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Diagnosis and Treatment Process

Treating head and neck cancer should always start at UPMC’s Eye and Ear Institute. It is important that all patients’ conditions are considered on an individual basis to ensure the proper care and treatment plans are chosen. There is a specific sequence of events that doctors follow to ensure that the best individualized care is provided. The following is the sequence of events patients can expect after they have scheduled an appointment with an otolaryngologist (head and neck surgeon) to assess their possible conditions:

  • Diagnosis and treatment process
  • Prevention and risk factors
  • Patient services

All appointments can be made by contacting UPMC’s Eye and Ear Institute.

  • Diagnosis

    During the first visit the doctor will diagnose the tumor as benign (non-cancerous) or malignant (cancerous). If the tumor is malignant then the doctor will also determine what stage the cancer is in. The physician may perform one or many of the following procedures:

    • Physical examination
    • Scan (CT, MRI, and/or PET)
    • Needle biopsy (awake in the office)
    • Brief outpatient exam (under anesthesia)

    Staging describes the extent of the cancer. It is important for the otolaryngologist to identify the primary site of the tumor and whether the cancer has spread to the lymph nodes in the neck or elsewhere. The following are the staging classifications:

    • Stage I:

      Cancers are small, localized and usually curable

    • Stage II:

      Cancers are typically small and locally advanced

    • Stage III and IV:

      Cancers have spread to local lymph nodes and generally metastatic (have spread to other parts of the body) and require combined treatment with surgery and radiotherapy and/or chemotherapy

  • Treatment Discussion and Decision

    Once results from the diagnosis process are in, UPMC’s head and neck cancer specialists meet at the weekly multi-disciplinary conference to discuss the best treatment for each patient on an individual basis. This multidisciplinary approach includes a team of UPMC practitioners specializing in several areas of cancer treatment.

    Once the treatment options are determined by the team, the patients’ cases are assigned to the treating doctor who will contact the patient to start treatment. The multidisciplinary team includes the following practitioners:

    Otolaryngologist

    • Head and neck surgeon who removes tumors

    Medical Oncologist

    • Physician who treats cancer with chemotherapy

    Radiation Oncologist

    • Physician who specializes in the use and administration of radiotherapy

    Prosthodontist

    • A dentist who advises patients in maintaining healthy oral hygiene

    Collaborative Practice Nurse

    • A nurse who coordinates patient testing and treatment

    Treatment Room Nurse

    • A nurse who specializes in the delivery and monitoring of chemotherapy and other treatments

    Clinical Research Nurse Coordinator

    • A nurse who works with patients and otolaryngologists who are participating in clinical trials

    Social Worker

    • Assists patients coping with cancer-related stress

    Dietitian

    • Provides nutritional advice for patients

    Speech and Swallowing Therapist

    • Works with patients who have difficulty speaking and swallowing after surgery

    Plastic Surgeon

    • Surgeon who performs reconstructive surgery
  • Treatment

    The patient is contacted by a doctor to discuss treatment options. The treatment process is dependent on the type, tumor size, location, and stage of cancer. Combined modality therapy is the principal treatment method for patients, which may include one or more of the following methods:

    • Surgery
    • Chemotherapy
    • Radiation Therapy
  • Follow-Up

    Most recurrent tumors appear within the first two years following treatment. Follow-up appointments will be made during the first two years to monitor this risk.

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