Head and Neck Cancers Treatment Program

Overview

Physicians at the Center for Head and Neck Cancers have among the longest experience and deepest expertise in the United States in treating these rare cancers. We routinely manage significant volumes of head and neck cancer sub-types that other centers may see only once or twice a year.

Our multidisciplinary team of head and neck cancer specialists treat patients with tumors of the:

• Oral cavity (lips, tongue, hard palate, floor of mouth, gums)
• Oropharynx (middle of throat behind mouth, including tongue base, tonsils, and soft palate)
• Larynx
• Hypopharynx (lower throat)
• Paranasal sinuses
• Nasopharynx
• Salivary glands (Parotid, submandibular and minor salivary glands)
• Thyroid
• Other, including skin cancers of the head and neck

Our medical and radiation oncology specialists collaborate with imaging and surgical experts at the internationally respected Massachusetts Eye and Ear Infirmary (MEEI) to provide comprehensive care for every patient. We are among the busiest centers in the nation and one of only a handful to offer proton therapy and a high volume of free-flap tissue transfer operations. We also offer specialized diagnostic services, including unique testing of certain patients' tumors to allow for individual risk assessment and personalization of head and neck cancer treatment.

Medical Oncology

Medical oncologists incorporate conventional therapies, investigational drugs, and targeted agents into treatment strategies customized to provide the most successful outcome for each patient. We have a special focus on incorporating targeted agents into concurrent chemo-radiation treatment approaches in order to maximize cure rates and minimize side effects of treatment for advanced head and neck cancers.

Excellence in Surgical Care

We collaborate with Head and Neck surgeons from the Massachusetts Eye and Ear Infirmary to provide cutting-edge surgical care for head and neck cancers, maximizing cancer control while preserving function and appearance. Innovative surgical techniques include:

• Free-flap tissue transfers to preserve or restore appearance and function after treatment. Our commitment to reconstructive excellence incorporates all aspects of reconstructive surgery from microvascular free tissue transfer, pedicled tissue reconstruction, locoregional cervicofacial flaps, tissue expansion and recontouring, as well as alloplastic rehabilitation. Our annual volume ranks our program as one of the busiest in the nation
• Voice-preserving endoscopic laser excision of laryngeal cancer. The Mass General/MEEI efforts in voice restoration following laryngeal surgery are recognized throughout the world and benefit from our close relationship with the Voice and Speech Center at MEEI
• Specialized procedures to treat cranial base tumors including endoscopic skull base resection and proton beam radiotherapy. The Mass General/MEEI Cranial Base Center brings together the an extensive multidisciplinary group comprised of MEEI Head and Neck Surgery, Ophthalmology, Head and Neck Radiology, Neurotology, Rhinology, Neurosurgery, Radiation Oncology and Medical Oncology
• Specialized thyroid and parathyroid cancer surgery with major research interests including recurrent laryngeal nerve electrophysiologic monitoring during thyroid surgery, and intraoperative parathyroid hormone analysis during parathyroid surgery

Multidisciplinary Patient Care

Depending on the stage and other characteristics of your cancer, the treatment may include surgery, chemotherapy, radiation therapy or a combination of these therapies. Your treatment team is comprised of a multidisciplinary group of head and neck cancer specialists with expertise in providing state-of-the-art care in the rapidly evolving area of head and neck cancer management. The team also incorporates specialty rehabilitative services to provide the finest in complete patient care. Your team may include:

• Medical oncologists design the most appropriate combination of chemotherapy, chemoradiation and targeted therapy for your particular cancer.
• Radiation oncologists offer innovative radiation therapy techniques customized to your individual needs and designed to deliver the most effective therapeutic radiation to the cancer while preserving normal nearby tissue.
• Head and Neck surgeons with advanced training in the surgical treatment of head and neck cancers provide the most advanced surgical techniques to maximize tumor removal and preserve function and appearance
• Microvascular surgeons perform state-of-the-art reconstruction utilizing free tissue transfers to optimize function and appearance
• Radiologists offer advanced state-of-the-art imaging and expertise to evaluate tumors, assist in surgical and radiation treatment planning, and monitor the results of treatment
• Pathologists evaluate tumor samples to provide precise diagnostic information, including any biomarkers that can help your team design the best treatment plan for you
• Oral surgery prosthodontists make prostheses to aid in functional rehabilitation
• Oral maxillofacial surgeons help restore function and appearance
• Speech and language pathologists work with patients to maximize speech and swallowing functions affected by treatment. These specialists, along with oncology nutritionists, are integrated into all phases of the care plan, to mitigate the complications of treatment that can occur in head and neck tumors
• Oncology nurses and nurse practitioners bring special expertise in cancer care for patients with head and neck cancer
• Oncology psychiatrists, social workers, and chaplains provide family, spiritual, emotional and mental health support.
• Palliative care providers work with your team to address pain and quality-of-life concerns

Members of your care team meet regularly with you and your referring physician to ensure clear communication and seamless coordination of care.

Expertise in Diagnosing and Staging Cancer

Precise diagnosis, tumor characterization and staging (determining whether the cancer has spread) are the basis for designing the most appropriate treatment plan for you.

A complete diagnostic workup includes a careful physical examination of the head and neck, including examination of the throat and voice box with a fiber-optic laryngoscope.

Our team of pathologists sub-specializes in head and neck cancers and uses conventional and molecular analysis techniques to establish the correct diagnosis and identify biologic markers to guide therapy.

We collaborate with MEEI radiologists who have special expertise in head and neck cancers and offer sophisticated imaging technologies to provide the most precise diagnostic and staging information. Advanced imaging technologies include:

• CT to pinpoint the location, size and shape of the tumor
• MRI to pinpoint the location, size and shape of the tumor
• PET/ CT to gain integrated anatomic and functional information and aid in targeting treatment

Pioneering Radiation Therapies

Our radiation oncologists offer a range of therapies designed to shrink or destroy tumors while protecting normal tissue. Advanced technologies include:

• Proton therapy, a highly focused form of radiation that delivers more radiation to the tumor and less to surrounding tissue than conventional photon radiation. Our physicians have the longest experience in the U.S. in using protons to treat head and neck tumors
• Intensity-modulated radiation therapy (IMRT) uses advanced computer software to create beam configurations that “paint” target areas with more radiation in order to maximize tumor destruction while sparing normal tissue
• Stereotactic radiosurgery (SRS), a form of radiation that uses several converging beams to focus a large dose of radiation on the tumor. We are one of the few centers in the country offering SRS with protons.
• High dose rate brachytherapy in which radioactive seeds are introduced via catheter to tumor sites and radiation is administered from the inside out, resulting in a very precise therapy that focuses radiation on the tumor and spares surrounding normal tissue. Brachytherapy implants are placed in the operating room at tumor margins to enhance tumor destruction
• Intraoperative radiation therapy allows the application of additional radiation therapy to be delivered at the time of surgical resection

Learn more about radiation therapy.

Developing Better Therapies through Research

Our active research program includes both basic science and translational research initiatives. These ongoing efforts are designed to connect our basic science advances with therapeutic interventions, as well as to:

• Identify genetic abnormalities that drive squamous cell cancers
• Identify tumor biomarkers that may predict prognosis or guide therapy
• Investigate the role of circulating tumor cells (CTCs) in detecting metastases through a simple blood test. This information could then be used to personalize therapy and potentially, to improve outcomes
• Understand the mechanisms behind the development of thyroid and salivary gland cancers

Clinical Trials

Our clinical trials portfolio focuses on developing more effective treatments and limiting the complications of therapy on speech and swallowing and improving quality of life.

Find Clinical Trials for Head and Neck Cancer.