John Truelson, M.D.

Biography

“Our mission is maximizing organ preservation, functional outcome, and cosmetic appearance without sacrificing cure rates for head and neck cancers.”

-Dr. John Truelson

Background

Dr. Truelson has been in practice for over 30 years. After thousands of intricate surgeries and frequent consultations with colleagues across the nation, Dr. Truelson has built a reputation as an elite subspecialist in head and neck surgery. His referral-based practice is one of the busiest at UT Southwestern.

Among the multitude of surgical specialties, he found head and neck surgery to be the most fascinating and has committed his life’s work to being one of the best. Head and neck surgery is challenging due to its inherent complexity, and Dr. Truelson chose the specialty because of the opportunity to optimally affect the quality of life for patients with these difficult problems. Cancers and other abnormalities of the head and neck have the potential to affect personal appearance and disrupt the function of the face, mouth, nose, and throat. While the primary focus is on curing disease, preserving or restoring the vital functions of breathing, speaking, and swallowing must also be a priority.

Philosophy & Approach

Dr. Truelson believes the medical advances he has witnessed over the last three decades in treating head and neck cancer are the direct result of refusing to be satisfied with the status quo.

“If it’s not broken, then break it…and find a better way to do it,” he says.

Ironically, he does not always see surgery as the first—or even necessarily the best avenue.

“My job is not to force any specific treatment modality. Even though I am a surgeon, I see my primary role as helping to cure the patient while maintaining their functionality. Sometimes that means surgery, sometimes not. I don’t want to ask someone, ‘Which wing do you want to fly without?’ I want to give them back a normal life.”

Dr. Truelson considers all the options available to each patient through his network of specialists, and he emphasizes that even with the same diagnoses, no two patients are alike and can respond differently for many reasons. Because of this, every treatment plan is customized and frequently reviewed and updated with his team.

How Dr. Truelson Feels About His Patients

Dr. Truelson finds it easy to relate to his patients because of his confidence that he has something to offer them.

What information does he want to get across to every patient that comes to see him? “That I am on their side. That despite how vulnerable, confused, or anxious they might feel right now, they are going to get through this. That I care about them and will be with them the whole way.”

Dr. Truelson tries to spend all the time necessary to make each patient and their family feel they are heard. “We see individuals, not ‘cases’ and want them to know and feel comfortable that we are giving them the best solution toward a cure and a normal life. They should leave knowing we are their home base.”

The Measure of Success

At UT Southwestern, brilliant minds are commonplace. Awards, honors, and achievements are part of the pursuit of excellence that defines those practicing medicine at the highest level. Nothing matters more to Dr. Truelson than the people he works with and the patients whom he treats.

“My greatest satisfaction comes from seeing my patients return to health. The letters of thanks I have received from patients are always humbling, and I have read them more than once.”

Dr. Truelson is also the Residency Program Director for his department at UT Southwestern. He spends a large portion of his time working with residents and planning the entire educational process.

“Watching their collective journeys into becoming skilled specialists in five years is an amazing process that I am fortunate to be part of it. There is so much promise in the next generation of surgeons.”

About UT Southwestern

According to Dr. Truelson, what makes UT Southwestern distinctive from other medical centers dedicated to cancer care is the depth and breadth of knowledge across the campus, both in the clinical practices and in basic sciences. The experience, training, and commitment to the spirit of continuous improvement surrounding every specialty is extraordinary. Treatment protocols are important, but cancer centers that are overly protocol (or rules) driven may use a more restrictive lens when considering options for every patient.

Dr. Truelson describes UT Southwestern as being “non-prescriptive,” and filled with specialists working together that have questions, and answers to questions, that many other institutions may not even consider asking. The academic energy is intense.

While the Head & Neck Division at UT Southwestern has been doing complex surgery such as endoscopic procedures and reconstructive free flaps for over 25 years, the primary focus is organ preservation whenever possible. Endoscopic and robotic cancer surgery limit the impact to normally functioning organs, but non-surgical chemotherapy/radiation programs have also been a large and essential part of treatment resources.

Currently, UT Southwestern is engaged in a number of studies evaluating non-surgical methods using targeted agents and immune therapy, which allows for a patient’s own white blood cells to kill cancers. This type of treatment is very new but with continued research could ultimately limit or eliminate the need for surgery, chemotherapy or radiation. These studies are complex and seem slow, but significant progress has been made in the last 30 years in reaching for the ultimate goal of maximizing organ preservation and functional outcome, without sacrificing cure rate. In many cases cure rates have actually improved with less functional deficit - which is the primary goal. Noteworthy progress has also been realized for benign disorders such as airway narrowing, salivary stones and infections which can substantially affect quality of life.

The Head & Neck Division of UT Southwestern is also conducting studies to identify cancer in “at risk” individuals prior to the emergence of any symptoms—at very early stages of cancer development. Dr. Truelson is eagerly awaiting the day when throat cancer will become as treatable as "strep throat”.

“Today many people are surprised to learn there is real improvement in cure rates. For instance, certain oropharyngeal cancers are cured in up to 95% of cases without any significant long-term sacrifice of function or appearance.”

In the past, cure rates were significantly lower, and even if some were “cured,” patients’ functional results were often poor. Continual study, research, and newer techniques have significantly improved outcomes, while at the same time de-escalating treatment intensity resulting in less side effects. Even when extensive surgery becomes necessary, reconstructive surgery and rehabilitative programs serve to maximize functional outcome.