NewYork-Presbyterian. The University Hospital of Columbia and Cornell.

Find A Physician

Return to Head and Neck Cancer Overview

Hospital News

Return to Head and Neck Cancer Overview

Research and Clinical Trials

Return to Head and Neck Cancer Overview

Health Library

Return to Head and Neck Cancer Overview

Clinical Services

Return to Head and Neck Cancer Overview

Head and Neck Cancer

Tumors that form in the head and neck can affect a host of functions often taken for granted, such as speech, swallowing, facial nerve function, and facial appearance. Thus, optimal diagnosis and therapy requires the comprehensive approach preferred by physicians of NewYork-Presbyterian Cancer Centers. The Centers' teams devise plans that not only destroy a tumor, but also provide for functional rehabilitation of the patient.

Diagnostic Innovations

In the head and neck, tumors may be either primary or secondary. Primary tumors originate in the head or neck itself, for example in the thyroid, throat, larynx, salivary gland, brain, or other locations. Secondary cancers are tumors that have spread from primary masses in other parts of the body. Most often, secondary tumors of the neck originate in the lung, breast, kidney, or from melanomas in the skin.

NewYork-Presbyterian Cancer Centers offer patients the latest diagnostic tools for detecting the presence of a malignancy and assessing the stage of the cancer. The Cancer Centers cache of technology includes magnetic resonance imaging (MRI), computed tomography (CT) scan, positron emission tomography (PET), single photon emission tomography (SPECT) scans, and several methods of biopsy.

Therapeutic Excellence

At NewYork-Presbyterian Hospital, multidisciplinary teams with skills in microvascular free tissue transfer, oral surgery, neurosurgery, neuro-otology, radiation oncology, medical oncology, speech therapy, and physical therapy aid in the development of treatment strategies for patients with advanced tumors of the throat, parotid gland, and skull base. Our clinical facilities feature the latest in video and digital endoscopic technology for the diagnosis and management of head and neck cancer. New cases are discussed among experts from various medical specialties, and treatment plans are developed based on function-sparing, minimally invasive approaches, which do not compromise survival.

Advances in Surgery

NewYork-Presbyterian Hospital is a leader in the refinement of techniques and technology for skull base surgery. For tumors of the skull base, otolaryngologists work together with neuro-ophthalmologists and neurosurgeons to develop the optimal surgical plan for each patient. Many skull base surgeries are now performed endoscopically, allowing surgeons to treat most patients without making facial incisions.

Stereotactic Techniques
Otolaryngologists at NewYork-Presbyterian Hospital/Columbia University Medical Center, together with the neurosurgery department, are researching minimally invasive, stereotactic techniques for skull base surgery. Stereotactic radiological techniques, which precisely target radiation, simultaneously maximize the removal of tumors and inflammatory lesions while minimizing surgical risks and adverse effects. As with any minimally invasive surgery, the advantages of stereotactic techniques include reduced risk of infection, less stress on the immune system, less pain and scarring, and shortened recovery time.

Radiation Therapy

Gamma Knife Radiation
NewYork-Presbyterian Hospital is one of only 100 sites worldwide to have this 20-ton radiosurgery system. Using a three-dimensional approach, it is capable of directing up to 201 beams of gamma radiation to converge, with pinpoint accuracy, on a target within the brain. The gamma knife technology allows for the highest level of precision in positioning radiosurgical beams, minimizing damage to surrounding healthy tissue and increasing effectiveness. Unlike traditional open skull procedures, which can require several days in the hospital and weeks or months of recuperation, patients treated with the gamma knife can often go home the same day and return to work or school immediately. Recently, the radiosurgical center treated its 1,000th patient with the gamma knife. One of the busiest centers in the country, patient satisfaction ratings for the past year were over 98 percent based on 98 percent of patients responding.

Intensity Modulated Radio-Therapy (IMRT)

This sophisticated stereotactic technique is being utilized for large, irregularly shaped lesions surrounded by healthy tissue that is especially sensitive to radiation. This system, which can also be given with fractionation, employs beam-intensity modulation technology that shapes the radiation to conform to the target site.

Concurrent Chemotherapy and Radiation

This therapy is aimed at preserving organs in patients with early and moderately advanced head and neck cancer. While the treatment is intense and has significant after effects, doctors at NewYork-Presbyterian Hospital/Weill Cornell Medical Center evaluating the treatment have found results promising in terms of both organ preservation and cure.

Experimental Therapies

Hormone Therapy

NewYork-Presbyterian Cancer Centers recently conducted a study of the efficacy of anti-epidermal growth factor receptor (EGFr) Antibody C225 in combination with chemotherapy in patients with metastatic or recurrent squamous cell head and neck carcinoma.

Cell cycle inhibitor

Recently, NewYork-Presbyterian/Columbia completed a study in collaboration with the Dana Farber Cancer Center, evaluating a novel cell cycle inhibitor in patients with recurrent head and neck cancers. Promising changes in Rb-gene patterns suggest this may be a useful drug when combined with other agents.

Prevention

About 90 percent of head and neck cancers are caused by tobacco and alcohol use, and the deaths from these cancers are largely preventable. Cancers of the mouth and throat are nearly nonexistent in adults who do not smoke or drink. People who have been exposed to radiation, either during medical treatments as children (common in decades past) or from nuclear radiation sources, are at considerable risk for thyroid cancer and should be screened yearly.

Research

Gene Therapy

Genetic research at NewYork-Presbyterian/Weill Cornell involves the combination of an oncolytic virus with immunomodulatory genes, such as interleukin-2. In a preclinical tumor model, this combination achieved complete remission of established tumors. Future research will focus on defining the immunologic response as well as optimizing the efficacy of this treatment paradigm.

Facial Nerve Regeneration

Some head and neck cancer patients may experience facial nerve damage because of a mass, or after its removal. NewYork-Presbyterian/Columbia clinicians are investigating ways to stimulate the facial nerve to regenerate itself. Currently, the group is working with various growth factors related to facial nerve injury, including retrograde injury signal peptides.

Voice and Swallowing Center

Tumors and resulting head or neck surgery can cause dysphagia, or difficulty in swallowing. The Voice and Swallowing Center, located at NewYork-Presbyterian/Columbia, is dedicated to the evaluation and treatment of voice and swallowing problems. The center consists of a team of nationally recognized specialists and offers patients access to state-of- the-art diagnostic technology, emergency care, and education. Treatment options include behavioral voice therapy, medications, phonosurgery, botulinum (Botox) injections, laryngeal reconstruction or framework surgery, and postcancer voice rehabilitation. In addition, physicians here have introduced and are providing training in flexible endoscopic evaluation of swallowing with sensory testing – a non-radioactive alternative to barium swallow x-rays. The test permits direct assessment of the motor and sensory aspect of the patient's ability to swallow.