Head and Neck Cancers

ENT Specialists treat head and neck cancers with robotic technology 

The Surgeons Behind the da Vinci Robot

Drs. Huntley and Krowiak, CENTA group ENT cancer specialists for St. Vincent Cancer Care, explain that robotic technology enables them to highly magnify the areas of the throat and see cancerous lesions, then use fine instruments to remove cancerous lesions. The TORS surgical approach avoids incisions through the face and neck, improves recovery and minimizes the impact on healthy tissue.

Are you at risk for Oral Cancer?

St. Vincent Cancer Care encourages adults to get oral examinations of the mouth, tongue, tonsils and throat at you next dental or physical exam. Men, especially smokers, are diagnosed with these types of head and neck cancers twice as often as women. The ENT specialists (CENTA otolaryngologists) have an ENT Tumor Clinic [more info] to screen adults with suspicious symptoms and to encourage early detection of benign and cancerous tumors. In other cases, referrals to the ENT cancer specialists happen after a dentist or family physician does an oral exam of a patient and detects suspicious tissue in the mouth and neck. They may use a special light to aid in the discovery of pre-cancerous tissues.

For more information about head and neck cancer (also referred to as oral cancer or throat cancer) call the CENTA group at 317-926-1056.

Excessive smoking and alcohol use are the top risk factors for oral cancers

Early oral cancer signs are similar to a sore throat or a cold that doesn't go away after 2 or more weeks, such as hoarseness, a mouth sore, and red or white discoloration of the mouth tissue. Yet, sometimes an early symptom is abnormal breathing -- often related to poor sleep, snoring and those diagnosed with obstructive sleep apnea. St. Vincent affliated board-certified ENT specialists treat all types of ear, nose and throat diseases including related conditions, including sleep apnea. The first step is a thorough physical exam and medical history. Head and neck cancers are more so associated with environment and behavior than genetics. Keep a diary of when symptoms start and your environment. These are important details to share during your appointment.

Advanced oral cancer symptoms include:  

  • Difficulty swallowing or feeling like something is stuck in your throat
  • Coughing up blood
  • Numbness in the mouth
  • Ear pain on one side only
  • A sore under a denture that doesn't heal
  • Difficulty moving the tongue or jaw
  • A lump in the mouth or on the neck
  • Unexplained weight loss

Prevent these cancers by changing health and environmental factors linked to head and neck cancers

  • Protect your lips from sunburn by using a UV-30 SPF-rated sunblock for the lips.
  • Stop smoking and limit daily - weekly alcohol use.
  • Maintain a good, balanced diet of fruits and vegetables. These foods have protective nutrients.
  • Protect yourself against the most common sexually transmitted disease – HPV (Human Papillomarvirus) -- linked to oropharynx cancer at back of the throat, including the base of the tongue and tonsil. HPV also causes most cervical cancer cases and is associated with other cancers (http://www.cdc.gov/cancer/hpv/index.htm). A vaccine is available to help prevent HPV and these cancers.

Source: CDC.gov – Rate of oral cancer due to HPV infection is higher in men than women. Other factors such as cigarette smoking and alcohol consumption also increase ones risk for head and neck cancers.

Treating head and neck cancers

There are many types and stages of head and neck cancers. Sometimes neo-adjuvant chemotherapy is used just prior to surgery to reduce the size of the tumor. In more advanced cases, the cancer cells may be more aggressive and locally advance to the lymph nodes. St. Vincent Cancer Care has an active multidisciplinary head and neck malignancy committee that routinely meets to review complex and challenging cases. The expertise on these physician on this tumor boards directly benefits St. Vincent Cancer Care patients and their loved ones.

ENT-trained oncology nurses and a St. Vincent patient navigator [317-338-3900] are available to help coordinate the oncology treatment schedule and follow-up rehabilitative services. St. Vincent provides many types of supportive services for your individual goals including patient and caregiver support groups and classes. There is no cost to St. Vincent Cancer Care patients for navigation services and educational support programming.

Throat Cancer (pharynx)

The St. Vincent affiliated ENT group, CENTA based in Carmel, IN, is the only group in Indiana doing trans-oral robotic surgery (TORS). Using a 3D, high-definition vision system, these physicians are able to better visualize the cancer cells in the throat. A small and flexible microscope goes into the throat and has a laser that destroys the tumor cells. These highly-trained surgeons utilize the da Vinci® robotic surgical technology to enhance the precision and dexterity of the surgical technique. They are able to target the cancerous cells while preserving the healthy tissue, especially the patient's vocal cords. This ENT group has oncology-trained speech therapists to help guide our patients through the recovery process.

Larynx cancer (voice box)

A specific type of throat cancer is larynx cancer which affects the vocal chords. Patients often notice voice changes or a sore throat that doesn't go away. Early diagnosis of the larynx (or voice box) located between the base of the tongue and the trachea, significantly impacts long-term survivorship. Treatment often includes 3D-high definition laser surgery and/or vocal cord stripping, with or without radiation therapy, and in some cases, chemotherapy depending on the stage of the tumor. The surgical goal of this type of procedure is to lessen the amount radiotherapy or chemotherapy needed and to improve survivorship. If the voice box needs to be removed, not only is the voice altered but so is swallowing and respiration. CENTA physicians are the first group in Indiana to do successful voice restoration using an implanted voice box. Voice rehabilitation is essential for a holistic recovery – so that physically, mentally and spiritually, the patient reengages with daily activities. Throughout the recovery process, patients also work closely with speech therapists to regain vocal quality.

Cancer of tongue and tonsils

Treating these cancers with state-of-the-art robotic therapies enables the ENT specialists to target the tumor at the back of the tongue and on the tonsils and surgically remove the cancerous tissue. These cancer cells are often flat, thin, scale-like cells (called squamous cells). The precision of this approach often reduces the length of chemotherapy needed and spares the patient from radiation therapy. These patients have a shorter recovery period after surgery and have demonstrated strong outcomes.

Skull-based tumors.

The ENT specialists team up with the neurosurgeons to treat St. Vincent patients with skull-based tumors. An ENT specialist is trained in the diseases and anatomy of the ear, nose and throat. Skull-based tumors, although rare, can impact this anatomy and require a highly-coordinated surgical team approach. That is why St. Vincent Cancer Care physicians build a team around the patient and develop a personalized treatment plan that accounts for the physical, mental and spiritual impact on the patient and his or her family.

For more information about head and neck cancers, go to the St. Vincent Health Information Library. The Oral Cancer Foundation also has relevant patient and caregiver information.