Robotic surgery pioneer warns of increase in throat cancer

By Christopher Tobutt

Dr. Carlos Perez-Mitchell has been at the forefront of new techniques in robotic surgery, which allow surgeons to perform operations in places of the human body that are otherwise very difficult to access. Robotic surgery has enabled him to operate on cancers of the head and neck, which is his specialty. He was recently sharing medical information at a cancer conference in the Cayman Islands, and Dr. Perez-Mitchell believes that some of this information was important to share with the general public, because it involves way to prevent the spread of human papillomavirus; a virus which has a direct relationship with cancers of the throat.

“We are seeing these types of cancer of the throat more and more in younger patients. 20 years ago we used to see these type of cancers was almost exclusively in an older population of smokers and drinkers. That has changed 180 degrees,” he said. “People catch it by engaging in oral sex. That is why we have some strong campaigns, at least in the United States, for vaccination against this virus. The vaccine covers nine different strains of the virus. One of the strains that it covers is Strain 16, and if you get infected with this particular strain then your chances of developing cancer of the throat increases thirty fold.”

The good news is that the vaccine is available, and effective against the spread of the main cancer-causing strain of the papillomavirus. “If everyone gets vaccinated, we should see this cancer disappearing,” he said. The bad news is that not enough people know about the dangers of engaging in oral sex, and not enough people know about the availability of the vaccine, either.

But it isn’t solely transmitted through oral sex: “The reality is you can sometimes get the virus by French-kissing, too,” he explained. “It’s very virulent – that means it is very easy to transmit,” he said. Dr. Mitchell Perez wants to spread the good news about the vaccine, and the bad news about the dangers of the cancer the virus can cause.

Talking about his career in the field of robotic surgery, Dr. Perez-Mitchell said that after he graduated from medical school in 2001, Dr. Perez Mitchel who is now based in South Florida and part of the Memorial Healthcare System sought more specialist training in the area of the ear, nose and throat. “My biggest breakthrough was being in the right place at the right time,” he said. “When I was in the University of Pennsylvania, I was fortunate enough to be trained by Dr. Gregory Weinstein who was the inventor of a robotic technique, called Trans-Oral Robotic Surgery. That technique became approved by the FDA in December of 2009.”

Robotic surgery not only makes surgery of the throat and neck easier and more practical, it also comes with the benefit of not being so intrusive or traumatic. Before, surgery in this area of the body involved cutting the lower lip, and an extensive area of the lower jaw to gain access to the affected area. “That’s a longer surgery where patients spend more time in the hospital, and the patients wind up with a feeding tube and a tracheostomy tube, The surgery was extremely morbid, mutilating I could say,” he said. The new robotic system is called the Davinci Robot, and the relative ease which the technique provides makes the recovery time much quicker. “It has three components. One of them is like a consul, as if you were playing a video game. Then there is another device – which is called the patients cart, which has tentacles. It has different arms, and each arm is capable of receiving a specific instrument,” he said. One of the arms contains a camera, so that the surgeon can see the operation. “Our advantage is we have a means of accessing the cancer through the mouth. The access is pretty rapid, and it is there for us.” He said.