High-Tech Help for Head and Neck Cancer

If you want a glimpse of the future of cancer surgery, meet da Vinci®. He—or it—is a surgical robot, part of a significant shift from traditional methods of treatment to more minimally invasive techniques. Thanks to new high-tech tools like da Vinci®, the UAB Comprehensive Cancer Center has become a leader in this movement, most recently adapting the robot to help treat head and neck cancer.
The da Vinci® is a state-of-the-art system that scales, filters and translates the surgeon's hand movements into the precise motions of micro-instruments at the operation site within the patient’s body. Seated a few feet away from the patient, the surgeon looks through a viewfinder at three-dimensional images not available in traditional surgery.
Since acquiring the da Vinci® system more than two years ago, the Cancer Center has expanded its role in surgeries. The robot was first used strictly for radical prostatectomies. Then the center became the first in Alabama to apply the it to radical hysterectomies in women with early invasive cervical cancer. Now the Cancer Center is the first in Alabama—and the Southeast—to utilize da Vinci® to treat head and neck cancer patients.

Why Head and Neck Cancer?
Head and neck cancer accounts for about 3 to 5 percent of all cancer cases in the United States, according to the American Cancer Society. An estimated 45,660 people were diagnosed in 2007, and more than 11,000 died from the disease. Head and neck cancer affects men at a much higher rate than women; in 2007, 33,140 men were diagnosed compared to 12,520 women, and 8,080 men died as opposed to 3,130 women. The overall survival rate is about 50 percent.
“One of the main reasons the survival rate is so low is that 80 percent of patients are diagnosed when the cancer is in a very late stage," says William Carroll, M.D., UAB head and neck surgeon and Cancer Center scientist. "When it's caught early, the survival rate jumps to nearly 90 percent.”
Head and neck cancers are treated with surgery, chemotherapy, radiation therapy or a combination of all three. Surgery is especially difficult for this type of cancer, because the location of the tumor can affect basic functions such as eating, talking or even breathing. “At one point, there seemed to be a shift away from surgery, because it was so stressful for patients,” Dr. Carroll says.

Another Shift in Treatment
But the increased use of minimally invasive techniques—specifically, the da Vinci® robot—is changing all of that.
“We designed a protocol here that involves treating 40 patients using the da Vinci® system," Dr. Carroll says. "We've already enrolled more than 20 patients, and the early results have been extremely promising.”
Dr. Carroll and his colleagues are finding that patients who undergo da Vinci® surgery require shorter hospital stays, no feeding tubes and no swallowing rehabilitation. They also experience less pain and disfigurement. He stresses that not all head and neck cancer patients are ideal candidates for the da Vinci® surgery and that it is still early in the research process.
“Our goal is to prove that the robot is safe and eventually help these patients who otherwise would require drastic surgery," Dr. Carroll says. "We want all of our patients to have better quality of life and better cancer outcomes.”