The main treatments for cancer that starts in the ear canal, middle and inner ear are surgery and radiotherapy. Depending on the stage of your cancer you may also have chemotherapy.
The ear canal is actually part of the outer ear. But it is included in this section about middle and inner ear cancer. This is because the treatment of ear canal cancer is different to outer ear cancer.
How your doctor decides on treatment
The treatment you have depends on:
- where in the ear the cancer is
- the type of cancer
- the size of the tumour
- whether it has spread outside the area it started in (the cancer stage)
- your general health
People who have cancers that start in the head and neck usually see a team of specialist doctors and other health professionals. They include:
- head and neck surgeons – including ear, nose and throat surgeons, mouth and facial bone surgeons, and plastic surgeons
- specialists in cancer drugs and radiotherapy – oncologists
- specialist nurses, physiotherapists and dieticians
The type and amount of surgery you need depends on where the cancer is and whether it has spread into surrounding tissues or nearby structures like bone.
Your surgeon will remove the tumour together with an area of tissue surrounding it that is completely free of cancer cells. The area is called a clear margin. It helps lower the risk of the cancer coming back.
Your surgeon might remove some or all of the following:
- the ear canal
- part or all of the temporal bone
- the middle ear
- the inner ear
The temporal bone is the bone at the side of your skull, by the ear. The operation to remove the temporal bone is called a mastoidectomy or temporal bone resection.
Rarely, your surgeon might need to remove the facial nerve. This runs down the side of the face and through the salivary gland. They may also need to remove the lymph nodes in your neck and the salivary gland on that side of your head.
After your operation
You will have stitches and a dressing over your wound. There will also be 1 or 2 small tubes near your wound to drain any fluid. The tubes help to reduce swelling. They take a couple of days to stop draining fluid before your nurse or doctor takes them out.
You also have a drip for fluids to stop you getting dehydrated. You will have painkillers to control any pain.
How long you need to spend in hospital depends on your operation. Your doctor will tell you what to expect beforehand.
Hearing and balance
It is unlikely that you will be able to hear on that side if the surgeon removes your middle and inner ear. You might find that your balance is affected and you feel dizzy.
It might be possible for the surgeon to rebuild (reconstruct) some of the ear so that you can hear.
Your scar line is likely to be behind your ear or in a natural crease on your face. Surgeons are particularly skilled in removing the tumour and rebuilding the area. So most people won’t look any different afterwards.
Before your operation, ask your surgeon how the surgery will affect your appearance, hearing, and eating. It can help if you know what to expect.
Radiotherapy uses high energy rays to treat cancer. You might have radiotherapy:
- as your main treatment
- after surgery, if your surgeon hasn’t been able to remove a clear margin of tissue from around the tumour
- with chemotherapy (chemoradiotherapy)
Radiotherapy after surgery can lower the risk of the cancer coming back.
You usually have radiotherapy every day (from Monday to Friday) for between 4 and 7 weeks.
At your first appointment your radiotherapy doctor (clinical oncologist) plans your treatment. This planning appointment takes a couple of hours but after that each treatment only takes a few minutes.
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy won’t cure cancer of the ear on its own but doctors might use it if you can’t have other treatments, or to relieve symptoms.
To help cure ear cancer, researchers have been looking at giving chemotherapy with radiotherapy before or after surgery. We need more research to find out how well this works and when it is best to have chemotherapy.
The chemotherapy drugs you might have include fluorouracil and cisplatin.
You have regular check ups once your treatment has finished. Your doctor will examine your ear and ask about your general health.
This is your chance to ask any questions you have and to tell your doctor if anything is worrying you.
How often you have check ups will vary, depending on your situation. They usually start off every 2 or 3 months and become less often as time goes on.
Coping with a diagnosis of a more aggressive cancer can be especially difficult, both practically and emotionally. Being well informed about your cancer and its treatment can make it easier to make decisions and cope with what happens.
Talking to other people who have the same thing can also help.
Our discussion forum Cancer Chat is a place for anyone affected by cancer. You can share experiences, stories and information with other people who know what you are going through.
The Rare Cancer Alliance offer support and information to people affected by rare cancers.