Dr. Jonas Sokolof: Head and Neck Cancer, Part 1

RUSK Insights on Rehabilitation Medicine

Dr. Jonas Sokolof graduated from the New York College of Osteopathic Medicine. He completed his PM&R residency at Harvard Medical School and his fellowship at the Kessler Institute. He joined NYU Langone Health and the Rusk Rehabilitation Institute in 2018 where he has served as director of oncological rehabilitation. His research interests include the role of lifestyle intervention in the rehabilitation of cancer patients.

In Part 1 of his presentation, he indicated that head and neck cancer is a unique pathology where a huge impact is made by physiatry. This kind of cancer is more commonly associated with older males, alcohol and tobacco use, genetics, and other factors. Head and neck cancer is on the rise in younger males. He mentioned different cancer subtypes, such as oral cavity and lip. Induction chemotherapy and chemoradiation tend to be the main forms of treatment presently rather than surgery alone. Radiation affects the surrounding tissue, which is where we as physiatrists come into play. The more common conditions encountered include pain, dysphagia, inability to open the mouth, and limited head and neck mobility. As physiatrists, there are conditions that we ourselves proactively can treat as opposed to speech and swallowing dysfunctions that we refer to other clinicians. Fibrosis can extend throughout the entire radiation field, affecting all the skin, nerves, muscles, and blood vessels. Radiation tends to disrupt the normal phases of healing. He described various effects that are irreversible. Patients usually are referred to physiatrists at the first sign of lymphedema. He stated that a high suicide rate is associated with this kind of cancer. Physiatry care should be involved in every stage of treatment. He carries over a sports medicine approach to oncological rehabilitation with the first step in the process being pain control followed by range of motion and strength and endurance. He also described some interventions for treating lymphedema.