PROGRAM DESCRIPTION

Overview: The Head and Neck Tumor Center at the Medical University of South Carolina (MUSC) is one of the largest programs in the US devoted to the care of the head and neck cancer patient.  The program is based within the Hollings Cancer Center at MUSC, the only NCI-designated cancer center in South Carolina.  The focus of the MUSC Head and Neck Tumor Center is on providing compassionate, comprehensive and innovative care to all patients and their families.  Overall, 750 – 800 new patients with head and neck cancer are evaluated at MUSC annually. The MUSC Head and Neck Tumor Center has a strong multidisciplinary focus, with providers from Head and Neck Surgery, Radiation Oncology, Medical Oncology, Maxillofacial Prosthdontics, Speech/ Swallowing Therapy, Dental Oncology, Nutrition, Social Work and related fields working together to provide the optimal care for head and neck cancer patients.  In 2011, the Head and Neck Tumor Center was cited as the best interdisciplinary clinical program at MUSC.  The Head and Neck Tumor Center also has an extremely robust research portfolio. Currently, the program has 15 open clinical trials in head and neck cancer, along with 10 NIH-funded basic science laboratories or translational research programs with over four million dollars annually in research funding.  The MUSC Head and Neck Tumor Center is a division of the MUSC Department of Otolaryngology-Head and Neck Surgery but was approved as an institutional center at MUSC crossing many disciplines.  The Department of Otolaryngology – HNS at MUSC is ranked 10th nationally among Otolaryngology departments for NIH funding, with over $5.5 million in current grants.  The most recent US News & World report study ranked the MUSC Department of Otolaryngology as #2 in the Southeastern US.

The Fellowship in Surgical Oncology and Microvascular Reconstruction of the Head and Neck at MUSC provides the highest level of training in the management and surgical treatment of head and neck cancer.   Each Fellow enters as Clinical Instructor level faculty and performs approximately 280 major cases per year as primary surgeon.  Depending on their level of interest, fellows will participate in 50 – 100 cases of microvascular free tissue transfer for head and neck reconstruction.  Fellows also have the opportunity to perform surgical procedures with surgeons from other specialties, including Facial Plastics, Dermatologic Surgery, Oral and Maxillofacial Surgery, Ophthalmology, Thoracic Surgery, and Vascular Surgery.  In addition to working with senior faculty in a clinical setting, each Fellow also has an independent head and neck cancer clinic and is not responsible for general otolaryngology patients.   In this setting, fellows evaluate new patients each week and have primary management responsibility for all patients seen in their clinic.  All patients evaluated in the Fellows’ clinic who require surgical intervention are operated upon by the Fellows with the supervision or assistance of senior faculty as appropriate.  In this manner, Fellows have the opportunity to function largely independently as junior faculty in accordance with their skill and experience levels.  Fellows also have short clinical rotations with specialists from Radiation Oncology, Medical Oncology, Oral Pathology, Head & Neck Pathology, Maxillofacial Prosthodontics and Speech Pathology.  Research opportunities abound.  Fellows participate in all Head and Neck Clinical Trials meetings and are required to complete at least one translational research project during the fellowship along with other clinical studies or review projects.  For those interested in undertaking more dedicated research time, there is the option to devote an additional year exclusively to research.

Objectives: The goals and objectives of the Fellowship in Surgical Oncology and Microvascular Reconstruction of the Head and Neck are as follows:

1. Provide comprehensive, hands-on training in Head and Neck Surgery including the treatment of complex endoscopic and open aerodigestive, cutaneous, endocrine and skull base neoplasms.
2. Establish a strong foundation in research methods in preparation for a career in academic Head and Neck Surgery.
3. Instill a team-based multidisciplinary approach and philosophy for addressing the most complex issues confronting the Head and Neck surgeon.
4. Provide thorough training in microvascular techniques for reconstruction of head and neck defects.

Eligibility: Applicants for the head and neck oncologic and reconstructive fellowship must have completed a residency program in Otolaryngology, General Surgery or Plastic Surgery.  The applicant should have significant experience in surgery of the head and neck and be BC/BE in Otolaryngology, General Surgery, or Plastic Surgery. A South Carolina medical license must be obtained prior to the fellowship year as well as VA privileges.  Applicants are required to complete a written application, including three letters of reference, and a personal on-site interview.  All interested US and Canadian fellowship applicants must be registered with the Match Program of the Advanced Training Council of The American Head and Neck Society to be considered for a position.  The Medical University of South Carolina is an equal opportunity affirmative action employer.  Women and minorities are encouraged to apply.

Research Opportunities:

Steve A. Rosenzweig, Ph.D. – Professor – Department of Cell & Molecular Pharmacology:

Research is focused on the role of the insulin-like growth factor (IGF) system in cancer progression, metastasis and therapeutics in solid tumors, with particular emphasis on IGF-1R crosstalk to vascular endothelial growth factor receptors. This work combines basic, mechanistic experimentation with animal studies and translational approaches using human specimens, thereby providing an optimal environment for students, postdoctoral fellows and junior faculty to pursue successful research projects. In particular, we are examining the mechanisms by which VEGF signaling in head and neck squamous cell carcinoma regulates invadopodia formation and invasive activity. In a second project, we are developing IGFBP-2 as a therapeutic that would have utility in a number of cancers in which IGF-1 receptor signaling leads to enhanced tumorigenicity.

Viswanathan Palanisamy, Ph.D. – Associate Professor – Department of Oral Health Sciences:

Research is focused on investigating the post-transcriptional changes that regulate the gene expression patterns during oral cancer and mucositis development. My primary research interest is to investigate the post-transcriptional changes that regulate the gene expression patterns during oral cancer and mucositis development. I have the expertise in RNA and salivary biology, oral cancer, leadership skills and scientific determination to pursue academic research as a career will help me to successfully carry out the proposed grant application. Specifically, I have a strong background in studies aiming at post-transcriptional gene expression in oral cancer with special training and expertise in genomics and transcriptomics of oral health research. Given my Biochemistry and Molecular Biology training, and interests in oral health and oncology research, I am well-suited as an investigator training head and neck surgical oncology fellows.  With a strong working knowledge in RNA biology, I teamed up with Drs. Terry Day, Marion Boyd Gillespie and David Neskey to study post-transcriptional regulation in head and neck squamous cell carcinoma.

Rita I. Young, Ph.D. – Associate Chief of Staff for Research – Ralph H. Johnson VAMC

Research focus is in the area of Oncology, with particular emphasis on immune regulation in patients with squamous cell carcinoma of the head and neck (HNSCC).  Immunotherapy for cancer patients is a treatment approach that has been the thrust of my studies.  However, stimulation of anti-cancer immune reactivity is hampered by the severe immune dysfunction in cancer patients.  The studies in my lab have identified several mechanisms by which to overcome this immune dysfunction so that subsequent immune vaccines can be effective.  Toward this goal, my basic science laboratory studies have progressed into several clinical trials with HNSCC patients.  The present study aims to capitalize on an immune stimulatory phenotype that is present in the early stages that lead to HNSCC development.  This translational study to sustain an immune stimulatory environment so as to limit tumor progression is expected to lead to novel approaches for patients who are at high risk of developing oral cancer.  I have been an independent PI for more than 25 years with national, peer-reviewed funding from VA, NIH, DOD, and others.  I am well qualified to serve as a mentor and oversee the training of head and neck surgical oncology fellows.

Besim Ogretmen, Ph.D. – Professor – Department of Biochemistry & Molecular Biology

Research is focused on the molecular mechanisms of the regulation of telomerase and telomeres by ceramide signaling. Furthermore we are investigating the mechanisms of ceramide-mediated regulation of PP2A by lipid-protein interactions along with the regulation of ER stress and apoptosis by sphingolipid metabolism.  We have are also studying the mechanisms of lipid-regulated cancer metastasis and drug resistance in HPV associated head and neck squamous cell carcinoma.   Given my background in biochemistry and lipid metabolism along with my ongoing collaborations with Drs. Terry Day and David Neskey I am well-positioned to provide mentorship to head and neck surgical oncology fellows interested in pursing a career as a surgeon scientist.  With a strong working knowledge in RNA biology, I teamed up to study post-transcriptional

David M. Neskey, M.D. – Assistant Professor – Department of Otolaryngology, Division of Head and Neck Surgical Oncology, Department of Cell and Molecular Pharmacology:

Research is focused on the impact of mutations in the tumor suppressor, TP53, on tumor progression and metastases.  This work combines a translational component including the analysis of clinical and genomic data with preclinical modeling including in vitro assays of cell proliferation, migration, and invasion and in vivo experiments including orthotopic mouse models of oral cancer and tail vein metastatic models.  We are currently investigating novel mechanisms associated with oncogenic characteristics of p53 mutations, which combines genomic sequence analysis with high throughput screens of candidate genes.  The goal of these studies is to identify novel targets for potential therapeutic intervention.  A second project investigates the role Myosin IIA, a nonmuscle myosin recently identified as tumor suppressor in HNSCC, in the oncogenic properties of mutant p53.  My role as a surgeon scientist focused on translational research provides a great opportunity for aspiring surgeon scientists specifically with my expertise in cellular biology, genonomics, clinical outcomes research.

Evan M. Graboyes, MD – Assistant Professor – Department of Otolaryngology:

Research is focused on improving the quality and equity of patient-centered head and neck cancer care which are critically important policy items, clinical issues,  and national  research  priorities. My work combines mixed methods  study designs, Patient-Reported  Outcome measures,  administrative datasets, and  clinical  and translational trials to develop and implement patient-centered quality improvement interventions in a collaborative, interdisciplinary team  approach.  Ongoing projects include a multi-phase study improving the timeliness and equity of postoperative radiation following head and neck cancer surgery. A second project involves studying the longitudinal course of, risk factors for, and treatment options for body image disturbance in patients with surgically-managed head and neck cancer.  My role as a surgeon-scientist focused on translational research provides opportunities for aspiring surgeon-scientists with my background interest in health services and clinical outcomes research.

Supervision, Teaching & Call:  The Fellow will participate in the outpatient evaluation and treatment, inpatient care, and surgical treatment of over 700 new patients per year.  The Fellow will work under the supervision of senior faculty, but will also have the opportunity to increasingly function independently during the course of the training year as appropriate. Trainees are evaluated monthly by program faculty and semiannual reviews are performed with the Program Director in person.

PAST FELLOWS
2002-2003 Michael Burnett, M.D. – New York Otolaryngology Group, New York, NY.
2003-2004 Serap Koybasi, M.D. – Abant Izzet Baysal University, Bolu, Turkey.
2004-2005 Joshua D. Hornig, M.D. – Medical University of South Carolina, Charleston, SC.
2005-2006 Allen O. Mitchell, M.D. – Naval Medical Center, Portsmouth, VA.
2006-2007 Oleg N. Militsakh, M.D. – University of Nebraska Medical Center, Omaha, NE.
2007-2008 Luke O. Buchmann, M.D. – University of Utah, Salt Lake City, UT.
2008-2009 Nadia Mohyuddin, M.D. – Baylor College of Medicine, Houston, TX.
2009-2010 Tanya Fancy, M.D. – West Virginia University Health Sciences Center, WV.
2010-2011 Wayne Cardoni, M.D. – National Naval Medical Center, Bethesda, MD.
2010-2011 Trinitia Cannon, M.D. – University of Oklahoma Health Sciences Center, Oklahoma City, OK.
2011-2012 Barry T. Malin, M.D., M.P.P. – Medical University of South Carolina, SC.
2011-2012 Akash Anand, M.D. – Private Practice, Metairie, LA.
2012-2013 Arnaud Bewley, M.D. – University of California, Davis
2012-2013 Mayuri Rajapurkar, M.D. – Private Practice, Nadiad, Gurarat, India.
2013-2014 Jeffrey Houlton, M.D. – University of Washington, Seattle, WA.
2013-2014 Paul Tennant, M.D. – University of Louisville, Louisville, KY.
2014-2015 Rusha Patel, MD
2014-2015 Shaum Sridharan, MD
2015-2016 Sobia Khaja, MD – University of Minnesota
2015-2016 Elizabeth Nicolli, MD – University of Miami
2016-2017 Evan M. Graboyes, MD – Henry Ford Health System, Detroit, MI
2016-2017 Suhael Momin, MD – Medical University of South Carolina