New vision about the future of head and neck cancer treatment draws top talent

What’s apparent after spending a short amount of time with Jason Newman, M.D., is his passion and laser focus.

“If you think about the things in your own life that bring you joy and excitement, it’s often related to this part of the body,” Newman said, gesturing to his face. “If you’ve had a cancer in this area, it’s very hard to even interact with people without them noticing. It’s how we socialize and make connections. It can affect something as simple as eating and speaking. The head and neck cancers that we treat affect all of those things, which to me are some of the things that give life meaning and joy.”

It’s what keeps Newman up at night, figuring out better ways to raise the bar in treating these patients. It’s why he joined MUSC in March, taking on two critical roles. One involves leading the strategic growth of cancer programs across the state for MUSC Hollings Cancer Center, and the other is growing an already top-notch team of specialists as director of the Division of Head and Neck Oncology in the Department of Otolaryngology. The goal is to set the next standard of care for these patients and to make quality cancer care more accessible across the state, he said.

Newman brings an impressive pedigree to both roles.

He completed residencies in Otolaryngology at Manhattan Eye, Ear and Throat Hospital; New York Presbyterian Hospital, affiliated with Columbia and Cornell universities; and Memorial Sloan Kettering Cancer Center, all located in Manhattan. Newman then went on to serve as director of the cancer service line at Pennsylvania Hospital, director of Head and Neck Surgery, co-director of the Cranial Base Center and director of the Head and Neck Fellowship Program at the University of Pennsylvania Perelman School of Medicine.

“We bring cutting-edge medicine to patients who need it, and these are often patients who find themselves in very complicated situations — previously treated cancers, cancers that have undergone multiple attempts of cure. We want to see these complicated patients because we often have the best tools to help them.”
— Dr. Jason Newman

When the positions at MUSC and Hollings opened up, Newman said he couldn’t resist the opportunity to lead the head and neck division as well as play an influential role in the expansion of cancer care across the state for Hollings, which is South Carolina’s only National Cancer Institute-designated cancer center and one of only 71 in the nation. Hollings offers the resources, research base and clinical trial base to support innovative advances, he said.

“We bring cutting-edge medicine to patients who need it, and these are often patients who find themselves in very complicated situations — previously treated cancers, cancers that have undergone multiple attempts of cure. We want to see these complicated patients because we often have the best tools to help them,” he said, adding that another goal is to catch these cancers early so that patients have the highest chances of getting the best outcomes.

Newman said MUSC’s head and neck division always has had an impressive reputation. “It has a great faculty, great training, great research, and literally, it has been a place that's been on my list of places that if I ever left Penn, I would want to move to. I want to see the next generation of what can happen here. It has a strong foundation and history of academic success, and I think the combination of that and the new chair, Dr. Rob Labadie, whom I really like, will grow the head and neck program to tremendous heights.”

New treatment paradigms

Newman often likes to wear a pin with the slogan “research cures cancer.”

“We may be doing everything that's delivering the perfect standard of care right now, but if we’re still not curing 100% of cancer, we have work to do, right? I think one of the roles of an NCI-designated cancer center and its physicians and other care providers is not just to provide the best care currently available but also to start exploring what the next level of that care will be,” he said.

One of the first items on his leadership agenda is to align studies clinically to develop treatment protocols that will most favorably affect the quality of life for patients. Newman will be part of that effort, as he also is actively involved in research focused on head and neck cancer clinical trials, including injectable cytokines for head and neck cancer and survivorship studies to improve the quality of life for these patients.

Board certified in otorhinolaryngology, Newman’s areas of expertise include head and neck cancer surgery, robotic surgery, anterior cranial base surgery and thyroid surgery, with a special interest in minimally invasive approaches. He also specializes in fluorescent guided surgery. “These fluorescent surgeries that we do are really amazing. I mean, literally, the tumor glows, making it pretty easy to see and easier to achieve a higher rate of negative margins of cancer,” he said.

 

“The goal is to do medicine in a novel way, with a new perspective, with Hollings pushing the cutting edge of what's happening in head and neck cancer medicine. What also is a driving force behind a place like Hollings and MUSC is educating the people who will then go out and deliver that care to patients locally, regionally and nationally.”

That education should involve community providers as well. “We envision the creation of a more robust statewide network to help manage these patients. We want people to feel there’s a single team of people caring for them.”

Most of the care can be delivered by the regional team, while the most complex care can be handled by the specialized head and neck team in Charleston. Together, the whole team can then take full advantage of resources to serve the patient most effectively. Bringing access to multidisciplinary teams, reviews by tumor boards and a review of clinical trials that would benefit a patient are all part of creating a care network to manage these patients, he said. Then other services could be handled through this network of care centers.

“That means offering medical support in local communities and providing educational outreach to health professionals who may not be seeing some of these cancers as regularly as we are,” he said. “And I think when you start to set up networks that allow for the delivery of care in that way, across the state, you will just generally elevate the level of excellence that can be delivered.”

“The goal is to do medicine in a novel way, with a new perspective, with Hollings pushing the cutting edge of what's happening in head and neck cancer medicine. What also is a driving force behind a place like Hollings and MUSC is educating the people who will then go out and deliver that care to patients locally, regionally and nationally.”
— Dr. Jason Newman

The plan is to disseminate the latest in oncology care to this network of health professionals so that together they can coordinate to meet the needs of these cancer survivors more fully, particularly head and neck patients.

A case in point is the rapid rise of human papillomavirus or HPV-related cancers, in which oropharyngeal cancer (OPC) now has surpassed cervical cancer. HPV, a DNA virus, preferentially infects the lymphoid tissues of the oropharynx, including the tonsils in the back of the throat and the tonsils in the base of the tongue. The Southeast has been considered the focal point of this growing epidemic, where the incidence of HPV-OPC has risen by more than 200% over the past several decades.

“If you look at the curve of how many patients are getting HPV-related cancers in their throat, it has now passed cervical cancer as the most common cancer caused by that virus. It’s still not very well known that the most common cancer caused by HPV is now throat cancer, base of tongue and tonsil cancer.”

The traditional way to take care of those patients has been either a major, disfiguring surgery or using aggressive amounts of chemotherapy and radiation. What researchers are finding out, though, is that these HPV-related cancers can have a 90% survival rate, which means studying less toxic treatments that can be given to these patients while still getting good outcomes.

“The way we treat patients will look very different than the way that they have been treated historically because we understand a lot more about this disease. We don't treat it the same way as we do if the cancer wasn't caused by the HPV virus. We will change the algorithm for how that entire category of patients gets treated,” he said. “But if you have a non-HPV related cancer, your chance of being cured is probably about 50 or 60%, so we really need to hit those patients with everything we've got because we need to keep them alive. That's priority No.1.”

New care paradigms

Newman knows that there are side effects of cancer treatments that sometimes don't even show up until much later.

“The best success is not just curing the cancer, but also taking care of the whole patient in the meantime, and that's an ongoing effort. We see side effects of our cancer treatments that sometimes don't even show up until two or three years after we've treated them. So, it’s not, ‘your treatment is over, and good luck, we’ll never see you again’ because we already know that two to four years out possible other side effects of cancer treatments could mean cardiac problems or hypothyroidism, dry mouth, dental problems or psychological concerns of recurrence.”

Newman and other Hollings researchers will be expanding survivorship services surrounding these patients, particularly head and neck patients. “We are starting to realize that that is a critical part of the equation. We need to help them manage the downstream side effects of all of what the cancer has done to them. One of the greatest successes is when patients find themselves getting back to most of what they were doing before we met them. To me, that's the best success.”

Hollings serves the entire state, so an important piece of expanding access to care both during and after treatment is to create regional centers of excellence throughout the state so that patients can get the best care that they need close to home, if possible, where they have important support systems. “We know as an institution that we need to support the physicians and the programs that are trying to deliver that.”

These networks also will make it easier to expand survivorship services. “I may do a great surgery on a patient in Charleston, but if I can't get them back into their community to meet with a speech and language pathologist or a radiation oncologist who are equally capable of managing their cancer, then we are not doing the best job that we can for these patients.

“It’s a challenging time in managing what patients are going through when they're experiencing their cancer journey. It’s mission critical to understand that we are not just treating cancer — that once they're patched up, everything is good. You have to appreciate that there are long- term side effects of this.”

Newman knows these are ambitious goals, and it’s why they’ve added more than 10 team members. “It’s so amazing how fast this team is growing, and it doesn’t just include surgeons. It’s advanced practice practitioners, the speech and language pathologists, nurse navigators, the nutritionists. It’s heartwarming to see all the different people being drawn to join this team. The hires we’re making are very deliberate to make sure we create a level of excellence in all the subspecialties that serve these patients.”

Initially drawn to the field of head and neck oncology because of the complexity of anatomy and physiology of the cases, Newman said it’s the patients who keep him motivated to make a difference. “These patients are so appreciative, and they are ones who need the help the most because they have a lot to lose when things go wrong. These cancers can cause a lot of problems. When I walk into a room and hear the words ‘Dr. Newman, you saved my life,’ it’s an honor and humbling to be able to help these patients in that way. That's what drives me to continue to do this.”

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