Multidisciplinary Head and Neck Cancer/Oral Oncology Program

Unique to the region, the Neag Comprehensive Cancer Center’s Head and Neck Cancer/Oral Oncology program combines the expertise and experience of world-class physicians and nurses with that of internationally recognized dental faculty from the University of Connecticut School of Dental Medicine. Together we provide comprehensive, coordinated, state-of-the-art care for patients diagnosed with head and neck cancers. In addition, the program includes renowned basic cancer researchers who are leading programs directed to the prevention, diagnosis and treatment of cancer.

The Head and Neck Cancer Program

The only service of its kind in Hartford County and the northern half of Connecticut, the program’s multidisciplinary team has seen hundreds of patients with head and neck cancer for evaluation and treatment since its founding in 1989.

The Head and Neck Cancer Program treats all types of head and neck cancer, excluding the brain and central nervous system, and includes specialists from the following disciplines: head and neck surgical oncology; radiation oncology; medical oncology; oral and maxillofacial surgery; oral rehabilitation services; nutrition; and social work. Specialists in neurologic surgery, plastic surgery, oculo-plastic surgery and dermatologic surgery are readily available to assist, as necessary.

• Head and Neck Surgery: including major resections of the oral cavity, pharyngeal or laryngeal cancer; combined craniofacial resections for nasal and sinus cavities; neck dissection; and Moh's surgery for skin cancer.
• Radiation Therapy: including TomoTherapy with state-of-the-art Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT), brachytherapy (radiation implants), stereotactic radiosurgery and radiotherapy, and linear accelerator based radiotherapy.
• Chemotherapy: including neoadjuvant (induction) chemotherapy, concurrent chemotherapy and radiotherapy, clinical trials, and chemotherapy with and without radiotherapy.
• Plastic and Reconstructive Surgery: including local or regional pedicled flaps, and microvascular free tissue transfer (free flaps).
• Rehabilitative Services: including speech and swallowing therapy, physical therapy, and occupational therapy.
• Medical Nutritional Therapy
• Social Services

What to Expect During Your Medical Appointment
Patients seen in consultation by members of the head and neck cancer team will typically be examined by all the various participating disciplines during their initial visit. The team then discusses various treatment options in a conference, and returns to the patients to convey its recommendations. This multidisciplinary approach greatly facilitates initial treatment planning, and allows the patient and family to be presented with a choice of treatment options, if available. In addition to optimizing coordination of standard therapies, this approach also helps ensure patients access to the latest clinical trials and protocols, if applicable. Reports summarizing findings and recommendations are sent quickly to referring physicians and dentists, as well as primary care physicians.

Dental Medicine/Oral Oncology Services

Expert faculty and staff at the UConn School of Dental Medicine work together and with the head and neck cancer team to provide state-of-the-art, coordinated care addressing the special dental needs and considerations of patients diagnosed with cancers of the head and neck.

The Oral Oncology team includes professionals from the following areas:

• Oral Medicine: Assessment and treatment planning prior to initiation of radiation therapy for cancers of the head and neck. Treatment-related dental service is coordinated with on site or community dentists. Consultation and management of oral side effects of cancer or cancer treatment is available. Clinical trials are available, including studies focused on oral mucositis, a common side effect of cancer treatments.
• Oral and Maxillofacial Surgery: Plate reconstruction of the mandible, bone grafts, dental implants, and tooth extractions.
• Oral and Maxillofacial Radiology: Dental and oral imaging for assessment and diagnosis of dental conditions that occur before and after cancer treatment.
• Oral and Maxillofacial Pathology Biopsy Service: The only oral pathology biopsy service in Connecticut. The service reviews approximately 4,300 diagnostic specimens annually. Board-certified oral pathologists provide oral diagnostic service based in the latest research and innovations in health care.

What to Expect During Your Dental/Oral Oncology Appointment
It is important that patients who will receive radiation treatment to the head or neck get a complete dental examination prior to starting radiation treatment. Radiation treatment can increase risks to the teeth and bone in the years following treatment. If a complete series of dental x-rays has not been recently taken, these will be needed as well.

Dentists who specialize in the effects on the mouth of medical treatments and conditions will evaluate the teeth, bones, gums and other oral tissues to determine the patient’s level of risk for dental complications in the future. Any recommended dental treatment needs that are identified can be quickly accommodated to allow radiation treatment to begin as soon as possible. Services are arranged through either the patient’s community dentist or a dentist on site at the School of Dental Medicine.

The oral oncology team works with the medical oncology team to conduct clinical trials targeting oral mucositis, a common side effect of radiation treatment.