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Head and Neck Cancers

The Head and Neck Cancers Program is composed of highly dedicated physicians and surgeons joined by a skilled team of rehabilitation specialists in speech, swallowing, and hearing restoration. All physicians are board certified and fellowship trained. A collaborative approach to care offers the most effective of treatment options for diseases affecting the ear, sinuses, larynx, and pharynx, while emphasizing the organ-sparing mission of Yale Cancer Center.

Dr. Wendell Yarbrough leads a multidisciplinary group of healthcare professionals, including head and neck surgeons, radiation oncologists, medical oncologists, physical and speech therapists, nutritionists, advanced practice nurses and social workers, as well as patient advocates. This team approach gives newly diagnosed patients a carefully determined treatment plan focused on providing the most comprehensive, effective care possible.

Less invasive surgeries; reconstructive breakthroughs

Radical neck dissections have been replaced in many cases by less radical surgeries that preserve nerves, arteries, and muscles in the neck. Patients continue to move, speak, breathe and eat normally after surgery. Patients with certain throat cancers, who a few years ago would have lost their vocal cords and their voices, can often be treated with a supraglottic laryngectomy, a less invasive surgery that preserves critical structures. Patients who undergo this surgery maintain their ability to speak, although they need to learn new ways to swallow. At Yale, rehabilitative specialists, led by Steven Leder, PhD, work with patients to help them adjust to and overcome some of these impairments.

One of the most exciting new surgical advances is the use of laser surgery to remove certain throat cancers using an endoscopic probe in the mouth. This technique allows surgeons to remove tumors without an open incision in the neck.

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. Research data indicate that the results of complex surgical procedures like these reconstructions are best accomplished by specialists who perform them on a regular basis.

Radiation: yielding new age weapons

There is a whole new arsenal dedicated to radiation therapy-external beam radiotherapy machines, such as linear accelerators, which produce x-rays and of increasingly greater energy. Intensity modulated radiation therapy, also known as IMRT, when used alone or combined with surgery, has been shown to allow targeting of the tumor while either eliminating or substantially decreasing the dose of radiation to normal tissues. IMRT delivers high doses of radiation directly to cancer cells in a very targeted way, much more precisely than is possible with conventional radiotherapy.

Dr. Yung Son is one of the most experienced radiation oncologists in the U.S. with regard to the incorporation of brachytherapy into cancer treatment programs. Brachytherapy, which is a technique that allows for the implantation of small radioactive seeds into or in close proximity to a tumor, can provide radiation to tumors in a very specific and controlled fashion. Brachytherapy, combined with external radiation therapy, can be used to cure head and neck cancers that could not be removed surgically without injury to speech and swallowing functions. These new approaches can often preserve the ability to speak and swallow normally, even in patients with advanced disease.

Chemotherapy update

Patients who receive chemotherapy with radiation for head and neck malignancies have a decreased risk of distant tumor spread. They experience both prolonged disease-free survival and prolonged overall survival. Thus, the integration of chemotherapy with radiation has changed our standard of care while enhancing efforts toward organ preservation. Dr. Hari Deshpande leads the medical oncology efforts for Head and Neck cancers.