begins in the nasopharynx, a box-like chamber behind the nose near the base of the skull at the upper part of the throat; air passes from the nose through the nasopharynx into the throat and lungs. It is very rare in the United States.
Salivary Gland: Salivary gland cancer affects the glands that rest on the sides of the face (parotid), below the jaw (submandibular), and inside the mouth and nose (minor salivary glands) that produce saliva. Salivary gland cancer is rare in the United States.
Neck: Many types of head and neck cancers can spread to the lymph nodes in the neck. In some cases, a mass in the neck can be the earliest sign of a problem. Rarely, cancers originate in the soft tissues, nerves, or blood vessels in the neck.
Head and neck cancer most commonly affects people over the age of 60 and develops more often in men than women. Various factors are known to raise the risk of head and neck cancer, including:
- Tobacco use (smoking and chewing)
- Moderate or heavy alcohol use (more than one drink per day)
- Human papillomavirus (HPV) infection is linked to most cases of oropharyngeal cancer, but most people with HPV infections of the mouth and throat do not develop this cancer.
- Excess body weight
- Poor nutrition
- Genetic syndromes
- Workplace exposures (fumes, chemicals, etc.)
Having any of these risk factors does not mean you will develop cancer, but if you are concerned about your risk, talk to your doctor.
There are no routine screening exams for head and neck cancer, but if you have any of the conditions that increase risk or notice any potential symptoms, talk to your physician. The sooner cancer is detected, the easier it may be to treat. Consider the following guidelines to help lower your risk of head and neck cancer:
- Avoid tobacco use
- Eliminate or reduce alcoholic beverages
- Maintain a healthy body mass index and lose weight if you are overweight
- Get regular dental check-ups to look for early signs of oral cancer
- Vaccination against the human papilloma virus (HPV vaccine)
Cancers of the head and neck usually have no early signs, so most are not found until they begin to cause symptoms.
Having any of these symptoms does not mean you have head or neck cancer; in fact, most are likely to be caused by infections, non-cancerous tumors or other conditions. However, if any symptoms last more than two weeks, talk to your doctor about them.
Oral cavity and oropharyngeal cancer symptoms may include:
- A sore on the lip or in the mouth that doesn't heal
- Pain in the mouth that doesn’t go away
- A lump or thickening in the lips, mouth or cheek
- A white or red patch on the gums, tongue, tonsil, or lining of the mouth
- Persistent sore throat or a feeling that something is caught in your throat
- Trouble chewing or swallowing
- Trouble moving the jaw or tongue
- Numbness of the tongue, lip, or other area of the mouth
- Swelling or pain in the jaw
- Dentures that start to fit poorly or become uncomfortable
- Loosening of the teeth or pain around the teeth
- Voice changes
- A lump or mass in the neck or back of the throat
- Pain in the ear
Laryngeal and hypopharyngeal cancer symptoms may include:
- Hoarseness or voice changes that last more than two weeks
- Persistent sore throat
- Pain or difficulty when swallowing
- Ear pain
- Difficulty breathing
- Lump or mass in neck (as it spread to nearby lymph nodes)
Nasopharyngeal cancer symptoms often affect only one side of the neck and may include:
- A lump or mass in the neck
- Hearing loss or ringing in the ear
- Pain or feeling of fullness in the ear
- Ear infections that keep coming back (especially without an upper respiratory infection)
- Nasal blockage or stuffiness
- Nosebleeds
- Headaches
- Facial pain or numbness
- Trouble opening the mouth
- Blurred or double vision
- Trouble breathing or talking
Salivary gland tumors can affect several important nerves and structures in the face and neck. Salivary gland cancer symptoms may include:
- A lump or swelling in your mouth, cheek, jaw, or neck
- Pain in your mouth, cheek, jaw, ear, or neck that does not go away
- A difference between the size and/or shape of the left and right sides of your face or neck
- Numbness or weakness in part of your face
- Trouble opening your mouth widely
- Fluid draining from your ear
- Trouble swallowing
Nasal cavity and paranasal cancer symptoms often affect only one side of the face and may include:
- Nasal congestion and stuffiness that doesn’t improve or worsens
- Pain above or below the eyes
- Blockage of one side of the nose
- Post-nasal drip (nasal drainage in the back of the nose and throat)
- Nosebleeds
- Pus draining from the nose
- Problems with sense of smell
- Numbness or pain in parts of the face
- Loosening or numbness of teeth
- A lump or mass on the face, roof of the mouth or inside the nose
- Constant watery eyes or bulging of one eye
- Loss or change in vision
- Ear pain or pressure, or hearing loss
- Trouble opening the mouth
- Enlarged lymph nodes in the neck (seen or felt as lumps under the skin)
Your doctor will perform a physical examination and medical history and may refer you to a head and neck cancer specialist, such as an ear, nose and throat (ENT) doctor (otolaryngologist) or an oral and maxillofacial surgeon.
Depending on the type of cancer, you may have diagnostic tests including:
- Endoscopy: This test uses a long, thin tube inserted through the mouth into the throat to directly view the area. Various types of endoscopy examine different areas.
- Flexible laryngoscopy examines the larynx, pharynx, vocal cords and the back of the throat.
- A rigid endoscope examines the nasal passageways and allows for suctioning and manipulation.
- Magnetic resonance imaging (MRI): Using radio waves and strong magnets, MRI provides detailed images of any growths in the head or neck. MRI also can help determine if cancer has spread.
- Computed tomography (CT) scan: A CT imaging scan uses X-rays to provide information about the size, shape and location of growths and can help determine if cancer has spread.
- Positron emission tomography (PET) scan: A PET scan uses a radioactive drug called a tracer to detect malignant disease, highlighting tissues that are metabolically active. The tracer may be injected, swallowed, or inhaled, depending on the area being studied.
- Fine needle biopsy: If the physician suspects a growth may be cancer, they may perform a biopsy to remove a tissue sample from the growth for testing.
From the latest targeted therapies to the most innovative approaches emerging through clinical trials, Providence leverages the full power of today’s most advanced, evidence-based therapies to treat head and neck cancer. Your personalized treatment plan will depend on the type of cancer you have, how advanced the cancer is (known as the stage), your overall health and other factors.
Treatment for head and neck cancer may include any or all of the following:
Surgery removes the tumor and surrounding tissue, including diseased lymph nodes. Many types of head and neck cancer surgeries can be performed using minimally invasive surgical techniques, including robotic, laser, and endoscopic.
There are several types of surgery for head and neck cancer:
Oropharynx surgical procedures include:
- Transoral robotic surgery for removal of tumors of the tonsils, base of tongue, oropharynx, and supraglottic larynx
- Transoral laser surgery for precise tissue cutting
- Diagnostic endoscopy for biopsy
Nasal and Sinus surgical procedures include:
- Endoscopic approaches to the sinuses, skull bases, and orbit
- Image-guided surgery
- Endoscopic nasopharyngectomy
- Anterior skull base resection
Larynx surgical procedures include:
- Transoral laser microsurgery: Removes cancers of the vocal cord and surrounding tissues, with preservation of surrounding normal tissues
- Supracricoid partial laryngectomy: Open surgery with preservation of the breathing, speaking, and swallowing function of the larynx
- Partial laryngectomy: Removes part of the larynx and helps keep the ability to talk. This procedure is sometimes performed through a minimally invasive transoral approach with either robot or laser technologies
- Total laryngectomy: Removes the whole larynx and creates an opening in the front of the neck to allow the patient to breathe (tracheostomy)
Salivary tumor surgical procedures include:
- Parotidectomy: Removal of all or part of the salivary gland on the side of the face
- Removal of submandibular gland
Reconstruction procedures include:
- Free tissue transfer of bone or soft tissue from other sites in the body
- Local or regional flaps for aesthetic and functional reconstruction
Other head and neck surgical procedures include:
- Excision of skin cancers
- Lymph node dissections
- Glossectomy, or removal of part of the tongue
- Treatment of osteoradionecrosis following radiation therapy
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Radiation therapy also may be used to shrink a tumor before surgery, or after surgery to kill cancer cells that were not removed.
We offer specialized radiation therapy technologies that are especially important in treating head and neck cancer:
- 3-D conformal radiation therapy (3D-CRT) uses precise three-dimensional scans of tumors to deliver more focused and accurate high-dose radiation to the precise size, shape and depth of cancerous tumors.
- Intensity-modulated radiation therapy (IMRT) allows physicians to deliver a highly precise form of radiation therapy by simultaneously directing different intensities of radiation to the same region of the body. IMRT is important in treating head and neck cancer, as there are many critical structures in the head and neck immediately adjacent to the treatment region which must be protected from excess radiation.
Immunotherapy uses medicines that help your own immune system identify and destroy cancer cells. The immune system turns proteins on immune cells (known as checkpoints) on or off to trigger an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immunotherapy drugs called “checkpoint inhibitors” target these checkpoints to keep cancer cells from using them.
Targeted therapies destroy cancer cells or stop their growth by targeting metabolic defects in cancer cells. They are sometimes taken in pill form.
Chemotherapy uses drugs to kill cancer cells or stop them from dividing. Chemotherapy may be used to shrink a tumor before surgery, or after surgery to kill cancer cells that were not removed.
Our services are provided by a cancer care team that not only understands the importance of comprehensive support, but also values each patient’s individual needs.
Genetics play an important role in your medical health and that of your family members, as they help you understand the influence of inherited gene changes linked to cancer. Genetic counseling and testing are available for all hereditary cancer syndromes and familial patterns of cancer. Our genetic counselors combine genetic test results, personal factors, family history, and counseling to generate a personalized genetic risk assessment with estimates of future cancer risks for both individuals and family members. The process of genetic counseling creates risk estimates as well as improved patient and physician understanding, which leads to individualized medical management, empowered cancer prevention, and appropriate risk reduction strategies. Learn more to see if genetics counseling is right for you.
Clinical trials are research studies that test the safety and effectiveness of new medical treatments. Patients who volunteer for clinical trials often gain access to the newest advancements and investigational therapies. At Providence, our physicians work closely with our world-class research team to make appropriate clinical trials a regular part of our patients’ care options.
To learn more visit:
- In Los Angeles, Research and Clinical Trials | Providence
- In Orange County, Research and Clinical Trials | Providence
Head and neck cancers can have ripple effects that extend beyond your physical health. At Providence, we believe in treating the whole person, not just the cancer. We believe in empowering our patients, and their families, in mind, body and spirit. We foster a partnership with you and your loved ones. We are here for you every step of your journey. Our multidisciplinary approach and commitment include a variety of helpful and supportive services to keep you and your family informed and healthy, such as these:
- Cancer navigators
- Counseling
- Social work services
- Financial counseling
- Cancer survivorship programs and clinics
- Support groups and wellness groups
- Inpatient and outpatient rehabilitation (physical, speech and swallowing therapy)
- Integrative medicine (e.g., acupuncture, reiki, sound bath, biofeedback)
- Nutrition services
- Home health care
- Palliative care
- Hospice
*Treatment options and services may differ based on location.
We welcome your questions! Call 800-538-0476 for more information or complete the online form.
