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Cancers and Tumors

Division of Head and Neck Surgical Oncology

The Division of Head and Neck Surgical Oncology offers patients comprehensive and collaborative care for a multitude of head and neck cancers. Our team practices out of the UCSF Ron Conway Family Gateway Medical Building, one of the nation’s top ten medical centers. Patients partner with their surgeon to understand their disease and treatment options in a comfortable and caring environment.

We are a specialized and multidisciplinary team specifically assembled to optimize patient outcomes. We partner with speech-language pathologists, reconstructive surgeons, radiation oncologists, medical oncologists, dental oncologists, nutrition, nursing, social work, psycho-oncology, as well as appropriate surgical specialties to offer world-class care. We, as a team, are committed to an effective, accessible, friendly, and informative experience for all of our patients before, during, and after treatment.

Head and Neck Cancer

Every year, approximately 100,000 people in the United States are diagnosed with head and neck cancer. The team at UCSF Surgical Oncology provides extensive services and comprehensive care for patients with benign and malignant tumors of the head and neck. Areas of expertise and specialty include benign and malignant tumors and cancers throughout the entire head and neck:

  • Lip, Oral, and Tongue
  • Oropharynx (Tonsil and Base of Tongue)
  • Larynx
  • HPV-related Cancers
  • Melanoma and other Skin Cancers
  • Ear and Temporal Bone
  • Thyroid and Parathyroid
  • Parotid and Salivary Gland
  • Paranasal Sinus and Nasal Cavity
  • Carotid Body and Parapharyngeal Space

Advanced Diagnostics and Treatments

We offer a range of new cutting-edge techniques to help diagnose and treat disorders of the head and neck. These technologies offer the highest standard of care to our patients.

  • Transoral robotic surgery (TORS)
  • In-office ultrasonography
  • Flexible nasopharyngoscopy with stroboscopy
  • Sentinel lymph node biopsy
  • Transnasal/endonasal endoscopic skull base surgery

Multidisciplinary Care

We provide our patients with multidisciplinary care programs that allow face-to-face collaboration between cancer care specialists. Our Head and Neck surgeons work closely with our colleagues from Head and Neck Reconstructive Surgery, Radiation Oncology, Medical Oncology, Pathology, and Radiology to form specialized Tumor Boards dedicated to delivering the highest quality of cancer care.

  • Head and Neck Tumor Board
  • Thyroid Tumor Board
  • Visible Tumor Board
  • Melanoma Tumor Board

We participated in a number of Institutional and National Clinical Trials aimed to advance cancer care. For more information, please visit Clinical Trials.

Thyroid and Parathyroid Surgery

Head and Neck Endocrine (Thyroid and Parathyroid) Surgery provides comprehensive care for patients with thyroid and parathyroid diseases using both surgical and non-surgical approaches.

In addition to their expertise in head and neck endocrine surgery, our doctors bring a new dimension to the clinical practice in the form of real-time, office-based ultrasonography. Not only is ultrasound a non-invasive and painless imaging modality that is dynamic, sensitive, interactive, and convenient for patients, it has also proven to be an extremely useful tool for operative planning and anatomic teaching. State-of-the-art management of patients with thyroid cancer involves ultrasonographic surveillance for thyroid bed and lymph node metastases, which our doctors incorporate into patient perioperative care. Patients frequently undergo consultation and diagnostic ultrasound examination, all in one visit, for maximum patient convenience and efficiency.

Common thyroid and parathyroid disorders our doctors provide expert treatment include:

  • Thyroid nodules
  • Goiters
  • Papillary thyroid carcinoma
  • Medullary thyroid carcinoma
  • Anaplastic thyroid carcinoma
  • Parathyroid adenoma
  • Hyperparathyroidism

Transoral Robotic Surgery (TORS)

In addition to open conventional surgical approaches, the team at Head and Neck Surgical Oncology offers mminimally-invasive techniques to patients. Drs. Patrick Ha and William Ryan have been uniquely trained to use the DaVinci surgical robotic system as well as other endoscopic laser tools to remove tumors from difficult to reach areas of the throat.

Minimally Invasive Skull Base Surgery (MISB)

Minimally Invasive Skull Base Surgery is a rapidly evolving field applying endoscopic technology to remove tumors in the head and neck, skull base, and intracranial compartment. We work to develop new approaches and new technology in this field; publish clinical experience and outcomes; develop and publicize a systematic approach to skull base lesions; and provide a consistent educational effort, including on-site courses, publications, and presentations at meetings and conferences.

The role MISB surgery is expanding in the management of benign and malignant tumors of the paranasal sinuses and skull base, providing access to the pituitary gland and certain intracranial lesions. MISB surgery uses an endoscope - a long, flexible instrument attached to a camera and a light source - to guide surgeons through very small ports of entry to remove these tumors. These procedures involve very small or no incisions, resulting in fewer complications, reduced blood loss, and shorter recovery times for patients.

Please also visit the minimally invasive skull base surgery site, here.

Salivary Gland Surgery

Salivary Gland Neoplasms, Benign and Malignant

Salivary gland tumors and cancers are treated in conjunction with the UCSF Head and Neck Surgery Center and the UCSF Helen Diller Comprehensive Cancer Center. Salivary gland disorders include diseases affecting the parotid gland, submandibular gland, and minor salivary glands. Some common disorders of the salivary glands that are treated by our physicians include:

  • Pleomorphic adenoma
  • Warthin's tumor (papillary cystadenoma lymphomatosum)
  • Oncocytoma
  • Mucoepidermoid carcinoma
  • Adenoid cystic carcinoma
  • Acinic cell carcinoma
  • Adenocarcinoma
  • Carcinoma ex-pleomorphic adenoma
  • Squamous cell carcinoma
  • Parapharyngeal Space Tumors
  • Parotid Gland Cancer
  • Parotid Gland Tumors
  • Salivary Gland Disorders
  • Salivary Gland Stones
  • Salivary Gland Tumors
  • Submandibular Gland Cancer
  • Submandibular Gland Tumors
  • Salivary gland disorders
  • Salivary gland neoplasms

Sialendoscopy

As one of the first centers in the United States to pioneer sialendoscopy techniques, the UCSF Sialendoscopy Center is globally recognized as a leader in the development and advancement of this minimally invasive therapy. Prior to sialendoscopy, treatment for salivary gland obstruction due to stones was limited to surgical removal of the affected gland. Modern technology allowed for the development of extremely small endoscopes (size range: 0.8mm to 1.6mm). Drs. William Ryan and Jolie Chang have been trainsed to use this small endoscopic camera system to enter the salivary ducts through the mouth and examine the duct system for problems such as salivary duct stones (sialolithiasis) and scarring (stenosis). Our providers are able to use the sialendoscope to guide forceps and wire baskets to remove salivary stones and break up larger stones using a laser (lithotripsy). Sialendoscopy also allows for the application of medications for treatment of blocked salivary ducts. Often these treatments involve limited or no incisions in the mouth and can be an alternative to open surgery or salivary gland removal.

Our sialendoscopy experts train head and neck surgeons around the nation on cutting-edge sialendoscopic techniques and are actively engaged in advancing the field through innovation and research. Some of their studies have addressed:

  • The combination of sialendoscopy with ultrasound imaging for diagnosis and therapies.
  • Predicting which patients would benefit from sialendoscopic surgery.
  • Following patients with stones and stenosis to study the benefits of sialendoscopy.
  • Surgical techniques for accessing the salivary ducts.
  • Pioneering new techniques to remove and break apart salivary stones.

Other Salivary Gland Conditions

Many processes may affect the salivary glands, from previous therapies to systemic illnesses. These can include:

  • Recurrent salivary gland swelling or enlargement
  • Radiation Therapy
  • Radioactive Iodine
  • Sjogren’s Syndrome
  • Salivary gland infections, parotitis
  • Trauma

Advanced Head and Neck Reconstruction

Our team includes Head and Neck reconstructive surgeons who are highly skilled to recreate both form and critical function of the head and neck. Advanced reconstruction techniques include local flaps, regional flaps, and microvascular free flaps.

Speech and Swallowing Rehabilitation

Dysphagia or difficulty swallowing is a common challenge shared amongst the head and neck cancer population. Comprehensive assessments are performed utilizing technologically advanced equipment, including Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Modified Barium Swallow Studies (MBSS). Individualized therapy programs to treat speech and/or swallowing disorders are provided by our specialized speech and swallowing therapists.

Head and Neck Research and Education

Our surgeons believe in the power and importance of research to improve treatments and education to train aspiring surgeons. They are actively involved in teaching and lecturing in the UCSF School of Medicine and the UCSF Otolaryngology-Head and Neck Surgery Residency-Training Program. They are among the directors and regular faculty participating in yearly courses attended by physicians from around the nation:

  • The UCSF Head and Neck Cancer and Endocrine Surgery Update Course in San Francisco, CA
  • The UCSF Sialoendoscopy/Salivary Duct Surgery Course in San Francisco, CA
  • The UCSF Skull Base Dissection Course in San Francisco, CA
  • The UCSF Otolaryngology-Head and Neck Surgery Update Course in San Francisco, CA
  • The UCSF/Tripler Pacific Rim Otolaryngology-Head and Neck Surgery Update Course in Honolulu, HI

Our Team Members

Head and Neck Surgical Oncology

Reconstructive Surgery

Salivary Surgery and Sialendoscopy

Speech and Language Pathologists