Proton Therapy Treatment for Head and Neck Cancer

Proton Therapy for Head and Neck Cancer Treatment

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Cancers known as head and neck cancers most often appear in the squamous cells, which line areas like the throat, mouth, nose, and esophagus sometimes causing face and neck disfiguration and impacting speech, sight and sense of smell. The greatest risk factors for these cancers include alcohol and tobacco use, including the use of smokeless tobacco. Acid reflux and obesity are indicators of higher risk for esophageal cancer.

Just as with brain and eye cancers, vulnerable, critical tissues and structures usually surround tumors that form in these regions, include the spinal cord and jawbone. As a result, they are prone to inadvertently receiving secondhand radiation when traditional radiation treatment methods are used.

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Symptoms of head and neck cancers will vary depending on the affected area. Symptoms include:

  • A lump or sore in the throat
  • A persistent sore throat
  • Difficulty swallowing
  • Change or hoarseness in voice
  • Recurring pain in the neck or throat
  • Frequent headaches
  • Blocked sinuses that do not clear
  • Chronic sinus infections
  • Swelling under the chin and around the jawbone
  • A white or red patch on gums, tongue or lining of the mouth
  • Heartburn or indigestion

If one or more of these symptoms appear and remain for up to two weeks, contact your doctor immediately.

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A physician may recommend a physical examination in which the oral and nasal cavities, neck, throat, and tongue are inspected using a small mirror and lights and the neck, lips, gums and cheeks are inspected for the presence of lumps.

A doctor may also use an endoscope, a thin, lighted tube, to examine areas inside the body or complete lab tests on samples of blood, urine or other bodily substances. A biopsy, in which tissue is removed and checked for cancer, may be used as well, along with x-rays, CT scans or magnetic resonance imagining (MRI).

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Proton therapy allows specialists to target and control the areas in which protons are emitted into the body and release their energy, increasing the radiation’s effectiveness while decreasing damage to the structures surrounding the treatment area. Patients will be at a lower risk for many negative side effects, including dry mouth and bone injury. Depending on the size of the tumor, a combination of proton and surgical therapy methods may be used for treatment.

More than 60,000 Americans are diagnosed annually with head and neck cancer. When treating head and neck tumors it’s critical to protect the delicate organs that surround the tumor. Proton therapy can substantially reduce damage to eyes, optic nerves, salivary glands, and other tissue and organs near head and neck tumors.7-9 Proton therapy also reduces the likelihood of side effects such as blindness, hearing deterioration, and dry mouth.8 Secondary malignancies are also less likely with proton therapy.7

  • Head and neck tumors treated with proton therapy7,8,14
  • Nasopharynx (back of the nose where it meets the throat)
  • Nasal (nose) cavity
  • Paranasal sinuses (sinuses in the face)
  • Oropharynx (area of the throat at the back of the mouth), including tonsils and base of tongue
  • Esophagus

In the chart below, the grey/white areas indicate no radiation exposure, while the colored areas indicate radiation exposure.

7 Steneker M, Lomax A, Schneider U. Intensity modulated photon and proton therapy for the treatment of head and neck tumors. Radiother Oncol. 2006;80(2):263-267.

8 Taheri-Kadkhoda Z, Björk-Eriksson T, Nill S, et al. Intensity-modulated radiotherapy of nasopharyngeal carcinoma: a comparative treatment planning study of photons and protons. Radiat Oncol. 2008;3:4.

9 Yeung D, Malyapa RS, Mendenhall WM, et al. Dosimetric comparison of IMRT and proton therapy for head and neck tumors. Int J Radiat Oncol Biol Phys. 2006;66(3):S412.

14 Chan AW, Pommier P, Deschler DG, et al. Change in patterns of relapse after combined proton and photon irradiation for locally advanced paranasal sinus cancer. Int J Radiat Oncol Biol Phys. 2004;60(1):320

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For more information for patients considering proton therapy for head and neck cancer treatment.