Head & Neck Cancer Care

Our head and neck cancer specialists use advanced screening and diagnostic tools to provide accurate and timely diagnoses. Depending on your symptoms and overall health, you may require one or more types of medical testing.

Physical Exam

During a physical exam, your doctor will check for lumps on the neck, lips, gums and cheeks. They will also examine the nose, mouth, throat and tongue for any abnormalities. Blood or urine tests may be part of your evaluation.

Endoscopy

An endoscopy allows your doctor to see inside your throat. A thin, flexible, lighted tube called an endoscope is gently inserted through your nose into your throat. This is a simple, quick, and well tolerated examination that can occur in the office with numbing of the nose or is sometimes arranged to be done under anesthesia.

Biopsy

A biopsy involves removing a small sample of tissue for laboratory analysis. The tissue is examined to determine whether it is cancerous.

One common type of biopsy is a fine needle aspiration. During this office-based procedure performed with local numbing medication, cells are removed using a thin needle inserted directly into a tumor or lymph node.

In other cases, sedation or anesthesia is required in order to obtain a biopsy. Your surgeon will be able to explain what to expect in these situations.

X-Ray with Barium Swallow

A barium swallow X-ray creates detailed images of your swallowing passageway. You will eat or drink foods or drinks that are coated with barium, which allows them to show up on an x-ray. A series of x-rays are then taken while you swallow, which allows your treatment team to assess your swallowing in real time.

CT Scan

A CT scan may be used to measure the size of a tumor. This imaging test combines X-ray images from multiple angles to create a three-dimensional picture of the area being examined.

In some cases, a special dye called contrast is given before the CT scan to improve image clarity. The contrast may be injected through an intravenous line or taken as a liquid by mouth.

MRI

An MRI scan uses magnetic fields to produce detailed images of soft tissues, such as the neck, tonsils and the base of the tongue. Contrast dye may be given through an IV to enhance the images. MRI is another way to measure tumor size and evaluate surrounding tissue.

Positron Emission Tomography (PET) Scan

A PET or PET-CT scan is a specialized scan used mostly in cancer patients to screen the whole body for cells that could be cancerous. This is typically used before starting cancer treatment to better understand the stage of the cancer; and sometimes after treatment is complete to determine if the treatment was effective.

After your head and neck cancer care team reviews your case, you will receive a personalized treatment plan. Explore the treatment options available for your diagnosis.

Head & Neck Cancer Surgery

Not all cancers of the head and neck are treated with surgery, but most patients who need surgery as part of their treatment plan can have that done locally at Exeter Hospital. If the patient would benefit from a surgery not offered at Exeter Hospital, you can receive that surgery through our partnership with BIDMC. Our head and neck surgeons offer advanced, minimally invasive and robotic procedures to treat oral, pharyngeal, laryngeal, nasal, salivary, thyroid, and skin cancers.

Robotic Surgery

In some cases, surgeons use a surgical robot to remove tumors from the mouth or throat. The robotic arms are carefully positioned inside your mouth, while the surgeon controls the robotic arms from a console.

An assistant remains at the head of your bed to provide support as needed. Robotic surgery allows access to areas that are difficult to reach by hand.

Surgery for Skull Base Tumors

Our surgeons have advanced training in the removal of complex skull base tumors. Many of these tumors can be removed using minimally invasive approaches that do not require opening the skull. The surgical approach depends on factors such as the location and size of the tumor, and whether it involves nearby blood vessels or nerves. Our surgeons are experienced in all approaches and will discuss all surgical options with you.

Chemotherapy

If chemotherapy is part of your treatment plan, your doctor will explain how it is administered, the goals of the treatment, and what side effects can be expected. You will have a teaching session prior to receiving chemotherapy to better understand the process and ask questions.

Immunotherapy

Immunotherapy is a treatment that focuses your own body’s immune system on attacking cancer cells inside your body. It is not used for all types of head and neck cancers but can be quite effective in certain situations. Your treatment team will advise if immunotherapy is appropriate to treat your cancer.

Radiation Therapy

Radiation therapy uses high-energy x-rays to target and destroy cancer cells in areas like the mouth, throat, or voice box, shrinking tumors while sparing healthy tissue. It's often the main treatment for early-stage cancers, avoiding surgery to preserve speech and swallowing, or combined with chemotherapy for advanced cases to boost survival. Treatments occur daily over 6-7 weeks via precise techniques, which mold x-ray beams to the tumor's shape.

Our team is dedicated not only to treating cancer but also to supporting patients and their families through every stage of care.

Services include:

• Nurse navigation to guide you through treatment and recovery
• Genetic counseling and testing when appropriate
• Survivorship programs to support long-term health after treatment
• Emotional, nutritional, and rehabilitative resources to promote overall well-being