If you have been diagnosed with a type of head and neck cancer, know that there are many treatment options available to you. In this article, we’ll describe these options, with a focus on immunotherapy.
How is head and neck cancer treated?
Head and neck cancers most often begin in the squamous cells, which are flat cells that line the mouth, nose or throat. They are also referred to as squamous cell carcinomas. The main treatment options are:
- Surgery – removing cancer cells
- Radiation – using high-energy rays to kill cancer cells
- Chemotherapy – using drugs to destroy cancer cells
- Monoclonal antibodies (also known as immunotherapy) – using your body’s own immune system to attack cancer
- Tyrosine kinase inhibitors – block the action of a specific protein in cancer cells, which may then slow or stop cancer from growing
Both monoclonal antibodies and tyrosine kinase inhibitors are types of targeted therapies since they target specific proteins involved in the growth of cancer cells.
Choosing your treatment plan
Everyone’s head and neck cancer is different. So, your doctor will need to consider factors specific to you to determine a personalized treatment plan, including where your cancer is, its stage, and your overall health.
He or she will also do some blood tests to biologically profile your cancer, which will give your doctor more information on how your tumour behaves. This will help determine if you are a good candidate for certain treatments, like immunotherapy.
There are many different types of head and neck cancer, depending on where it starts. Your treatment plan will depend on your particular type of cancer.
What is immunotherapy, and how does it work?
Normally, our immune system protects our bodies from outside invaders (like bacteria and viruses) and unhealthy cells that cause cancer.
But, some cancer cells can “hide” from the immune system because they look a lot like normal cells. Immunotherapy helps the body’s own immune system fight cancer.
The immunotherapies currently available for head and neck cancers belong to a group of medicines called monoclonal antibodies. These antibodies bind to a unique spot (called an antigen), like a key fitting into a lock.
They work in one of two ways:
By binding to an antigen on the surface of certain tumour cells, the tumour cell can no longer receive the messages it needs to grow.
T cells move through your body and attack cells that aren’t a “normal” part of you – but some cancers can “confuse” the T cells and stop them from attacking by switching off their activity.
The monoclonal antibody will bind to either the T cells or the cancer cells so that the tumour cell can no longer switch off your T cells – meaning that the cancer can’t “hide” from your immune system.
Then, the T cells can do their job and attack the cancer cells.
Immunotherapy can be offered alone or in combination with other therapies (such as radiation and chemotherapy) when your cancer is advanced, or has spread or returned and cannot be removed by surgery.
By profiling your cancer, your doctor can tell you if you may be a good candidate for immunotherapy.
What should I know before starting immunotherapy?
Immunotherapy has been proven to be effective at helping the body fight cancer cells – but it can also cause your body to target normal cells, which can lead to side effects. Everyone’s experience with treatment is different.
In general, side effects with immunotherapy may include flu-like symptoms (which includes fever, chills, weakness, dizziness, nausea or vomiting, muscle or joint aches, fatigue, headache, trouble breathing, and low or high blood pressure). You may also experience swelling and weight gain from retaining fluid, heart palpitations, sinus congestion, diarrhea, risk of infection, and organ inflammation.
Some people also experience skin reactions at the injection site or severe reactions during the infusion, such as difficulty breathing and feeling faint. You may experience other side effects than those listed. For more information, talk to your doctor.
Open communication is key
When talking about your treatment options with your doctor, make sure to ask all the questions you have, including how the treatment works, how it is given, treatment goals and possible side effects.
It may be helpful to bring someone with you to your visit as support, and to help write down notes. Being engaged in your care plan is an important part of achieving the best possible treatment outcomes.
If you would like more information about immunotherapy for head and neck cancer, speak with your doctor.