Head and Neck Cancer Treatment: A Complete Guide
Published on April 24, 2025
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Head and neck cancer is a broad term for several types of cancers that include the mouth (oral cavity), throat (pharynx), voice box (larynx), sinuses and nose cavity, and salivary glands. Head and neck cancer is curable if detected early. Sometimes, it can be removed with just surgery or radiation alone. More advanced cancer may be treated with a combination of surgery, radiation therapy, or chemotherapy.
Newer medical treatments such as targeted therapy and immunotherapy may also be used in combination with conventional treatments.
Treatment for head and neck cancer depends on factors that include the location of the tumor, the stage of cancer, likeliness of spreading, and a person’s overall health. The goal of any oncologist team’s treatment plan is not only to eliminate the cancer but also to preserve the patient’s ability to speak, swallow, maintain social activity, and make facial expressions.
Surgery
Surgery may be necessary to remove a tumor. For many head and neck cancers — including cancer of the thyroid, salivary gland, and mouth — a surgeon will remove the cancerous tumor as well as surrounding tissues and lymph nodes if necessary (for example, if it’s possible the cancer has spread).
Other surgery options for head and neck cancers in harder-to-reach areas include:
- Endoscopic Surgery This procedure uses an endoscope — a thin, lighted tube with a camera lens — to view the tumor and surrounding structures and a laser to vaporize or cut out the tumor. An endoscope is often used for removing tumors in the sinuses to avoid incisions on the face. It can also remove cancers from the far areas of the mouth and neck.
- Transoral Robotic Surgery (TORS) This is used to remove tumors of the throat at the back of the mouth (oropharynx). The system includes a robotic arm mounted with surgical knives and lasers and a separate arm with a camera to display high-definition three-dimensional images to guide the surgeon.
Whenever possible, doctors will use a minimally invasive surgery to shorten the recovery time and prevent disfiguration. Surgery may be followed by other therapies, including radiation, chemotherapy, or both, to destroy any cancer cells that couldn’t be removed during surgery.
If surgery results in the removal of the tongue, jaw, or major tissue, reconstructive surgery may be performed to restore the appearance and function of the area.
A specific surgical treatment may be recommended depending on the location and the stage of the cancer. Types of cancer in which surgery may be necessary include:
- Cancer of the voice box: This may include the larynx (voice box), vocal cords, or part of the pharynx (the cavity behind the nose and mouth). Minimally invasive robotic surgery can be used to access hard-to-access areas of the throat. A surgical operation that removes the voice box plus a portion of the throat and potentially part of the esophagus or thyroid is called a laryngopharyngectomy. A partial laryngopharyngectomy removes part of the throat and part of the voice box.
- Mouth cancer: This may involve removing and reconstructing part of the jaw, roof of the mouth, or tongue, depending on the size and location of the tumor.
- Sinonasal cancer: Surgery is often performed using endoscopic technology to prevent incisions to the face.
- Salivary gland cancer: An incision is made in front of the ear and down the neck. Radiation therapy may be used to destroy remaining cancer cells in or around the salivary glands.
- Cancer of the lymph nodes in neck: Removal of lymph nodes may be required.
Side Effects of Surgery
Side effects of surgery depend on the type and location of the surgery. Common side effects from head and neck surgery include:
- Temporary or permanent loss of voice
- Numbness
- Impaired speech
- Difficulty swallowing or chewing
- Swelling of the mouth or throat area
- Facial drooping, numbness, or disfigurement
Recovery times vary. You may be able to go home the same day as surgery for early-stage cancer, with a recovery time of two to three days. More complicated surgery, including reconstruction, may require a longer hospital stay and several weeks to recover.
Radiation
Radiation therapy sends high-energy X-rays or other particles through the skin to destroy cancer cells and shrink tumors. External-beam radiation therapy for head and neck cancers delivers radiation from a machine outside the body to destroy a cancer’s DNA, denying it instructions to grow and multiply.
A radiation oncologist will determine whether radiation therapy would be beneficial and which type is best for your specific head or neck tumor.
Types of external radiation therapy include:
- 3D conformal radiation therapy, which uses CT scans to create a 3D model of the tumor as a guide
- Intensity-modulated radiation therapy (IMRT), which directs radiation beams at the tumor while minimizing damage to nearby healthy cells
- Tomotherapy or stereotactic radiosurgery, a more precise form of radiation than IMRT that uses maps to help a machine accurately deliver beams of radiation to a small tumor from different angles
- Proton therapy or particle therapy, which uses energy from positively charged protons to kill cancer cells. Research has shown that proton therapy may have advantages to IMRT in terms of recovery.
- Arc-based radiotherapy, which directs beams of energy of varying intensity in an arc-like pattern
Radiation therapy can be a standalone treatment or it can be used in combination with surgery or chemotherapy. Radiation may also be delivered after surgery to destroy any remaining cancer cells that weren’t removed.
Side Effects of Radiation
The side effects of radiation depend partly on the region of the head or neck being treated, and may include:
- Pain, sores, or redness in mouth
- Taste changes
- Dry mouth
- Weakened teeth
- Skin discoloration that resembles a burn
- Hearing loss
Most of these side effects will end soon after treatment has finished. Some, however, may be long-term or permanent.
Chemotherapy
Chemotherapy may be necessary to achieve the best control of cancer.
Chemotherapy uses one or more medications to kill cancer cells and to keep them from growing and making more cells. They are often given through an intravenous (IV) tube in the arm. You can also receive them as a capsule or pill.
Common chemo medications used for head and neck cancer include:
- carboplatin
- cisplatin (Platinol)
- docetaxel (Taxotere)
- fluorouracil
- methotrexate or MTX (Rheumatrex, Trexall)
- paclitaxel (Taxol)
Chemotherapy may be combined with radiation, surgery, or both. Chemotherapy can increase the sensitivity of the tumor to radiation, which may improve the success of radiation therapy.
Side Effects of Chemotherapy
Chemotherapy drugs attack cells that are dividing quickly, like cancer cells. But they can also affect healthy cells in the body that divide quickly, such as those in bone marrow, the lining of the mouth and intestines, and the hair follicles. This can lead to unwelcome side effects.
Side effects of chemotherapy depend on the type of drugs given, the dosage, and length of treatment. They typically include:
- Fatigue
- Mouth sores
- Skin changes
- Nausea and vomiting
- Hair loss
- Trouble concentrating and focusing
- Infection
- Diarrhea
Although chemotherapy side effects usually go away quickly, some may linger for months or years.
Targeted Therapy
Targeted therapy uses drugs to pinpoint a cancer’s specific genes or proteins that it uses to grow — and blocks their growth. A person may receive one type of medication at a time or a combination of medications given at the same time. This therapy can be given with chemotherapy, radiation therapy, or surgery.
Unlike traditional chemotherapy, which kills cells that are already made, targeted therapy prevents cells from copying themselves.
A doctor may run tests to identify the genetic mutations, proteins, and other substances in a tumor to find the most effective treatment.
The drug cetuximab (Erbitux) may be given to target and block a tumor protein called epidermal growth factor receptor (EGFR). It’s given as an IV infusion. Side effects of cetuximab may include fatigue, red or peeling skin, and diarrhea.
Some patients with thyroid cancer may benefit from targeted therapy when radioactive iodine therapy no longer works. For example, the U.S. Food and Drug Administration (FDA) has approved use of oral lenvatinib (Lenvima) and selpercatinib (Retevmo).
Larotrectinib (Vitrakvi) and entrectinib (Rozlytrek) are oral medications targeting mutations in NTRK genes. These are not first-line therapies: Larotrectinib and entrectinib are approved as a treatment for head and neck tumors that are metastatic or can’t be removed with surgery and also have the NTRK gene mutation.
Side Effects of Targeted Therapy
Side effects of targeted therapy may differ from those of chemotherapy and other treatments. These side effects include:
- Skin issues, such as rashes or dryness
- High blood pressure
- Issues with blood clotting and wounds healing
- Heart damage
- Swelling
- Autoimmune reactions
Immunotherapy
Immunotherapy uses drugs to improve the immune system’s ability to identify and destroy cancer cells. Checkpoint proteins are a type of protein on immune cells that switch on or off immune responses to foreign cells. Some cancer cells use these checkpoint proteins to “hide” from the immune system and evade attacks. A type of immunotherapy drug called checkpoint inhibitors helps the immune system better identify and attack these cancer cells.
The medications in this class used for head and neck cancer target the PD-1/PD-L1 checkpoint protein, and include:
- pembrolizumab (Keytruda), used for many advanced head and neck cancers that have spread or returned after treatment
- nivolumab (Opdivo), also used for certain advanced head and neck cancers that have spread or returned after treatment
- dostarlimab (Jemperli), approved for patients with advanced head and neck cancer that has DNA mismatch repair deficiency, in which genetic mutations build to form a cancerous tumor
Possible side effects of immunotherapy include:
- Skin reactions
- Flu-like symptoms
- Diarrhea
- Autoimmune disease
- Weight changes
Rehabilitation and Therapy
Head and neck cancer and its treatments may affect speech, swallowing, or other functions. Your care team may recommend different types of rehabilitation therapy and techniques to aid your recovery.
- Physical therapy
- Dietary counseling
- Speech therapy
- Education
If you have surgery to remove your voice box, you may need to learn to care for a stoma, which is a hole added to your windpipe to help you breathe. You also may receive guidance on how to care for feeding tubes and how to lower your infection risk.
The Takeaway
- When detected early, head and neck cancer can be curable.
- Treatments such as surgery, chemotherapy, and radiation therapy may be combined to control cancer if it has not been removed, recurs, or has spread.
- Side effects for most treatments are temporary, though some may linger.
Resources We Trust
- Mayo Clinic: Head and Neck Cancers
- National Cancer Institute: Head and Neck Cancers Fact Sheet
- Cancer Care: Coping With Oral and Head and Neck Cancer
- Head & Neck Cancer Alliance: Life After Treatment
- Memorial Sloan Kettering: Resources for Head and Neck Cancer Survivors
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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Meet Our Experts
Tawee Tanvetyanon
Medical Reviewer
Tawee Tanvetyanon, MD, MPH, is a professor of oncologic sciences and senior member at H. Lee Moffitt Cancer Center and Morsani College of Medicine at the University of South Florida in Tampa. He is a practicing medical oncologist specializing in lung cancer, thymic malignancy, and mesothelioma.
A physician manager of lung cancer screening program, he also serves as a faculty panelist for NCCN (National Comprehensive Cancer Network) guidelines in non-small cell lung cancer, mesothelioma, thymoma, and smoking cessation. To date, he has authored or coauthored over 100 biomedical publications indexed by Pubmed.
Larry Buhl
Author
A multimedia journalist and author, Larry Buhl is a longtime contributor to Positively Aware, TheBodyPro and Capital & Main. He has also contributed to KQED, Marketplace, Distillations, The New Republic, A&U, Salon, Fast Company, the BBC and others. He's based in Los Angeles.