July 31, 2025 • 40 mins
When we think of cancer, we commonly think about the predominant ones…like breast, prostate, and lung. We don’t often think about cancers found above the collarbone…such as throat, nose, and mouth. Dr. Scharukh Jalisi, Chief of Head and Neck Surgery at Beth Israel Deaconess Medical Center, was in to chat with Dan about cancers that develop above the neck.
You can hear NightSide with Dan Rea, Live! Weeknights From 8PM-12AM on WBZ - Boston's News Radio.
You can hear NightSide with Dan Rea, Live! Weeknights From 8PM-12AM on WBZ - Boston's News Radio.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
It's night Side with Dan Ray on w BZ, Boston's
news radio.
Speaker 2 (00:07):
All right, thank you very much, Dan, as we move
into our first talk hour, we are delighted to welcome
back to Nightside the chair of the Head and Neck
Surgery Department Cancer Surgery Department at Beth Israel, Deacon his Hospital,
Doctor Sharuke Jalusi, Doctor Julisi, welcome back to night sid.
Speaker 3 (00:29):
How are you great? Thank you Dan for having me again.
And I hope you are list started at having a
good day today, but thank you for having me here.
Speaker 2 (00:39):
Well. Thank you very much, particularly at the end of
a long day in the hospital. Again. You're you're the
head of the auto laurenology department. That is, of course
a Latin word which I'm not going to try to
pronounce more than once.
Speaker 3 (00:59):
And uh and.
Speaker 2 (01:01):
I I assume we're What we're talking about is all
the issues that that you that you deal with. I
have a friend of mine who we won't identify, who's
a patient of yours, and he encouraged me to to
get in touch with you because he said, you know,
your great human being and a great surgeon and and
(01:21):
and he's dealing with a very difficult set of circumstances,
how rare. Let me start off with the question of
how rare are the head and neck cancer diagnoses that
you deal with on I'm sure on a regular basis,
but most of us don't think of those, do we.
Speaker 3 (01:43):
No, So thank you Dan so so just for for background.
Otto rhino laryngology is a name of our specialty, which
is ear, nose, and throat, and the specialty specializes in
the head and neck region pretty much to do anything
you can say golf, that we do in the head
and neck, and we have subspecialists doing various things. I
(02:05):
myself my sub specialist dealing with head and neck cancer
and reconstruction and skull based surgery and so dealing with
tumors that go to a lot of places and your
head a neck, including towards your brain, and so on
and so forth. To answer your question, yes, head and
neck cancers are probably the sixth most common cancers in
the United States. They lag behind the more common cancers
(02:29):
like breast cancer and we hear lung cancer, and those
are the more common ones that afflict us of colon cancer.
But head and neck cancer is there. It's always been there,
and it affects us but head and neck cancer is
a bucket. Is many cancers that are put into one
big bucket, and starting from your skin, it involves your
(02:51):
skin cancers, melanoma, squama cell cancer, there's basal cell cancers,
and then the more intense cancers WHI says though that
afflict your throat, they can afflict your sinuses, your nose,
and from there, you know, these cancers can spread into
your brain. Then in your mouth. You know, we have
mouth cancers that we deal with, your tongue cancers that
(03:14):
can go into your job on uh. And then we
have a larynx cancer, which is the voice box cancer,
which was more common because of smoking, which has gone
down over the years, but it's still around. And and
then you have these other cancers around the throat uh,
the upper part of the food pipe. So there's a
(03:36):
long list, laundry list of cancers that reside in They
had an egg that someone like me deals with and
I specialize in at Beth Israel and soon to be
Dana Farber Bet Israel. So it's it's an exciting thing
that I do. I love what I do.
Speaker 2 (03:51):
It's obviously you can hear the passion in your voice,
so live I always like ask questions, and we, as
I continue to say, we don't script question. These are
questions that come to my mind. And my question is
this group of cancers that you deal with again, as
you said to me one time above the collarbone, are
(04:12):
we here in America? Are we more susceptible to those cancers?
Are they diagnosed more in this country for for them
to You know, obviously we learned a long time ago
to stop smoking, but everybody can still smoke. I get it.
And there are other causes of cancers. I know that alcohol,
(04:37):
you know, a lot a lot of alcohol can cause cancer.
But first of all, put it in context, how do
we do as a nation? Is there anything in you know,
in our atmosphere, in our water supply, or anything that
makes us more susceptible to these cancers? Are as bad
as they are? Are we doing better than other parts
(04:59):
of the world.
Speaker 3 (05:01):
So I think that's hard to say, because we obviously
have better medical and healthcare in the United States, so
you can get diagnostics and then get treated. For example,
you know South Asia or cancer is actually the leading
cancer in South Asia versus in the United States, who
had a net cancer the sixth common one and the
(05:22):
reason it's more common over there is because of habits
such as tobacco chewing, betlenut chewing. We used to see
a lot of tobacco chewing in the US. I've been
in Boston doing this for close to twenty five years,
and we have people who are chewing snuff. We used
to see that. I think it's gone down. Smoking and
alcohol obviously at the big risk factor, but you look
(05:46):
at some other countries, Asian countries where alcohol may be banned.
In those places, they have other risk factors such as
again tobacco derived of factors that people chew and get cancers.
We on the other hand, obviously our nation with the
fair skinned individual, so we do have a higher burden
of skin cancer. So that's something I think we probably
(06:12):
see more obviously. Having said that, and I think we
talked about it in the last time. We talked that
if your dark skin and you get skin cancer, that
has a worse proagnosis than if your light skin have
and have skin cancer because the color the tone of
your skin does protect you from the effects of the sun.
So but if your light skin, you'll get it easily damaged.
(06:34):
While you're dark skin, it's not that, but if you
get cancer and a dark skin, that means a lot
of damage had to happen. So to answer your question, Dan,
I think it's relative where you are. Most countries are
the United States. I think head and neck cancer is
more prevalent but probably gets less treated, you know. And
(06:55):
we can talk about the end of the show about
some of the mission trips that we do to help
with head in next answer in other countries to train
and stuff, and what we've done as a training paradigm.
But that's why we are I think we are blessed
to be in the US. I think there's a lot
of doctors. We can get early detection, we can get
detection per se, and then we can get treated. That's
the most important thing.
Speaker 2 (07:15):
Okay, So when we get back, what I want to
do is I want to talk about some of the
obvious things that all of us, irrespective of our age
or our circumstance in life, should be doing to minimize
the chances. And at some point I want to ask
you about the genetic considerations of the cancers that you treat,
(07:36):
and is it something that people can almost potentially anticipate
and is there anything that they can do in advance
if there is a header net cancer within their family,
within their genes. So we got a lot of areas
to cover. I also want to open the phone lines
early and give people an opportunity to ask whatever questions
(07:57):
they would like to ask. Six months, even, two, five, four,
ten thirty or six one, seven, nine, three, one ten
thirty those are the numbers. Will take the calls as
they come in UH. And doctor Jalisi is very generous
and has been always very generous with me in terms
of his time and again he has long days.
Speaker 4 (08:21):
UH.
Speaker 2 (08:21):
So I'm so appreciative the fact that he would join
us tonight and take phone calls. I was fascinated with
the conversation we had a week ago, and I just
think that this is one that I want to give
each of you an opportunity should you, should you avail yourself,
give us a call. Six one, seven, two, five, four
ten thirty, six one seven, nine, three one ten thirty.
(08:41):
My name is Stan Ray. My guest is doctor Sharuk Jalisi. UH.
He is the head, the chair of the head and
neck UH surgery department at Israel Deaconess and it has
an amazing job on what he has to deal with
back on Nightside right after.
Speaker 1 (09:01):
This, You're on Night Side with Dan Ray on WBZ
Boston's news radio.
Speaker 2 (09:07):
With me is doctor Sharuk Julysi. We have phone calls already,
so if it's okay with you, Doctor Julicy, I want
to accommodate callers, and we will talk about the mission trips.
We will talk about what people can do to minimize
the the chances of getting a header neck cancer header
(09:29):
neck cancer diagnosis. And I also want to talk to
you about the prevalence of tongue cancer amongst young men,
men in their thirties and early forties, which seems to
be a statistical anomaly. So we're going to keep those
questions in mind. But I want to go to some callers.
If that's okay with.
Speaker 5 (09:46):
You, absolutely, okay, let's start it off.
Speaker 2 (09:48):
Let's go to Elizabeth in Medford. Elizabeth, welcome. You're on
with doctor Sharook Jalasy. What is your question or comment? Elizabeth?
Speaker 6 (09:57):
Go right ahead, great, Hi Dan high. Doctor. I was
wondering if you could talk about infiltrating skin cancers. There's
basil and squamous and they're infiltrating types and they're more
serious than the regular they're more like melanoma and often
MOS is sun for the faith. My question is that
(10:21):
could they actually go deeper and when they do the
most they will take off the skin until the cancer
is gone, until they have the clean margins. But can
it come back and are you seeing an increase in
those types of cancers.
Speaker 3 (10:39):
Yeah, so that's a great question. So yes, sqlima cell
cancers and not even basil cell cancers can come in
more invasive varieties, typically basil cell cancers for example, we
can start with those are ones that stay in the
area and are more locally destructive, and MOS is a
great technology to take care of them. We have a
(11:02):
big MOS unit and they'll go in and take off
these tumors and again it's a tissue sparing kind of
technology where you know, the tumor is cut, the margins
that are checked right away, and there's any cancer left behind,
it gets cleaned up. But there are time when these
tumors are very deep. You know, there are times when
(11:22):
our most surgeons will see that this is going into
the muscles. That's where they will refer the patient to
headed next surgeons or our head and next service and
for us to do a more aggressive operation. That's where
we also start getting concerned. Depending on the thickness or
depth of the tumor is if the cancer may have
(11:42):
spread into your lymph nodes. And so at that point
in time, a whole diagnostic plan is started, which includes
CT scans off your neck, we may do cets of
your chest. We may even do an MRIs or PET
scans depending on where you are. PET scans being hold
by the scans where a special radioactive die is given
(12:03):
and we see things are spread and below your collar
bones for the most part, So all these diagnostics are
done so that a therapeutic plan is then made for
the patients. That Israel, we have our cutaneous oncology clinic
either on the head and neck part of that, and
then we have other surgeons who manage the body below
(12:24):
the collarbone and then we do that in sync with
our medical oncologists and radiation on collages. So again it's
important when you are facing something more intense to be
seen by a team. You know, not one person can
make a decision or should make a decision on the
therapy plan, so we work as a group, and I
think multisparay care is very important when you start seeing
(12:46):
these invasive cancers. The other question was can cancer come back?
And absolutely cancer can come back. Even one cell that
may be left behind or gets reactivated can bloom again.
That's why long term surveillance or follow up in the
form of skin cancer, have a very good relationship with
(13:07):
your dermatologist. Make sure the person has checked out very often,
so often four to six months. And if you've got
multiple skin cancers, which you see a lot of patients
here in New England who've had many, many skin cancers,
they need more frequent checkups so that if a new
lesion is identified, it can be biop seed and a
(13:28):
new treatment plan can be made. The good news is
for the most part these cancers can be treated. But
then we do see the very aggressive varieties that need
not just surgery, not just most surgery, but open surgery,
which is what I do. You know, bigger operations, and
then we put you back together. We take different parts
of your body to reconstruct you. And I think last time,
(13:52):
as I said, the reconstructive techniques have come a long way.
The head and NEX team we had headed next surgeons
we do all the reconstruction and plastics work, so typically
there's no secondary team in our institution. But you know,
we we work together as a group to take the
cancer out, put it back together, and then if you
need additional treatment like radiation or chemotherapy or now immunotherapy,
(14:17):
then we pass you on to our medical oncology and
radiation oncology colleague. So it's a group effort to deal
with the aggressive tumors. And with the multi stree approach,
we realize and to our research as well, that that
is the best way to be treated is in a
multi dispree setting. I hope that answered your question.
Speaker 2 (14:34):
It's a very comprehensively answer, Elizabeth, great question. I hope
that's satisfactory.
Speaker 6 (14:39):
Very thorough. Thank you so much.
Speaker 2 (14:41):
All right, thanks Elizabeth, appreciate your call. Six six one
seven ninety. Let me go down to Tom on Cape Cod. Tom,
you are next on night Side with doctor Sharu Jalisi.
Go right ahead.
Speaker 7 (14:57):
Before I get to the question the other than I
unceremoniously mentioned quickly that you were in the you've served,
doc country. I just want to say thank you for
your service.
Speaker 2 (15:09):
It wasn't much, but thank you very much. That's a
long time ago. Go right ahead, Well.
Speaker 7 (15:16):
It's still it still counts all right, Now the question
I have is vaping? What what what possible problems for
that cause?
Speaker 2 (15:32):
Okay, you broke up a little bit, so just repeat
the question. Please talk me, Jef.
Speaker 7 (15:38):
What what what possible problems could vaping cause?
Speaker 2 (15:43):
Oh? I suspect doctor Jalisi has a good answer for that,
Doctor Jalasi. Vaping has become more popular, particularly amongst young people.
What what what is the admonition you give people who
decide they want to vapor?
Speaker 3 (16:00):
Yeah? So I think as a great question mark, Thanks
for asking that. By the way, a big problem in
a youth. I think vaping is now becoming a problem
in high school. Uh, the problem vaping is again I'm
not a lung specialist, but we are seeing folks with
a lot of lung issues of the lung we haven't
(16:22):
seen so far, and I don't think we have enough
experience we see what the long term impact of vaping
would it would be, would it still be causing cancers
or not? We don't know as yet, but we are
still looking out for it. But we do know that
people who vape long term their lungs do have problems.
We see them. We have like, for example, I have
patients who vape, and they do have challenges during general
(16:46):
anaesthesia on recovery, and so I think we have to
be cognizant. And I think it's very important to let
your treating team know that you vape, because everyone thinks
so I don't smoke, so I will be okay. Smoking
has its own issues with wound healing. Then nicotine slows
down wound healing. So if you're having an incision, you're
gonna have a worse customeric outcome if you do smoke actively.
(17:10):
But vaping right now is having more giving us more
challenges on how your lungs react to anesthesia and stuff
like that. I don't think we have enough data as
yet to say vaping is going to cause cancer, but
I think the jury's out there right now. But if
you can avoid vaping, I think it's better for the lungs.
(17:30):
The lungs stay healthy, and I think you will breathe better.
Speaker 2 (17:34):
Absolutely, Tom, the connection is not great, but I thank
you for the question. I'm not sure if we've lost
you already, but it sounds I thank you very much.
Speaker 3 (17:45):
To thank you, Tom.
Speaker 2 (17:48):
We'll talk again. We're going to take a break here
for the news at the bottom of the hour. I
actually do have a couple of quick lines if you
want to get in. I've got calls lined up. Lola
is next. I got John and Julia coming up six one, six,
one seven. I have a lot to go over with
doctor Sharouk Jalisi. Uh, but your questions are equally important
(18:11):
and perhaps more important. We will cover it all, I
promise between now and ten o'clock. Here's the news. We'll
be back in just a few minutes.
Speaker 1 (18:20):
It's Night Side Boston's news radio.
Speaker 2 (18:26):
My guess is doctor Sharouk Julisi. He is the chair
of the Head and Neck Surgery. He's a head of
neck surgeon, head of the department at the Beth Israel Deaconus.
There's there's a bunch of calls, doctor Jalisi. Let me
just ask this question quickly, and that is some cancers
(18:46):
have a genetic aspect to them. Where do head and
neck cancers fit on the genetic calculations?
Speaker 8 (18:57):
Is it.
Speaker 2 (18:59):
Calm? Is there a genetic aspect to the head and
neck cancers generally?
Speaker 3 (19:05):
Yeah, So then that's a great question. Most of the
genetically oriented head neck cancer which run in families are
those that typically we see is with thyroid cancer, so
we manage a lot of pyroid cancer, which can run
in families. There are certain syndromes that associate thyroid cancer
with other tumors, called the multiple endocrine neoplasia syndromes, So
(19:29):
that's where the most of the genetic stuff comes in.
There's another genetic part which we do see is in
non cancer disease a head neck, which are called paragangliomas
or those are growths off here for example the nerve
that helps you swallowing, or the vagus nerve, and they
can run in families as well. But otherwise, most head
and neck cancers do have some kind of genetic derangement,
(19:52):
which is why the cancer developed. And now with new technologies,
there are studies you can do to look at what
these derangements are, and some of the companies that do
them become so advanced that they can actually also give
a recommendation of what drug may be available out there
to help in the treatment. So I think we've come
(20:13):
a long way just in the last fifteen years in
the management of these tumors, getting more data about the
genetic makeup. But from a genetic perspective, that what will
I hand down to my children. Is mostly thyroid cancer
that I deal with, but otherwise it's just what we
call sporadic cancer. Someone in the family may get it
(20:37):
and why A lot of times you don't know, you know.
But in the old days we would say risk factors.
You drink too much or you smoke too much, and
that's what's happening. But now, obviously we have cancers that
are coming up which are virally mediated that we will
be talking about.
Speaker 2 (20:53):
Okay, so one other question, are you a believer? There
are now blood tests that are available. I think one
company is Galleria or Gallery where they do a blood
test and they can see that the cancer cells shed
and they sometimes they say that they can pick up
(21:14):
cancers at early stages, stage one or stage two through
those blood tests. Do you buy? Are you a believer
in that? So that's those are emerging. Those are emerging
I think in the last four or five years. I'm
just curious if you think they have some validity.
Speaker 3 (21:34):
So so then I'm not familiar with this particular company
you're talking about. But so far ahead and neck world,
we do not have testing that can help us with this.
We do have certain testing for cancers that are now
related to the human papanoma virus where we can do
a human papanoma virus a DNA test on people who
(21:56):
are diagnosed with cancer, and we can use it as
a marker, uh to see if the treatment was successful
or the cancer is coming back. So it's a it's
a it's a good tool that we use now in
people who have these HPV related cancers of the throat,
where we can follow these patients longitudinally and see if
(22:18):
this marker is going up. And we've noticed that this
marker may start going up several months sometimes before the
actual cancer is clinically or physically evident. So it allows
us a little jump start to start testing the patient,
doing more scan and so on and so forth if
(22:39):
this test become positive. But we don't have a test
that can tell us that, oh, this person doesn't have
a clinical finding, but this blood test is saying that
they may have a cancer. We do not have anything
like that in the head and night.
Speaker 2 (22:50):
All right, let's keep rolling here. Let me go to
Lola in Watertown. Lola you with doctor Zelsi, Go right ahead, Lola, Hi.
Speaker 8 (22:57):
Director Solici Jalausy. I would I'd like to know if
you could discuss the correlation between parasites that are coming,
some of them from uncooked you know, shellfish drinking contaminated water,
fruits and vegetables that are not washed. And then also
(23:21):
adding the commercial food supply versus the organic food supply.
I realized the air is polluted, but they're using pesticides
in our food. It's not labeled, and so we have
a big salad bowl of how anybody can get cancer
(23:45):
from virtually anything.
Speaker 2 (23:47):
Okay, that is a huge question that you've asked, Lola,
and I don't know that it is within the field
of specialty of doctor Jelici, but let's give them a
shot at it, doctor Julyici.
Speaker 3 (24:00):
It's a it's a it's a big question. So thank
you Lola for asking. I mean, obviously we know if
you just think about it, that there are chemicals that
are carcinogenic or produce cancers.
Speaker 2 (24:13):
Uh.
Speaker 3 (24:13):
And you know, over the years, we have a food
supply where these chemicals and parties have been used. I
think there's research. I don't. I don't know any had
next cancer that's directly correlated with with these, but obviously
common sense says if you have a bad food supply,
it's going to affect you. So so that's where I'm
(24:36):
going to leave it at because I think more research
needs to be done. I think it requires money and
and I hope that these kind of grants are available
or maybe the public sponsors these kind of association kind
of studies that we can do. And we'd love to
do one on head and nag and see if people
know about where their food came from and how it
correlates with rates of cancer. I think that'll be very nice.
Speaker 2 (24:59):
That's it's a great question. I got to move quickly
because I got backed.
Speaker 8 (25:04):
I associated thank you. We have to take responsibility for
our own body, so we can't leave it all up
to the doctor once we get sick. Prevention is very important.
Speaker 2 (25:16):
Big part of our conversation tonight, that's for sure. Thank
you so much.
Speaker 8 (25:20):
Thank you both. Thank you.
Speaker 2 (25:22):
Let me go next to Julia on Cape Cod. Second
call from Cape Cod tonight. Hi Julia, how are you.
Speaker 9 (25:28):
I'm great right now. I'm having a little problem with
cancer on my lower shin and I developed it in
I developed it in Virginia and it was sway miss
Sole cancer, which was very bad because it went undiagnosed
(25:50):
by two special dermatologists and by the time it developed
it with a two by three tumor on my shin.
Speaker 2 (25:59):
Again, bear in mind that that doctor Julasi deals with
above the callar, bone head and neck surgery.
Speaker 9 (26:07):
What's your question, I understand that. I just wanted to
ask him. I'm up in Boston now alesion has come back,
and I'm very afraid. I don't know where to go
for a good most surgeon.
Speaker 10 (26:19):
What hospital I should go to, well, who I should.
Speaker 9 (26:21):
Turn to to get I have to have it taken off.
It was biopsied already. It's negative. I mean it's positive
for disclaimers. Again, it's only one in you.
Speaker 2 (26:32):
I understand, Julia.
Speaker 9 (26:33):
I'm just problem and the whole what happened is my
whole wound. He hissed. It opened up and it took
four months of being off my feet and special diet
to bring my skin together.
Speaker 2 (26:46):
Julia.
Speaker 9 (26:48):
I'm very worried. Julia just signed out from him.
Speaker 2 (26:51):
Do me a favor, Rob, if you could take Julia
down and have her turn her radio down and tell
her I need to talk to her and she needs
to hear me, because I don't know that doctor Julisi
is in a position where he's going to be able
to diagnose something like this. Uh, bring her back when
when she's when she can listen real quickly, Julia, can
you hear me now?
Speaker 8 (27:12):
Yes?
Speaker 2 (27:12):
I can. Okay, Julia, you have a question. You're visiting
Boston or you here for medical treads.
Speaker 9 (27:17):
I live in Boston. I went to Boston College.
Speaker 2 (27:20):
Okay, Okay, fine, so you're so okay. Do you have
doctors in Boston?
Speaker 9 (27:26):
No? I don't. This is what I'm trying to find
the most surgeon in Boston, and I'm at a loss.
Speaker 2 (27:32):
Do you have a Julia. What I'm trying to do
here is I'm trying to save time. Do you have
a primary care physician?
Speaker 8 (27:39):
No?
Speaker 9 (27:39):
I don't.
Speaker 2 (27:40):
How can you be a graduate of Boston host?
Speaker 9 (27:42):
I do have one at the Brigham. I do have
a primary.
Speaker 2 (27:46):
Okay, you then need to call that doctor because it's
it puts doctors Jualsi in an awkward position, uh to
ask him that question. In all fairness, I'm sure that
if you have a good doctor at the Brigham, it's
a great facility that they will be able to get
you to whatever, uh doctor you need to get treated.
(28:07):
So I don't mean to disappoint you, but it just
puts doctor Julisi in a very awkward position.
Speaker 9 (28:13):
I recommend anyone, but I did want to ask them
if there is a possibility that from this first cancer
there might have been a metastasis, a couple of cells
that stayed there and all of a sudden they're coming
to fruition, They're coming up through the skin again.
Speaker 2 (28:30):
He can't answer that question. I don't think it's fair
to him. Let me give him a chance. Doctor Zelici,
I don't think that's a fair question for you to
be asked because you haven't had a chance to diagnose Julia. No.
Speaker 3 (28:41):
No, I think I think Julian needs a comprehensive evaluation.
I agree with Dan, you should talk to your doctors
and go in and see who's in your network and
get further treated. But again, this is something in your legs.
So there are other surgeons who are really good who
will take care of this.
Speaker 2 (28:58):
And if you're at Brigham, if you're if you're Brigham
in Women's, we're blessed with great hospitals here, Julia, So
please get in as quickly as possible, uh and get
it treated. Okay, college all right, thank you, Julia, Thank you.
I think Julia had trouble hearing us as well, Doctor Zulici,
I apologize, yeah, very very quickly. Could you reference you've
(29:21):
told me that there is a an uptick in young men,
young men meaning in their thirties and early forties with
tongue cancer, which which may be related to the HPV virus.
Speaker 3 (29:34):
Correct. So we are seeing pretty much a rising increase
in the human papalmon virus that Saint marus that effects
which we've known affects women, causing cervical cancer and gynecologic cancer.
Speaker 6 (29:48):
Uh.
Speaker 3 (29:48):
And it's now causing men and some women, but more
prevalent than men of coat cancer which involved your tonsil
uh in the back of it hung uh. And it's
kind of again as you said, then afflicts people in
the thirties and forties, and it is on the rise.
I think the risk factor that the cause of relationship
(30:10):
has come up with oral genital intercourse and having multiple
sexual partners. But interestingly, it does not even if you
have HPV, not everyone develops cancer. And that's a big
topic of research as to why what's so special in
the patients who develop cancer versus that don't. And we
(30:32):
also see this in monogamous couples where one partner may
have the throat cancer which HPV related, and the other
partner never gets it. And it's kind of fascinating why
that happens, and we don't have answers, but we do
know that, you know, throat cancers are afflicting young people.
They don't have the typical risk factors of smoking, tobacco, chewing,
(30:55):
alcohol abuse. But if you start having throat pain, you
start having a lump in your neck, please please, please
get it checked out. Because we've seen too many young
people who are diagnosed with cancer and we uh uh
this treatment that will give you long term survival, and
so it's very important to get it diagnosed, checked out
and treat it accordingly.
Speaker 2 (31:16):
Excellent, excellent. We have more phone calls right after this
break with my guest doctor Charuk Zosi. He is a
head and neck cancer surgeon at Beth Israel Deaconess Hospital.
And what is really great about him is he's he's
willing to spend time with us and take your question.
So we will get to at least three or four
more callers will do it quickly.
Speaker 1 (31:36):
Right after the break, It's Night Side with Dan Ray,
Boston's News Radio.
Speaker 2 (31:44):
My guest is doctor Sharuk Zlisi, headed neck chief, head
and neck surgeon at Boston Beth Israel Deaconess. Folks, I
know we have full lines. I'm going to ask everybody
to please be as direct and with your question as possible.
John and Waltham, John with doctor Julicy, Go right.
Speaker 11 (32:01):
Ahead, Hi Daan, Hi doctor Jualica. How's everybody doing.
Speaker 2 (32:05):
We're doing great. You're gonna do better when you get
to your question. Go ahead. John.
Speaker 11 (32:09):
I'm a patient of doctor Jules and he did my
scream a cell cancer on the top of my head
well nine months ago.
Speaker 2 (32:17):
Woa, congratulations.
Speaker 11 (32:19):
I can't say enough about this guy. He really did
a great job and the whole team.
Speaker 2 (32:23):
So John, that's great so much.
Speaker 3 (32:26):
That means a lot.
Speaker 2 (32:29):
That is amazing. That must give you an incredible amount
of feeling of accomplishment. How old are you John, if I.
Speaker 11 (32:38):
Could ask, I just turned eighty years old.
Speaker 2 (32:42):
Okay, and you discovered this. It was a skin cancer melanoma.
Speaker 11 (32:49):
No, it was a scream as cell squam cell. Yeah,
and my dematolis picked it out. I just saw a
little bump on my head and she took a little
piece out and BIOPSI bioposite and she says, you're gonna
go see doctor Jalasy, you know, and did the surgery,
did the radiation. I'm still part of the team. I
(33:10):
get tested every six months and the doctor did a
really great job. It wasn't easy for me, but you know,
I came out of it pretty good. You know, So
you want to take free kids the doctor Jalice.
Speaker 2 (33:26):
Congratulations Sean.
Speaker 11 (33:28):
And I know I know he'll probably remember me if
he sees me. But you know, I can't say enough
about the guy.
Speaker 2 (33:34):
What what a what a great tribute. Thank you, John.
I do appreciate it so much. Thank you. Let me
go to that's that's an honor, doctor Julici, I'll tell
you honor.
Speaker 3 (33:43):
Thank you so much. John. It's great. I had a
long day and it was great to hear.
Speaker 2 (33:47):
That Deborah is in Salem. Deborah next on nightside. We're
getting tight on time, deb go right ahead.
Speaker 10 (33:54):
Yes, I'll be quick, Dan, thank you for taking my call. Awesome,
Thank you Dan. We're all you do for everyone else.
Doctor Julius, help apparent your name correctly. I want to
thank you for work you do in dedication to everyone.
I have any question about the time I have I
have to be quick. I have a question about the time.
(34:14):
I'm a lifelong non smoker and I am conscious with
about my dental appointments twice a year. Would it be
a waste of my time to ask my dentists to
check my tongue once a year, because.
Speaker 2 (34:31):
Dentist should do that anyway.
Speaker 3 (34:35):
Yes, yes, it's a dentist, your dental hygienis and your
dentists would be checking your mouth regularly. I think that's
a that's a great uh screating service that most dentists
do and should be doing.
Speaker 2 (34:46):
Uh.
Speaker 3 (34:46):
So yeah, absolutely have them check your whole mouth out.
They as you walk around, the check the gums, They
looking at the whole mouth and if anything suspicious shows up,
then they usually refer to us had an ex surgeon
or or also to get a bopsy. Uh and then
you go from there and then if you need a treatment.
But that's a great, great opportunity to get yourself checked
(35:07):
out and screened.
Speaker 2 (35:09):
For that question. Thank you, Jan, thank you have a
great night. That's a great question. I lean in Pembroke.
I lean you in next on nice side with doctor
Sharuk salsij Hi.
Speaker 4 (35:20):
Thank you for taking my call doctor. I have a
question in regards to diroid cancer. I am one of
six sisters, and five of my sisters have had diroid
cancer and had the diroid taken out. I also have
three nieces that have had diroid cancer. The doctors at
the time told us that it wasn't hereditary, but I'm
(35:40):
wondering what causes it, and now I have a granddaughter
to on a little concerns.
Speaker 3 (35:45):
Yeah, so this is a classic situation where I think
you have your family does have a genetic component of
pyroid cancer, and if you want, you can have yourself
genetic tested. We live in Massachusetts where there are opportunities
to meet with a geneticist that can do a whole
family tree and do additional testing. But everyone in the family,
(36:08):
it seems like it sounds like most of the women
in the family get affected, which again Tyroi's answer is
more common in women than men. But if it does
afflict men, it is more aggressive for the for the audience,
so it has to be checked out. But everyone in
your family should be if they haven't had that tyroid
taken out, even if they have had it taken out,
(36:28):
should be having at least a thyroid ultrasound for screening,
just to make sure there's not something that's there that
needs to be taken out. So if you haven't had surgery,
I'm assuming you've had your thyroid ultrasound done and anything
that needs to be bopsied should be bob sied. Then
you should be the person who should have constant surveillance
long term.
Speaker 11 (36:48):
Okay, Aileen, thank you.
Speaker 2 (36:50):
That's a great question. I hope you follow the doctor's advice.
Speaker 10 (36:53):
Okay, I absolutely will, thank you, Thank you.
Speaker 3 (36:56):
Very much the night, thank you.
Speaker 2 (36:57):
We are just flat out of time here. I'm going
to give Bob. Bob, I can give you about thirty
five or forty seconds. Can you do anything with it?
Speaker 5 (37:06):
I certainly can. Dean, I was your final caller on
Friday where I told you I was cured of cancer,
and I wanted to mention to your audience how important
it is to donate blood because especially cancer patients require
a lot of blood like I did. And please go
out and donate blood.
Speaker 2 (37:26):
A perfect way to end the last call. Bob. Thank you,
thank you for your brevity, and thank you for your success.
Speaker 3 (37:34):
And thank you.
Speaker 5 (37:35):
Thank you to the doctor. Thank you to the doctor
and his entire team, and especially the team that looked
after me at the MGH. They're all professionals and amazing people.
Speaker 2 (37:45):
All right, thanks, thank you so much, Bob doctor. Obviously,
one of the things we talked about last week was
preventive menace measures, making sure that you see skincare of physicians,
make sure you wear a hat and all of that.
So we've covered that, but I do want to give
you a chance to mention your mission trips because I
(38:05):
think that's important to you.
Speaker 3 (38:08):
Oh yeah, So, I think then the biggest thing is
we obviously everyone knows we're facing a doctor shortage. I've
been in lifelong academician. I've trained a lot of residents,
a lot of surgeons who do head of next surgery
over the last twenty five years, and yet we're at
a cusp of having a huge shortage for surgeons and doctors.
And so we've been teaching and training doctors, but more
(38:32):
so in the US. So I run a fellowship program
at Harvard and Beth Israel where we bring in fellows
from outside the country and they go back to the
countries and are very impactful people. You know, we have
fellows from who've gone back to Israel. We have fellows
from Saudi Arabia, from Pakistan, so all over the place.
We send these folks back and they do amazing stuff.
(38:55):
Within the US, obviously, we have a big residency program
at Harvard and before that I was at Boston University,
so we trained these and then what we realized was
that we don't have much a lot of technology in
foreign countries. So I've been running a mission trip for
the last twenty years to Pakistan where we go down
and do seminars, teaching seminars. Then we do free surgery
(39:17):
in the government hospitals to really people who have nothing
and help them get at least good quality surgical care.
And I think a few years ago, maybe the audience
and you had heard that there was a big article
in Landset, which is a big journal, that there is
a big inequity in surgical delivery of surgical care across
(39:37):
the world the US leads doctor Lesk.
Speaker 2 (39:41):
Is there a location where people could contribute to this effort?
Speaker 8 (39:47):
Oh?
Speaker 3 (39:47):
Absolutely, I mean you can go to our website at
the bethesviel Dgulous Medical Center and forward slash the auto
Laryngology program, and we have our division donation fund and
you can do and if you want after that, I can,
I can send the link to you, and that really helps.
Speaker 2 (40:05):
If you could send that that link to me, I
promise you I will publicize it. I'm just flat up
against the newscast. I must thank you profusely for your
time tonight. It was a great hour, not a good hour,
it was a great hour. Thank you so much, and
send me that link and we'll do some more on
this subject.
Speaker 3 (40:24):
I promise you. Thank you so much, Dan, and I
hope your audience learned something.
Speaker 2 (40:29):
I'm sure they did. I'm sure they did. Thank you
very much, doctor Sharoup Solsi and I will get all
that information of everyone. I'm a little bit later in
the newscast, that's my fault. We'll be back right after
the ten
It's night Side with Dan Ray on w BZ, Boston's
news radio.
Speaker 2 (00:07):
All right, thank you very much, Dan, as we move
into our first talk hour, we are delighted to welcome
back to Nightside the chair of the Head and Neck
Surgery Department Cancer Surgery Department at Beth Israel, Deacon his Hospital,
Doctor Sharuke Jalusi, Doctor Julisi, welcome back to night sid.
Speaker 3 (00:29):
How are you great? Thank you Dan for having me again.
And I hope you are list started at having a
good day today, but thank you for having me here.
Speaker 2 (00:39):
Well. Thank you very much, particularly at the end of
a long day in the hospital. Again. You're you're the
head of the auto laurenology department. That is, of course
a Latin word which I'm not going to try to
pronounce more than once.
Speaker 3 (00:59):
And uh and.
Speaker 2 (01:01):
I I assume we're What we're talking about is all
the issues that that you that you deal with. I
have a friend of mine who we won't identify, who's
a patient of yours, and he encouraged me to to
get in touch with you because he said, you know,
your great human being and a great surgeon and and
(01:21):
and he's dealing with a very difficult set of circumstances,
how rare. Let me start off with the question of
how rare are the head and neck cancer diagnoses that
you deal with on I'm sure on a regular basis,
but most of us don't think of those, do we.
Speaker 3 (01:43):
No, So thank you Dan so so just for for background.
Otto rhino laryngology is a name of our specialty, which
is ear, nose, and throat, and the specialty specializes in
the head and neck region pretty much to do anything
you can say golf, that we do in the head
and neck, and we have subspecialists doing various things. I
(02:05):
myself my sub specialist dealing with head and neck cancer
and reconstruction and skull based surgery and so dealing with
tumors that go to a lot of places and your
head a neck, including towards your brain, and so on
and so forth. To answer your question, yes, head and
neck cancers are probably the sixth most common cancers in
the United States. They lag behind the more common cancers
(02:29):
like breast cancer and we hear lung cancer, and those
are the more common ones that afflict us of colon cancer.
But head and neck cancer is there. It's always been there,
and it affects us but head and neck cancer is
a bucket. Is many cancers that are put into one
big bucket, and starting from your skin, it involves your
(02:51):
skin cancers, melanoma, squama cell cancer, there's basal cell cancers,
and then the more intense cancers WHI says though that
afflict your throat, they can afflict your sinuses, your nose,
and from there, you know, these cancers can spread into
your brain. Then in your mouth. You know, we have
mouth cancers that we deal with, your tongue cancers that
(03:14):
can go into your job on uh. And then we
have a larynx cancer, which is the voice box cancer,
which was more common because of smoking, which has gone
down over the years, but it's still around. And and
then you have these other cancers around the throat uh,
the upper part of the food pipe. So there's a
(03:36):
long list, laundry list of cancers that reside in They
had an egg that someone like me deals with and
I specialize in at Beth Israel and soon to be
Dana Farber Bet Israel. So it's it's an exciting thing
that I do. I love what I do.
Speaker 2 (03:51):
It's obviously you can hear the passion in your voice,
so live I always like ask questions, and we, as
I continue to say, we don't script question. These are
questions that come to my mind. And my question is
this group of cancers that you deal with again, as
you said to me one time above the collarbone, are
(04:12):
we here in America? Are we more susceptible to those cancers?
Are they diagnosed more in this country for for them
to You know, obviously we learned a long time ago
to stop smoking, but everybody can still smoke. I get it.
And there are other causes of cancers. I know that alcohol,
(04:37):
you know, a lot a lot of alcohol can cause cancer.
But first of all, put it in context, how do
we do as a nation? Is there anything in you know,
in our atmosphere, in our water supply, or anything that
makes us more susceptible to these cancers? Are as bad
as they are? Are we doing better than other parts
(04:59):
of the world.
Speaker 3 (05:01):
So I think that's hard to say, because we obviously
have better medical and healthcare in the United States, so
you can get diagnostics and then get treated. For example,
you know South Asia or cancer is actually the leading
cancer in South Asia versus in the United States, who
had a net cancer the sixth common one and the
(05:22):
reason it's more common over there is because of habits
such as tobacco chewing, betlenut chewing. We used to see
a lot of tobacco chewing in the US. I've been
in Boston doing this for close to twenty five years,
and we have people who are chewing snuff. We used
to see that. I think it's gone down. Smoking and
alcohol obviously at the big risk factor, but you look
(05:46):
at some other countries, Asian countries where alcohol may be banned.
In those places, they have other risk factors such as
again tobacco derived of factors that people chew and get cancers.
We on the other hand, obviously our nation with the
fair skinned individual, so we do have a higher burden
of skin cancer. So that's something I think we probably
(06:12):
see more obviously. Having said that, and I think we
talked about it in the last time. We talked that
if your dark skin and you get skin cancer, that
has a worse proagnosis than if your light skin have
and have skin cancer because the color the tone of
your skin does protect you from the effects of the sun.
So but if your light skin, you'll get it easily damaged.
(06:34):
While you're dark skin, it's not that, but if you
get cancer and a dark skin, that means a lot
of damage had to happen. So to answer your question, Dan,
I think it's relative where you are. Most countries are
the United States. I think head and neck cancer is
more prevalent but probably gets less treated, you know. And
(06:55):
we can talk about the end of the show about
some of the mission trips that we do to help
with head in next answer in other countries to train
and stuff, and what we've done as a training paradigm.
But that's why we are I think we are blessed
to be in the US. I think there's a lot
of doctors. We can get early detection, we can get
detection per se, and then we can get treated. That's
the most important thing.
Speaker 2 (07:15):
Okay, So when we get back, what I want to
do is I want to talk about some of the
obvious things that all of us, irrespective of our age
or our circumstance in life, should be doing to minimize
the chances. And at some point I want to ask
you about the genetic considerations of the cancers that you treat,
(07:36):
and is it something that people can almost potentially anticipate
and is there anything that they can do in advance
if there is a header net cancer within their family,
within their genes. So we got a lot of areas
to cover. I also want to open the phone lines
early and give people an opportunity to ask whatever questions
(07:57):
they would like to ask. Six months, even, two, five, four,
ten thirty or six one, seven, nine, three, one ten
thirty those are the numbers. Will take the calls as
they come in UH. And doctor Jalisi is very generous
and has been always very generous with me in terms
of his time and again he has long days.
Speaker 4 (08:21):
UH.
Speaker 2 (08:21):
So I'm so appreciative the fact that he would join
us tonight and take phone calls. I was fascinated with
the conversation we had a week ago, and I just
think that this is one that I want to give
each of you an opportunity should you, should you avail yourself,
give us a call. Six one, seven, two, five, four
ten thirty, six one seven, nine, three one ten thirty.
(08:41):
My name is Stan Ray. My guest is doctor Sharuk Jalisi. UH.
He is the head, the chair of the head and
neck UH surgery department at Israel Deaconess and it has
an amazing job on what he has to deal with
back on Nightside right after.
Speaker 1 (09:01):
This, You're on Night Side with Dan Ray on WBZ
Boston's news radio.
Speaker 2 (09:07):
With me is doctor Sharuk Julysi. We have phone calls already,
so if it's okay with you, Doctor Julicy, I want
to accommodate callers, and we will talk about the mission trips.
We will talk about what people can do to minimize
the the chances of getting a header neck cancer header
(09:29):
neck cancer diagnosis. And I also want to talk to
you about the prevalence of tongue cancer amongst young men,
men in their thirties and early forties, which seems to
be a statistical anomaly. So we're going to keep those
questions in mind. But I want to go to some callers.
If that's okay with.
Speaker 5 (09:46):
You, absolutely, okay, let's start it off.
Speaker 2 (09:48):
Let's go to Elizabeth in Medford. Elizabeth, welcome. You're on
with doctor Sharook Jalasy. What is your question or comment? Elizabeth?
Speaker 6 (09:57):
Go right ahead, great, Hi Dan high. Doctor. I was
wondering if you could talk about infiltrating skin cancers. There's
basil and squamous and they're infiltrating types and they're more
serious than the regular they're more like melanoma and often
MOS is sun for the faith. My question is that
(10:21):
could they actually go deeper and when they do the
most they will take off the skin until the cancer
is gone, until they have the clean margins. But can
it come back and are you seeing an increase in
those types of cancers.
Speaker 3 (10:39):
Yeah, so that's a great question. So yes, sqlima cell
cancers and not even basil cell cancers can come in
more invasive varieties, typically basil cell cancers for example, we
can start with those are ones that stay in the
area and are more locally destructive, and MOS is a
great technology to take care of them. We have a
(11:02):
big MOS unit and they'll go in and take off
these tumors and again it's a tissue sparing kind of
technology where you know, the tumor is cut, the margins
that are checked right away, and there's any cancer left behind,
it gets cleaned up. But there are time when these
tumors are very deep. You know, there are times when
(11:22):
our most surgeons will see that this is going into
the muscles. That's where they will refer the patient to
headed next surgeons or our head and next service and
for us to do a more aggressive operation. That's where
we also start getting concerned. Depending on the thickness or
depth of the tumor is if the cancer may have
(11:42):
spread into your lymph nodes. And so at that point
in time, a whole diagnostic plan is started, which includes
CT scans off your neck, we may do cets of
your chest. We may even do an MRIs or PET
scans depending on where you are. PET scans being hold
by the scans where a special radioactive die is given
(12:03):
and we see things are spread and below your collar
bones for the most part, So all these diagnostics are
done so that a therapeutic plan is then made for
the patients. That Israel, we have our cutaneous oncology clinic
either on the head and neck part of that, and
then we have other surgeons who manage the body below
(12:24):
the collarbone and then we do that in sync with
our medical oncologists and radiation on collages. So again it's
important when you are facing something more intense to be
seen by a team. You know, not one person can
make a decision or should make a decision on the
therapy plan, so we work as a group, and I
think multisparay care is very important when you start seeing
(12:46):
these invasive cancers. The other question was can cancer come back?
And absolutely cancer can come back. Even one cell that
may be left behind or gets reactivated can bloom again.
That's why long term surveillance or follow up in the
form of skin cancer, have a very good relationship with
(13:07):
your dermatologist. Make sure the person has checked out very often,
so often four to six months. And if you've got
multiple skin cancers, which you see a lot of patients
here in New England who've had many, many skin cancers,
they need more frequent checkups so that if a new
lesion is identified, it can be biop seed and a
(13:28):
new treatment plan can be made. The good news is
for the most part these cancers can be treated. But
then we do see the very aggressive varieties that need
not just surgery, not just most surgery, but open surgery,
which is what I do. You know, bigger operations, and
then we put you back together. We take different parts
of your body to reconstruct you. And I think last time,
(13:52):
as I said, the reconstructive techniques have come a long way.
The head and NEX team we had headed next surgeons
we do all the reconstruction and plastics work, so typically
there's no secondary team in our institution. But you know,
we we work together as a group to take the
cancer out, put it back together, and then if you
need additional treatment like radiation or chemotherapy or now immunotherapy,
(14:17):
then we pass you on to our medical oncology and
radiation oncology colleague. So it's a group effort to deal
with the aggressive tumors. And with the multi stree approach,
we realize and to our research as well, that that
is the best way to be treated is in a
multi dispree setting. I hope that answered your question.
Speaker 2 (14:34):
It's a very comprehensively answer, Elizabeth, great question. I hope
that's satisfactory.
Speaker 6 (14:39):
Very thorough. Thank you so much.
Speaker 2 (14:41):
All right, thanks Elizabeth, appreciate your call. Six six one
seven ninety. Let me go down to Tom on Cape Cod. Tom,
you are next on night Side with doctor Sharu Jalisi.
Go right ahead.
Speaker 7 (14:57):
Before I get to the question the other than I
unceremoniously mentioned quickly that you were in the you've served,
doc country. I just want to say thank you for
your service.
Speaker 2 (15:09):
It wasn't much, but thank you very much. That's a
long time ago. Go right ahead, Well.
Speaker 7 (15:16):
It's still it still counts all right, Now the question
I have is vaping? What what what possible problems for
that cause?
Speaker 2 (15:32):
Okay, you broke up a little bit, so just repeat
the question. Please talk me, Jef.
Speaker 7 (15:38):
What what what possible problems could vaping cause?
Speaker 2 (15:43):
Oh? I suspect doctor Jalisi has a good answer for that,
Doctor Jalasi. Vaping has become more popular, particularly amongst young people.
What what what is the admonition you give people who
decide they want to vapor?
Speaker 3 (16:00):
Yeah? So I think as a great question mark, Thanks
for asking that. By the way, a big problem in
a youth. I think vaping is now becoming a problem
in high school. Uh, the problem vaping is again I'm
not a lung specialist, but we are seeing folks with
a lot of lung issues of the lung we haven't
(16:22):
seen so far, and I don't think we have enough
experience we see what the long term impact of vaping
would it would be, would it still be causing cancers
or not? We don't know as yet, but we are
still looking out for it. But we do know that
people who vape long term their lungs do have problems.
We see them. We have like, for example, I have
patients who vape, and they do have challenges during general
(16:46):
anaesthesia on recovery, and so I think we have to
be cognizant. And I think it's very important to let
your treating team know that you vape, because everyone thinks
so I don't smoke, so I will be okay. Smoking
has its own issues with wound healing. Then nicotine slows
down wound healing. So if you're having an incision, you're
gonna have a worse customeric outcome if you do smoke actively.
(17:10):
But vaping right now is having more giving us more
challenges on how your lungs react to anesthesia and stuff
like that. I don't think we have enough data as
yet to say vaping is going to cause cancer, but
I think the jury's out there right now. But if
you can avoid vaping, I think it's better for the lungs.
(17:30):
The lungs stay healthy, and I think you will breathe better.
Speaker 2 (17:34):
Absolutely, Tom, the connection is not great, but I thank
you for the question. I'm not sure if we've lost
you already, but it sounds I thank you very much.
Speaker 3 (17:45):
To thank you, Tom.
Speaker 2 (17:48):
We'll talk again. We're going to take a break here
for the news at the bottom of the hour. I
actually do have a couple of quick lines if you
want to get in. I've got calls lined up. Lola
is next. I got John and Julia coming up six one, six,
one seven. I have a lot to go over with
doctor Sharouk Jalisi. Uh, but your questions are equally important
(18:11):
and perhaps more important. We will cover it all, I
promise between now and ten o'clock. Here's the news. We'll
be back in just a few minutes.
Speaker 1 (18:20):
It's Night Side Boston's news radio.
Speaker 2 (18:26):
My guess is doctor Sharouk Julisi. He is the chair
of the Head and Neck Surgery. He's a head of
neck surgeon, head of the department at the Beth Israel Deaconus.
There's there's a bunch of calls, doctor Jalisi. Let me
just ask this question quickly, and that is some cancers
(18:46):
have a genetic aspect to them. Where do head and
neck cancers fit on the genetic calculations?
Speaker 8 (18:57):
Is it.
Speaker 2 (18:59):
Calm? Is there a genetic aspect to the head and
neck cancers generally?
Speaker 3 (19:05):
Yeah, So then that's a great question. Most of the
genetically oriented head neck cancer which run in families are
those that typically we see is with thyroid cancer, so
we manage a lot of pyroid cancer, which can run
in families. There are certain syndromes that associate thyroid cancer
with other tumors, called the multiple endocrine neoplasia syndromes, So
(19:29):
that's where the most of the genetic stuff comes in.
There's another genetic part which we do see is in
non cancer disease a head neck, which are called paragangliomas
or those are growths off here for example the nerve
that helps you swallowing, or the vagus nerve, and they
can run in families as well. But otherwise, most head
and neck cancers do have some kind of genetic derangement,
(19:52):
which is why the cancer developed. And now with new technologies,
there are studies you can do to look at what
these derangements are, and some of the companies that do
them become so advanced that they can actually also give
a recommendation of what drug may be available out there
to help in the treatment. So I think we've come
(20:13):
a long way just in the last fifteen years in
the management of these tumors, getting more data about the
genetic makeup. But from a genetic perspective, that what will
I hand down to my children. Is mostly thyroid cancer
that I deal with, but otherwise it's just what we
call sporadic cancer. Someone in the family may get it
(20:37):
and why A lot of times you don't know, you know.
But in the old days we would say risk factors.
You drink too much or you smoke too much, and
that's what's happening. But now, obviously we have cancers that
are coming up which are virally mediated that we will
be talking about.
Speaker 2 (20:53):
Okay, so one other question, are you a believer? There
are now blood tests that are available. I think one
company is Galleria or Gallery where they do a blood
test and they can see that the cancer cells shed
and they sometimes they say that they can pick up
(21:14):
cancers at early stages, stage one or stage two through
those blood tests. Do you buy? Are you a believer
in that? So that's those are emerging. Those are emerging
I think in the last four or five years. I'm
just curious if you think they have some validity.
Speaker 3 (21:34):
So so then I'm not familiar with this particular company
you're talking about. But so far ahead and neck world,
we do not have testing that can help us with this.
We do have certain testing for cancers that are now
related to the human papanoma virus where we can do
a human papanoma virus a DNA test on people who
(21:56):
are diagnosed with cancer, and we can use it as
a marker, uh to see if the treatment was successful
or the cancer is coming back. So it's a it's
a it's a good tool that we use now in
people who have these HPV related cancers of the throat,
where we can follow these patients longitudinally and see if
(22:18):
this marker is going up. And we've noticed that this
marker may start going up several months sometimes before the
actual cancer is clinically or physically evident. So it allows
us a little jump start to start testing the patient,
doing more scan and so on and so forth if
(22:39):
this test become positive. But we don't have a test
that can tell us that, oh, this person doesn't have
a clinical finding, but this blood test is saying that
they may have a cancer. We do not have anything
like that in the head and night.
Speaker 2 (22:50):
All right, let's keep rolling here. Let me go to
Lola in Watertown. Lola you with doctor Zelsi, Go right ahead, Lola, Hi.
Speaker 8 (22:57):
Director Solici Jalausy. I would I'd like to know if
you could discuss the correlation between parasites that are coming,
some of them from uncooked you know, shellfish drinking contaminated water,
fruits and vegetables that are not washed. And then also
(23:21):
adding the commercial food supply versus the organic food supply.
I realized the air is polluted, but they're using pesticides
in our food. It's not labeled, and so we have
a big salad bowl of how anybody can get cancer
(23:45):
from virtually anything.
Speaker 2 (23:47):
Okay, that is a huge question that you've asked, Lola,
and I don't know that it is within the field
of specialty of doctor Jelici, but let's give them a
shot at it, doctor Julyici.
Speaker 3 (24:00):
It's a it's a it's a big question. So thank
you Lola for asking. I mean, obviously we know if
you just think about it, that there are chemicals that
are carcinogenic or produce cancers.
Speaker 2 (24:13):
Uh.
Speaker 3 (24:13):
And you know, over the years, we have a food
supply where these chemicals and parties have been used. I
think there's research. I don't. I don't know any had
next cancer that's directly correlated with with these, but obviously
common sense says if you have a bad food supply,
it's going to affect you. So so that's where I'm
(24:36):
going to leave it at because I think more research
needs to be done. I think it requires money and
and I hope that these kind of grants are available
or maybe the public sponsors these kind of association kind
of studies that we can do. And we'd love to
do one on head and nag and see if people
know about where their food came from and how it
correlates with rates of cancer. I think that'll be very nice.
Speaker 2 (24:59):
That's it's a great question. I got to move quickly
because I got backed.
Speaker 8 (25:04):
I associated thank you. We have to take responsibility for
our own body, so we can't leave it all up
to the doctor once we get sick. Prevention is very important.
Speaker 2 (25:16):
Big part of our conversation tonight, that's for sure. Thank
you so much.
Speaker 8 (25:20):
Thank you both. Thank you.
Speaker 2 (25:22):
Let me go next to Julia on Cape Cod. Second
call from Cape Cod tonight. Hi Julia, how are you.
Speaker 9 (25:28):
I'm great right now. I'm having a little problem with
cancer on my lower shin and I developed it in
I developed it in Virginia and it was sway miss
Sole cancer, which was very bad because it went undiagnosed
(25:50):
by two special dermatologists and by the time it developed
it with a two by three tumor on my shin.
Speaker 2 (25:59):
Again, bear in mind that that doctor Julasi deals with
above the callar, bone head and neck surgery.
Speaker 9 (26:07):
What's your question, I understand that. I just wanted to
ask him. I'm up in Boston now alesion has come back,
and I'm very afraid. I don't know where to go
for a good most surgeon.
Speaker 10 (26:19):
What hospital I should go to, well, who I should.
Speaker 9 (26:21):
Turn to to get I have to have it taken off.
It was biopsied already. It's negative. I mean it's positive
for disclaimers. Again, it's only one in you.
Speaker 2 (26:32):
I understand, Julia.
Speaker 9 (26:33):
I'm just problem and the whole what happened is my
whole wound. He hissed. It opened up and it took
four months of being off my feet and special diet
to bring my skin together.
Speaker 2 (26:46):
Julia.
Speaker 9 (26:48):
I'm very worried. Julia just signed out from him.
Speaker 2 (26:51):
Do me a favor, Rob, if you could take Julia
down and have her turn her radio down and tell
her I need to talk to her and she needs
to hear me, because I don't know that doctor Julisi
is in a position where he's going to be able
to diagnose something like this. Uh, bring her back when
when she's when she can listen real quickly, Julia, can
you hear me now?
Speaker 8 (27:12):
Yes?
Speaker 2 (27:12):
I can. Okay, Julia, you have a question. You're visiting
Boston or you here for medical treads.
Speaker 9 (27:17):
I live in Boston. I went to Boston College.
Speaker 2 (27:20):
Okay, Okay, fine, so you're so okay. Do you have
doctors in Boston?
Speaker 9 (27:26):
No? I don't. This is what I'm trying to find
the most surgeon in Boston, and I'm at a loss.
Speaker 2 (27:32):
Do you have a Julia. What I'm trying to do
here is I'm trying to save time. Do you have
a primary care physician?
Speaker 8 (27:39):
No?
Speaker 9 (27:39):
I don't.
Speaker 2 (27:40):
How can you be a graduate of Boston host?
Speaker 9 (27:42):
I do have one at the Brigham. I do have
a primary.
Speaker 2 (27:46):
Okay, you then need to call that doctor because it's
it puts doctors Jualsi in an awkward position, uh to
ask him that question. In all fairness, I'm sure that
if you have a good doctor at the Brigham, it's
a great facility that they will be able to get
you to whatever, uh doctor you need to get treated.
(28:07):
So I don't mean to disappoint you, but it just
puts doctor Julisi in a very awkward position.
Speaker 9 (28:13):
I recommend anyone, but I did want to ask them
if there is a possibility that from this first cancer
there might have been a metastasis, a couple of cells
that stayed there and all of a sudden they're coming
to fruition, They're coming up through the skin again.
Speaker 2 (28:30):
He can't answer that question. I don't think it's fair
to him. Let me give him a chance. Doctor Zelici,
I don't think that's a fair question for you to
be asked because you haven't had a chance to diagnose Julia. No.
Speaker 3 (28:41):
No, I think I think Julian needs a comprehensive evaluation.
I agree with Dan, you should talk to your doctors
and go in and see who's in your network and
get further treated. But again, this is something in your legs.
So there are other surgeons who are really good who
will take care of this.
Speaker 2 (28:58):
And if you're at Brigham, if you're if you're Brigham
in Women's, we're blessed with great hospitals here, Julia, So
please get in as quickly as possible, uh and get
it treated. Okay, college all right, thank you, Julia, Thank you.
I think Julia had trouble hearing us as well, Doctor Zulici,
I apologize, yeah, very very quickly. Could you reference you've
(29:21):
told me that there is a an uptick in young men,
young men meaning in their thirties and early forties with
tongue cancer, which which may be related to the HPV virus.
Speaker 3 (29:34):
Correct. So we are seeing pretty much a rising increase
in the human papalmon virus that Saint marus that effects
which we've known affects women, causing cervical cancer and gynecologic cancer.
Speaker 6 (29:48):
Uh.
Speaker 3 (29:48):
And it's now causing men and some women, but more
prevalent than men of coat cancer which involved your tonsil
uh in the back of it hung uh. And it's
kind of again as you said, then afflicts people in
the thirties and forties, and it is on the rise.
I think the risk factor that the cause of relationship
(30:10):
has come up with oral genital intercourse and having multiple
sexual partners. But interestingly, it does not even if you
have HPV, not everyone develops cancer. And that's a big
topic of research as to why what's so special in
the patients who develop cancer versus that don't. And we
(30:32):
also see this in monogamous couples where one partner may
have the throat cancer which HPV related, and the other
partner never gets it. And it's kind of fascinating why
that happens, and we don't have answers, but we do
know that, you know, throat cancers are afflicting young people.
They don't have the typical risk factors of smoking, tobacco, chewing,
(30:55):
alcohol abuse. But if you start having throat pain, you
start having a lump in your neck, please please, please
get it checked out. Because we've seen too many young
people who are diagnosed with cancer and we uh uh
this treatment that will give you long term survival, and
so it's very important to get it diagnosed, checked out
and treat it accordingly.
Speaker 2 (31:16):
Excellent, excellent. We have more phone calls right after this
break with my guest doctor Charuk Zosi. He is a
head and neck cancer surgeon at Beth Israel Deaconess Hospital.
And what is really great about him is he's he's
willing to spend time with us and take your question.
So we will get to at least three or four
more callers will do it quickly.
Speaker 1 (31:36):
Right after the break, It's Night Side with Dan Ray,
Boston's News Radio.
Speaker 2 (31:44):
My guest is doctor Sharuk Zlisi, headed neck chief, head
and neck surgeon at Boston Beth Israel Deaconess. Folks, I
know we have full lines. I'm going to ask everybody
to please be as direct and with your question as possible.
John and Waltham, John with doctor Julicy, Go right.
Speaker 11 (32:01):
Ahead, Hi Daan, Hi doctor Jualica. How's everybody doing.
Speaker 2 (32:05):
We're doing great. You're gonna do better when you get
to your question. Go ahead. John.
Speaker 11 (32:09):
I'm a patient of doctor Jules and he did my
scream a cell cancer on the top of my head
well nine months ago.
Speaker 2 (32:17):
Woa, congratulations.
Speaker 11 (32:19):
I can't say enough about this guy. He really did
a great job and the whole team.
Speaker 2 (32:23):
So John, that's great so much.
Speaker 3 (32:26):
That means a lot.
Speaker 2 (32:29):
That is amazing. That must give you an incredible amount
of feeling of accomplishment. How old are you John, if I.
Speaker 11 (32:38):
Could ask, I just turned eighty years old.
Speaker 2 (32:42):
Okay, and you discovered this. It was a skin cancer melanoma.
Speaker 11 (32:49):
No, it was a scream as cell squam cell. Yeah,
and my dematolis picked it out. I just saw a
little bump on my head and she took a little
piece out and BIOPSI bioposite and she says, you're gonna
go see doctor Jalasy, you know, and did the surgery,
did the radiation. I'm still part of the team. I
(33:10):
get tested every six months and the doctor did a
really great job. It wasn't easy for me, but you know,
I came out of it pretty good. You know, So
you want to take free kids the doctor Jalice.
Speaker 2 (33:26):
Congratulations Sean.
Speaker 11 (33:28):
And I know I know he'll probably remember me if
he sees me. But you know, I can't say enough
about the guy.
Speaker 2 (33:34):
What what a what a great tribute. Thank you, John.
I do appreciate it so much. Thank you. Let me
go to that's that's an honor, doctor Julici, I'll tell
you honor.
Speaker 3 (33:43):
Thank you so much. John. It's great. I had a
long day and it was great to hear.
Speaker 2 (33:47):
That Deborah is in Salem. Deborah next on nightside. We're
getting tight on time, deb go right ahead.
Speaker 10 (33:54):
Yes, I'll be quick, Dan, thank you for taking my call. Awesome,
Thank you Dan. We're all you do for everyone else.
Doctor Julius, help apparent your name correctly. I want to
thank you for work you do in dedication to everyone.
I have any question about the time I have I
have to be quick. I have a question about the time.
(34:14):
I'm a lifelong non smoker and I am conscious with
about my dental appointments twice a year. Would it be
a waste of my time to ask my dentists to
check my tongue once a year, because.
Speaker 2 (34:31):
Dentist should do that anyway.
Speaker 3 (34:35):
Yes, yes, it's a dentist, your dental hygienis and your
dentists would be checking your mouth regularly. I think that's
a that's a great uh screating service that most dentists
do and should be doing.
Speaker 2 (34:46):
Uh.
Speaker 3 (34:46):
So yeah, absolutely have them check your whole mouth out.
They as you walk around, the check the gums, They
looking at the whole mouth and if anything suspicious shows up,
then they usually refer to us had an ex surgeon
or or also to get a bopsy. Uh and then
you go from there and then if you need a treatment.
But that's a great, great opportunity to get yourself checked
(35:07):
out and screened.
Speaker 2 (35:09):
For that question. Thank you, Jan, thank you have a
great night. That's a great question. I lean in Pembroke.
I lean you in next on nice side with doctor
Sharuk salsij Hi.
Speaker 4 (35:20):
Thank you for taking my call doctor. I have a
question in regards to diroid cancer. I am one of
six sisters, and five of my sisters have had diroid
cancer and had the diroid taken out. I also have
three nieces that have had diroid cancer. The doctors at
the time told us that it wasn't hereditary, but I'm
(35:40):
wondering what causes it, and now I have a granddaughter
to on a little concerns.
Speaker 3 (35:45):
Yeah, so this is a classic situation where I think
you have your family does have a genetic component of
pyroid cancer, and if you want, you can have yourself
genetic tested. We live in Massachusetts where there are opportunities
to meet with a geneticist that can do a whole
family tree and do additional testing. But everyone in the family,
(36:08):
it seems like it sounds like most of the women
in the family get affected, which again Tyroi's answer is
more common in women than men. But if it does
afflict men, it is more aggressive for the for the audience,
so it has to be checked out. But everyone in
your family should be if they haven't had that tyroid
taken out, even if they have had it taken out,
(36:28):
should be having at least a thyroid ultrasound for screening,
just to make sure there's not something that's there that
needs to be taken out. So if you haven't had surgery,
I'm assuming you've had your thyroid ultrasound done and anything
that needs to be bopsied should be bob sied. Then
you should be the person who should have constant surveillance
long term.
Speaker 11 (36:48):
Okay, Aileen, thank you.
Speaker 2 (36:50):
That's a great question. I hope you follow the doctor's advice.
Speaker 10 (36:53):
Okay, I absolutely will, thank you, Thank you.
Speaker 3 (36:56):
Very much the night, thank you.
Speaker 2 (36:57):
We are just flat out of time here. I'm going
to give Bob. Bob, I can give you about thirty
five or forty seconds. Can you do anything with it?
Speaker 5 (37:06):
I certainly can. Dean, I was your final caller on
Friday where I told you I was cured of cancer,
and I wanted to mention to your audience how important
it is to donate blood because especially cancer patients require
a lot of blood like I did. And please go
out and donate blood.
Speaker 2 (37:26):
A perfect way to end the last call. Bob. Thank you,
thank you for your brevity, and thank you for your success.
Speaker 3 (37:34):
And thank you.
Speaker 5 (37:35):
Thank you to the doctor. Thank you to the doctor
and his entire team, and especially the team that looked
after me at the MGH. They're all professionals and amazing people.
Speaker 2 (37:45):
All right, thanks, thank you so much, Bob doctor. Obviously,
one of the things we talked about last week was
preventive menace measures, making sure that you see skincare of physicians,
make sure you wear a hat and all of that.
So we've covered that, but I do want to give
you a chance to mention your mission trips because I
(38:05):
think that's important to you.
Speaker 3 (38:08):
Oh yeah, So, I think then the biggest thing is
we obviously everyone knows we're facing a doctor shortage. I've
been in lifelong academician. I've trained a lot of residents,
a lot of surgeons who do head of next surgery
over the last twenty five years, and yet we're at
a cusp of having a huge shortage for surgeons and doctors.
And so we've been teaching and training doctors, but more
(38:32):
so in the US. So I run a fellowship program
at Harvard and Beth Israel where we bring in fellows
from outside the country and they go back to the
countries and are very impactful people. You know, we have
fellows from who've gone back to Israel. We have fellows
from Saudi Arabia, from Pakistan, so all over the place.
We send these folks back and they do amazing stuff.
(38:55):
Within the US, obviously, we have a big residency program
at Harvard and before that I was at Boston University,
so we trained these and then what we realized was
that we don't have much a lot of technology in
foreign countries. So I've been running a mission trip for
the last twenty years to Pakistan where we go down
and do seminars, teaching seminars. Then we do free surgery
(39:17):
in the government hospitals to really people who have nothing
and help them get at least good quality surgical care.
And I think a few years ago, maybe the audience
and you had heard that there was a big article
in Landset, which is a big journal, that there is
a big inequity in surgical delivery of surgical care across
(39:37):
the world the US leads doctor Lesk.
Speaker 2 (39:41):
Is there a location where people could contribute to this effort?
Speaker 8 (39:47):
Oh?
Speaker 3 (39:47):
Absolutely, I mean you can go to our website at
the bethesviel Dgulous Medical Center and forward slash the auto
Laryngology program, and we have our division donation fund and
you can do and if you want after that, I can,
I can send the link to you, and that really helps.
Speaker 2 (40:05):
If you could send that that link to me, I
promise you I will publicize it. I'm just flat up
against the newscast. I must thank you profusely for your
time tonight. It was a great hour, not a good hour,
it was a great hour. Thank you so much, and
send me that link and we'll do some more on
this subject.
Speaker 3 (40:24):
I promise you. Thank you so much, Dan, and I
hope your audience learned something.
Speaker 2 (40:29):
I'm sure they did. I'm sure they did. Thank you
very much, doctor Sharoup Solsi and I will get all
that information of everyone. I'm a little bit later in
the newscast, that's my fault. We'll be back right after
the ten
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