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Proton Therapy for Head and Neck Cancers

Cancerous and non-cancerous tumors can occur in the skull base and neck, and even benign tumors in these areas may cause symptoms or threaten the health and well-being of a patient.

MD Anderson provides comprehensive care for patients who have benign or malignant head and neck tumors. Treatment options include surgery, radiation, chemotherapy, or any combination of the three.

The MD Anderson Proton Therapy Center treats head and neck cancers of the:

Nasal and sinus cavities
Oral cavity, including the salivary glands, tongue and tonsils
Larynx
Eye
Skull base
Spine

Undergoing proton therapy for olfactory neuroblastoma during the COVID-19 pandemic

After a series of nosebleeds in 2005, I was diagnosed with a rare form of cancer called olfactory neuroblastoma. I had surgery to remove the skull base tumor in my sinus cavity, followed by radiation therapy. I was then cancer-free for almost 15 years.

But in September 2019, I discovered a lump on the side of my neck. The cancer had returned and spread to my lymph nodes.

An MRI confirmed that the tumor had returned in my sinus cavity. In November 2019, I underwent two rounds of chemotherapy, followed by two surgeries in January and February 2020. The first surgery was to remove the cancer in my lymph nodes. The second surgery was to go back in my sinus cavities and remove the skull base tumor that had returned. Since I had received radiation therapy previously, my doctors recommended that I receive proton therapy this time. At my doctor’s recommendation, I came to the MD Anderson Proton Therapy Center.

My olfactory neuroblastoma treatment at the Proton Therapy Center

My proton therapy treatment was scheduled in March 2020, right after the COVID-19 pandemic started. Since we live in South Carolina, my family and I made the 15-hour drive to MD Anderson in Houston. The schools were closed during this time and my wife could work from home, so we brought our 6- and 9-year-old children with us.

Radiation oncologist Dr. Brandon Gunn helped me through proton therapy with ease. I received treatment five days a week. I had a small amount of hair loss on the back of my head and a rash on the side of my neck and face where the radiation was most concentrated. My care team recommended that I stay out of the sun to let my skin heal.

The Proton Therapy Center nutritionist, Haley Deas, gave me guidance on what to eat if I had trouble swallowing because of the radiation. However, I did not have those side effects.

The staff at the Proton Therapy Center were extremely professional and thorough. They went out of their way to make sure my treatment went smoothly.

Life after olfactory neuroblastoma treatment

We returned home to South Carolina in early May. Fortunately, my job as a compliance officer at a bank has allowed me to work from home since my olfactory neuroblastoma diagnosis in October 2019.

So far, all my scans have come back negative for new tumors. My follow-up appointment with Dr. Gunn in August will be a virtual visit, so we will not have to make the trip back to Houston as the COVID-19 pandemic continues.

I now appreciate each day a little more and try not to let unimportant things bother me or worry much. Life is short enough as it is. When I was undergoing chemotherapy, surgeries and proton therapy, there were times when I got discouraged, but I reminded myself to keep moving forward. After all, that is the only direction to go.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

The power of protons

Proton therapy allows for the effective treatment of complicated head and neck tumors, while minimizing the radiation dose to vital structures such as the eyes, mouth and brain. Vital physical functions such as vision, smell, taste and swallowing remain virtually untouched when a patient is treated with proton therapy.

Many head and neck cancer patients can benefit from the precision of intensity modulated proton therapy, or IMPT, a treatment offered exclusively at MD Anderson. IMPT delivers protons to the most complicated tumors by focusing a narrow proton beam and essentially "painting" the radiation dose onto the tumor layer by layer.

The need to implant a feeding tube during head and neck treatment, which can occur in up to 60% of standard radiation patients, may be avoided in IMPT patients due to less collateral damage to the oral cavity.

Side effects such as nausea, damage to the salivary glands, loss of taste and endocrine disorders are also reduced with proton therapy. This enables patients to better maintain their weight and hydration, contributing to successful treatment outcomes and substantially improving quality of life both during and after cancer treatment.

Proton Therapy for Head and Neck Cancers

This image demonstrates how proton therapy can be more beneficial in sparing important structures on the head and neck area in comparison to traditional radiation (IMRT). In this case proton therapy was able to spare the oral cavity, brain stem, larynx and spinal cord.

Proton Therapy Clinical Trials

Clinical trials underway at the Proton Therapy Center are dedicated to understanding the advantages of protons for treatment of head and neck tumors.

This includes the first randomized Phase II/III trial comparing IMPT to standard conformal radiation therapy in patients with oropharyngeal carcinoma, which occurs at the back of the throat.

The trial aims to measure proton therapy’s ability to reduce a range of side effects common to head and neck cancers.

Expectations

Proton therapy treatment for head and neck cancer typically takes about 15-30 minutes each day and is delivered five days a week for 4-7 weeks. Most patients tolerate it extremely well and can continue to work and exercise during and immediately after treatment is complete.