Each year, approximately 40,000 new cases of cancer of the head and neck will be diagnosed in the United States. Tobacco and alcohol use are clearly the primary preventable risk factors for these cancers. Although patients with early stage cancers have high cure rates, most patients have advanced disease at the time of diagnosis. The optimal care of these patients is therefore complex and requires a true multidisciplinary approach.
The focus of the Multidisciplinary Head and Neck Cancer Program at Montefiore Medical Center and the Albert Einstein Cancer Center is on the development of innovative approaches for the early detection and intervention of head and neck cancer as well as studying new strategies for the treatment of advanced disease, emphasizing the integration of new molecular therapies in the existing modalities in surgery, radiotherapy and chemotherapy.
Patients referred to the Multidisciplinary Head and Neck Program will be seen in a multidisciplinary head and neck clinic by an Otolaryngologist, a Radiation Oncologist and a Medical Oncologist on the same day. A comprehensive, individualized and coordinated therapeutic plan is developed at a weekly multidisciplinary head and neck cancer conference consisting of a team of specialists from Neuroradiology, Otolaryngology, Pathology, Radiation Oncology and Medical Oncology. Innovative clinical research protocols available at the Montefiore Einstein Center for Cancer Care are offered to all patients where appropriate.
Spiral CAT of the chest has been demonstrated to be much more sensitive than the regular chest-X ray in detecting small lung cancers. Montefiore is establishing a collaboration with Weil/Cornell Medical College to screen individuals at risk of lung cancer because of a significant past smoking history. These studies employing spiral CAT scanning will be expanded to screen patients who have had previous head and neck cancer, with the intention of initiating early therapeutic intervention of recurrences and second primary tumors.
Researchers at Montefiore Medical Center and the Albert Einstein College of Medicine are planning to study early genetic damage to the upper aerodigestive tract in youths with less than 5 years smoking history. The objective of this study is to select youths who show a higher probability of developing cancer later in their lives. These individuals may then be offered early and intensive preventive and therapeutic interventions that include smoking and alcohol cessation and the use of agents given by inhalation that directly go to the areas damaged by tobacco.
The Tobacco-Related-Malignancy Program at Montefiore and Einstein is heavily involved in testing innovative treatments of head and neck and lung cancer and pre-malignant conditions by targeting specific molecular abnormalities within the tumors. Dr. Perez-Soler, Chairman of the Department of Oncology, and clinicians at Montefiore and Einstein have pioneered and are at the forefront of the clinical development of many of these agents. Emphasis is placed on the development of signal transduction inhibitors, a series of small molecular agents that block different growth pathways used by the tumor cells to grow in uncontrollable ways. Some of these compounds have shown very promising antitumor activity in studies conducted by Montefiore Medical Center clinical investigators. Current therapeutic approaches available also include intratumoral gene therapy in association with conventional radiation or chemotherapy.
DNA Microarray technology, pioneered at Einstein, is currently being employed to prospectively evaluate the tumors of resected head and neck cancer patients with the intention of determining specific genetic profiles in tumors that are associated with patient response or failure of standard therapeutic regimens.
To find out more about ongoing head and neck cancer studies or to refer patients for clinical investigation, please contact 718-904-2754. Patients are referred back to their referring physicians' offices after completing the program.