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Head and Neck Cancer

Technology Helps Patients Access Care Faster

The University of Virginia Health System’s Head and Neck Cancer Program is using secure videoconferencing technology to create a virtual head and neck cancer multidisciplinary clinic. The virtual clinic enables simultaneous consultations with multiple UVA specialists, coordinated with a patient’s scheduled visit. The goal: begin a tailored treatment plan two weeks after diagnosis instead of four weeks after diagnosis.

This new system allows UVA doctors in multiple locations to discuss a case by video with colleagues and the patient and examine the patient with an endoscope before a biopsy is scheduled. Head and neck surgeons, radiation and medical oncologists, radiologists and dentists can participate. Offsite physicians can interact with the patient via webcams on hospital computers, where they can also view the results of initial examinations.

Head and neck cancers are usually symptomatic at the time of diagnosis. The majority of these cancers are squamous cell carcinomas, which grow relatively quickly. More than 20 percent of patients can be upstaged over a six- to eight-week workup period, making a faster start to treatment critical to a patient’s care and quality of life.

“This new program should dramatically improve the quality of a patient’s experience at UVA,” says radiation oncologist Paul Read, MD, PhD. “Many patients are on pain medication. Some are losing weight. Some have problems swallowing. Anything we can do to condense the time from ‘we know you have a problem’ to ‘we start treating it,’ the better.”

“We want to facilitate efficient patient care,” says Mark Jameson, MD, PhD, a head and neck oncologic and reconstructive surgeon at UVA. “This new system allows us to move faster at the initial evaluation to get patients to treatment. If a patient comes in complaining of a sore throat, we can use an endoscope and examine the larynx. If we see cancer, our radiation and medical oncologists are right there via video. They can see the problem on their computer screen and help us work with the patient to determine the right course of treatment.”

The virtual clinic can also rule out cancer, offering reassurance to patients and their families who come to UVA with a head or neck problem. The pilot program began in June 2009 and was developed by the Head and Neck Cancer Team, led by Paul A. Levine, MD, FACS, chair of UVA’s Department of Otolaryngology - Head and Neck Surgery.

“We know our quality of care for head and neck cancer is excellent,” Levine says. “Now we want the ease of care to be equal to the quality. We will never lose the direct personal contact that is important to patient care, but this is a more efficient way to get the process started.” Another benefit for patients is reducing the number of appointments, alleviating stress and travel time. The virtual clinic also lets patients get to know the team of UVA doctors who’ll be treating them and ask questions in a safe, confidential environment.

“When a patient actually gets to participate with the specialists dedicated to his or her care and ask them questions directly, it adds a lot of value,” Read says. “We can come up with a consensus about a treatment. We’ve all seen the patient. We all know what everyone else has told the patient. This new approach can improve communication so patients don’t get mixed messages from their physicians.”

Every year, UVA clinicians treat more than 200 new patients with head and neck cancer from throughout Virginia and the Mid-Atlantic. “Our whole goal is to get patients back to eating and talking, back to a regular life as soon as possible,” Jameson says.

The Head and Neck Cancer Program at UVA is part of the University of Virginia Cancer Center, a National Cancer Institute-designated Cancer Center. The multidisciplinary team includes otolaryngologists, hematologists, medical oncologists, radiation oncologists, dentists, radiologists and pathologists as well as speech-language pathologists, nutritionists, palliative care experts, nurses and psychosocial support staff.

To refer a patient for head and neck cancer treatment, please call UVA Physician Direct at 800.552.3723.