Surgery for Head and Neck Cancer

Surgery is an important part of the treatment of head and neck cancers and aims to remove them completely. The part of your mouth or throat that the doctor may remove depends on where the tumour is. Very small cancers can often be treated with a simple surgical operation under local or general anaesthetic, or with laser surgery, with no need to stay in hospital overnight.

If the cancer is larger, surgery will often involve a hospital stay and an operation under general anaesthetic. Sometimes the amount of surgery may involve more than one part of your head and neck, and may cause scarring on your face or neck. Some people may also need to have reconstructive surgery to the face.

Specialist types of surgery

Laser surgery may sometimes be used to remove small tumours in the mouth and the pharynx. This may be combined with a light-sensitive drug (sometimes called a photosensitising agent) in treatment known as photodynamic therapy (PDT).

A type of surgery called micrographic surgery or Mohs’ surgery is sometimes used for cancers of the lip. The surgeon removes the cancer in thin layers, and the tissue that has been removed is examined under a microscope during the surgery. The surgeon will continue to remove more layers until no cancer cells are seen in the tissue. This technique makes sure that all the cancer cells are removed, but that only the minimum of healthy tissue is removed.

What to expect from the operation

If you need to have surgery, your doctor will discuss the best type of operation for you, depending on the size and position of your cancer, and whether it has spread. It is important to make sure that you have discussed your operation fully with your surgical team. This will help you to understand exactly what is going to be removed and how this will affect you after the operation – in both the short and the long term.

It is likely that during the operation the surgeon will also remove some of the lymph glands on one or both sides of the neck, even if they are not swollen. This is called a neck dissection. Sometimes this is done because the glands may contain a small number of cancer cells that did not show up in the earlier scans.

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