Stopping radiotherapy for head and neck cancer is dangerous due to aggressive tumor progression

All cancers that occur in the neck area between the base of the brain and the collarbone are called head and neck cancers.

When treating head and neck cancer with radiation therapy, it is very dangerous to stop it due to side effects, including radiation mucositis, an expert recently warned.

“Despite difficulties, it is important to treat head and neck cancer diligently in the early phase to prevent it from recurring,” said Professor Kim Ji-won of the Department of Otolaryngology at Inha University Hospital on the YouTube channel with the same name as the institution.

“For various reasons, it is necessary to complete conservative treatment. During treatment, however, some patients lose weight and suffer from pain whenever they swallow due to radiation mucositis,” Professor Kim explained. “In particular, patients with head and neck cancer have poor lung function due to smoking and cannot eat well because of the disease, so there are many patients who are thin from the beginning of treatment, which makes treatment difficult.”

All this shows why it is important to be careful when undergoing radiation therapy for head and neck cancers, including “laryngeal cancer” that occurs in the larynx, “tongue cancer” that occurs in the oral cavity, “oropharyngeal cancer” that occurs in the tonsils, “pharyngeal” cancer that occurs in the pharynx at the entrance to the esophagus, and “thyroid cancer,” which is the most common cancer in Korea.

“In the case of radiation therapy, it is important to have a good nutritional intake in the early stages, as it is often difficult to eat well after three to four weeks of treatment due to canker sores, and it is essential to maintain adequate muscle mass by exercising moderately,” Professor Kim advised.

Treatment for head and neck cancer includes surgery, chemotherapy, and radiotherapy, the same as for other cancers. However, unlike other cancer treatments, it is characterized by the need to consider other factors than just removing the cancer.

“The principle of head and neck cancer treatment is not just to remove the cancer but to try to root out the cancer while preserving the patient's ability to eat, speak, and breathe as well as their appearances,” Kim said.

Depending on where the cancer is located in the head and neck, the preferred treatment approach may vary.

“Nasopharyngeal cancers are treated with chemoradiotherapy rather than surgery, while oral cancers are treated surgically first. Early-stage oral cancer is often treated with surgery, and advanced oral cancer requires chemoradiotherapy after surgery to remove residual cancer for a higher cure rate,” Professor Kim said.

Surgery is also prioritized for thyroid cancer, and, depending on the stage, additional radioactive iodine treatment may be given after surgery to eradicate residual cancer.

“In the cases of oropharyngeal, hypopharyngeal, and laryngeal cancers, surgery and radiotherapy are used as monotherapy for early-stage cancers, and radiotherapy after surgery for advanced cancers,” Kim explained. “However, if medical professionals judge that there is a large functional loss, chemoradiotherapy is given from the beginning without surgery.”