Head and Neck Cancers

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The Head and Neck Cancer Program at Smilow Cancer Hospital provides total care for patients diagnosed with cancers of the head and neck. We offer dedicated attention, innovative and organ-sparing treatment options, and cutting-edge research, coupled with the recognized excellence of a National Cancer Institute-designated Comprehensive Cancer Center. By carefully balancing treatment efficacy with quality-of-life, our collaborative approach to care personalizes treatment options for tumors affecting the neck, larynx (voice box), pharynx (throat), oral cavity (mouth), ear, sinuses, tonsils, and salivary glands, as well as cervical (neck) lymph nodes or neck structures. Our multidisciplinary group of healthcare professionals focused on head and neck cancers includes: head and neck surgeons, radiation oncologists, medical oncologists, physical therapists, speech-language pathologists, nutritionists, a smoking cessation specialist, dentists, a physical/lymphedema therapist, advanced practice nurses, and social workers. 

Given the effects of cancers of the head and neck region and their treatment on swallowing and speech, as well as appearance, a team approach is critical to attain the highest cure rates while maximizing post-treatment function. All physicians are board-certified and fellowship-trained. At Smilow Cancer Hospital, patients in Connecticut and beyond benefit from the expertise of a team approach to cancer care. The Head and Neck multidisciplinary team meets in a weekly Tumor Board Conference to review cases and offer patients the best treatment plans focused on providing the most comprehensive, effective, and personalized care possible. Optimal care plans are based on the most up-to-date research performed at Yale and elsewhere.

Less Invasive Surgeries/Reconstruction

One of the most exciting new surgical advances is the use of new techniques for tumor removal that avoid neck incisions and preserve function. Transoral robotic surgery (TORS) can be used to remove certain throat cancers while avoiding skin and bone incisions. This approach speeds healing and shortens a patient’s hospital stay. Likewise, patients with certain laryngeal cancers, who a few years ago would have lost their vocal cords and their voices, can often be treated with less invasive surgeries. Patients who undergo these treatments maintain their ability to speak, although they may need to alter their diet or learn new swallowing techniques. At Yale, rehabilitative specialists work with patients to help them adjust to and overcome some of these swallowing impairments. In many cases radical neck dissections have been replaced by less radical surgeries that preserve the nerves, arteries, and muscles in the neck. Patients continue to move, speak, breathe, and eat normally after less radical surgeries, but without sacrificing cure rates. Breakthroughs in reconstructive surgery represent one of the biggest success stories for head and neck cancer patients. Reconstructive surgery has improved dramatically, yielding previously unattainable cosmetic and functional outcomes. Patients have better outcomes when complex surgical procedures, like these reconstructions, are done by experienced specialists who perform them on a regular basis.

Medical Oncology

The integration of chemotherapy with radiation has become very important for patients with head and neck cancer that involves the lymph nodes or is locally extensive, and this approach can lead to organ preservation and increase the chance of cure for many patients. Breakthroughs in targeted therapy and biomarkers allow a personalized approach that can avoid the toxicities of conventional chemotherapy in some cases, and new treatments to prevent recurrence in high-risk situations are also under study. For patients with recurrent disease, new anti-cancer drugs and immunotherapies are also available. Led by Dr. Barbara Burtness, the medical oncology team at Smilow Cancer Hospital continues to study innovative new treatments, and our patients have the opportunity to receive such novel therapies through exciting clinical trials only available at our Hospital. Yale medical oncologists have unique expertise in head and neck cancers. In addition, our medical oncologists are happy to see patients for a second opinion.

Radiation Oncology

Radiation is critical for cure of almost all advanced head and neck cancers. Radiation therapy can be delivered alone or combined with chemotherapy as a primary therapy or after surgical therapy. New radiation techniques that precisely aim beams to target tumors are very important for patients with head and neck tumors since crucial structures are often very close to the tumors. Intensity modulated radiation therapy (IMRT) effectively targets the tumor while simultaneously minimizing damage to normal tissues. Clinical trials are currently testing whether the overall dose of radiation can be reduced in certain patients who are extremely treatment responsive. Novel agents to sensitize cancer cells to radiation and to maintain treatment responses are also under study.