Head & Neck Surgery and Oncology

Head & Neck Surgery and Oncology

Head & Neck Surgery and Oncology

UW Department of Otolaryngology: Head and Neck Surgery in collaboration with the Seattle Cancer Care Alliance is the Northwest's leader in head and neck cancer care and is ranked as one of the top five cancer centers in the nation.

Studies have shown that the first treatment you receive for cancer is by far the most important. That's why your first choice in a treatment center needs to be the right one. The Department of Otolayryngology: Head and Neck Surgery at the University of Washington partners with the Seattle Cancer Care Alliance to offer patients the full range of disciplines that come together to deliver state-of-the-art integrated care. The Seattle Cancer Care Alliance was founded to incorporate the expertise of all three parent institutions, the Fred Hutchinson Cancer Research Center and UW Medicine, to deliver the best care possible. Patients who begin their treatment at Seattle Cancer Care Alliance often have better outcomes than those who started treatment elsewhere. Not only can you expect the best standard of care available, patients at SCCA have access to advanced therapies and treatments being explored in one of the clinical trials for head and neck cancers. Research and  therapies are truly intertwine to offer patients the therapies of tomorrow, today.

Patients at SCCA have access to the advanced care of the Otolaryngology-Head & Neck Surgery Center at University of Washington Medical Center (UWMC) that attracts hundreds of new patients each year and performs complex reconstructions with great results. In 80 percent or more of the cases, the doctors can save a patient's larynx or voice box.

Every year, some 350 new head and neck cancer patients are evaluated at UWMC. A multidisciplinary Head and Neck Tumor Board, which includes head and neck surgeons, reconstructive surgeons, dental surgeons, radiation oncologists, medical oncologists, neuroradiologists, and pathologists, meets weekly to discuss the cases and come up with the best treatment plan for each patient. 

Most head and neck cancers are found in people over age 40. Men are two to three times more likely than women to have head and neck cancer, although rates in women have been rising along with their growing use of tobacco and alcohol. The number of cases related to HPV, the same virus that causes cervical cancer in women, seems also on the rise.

If cancer is limited to the lining of your mouth and throat, it is called carcinoma in situ. When the cancer penetrates the surface lining, it's called invasive squamous cell carcinoma. If it arises from glands below the surface lining, it is called adenocarcinoma, adenoid cystic carcinoma, or mucoepidermoid carcinoma.

Read more about these cancers in the page links below:

While many cancers of the head and neck are curable, treatment depends on where the cancer is, the severity of the disease, and the patient's age and overall health. The primary method of treatment is surgery (removing the cancer cells). Radiation (using high-dose X-rays to kill cancer cells) and chemotherapy (using high-dose anti-cancer medication) are also used.


Great advances have been made in surgical procedures so that structures affected by cancer can either be spared from removal, or reconstructed well enough that the patient is not disfigured. The larynx, or voice box, can be saved in half the cases in which it would have been removed in the past. When part of the lower or upper jaw needs to be removed, doctors can now refashion a jawbone using bone from the patient's leg, hip, or shoulder blade. The tongue can even be reconstructed with appropriate soft tissue from various parts of the body.

For patients in whom a structure cannot be saved or restored, there are several new ways of helping to improve speech, swallowing, and other functions. Doctors can now restore a patient's vocal ability using a quick implant procedure. Other options for restoring a person's vocals include an electrolarnyx - a device placed against the neck to help form words and a tracheosophageal puncture - a surgical procedure that restores the patient's ability to deliver air into the throat and eventually allows speech.

Using a simultaneous, two-team approach during surgery, oncologic and reconstructive surgeons work alongside one another. Their team efforts, combined with the anesthesia and operating room nursing staff, has significantly shortened procedure times. After surgery, the team of nurses, speech pathologists, and social workers work with patients to help them recover and rehabilitate quickly.

Newest Techniques

The newest technique offered is Transoral Robotic-assisted Surgery (TORS) for tumors of the upper aerodigestive tract (tumors of the back of the tongue and throat). UW Medical Center is the only center in the region to offer this specialized surgery. Use of the da Vinci Robot allows patients to return home in only a day or two without experiencing the long-term effects of more invasive techniques, which were once the only surgical option available.

Click the link below to see a video about one of our patients treated with TORS. 
Lydia's Story - Who knew that getting cancer could be a path leading to Carnegie Hall? When Lydia Miner discovered a lump in her throat, she faced a blistering regime of radiation ...

Radiation Therapy

  • Over the last decade there have been tremendous technical advances in head and neck radiotherapy. Intensity modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), and adaptive radiotherapy are a few.
  • IMRT combined with IGRT allows for very precise delivery of radiation therapy to tumors while sparing normal structures. Adaptive radiotherapy is the process of varying the radiation intensity according to changes in tumor dimensions during treatment. The goal is to cure the patient while minimizing their side effects.
  • Head and neck radiotherapy is a highly complex and specialized field. SCCA patients are cared for by specialized radiation oncologists with clinical experience specifically in treating head and neck cancers using state-of-the-art technology in a patient-centered approach.
  • For us, every patient is unique and care is individualized according to his or her specific clinical situation.

Unique to our program are the following: 

  1. Quality assurance components among the head and neck radiation oncologists that ensure a uniform quality of care and technical expertise for all our patients.
  2. Specialized head and neck supportive care includes nursing, nutrition, speech pathology, lymphedema care, and specialized dental support with unique devices to minimize radiation toxicity.
  3. Internationally recognized cyclotron (fast neutron therapy) to treat rare salivary gland tumors.
  4. Several clinical trials testing newer strategies in cancer care.
  5. For complicated tumors involving vital structures, we have highly specialized experience with integrated approaches incorporating Gamma Knife radiosurgery.
  6. Proton therapy, an advanced form of radiation treatment and an important alternative to standard X-ray radiation for many types of cancer and some non-cancerous tumors. Learn more about proton therapy for head and neck cancer.


The use of systemic therapy in head and neck cancer has expanded in the last few years. Chemotherapy, in combination with radiotherapy, is now the standard of care for patients with locally advanced disease, either as a primary treatment or after surgical resection.

Targeted therapies have improved the efficacy of conventional chemotherapy and in some cases are used alone as a monotherapy. Recently, the use of targeted therapy has shown progress and we have started using agents that specifically target growth receptors on tumor cells, such as cetuximab and erlotinib. Other encouraging new discoveries harnessing the power of the immune system are being tested and developed here at the Seattle Cancer Care Alliance. Please refer to the SCCA website for a full list of available trials for head and neck cancer patients.

The highest quality multidisciplinary care uses systemic therapy as an integral part of head and neck cancer care. Every patient requiring systemic therapy at SCCA has the option of receiving the standard of care or participating in innovative clinical studies that explore new approaches to fight their disease.

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