The main treatment for local cancer is primary surgery and removal of lymph nodes. Full dose radiotherapy can be used in regions where functions such as speech can be conserved. Radiotherapy can be administered in parallel with advanced chemotherapy and both can be used to relieve symptoms. 

In some cases of head and neck cancer, the medical team can talk about palliative care. Palliative care aims to improve the quality of life by alleviating the symptoms of cancer. In addition to slowing the spread of head and neck cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies. Palliative surgery or radiation can temporarily relieve pain, and in 30-50% of patients, chemotherapy can produce an improvement that lasts for an average of 3 months. A gradual approach to pain management is essential for pain control.

Surgery

Endoscopic surgery has become more common, has similar or better healing rates than open surgery or radiotherapy, and morbidity is significantly lower. Endoscopic methods are most often used for laryngeal surgery and usually use a laser to make cuts.

Advanced stage disease (Stages III and IV) often requires multimodal treatment, which includes a combination of chemotherapy, radiotherapy, and surgery. 

Chemotherapy

Chemotherapy is usually not used as a primary treatment for healing. Primary chemotherapy is reserved for chemosensitive tumors, such as Burkitt\’s lymphoma or for patients who have metastases. Several drugs – cisplatin, fluorouracil, bleomycin, and methotrexate – provide palpation for pain and may lower the tumor.

Radiotherapy

Radiation therapies for head and neck cancers have many side effects but are often indicated in head and neck cancers. Radiation therapy can also cause oral and dermal mucositis in the skin covering the tissue, which can lead to cutaneous fibrosis. Loss of taste and smell often occur but are usually transient.

All cancer treatments have potential complications and adverse effects. The toxic effects of chemotherapy include general malaise, nausea, and vomiting, mucositis, hair loss, gastroenteritis, hematopoietic suppression, etc.

Treatment of tumor recurrence

Managing recurrent tumors after therapy is complex and has possible complications. A palpable mass or ulcerative lesion with edema or pain at the primary site after treatment suggests a persistent tumor. Patients with relapsed radiotherapy are best treated by surgery.