There are three main types of treatment for head and neck cancers: surgery, radiotherapy and chemotherapy. Photodynamic therapy (PDT) and biological therapies may also be used. Sometimes the treatment of head and neck cancers will involve two or more treatments combined together.

For most people, the treatment is aimed at removing the cancer and reducing the chances of the cancer coming back.

Cancers affecting the head and neck are uncommon and therefore people with this type of cancer are usually treated in specialist cancer hospitals. This may mean that you have to travel for your treatment.

In most hospitals a team of specialists will decide the treatment that is best for you. This multidisciplinary team will include:

• an oral and maxillofacial surgeon (a doctor or dentist who specialises in surgery to the mouth and jaws) or an ear, nose and throat (ENT) surgeon;
• a clinical oncologist (chemotherapy and radiotherapy specialist).

The team will often include a number of other healthcare professionals such as a:

• dentist or oral hygienist
• nurse specialist
• speech and language therapist
• dietitian
• physiotherapist
• occupational therapist
• psychologist or counsellor.

Together they will be able to advise you on the best course of action and plan your treatment, taking into account a number of factors. These include your age, general health, the tumour type and stage.

If two treatments are equally effective for your type and stage of cancer – for example, surgery or radiotherapy – your doctors may offer you a choice of treatments. Sometimes people find it very hard to make a decision. If you are asked to make a choice, make sure that you have enough information about the different treatment options, what is involved and the side effects you might have, so that you can decide what is the right treatment for you.

Remember to ask questions about any aspects that you do not understand or feel worried about. You may find it helpful to discuss the benefits and disadvantages of each option with your doctor, specialist nurse, or with the nurses in our cancer information and support service.

Before you have any treatment, your doctor will explain the aims of it to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form, you should be given full information about:

• the type and extent of the treatment you are advised to have
• the advantages and disadvantages of the treatment
• any other treatments that may be available
• any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.

Patients often feel that hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.

Many people are frightened at the thought of having cancer treatments, particularly because of the potential side effects. Some people ask what would happen if they did not have any treatment.

Although many of the treatments can cause side effects, these can usually be controlled with medicines.

Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. In people with early-stage head and neck cancer, surgery or radiotherapy is often done with the aim of curing the cancer. Occasionally additional treatments are also given to reduce the risks of it coming back.

If the cancer is at a more advanced stage the treatment may only be able to control it, leading to an improvement in symptoms and a better quality of life. However, for some people the treatment will have no effect upon the cancer and they will get the side effects with little benefit.

If you have been offered treatment that aims to cure your cancer, deciding whether to accept the treatment may not be difficult. However, if a cure is not possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to make a decision.

Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, with medicines to control any symptoms.

Even though a number of cancer specialists work together as a team to decide upon the most suitable treatment, you may want to have another medical opinion. Most doctors will be pleased to refer you to another specialist for a second opinion, if you feel that this will be helpful. The second opinion may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will give useful information.

If you go for a second opinion, it is a good idea to take a friend with you, and to have a list of questions ready, so that you can make sure your concerns are covered during the discussion.