The James has one of the largest head and neck cancer departments in the country, featuring experts in robotic and reconstructive surgery, proton radiation, chemotherapy and immunotherapy treatments, as well as cutting-edge clinical trials. “The key is you need a huge support network [of nurses, therapists and other specialists] to get patients through surgery, radiation, chemotherapy and immunotherapy … we have a team of more than 200,” said Matthew Old, MD, director of the James Department of Otolaryngology – Head and Neck Surgery. Any cancer above the clavicle, except for brain tumors, are head and neck cancers. The number of head and neck cancer cases is on the rise, Old said, adding the reason is the prevalence of the human papillomavirus in adults. “We’ll see an increased rate for the next 10 to 15 years because the HPV vaccine wasn’t available a few decades ago … HPV is the cause of about half the head and neck cancers we see.” James surgeons perform about 350 transplants a year for their head and neck cancer patients. “We are all cross trained in reconstructive surgery,” Old said. “We can take tissue and bone from a patient’s body and use it to reconstruct their tongue, mouth, jaw, any type of defect.” Old said that between 50 and 60 head and neck cancer patients receive radiation therapy daily at the James. The James is one of the few cancer hospitals offering proton radiation and it’s “more precise and we think it minimizes the long-term consequences to the patient,” Old said. There are about 20 head and neck cancer clinical trials at the James. In one trial initiated by James physicians and scientists, patients receive immunotherapy before surgery. “This is done to prime the immune system to recognize the cancer cells as foreign,” Old said. “Then after surgery, the patient receives a year of immunotherapy.” In another clinical trial, James doctors utilize circulating tumor DNA to determine the effectiveness of treatment for their patients. “We can watch their response to treatment and tailor the treatment accordingly,” Old said.