Head and neck sarcomas are a group of tumours that can develop anywhere in the head and neck area.
They can be a range of different subtypes, and develop in the bone or soft tissue.
Some types of sarcoma that can occur in the head and neck area include:
You can click here for a full list of sarcoma subtypes.
Signs and symptoms
Symptoms of head and neck sarcomas can vary depending on the size and location of your tumour. You might experience:
- A blocked nose
- Facial pain
- Swelling
- Loose teeth
- A loss of sensation in a particular area
- Weight loss
- A lump or swelling
Diagnosis
A diagnosis of head and neck sarcoma may start with a visit to your GP who will then refer you to a specialist doctor.
Your symptoms will be investigated using a series of tests that may identify sarcoma. Tests may include:
- Physical examination – looking at and feeling any lump
- A scan – taking pictures of the inside of the body using ultrasound, PET scan, CT or MRI
- An ultrasound guided core needle biopsy – take a tissue sample of the tumour or lump, using an ultrasound to guide a needle to the right place, under local anaesthesia
- An open biopsy – when a larger piece of tissue needs to be taken for examination, a doctor will take a tissue sample of the tumour under local or general anaesthesia
A clear diagnosis will be made after a pathologist with experience of sarcoma has examined a tissue sample.
To read more about scans and tests, click here.
Treatment
Surgery
Surgery is the main treatment for most head and neck sarcomas. The surgeon will remove the tumour and will aim to take out an area of normal tissue around it too when possible. This is known as taking a margin. Head and neck sarcomas can sometimes touch or press on surrounding organs. In these cases, the surgeon will aim to remove the tumour along with the tissue next to it. This is known as removing a tumour ‘en bloc’. Sometimes this will mean taking out blood vessels, lymph nodes, soft tissue and bone.
Surgery for head and neck sarcoma can affect your appearance and leave you with difficulties in speech and swallowing. You will be given specialist advice and support to explain how this will affect you.
The treatment you receive should take into account your individual situation and your doctor or clinical nurse specialist should talk you through all possible treatment options. You should also have the opportunity to ask any questions you may have regarding the future implications of your surgery.
In some cases, it might not be possible to remove the tumour completely. In these cases, it is unlikely that surgery will be recommended.
Radiotherapy
This treatment uses high-energy radiation beams to destroy cancer cells. It is used to treat sarcomas of the head and neck.
In some cases, radiotherapy to the tumour can be used before surgery to shrink the tumour, allowing doctors to operate and remove it more easily.
It can also be used after surgery to kill any local cancer cells.
Before beginning radiotherapy, you might have a number of tests. These may include:
- A dental assessment
- A hearing assessment
- An appointment with a dietician
- You might be assessed for a feeding tube, which can be used to ensure you have nutrition, water and medication
Chemotherapy
This treatment uses anti-cancer drugs to destroy cancer cells. Using chemotherapy as a treatment for head and neck sarcoma depends on the subtype of tumour, as different sarcoma subtypes respond to chemotherapy in different ways. In some subtypes, it is used to try and shrink a large tumour so it is safe to be operated on.
Chemotherapy is sometimes used after surgery to prevent the cancer coming back. Chemotherapy is also used to treat sarcomas that have spread to other parts of the body. In other cases, you might need a combination of chemotherapy, radiotherapy and surgery.
Discuss chemotherapy treatment with your specialist team who will be able to give you specific information about your sub-type.
Clinical trials
You may be offered an opportunity to take part in a study to investigate new diagnosis methods, drugs or treatments. Some studies also look at the care and well-being of patients. Your doctor or nurse can give you more information on opportunities for you to take part in a clinical trial.
After treatment
After treatment, you will have regular follow-up appointments for several years. You should receive a follow-up schedule from your sarcoma clinical nurse specialist. The usual practice will include:
- A chance to discuss symptoms
- Scans and tests, which may consist of blood tests and a clinical examination. You might also need a chest x-ray or a CT or MRI scan
Every form of head and neck sarcoma is treated differently, but there are some common issues which people may face while recovering. You can read more about these issues and how best to deal with them here.
Living with
Head and neck sarcoma can reappear in the same area after treatment. This is called a local recurrence.
Head and neck sarcoma can come back near the site of your first tumour or spread within the head and neck region. If the sarcoma does reappear, it is important to get guidance on further management from the specialist sarcoma centre. Your further treatment will be assessed on an individual basis.
If you are worried about your sarcoma returning, contact your doctor or nurse. They may decide to bring forward the date of your follow up appointment to investigate your concerns.
What if my cancer spreads?
Sometimes sarcoma can spread to other parts of the body. This is called metastasis or secondary cancer. In sarcoma patients, secondary cancer may appear in the lungs, which is why a chest x-ray is taken at follow-up appointments. However, this is less common in cases of head and neck sarcoma.
Treatment for secondary cancer may involve surgery, radiotherapy or chemotherapy as appropriate. Your treatment will be assessed on an individual basis.
