May 4, 2015 | by Robin Heffler
Surgery for head and neck cancers is unarguably complex, requiring extremely controlled movements and exceptional training.
“Given where we are operating, our primary concern is maintaining speaking, swallowing and breathing,” said Ellie Maghami, M.D., chief of head and neck surgery, who recently teamed with Robert Kang, assistant clinical professor of otolaryngology and surgery, to perform a supraglottic laryngectomy, removal of a portion of a patient’s cancerous larynx, or voice box, above the vocal chords. “We want to treat disease and maintain the anatomy to have safe functioning.”
Maghami and Kang used a robot to help them perform that surgery.
They avoided the traditional operation, which splits open the jawbone, and instead performed the procedure through the patient’s mouth, using tiny robotic instruments to reach the back of the throat. That approach minimizes invasiveness, complications and scarring, and significantly reduces or eliminates the need for additional reconstructive surgery, while maximizing function.
Robotic operations require intensive training and extreme skill – and are only offered at large or highly specialized medical centers, such as City of Hope. They’re also only done in cases in which the cancer can be exposed completely and is not too extensive.
Complex though robotic procedures are, they’re only one of the many leading-edge technologies at City of Hope used in head and neck cancer treatment. Transoral laser microsurgery, which uses a laser beam viewed through a microscope to remove cancers at the back of the throat and voice box without external incisions, is another.
Where high-tech care meets compassionate care
But what truly sets the head and neck program apart is not only its physicians’ abilities to perform complex, leading-edge procedures with the latest technology, but their comprehensive and compassionate approach to patients.
“We have in place a sophisticated, multidisciplinary head and neck team, which covers every aspect of the care required,” Maghami said. “The patient becomes the hub to which we’re all connected. We put together plans to maximize the chances of beating the cancer and minimize the toxic effects of radiation and chemotherapy. And surgeons don’t hand off care to others after surgery, but manage postoperative and follow-up care as well.”
Mona Swinehart, an oncology-certified nurse who coordinates treatment for surgical patients at City of Hope, said care begins as soon as patients register with the call center.
“Our goal is to have all patients given to an R.N., who gets a health history, chooses an appropriate doctor, answers all questions, explains how the City of Hope system works and helps them to feel comfortable with the system,” she said. “The head and neck oncology service is probably one of the most passionate teams here. It treats very serious cases, and everyone on the team is totally dedicated.”
Swinehart said that doctors across the country refer patients to Maghami, who has received “wonderful” reviews from her patients. Kang too gets many referrals, she said, and is known for his warmth with patients and their families. Sometimes, she said, he even prays with patients who ask.
“Patients are here for many years,” Swinehart said. “Doctors often take that extra step of being a friend to the patient. I’ve seen doctors who’ve gone to patients’ weddings.”
Research makes a difference
A large part of the strength of the head and neck cancer program is the strength of the larger organization, Maghami said. “City of Hope is a center of excellence,” she said. “We sit at the national table evaluating diseases from the most recent information coming out of labs and clinical trials. We also institute more clinical trials here than anywhere else.”
An associate professor of surgery and holder of the Norman and Sadie Lee Foundation Endowed Professorship in Head and Neck Cancer, Maghami is currently researching the potential to turn cancer cells back into normal cells through bioengineered and modified viruses. In another study, she is targeting immune-system cells to enhance the effectiveness of radiation.
Similarly, Kang is engaged in several research projects. One seeks to target a gene that already has increased the effectiveness of radiation in cancers other than the head and neck. Another is a clinical trial with Maghami, examining the results of robotic surgery.
“We spent the first 10 years building the clinical program as the place to go to,” Maghami said. “In the next 10 years we want to build the academic program, which will further enhance the effectiveness of our clinical work.”
Learn more about treatment and research of head and neck cancers at City of Hope.
Learn more about becoming a patient or getting a second opinion by visiting our website or by calling 800-826-HOPE (4673). You may also request a new patient appointment online. City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.