Head and Neck Cancer: Surgery

Surgery for head and neck cancer is done to remove the cancer. There are a lot of different cancers covered under "head and neck cancers;" cancers in the sinuses, tongue, throat, and voice box. The type of surgery needed depends on where the cancer is, how big it is, the type of cancer, and if it has spread from where it started. If nearby lymph nodes are swollen, there may be cancer in them, so they are removed, too.

Types of Surgery

Head and neck cancer can be treated with:

• Laser surgery. This may be used for an early stage tumor, especially if it is in the larynx or voice box.

• Excision. This is the most common type of surgery for head and neck cancer. It removes the tumor, along with some of the healthy tissue around it.

• Lymph node dissection or neck dissection. Some of the lymph nodes near the cancer may be removed if the doctor thinks the cancer has spread. This may be done at the same time as the excision.

• Reconstructive or plastic surgery. Cancer surgery may remove major tissue, such as the jaw, skin, or tongue. Reconstructive or plastic surgery may be done after this to replace that tissue. This means you may have more than 1 surgery.

Risks of head and neck cancer surgery

All surgery has risks. The risks of head and neck cancer surgery include:

• Excess bleeding

• Bruising

• Infection

• Swelling in your mouth or throat which can make it hard to breathe

Possible long-term or permanent side effects depend on the type of surgery and include:

• Damage to nerves and other tissues near the cancer

• Scarring

• Dental problems

• Changes in how you eat

• Changes in senses of smell and taste

• Changes in how you talk or loss of the ability to talk the way you did before

• Changes in how you breathe

• Changes in how you look

• Hearing loss

• Decreased thyroid hormone levels

Talk with your healthcare provider about the side effects you may have after surgery.

Getting ready for your surgery

Your healthcare team will talk with you about the surgery options that are best for you. You may want to bring a family member or close friend with you to appointments. Write down questions you want to ask about your surgery. Make sure to ask about:

• What type of surgery will be done

• What will be done during surgery

• The risks and possible side effects of the surgery

• Will there be changes in how you talk, breathe, or eat

• When you can return to your normal activities

• What you will look like after surgery

Before surgery, tell your healthcare team if you are taking any medicines. This includes over-the-counter medicines, vitamins, and other supplements. This is to make sure you’re not taking medicines that could affect the surgery. After you have discussed all the details with the surgeon, you will sign a consent form that says that the healthcare provider can do the surgery.

You’ll also meet the anesthesiologist and can ask questions about the anesthesia and how it will affect you. Just before your surgery, an anesthesiologist or a nurse anesthetist will give you the anesthesia medicines so that you fall asleep and don’t feel pain.

After your surgery

The side effects of surgery for head and neck cancer depend on the location and size of the tumor, and the type of surgery that is done. Here are some things you can expect after surgery:

• Short-term or temporary pain in the area of the operation. You may be uncomfortable for a few days after surgery, but pain can be controlled with medicine. You should discuss pain relief with the doctor or nurse.

• You may feel tired or weak and your face may be swollen for a while. The amount of time it takes to recover from surgery is different for each person.

• You may have trouble chewing, swallowing, or talking. Breathing may also be affected. These problems may be temporary or permanent. 

• If the surgery was extensive, you may look different. Talk with your doctor about reconstructive surgery and your rehabilitation plan.

• Your shoulders and neck may be weak and stiff.

Recovering at home

When you get home, you may get back to light activity, but you should avoid strenuous activity for 6 weeks. Your healthcare team will tell you what kinds of activities are safe for you while you recover.

A speech pathologist may help you learn how to swallow or talk again. A physical therapist may help you with special exercises if you have shoulder or neck problems. Follow the instructions you are given and know when and how to get help if you need it.

When to call your healthcare provider

Let your healthcare provider know right away if you have any of these problems after surgery:

• Bleeding

• Breathing problems

• Redness, swelling, or fluid leaking from the incision

• Fever

• Chills

• Unable to eat

• Pain or swelling in your legs

Your healthcare team will tell you what to watch for and when to call them. Be sure you have a number to call if you need help after office hours or on weekends.