Head and neck cancers are among the most challenging cancers to treat with radiation therapy. In part, this is because they are so close to critical structures like the spinal cord, brainstem and the visual and hearing areas of the brain. Also, head and neck tumors are often located close to or involve sensitive areas of the head, such as the mouth and throat, so radiation treatment courses can be very intense and have significant side effects, especially when combined with chemotherapy.
Because protons are charged particles, not an X-ray beam, doctors can often prescribe higher doses of radiation safely to the tumor and reduce the risk of complications by avoiding the healthy tissue. The precision and properties of proton therapy mean doctors can reduce the side effects of treatment.
Patients are often seen at the Fred Hutch Head and Neck Multidisciplinary Clinic, where their case is reviewed by many specialists at once to help carefully plan their treatment decisions. At weekly head and neck tumor board meetings, a team of providers with expertise in head and neck cancers, that includes radiation oncologists, medical oncologists, otolaryngologists, radiologists and pathologists, discuss patients and strategize the best treatment plans.
One of our experts in head and neck radiation is Jay Liao, MD. He has been with the proton therapy facility since it opened in March 2013.
“There are always new developments happening in head and neck oncology, which is why this is such an exciting field to be involved in,” says Liao. “After 10 years, we have a lot of experience in the use of proton therapy for head and neck cancer and have a better understanding of its benefits as well as its limitations. We continue to closely track the long-term treatment and quality of life outcomes.” Our doctors continue to study protons, and currently have a clinical trial open looking at the benefit of a novel oral swish in reducing oral mucositis in patients who are undergoing chemotherapy and radiation with either photons (X-rays) or protons.
Liao is also involved in a new multicenter study for patients with certain salivary gland cancers with a specific genetic signature (HER2 positive). This study will evaluate the effectiveness of surgery followed by either photon radiation (X-rays) or proton radiation therapy, combined with chemotherapy and a new antibody drug targeting HER2. In addition, studies are being planned for patients with certain favorable prognosis HPV-associated head and neck cancers, focusing on strategies to make treatment less intense and decreasing side effects, while maintain high cure rates.
“The merger of Seattle Cancer Care Alliance with Fred Hutch this past fall should help further streamline care for our patients by bringing all the efforts of our team under one umbrella,” says Liao. “This will pave the way for more research collaborations.”
The multi-disciplinary approach to care at Fred Hutch allows for more resources, such as a dedicated nurse navigator to help with care coordination for our head and neck cancer patients. Fred Hutch is also working to improve the process of connecting our patients with the supportive care services that they often need during and after treatment, such as social work, speech/swallow/language therapy, physical therapy, pain management and palliative care.
The head and neck team hopes to eventually expand the multidisciplinary clinic by opening more regional clinics, and they are excited to have recently added Neil Panjwani, MD, to the team.
As a group, head and neck cancers are the seventh most common cancer in the world. Nearly 70,000 individuals are diagnosed with head and neck cancer each year in the U.S. Smoking is the biggest risk factor for most head and neck cancers, but patients should also avoid smokeless tobacco products and consider limiting consumption of alcohol.
“Don't smoke,” says Liao. “Quit smoking if you do, as this will substantially reduce your risk of head and neck cancer as well as many other cancers.”
For most patients, no hereditary basis for head and neck cancer risk has been identified. However, ongoing research is studying the genetic characteristics of people who don’t have traditional risk factors for head and neck cancer to better understand the causes.
If you would like to speak to one of our doctors about proton therapy for head and neck cancers, email email@example.com.
As a world-class, NCI-designated comprehensive cancer center, Fred Hutchinson Cancer Center continuously strives to improve patient care and remain on the forefront of research and technology. To seamlessly merge our many clinics and facilities into one organization, we’ve recently hired Joseph Riggs, MHSA, into the newly formed position of vice president of radiation oncology at Fred Hutch. In addition, Jing Zeng, MD, the medical director for the Fred Hutch proton therapy facility, has taken on the role of vice chair of clinical affairs in the Department of Radiation Oncology at UW Medicine.
Together, Riggs and Zeng will work with leaders at the proton therapy facility, UW Medical Center – Montlake, UW Medical Center – Northwest, Harborview Medical Center, Fred Hutch – South Lake Union, Fred Hutch – Peninsula and the clinic at the Seattle Veterans Affairs hospital to integrate our treatment centers and enable our sites to continue to provide top-of-the-line patient-centered care.
Riggs joins us from Jefferson Health in Philadelphia, Pennsylvania, where he served as enterprise administrator of radiation oncology. In that role, he helped streamline and improve clinical operations and efficiencies across seven radiation oncology centers. Before that, Riggs participated in planning the opening of the Johns Hopkins Proton Therapy Center in Washington, D.C.
Zeng is an accomplished clinical leader in thoracic and genitourinary radiation oncology and has swiftly progressed into clinical leadership roles at UW Medicine and Fred Hutch. She brings her passion for clinical care and deep knowledge of clinical operations into her new role.
Both Zeng and Riggs know that proton therapy is an important radiation modality in the treatment of solid tumors. “Proton therapy facilities continue to open around the world,” says Riggs. “With more than 10 years of experience, Fred Hutch continues to be a world leader in proton therapy. By bringing our proton facility under the broader Fred Hutch organization, we will be able to continue providing world-class care for our patients.” Seattle Cancer Care Alliance, including the proton therapy facility, merged with Fred Hutchinson Cancer Research Center in September 2021 to form a comprehensive cancer center that better connects all aspects of cancer care, from research to treatment.
“One priority of this assimilation,” adds Zeng, “is to make proton therapy even more easily accessible. We want it to be as easy as possible for our patients to get the care they need, no matter where they entered the system, be it Harborview or Peninsula or the proton therapy facility. The ultimate question is, ‘How do we grow together?’”
Coming together as one organization has hurdles. One challenge is the different software systems used in patient charting and treatment planning among sites. Riggs’ vision is to incorporate software and hardware solutions, service contracts and top-notch technology at all facilities. In addition, he plans to implement improved best practices, policies, and procedures at all Fred Hutch treatment centers. The goals are to provide patients with superior experience and clinical outcomes, to improve faculty and staff happiness, to enhance research capability and to offer the most advanced technology.
Zeng is working with the proton team to bring more state-of-the-art technology to the facility. “Technology is rapidly evolving in our industry, and we want to ensure that we offer the latest advancements in proton therapy for our patients,” says Zeng.
“I am honored to take on my new role at Fred Hutch and excited about the important work we will accomplish in harmonizing our practices into a highly efficient radiation oncology enterprise,” says Riggs. “This will help us provide the best experience and the highest quality of care for our patients as we help cure their cancer.”
If you have questions for Zeng or Riggs, or about the integration of Fred Hutch, please email firstname.lastname@example.org.
Camille Piche, RN, recently joined the nursing team at the proton therapy facility. She previously worked at the Fred Hutch Pain Clinic. As a nurse, Piche provides day-to-day care and helps coordinate any additional medical services a patient might need during their proton treatment, including blood tests, scans, medical appointments or other services.
“For me, one of the most meaningful aspects to nursing is being able to connect with individuals going through some of the most difficult circumstances,” says Piche. “It’s an absolute privilege for me to get to hear from them and find ways to support, advocate and provide better care. Even outside of oncology, being able to connect and build relationships while caring for patients is huge.”
Early in her career, Piche volunteered as a triage nurse in a refugee clinic in Jordan. She primarily worked with women and children from Syria as well as some Kurdish families. In her role, she helped with initial assessments, basic testing, background information and any other needs before they saw the doctor. She also spent time visiting Turkey and Israel.
“It was extraordinary to experience the cultures and even more incredible to meet, spend time with and learn from the people there,” says Piche. “Also, the food was so good!”
Prior to joining the Fred Hutch team, Piche worked at Seattle Children’s Hospital on the Psychiatry and Behavioral Medicine Unit (PBMU) and on the Cancer Care Unit.
“I am looking forward to working with kiddos again in this new role. I love the honesty, resilience and laughs that the kids bring to my work,” says Piche.
Originally from Minnesota, Piche and her wife, Amanda, who also works at Fred Hutch as a lab supervisor, live with their German Shepherd mix, Lady. They enjoy baking, cooking and doing puzzles.
“I’m excited to work with the staff at the proton facility,” she says. “One thing I love about it is having so many brains in one building — everyone here has so much knowledge and is doing such interesting work. I can’t wait to continue to meet and learn from everyone!”
Please welcome Piche when you see her.
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