Duke doctors and scientists are at the forefront of the quest to develop new treatments and cures for head and neck cancers and to reduce treatment side effects. For example:

• Duke experts were at the international forefront in development of a new standard of care for patients with advanced stage head and neck cancer. The strategy, which uses an innovative combination of intensive, twice-daily radiation therapy and simultaneous chemotherapy, has significantly improved the probability of curing many patients.
• Duke researchers were amongst the first worldwide to measure oxygen levels in head and neck cancer and to demonstrate that low concentrations were strongly linked to the likelihood of cancer recurrence after treatment.
• Duke physicians are now leading a large worldwide trial that will determine whether the addition of a new drug to the simultaneous radiation and chemotherapy regimen can overcome the adverse effect of poor tumor oxygenation.
• The Duke Head and Neck Cancer Clinic is also testing a drug that can measure the levels of oxygen in tumors without the need for additional, invasive procedures. The drug, EF-5, will allow doctors to evaluate tumors to better understand why certain tumors behave more aggressively than others.
• Duke is conducting the only trial in the United States that explores the benefits of adding two molecularly targeted drugs to simultaneous radiation and chemotherapy in the treatment of head and neck cancer. One drug starves the tumor by preventing angiogenesis, the creation of a tumor blood supply. The other drug shuts down receptors on a tumor cell that would normally send signals telling it to grow.
• Duke researchers were involved in the groundbreaking international trial of amifostine to prevent radiation induced dry mouth and damage to salivary glands that can result from head and neck cancer treatment.
• Duke patients have access to a new treatment technique that is designed to protect healthy tissue. The technique, called intensity modulated radiotherapy (IMRT), enables doctors to more precisely target the tumor and reduce the amount of radiation that is delivered to healthy tissues, both salivary glands and other organs. The MRI and PET/CT scanners play a critical role in the planning of this treatment both in routine and investigative settings.
• Duke physicians have been actively involved in the development of function sparing head and neck cancer operations that result in better function and less disfigurement for patients.
• Duke researchers are actively evaluating the role of intensive nutritional support and counseling during radiation and chemotherapy for head and neck cancer.
• Much of the knowledge initially gained in the treatment of head and neck cancer patients at Duke has led to the development of new treatments for other types of cancer.