Treatment of Recurrent Cancer of the Throat
Patients with recurrent cancer of the throat have residual cancer after initial treatment or a recurrence after an initial complete response. Recurrent throat cancer falls into one of two broad categories: 1) a cancer that returns locally or regionally and 2) metastatic recurrence, or a recurrence at a distant site. Historically, due to the lack of local disease control and the spread of the cancer, patients with metastatic disease tended to have a poor long-term survival rate, however advances in targeted precision medicines and immunotherapies are increasing disease control and providing new treatment options.
The following is a general overview of treatment for recurrent cancer of the throat. Treatment may consist of surgery, radiation, chemotherapy, targeted precision medicines, or a combination of these treatment techniques. Multi-modality treatment using two or more techniques is increasingly recognized as an important approach for increasing a patient’s chance of cure or prolonging survival. In some cases, participation in a clinical trial utilizing new, innovative therapies may provide the most promising treatment. The information on this website is intended to help educate patients about their treatment options and to facilitate a mutual or shared decision-making process with their treating cancer physician.
Approaches to Treatment
Local or Regional Recurrence: The cornerstone of treatment for local or regional recurrence is surgery and/or radiation therapy, and may include systemic therapy. The use of radiation/surgery is influenced by the location and size of the recurrent cancer and prior treatment. If the patient initially received radiation therapy, surgery can sometimes be utilized to control a local or regional recurrence of the cancer. If a patient was initially treated with surgery, radiation therapy or a combination of these modalities may be effective for controlling the cancer recurrence. For more information on radiation and surgery for throat cancer, go to Radiation Therapy for Head and Neck Cancers and Surgery for Head and Neck Cancers. In summary:
- Surgical resection is used if radiation therapy fails and if technically feasible.1
- Radiation therapy is used, if not previously used in curative doses that preclude further treatment, if surgery fails.
- Surgical salvage if technically feasible, when surgery fails.
- Systemic therapy with chemotherapy or other drugs is used for metastatic disease.2
Metastatic Recurrence: Systemic therapy figures prominently in the treatment of metastatic recurrent cancer of the throat. Systemic therapy is treatment directed at destroying cancer cells throughout the body, and may include chemotherapy, targeted therapy, or immunotherapy. Most patients with recurrent metastatic throat cancer are treated with systemic chemotherapy or immunotherapy. Patients with recurrent metastatic disease who have not received radiation therapy may be treated with combinations of radiation and systemic therapy.
The goal of administering systemic therapy to patients with metastatic recurrent throat cancer is to relieve symptoms, delay cancer progression and prolong survival. Systemic therapy may include one or a combination of drugs. Combination therapy is more commonly utilized due to improved response rates over single drugs. Clinical trials aimed at identifying the optimal combination therapy regimen and evaluating novel anti-cancer therapies for recurrent throat cancer are ongoing.
Strategies to Improve Treatment
The development of more effective cancer treatments requires that new and innovative therapies be evaluated in patients with throat cancer. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. Participation in a clinical trial may offer patients access to better treatments and advance the existing knowledge about treatment of throat cancer. Patients should discuss the risks and benefits of clinical trials participation with their physician. Areas of active exploration to improve the treatment of advanced cancer of the throat include the following:
PD-1 Inhibitors: Keytruda® (pembrolizumab) and Opdivo® (nivolumab) belong to a new class of medicines called PD-1 inhibitors that have generated great excitement for their ability to help the immune system recognize and attack cancer. PD-1 is a protein that inhibits certain types of immune responses. Drugs that block PD-1 enhance the ability of the immune system to fight cancer. Both Opdivo and Keytruda are immunotherapies that work by blocking PD-1 and have demonstrated impressive activity in the treatment of head and neck cancer.3,4
You are not alone—The CancerConnect Head & Neck Cancer Community is the leading Social Media Application for Head & Neck Cancer patients and caregivers seeking information, inspiration, and support in the wake of a cancer diagnosis. With over 50,000 members the network offers patients and caregivers a thriving community to support the many ongoing needs from diagnosis to survivorship. Login or register here.