Head and neck oncology

We are a regional centre for head and neck surgery and our head and neck cancer services include primary assessment and diagnosis, specialist review, surgery and follow up.

The surgical team includes maxilllofacial surgeons and an ENT surgeon, all with sub specialty experience in tumours of the mouth, throat, neck and head.

Both routine and advanced surgery is carried out, including laser surgery and advanced reconstructive techniques. This may include routine tongue cancer ablation and simple free tissue transfer to complex facial or laryngopharyngeal ablation requiring advanced complex free tissue transfer techniques.

The surgical team meet weekly as a multidisciplinary team with other local ENT surgeons, oncologists, speech and language therapists, psychological therapists, dieticians and specialist nurses to offer co-ordinated state-of-the-art care to both inpatients and outpatients.

Our Macmillan Head and Neck Clinical Nurse Specialists, Clare Lancaster, Bincey Joseph and Michelle Dubber, act as a point of contact for patients, relatives, carers and other healthcare professionals and coordinates care and psychological support for patients receiving treatment for head, neck and thyroid cancer at QVH.

We also provide treatment for patients with associated skull base disease in conjunction with Hurstwood Park neurosurgery centre.

Consultant treatment outcomes

As part of a drive to give patients more information about their treatment and help the NHS drive up and maintain the quality of care, NHS England is now publishing mortality rates for individual hospital consultants in ten specialties including head and neck cancer.

Head and neck surgeons at QVH have been 100% compliant with entering cases using the new DAHNO (Data for Head and Neck Oncologists) data collection system. The data is based on the initial treatment of new diagnosis cancer only, and not on salvage surgery or treatment of recurrent disease or advanced skin cancer – all of which is also frequently performed at QVH.

Mr Brian Bisase

Specialist interests: Head and neck cancer ablation and reconstruction, including micro-vascular surgery and surgical dermatology; maxillofacial trauma surgery; salivary gland disease; and routine oral surgery.

Mr Brian Bisase graduated in dentistry and medicine from the University of London, where he was awarded the Newland Pedley Medal and Scholarship. After completing his surgical training, Mr Bisase undertook higher training in oral and maxillofacial surgery over a five year period, working across the Royal Surrey County Hospital in Guildford, Guys and Kings College Hospitals in London, and here at QVH.

He was awarded the British Association of Oral and Maxillofacial Surgery Gold Medal for coming top in the intercollegiate maxillofacial surgery FRCS exams in 2009. He undertook further specialist training in Toronto, Canada and at the Royal Marsden Hospital where he developed experience in thyroid, anterior skull base and sarcoma surgery, laryngo-pharyngeal reconstruction and advanced reconstruction of the complex defect. He joined QVH in January 2012.

Mr Bisase is an active member of the British Association of Oral and Maxillofacial Surgery and British Association of Head and Neck Oncologists where he has presented clinical research projects and been published in their journals. He is also published in other peer reviewed journals and plays an active part in research at QVH and collaboration with other hospitals. He is a member of the NICE (National Institute for Health and Care Excellence) quality assurance and framework group.

In addition to his clinical work at the Trust, he is the Trust clinical lead for head and neck (H&N) cancer. He also works closely with the Surrey and Sussex Cancer Alliance and is its clinical lead for head and neck cancer. He also devotes time to teaching, professional training and  steers the clinical outcomes group for head and neck surgery at QVH. He is national leader for question writing section 1 for the JCIE (Joint Committee for Intercollegiate Examinations) for the FRCS maxillofacial consultant examinations. Mr Bisase is also project lead for the introduction of a number of programmes aimed at improving patient care such as – Tracheostomy Care and the Enhanced Recovery Programme for patients undergoing major Head and Neck surgery (ERPHN), sentinel node biopsy and electrochemotherapy. QVH is the only provider of the latter two services in the South East of England. Together with allied healthcare professionals at QVH, Mr Bisase has introduced a process for collating the feedback of head and neck cancer patients.

Mr Bisase’s major cases are all fully discussed in a multi-disciplinary team, he ensures that they have received sufficient testing for diagnosis, and treatment plans are in line with national standards.

Mr Bisase also runs clinics at Horsham and Maidstone hospitals.

Professor Jag Dhanda

Areas of expertise: Head and Neck Ablation and Reconstruction, Dental Implants and Virtual Reality in Medicine and Surgery, Extended Reality in Surgical Education.

Research areas: Extended Reality in Medical and Surgical Training and Global Health, Translational Research in Molecular Oncology and Microbiomics.

Professor Jag Dhanda is a dual qualified oral and maxillofacial surgeon with a clinical specialty interest in head and neck cancer ablation and reconstruction. He studied dentistry and a BSc (Hons) in Cellular and Molecular Pathology at the University of Bristol. He then went on to complete a medical degree at Barts and the London Medical School and a PhD at the University of Liverpool. He has been the successful recipient of three Royal College of Surgeons of England research fellowships (college, board and specialty) and a CRUK felllowship.

Professor Dhanda has been a previous council member for the British Association of Oral and Maxillofacial Surgeons, and he is an elected board member for Faculty of Dental Surgery, Royal College of Surgeons of England. He completed his surgical training in Bristol, London, the West Midlands, and East Grinstead including a trainee interface group advanced head and neck reconstructive fellowship. His NHS surgical practice focuses on advanced head and neck reconstructive procedures including free tissue transfer and microvascular surgery. Professor Dhanda is also a practicing dental implant surgeon in the South East.

Research
Professor Dhanda completed a PhD in the molecular determinants of head and neck cancer using three-dimensional tissue modelling and transcriptomics. He supervises PhD students including a NIHR doctoral research fellow exploring the role of iKnife technology and robotic surgery in head and neck cancer.

Professor Dhanda is the founder and clinical lead for Virtual Reality in Medicine and Surgery (VRiMS.net), a free for trainee resource using live streaming and restreaming of cadaveric and live surgical techniques in virtual reality. He is conducting studies to scientifically validate the educational benefit of extended reality in medical education for multiprofessional using a combination of eye tracking, physiological sensors, and motion capture to determine whether virtual reality training can be at least equivalent to, or better than, conventional face to face training. He is also developing a skin cancer augmented reality app to guide surgeons in diagnosis and surgical techniques for managing facial skin cancer.

Teaching
Professor Dhanda is the founder and clinical lead for the East Grinstead Head and Neck Course, a cadaveric course in lower limb perforator free flaps, virtual surgical planning for facial reconstruction and advanced microvascular surgery techniques. He is also the cofounder of CRANIOMAX, a hands-on cadaveric course for ENT, neurosurgeons, oral and maxillofacial surgeons, aesthetic surgeons, and dermatologists. He uses a combination of virtual reality and augmented reality to train surgeons nationally and internationally.

Professor Dhanda is also coordinating a global health programme hosting rural doctors from low to middle income countries that receive training in WHO Global Burden of Disease procedures. He regularly travels to low to middle income countries and rural settings to train doctors and surgeons with recent visits to Uganda, Kenya, India, Zambia, Cameroon and Tanzania.

Selected publications
Dawoud BES, Kent S, Tabbenor O, George P, Dhanda J. Dental implants and risk of bleeding in patients on oral anticoagulants: a systematic review and meta-analysis. Int J Implant Dent. 2021 Aug 25;7(1):82. doi: 10.1186/s40729-021-00364-5. PMID: 34430994; PMCID: PMC8385035

Bowe CM, Bean T, Loke R, Gallagher N, Rooney J, Surwald C, Dhanda J, Moody A, Bisase B, Norris P, Barrett AW, Lachanas V, Doumas S. Merkel cell carcinoma of the head and neck in the south-east of England. Br J Oral Maxillofac Surg. 2021 Jun 25:S0266-4356(21)00240-0. doi: 10.1016/j.bjoms.2021.06.009. Epub ahead of print. PMID: 34465487.

Barrett AW, Pratt MK, Sassoon I, Bisase BS, Newman L, Tighe JV, Norris PM, Dhanda J, Gulati A. Perineural and lymphovascular invasion in squamous cell carcinoma of the tongue. J Oral Pathol Med. 2020 Aug 20. doi: 10.1111/jop.13104. Epub ahead of print. PMID: 32815232.

Butler D, Davies-Husband C, Dhanda J, Francis I, Gulati A, Kapoor K, Newman L, Norris P, Sadiq Z, Surwald C, Upile N, Vorster T, Bisase B. Head and neck oncological ablation and reconstruction in the COVID-19 era – our experience to date. Br J Oral Maxillofac Surg. 2020 Oct;58(8):1008-1013. doi: 10.1016/j.bjoms.2020.06.011. Epub 2020 Jun 17. PMID: 32576467; PMCID: PMC7298505.

Omran A, Hutchison I, Ridout F, Bose A, Maroni R, Dhanda J, Hammond D, Moynihan C, Ciniglio A, Chiu G. Current perspectives on the surgical management of mandibular third molars in the United Kingdom: the need for further research. Br J Oral Maxillofac Surg. 2020 Apr;58(3):348-354. doi: 10.1016/j.bjoms.2020.01.007. Epub 2020 Mar 4. PMID: 32143937.

Borsetto D, Higginson JA, Aslam A, Al-Qamachi L, Dhanda J, Marioni G, Franchella S, Frigo A, Praveen P, Martin T, Parmar S, Nankivell P. Factors affecting prognosis in locoregional recurrence of oral squamous cell carcinoma. J Oral Pathol Med. 2019 Mar;48(3):206-213. doi: 10.1111/jop.12815. Epub 2019 Jan 20. PMID: 30576014.

Jundt JS, Marchena JM, Hanna I, Dhanda J, Breit MJ, Perry AP. Evolving Technologies for Tissue Cutting. Oral Maxillofac Surg Clin North Am. 2019 Nov;31(4):549-559. doi: 10.1016/j.coms.2019.07.009. Epub 2019 Aug 31. PMID: 31481290.

SERPINE1 and SMA Expression at the Invasive Front predict Extracapsular Spread and Survival in Oral Squamous Cell Carcinoma. J Dhanda, A Triantafyllou, T Liloglou, H Kalirai, B Lloyd, R Hanlon, R Shaw, DR Sibson, J Risk. British Journal of Cancer, 111(11), 2114-2121. doi:10.1038/bjc.2014.500

Jayaram SC, Muzaffar SJ, Ahmed I, Dhanda J, Paleri V, Mehanna H. Efficacy, outcomes, and complication rates of different surgical and nonsurgical treatment modalities for recurrent/residual oropharyngeal carcinoma: A systematic review and meta-analysis. Head Neck. 2016 Dec;38(12):1855-1861. doi: 10.1002/hed.24531. Epub 2016 Jul 13. PMID: 27405247.

Dhanda J, Pasquier D, Newman L, Shaw R. Current Concepts in Osteoradionecrosis after Head and Neck Radiotherapy. Clin Oncol (R Coll Radiol). 2016 Jul;28(7):459-66. doi: 10.1016/j.clon.2016.03.002. Epub 2016 Mar 30. PMID: 27038708.

Mr Aakshay Gulati

Specialist interests: Head and neck oncology and microvascular facial reconstruction, surgical dermatology and reconstruction, salivary gland surgery, complex oral surgery and implantology.

Mr Aakshay Gulati is a dually qualified oral and maxillofacial surgeon. He obtained his Bachelor’s degree in Dental Surgery in 1996 and worked in a series of hospital posts in oral surgery around the London region for five years, successfully obtaining the Fellowship in Dental Surgery (FDSRCS), awarded by the Royal College of Surgeons of England in 2001.

Thereafter he graduated in Medicine (MBBS) from King’s College London in 2006 and completed generic surgical training, which culminated in the Membership of Royal College of Surgeons (MRCS) in 2009. His higher surgical training in oral and maxillofacial surgery was based in the south coast of England and this led to the award of the Fellowship of the Royal College of Surgeons in Oral and Maxillofacial Surgery (FRCS-OMFS) in 2014. He has completed a head and neck and microvascular reconstruction fellowship in a renowned centre in Munich in 2012 and was subsequently also selected for the highly coveted national interface head and neck fellowships. He has also developed an interest in implantology and has completed advanced training in the field.

Mr Gulati is the clinical tutor for oral and maxillofacial surgery in East Grinstead. He is on the review panel and has publications in various peer reviewed journals. He is passionate about teaching and regularly lectures in oral and maxillofacial surgery and implantology. He has had the opportunity of being invited as guest lecturer and keynote speaker on head and neck reconstruction at international scientific meetings.

Mr Gulati was the recipient of the Leibinger Prize in 2012. He is also actively involved with leadership roles as an executive board member of the European Association for Cranio-Maxillo-Facial Surgery.
Mr Gulati’s surgical interests lie in head and neck oncology and microvascular reconstruction, salivary gland surgery, surgical dermatology, complex oral surgery and implantology. His clinics are based in East Grinstead and the Medway region, and he is also a member of the West Kent Head and Neck Multidisciplinary team.

Mr Laurence Newman

Specialist interest: Maxillofacial surgery

Mr Laurence Newman has been a Consultant Maxillofacial / Head and Neck Surgeon since 1997. His clinical practice is focused on the management of benign and malignant head and neck tumours. He operates on approximately 70 major head and neck cases annually.

He is also the Chair of the head and neck multidisciplinary team at the Kent Oncology Centre.

Mr Newman was a member of the Guideline Development Group at NICE (the National Institute for Health and Care Excellence) responsible for writing national guidelines for the management of head and neck cancers that were published in 2016.

He has a Master in Laws Degree (LLM) and is actively involved in medicolegal matters, particularly involving clinical negligence. He works closely with NHS Resolution and the NHS Ombudsman.

Mr Newman is currently an Assessor of Examiners for the FRCS examination in Maxillofacial Surgery and was the Chair of the Court of Examiners from 2010-2013. He helps to quality assure the examination process which impacts on patient safety.

Mr Paul Norris

Specialist interests: Oral and skin malignancy of the head and neck, particularly reconstruction of the post-ablative defect including microvascular surgery; surgery involving salivary gland disease; facial trauma; and dentoalveolar surgery.

Mr Paul Norris works at the world famous Queen Victoria Hospital in East Grinstead, Darent Valley Hospital Dartford and Maidstone Hospital.

He graduated in medicine from the University of London (Kings College Hospital) in 1998. As he specialises in the surgical ablation and reconstruction of head and neck cancer patients he also studied dentistry, gaining another degree from the University of London. He is a Fellow of the Royal College of Surgeons of both England and Edinburgh.

After experience in general, vascular, plastics, orthopaedics and urology surgery, Paul entered higher surgical training in oral and maxillofacial surgery working at Addenbrooke’s Hospital Cambridge, QVH, University College London Hospital, The Eastman Dental Hospital and Great Ormond Street Hospital in London. He passed the Intercollegiate Examination in Maxillofacial Surgery in March 2007 and has been on the Specialist Register of the General Medical Council since September 2008. He took up appointment as a consultant at QVH in November 2008.

Mr Norris devotes a significant amount of time to teaching, professional training and continuing medical education. He lectures internationally and was honoured to be asked to undertake head and neck cancer educational courses recently for the International Association of Oral and Maxillofacial Surgery in Indonesia and Malaysia.

Qualifications: BDS, MBBS, FDSRCS (Eng), FRCS (Ed), FRCS(OMFS)

Mr Zaid Sadiq

Mr Zaid Sadiq joined Queen Victoria Hospital in 2020 after working as a consultant for several years at University College London Hospital and Great Ormond Street Hospital.

Mr Sadiq is qualified in both dentistry and medicine. He completed higher surgical training in Oral and Maxillofacial Surgery in the London KSS region. He completed a Head and Neck reconstruction fellowship in Edinburgh and is accredited by the Royal College of Surgeons of England.

He is an honorary lecturer at University College London.

Mr Sadiq has a keen interest in cancer, reconstructive surgery and tissue engineering, as well as providing a spectrum of oral and maxillofacial practice. He has authored many scientific articles and contributed to various surgical books on head and neck surgery.

Mr John Tighe

Clinical Director for Head and Neck Services

Specialist interests: Management of patients undergoing surgical treatment and reconstruction for head and neck malignancy.

Mr John Tighe is a Consultant Oral & Maxillofacial Surgeon at Queen Victoria Hospital in East Grinstead and has been in post since 2002.

Mr Tighe is qualified in both dental surgery (U. Bristol 1986) and medicine (U. London 1990) and carried out his higher surgical training locally on the South Thames rotation. As well as his duties at East Grinstead he carries out a peripheral clinic at Uckfield Community Hospital and a rapid access clinic at East Surrey Hospital.

Mr Tighe has a special interest in the management of patients undergoing surgical treatment and reconstruction for head and neck malignancy and is a core member of the Brighton Head and Neck Oncology Multidisciplinary Team. In addition, Mr Tighe carries out a broad spectrum of oral and maxillofacial surgical procedures including salivary gland surgery, surgical dermatology and dental implantology.

His latest major cases show that he ensures all his patients are fully discussed in a multi-disciplinary team, and ensures that they have received sufficient testing for diagnosis and treatment plans.

John Tighe, year ending October 2014:
No. of major surgical procedures: 12 cases.
Pre-treatment multi-disciplinary team discussion: 12 cases (100% of cases).
Resective pathology multi-disciplinary team discussion: 12 cases (100% of cases).

Mr Navdeep Upile

Special interests: Malignant ablative head and neck surgery and all aspects of benign head and neck surgery

Mr Navdeep Upile is an Otolaryngologist, head and neck surgeon, who is fully trained within all aspects of ENT. He is a keen advocate of minimal access techniques such as trans-oral laser resection.

He read medicine in Newcastle University and was awarded the Stephen Scott Scholarship for performance in his undergraduate examinations. He was also fortunate to competitively win a Wolfson Bursary to fund an intercalating degree resulting in a BMedSci ( Hons).

After medical school, Mr Upile undertook a foundation programme in the Newcastle Upon Tyne Teaching Hospitals before starting surgical training in the East of England. During this time he completed his membership exams for General surgery (MRCS) before finding his passion in Otorhinolarygology/ENT. He also gained his Diploma in Otorhinolaryngology Head and Neck Surgery (DOHNS).

Mr Upile then went onto pursue his research ambitions with Professor Terry Jones in head and neck oncology and was awarded grants by both the Royal College of Surgeons England and Cancer Research UK.  He was awarded a National Institute for Health Research (NIHR) academic clinical fellowship which allowed him to pursue higher surgical training in the Mersey deanery alongside research. During this time he also pursued his teaching ambitions which led to him gaining a Post Graduate Certificate in Teaching and Learning in Higher Education and was made a Fellow of the Higher Education Academy (FHEA).

Mr Upile completed his higher surgical training rotating through Alder Hey Children’s Hospital, the Royal Liverpool and Aintree University Hospital. He was awarded his Fellowship for the Royal College of Surgeons ( FRCS ORL-HN) in November 2017.

Having completed surgical training and gaining his Certificate of completion of training (CCT) within the UK, Mr Upile sought advanced subspecialist training internationally. He successfully won funding from both the Royal College of Surgeons (The Colledge Family Memorial Fellowships) and the Peel Foundation (The Peel  Rothwell Jackson Travel Fellowship). These facilitated him travelling to the Royal Brisbane and Women’s Hospital, Australia. Here he undertook this prestigious clinical fellowship, developing expertise in all aspects of advanced head and neck surgery including laser and robotic work.

Mr Upile has a passion for research and training. He actively has recruited for ongoing clinical trials and acted for a surgical mentor for several junior trainees. This research and training focus ensures that Mr Upile is abreast of current advances within his field and allows him to offer his patients the highest quality of care.

He also runs clinics out of Medway Maritime Hospital.