Head & Neck cancer Surgery

The physicians of Bellingham ENT provide surgical diagnosis and treatment for a wide variety of cancers of the head and neck. This includes cancer of the oral cavity, tonsils, base of tongue, thyroid gland, throat, and voice box.

Cancers in the head and neck are found more frequently in older patients who smoke, however some cancers develop in younger patients who have never smoked. The Human Papilloma Virus (HPV) has been associated with an increase in tonsil and tongue cancers in patients who are younger and have less of a smoking history. Cancers can present as a painless lump in the neck or from local symptoms such as trouble swallowing, changes in voice, bleeding, snoring, and oral pain.

The work up for possible cancer usually starts with a comprehensive head and neck history and physical examination. This may include a flexible laryngoscopy, which is an examination of the back of the throat and voice box with a small endoscope that is passed through the nose. This examination is typically painless, and performed during an office examination. Further work up may include a biopsy. This can be a biopsy of the primary lesion or a needle biopsy of a lump in the neck. In addition to a biopsy, a CT scan is frequently done to assess the extent of the lesion and involvement of any of the neck lymph nodes.

After the work up is complete, the surgeons of Bellingham ENT will discuss the possible treatment options. In general, treatment options include surgical removal of the cancer, radiation therapy, chemotherapy, or combinations such as surgery followed by radiation or radiation with chemotherapy. The choice of treatment will partially be determined by the survival prognosis and the risks of each treatment option. Your work up may also involve having your case presented at the Peace Health St. Joseph Medical center weekly tumor board conference and consultations with a radiation oncologist and/or medical oncologist. Some cancers such as thyroid cancer require follow up with an endocrinologist after treatment.

The surgeons of Bellingham ENT perform most surgeries for Head and Neck cancer, although there are some surgeries that are only performed at tertiary care medical centers such as free flap reconstructions or robotic surgery. Referrals to surgeons in Seattle may be arranged if appropriate. After successful treatment, cancer surveillance begins with 5 years of intermittent office visits to examine for any early signs of recurrent cancer. After 5 years without recurrence, the cancer is cured.


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