David Sher, M.D. Answers Questions On: Treatments for Head and Neck Cancer

The first thing I try to do with my patients is to establish trust. It’s important for them to know that I am personally interested in their welfare, that they are not just a number to me. When patients have that confidence they are more likely to find it easier to put up with the demands of their treatment. This is especially important for head and neck patients because treatment can sometimes be challenging in terms of side effects. By sharing my experience and knowledge of their type of condition, I hope to establish a relationship of trust that can help them keep moving through treatment.

Although cancer treatment is temporary, I believe it’s a lifelong relationship between doctor and patient. More and more, head and neck cancer patients are surviving and living with the long-term effects of their treatment. It’s our responsibility to continue with them and make sure their quality of life and function are as good as possible.

The biggest change in oropharyngeal cancer is the division between cancers that are linked with the human papillomavirus (HPV) and those that are not. Since this association was made a few years ago, treatments have been developed that are very effective at targeting HPV-positive oral cancers.

More recently, physicians have come to appreciate the role that smaller glands other than the parotid play in maintaining salivary function. These are organs at risk that we didn’t know about just a few years ago. By designing radiation treatment plans that avoid these small glands, we can better preserve normal salivary function after radiation treatment.

Outcomes research is a bit of a catch-all phrase that encompasses research into quality-of-life, the population-based effectiveness of competing interventions, and comparative value and cost-effectiveness. I am interested in all of these domains because successful therapies cannot simply be defined by positive statistical tests from randomized trials. Successful therapies must attempt to preserve quality-of-life. They must be feasible enough to be implemented in the “real world,” outside of a well-controlled clinical trial, and they should possess value to the community. Investigating these critical aspects of head and neck cancer treatments is a passion of mine, and I am excited to work with colleagues here at UT Southwestern in this area.