Head and Neck Cancer in South Carolina
Head and neck cancer is the common terminology applied to malignancies of the upper aerodigestive tract. Of these malignancies, oral and pharyngeal cancers are the most common and when combined are labeled as “oral cancers”, representing 30,200 new cases per year and nearly 8,000 deaths per year in the United States. South Carolina ranks first among the fifty states (second only to the District of Columbia) for oral cancer mortality when data are pooled for all races and both sexes. 

Oral cancer mortality rates in South Carolina exceeded the corresponding race- and sex-specific national averages among white males (ranked 12th out of the 50 states), white females (ranked 10th), and black males (ranked 18th); black females were ranked 30th. South Carolina oral cancer mortality rates were almost five times as high among black males as among black females, almost three times as high among white males as among white females, and almost twice as high among black males as among white males, but only 10% higher among black females than among white females.

The major risk factors of oral cancers include tobacco and alcohol use although dietary factors and excessive sun exposure may contribute to certain oral and pharyngeal cancers making the majority of oral cancers potentially preventable with behavioral modifications alone. As five-year survival often is directly correlated to stage at diagnosis, prevention and early detection efforts have the potential not only for decreasing the incidence but also improving the survival of those that do develop this disease. 

Unfortunately, the majority of oral cancers are diagnosed in advanced stages (III and IV), which directly correlates with a lower survival although the overall five year survival for all stages remains less than 60% making it one of the most deadly cancers in the United States. Despite advances in combined modality treatment (chemotherapy/radiation) and organ (tongue, voice box) preservation techniques, survival has not improved in the past thirty years. Those that do survive often have difficulty with speaking and swallowing in addition to dry mouth and cosmetic deformities of the face, jaw and neck. It is not uncommon for head and neck patients to have part or all of their tongue and voice box removed during treatment. 

There is an obvious opportunity in our state to reduce the incidence, morbidity and mortality from oral cancers for the citizens of South Carolina. This can be done through education, awareness, research and standardization of the high quality of care in each corner of South Carolina. This is the cornerstone of the specific aims of this application and is achievable.
 

Head and Neck Cancer at Hollings Cancer Center
Under the leadership of Terry A. Day, M.D., Director, Division of Head and Neck Oncology Surgery, the Head and Neck Tumor Program at Hollings Cancer Center is the most comprehensive of its kind in the state. In fact, few centers in the country are organized to offer this level of multidisciplinary expertise. It is the only regional referral center for head and neck cancer in South Carolina. Comprised of representatives from more than 20 disciplines – from surgical and radiation oncology to maxillofacial prosthodontics and speech therapy – the multidisciplinary team offers the latest treatment modalities available for head and neck neoplasms. 

Patients are not only evaluated by the entire team as mentioned earlier, but they are also evaluated at a weekly tumor conference. Patients are also assigned a head and neck nurse coordinator that serves as a resource to the patient and their caregivers for all phases of their care. Meeting the individual needs of each of our patients is our top priority. 

Our Dream: Distinguished Endowed Chair in Head and Neck Cancer
Distinguished Endowed Chairs hold tremendous prestige in the medical community. To hold a Distinguished Endowed Chair means that you have achieved recognized excellence in your work as a clinician and/or researcher. Endowed chairs are the premier recruiting tool used to secure senior level leaders with national reputations. It is highly competitive to recruit these leading clinicians and scientists. The ability to offer an endowed chair to a qualified individual puts us one step ahead of the competition. The ability to secure that individual opens the door to substantial benefits for the institution and the patients that we serve. 

Faculty members value the flexibility a chair gives them to pursue innovative clinical, educational, and research activities for which no other funding is available. Funding for endowed chairs has helped recruit several renowned physician-researchers to lead new initiatives and retain some of the most distinguished and sought-after professors. Endowed chairs also allow scientists and physicians to continue their research collaborations, attract knowledgeable and experienced faculty to their teams, build the appropriate infrastructure for further discovery, and promote more extensive collaborations within the university and the Southeast region. Additionally, the funds generated from this endowment will further enable the department to attract and retain distinguished faculty allowing them the time necessary to coordinate and lead these investigative efforts. 

A minimum contribution of $1,000,000 is required to endow a chair. With an endowment fund, only the investment income may be used. By policy set forth by the Medical University of South Carolina Foundation (MUSCF) Board, only a portion of investment income is expended (currently 5%), so that the Foundation’s endowment funds will grow over time. The corpus is never invaded, thereby ensuring existence of the endowment fund in perpetuity. The MUSCF is a 501(c)3 organization, contributions to which are tax deductible. All philanthropic gifts are received through the MUSCF.   Additionally, with new endowed chairs at the $2,000,000 level, Hollings Cancer Center will be able to compete for matching funds from the SC Centers of Economic Excellence program funded by the education lottery. 

Distinguished Endowed Chair in Head and Neck Oncology
Hollings Cancer Center is seeking funding to establish a Distinguished Endowed Chair in Head and Neck Oncology.  Specifically, Hollings Cancer Center is seeking to recruit an M.D., Ph.D or M.D/Ph.D. level clinician and/or researcher with experience in head and neck oncology and basic and translational research. 

Distinguished Endowed Chair in Head and Neck Oncologic Surgery
Hollings Cancer Center is seeking funding to establish a Distinguished Endowed Chair in Head and Neck Oncologic Surgery.  Specifically, Hollings Cancer Center is seeking to recruit an M.D., Ph.D or M.D/Ph.D. level clinician and researcher with experience in head and neck surgery and basic and translational research. 

Distinguished Endowed Chair in Head and Neck Radiation Oncology
Hollings Cancer Center is seeking funding to establish a Distinguished Endowed Chair in Head and Neck Radiation Oncology.  Specifically, Hollings Cancer Center is seeking to recruit an M.D., Ph.D or M.D/Ph.D. level clinician and researcher with experience in head and neck radiation and basic and translational research. 

Head and Neck Cancer Funding Needs

WORLDWIDE HEAD AND NECK TUMOR BOARDS ($100,000 per year)
Tumor boards are common around the United States and allow every member of the head and neck cancer multidisciplinary team to come together to discuss each patient’s care.  Few are as comprehensive as the Hollings Cancer Center Head and Neck Tumor Board which meets twice every week and prospectively examines the patients clinical history, radiology studies, pathology samples and recommends the best treatment for cure AND quality of life.  Over 30 specialists from dental and medical fields attend including surgeons, radiation oncologists, medical oncologists, speech pathologists, maxillofacial prosthodontists, reconstructive surgeons, radiologists and pathologists among many more.  Because of Hollings Cancer Center’s leadership in this area, cancer centers across the state and beyond have requested access to a live video/audio feed of these tumor board conferences to view/listen/learn about head and neck patient care.  These centers have also requested the ability to present and discuss their “local” patients at these conferences.  In order to meet this need and ensure Hollings Cancer Center’s expertise is available throughout the state and beyond, a separate video/audio room, technologic input/equipment, and an information technology specialist are required. 

HEAD AND NECK RESEARCH NURSE ($150,000 over two years)
The research nurse would be responsible for improving entry of database information required to evaluate the clinical course and follow-up of patients in the head/neck studies.   This will allow us to publish our pilot data and would provide for one of the few national centers with extensive tissue tumor banking, long term clinical follow-up and a comprehensive database. 

HEAD AND NECK CANCER RESEARCH SPECIALIST #1 ($100,000 over two years)
An additional research specialist with experience in the development of native cell lines from fresh cancer tissue is necessary to acquire known clinical behavior and outcomes with intramural in vitro studies of head and neck cancer

HEAD AND NECK CANCER RESEARCH SPECIALIST #2 ($100,000 over two years)
Research Specialist-A second research specialist with experience in mouse model systems in head and neck cancer will permit expansion of these projects and others into NCI competitive studies and future R01 projects in head and neck cancer.

HEAD AND NECK MULTIDISCIPLINARY EXAMINATION SUITES 
           (Two available at $50,000 each)
In addition to the basic requirements for an exam room, head and neck cancer patients require more specialized equipment due to problems in areas not typically visible to the clinician.  Specifically, in-room state-of-the-art technology will allow clinicians to view endoscopic examinations inside the ear, nose, sinuses, throat, voice box and esophagus. 

HEAD AND NECK CANCER DATABASE MANAGER ($35,000)
The most comprehensive studies in head and neck cancer to date are from institutions capable of performing basic/translational research and document prospectively, all patient data for cancer subtype.  This is a vital and critical component to future basic/translational/clinical trials in this area.

HEAD AND NECK PROGRAM (Unrestricted Gift of Any Level)
To support the overall development needs of the Head and Neck Cancer Program at Hollings Cancer Center with consideration of an offsite campus to enhance access and state-of-the-art care.

For more information, please contact Rachael D. Smith, Director of Development, Hollings Cancer Center, at (843) 792-7694 or smithrmd@musc.edu.  Thank you for the opportunity to share this vision with you.  We do hope you will support our efforts.