Improving Head and Neck Cancer Outcomes

Joe Cantlupe, for HealthLeaders Media , January 8, 2011
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Some hospitals are specifically becoming involved in examining that issue in unique partnerships. The Neag Comprehensive Cancer Center’s head and neck cancer/oral oncology program provides a team approach including physicians and nurses from the cancer center, and dental faculty and research dental hygienists from the University of Connecticut School of Dental Medicine to provide “coordinated, comprehensive care,” says Douglas E. Peterson, DMD, PhD, chair of the program in head and neck cancer and oral oncology, and professor in the Department of Oral Health and Diagnostic Sciences at the School of Dental Medicine.

Success Key No. 1: Team approach
Hospitals such as the University of Chicago Medical Center are offering more multidisciplinary techniques, such as minimally invasive surgery combined with chemotherapy and radiation treatment to preserve the voice function and the ability to swallow, as well as to improve survival outcomes.
The advancements in treating larynx cancer include ways to reconstruct the voice box so patients may not sound mechanical. Also, drug therapies during radiation protect the throat, minimizing posttherapy dry mouth conditions for head and neck cancer patients.

About 61% of patients with stage IV head and neck cancer survive five years after treatment under the multidisciplinary approach, compared to the national average of 38%, according to University of Chicago Medical Center data. “Length of life is a priority, and we make an impact on patients with recurrent head and neck cancer,” says Stenson, referring to the chemotherapy and radiation techniques.

A major technique in treating head and neck cancer is a team approach that includes surgeons, medical and radiation oncologists, physical and speech therapists, and other experts who carry out treatment options including behavioral voice therapy, laryngeal reconstruction, and postcancer voice rehabilitation.
Daniel J. Haraf, MD, professor of radiation and cellular oncology at University of Chicago, says the multidisciplinary approach is conducive to improved patient outcomes. “We work as a group, providing input for each case,” Haraf says, “to find what is best for the patient. We take the promise of radiation and chemotherapy, and substitute for surgery.”

The Chicago team’s approach was highlighted when it was approached by a top local chef who was afflicted with oral cancer and was told by other hospital leaders it would be necessary to remove his tongue.

Indeed, the standard therapy would have been removing the tumor surgically, followed by radiation therapy, Haraf says. Instead, Chicago hospital reversed the order of the routine course of treatment, using aggressive chemotherapy, drug treatment, and radiation to kill the tumor, Haraf says.

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