Treating head and neck cancers can be difficult: the goal is to shrink and eradicate the tumor while preserving head and neck function. “However, most treatments tend to be really disruptive to patients’ lives,” says Haythem Ali, M.D., a medical oncologist with Henry Ford Health. “Cancer treatment can inhibit everyday functions, such as swallowing, speaking, eating and breathing. We’re always trying to find ways to treat patients while keeping their lives as normal as possible.”
This is the dilemma that drives head and neck clinical trial research. “Any time we find a new treatment, we want to answer two questions,” says Dr. Ali. “How does it improve survival? (That’s the bottom line.) And then very immediately after that, how does it help preserve anatomy and structural continuity?”
Here, Dr. Ali and Steven Chang, M.D., director of the head and neck cancer program at Henry Ford Cancer, share some of the problems that head and neck clinical trials are hoping to solve.
The problem: Radiation can weaken the muscles needed for swallowing.
The clinical trial: “We have a clinical trial that’s trying to determine how speech therapy can be most effective to maintain patients’ swallow,” says Dr. Chang. “Should a speech pathologist intervene before starting treatment? Or during treatment? Swallowing therapy is a common behavioral treatment used to improve swallowing, but there currently isn’t a best practice.”
Another upcoming clinical trial will use a device that can monitor patients’ muscle contractions. “A swallow specialist—and the patients themselves—will be able to watch them swallow on a screen to see if they’re using the right muscles and activating them enough,” Dr. Chang adds.
The problem: Surgery to remove tumors in the head and neck area can be very invasive and require extensive reconstruction.
The clinical trial: A clinical trial is determining whether CT scans and MRIs can predict certain pathological features in the cancer that will respond well to chemotherapy or radiation. If this clinical trial finds that CT scans and MRIs can do this, chemotherapy or radiation could be used as a successful treatment without the need for surgery at all.
The problem: There isn’t a well-established blood test to monitor HPV and throat cancers.
The clinical trial: “We are developing a clinical trial protocol that would be one of the first blood tests used to monitor HPV and throat cancer,” says Dr. Chang. “Right now, it’s mainly being studied for surveillance at diagnosis and after treatment. In the future, however, it could also be used as a screening tool for those who are at high risk of HPV-related cancers to ensure they aren’t developing throat cancer.”
The problem: Chemotherapy kills all rapidly dividing cells. It doesn’t distinguish between healthy cells and cancer cells, which can lead to side effects that inhibit daily function.
The clinical trial: Can immunotherapy—which uses your own immune system to target only the abnormal, cancer-causing cells—be given as a successful treatment with less side effects? “We have many clinical trials to see how immunotherapy can be most effective on cancer and least disruptive to quality of life,” says Dr. Ali. “At what point should it be given? Is it most effective in combination with radiation? There are many questions to answer.”
Several clinical trials are offered at the Henry Ford Cancer - Detroit. The new cancer pavilion in Detroit features a clinical trials office where patients can connect with research nurses to see which clinical trial opportunities are available to them. Call 1-888-777-4167 for more information.
Steven Chang, M.D.,is an otolaryngologist who specializes in the treatment of head and neck cancers. He is the director of the head and neck program at Henry Ford Cancer and sees patients at Henry Ford Cancer - Detroit.
Haythem Ali, M.D.,is a medical oncologist who sees patients at the Henry Ford Cancer - Brownstown and the Henry Ford Cancer - Detroit.