The type of treatment usually depends on how advanced the tumor is. This is called the tumor "stage." For most head and neck cancers, the stage is based on the type of tumor, its size, and whether it has invaded nearby tissues, lymph nodes, or other parts of the body.
Upper aerodigestive tract — These tumors usually are treated with radiation alone, or radiation and surgery combined. Chemotherapy may be added to improve the results of surgery and radiation. (Chemotherapy is the use of anticancer drugs.) In general, the more advanced the cancer, the more treatments will be required.
Larynx — Smaller cancers can be treated with radiation or with surgery that preserves the ability to speak. Adding chemotherapy and radiation may decrease the chances of having to remove the entire larynx.
If the entire larynx is removed, other treatments can restore the voice. Your doctor may suggest an external microphone device (electrolarynx), esophageal speech (in which air is expelled from the esophagus to make speech), or a tracheoesophageal puncture (in which a valve is inserted to allow air to leave the trachea and travel to the esophagus to provide esophageal speech).
Salivary glands — Smaller, early stage tumors can be treated with surgery alone. Larger tumors that have spread usually require surgery followed by radiation. Tumors that cannot be removed surgically are treated with radiation or chemotherapy.
Nasopharynx — High-dose radiation is the primary treatment. Chemotherapy and surgery can be used if the cancer does not respond well to radiation.
Sinuses and nasal cavity — Cancer in this area is usually advanced by the time it's discovered. The major concern is that the tumor will invade the skull near the eye and the brain. Surgery removes as much of the tumor as possible; radiation therapy follows, to kill any remaining cancer. Sometimes, radiation treatment is started before surgery to shrink the tumor.
Some surgeons use robotic surgery, such as a procedure called transoral robotic surgery, to operate on head and neck cancers. The robot can perform very delicate, minimally invasive surgery in hard-to-reach areas. The robot can reach places a surgeon's hands cannot easily access. It has shortened the time it takes to do complicated operations in the head and neck area and reduced surgical complications.