The Head and Neck Cancer Center is a major provider in the Northeast for patients with early-stage, recurrent, or aggressive head and neck cancers. The nationally recognized team of multidisciplinary specialists who care for these patients collaborate to manage patient care from the first consultation through treatment and follow-up. They combine their expertise in patient care with state-of-the-art treatment options while actively participating in clinical trials to provide tomorrow’s treatments today.

For more information or to refer a patient, call 617.414.4913 or email [email protected]. Patients with a diagnosis or strong suspicion of cancer are seen within 72 hours.

What Is Head and Neck Cancer?

According to the National Cancer Institute, each year, approximately 55,000 Americans are diagnosed with cancers of the head and neck. These malignancies can disfigure the face and neck and affect a person’s speech, eyesight, hearing, ability to swallow, and sense of smell.

Fortunately, many of these cancers are curable if caught at an early stage.

Cancers of the head and neck generally develop in the squamous cells (the outermost layer of cells) that line the moist surfaces inside the mouth, nose, and throat. Cells, the body's basic unit of life, divide to form new cells, and after performing their functions for a while, they die. Cancer cells do not die. Instead, they morph into a new type of cell and divide and produce extra cells that merge into a tumor. If the tumor is benign, it does not metastasize (spread) elsewhere in the body. If the tumor is malignant, it is cancerous and can metastasize to other parts of the body.

Ninety percent of head and neck cancer cases are squamous cell carcinomas: malignant tumors on the surface of the oral cavity, the aerodigestive tract (respiratory and digestive passages), and other organs.

The location of the cancer determines its name and affects its diagnosis and treatment. Sites of head and neck cancer include

  • Salivary glands
  • Nasal cavity and sinuses
  • Upper aerodigestive tract
    • throat (pharynx)
    • voice box (larynx)
    • oral cavity (lips, gums, cheeks, tongue, and roof and floor of the mouth
  • Thyroid cancer
  • Parathyroid cancer
  • Eye cavity (orbital tumors in the bones surrounding the eye)
  • Ear and temporal bone
  • Sarcomas (clusters of malignant tumors) in the neck
  • Tumors of the skull base, including squamous cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, esthesioneuroblastoma, sinonasal undifferentiated carcinoma (SNUC), sarcomas, lymphoma, hemangiopericytoma
  • Skin of the head and neck
  • Laryngeal cancer
  • Oropharyngeal cancer

Symptoms of Head and Neck Cancers

Many cancers of the head and neck produce early warning signs. General symptoms include a persistent sore, a lump, swelling, and soreness or pain in the face, neck, mouth, jaw, or throat.

Other symptoms vary with the type and location of the cancer, such as

  • Paralysis or numbness in the face or neck
  • Change in vision, pain, or bulging around the eye socket
  • Hearing loss or ear pain
  • Difficulty or pain when opening the mouth, chewing, swallowing, or speaking
  • Bleeding from the mouth or nose
  • Unusual white or red patches on the mouth lining, gums, tongue, or lips
  • Changes in the voice, such as hoarseness
  • Weight loss
  • Looseness of upper teeth
  • Dentures that no longer fit properly or comfortably

If any of these symptoms persist for more than two weeks, patients are advised to see their physician.

Causes of Head and Neck Cancers

Most head and neck cancers are linked to tobacco products, such as cigarettes, cigars, pipe tobacco, and smokeless tobaccos, such as chewing tobacco and snuff. Using both tobacco and alcohol puts an individual at greater risk than either of these habits alone. A subset of head and neck cancers may be caused by the human papillomavirus (HPV).

Other factors that may increase risk are

  • Age: Most head and neck cancers are found in people ages 50 and older.
  • Gender: Men are at greater risk to develop head and neck cancers than women.
  • Race: African Americans have a higher rate of head and neck cancer than do Caucasians, Hispanics, or Asians.
  • Radiation to the head and neck from previous radiation therapy
  • Poor oral hygiene
  • Exposure to airborne particles of asbestos, especially in the workplace
  • Excessive sun exposure

Diagnosis of Head and Neck Cancers

How Is Head and Neck Cancer Diagnosed?

Timely screening and detection can significantly reduce deaths from head and neck cancers, which at early stages have a cure rate as high as 90 percent. Diagnosis and treatment vary with the type and location of the cancer. However, most diagnostic work-ups will include the following steps:

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

Biopsy

Any suspicious mass of tissue or tumor is subject to a biopsy, or removal of cells from the mass. This is the only technique that can confirm the presence of cancer cells. The doctor will use a general or local anesthetic depending on the location of the mass, and then remove a sample of tissue to send to the lab. The sample is sent to a pathologist, a physician who is an expert at identifying diseased cells in tissue samples. Very often, a few stiches are used to help the area heal, and tenderness is felt for a short period of time.

Imaging Studies Head and Neck Cancer

In addition to laboratory tests of blood and urine, the diagnosis may involve imaging studies such as barium swallow x-ray, CAT (computed axial tomography) of MRI (magnetic resonance imaging) scans, or PET (positron emission tomography) scan, in which cancer cells become visible after absorbing treated sugar.

Based on these findings, patients may also meet with other BMC experts in a variety of specialties, including head and neck surgical oncology; neurosurgery; ophthalmology; pathology; radiology; dentistry, oral surgery, and prosthetics; speech and swallow rehabilitation; audiology; gastrointestinal surgery and nutrition; medical and radiation oncology; vascular surgery; and microvascular, reconstructive, and plastic surgery.

The results of these consultations and procedures are reviewed in a weekly multidisciplinary Head and Neck Tumor Board meeting. Each patient receives a comprehensive, individualized care plan, designed to meet his or her specific needs. Following this review, the patient’s BMC physician will discuss the recommendations of the Head and Neck Tumor Board with the patient and his or her family, and together they will develop a treatment plan that meets the patient’s specific needs.

Quality Metrics

The Head and Neck Oncology Team at Boston Medical Center is committed to providing the highest quality of comprehensive cancer care through our robust, multidisciplinary care team approach and our strong clinical trials program. 

In a recent American Head and Neck Society Quality Metrics database, BMC showed a superior performance to the nationwide study averages’ quality metrics, including: 

  • Lower rates of unplanned reoperations after cancer surgery, 
  • Providing multidisciplinary tumor board review to all patients, and 
  • Timely initiation of adjuvant therapy. 

We also outperformed the average in clinical trial enrollment, illustrating our commitment to improve access to therapeutic clinical trials for all patients. 

In addition to our comprehensive medical teams, which include oncologic surgeons, reconstructive surgeons, medical and radiation oncologists, and specialists in neuro-radiology and nuclear medicine, our multidisciplinary care teams encompass a wide array of other specialists to support and aid patients on their treatment journey. Staff include specialized speech language pathologists, patient navigators, oncology social workers, smoking cessation counselors, registered dieticians, and integrative medicine professionals. Many patients benefit from accessing acupuncture, yoga and cooking classes, and support groups. 

Along with providing excellence in cancer care, BMC’s Head and Neck Oncology team is committed to cancer prevention. The Human Papillomavirus (HPV) is a virus that causes many cancers, including cancers of the tonsil and back of the tongue. In an effort to improve access to the vaccine and reduce vaccine-preventable cancers in our community, the HPV vaccine is now available to all BMC patients in the Otolaryngology clinic. 
 

References

National Cancer Institute. 2013. “What are the side effects of treatment?” In “Head and Neck Cancers.” Last reviewed February 1, 2013. Accessed June 14, 2015. http://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet#q7

Contact Us

Treatments & Services

Radiation Therapy

Radiation uses special equipment to deliver high-energy particles, such as x-rays, gamma rays, electron beams or protons, to kill or damage cancer cells. Radiation (also called radiotherapy, irradiation, or x-ray therapy) can be delivered internally through seed implantation or externally using linear accelerators (called external beam radiotherapy, or EBRT).

Read more

External Beam Radiation Therapy

External beam radiation therapy is one of the most common types of radiation for cancer treatment. Radiation comes from a machine outside the body and delivers radiation to a specific location inside the body.

Read more

CyberKnife

CyberKnife delivers highly targeted beams of radiation directly into tumors, in a pain-free, non-surgical way. Guided by specialized imaging software, we can track and continually adjust treatment at any point in the body, and without the need for the head frames and other equipment that are needed for some other forms of radiosurgery.

Read more

Chemotherapy

Chemotherapy is a medication or combination of medications used to treat cancer. Chemotherapy can be given orally (as a pill) or injected intravenously (IV).

Read more

Integrative Therapy

Integrative medicine practices have been shown to reduce cancer-related symptoms such as pain, anxiety, nausea, and fatigue. The Program for Integrative Medicine and Health Care Disparities in the Department of Family Medicine at BMC combines conventional medical treatments with evidence-based complementary therapies. Free therapeutic massage to decrease preoperative anxiety and postoperative pain in cancer patients undergoing surgical procedures is available. In the Moakley Building, where BMC conducts much of its cancer care, a registered yoga instructor holds free biweekly yoga classes, and a licensed acupuncturist offers free acupuncture to cancer patients. Participants in these sessions have gained notable clinical benefits, reporting decreases in pain, depression, anxiety, nausea, and fatigue. Services to individual patients complement group activities. Consultations that focus on stress management, nutrition, and coordination of complementary therapies are also available.

Read more

Diagnostics and Tests

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

Read more

Biopsy

Any suspicious mass of tissue or tumor is subject to a biopsy, or removal of cells from the mass. This is the only technique that can confirm the presence of cancer cells.

Read more

Imaging Studies Head and Neck Cancer

In addition to laboratory tests of blood and urine, the diagnosis may involve imaging studies such as barium swallow x-ray, CAT (computed axial tomography) of MRI (magnetic resonance imaging) scans, or PET (positron emission tomography) scan, in which cancer cells become visible after absorbing treated sugar.

Read more

Our Team

BMC’s comprehensive Head and Neck Cancer Center of Excellence team includes physicians who work in head and neck surgical oncology and skull base surgery, radiation oncology, medical oncology, pathology, radiology, nuclear medicine, and speech language pathology. The team’s patient-centered, multidisciplinary approach assures each patient benefits from the collaborative expertise of physicians uniquely focused on their individual needs.

Head and Neck Surgeons

Heather A Edwards, MD

Director, Division of Head and Neck Surgery, Department of Otolaryngology, Boston Medical Center
Assistant Professor, Boston University School of Medicine

Special Interests

Minimally invasive approaches, Microvascular reconstruction, Improving functional outcomes after cancer care

Dr. Heather Edwards Head and Neck Cancer within Otolaryngology

Daniel L Faden, MD

Special Interests

Minimally invasive surgery, Management of HPV related oropharynx cancer

Placeholder image for doctor

Anand K Devaiah, MD

Professor, Department of Otolaryngology - Head and Neck Surgery
Professor, Department of Neurological Surgery

Special Interests

Endoscopic minimally invasive skull base surgery; Otologic/vestibular disorders; Lateral skull base diseases and tumors; Anterior skull base tumors/paranasal sinus diseases; Head and neck surgery; Head and neck cancer; General otolaryngology

Otolaryngology doctor headshot

Frederick T Drake, MD

Assistant Professor of Surgery, Boston University School of Medicine, Boston MA

Special Interests

Endocrine Surgery, including Thyroid Surgery, Parathyroid Surgery, Minimally Invasive Parathyroidectomy, Adrenal Surgery, Laparoscopic Adrenalectomy; General Surgery, including inguinal, umbilical, and ventral hernia repairs and laparoscopic cholecystectomy

Gregory A Grillone, MD

Professor and Chairman of Otolaryngology, Head and Neck Surgery

Special Interests

Benign and Malignant Tumors of the Head and Neck, Robotic Surgery and Minimally Invasive Surgery for Head and Neck Tumors, Laryngeal, Voice and Swallowing Disorders, Surgical Treatment of Sleep Apnea, Diseases of the Trachea and Esophagus, Zenker's Diverticulum

Gregory Grillone MD Headshot Otolaryngology

David McAneny, MD

Chief Surgical Officer
Vice Chair of Surgery
Professor of Surgery, Boston University School of Medicine

Special Interests

Endocrine surgery, Surgical oncology, Pancreas surgery, Hepatobiliary surgery, GI tract surgery

Andrea L Merrill, MD

Assistant Professor of Surgery, Boston University School of Medicine

Special Interests

Breast Cancer, Thyroid Nodules, Thyroid Cancer, Parathyroid Adenoma, Parathyroid Hyperplasia

Jacob P Noordzij, MD

Vice Chairman of Clinical Affairs for Otolaryngology
Professor of Otolaryngology, Head & Neck Surgery, Boston University School of Medicine

Special Interests

Hoarseness, Parathyroid, Thyroid and Voice Problems, Zenker's Diverticulum

Otolaryngology doctor headshot

Teviah E Sachs, MD

Section Chief, Surgical Oncology
Associate Professor of Surgery, Boston University School of Medicine, Boston MA

Special Interests

Surgical Oncology, Liver, Pancreas and Biliary Cancers, Cancers of the Stomach, Sarcoma, Melanoma

Provider headshot - surgery department

Lauren F Tracy, MD

Assistant Professor, Boston University School of Medicine

Special Interests

Hoarseness and voice disorders, Professional voice, Dysplasia and vocal cord cancer, Office-based laser laryngeal surgery, Airway and swallowing disorders, Diseases of the trachea and esophagus, Zenker's Diverticulum

Reconstructive Surgeons

Waleed H Ezzat, MD

Director, Division of Facial Plastic and Reconstructive Surgery
Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine

Special Interests

Microvascular surgery; Head and neck reconstructive surgery; Facial trauma; Head and neck cancer; Facial paralysis; Facial plastic surgery; Facial cosmetic surgery

Otolaryngology doctor headshot

Heather A Edwards, MD

Director, Division of Head and Neck Surgery, Department of Otolaryngology, Boston Medical Center
Assistant Professor, Boston University School of Medicine

Special Interests

Minimally invasive approaches, Microvascular reconstruction, Improving functional outcomes after cancer care

Dr. Heather Edwards Head and Neck Cancer within Otolaryngology

Nurse Practitioner

Medical Oncologist

Peter C Everett, MD

Clinical Assistant Professor of Medicine, Department of Medicine, Boston University School of Medicine

Special Interests

Lung Cancers, Squamous Carcinomas of the Head and Neck, Esophageal Cancers

Elizabeth Tiani, NP

Instructor of Medicine, Boston University School of Medicine

Special Interests

Hematology and Medical Oncology

Radiation Oncologists

Minh T Truong, MD

Chief and Chair, Boston Medical Center Radiation Oncology, Boston Medical Center
Professor, Boston University School of Medicine

Special Interests

Head and neck; Central nervous system; Skin; Airway amyloidosis

standard BMC headshot

Radiologists

Osamu Sakai, MD, PhD

Section Chief, Neuroradiology
Professor of Radiology, Boston University School of Medicine
Neuroradiology

Special Interests

Neuroradiology, Head and Neck Radiology, Trauma imaging, Oncologic imaging, Quantitative imaging

Nuclear Medicine Physicians

Gustavo A Mercier, MD, PhD

Section Chief, Nuclear Medicine
Clinical Associate Professor of Radiology, Boston University School of Medicine
Nuclear Medicine and Molecular Imaging

Special Interests

molecular imaging, oncology imaging, cardiology imaging, neurology imaging, cross sectional imaging

Sara K Meibom, MD

Clinical Associate Professor of Radiology, Boston University School of Medicine
Nuclear Medicine

Special Interests

PET/CT, Nuclear Medicine, Nuclear Cardiology , Therapy with Iodine 131, Radium-223, Yttrium-90, Special interest in head and neck PET/CT

Physician Assistants

Speech Language Pathologists

Jessica M Pisegna, PhD, MS-CCC-SLP, MEd

Director of Speech Language Pathology

Special Interests

Dysphagia (swallowing problems), Dysphonia (voice problems), Cognitive Deficits and Aphasia (language problems), Reflux-related disorders

Meredith B O'Dea, MS, CCC-SLP

Speech Language Pathologist

Special Interests

Dysphagia (swallowing problems), Dysphonia (voice problems), Reflux-related disorders, Alaryngeal Rehabilitation included Tracheoesophageal (TEP) Voice Restoration/Management

Kailey Vitale, MA, CCC-SLP

Speech Language Pathologist

Special Interests

Dysphagia (swallowing problems), Alaryngeal rehabilitation including tracheoesophageal (TEP) voice restoration/management, Evaluation and treatment of swallowing problems after head and neck cancer

Additional Information

Head and Neck Cancer Clinical Trials

BMC offers a number of clinical trials specifically for head and neck cancer patients. Promising new techniques in the diagnosis, treatment, and care of patients with head and neck cancers are tested in these studies. The number and types of clinical trials available are constantly changing. View an up-to-date list of ongoing trials here. Those interested in participating in any clinical trials at BMC should talk with their physician.

News

Helping Patients with Oral Cancer Avoid Cancer Recurrence

Surgery is a common treatment for oral cancer, and usually includes a margin of tissue around the tumor being taken out to ensure that surgery removes all the cancer cells. Pathology will examine pieces of that margin during surgery to tell the surgeon if they need to take out more tissue, but it’s impossible for all of the tissue to be analyzed quickly enough to be 100 percent accurate. 

This means that in some cases, cancer cells will still be hiding and the patient might need a second surgery or radiation, both of which further increase the risk of problems with swallowing and speech.

To maximize the likelihood of getting the full tumor out, providers and researchers in BMC’s Department of Otolaryngology have partnered with BU Bioengineering to build a tool that will help identify potential cancer cells in a tissue sample and guide Pathology on where to examine further. This will then help ensure that all the cancer can be removed in one surgery. To study this procedure, the team has received a $3.5 million grant for a five-year study. Congratulations!

Affiliations

Boston University School of Medicine Logo

As the principal teaching affiliate of Boston University School of Medicine (BUSM), Boston Medical Center is devoted to training future generations of healthcare professionals.  Learn more about Boston University School of Medicine.