Stem Cells and Treatment

How do doctors treat head and neck cancer?

The primary methods to treat head and neck cancer hasn't varied in nearly 20 years.

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There are two primary treatments for squamous cell carcinoma - head and neck cancer - and they haven't changed much over the years. When appropriate, doctors use surgery to remove the tumor.

An alternative to surgery is radiation. Recently, radiation is often given in combination with chemotherapy - because using the two treatments together improves patient outcomes in certain situations. The benefit of using chemotherapy with radiation was demonstrated about 20 years ago in research led by U-M scientist Gregory Wolf. Chemotherapy used alone is generally not effective for head and neck cancer.

Today, patients benefit from precise radiation therapy and more effective reconstructive surgery, which is performed immediately after the cancer is removed. Once surgeons take out a patient's tongue or a portion of the jaw, physicians have better rehabilitation options available than before. This doesn't affect cancer treatment, but it does improve patients' quality of life and reduces side effects.

The biggest challenge for patients with head and neck cancer is that the effects of treatment can be very visible. It can affect patients' ability to swallow and talk. The biggest challenge for physicians is to help patients look normal and be able to swallow and speak, as well as to cure their cancer.

Will research on cancer stem cells help patients with head and neck cancer?

Dr. Prince discusses how this research benefits patients with head and neck cancer.

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Scientists hope so, but there's a lot of work that needs to be done. There's still so much researchers don't understand about cancer stem cells, especially their propensity to spread and be resistant to treatment. Some scientists believe aggressive tumors have a different subtype of cancer stem cells than less aggressive cancers. At this point, no one knows for sure.

One big question is why some cancers are associated with tobacco use and some aren't. There almost certainly is a causal relationship between head and neck cancer and tobacco use, but scientists don't understand why. Could tobacco use cause cancer stem cells to develop in the first place? What role does smoking play in the development of cancer? These are major unanswered questions.

Could this research lead to new treatments for head and neck cancer?

Research into head and neck cancer stem cells will answer many questions. Dr. Prince shares the one question he'd like most to answer.

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Everybody's cancer is a little bit different. Doctors need a way to tell which patients will respond to radiation or surgery alone, and which patients need radiation with chemotherapy.

Current treatment studies are based on general results from a large number of patients with similar tumors, even though tumors are never exactly the same. Because these studies look at the effects of treatment on all cancer cells, the results are not specific enough.

To design personalized treatment for an individual's cancer, scientists need to understand the individual's cancer stem cells. What they really need to do is look at the genetics of the cancer stem cell, which is more precise than the genetics of all cancer cells. If researchers can select just the cancer stem cells and study them on their own in isolation, doctors will be able to treat patients more effectively.

Dr. Prince and his collaborators are investigating how to stimulate a patient's immune system to destroy cancer stem cells in head and neck cancer. This research holds great promise as a new method to eradicate this critical population of cancer cells.

Get more information about this important research on our Research Updates page.

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