Chapter 01: Head and Neck Oncology and Related Specialties
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Description
In this chapter, Dr. Goepfert explains that Head and Neck Oncologists work in concert with Radiation oncologists and Medical oncology in order to address the challenges of cancers of the head and neck. “Head and neck” specialists address any cancer occurring between the chest and the brain, and Dr. Goepfert lists the organs, tissues, structures, and functions that cancer can attack. Dr. Goepfert notes that Head and Neck is an “abundant field,” that draws on additional specialties, such as pathology, imaging, oncologic dentistry and such rehabilitative specialties as speech pathology.
Identifier
GeopfertH_01_20120827_C01
Publication Date
8-27-2012
City
Houston, Texas
Interview Session
Helmuth Goepfert, MD, Oral History Interview, August 27, 2012
Topics Covered
The Interview Subject's Story - Overview; Overview; Definitions, Explanations, Translations; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care
Transcript
Tacey Ann Rosolowski, PhD:
All right. We are recording. I’m Tacey A. Rosolowski, interviewing
Helmuth Goepfert, MD:
for the Making Cancer History Voices Oral History Project run by the Historical Resources Center at MD Anderson. This interview is taking place on the tenth floor of the Pickens Academic Tower opposite from the Department of Head and Neck Surgery. Dr. Goepfert is a Professor Emeritus in that department. From 1990-2003 he held the M.G. and Lillie A. Johnson Chair for Cancer Treatment and Research. He also served as chair of the Department of Head and Neck Surgery from 1982 until his retirement from clinical practice in 2003. This is the first of two planned interview sessions. Today is August 27, 2012, and the time is about 2:03 So thank you, Dr. Goepfert, for taking part in the oral history project.
Helmuth Goepfert, MD:
Thank you.
Tacey Ann Rosolowski, PhD:
Now, I wanted to start with just a couple general questions to get a sense of your specialty. I wanted to ask, what are the special challenges that an oncologist faces with head and neck cancers?
Helmuth Goepfert, MD:
Okay. Your group here—the oncology—three specialties basically. You have Radiation Oncology, Medical Oncology, and Head and Neck Surgery. All three specialties, for many years, have worked very closely together in the management of head and neck cancer in this institution and have shared the patient load that has come in through the input of the different specialties and the input of different treatments. So, the special challenges, of course, are that you have—number one—you have the complexity of the organs that are involved. As we speak now, we deal with our mouth, with our throat, with our voice box—or larynx. We have the nose through which with we breathe. We have the sinuses. Of course, then we see through our eyes. They are in the field as well. So basically, what you’re dealing with is anything that is between the chest and lungs, and the brain itself is involved in this specialty, and we have a variety of tissues here to deal with. We have the lining of what is called the upper aerodigestive tract, which basically is the breathing system, the eating system, the swallowing system, and the speak system. You have tissues that deal with digestion, not only the oral cavity itself but the saliva that is produced by the salivary glands. These can present abnormalities. Then you have the thyroid gland that is basically located within the neck and is an organ, again, that is subject to diseases that are treated by Head and Neck in one form or another. You have then, of course, the skin that covers everything, and by skin we mean the scalp skin, the face skin, and the skin of the neck. There are diseases there that you normally see in dermatology or plastic surgery, so there is a group of diseases that are involved that are present in t7his case. We have so-called squamous epithelium, we have glandular epithelium, we have connective tissue and integuments, we have bones, and we have cartilage, so we have a series of tissues that can have abnormalities that would require intervention. You have important structures in this area. You have the blood vessels that go to the brain, of course, without which function we couldn’t exist anyhow. You have the veins, the arteries. You have all the nervous system that goes through this area. Particularly, in the neck itself there are nerves that function with the lower gastrointestinal tract to speak to the esophagus and the stomach. You have nerves that deal with breathing and respiration, and then you have all the nerves that go through the innervation of the upper extremities, which is the brachial plexus on both sides, so there is an abundance of tissues that can give us challenges in one form or another. When I speak about the three specialties that are involved here, these are the clinical specialties, of course. There is always the very important field of pathology of the head and neck. There is the very important field of imaging studies of the head and neck, which is a specialty. You have all the ancillary specialties that participate in the care of head and neck cancer—speech pathology, because we do alterations of deglutition with our treatments or patients have tumors or abnormalities that cause alteration of deglutition, of course, alteration of speech, alteration of breathing. And then you have the other sensory organs that are important here. I already referred to vision, but you have the sense of smell, and you have the sense of hearing. All of these in one form or another we deal with through sub specialization, more or less. So, in view of that, as I say, you can always write a whole book on any of these areas. There are volumes written about salivary glands, volumes written about the thyroid. About ophthalmology, certainly there is a subspecialty that we head, and neck surgeons basically don’t deal with unless it is in the context of cancer of some sort or in the context of the lacrimal glands, for example, which can cause problems. So, it is a very abundant field, and you can sort of subspecialize or specialize in any one of the areas. So, if anytime you go into treating something here, you have to deal with certain functions that will be altered that can undergo permanent changes or that can present significant challenges for rehabilitation. Another group that is vividly involved in the care of these patients are the oncologic dentists or Dental Oncology, as the department used to be called. Certainly, speech pathology I mentioned already before. The other subspecialty that is married to oncologic dentistry is prosthodontics. You take off, for example, a portion of a jaw, a portion of the maxilla, and you can rehabilitate that by prosthesis. They are already very adept at making prostheses in case somebody loses a nose. They make a prosthesis that looks like a nose. All of these are subspecialties that contribute to the care of patients that have diseases in the head and neck area.
Recommended Citation
Goepfert, Helmuth MD and Rosolowski, Tacey A. PhD, "Chapter 01: Head and Neck Oncology and Related Specialties" (2012). Interview Chapters. 1000.
https://openworks.mdanderson.org/mchv_interviewchapters/1000
Conditions Governing Access
Open
