Salivary Gland Cancers
GBMC Physician Addresses Salivary Gland Cancers,
Introduces Laser Technique for Early Glottic Cancer
As an employee and trainee of the Johns Hopkins Department of Otolaryngology, Patrick Ha, MD, knew of GBMC's reputation in head and neck cancer from the start, making it a win-win for him to join Greater Baltimore Head & Neck Associates as a member of the head and neck surgery team. "The Center's clinical work is at a high level and has tremendous experience with patients who have head and neck cancer. Truly, this is a great place to work and begin my career."
Intrigued by cancers of the salivary glands, Dr. Ha's clinical and research work is focused on this "underserved and under-researched group of cancers." Of head and neck cancers, he notes, only five percent attack the salivary glands. Within this small number, however, there are 30 to 40 different types of tumors that can affect the salivary glands.
"Each tumor behaves differently with regard to aggressiveness, metastatic potential, and outcome. From a molecular
standpoint, these are unusual tumors to study," he says. For example, certain salivary gland cancers that have metastasized may not necessarily shorten the lifespan. Furthermore, many salivary gland malignancies may not be linked to smoking. It is these mechanisms of disease that he is studying through an NIHfunded research grant.
"The disease has very good survival rates if caught early. About 80 percent of salivary gland tumors are benign. The other 20 percent are treatable with surgery and post-operative radiation therapy." The team approach at the Dance Center is an ideal environment for patient care and research pursuits, states Dr. Ha, who also maintains a dual appointment with the Johns Hopkins Department of Otolaryngology, where his research lab is located.
Lasers Attack Early Glottic Cancer
Another effort by Dr. Ha is the use of lasers for early glottic cancers, an approach called transoral laser surgery. Instead of making an incision in the neck as with traditional surgery, this technique allows the surgeon to use an endoscope to visualize the larynx. The surgeon focuses a carbon dioxide laser beam to excise the cancer, sparing nearby healthy tissue. Patients return home within one to two days, versus a week with traditional surgery. They also realize decreased discomfort, less scarring and a faster recovery. There are improved aesthetic and functional outcomes, and these techniques offer similar survival rates to more traditional surgery or radiation therapy.
This new technique represents an alternative to surgery for many patients, although individuals who have large tumors or tumors that are inaccessible may not be suitable candidates. "We can pick and choose which approach is best based on the patient's needs," Dr. Ha explains.
For patients for whom transoral laser surgery is not the ideal option, a combination of open surgery, radiation therapy and chemotherapy is often effective, he notes. "Previously, radiation therapy was not as sophisticated as today's approach, necessitating reliance on surgery. Now, radiotherapy is established firmly as a complement or alternative to surgery in many cases.
"There isn't always a clear-cut answer. Our goal is to offer options that best serve the patient," says Dr. Ha.
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