Using robotics to treat cancer

November 19, 2010 2:43:11 PM PST
Cancers involving the head and neck, meaning the mouth, nose and throat make up about five percent of all cancers in the country.

Smoking and alcohol use are risk factors.

These cancers used to be hard to treat, often with disfiguring surgery. With the help of technology, doctors can now often access head and neck areas through the mouth. The Montefiore-Einstein Center for Cancer Care is one of only a few of hospitals trying a robotic approach.

Tom Scaccia is a firefighter, a cook, a grandfather and a fortunate throat cancer survivor. The radiation treatment that got rid of his cancer damaged his throat. He would have to have surgery that would mean cutting his face in two. But a high tech, though unproven, tool offered him hope.

"I figured it was going to help me, and rather than lose my tongue and walk around with a hole in my throat, I figured it was worth a shot," he said.

Tom agreed to robotic surgery to his neck, something only performed in a handful of centers in the country.

Tom's cancer was at the back of his tongue, way down in the throat. The radiation treatments killed the cancer and killed the normal tissue around it.

Head and neck surgeon Dr. Richard Smith devised the robotic surgery to avoid the disfiguring alternative.

"You'd have to split the lip in the middle. You'd have to split the jaw open it up like a book just to get there," he said.

Instead, the robotic technique goes through the mouth to remove the damaged region. Tom's forearm provided the tissue graft to replace it. Dr. Evan Garfein was tom's plastic surgeon.

"We were able to place tissue in through a small incision through the side of his neck and sew that tissue to the base of his tongue," he said.

Tom's back today for an injection to repair a paralyzed vocal cord, the result of either the radiation or perhaps a complication of his robotic surgery. But Tom's not complaining, as he tells the cancer patients he helps counsel.

"There is sunlight afterwards. You just got to keep your mindset that you're going to be well," he said.

What was amazing to me about this surgery is that tom was back to work two weeks after the robotic procedure. Recovery from the drastic operation that splits the face and removes the tongue has a recovery time of three months. Robotics is used generally in heart and prostate surgery. Dr. Smith is one of the pioneers in its use for the head and neck.