Head & Neck Cancers Program
Head and Neck Cancers Program
The Head and Neck Cancers Program at Smilow Cancer Hospital provides total 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.
Our multidisciplinary team includes head and neck surgeons, radiation oncologists, medical oncologists, pathologists, physical therapists, speech-language pathologists, nutritionists, a smoking cessation specialist, dentists, a physical/lymphedema therapist, advanced practice nurses, and social workers. Functional outcome is an important element in deciding which treatment approach is recommended.
Our program offers a promising new surgical technique, transoral robotic surgery (TORS), 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.
Patients who undergo these treatments maintain their ability to speak, although they may need to alter their diet or learn new swallowing techniques. At Yale, rehabilitative specialists work with patients to help them adjust to and overcome some of these swallowing impairments.
In many cases, radical neck dissections have been replaced by less radical surgeries that preserve the nerves, arteries, and muscles in the neck.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.
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.
A study led by Yale Cancer Center revealed that the checkpoint inhibitor pembrolizumab (Keytruda) offers patients with advanced head and neck cancers longer survival time; this led to FDA approval of immunotherapy as first-line treatment in head and neck cancer that has recurred or spread.
Radiation treatment is critical for almost all 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 (IMRT) to effectively and more precisely target head and neck tumors.
Our doctors work in close coordination with ENT surgeons, medical oncologists, radiologists, and pathologists to design a specific radiation plan after extensive multidisciplinary review.
During the course of radiation treatment, patients are carefully evaluated by their physician and support team weekly. The team works to address any symptom management, nutritional needs, or social support needs. After treatment is completed, the radiation oncologist will help with cancer surveillance and symptom management.
Clinical Trials and Research
Head & Neck Cancers Program Members
Clinical Program Leader
Benjamin L. Judson, MD, MBAOtolaryngology SurgeryBenjamin Judson, MD, is an otolaryngologist, interim chief of Yale Medicine Otolaryngology, and chief ambulatory officer of Smilow Cancer Hospital at Yale New Haven. He specializes in performing surgery to remove benign and malignant tumors of the head and neck, which can range from oral cavity tumors, to pharynx and larynx tumors, to skin cancers. “I enjoy what I do tremendously,” says Dr. Judson, who typically works with a team of other specialists, including oncologists, radiologists and pathologists. He’s found it’s important to listen carefully to his patients’ concerns, then go over each patient’s records as a group. Taking time to communicate information to the patient is especially important, he says. “I think it makes all the difference,” he says. The biggest change in the care of patients with head and neck cancer is minimally invasive surgery, and it is evolving on multiple fronts, Dr. Judson says. Such techniques and tools as lasers, surgical robots, and operating through the mouth to avoid incisions are approaches that can mean an easier recovery for the patient, with fewer aesthetic and functional side effects, he says. “These techniques might not be appropriate for every patient, but when they are they are a total game changer.” The next step researchers are working on revolves around achieving a better understanding the biology of head and neck tumors, he says. This knowledge will help doctors to tailor treatment for each patient more precisely, maximizing their ability to cure the disease while minimizing side effects. An associate professor of otolaryngology at Yale School of Medicine, Dr. Judson has research interests in investigating outcomes and quality in head and neck cancer therapy. He is also involved in supporting a biorepository of head and neck cancers to support continued research that would ultimately improve care at Yale and other institutions.
News from Head & Neck Cancers Program
Head & Neck Cancer Trials
- Gynecological Cancers, Head and Neck Cancers, Lung Cancer, Sarcoma Cancers, Cancer
A Phase 2 Open Label Study of Sacituzumab Govitecan (IMMU-132) in Subjects With Metastatic Solid Tumors
- Head and Neck Cancers
A Phase 2, Randomized, Open-label Three-arm Clinical Study to Evaluate the Safety and Efficacy of Lenvatinib (E7080/MK-7902) in Combination With Pembrolizumab (MK-3475) Versus Standard of Care Chemotherapy and Lenvatinib Monotherapy in Participants With Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (R/M HNSCC) That Have Progressed After Platinum Therapy and Immunotherapy (PD-1/PD-L1 Inhibitors) (LEAP-009)