Patient Services

The Head and Neck Cancer Program of UPMC Cancer Centers provides state-of-the-art, evidence-based care to patients with head and neck cancers* by combining the skills and experience of physicians and other health care professionals in an interdisciplinary and coordinated way.

The Program consists of a multidisciplinary team committed to the study of new approaches to prevention, diagnosis, treatment and rehabilitation of patients with carcinomas of the head and neck. Patients may be referred for diagnostic care to one of several practitioners, including: surgeons; medical and radiology oncologists; pathologists; and/or dentists. Reconstructive and rehabilitative resources are available in conjunction with practitioners skilled in the following specialties: plastic surgeons; speech pathologists; and nutritionists. Additional services are also available through the program's connection with two outstanding centers: the University of Pittsburgh Voice Center and the UPMC Swallowing Disorders Center.

The Program is also affiliated with the University of Pittsburgh Oral Cancer Center, located within the Eye and Ear Institute. Patients are evaluated by University of Pittsburgh Physicians and Ear, Nose, Throat (ENT) specialists and their assistants, which may include resident medical and nursing staff. Patients may be referred to the Program upon the recommendation of another provider such as a family physician or dentist; or may self-refer for a second opinion or screening.

New patients should arrange for recent medical records to be forwarded prior to their appointment, or hand-deliver them the day of their appointment. The records will be reviewed by the surgeon; A definitive diagnosis is usually made as a collaborative effort among head and neck staff, radiologists and/or pathologists. Patients should allow adequate time for a thorough examination and expect to provide a complete medical history.

New patients should arrange for their medical records to be forwarded prior to their appointment or hand-deliver them the day of their appointment. All patients should hand-carry their radiology films including x-rays, CT scans, etc. and any imaging studies and original microscopic slides for UPMC physicians to review. Patients may need to hand-carry their pathology slides to have them reviewed by our expert pathologists. A treatment plan is made through a collaborative effort among Program staff, surgeons, radiologists, radiation oncologists, medical oncologists and/or pathologists. Patients should allow adequate time for a thorough examination and expect to provide a complete medical history, including current medications.

To schedule an appointment at UPMC Cancer Centers, contact the UPMC Cancer Centers Information and Referral Service at 412-647-2811.

Specific head and neck cancer services

• As part of ongoing research studies, serial biopsies are performed to assess molecular changes associated with head and cancer and its response to therapy.
• The Program offers a phase II trial in which patients with advanced head and neck cancer are administered vitamin D and dexamethasone. The treatment, which is not highly toxic and therefore better tolerated by patients, is followed by computerized tomography (CT) scans on regular intervals to assess tumor status. The trial is in its very early stages and is based on findings of previous University of Pittsburgh Cancer Institute (UPCI) studies.
• A National Institutes of Health-funded phase I trial is ongoing to examine the safety and biologic consequences of intratumoral injection of a gene to block epidermal growth factor receptor production in patients with recurrent head and neck cancer. Eligible patients must have tumors that are not amenable to surgery and have received external beam radiation therapy and chemotherapy in the past. Treatment includes weekly injections for four weeks. To date, the treatment has been very well tolerated by patients and there has not yet been a dose-limiting toxicity. Additionally, researchers have noted some effect on the tumor.
• The Program offers highly skilled surgical management of disease.
• Combined chemotherapy and radiation therapy for the primary treatment of oropharyngeal/hypopharyngeal cancers is provided to preserve function and avoid surgical resection.
• The Program is initiating a trial of combination chemoprevention to patients at risk for a second primary. Treatment will include interferon alpha, retinoic acid and vitamin E.
• Experts in prosthodontics and prosthetics make it possible to reconstruct complex defects with the use of prostheses, which are most commonly used in palate reconstruction. Close collaboration with plastic surgeons optimizes reconstruction and preserves function. Additionally, rehabilitative resources are available in conjunction with speech pathologists and nutritionists.
• A study in collaboration with the UPCI Division of Cancer Control and Population Sciences is examining smoking cessation and psychological support in the perioperative setting.
• Intensity-modulated radiation therapy is used to treat patients with head and neck tumors.
• A detoxification program is offered to patients with cancer of the mouth and throat who have long histories of continued alcohol use and require surgery. The sudden cessation of alcohol use caused by surgery may lead to postoperative withdrawal, which may threaten life. The program identifies at-risk patients prior to surgery and provides them an opportunity to withdraw preoperatively under medical supervision and then have surgery afterward.

* Head and neck cancers include cancers of the lip/oral cavity/pharynx, nasal cavity, middle ear, accessory sinuses, larynx and eye / adnexa.

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