Dentist, surgeon begins new era in treating head and neck cancers
Dr. David Kang, assistant professor in oral and maxillofacial surgery, has joined Texas A&M University Baylor College of Dentistry as its first head and neck oncologic and microvascular reconstructive surgeon. His job description is complex, but the meaning isn’t lost on patients with oral cancer facing the reality of surgery.
This dual-trained dentist and physician spent an additional year after his oral and maxillofacial surgery residency to complete a fellowship in head and neck oncologic surgery at the University of Michigan. He has returned to Dallas with the in-depth training he needs to not only remove cancerous head and neck tumors but also reconstruct the entire surgical area – providing a critical step in a patient’s return to normalcy following a life-altering diagnosis and treatment.
Kang anticipates coordinating a multidisciplinary approach to caring for cancer patients with the various specialists involved in their treatment.
“Our patients are frequently presented to the Head and Neck Tumor Board, which meets twice a month to discuss treatment options including surgery, radiation therapy and chemotherapy,” Kang says.
Many of the patients Kang treats are dealing with the side effects of radiation – a treatment that, while often effective at combating cancer, is notorious for wreaking havoc on the healthy areas of the body through which it passes. He takes special steps to ensure that his patients’ reconstructions hold up to the radiation that may occur post-surgery.
“In the past, post-surgery radiation treatment led to a decreased quality of life,” Kang says. “But now, we’ve had major advancements in reconstructive surgery and can harvest vascularized tissue from any area on the patient’s body.”
This free tissue transfer approach—or free flap—returns form and function to the patient by using skin, fascia, muscle, nerve or bone tissue to reconstruct any defect, regardless of the size. The free flap approach, Kang notes, has become the gold standard in reconstruction of the oral cavity.
The procedure also provides immediate blood flow to the tissue and allows the surgical site to heal rapidly, allowing patients to begin radiation treatment within four to six weeks.
While the free flap procedure is impressive, it may not be the ideal choice for all patients, Kang says. With longer operating and hospitalization times, it can be a medical burden for patients with additional health problems.
“When a less invasive option is in order for maxillary defects, we will often opt for placement of an obturator, which is very similar to a denture and closes off the defect and restores facial contour,” Kang says. “As with any treatment, we work in collaboration with other health care professionals to find the best treatment plan possible for each individual patient.”
Story contributed by Jenny Fuentes, Texas A&M Baylor College of Dentistry