Cancers of the tongue, tonsil, and throat are being diagnosed at an increasing rate, even in the non-smoking population. Transoral Laser Microsurgery (TLM) and Trans Oral Robotic Surgery (TORS) are some of the newest intervention available for patients with these cancers.
During my first 3 years of medical school in Cleveland, I frankly did not know anything about cancers of the mouth and throat (otherwise called "Head & Neck Cancer"). Really, I did not know you could get cancer in the tongue or tonsil! It wasn't until the final year of medical school that I was exposed to the field of Head & Neck Surgery, that I realize the impact of these cancers on the quality of life of patients.
Those cancers are generally not featured in the media, and I would argue that most of us will live a lifetime without meeting more than a handful of patients who have this type of cancer. There is no marathon, 10K walk, or charity gala on behalf of Head & Neck Cancer... right? Well, we did have some high-profile patients in the past few years. We all remember Michael Douglas (actor), George Karl (former coah of the now defunct Supersonics...moment of silence), and Roger Ebert (movie critic)...
Well, this type of cancer is now being diagnosed at an increasing rate. And not just in the smoking population! We are now seeing many young patients, who have never smoked, who get diagnosed with Head & Neck cancer. I mean, we are talking about patients in their 20's and 30's! This is possibly due to generational lifestyle changes, as there is now strong scientific evidence that certain types of HPV (Human Papilloma Virus) are causing this cancer. Yes... It's the same virus that causes cervical cancer in women. This topic probably warrants its own separate blog, and I'll get on it next time!
The symptoms, diagnosis, and pathophysiology of this cancer is beyond the scope of this blog. If you want to know more about symptoms, diagnosis, etc..., just leave a comment, and I'll try to answer your questions and comments as promptly as possible.
The goal of this blog is to highlight some of the new treatment paradigm for this type of cancer. More specifically, new minimally invasive surgical procedures called Transoral Laser Microsurgery (TLM) and Trans Oral Robotic Surgery (TORS).
Traditionally, Head & Neck cancers require either major surgery or intense chemo-radiation, or sometimes even a combination of surgery and chemo-radiation. Surgery will often result in difficulty swallowing and speaking. Chemo-radiation has improved results in swallow and speech, but even the non-surgical treatment protocol will often leave the patient with significant deficit.
So what are the new options? What if we could remove the cancers through the mouth? What if we didn't have to break open the lip and jaw to get to the throat? What if we could excise the cancer and still allow the patient to swallow and talk normally? What if we could decrease the amount of radiation and chemo? Well, many innovators have asked themselves these questions, and we have now some answers to these questions. Evolving answers, obviously, as new technology will continuously allow us to push the cutting edge even further.