GRACE :: Head/Neck Cancer


Late Stage Oropharynx Cancer, Planning for External Beam Radiotherapy by Dr. Geoffrey Geiger

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Graphic showing radiotherapy targeting planDr. Geoffrey Geiger, University of Pennsylvania, discusses the process of planning radiotherapy for head and neck cancer.


Late Stage Oropharynx Cancer, Planning for External Beam Radiotherapy Audio Podcast


What you will hear in part 2

  • What to expect during radiation treatment


Glossary of terms you will hear in part 2

For other cancer-related definitions, visit the National Cancer Institute’s online glossary at

  • Chemotherapy – Treatment with drugs that kill cancer cells.
  • CT scan – A procedure that uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create 3-dimensional (3-D) views of tissues and organs. A dye may be injected into a vein or swallowed to help the tissues and organs show up more clearly. A CT scan may be used to help diagnose disease, plan treatment, or find out how well treatment is working. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.
  • External beam radiotherapy – Radiation that comes from a machine outside the body
  • MRI – A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, NMRI, and nuclear magnetic resonance imaging
  • Oropharynx/Oropharyngeal cancer – Cancer that forms in tissues of the oropharynx (the part of the throat at the back of the mouth, including the soft palate, the base of the tongue, and the tonsils). Most oropharyngeal cancers are squamous cell carcinomas (cancer that begins in flat cells lining the oropharynx).
  • Parotid gland – The largest of the salivary glands, which make saliva and release it into the mouth. There are 2 parotid glands, one in front of and just below each ear.
  • PET scan – A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is taken up. Because cancer cells often take up more glucose than normal cells, the pictures can be used to find cancer cells in the body. Also called positron emission tomography scan.
  • Radiation therapy/Radiotherapy – The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. 
  • Squamous cell carcinoma – Cancer of the head and neck that begins in squamous cells (thin, flat cells that form the surface of the skin, eyes, various internal organs, and the lining of hollow organs and ducts of some glands). Squamous cell carcinoma of the head and neck includes cancers of the nasal cavity, sinuses, lips, mouth, salivary glands, throat, and larynx (voice box). Most head and neck cancers are squamous cell carcinomas.


8 Responses to Late Stage Oropharynx Cancer, Planning for External Beam Radiotherapy by Dr. Geoffrey Geiger

  • aunttootsie001 says:

    Going to try this again, my Son had Surgery on Thursday where they removed 2/3 rds of the bars of his tongue. They also opened him up from under his chin all the way around to the back of his left ear. One major problem is he is diabetic and he’s in ICU and they are having trouble to get it down and regulate it! Before surgery they thought he’d have to have Radiation but now he will have to have both! Any suggestions as to how to regulate his sugar? I will be seeing him tomorrow. Lorrie P.S I have been on this website for almost 3 years as a Lung Cancer patient!

  • Dr. Geiger says:

    Hi Lorrie – I hope this finds you well. Congratulations to you as a 3 year survivor.

    He’ll probably require both chemotherapy and radiation because of either the amount of disease in his neck (if they performed a nodal assessment of the neck or “neck dissection”) or because they don’t think they’ll be able to remove all of the tumor with negative margins.

    Being diabetic can certainly add an extra layer of variables to an already complex situation but they are probably using insulin right now to regulate his sugars in the intensive care unit. Once he is out, it’ll be a more complex situation as they try to get his sugars in check as he recovers from surgery. That will be more complicated since it will depend on his food intake following the surgery (I am guessing that he has had a PEG tube placed) and end of his hospitalization. I wish I could be more helpful with respect to how to manage his insulin but that would best be answered by either an endocrinologist or an internal medicine doctor who has significant experience with managing blood glucose in patients after major surgeries.

    I hope this helps — take care, and good luck. I hope he does well in the post surgical setting.

  • aunttootsie001 says:

    Thank You Dr. Geiger for your support! The days since his surgery have been tough. Yesterday they finally made some headway with his sugar. As far as his Surgery they said it is doing well. They did tell him he’d have 5 or 6 weeks to heal which I knew then he’ll start Chemo and Radiation. Hoping he’ll be able to do it locally it’s over an hour drive each way to the Clinic. At any rate today he finally made it out of ICU into a step down program. He was off the anxiety Meds and off so much pain Meds. Head a lot clearer. Praying he’s headed in the right direction. This is going to be tough on him until he gets used to it! Thanks again!

  • aunttootsie001 says:

    I’m hoping to find out what stage he is at and what his cancer is. I am guessing Squamous and at least Stage 3 maybe 3A. Not sure staging is the same as Lung Cancer. I’ll get more answers from my daughterinlaw when I see her next.

  • Dr. Geiger says:

    Please let me know if you have questions moving forward. Take care.

  • aunttootsie001 says:

    Thank You very much! I appreciate you and all of Grace!

  • aunttootsie001 says:

    Update on Son, at this point I have yet to get an answer as to what type of Cancer it is or Staging. He starts Chemo and Radiation on the 2nd of June. I will see him this weekend before he goes so I hope to get some answers. He said he doesn’t want to make a big deal out of this! I told him But it is a Big Deal! Will touch base once I have more info. Thanks!

  • aunttootsie001 says:

    Well here’s where we are! My son Chris has had Surgery for Tongue Cancer. They removed 2/3rds of his tongue and rebuilt it at the same time. They also opened him up from behind left ear to just past under his chin to remove lymph nodes. Was in ICU for 4 days then almost 2weeks in step down. He was doing pretty well by the time they started Chemo just two infusions of Cisplatin. At the same time he was having Radiation. His final two weeks they had to admit him as he got blisters pretty bad on his tongue and throat. Wasn’t able to swallow or talk. He just finished on Sunday. They were planning on sending him home. They trained his wife to use feeding tube. Then on Monday evening he stopped breathing and they had to use the paddles on him there and once he was taken to ICU. He is on a ventilator because he wasn’t breathing on his own. They aren’t sure but think he may have has two heart attacks or even have an infection somewhere in his body. They are still running tests. This is very upsetting to say the least. Has this ever happened to someone else? Trying to stay positive! I know what he has been thru is a lot. He also could have had a stroke he is prone to clots. They removed two from his neck at the time of surgery and while in ICU the first time his right arm and hand were swollen and they found two more clots. His hand has not recouperated from that yet. So I would appreciate any input and I ask my Grace Family for prayers Please! Lorrie

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