Multidisciplinary Head & Neck Cancer Care
Head & Neck Surgery
We are the pioneers of major scientific breakthroughs
- Organ preservation approaches to head and neck cancer.
- New drugs for head and neck squamous cell carcinoma (HNSCC) and extending uses of existing drugs to HNSCC and nasopharyngeal carcinoma (NPC).
- Advanced radiation therapy techniques that limit toxicity and improve outcomes.
- Minimally Invasive and Robotic Surgery
- Stem cell work that extends the findings of the first paper, demonstrating the existence of “cancer stem cells” in HNSCC by researchers from Stanford and Michigan in 2007; and a 2009 Stanford study establishing that stem cell properties of patients’ malignancies correlate with prognosis. This work led to subsequent stem cell papers in 2011 and 2012.
- Normal tissue stem cell studies to identify salivary gland stem cells and to manipulate them for preservation and/or restoration of salivary gland function from radiation damage.
- HNOP’s breadth of research studies and protocols including treatment of intermediate and advanced disease as well as hypoxia imaging.
- Creation of the first head and neck multidisciplinary tumor patient conference (tumor board; 1976) in the U.S.
- Introduction of the first use of chemotherapy with irradiation for head and neck squamous cell carcinoma (HNSCC), which is the basis of organ-preservation chemoradiation in the U.S.
- Close working relationships with:
- Neurosurgery, Interventional Radiology, and Neuroradiology,which are critical for complex open and endonasal endoscopic skull base surgery.
- Endocrinology in the treatment of thyroid cancer.
- Dermatology in the treatment of advanced skin cancers.
- Innovative research by physicians now at Stanford that demonstrates the utility of the FDA-approved Mobetron for intraoperative radiation therapy.
- Contributing research in a Phase II trial of immunotherapy in intermediate and advanced surgically-treated HNSCC. A Phase III trial is now planned.
- Leadership in the head and neck disease site committee of the Radiation Therapy Oncology Group to develop new nation-wide clinical trials in head and neck cancer.
- Biomarker studies to identify novel circulating biomarkers for prognostication and post-treatment surveillance in head and neck cancer.
- Strong links to developmental therapeutics such as the advancement of new drugs to treat cancer.
- Provision of a full range of treatment options that include minimally invasive surgery, robotic surgery, stereotactic radiosurgery such as CyberKnife, microvascular reconstruction, intraoperative radiation therapy (IORT), and new chemotherapy trials.
What is Head & Neck Cancer?
Head and neck cancer is a term that can include the broad array of tumors which may arise in this anatomically diverse region of the human body. Most often, the term head and neck cancer refers to tumors that arise from “squamous” cells that line the moist, mucosal surfaces of the mouth and throat. In fact, 95% of head and neck tumors are squamous cell carcinoma.
Tumors of the thyroid, salivary, and parathyroid glands, as well as cancers of the brain, nose and paranasal sinuses, esophagus, and eye, are not usually categorized as head and neck cancer. Furthermore, tumors of the skin, muscle and bone arising in the head and neck are also typically not included in this term.
Head and neck cancer is then further classified by its location within the mouth and throat:
The lips, the oral tongue” (the forward two-thirds or front part of the tongue), the gums lining the upper and lower jaws, as well as the lining inside the cheek. The area known as the floor of the mouth is a mobile area between the lower jaw and gum and the oral tongue. The roof of the mouth or “hard palate” is also included as part of the oral cavity. Finally, a small triangulated area of mucosa or gum lining the area behind the last wisdom tooth is called the“retromolar trigone” and is also part of the oral cavity.
In medical terminology, the throat is known as the pharynx. In fact, the pharynx is supple tube or funnel that connects both the nose and mouth to the swallowing tube or esophagus. The pharynx is composed of three parts: the nasopharynx (the area just behind the nose); the oropharynx (behind the oral cavity and in the back of the mouth], and the hypopharynx, which surrounds the voice box and leads into the esophagus.
The larynx critical not only for the production of speech, but also breathing and swallowing. The “supraglottic” larynx has a valve called the epiglottis, which covers the larynx during swallowing to prevent “aspiration” of food into the lungs.
HNOP offers multi-disciplinary, collaborative and integrated evaluation and care for patients with head and neck cancers.
Head & Neck Surgery