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Head and Neck Surgery

Older Cancer Patients: To Operate or Not to Operate? Part 1

Sunday, October 1, 2023
9:30 AM - 10:30 AM East Coast USA Time
Location: 201AB

    Panelist(s)

  • Sid V. Puram, MD PHD

    Chief, Head and Neck Surgery
    Washington University - St. Louis
    St Louis, MO, United States

  • Neal D. Futran, MD, DMD

    Dept chair
    University of Washington Medical Center
    SEATTLE, WA, United States

  • Karen M. Kost, MD, FRCS

    Professor of Otolaryngology-Head and Neck Surgery, Director of the Voice and Dysphagia Laboratory, McGill University
    McGill University Health Center
    Westmount, QC, Canada

    • Moderator(s)

  • Hilary Caitlyn McCrary, MD, MPH

    Assistant Professor
    Huntsman Cancer Hospital and University of Utah
    Salt Lake City, UT, United States

Disclosure(s):
Sid V. Puram, MD PHD: No relevant relationships to disclose.
Neal D. Futran, MD, DMD: No relevant relationships to disclose.
Karen M. Kost, MD, FRCS: No relevant relationships to disclose.
Hilary Caitlyn McCrary, MD, MPH: No relevant relationships to disclose.
PROGRAM DESCRIPTION: As the average age of individuals across the world continues to rise, the elderly represent an increasing proportion of patients with head and neck cancer. Comorbid conditions, restricted life expectancy, and other factors must be carefully considered when exploring treatment options for these patients, including traditional modalities of therapy (surgery, radiation, and systemic therapy) and palliative options. However, these patients also pose unique challenges when undergoing treatment, as elderly patients are more likely to experience complications and treatment interruptions. In this seminar, we will provide an interactive but didactic introduction to the management of elderly patients with head and neck cancer followed by a tumor board-based panel. The didactic portion will provide an evidence-based summary of the options (including reconstructive techniques), challenges, outcomes, and complications associated with treating elderly head and neck cancer patients. Patient indices other than age, which can be helpful in the medical decision ­making process, will also be discussed, along with palliative care and the surgeon's role in facilitating palliation. The tumor board discussion will provide a rich foundation of six patient cases, with discussion and debate by widely renowned panelists. Audience participation and feedback via live, interactive polling throughout the cases will be integrated to help shed further insight into practice patterns, audience preferences, and changes in opinion as the seminar progresses. Given the challenges posed by this unique set of patients, this topic should be of value to otolaryngologists across diverse practice settings.

OUTCOME OBJECTIVE 1: Describe options, outcomes, and complications of surgically-treated, elderly patients with head and neck cancer.

OUTCOME OBJECTIVE 2: Incorporate measures other than age (e.g. frailty) in the treatment selection process.

OUTCOME OBJECTIVE 3: Define the role of the head and neck surgeon in end-of-life discussions and palliative care.

BACKGROUND STATEMENT: There is increasing interest in the controversial topic of the role of surgery versus palliative care in elderly patients with head and neck cancer. This topic was independently proposed by 3 different committees at the 2019 meeting and since then has been very well attended with high ratings.