DETROIT – Henry Ford Cancer Institute is a leader in providing a minimally invasive procedure called a sentinel lymph node biopsy for patients with early stage oral cancer. The biopsy can be performed at the same time oral cancer is surgically removed, and it can determine if the cancer has spread to nearby lymph nodes.
For Henry Ford patient Marlene Calverley, the biopsy meant having three lymph nodes removed versus 30-60 lymph nodes, and a two-inch scar instead of a five-to-six-inch scar. It also meant no neck drains, no physical therapy, and a decreased risk of complications.
“We are one of the few – if not the first – medical center in the State of Michigan to adopt this new paradigm for treating early oral cavity squamous cell cancers,” says head and neck cancer surgeon Tamer A. Ghanem M.D., Ph.D., director of Growth, Access, and Service for the Department of Otolaryngology at Henry Ford Cancer Institute. This new paradigm is based on a standard treatment for breast cancer and melanoma skin cancer.
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The early data shows that sentinel lymph node biopsy may improve patients’ survival rate. Research also demonstrates a significant decrease in recovery time, complications, and effects attributed to a treatment, says Steven Chang, M.D., director of the Head and Neck Oncology program and the Microvascular Surgery Division at the Henry Ford Cancer Institute.
Head and neck cancers are among the most common cancers in the U.S. and globally. At the time patients are first diagnosed with oral cancer, about 15-25 percent of them have hidden microscopic cancer cells in the lymph nodes of the neck.
During a routine dental exam, Calverley was told to watch a small spot on her tongue. Three years later, an oral surgeon discovered cancer. Knowing there was a significant chance of cancer spreading, the surgeon recommended a neck dissection to remove all the lymph nodes.
At Henry Ford, Dr. Chang would offer a new and more precise treatment approach.
Traditionally, when oral cancer is found, neck surgery is performed and all the lymph nodes are removed, whether they are known to be diseased or not. However, about 75-85 percent of the patients do not need this surgery. After surgery, patients may require neck drains, and some will experience shoulder and lip weakness caused by exposing and manipulating the nerves, says Dr. Chang. Also, patients will have a large scar and longer recovery time.
In the past, patients who had early oral cavity lesions and who were at risk for hidden cancer in the lymph nodes were routinely offered extensive neck surgery to find any diseased nodes. Now, we are offering a simple sentinel node biopsy to select patients to find diseased nodes, says Dr. Ghanem.