Gina Mauro

A guide for patients to understand HER2-positive breast cancer, treatment options by stage and how to talk with your oncologist.

A Patient Guide to Understanding HER2-Positive Breast Cancer

HER2-positive breast cancer is a type of breast cancer where cancer cells have higher levels of the human epidermal growth factor receptor 2 (HER2) protein. This protein can promote cancer growth but also provides a target for therapies that have improved outcomes for patients across all stages.

HER2-positive — or human epidermal growth factor receptor 2 — breast cancer is largely driven by having copies of HER2 on its cell surface which, in turn, acts as an oncogenic driver of the cancer, telling the disease to grow.

“It used to be many years ago that this subtype of breast cancer was actually associated with worse outcomes than all the other subtypes, really because of this powerful driver of cancer cell growth,” 

Dr. Sarah M. Tolaney of Dana-Farber Cancer Institute explained in an interview with CURE.

However, ongoing research has led to the discovery of game-changing therapies which target HER2, providing patients with improved outcomes.

“Since the introduction of Herceptin, we have seen that outcomes actually become the same as someone who has a HER2-negative cancer, because we're able to really convert that cancer to one that is so much better behaved,” she explained.

Stage 1 HER2-Positive Breast Cancer Treatment

Patients with stage 1 HER2-positive breast cancer often have small tumors that have not spread to lymph nodes.

 Surgery followed by chemotherapy with HER2-targeted therapy such as Herceptin (trastuzumab), sometimes combined with Perjeta (pertuzumab).

 Alternative HER2-targeted therapies or clinical trial options if cancer persists.

 Advanced HER2-targeted therapies or antibody-drug conjugates, often in clinical trials.

“Not that anyone wants to choose to have a breast cancer — but if you had to pick one, sometimes people think, ‘Well, maybe it's good to think about a HER2-positive one’. [This is] because there are just so many drugs that will shut off that signal to the cancer cell and have dramatically changed outcomes,” Tolaney said.

Stage 2 HER2-Positive Breast Cancer Treatment

Stage 2 tumors are larger or involve nearby lymph nodes.

 Neoadjuvant therapy (treatment before surgery) with chemotherapy plus HER2-targeted therapy to shrink tumors and allow physicians to assess response.

 Switch HER2-targeted therapies or combination regimens based on response.

 Newer antibody-drug conjugates or clinical trial options for resistant disease.

Stage 3 HER2-Positive Breast Cancer Treatment

Stage 3 is locally advanced cancer that may involve multiple lymph nodes or nearby structures.

 Intensive chemotherapy and HER2-targeted therapy before surgery, followed by additional targeted therapy afterward.

 Adjust therapy with different HER2-targeted medications if cancer does not respond.

 Novel therapies, antibody-drug conjugates, or clinical trial options.

Metastatic HER2-Positive Breast Cancer Treatment

Metastatic cancer has spread beyond the breast to other organs.

 Taxane chemotherapy with Herceptin and Perjeta to shrink tumors, followed by maintenance HER2-targeted therapy.

 Enhertu (fam-trastuzumab deruxtecan-nxki) if cancer progresses.

 Xeloda (capecitabine) plus Tukysa (tucatinib) with Herceptin, then Kadcyla (ado-trastuzumab emtansine); clinical trials are also an option.

“Patients, when they're first diagnosed, get Taxol with Herceptin and Perjeta, then after that, go on to Enhertu, then often go on to Tukysa, capecitabine and Kadcyla, and then go from one treatment to the other with, usually chemotherapy and Herceptin,” Tolaney explained. “[However], this algorithm, I think, is going to continue to evolve.”

“There are so many choices and so many new therapies that are being studied in this setting, including multiple new antibody-drug conjugates targeting HER2 with different chemotherapy being delivered. I do expect that we are going to continue to see outcomes continue to improve for our patients, which is really very nice,” she concluded.

Additional Subtypes: Luminal B, HER2-Enriched, HER2-Low, HER2-Ultra Low

Some patients’ tumors may also have hormone receptor involvement, referred to as Luminal B. HER2 expression can vary:

 High HER2 activity and may respond strongly to targeted therapies.

 Tumors show some HER2 expression but may require different therapy approaches; new treatments are being studied in clinical trials.

Treatment choices depend on cancer stage, overall health, and personal preferences. Patients are encouraged to ask questions about therapy goals, side effects and options for clinical trials. Understanding HER2 status helps guide decisions and improves outcomes.

Your personal experience will be unique. By using this information as a foundation for your discussions, you can partner with your oncologist to make the best decisions for your health.

This article is for informational purposes only and is not a substitute for professional medical advice. Please contact your healthcare team with any questions or concerns.

For more news on cancer updates, research and education,

don’t forget to subscribe to CURE®’s newsletters here.

Articles

HER2-positive breast cancer is characterized by overexpression of the HER2 protein, which drives cancer growth. Historically associated with poor outcomes, advancements in HER2-targeted therapies, such as Herceptin, have significantly improved patient prognoses across all stages. Treatment strategies vary by stage, involving combinations of surgery, chemotherapy, and targeted therapies. Metastatic cases often require sequential treatment regimens. Emerging therapies, including antibody-drug conjugates, are under investigation. Understanding HER2 status is crucial for personalized treatment planning, and ongoing research continues to enhance therapeutic options and patient outcomes.

Nancee Pronsati discusses a new patient-authored guide for managing ALK-directed treatment side effects of lung cancer.

Nancee Pronsati was completing a half-marathon in 2016, but it was a challenging one, as she coughed through the entire race. After struggling with chronic bronchitis and coughing for nearly 2 years (and doctors telling her it was various infections), she finally received her diagnosis of stage 4 ALK-positive non-small cell lung cancer (NSCLC).

Fast forward to today, and she’s turned her diagnosis into an advocacy movement. She currently serves as vice president of ALK Positive, Inc., a patient-founded and -driven nonprofit organization dedicated to improving outcomes and quality of life for patients with ALK-positive disease. Most recently, she’s added the term 

 to her repertoire, as she, along with several lung cancer specialists and other ALK-positive patients, published the paper “Managing Lorbrena [lorlatinib] together: an overview and practical guide for patients by ALK-positive NSCLC patients and medical experts” in the journal 

The paper is meant to be a guide for patients diagnosed with the disease, as well as for practitioners who may not have the experience with the third-generation tyrosine kinase inhibitor (TKI) to manage its side effects and maintain quality of life. The paper also aims to empower shared decision making between patients and their clinicians.

“Being diagnosed with cancer can be lonesome and scary,” Pronsati said. “Even if you have a fantastic support system, they don't all understand and this is probably applicable to any kind of cancer, as many of the questions in the paper could be applicable to at least help people understand shared decision making. By joining a support group, looking for resources, reading documents like this, you can control so much of your own journey through this and at least be informed, educated and make it easier on yourself and your family.”

In an interview with CURE, Pronsati shared her ALK-positive NSCLC journey, the ins and outs of the published patient guide and how it is impacting others in the community.

CURE: Please describe your diagnosis and journey with ALK-positive NSCLC.

: It started in about 2014, which is weird for me to think back that long. I started to have chronic bronchitis and coughing and because at the time, I was relatively young and had not been a smoker ever, [my doctor] assumed it was pneumonia, bronchitis, or various kinds of chronic infections. I took a lot of antibiotics, and then finally, in 2016, I completed a half marathon, which I used to do pretty frequently, and I was coughing through the whole entire thing. I was with my sister, and she said, “You need to go find a real doctor.” It's not that I wasn't seeing real doctors, but there wasn't a lot of familiarity at that time with lung cancer in younger people who also had not smoked.

Finally, a doctor sent me for an x-ray, and I already had stage 4 lung cancer and innumerable lesions on both lungs. I was very fortunate to be at a great hospital where they sent my tissue out for biomarker testing right away. I was lucky enough to have 

-positive lung cancer; I've been on a TKI ever since. I have been one of the extremely lucky people; a lot of the oncologists call it "good ALK" because I have had a very long run on TKIs.

What has the course of your treatment for ALK-positive NSCLC been like?

I was originally on Xalkori [crizotinib], which was the only one available at that time for first-line treatment, and that lasted about 1 year. Then I had progression to my brain, which is very common progression for people who started on [Xalkori], who did not have any blood–brain barriers to protect the drugs to get to there. Then I went on Alecensa [alectinib]. Interestingly, since I am doing this paper about Lorbrena, I've been on Alecensa this entire time for eight years. I have had nine years of lung cancer and only changed TKIs one time. I have been extraordinarily lucky, that is the only answer that I have. Of course, science contributed to that, but I also have had a pretty lucky situation.

What prompted you to create this guide on Lorbrena for patients with ALK-positive NSCLC and healthcare professionals?

Part of what I do for ALK Positive, Inc. and what I have been doing for years, is aside from the very modest goal of finding a cure, we want to help extend the lives and the quality of lives of our patients. Aside from progression itself, side effects of TKIs are a big deal, and they impact people's lives a lot—and even their ability to stay on a TKI, which extends their life even more.

For me, whichever drug it was, is agnostic. I just felt like we need this information to get out there on how to help people manage side effects. It was Pfizer that came up with the idea originally, and they started to talk about how much they would like to incorporate the voice of patients into the paper. That was groundbreaking. I'm sure other organizations have done it, but we have had so much great feedback on the voice of patients. There were multiple patients involved throughout this paper and helping people understand how we feel about side effect management.

journal article for patients and healthcare professionals?

This particular document is good because it gives people tools, either to take [for themselves] or provide to their oncologist. It has a lot of question-and-answer sections that are there to help drive shared decision making. What I thought was critical about that is, if you had a community oncologist or a local oncologist, and not necessarily an ALK-positive specialist, you would know how to ask the questions about your side effects and drive them to the answers that they might not have come to on their own.

Not everyone is going to have done all the research on the CROWN study and understand all this. The tables in there help people understand what the side effects are, how many people they do impact, and at what point on your journey they often will hit, so you kind of have a better idea of expectations.

A third [takeaway] would be many of those [side effects] can be managed. They can be managed without stopping Lorbrena. They can be managed through doses and efficacy of Lorbrena remains, even if you lower your dosage often, or even take a break from your TKI—obviously, under the direction of your oncologist. [This is] the same with many of the other impacts, like the central nervous system, weight gain and [CNS]. Most, if not all, of those things can be managed without stopping Lorbrena, as long as it's still working for you.

Dose adjustments and/or treatment breaks with Lorbrena are great points to make with patients. The drug may be working, but patients might be suffering from related toxicities, so they might not want to speak up to their provider for fear of them changing or discontinuing therapy, or lowering dosage.

That is one of the main things that we focused on in this: understanding that you can have that open conversation and bringing these tools with you because they may not know. Your doctor may automatically think, "I can't lower the dosage. The recommended dose is 'X'," but it's, "No, let's try it down 25 milligrams." Or, “Here are some things to help manage CNS effects; here's how long they typically last. How can you help me through that?” People are so afraid to stop.

On the other side of that, sometimes the impacts are so terrible and [patients] feel so bad, so in specific cases they do want to stop, but that doesn't have to be the option. That doesn't have to be your path. You can try a lot of things before you stop.

You have been on Alecensa for the majority of your treatment, but you became an expert on Lorbrena for this paper. How did you educate yourself?

Because I belong to a support group, and have since 2015, many of these people are my personal friends, and especially in my job as vice president, I interact with so many patients. I had a strong anecdotal background on what people were experiencing and could bring that flavor. The other two patients who participated were Lorbrena-treated patients. Some of these [effects] do occur on alectinib, but it was interesting for me, coming from the perspective that I hadn't experienced it, to hear the conversations and be able to sit to think, "What if I were new?” Because that's what this guide is for: it is for someone who's never taken Lorbrena. I thought in some ways that I would be the target audience for it, and it helped me. You typically only hear the negative things about any medication. This was reassuring, even for me, to talk through how this could change someone's trajectory on Lorbrena, because that is likely the next medication that [I would] take.

What does it mean for you to be published in an academic journal?

I didn't think of any of that when we started this, because I don't think I understood that the result would be this kind of publication that got a good amount of press in the lung cancer world. For me, it was exciting. I was participating with renowned ALK-positive lung cancer oncologists from all over the world, from Asia, Australia, Canada, the United States as well as our director of clinical research.

As a patient, that was a little bit overwhelming, honestly, but it was nice the way they appreciated and took in all of our input and treated us as equal members of the paper. It felt like everybody was listening, each coming from our own viewpoint of the medicine and what we were trying to provide. I'm just happy to have provided something that is genuinely memorable and useful for our patients, because some things that we do aren't, some things we do are a thing you check off, and it doesn't really go anywhere. This one has had meaningful impact. It's been important and it's impacting people who don't have access to our key opinion leaders.

Nancee Pronsati, G. Liu, T.M. Bauer, et al. 

Managing lorlatinib together: An overview and practical guide for patients by ALK-positive NSCLC patients and medical experts

Nancee Pronsati, diagnosed with stage 4 ALK-positive NSCLC, transformed her experience into advocacy, becoming vice president of ALK Positive, Inc. She co-authored a guide on managing lorlatinib, a third-generation TKI, to aid patients and clinicians in handling side effects and enhancing shared decision-making. The guide provides tools for patients to engage with their oncologists, emphasizing that side effects can often be managed without discontinuing treatment. Pronsati's involvement in the publication highlights the importance of patient voices in medical literature and the impact of collaborative efforts.

Nancee Pronsati discusses a new patient-authored guide for managing ALK-directed treatment side effects in lung cancer and improving quality of life. 

From Patient to Author: Emphasizing Shared Decision Making in NSCLC

Diagnosed with multiple myeloma? Our guide explains each stage and treatment, helping you engage confidently with your care team.

Beyond the Diagnosis: A Stage-by-Stage Guide to Multiple Myeloma Treatment

Here are educational overviews of the different stages of multiple myeloma, designed to help a patient understand their diagnosis and treatment journey.

Multiple myeloma is a cancer of plasma cells

, a type of white blood cell found in the bone marrow. Healthy plasma cells are crucial for producing antibodies to fight infection. In multiple myeloma, these cells become cancerous and multiply uncontrollably, crowding out healthy blood cells and producing an abnormal protein called M-protein. This can lead to a variety of health problems, including bone damage, kidney issues, and weakened immunity.

Diagnosing a patient with multiple myeloma requires the integration of multiple data points, including blood work, pathology results, and imaging studies. Dr Amrita Krishnan and Cherry Rudge, a nurse practitioner, discuss the multifaceted diagnostic process for multiple myeloma in a recent 

, emphasizing the integration of blood tests, genetic and imaging assessments, and patient education to guide personalized treatment planning and enhance patient engagement in care.

Stage I: What is Smoldering Multiple Myeloma?

Smoldering multiple myeloma is a precancerous condition. Patients at this stage have a high number of M-proteins or a high percentage of myeloma cells in their bone marrow, but they do not show any symptoms or signs of organ damage from the disease. This is often an incidental finding from a routine blood test.

 Patients feel completely healthy. There is no evidence of bone lesions, kidney damage, high blood calcium, or anemia.

 The standard approach for smoldering myeloma is active surveillance, not immediate treatment. This involves regular monitoring with blood tests, urine tests, and sometimes bone surveys or imaging.

 While not all cases of smoldering myeloma will progress to active multiple myeloma, there is a risk. Your oncologist will discuss your specific risk factors to determine how often you should be monitored.

 The primary goal at this stage is to monitor for any signs of progression to active disease. This avoids the side effects of unnecessary treatment while maintaining a high quality of life.

Standard of care: Active Surveillance ("watch and wait"):

 For most patients with smoldering myeloma, the standard approach is active surveillance, not immediate treatment. This involves regular monitoring with blood tests, urine tests, and sometimes imaging studies (like bone surveys or PET scans) to check for any signs of progression. The goal is to avoid the side effects of unnecessary treatment while maintaining a high quality of life.

 The risk of progression from smoldering myeloma to active myeloma can be low, and not all cases will progress. Unnecessary treatment exposes patients to potential side effects of powerful drugs without a clear benefit at this early stage.

Clinical trials and high-risk smoldering myeloma:

 For patients with "high-risk" smoldering myeloma — meaning they have certain features that make them more likely to progress quickly — some oncologists may recommend participation in a clinical trial. These trials investigate whether early treatment can delay or prevent the progression to active multiple myeloma. Your doctor can discuss if this is a suitable option for you based on your specific risk factors.

Stage 2 and 3: How Do You Define Active Multiple Myeloma?

Active multiple myeloma is diagnosed when a patient with myeloma cells or M-protein shows at least one of the following signs of organ damage, often referred to by the acronym CRAB. CRAB is broken down by the following:

one lesions (bone fractures or lytic lesions)

 This is where you might start feeling symptoms like bone pain, especially in the back or ribs, fatigue from anemia, or general weakness.

 Unlike smoldering myeloma, active multiple myeloma requires immediate and aggressive treatment. The goal is to control the cancer, alleviate symptoms, and achieve remission.

 The first phase of treatment is called induction therapy. This often involves a combination of different drugs, like proteasome inhibitors, immunomodulatory drugs, and steroids, to kill the myeloma cells.

 For eligible patients, a stem cell transplant, specifically an autologous stem cell transplant using your own cells, is often considered after induction therapy to achieve a deeper and longer-lasting remission.

 Following a transplant or initial therapy, many patients will go on to a maintenance therapy regimen with a single drug to prevent the cancer from returning.

 The immediate goal is to reduce the myeloma cell burden, control symptoms, and aim for a complete or partial remission. The long-term goal is to manage the disease as a chronic condition.

Treatment Overview for Active Multiple Myeloma

 The first phase of treatment is called induction therapy. This typically involves a combination of three or four different drugs to rapidly reduce the number of myeloma cells. Common drug classes used in these combinations include:

 (e.g., Velcade [bortezomib], Kyprolis [carfilzomib]) that block the disposal of old proteins, causing myeloma cells to die.

 (e.g., Revlimid [lenalidomide], Pomalyst [pomalidomide]) that help the immune system attack the cancer cells.

 (e.g., Darzalex [daratumumab], Sarclisa [isatuximab]) that are engineered to attach to specific proteins on the surface of myeloma cells, marking them for destruction by the immune system.

 (e.g., dexamethasone) that are highly effective at killing myeloma cells and can help manage side effects of other drugs.

 For eligible patients, a high-dose chemotherapy and autologous stem cell transplant is often a key part of the treatment plan. This procedure:

Your own stem cells are collected and stored.

You receive very high doses of chemotherapy to kill any remaining myeloma cells.

Your collected stem cells are infused back into your body to repopulate the bone marrow and restore blood cell production.

 After induction therapy, with or without a stem cell transplant, many patients will start a long-term, low-dose 

. This is typically a single drug (most often lenalidomide) taken over a prolonged period to prevent the cancer from returning and to keep it in a state of remission.

 This is a crucial part of the treatment plan and focuses on managing symptoms and preventing complications. It may include:

 (e.g., zoledronic acid) to strengthen bones and prevent fractures.

Medications to manage anemia, kidney issues, or infections.

A relapse occurs when the myeloma returns after a period of remission. Refractory disease is when the myeloma either doesn’t respond to treatment or progresses while the patient is still on therapy. This is a common part of the multiple myeloma journey, as the cancer cells can adapt over time.

Key Features of Relapsed/Refractory Multiple Myeloma

 Your oncologist will likely change your treatment regimen. This might involve using different drug combinations, a new class of medication, or considering clinical trials.

 The good news is that there are many new and effective treatments being developed, including CAR T-cell therapy and bispecific antibodies, which harness the body's own immune system to fight the cancer.

 Symptom management is a key focus. If you're experiencing new bone pain, fatigue, or other issues, it's important to discuss them with your care team.

 The goal in this phase is to regain control of the disease, manage any symptoms, and find a new treatment plan that is effective and tolerable for you. It's an ongoing conversation between you and your doctor about the best path forward.

Treatment Overview for Relapsed/Refractory Multiple Myeloma

 The treatment approach changes based on what previous therapies you have received. The goal is to find a new combination of drugs that the cancer has not been exposed to or has not become resistant to. This might involve:

 For example, if you were on a combination of a proteasome inhibitor and an IMiD, your doctor might switch to a different combination or add a monoclonal antibody.

 If you had a long remission after a particular treatment, your doctor may consider reusing it.

 This is an exciting and rapidly evolving area of multiple myeloma treatment. Newer therapies, often used for relapsed/refractory disease, include:

 These are "off-the-shelf" drugs that have two arms. One arm attaches to a myeloma cell and the other attaches to an immune T-cell, bringing them together so the T-cell can directly attack and kill the cancer cell. (e.g., Tecvayli [teclistamab], Talvey [talquetamab]).

 This is a personalized cellular therapy. Your own T cells are collected, genetically modified in a lab to recognize and attack your myeloma cells, and then infused back into your body. While effective, it's a complex process that takes time to prepare. (e.g., Abecma [idecabtagene vicleucel], Carvykti [ciltacabtagene autoleucel]).

 A newer class of drug that blocks a protein in the cell's nucleus, causing myeloma cells to die.

 A targeted therapy used for a specific genetic subtype of multiple myeloma.

 When standard therapies are no longer effective, clinical trials are an excellent option. They provide access to the newest and most promising treatments before they are widely available. Your oncologist can help you identify and enroll in a clinical trial that is right for you.

Editor's note: Your personal experience will be unique. By using this information as a foundation for your discussions, you can partner with your oncologist to make the best decisions for your health.

Multiple myeloma is a cancer of plasma cells that leads to various health issues, including bone damage and kidney problems. Diagnosis involves blood tests, genetic assessments, and imaging studies. Smoldering multiple myeloma, a precancerous stage, requires active surveillance rather than immediate treatment. Active multiple myeloma necessitates aggressive treatment, including induction therapy and possibly stem cell transplant. Relapsed/refractory multiple myeloma involves changing treatment strategies, with emerging therapies like CAR T-cell therapy and bispecific antibodies offering new options. Clinical trials are crucial for accessing novel treatments.

This guide for newly diagnosed patients provides key information to help you understand your options and have informed conversations with your oncologist.

Understanding Head and Neck Cancer: A Guide for Newly Diagnosed Patients

A diagnosis of head and neck cancer can bring up many questions and concerns. Understanding the basics of your condition is the first step in your cancer journey. This guide is designed to provide you with key information about head and neck cancer, from diagnosis to treatment, to help you have an informed conversation with your medical team.

Head and neck cancers are a group of cancers that start in the cells of the mouth, throat, voice box, sinuses or salivary glands. The most common type is squamous cell carcinoma, which begins in the thin, flat cells that line these areas.

Risk factors for these cancers often include tobacco and heavy alcohol use. Another significant risk factor is the human papillomavirus (HPV), especially for cancers of the tonsils and the base of the tongue.

Diagnosis: Understanding Head and Neck Cancer

Your oncologist will use several methods to confirm a diagnosis and determine the extent of the cancer. This process, known as staging, helps your medical team create the most effective treatment plan.

 A doctor will examine the head and neck area for any abnormalities. A biopsy, which involves taking a small tissue sample, is the only way to definitively diagnose cancer.

 These tests provide detailed pictures of the inside of your body. Common scans include computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. They help determine the tumor's size, location and whether it has spread to other parts of the body.

 In some cases, a thin, flexible tube with a camera may be used to look inside the throat or voice box to get a closer look at the tumor and surrounding tissue.

Head and Neck Cancer Treatment Options: A Tailored Approach

Treatment for patients with head and neck cancer is highly personalized and depends on several factors, including the cancer's type, location and stage, as well a patient’s overall health. Your medical team may use one or a combination of the following therapies.

 The goal of surgery is to remove the tumor and some surrounding healthy tissue. For small tumors, this may be a straightforward procedure. For larger or more advanced cancers, surgery can be more complex and may require reconstructive procedures.

Dr. Zafar Sayed, an assistant professor of surgery (otolaryngology) and a part of the Head and Neck Cancers Program at the Yale School of Medicine, located in New Haven, Connecticut, 

 how surgical treatment has evolved for patients with this disease.

“The evolution in treatment, at least on the surgical side, has been to try to make things a little less invasive,” Sayed said. “Many of the surgeries we used to do decades ago, even before I was a physician, would involve placing tracheostomy tubes (breathing tubes in the neck) and feeding tubes (something called a G-tube, a gastrostomy tube, was very common). What we're doing with newer techniques is trying to limit the number of patients who need those measures long term. With some of the newer surgeries, you may need a tracheostomy or a feeding tube, but usually, that will be temporary, and by the time you go home, a lot of that has been removed so you can resume function.”

 This treatment uses high-energy x-rays or particles to kill cancer cells. It can be used alone for some early-stage cancers or in combination with other treatments. Radiation may also be given after surgery to eliminate any remaining cancer cells.

 Chemotherapy uses drugs to kill cancer cells. It's often used in combination with radiation therapy to make the cancer cells more sensitive to the effects of radiation.

 These are newer treatments that can be highly effective. Targeted therapies focus on specific genes or proteins that help cancer cells grow. Immunotherapy helps your body's own immune system find and destroy cancer cells.

: This treatment is a form of precision medicine that works by targeting specific molecules or pathways that cancer cells need to grow, divide and spread. Think of it like a smart bomb that seeks out a specific weak point in the enemy's fortress, rather than a carpet bomb that hits everything in its path.

For head and neck cancer, one common target is EGFR, a protein on the surface of some cancer cells that helps them grow. Drugs like Erbitux (cetuximab) are monoclonal antibodies that attach to EGFR, blocking its signals and preventing the cancer cell from multiplying. By zeroing in on these unique characteristics, targeted therapy can be very effective with potentially fewer side effects on healthy cells compared with traditional chemotherapy.

: Immunotherapy, on the other hand, doesn't directly attack the cancer cells. Instead, it unleashes and boosts your body's own immune system to find and destroy cancer cells. Normally, the immune system is very good at identifying and eliminating foreign invaders like bacteria or viruses. However, cancer cells can be tricky; they can use "checkpoints" to hide from the immune system and avoid being attacked.

The most common form of immunotherapy for head and neck cancer is called an immune checkpoint inhibitor. These drugs, such as Keytruda (pembrolizumab) and Opdivo (nivolumab), work by blocking the proteins that act as these "brakes" on your immune cells. By releasing the brakes, the immune system's T-cells are activated and can now recognize the cancer as a threat and mount a powerful attack. Immunotherapy can be used alone or in combination with other treatments and has shown promising results in treating advanced or recurrent head and neck cancers.

Adverse Effects: Managing Your Side Effects From Head and Neck Cancer Treatment

Cancer treatments can affect healthy cells, leading to side effects. Managing these side effects is a crucial part of your treatment plan. Your doctor or a specialized support team can provide strategies and medications to help.

 Common side effects of radiation therapy include a sore throat, changes in taste, dry mouth and skin irritation. Chemotherapy can cause nausea, fatigue and a higher risk of infection.

 Some side effects, like changes in speech, swallowing or dental issues, may persist after treatment ends. Your care team can connect you with specialists, such as a speech therapist or a dentist, to help manage these issues.

Beyond medical treatments, managing your daily life is an important part of your head and neck cancer journey. This includes focusing on your physical and emotional well-being.

 Treatment can make eating difficult. A registered dietitian can help you find food and liquid options that are easy to swallow and provide the nutrients you need.

In an interview with CURE, Kanisha Parikh, a dietitian at John Theurer Cancer Center in Hackensack, New Jersey 

shares tips for helping patients with cancer

, including those with head and neck cancer, maintain nutrition when eating becomes difficult. Examples include Greek yogurt, mashed avocado and macaroni and cheese; 

 A cancer diagnosis can be emotionally challenging. Talking to a therapist, joining a support group or connecting with other survivors can provide a sense of community and help you cope with the emotional toll.

 A physical or occupational therapist can help you regain strength and function after surgery or other treatments. A speech-language pathologist is often a vital part of the team, helping with issues related to swallowing and speaking.

Beyond Diagnosis: Your Voice is Key to Effective Head and Neck Cancer Care

Your medical team is your partner in this journey. Asking questions and voicing your concerns are essential for making informed decisions about your care. Consider discussing the following with your oncologist:

What is the specific type and stage of my cancer?

What treatment plan do you recommend and why?

What are the potential side effects of this treatment, both short- and long-term?

What support services are available to me, such as nutrition counseling or a patient support group?

Remember, a head and neck cancer diagnosis is a significant life event. By understanding your condition and actively participating in your care, you can navigate your treatment with confidence.

Editor’s Note: This guide is designed to be a starting point. Your personal experience will be unique. By using this information as a foundation for your discussions, you can partner with your oncologist to make the best decisions for your health.

CURE. Eating Tips for When Cancer Treatment Makes Meals Challenging. Published June 26, 2025. 

https://www.curetoday.com/view/eating-tips-for-when-cancer-treatment-makes-meals-challenging

CURE. Comforting Lentil Soup Recipe to Ease Side Effects During Cancer Care. Published June 25, 2025. https://www.curetoday.com/view/comforting-lentil-soup-recipe-to-ease-side-effects-during-cancer-care

CURE. Recognizing Symptoms During Head and Neck Cancer Awareness Month. Published April 18, 2025. https://www.curetoday.com/view/recognizing-symptoms-during-head-and-neck-cancer-awareness-month

Gina Mauro

A Patient Guide to Understanding HER2-Positive Breast Cancer

From Patient to Author: Emphasizing Shared Decision Making in NSCLC

Beyond the Diagnosis: A Stage-by-Stage Guide to Multiple Myeloma Treatment

Understanding Head and Neck Cancer: A Guide for Newly Diagnosed Patients

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