The location of any neck mass is also important because it offers a clue to the primary source. A biopsy is the next step, followed by a CAT scan or MRI if cancer is detected, and then an examination under anesthesia. Surgery and radiation are the usual treatments. Follow-up examinations are then given at frequent intervals. Photodynamic action requires the photosensitizer, oxygen, and light, Photofrin is administered intravenously and rapidly clears from most tissues bur remains in and around tumor cells for several days.
Laser is an effective way to deliver concentrated cold light to the tumor bed.
A major side effect of the treatment is skin photosensitivity, which can last from four to eight weeks, leaving the patient sensitive to sun and daylight. In the treatment of head and neck cancer, PDT has the advantage of selective destruction of the tumor cells without the sacrifice of normal cells in critical areas such as the tongue, larynx, and trachea. Also, new drugs, such as Photofrin, are being developed to lessen photosensitivity and increase tumor specificity. Indications are that PDT is a safe effective treatment for head and neck cancer. Poor nutritional status at diagnosis has a definite impact on prognosis.