Author: Ashish Patel, M.D., D.D.S., FACS, head and neck surgical oncologist, reconstructive surgeon, Providence Head and Neck Cancer Program, Providence Cancer Institute; and Head and Neck Surgical Associates
Receiving a head or neck cancer diagnosis can be frightening and potentially devastating to a person’s sense of identity and well-being. That’s why the Providence Head and Neck Cancer Program team at Providence Cancer Institute of Oregon views patient care through a wide lens that encompasses advanced treatments, investigational therapies and multidisciplinary support.
We take a pioneering treatment approach to minimize the impact head and neck cancer can have on a patient’s quality of life. For example, we use minimally invasive transoral robotic surgery (TORS) to remove cancer from the back of the throat, base of the tongue and larynx.
R. Bryan Bell, M.D., D.D.S., FACS, FRCS, medical director of Providence Head and Neck Cancer Program, was one of the first surgeons in the world to use TORS to treat head and neck cancer. TORS uses the DaVinci SP robot to perform surgery through the mouth without having to make an incision in the patient’s throat or lip or split the jawbone. This approach helps patients recover more quickly, and it reduces the risk of damaging tissues that affect speech and swallowing. It may be used alone or with a low dose of radiation or chemotherapy, which helps minimize life-altering side effects.
TORS also produces better outcomes, as we saw in a study conducted by the Providence Head and Neck team between 2011 and 2018. The patients in the study had HPV-positive oropharyngeal cancer and were treated with TORS, neck dissection and risk-adapted adjuvant therapy. The five-year overall survival rate was 91%, and the five-year probability of recurrence or cancer-associated death was less than 1%. The results of the study were published in the Oral Oncology Journal in 2020.
Using TORS as a first-line treatment allows us to study and better understand the patient’s tumor type and cancer. A pathology report tells us if the cancer has invaded lymph nodes, nerves or blood vessels, whether it is high grade or low grade, deep or superficial.
Combined with a genomic profile of the tumor, created by our research partners in the Molecular Genomics Laboratory and the Earle A. Chiles Research Institute, a division of Providence Cancer Institute, we can take a deep dive into a patient’s cancer type, mutation and immune system. The information we gather through genomic sequencing helps us map and tailor precise cancer treatments for our patients.
Working as an integrated team with the research arm of Providence Cancer Institute means our patients may have access to adoptive cellular therapy, a highly personalized type of cancer immunotherapy, and investigational therapies available through our clinical trials. Currently, we have several trials open to patients with head or neck cancers, including an investigator-initiated trial to evaluate the efficacy of an immunotherapy used prior to surgery. Providence is the only site in the world accepting patients for this trial.
Oral oncology supportive care for patients
Providence Oral Oncology and Oral Medicine, a part of the Providence Head and Neck Cancer Program, is unique to the Pacific Northwest. Oral oncologists, Amber L. Watters, D.D.S., MPH, MS, and Heidi J. Hansen, D.M.D., dental director of Providence Oral Oncology and Oral Medicine, help head and neck cancer patients manage both acute and chronic oral conditions, with a focus on the side effects of cancer treatments, such as radiation therapy to the head and neck, chemotherapy, stem cell transplant and antiresorptive therapy. Cancer treatments can cause a host of temporary or permanent oral problems, including:
- Dry mouth
- Dental disease related to cancer treatment
- Oral mucosal lesions and oral mucosal infections
- Oral graft versus host disease
- Tooth loss due to cancer treatment
- Medication-related osteonecrosis and osteoradionecrosis of the jaws
- Neuropathic pain, including burning mouth disorder
- Oral precancer
In addition, the oral oncology team treats oral and facial pain syndromes and provides diagnosis and management of oral dermatologic and autoimmune conditions, oral precancerous lesions and other conditions.
Providence Head and Neck Cancer Program
The Providence Head and Neck Cancer Program team includes head and neck surgeons, dental oncologists, radiation and medical oncologists, oncology nurses, radiologists, speech/physical/occupational therapists, pathologists, nurse navigators and social workers. We offer leading-edge care for patients with benign and malignant tumors of the oral cavity (mouth), tongue, pharynx (throat), larynx (voice box), nose, paranasal sinuses, salivary glands and thyroid gland, as well as tumors at the skull base. Our program is known nationally as a leader in minimally invasive surgical approaches and long-term outcomes that support quality of life for our patients. Learn more.
Clinical trials at Providence Cancer Institute
Learn more about current clinical trials for head and neck cancer patients.
To refer a patient for a trial:
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