What do we mean by 'Cancer of an Unknown Primary'? Cancer of Unknown Primary in the head and neck region occurs when the origin of the cancer is unknown, but is found to have spread to the lymph nodes in the neck. If it's not the cancer type you're looking for, please explore the information about other types of Head and Neck Cancers.
Your cancer care team will discuss the treatment options available for treating Cancer of Unknown Primary. This is also a good time to consider if you would like a second opinion. The treatment most suited to each person depends on many factors, including:
the number and size of the lymph nodes that are affected
personal factors (e.g. age, general health and treatment history)
treatments available (and whether any clinical trials are available)
your preferences for treatment.
The treatment options for Cancer of Unknown Primary are:
Surgery (often combined with radiotherapy and chemotherapy)
Radiation therapy (often combined with chemotherapy)
Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:
stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding
special stockings to reduce the risk of blood clots
early mobilisation (i.e not staying in bed) to reduce the risk of blood clots and chest infection
antibiotics to lower the risk of wound infection.
Before starting treatment, it is important that you consider stopping smoking to reduce the risk of infection and help you fully recovery after your treatment.
This is when radiation therapy is used on its own without surgery. Definitive radiation therapy may be targeted to one side of the neck area (unilateral), containing the cancerous lymph nodes, or both sides of the throat (bilateral) to treat all possible areas of primary cancer. Typically, radiation therapy is delivered daily (but not on weekends) over 7 weeks. Chemotherapy may be added to the radiation therapy (chemoradiation)
This is when radiation therapy is given after surgery and is used as an additional treatment to kill any cancer that may not have been removed during surgery. Adjuvant radiation therapy may also be given in combination with chemotherapy (called chemoradiation).
In cases where a cure is not possible, radiation therapy is used to relieve symptoms of advanced cancer of unknown primary. Symptoms that may require palliative radiation therapy include pain, bleeding, breathing and swallowing difficulties.
You will meet with many members of the cancer care team, who will help you learn how to look after yourself through radiation therapy, recovery and long term follow-up. They will also talk to you about side effects and how to manage them. It may be helpful to write down questions as they come up, so you can ask anyone in your cancer care team when you see them.
You might need to have some of your teeth taken out, this will depend on the area being treated and the dose of radiation therapy. It is important to take out any broken or infected teeth before radiation therapy. Taking out unhealthy teeth after radiation therapy can cause problems with the jaw bone. Further information about removing teeth and what to expect before and after the operation is available here.
Your cancer and its treatment can make it hard to eat and drink. Your doctor will recommend you see a dietitian to maximise your nutrition during treatment as well as while you are recovering. Sometime feeding tubes may be recommended depending on the area being treated and the dose of radiation therapy. There are two common types of feeding tubes:
Gastrostomy tube (sometimes called a PEG tube): this type of tube is inserted through your abdominal wall into your stomach, with part of the tube staying outside the stomach. A syringe can be attached to the tube to give you food this way if needed. The tube is inserted using a camera through the mouth into the stomach (gastroscopy) or using a CT scanner to guide insertion directly through the skin. If a PEG tube is needed, your doctor will organise this before starting your radiation therapy
Nasogastric tube: this type of tube goes through the nose down into the stomach and is usually used for short periods (days or weeks). A nasogastric tube can be inserted at any time (before, during or after treatment).
There are many other aspects of supportive care that are available, ask your doctor if you have any specific needs.
The side-effects of radiation therapy start around two weeks into treatment and progress through treatment to peak in the last week or just after treatment ends. The side effects start to improve 2-3 weeks after the end of treatment.
the dose of radiation therapy
the area being treated
whether or not chemotherapy is added to the radiation.
tiredness
skin irritation in the treated area e.g. redness, dryness and itching, weeping skin, scaling or sometimes skin breakdown (sores)
dry mouth and throat due to lack of saliva (called xerostomia)
ulcers in the mouth or throat that make it painful or difficult to chew or swallow
altered taste, which is usally a loss of taste or sometimes an unpleasant taste in the mouth
pain on swallowing or difficulty with swallowing.
Most side effects are short lived and may go away within 4–6 weeks of finishing radiation therapy. Some side effects may last for months after you finish radiation therapy and some may be permanent.
Chemotherapy works by destroying or damaging cancer cells. For head and neck cancers, chemotherapy is usually given into a vein through a needle with a catheter (tube) attached. Usually chemotherapy is used in combination with radiation therapy to make the radiation therapy more effective. It is usually given once a week or once every 3 weeks throughout the duration of radiation therapy. Unlike chemotherapy for many other cancers, most patients do not lose their hair or have severe nausea and vomiting.
nausea and vomiting
loss of feeling in the fingers and toes
some medications may cause kidney damage
hearing loss/thinning
ringing in the ears
rash
higher risk of infection (if the chemotherapy reduces the number of white cells in the blood)
Most of these side effects are short lived and may go away once you finish chemotherapy. Some side effects can take months or years to improve or may be permanent.
Once your treatments end, you will have regular follow-up appointments so that your doctor can check your recovery, make sure the cancer has not returned and monitor and treat any side effects that you may have.
Loading...