Head & Neck Cancers Program
The Head and Neck Cancers Program at Smilow Cancer Hospital and Yale Cancer Center provides comprehensive care, as well as innovative and organ-sparing treatment options, to patients with cancers of the head and neck. Our team sets the tone nationally and internationally for clinical trials and state-of-the-art cancer care. By carefully balancing treatment efficacy with quality-of-life, our collaborative approach to care personalizes treatment for tumors affecting the neck, larynx (voice box), pharynx (throat), oral cavity (mouth), ear, sinuses, tonsils, and salivary glands, as well as cervical (neck) lymph nodes or neck structures.
We understand that with cancers of the head and neck, how a patient lives after treatment is just as important as the treatment itself. Speaking, swallowing, breathing, and appearance are not secondary concerns, but are central to who a person is and how they engage with the world. That is why our team is dedicated to innovative, organ-sparing approaches that carefully balance treatment effectiveness with long-term quality of life. Every treatment plan is highly individualized, built around the specific tumor, the patient's overall health, and their personal goals and priorities.
This is made possible by the strength and depth of our multidisciplinary team. Our head and neck surgeons, radiation oncologists, and medical oncologists work in close collaboration with pathologists, speech-language pathologists, physical therapists, lymphedema specialists, nutritionists, dentists, smoking cessation specialists, advanced practice nurses, and social workers. Together, this integrated team meets regularly to review each case, align on a unified treatment strategy, and ensure that every dimension of a patient's wellbeing is addressed.
Functional outcomes are a cornerstone of our decision-making process. When evaluating treatment options, our team considers not only the likelihood of eliminating the cancer, but also the impact of treatment on a patient's ability to speak, eat, and live fully. This commitment to preserving function and dignity drives our investment in the latest surgical techniques, advanced radiation technologies, and novel systemic therapies.
Our Services
Surgical Care
Our program offers a promising new surgical technique, transoral robotic surgery, that can be used to remove certain throat cancers while avoiding skin and bone incisions. This approach speeds healing and shortens a patient’s hospital stay. Likewise, patients with certain laryngeal cancers, who a few years ago would have lost their vocal cords and their voices, can often be treated with less invasive surgeries.
In many cases, radical neck dissections have been replaced by less radical surgeries that preserve the nerves, arteries, and muscles in the neck. Patients continue to move, speak, breathe, and eat normally after less radical surgeries, without sacrificing cure rates. Additionally, in recent years, the field of reconstructive surgery has achieved many breakthroughs, yielding previously unattainable cosmetic and functional outcomes.
After surgery, patients are transferred to a specialized inpatient unit dedicated to head and neck cancer postoperative recovery, which helps to avoid prolonged stays in the ICU. The unit is designed specifically around the recovery needs and potential complications of these patients, with a care team experienced in recognizing and managing issues as they arise.
Medical Oncology
Our medical oncologists have unique expertise in head and neck cancers and dedicate their practice entirely to cancers of the head and neck. The integration of chemotherapy with radiation has become very important for patients with head and neck cancers that involve the lymph nodes or is locally extensive, and this approach can lead to organ preservation and increase the chance of cure for many patients. Breakthroughs in targeted therapy and biomarkers allow a personalized approach that can avoid the toxicities of conventional chemotherapy in some cases, and new treatments to prevent recurrence in high-risk situations are also being studied. For patients with recurrent disease, new anti-cancer drugs and immunotherapies are also available.
Our medical oncologists are engaged in research and trials looking at human papillomavirus (HPV)-directed vaccines and more tolerable chemotherapy regimens. Although immunotherapy is effective for patients with head and neck cancer when other options haven’t worked, it too can stop working. When this happens, our physicians are prepared to offer targeted therapies.
Radiation Oncology
Radiation treatment is critical for many advanced head and neck cancers. Radiation therapy can be delivered alone or combined with chemotherapy as a primary therapy or after surgery. Our radiation oncologists specialize in the use of intensity-modulated radiation therapy to effectively and more precisely target head and neck tumors.
Our team works in close coordination with ENT surgeons, medical oncologists, radiologists, and pathologists to design a specific radiation plan after extensive multidisciplinary review. During radiation treatment, patients are carefully evaluated by their physician and support team. After treatment is completed, the radiation oncologist will help with cancer surveillance and symptom management. Our radiation oncologists actively participate in clinical trials that explore novel agents to sensitize cancer cells to radiation, as well as new therapies that may help maintain treatment response. Through this active participation, they have access to the most up-to-date information and are involved in influencing the direction of head and neck cancer research in the future.
Pathology
The Yale Head and Neck pathology team diagnoses tumors in the mouth, throat, voice box, and salivary glands. They use advanced genetic and molecular tests to determine an exact, personal diagnosis for each patient. As the only head and neck subspecialty pathology practice in the state of Connecticut, they engage in a wide range of clinical and translational research that include genotype-phenotype correlation in viral-associated head and neck cancers.
Head and Neck High-Risk Premalignant Clinic
The High-Risk Oral Premalignant Clinic at Smilow Cancer Hospital is a specialized program for patients with precancerous mouth or throat growths. It provides close monitoring, preventive care, and early treatment to stop these growths from becoming cancer. This personalized, multidisciplinary care is focused on early cancer detection. Our team members include head and neck surgery, oral & maxillofacial surgery, dentistry, laryngology, oral pathology, head and neck pathology, radiology, oncology, radiation oncology, speech language pathology, genetic counselors, clinical coordinators, and supportive care.
Patient Support Services
Support begins even before surgery or chemoradiation, with a visit to the “prehab” clinic where patients meet with an advanced practice provider, a speech-language pathologist, a nutritionist, and a swallowing specialist who start patients on an exercise program to strengthen the swallowing muscle, which often reduces the need for a feeding tube after radiation or surgery.
This multidisciplinary support continues after treatment through a dedicated surveillance and rehabilitation clinic. Patients are followed at gradually increasing intervals for up to 10 years and are referred as needed for rehabilitation addressing speech, swallowing, lymphedema, nutrition, and other concerns.
