Head and Neck Cancer Program
3801 Sacramento Street, Second Floor
San Francisco, CA 94118
415-600-2450

The Head and Neck Cancer Program offers state-of-the-art imaging technology, as well as, individualized medical and surgical management of head and neck cancers. Our multidisciplinary team consists of experienced and skilled head and neck surgeons, radiologists, radiation and medical oncologists, specialty-trained pathologists and rehabilitation specialists.

Our surgeons are experts in melanoma excision, sentinel lymph node biopsy, and micro-reconstructive plastic surgery.

Mark I. Singer, M.D., FACS

Dr. Singer is a graduate of the Columbia University College of Physicians and Surgeons and has practiced head and neck surgery for over 30 years. His extensive career has been split between academic medicine at the University of California, San Francisco (UCSF) teaching for the past 15 years and private practice. He has made a number of contributions to the field of head and neck melanoma in reconstruction, rehabilitation, and cancer treatment.

Dr. Singer has worked closely with the UCSF Cancer Center Melanoma clinic and tumor board, and is currently providing head and neck surgery for melanoma and other advanced cutaneous malignancies at California Pacific Medical Center.

Dr. Singer is a member of the Physician Foundation at California Pacific Medical Center (PFCPMC). PFCPMC is committed to bringing the highest quality health care to the communities we serve through outreach clinics, education, and research and development.

Head and Neck Cancers

Head and neck cancers include cancers of the mouth, nose, sinuses, salivary glands, throat, larynx, and neck lymph nodes. These cancers can affect speech, appearance, swallowing and breathing. Annually, nearly 1.4 million Americas are diagnosed with cancer. Although head and neck cancers represent only about 4% of diagnosed cancer cases and are treatable, disfigurement and loss of basic functions can be devastating. Working with a patient-centered cancer team who addresses treatment, reconstruction, and rehabilitation provides patients the peace of mind, knowing that healing their cancer is just the first step to recovery. Returning patients to their full potential with a natural appearance is our ultimate goal.

Head and Neck Melanoma

Over the past decade there has been a substantial increase in head and neck melanoma attributed largely to an increased exposure to ultraviolet (UV) radiation from the sun and earlier recognition. The skin of the head and neck is exposed on a daily basis making this area of the body vulnerable to melanoma. People with fair or red hair, blue eyes, and light-colored skin who burn easily in the sun are at higher risk for developing melanoma. However, it has been estimated that one of every 75 persons born after the year 2000 will develop melanoma at some point in their life. Melanoma is less common than basal cell and squamous cell skin cancers, but it is far more serious. Nearly 30% of melanomas occur in the head and neck area and, as with most cancers, early detection and treatment result in optimal long-term outcomes.

Leading-edge Diagnostic Staging Tools

Sentinel Lymph Node Biopsy – sentinel lymph nodes, identified through lymphoscintography, are removed by the surgeon and examined in the pathology lab for the presence of cancer cells. This biopsy is performed based on the theory that cancer cells spread or metastasize in an orderly fashion away from the primary tumor to the sentinel lymph nodes and then further into other nearby lymph nodes. A negative biopsy result implies that the cancer has not spread into the lymph system; a positive test indicates the cancer has spread. Sentinel node biopsy provides oncology surgeons more precise cancer staging.

Lymphoscintography – is a nuclear medicine scan of the lymphatic system used to identify sentinel lymph nodes. A small amount of radioactive dye is injected in the skin near the melanoma. As the dye moves through the lymphatic system the sentinel lymph glands absorb the dye and can be easily identified and removed in the operating room.

PET/CT Imaging – housed within the Nuclear Medicine Department, the PET/CT scanner electronically fuses positron emission tomography (PET) scans with computed tomography (CT) images. PET scans show how the body metabolizes a low dose of radioactively-labeled glucose. Since malignant tumors use more glucose than normal tissue or benign tumors, PET scanning has become the imaging modality of choice for diagnosing and staging cancers. CT scanning provides clear anatomical views of the body’s internal structure. When PET images are combined with images obtained with a 64-slice CT, a three-dimensional reconstruction of the body’s inner structures is produced.

Micro-reconstructive Plastic Surgery

Micro-reconstructive surgeons use an operating microscope to rebuild tissue and reconnect blood vessels and nerves in the head and neck area. Vessels and nerves in these areas of the body are so small that the help of a surgical microscope is necessary to place the sutures in the walls of the blood vessels and nerve coverings. Micro-reconstructive surgeons are expert at rebuilding excised diseased tissue from autologous healthy tissue harvested from remote areas of the body.

Some of the world's foremost specialists in reconstructive, replantation, and transplantation microsurgery for fingers, hands, extremities, and facial parts practice at California Pacific. Since its inception in 1970, the Microsurgery Service has performed thousands of amazing reconstructive procedures, giving new hope to patients.

Head and Neck Cancer Rehabilitation

After treatment for any head and neck cancer, rehabilitative therapy is a critical component of follow-up care. Our knowledgeable oncology-focused rehabilitation team includes physical therapists, nutritionists, social workers, and speech-language pathologists. Improving challenging functional impairments can greatly enhance a person’s quality of life. Using swallowing and communication rehabilitation, in conjunction with physical therapy techniques, the rehab team assists patients reach their full-potential functionality, restoring neck and shoulder mobility, speech, and swallowing abilities. Speech-language pathologists provide individualized evaluations, assessments, and treatments aimed at helping individuals develop effective communication skills and restore impaired functions using specialized exercises and biofeedback to retrain muscles.