Respecting tradition while embracing innovation: Head and neck cancer surgeon strives to provide holistic care

Alexandra Kejner, M.D., radiates wonderment when she talks about head and neck anatomy.

“I think some of the most beautiful anatomy is in the head and neck. It is just gorgeous. You look at the picture in the textbook, and it actually does look like that in the neck,” she explained.

Even better than simply observing the anatomy is being able to help head and neck cancer patients by using tissue from elsewhere in the body to reconstruct parts of the head and neck that had to be removed along with the cancer, a technique called free-flap surgery.

“Free flaps are just amazing. It almost defies logic that you’re taking this big piece of tissue, and you're relying on a single artery and a single vein to feed that tissue to make it live,” she said. “And it's like a little miracle every time it happens. It's beautiful.”

Kejner is an otorhinolaryngologist – an ear, nose and throat doctor – who cares for head and neck cancer patients. She joined MUSC Health in September. Unlike many newcomers to Charleston, she didn’t cite the location as one of the draws, despite its overwhelming beauty and culture. Rather, she said she was drawn to MUSC Hollings Cancer Center and MUSC Health by the people who work here and by the mission of furthering cancer care throughout South Carolina.

Although her specialty is surgery, Kejner thinks it’s important to consider more than the surgery itself when caring for patients. She likes that cancer providers tend to build lifelong relationships with patients. She was inspired, as a resident, to see a patient returning 20 years after his treatment, just to say “hi.”

“One of the things that is really important to me is that when we get people in to treat them for cancer, we're treating the whole person,” she said. “So not just, ‘There's a tumor; we will fix it.’ But also looking at other underlying issues that have come into play and that have gotten us to this point, so looking at things like nutrition, smoking cessation and even genetics.”

 

Cancer care is multidisciplinary, and that’s especially true for head and neck cancer, where doctors collaborate with speech language pathologists, physical and occupational therapists, social workers, nutritionists and more.

Head and neck cancer patients, in particular, are more likely to have mental health struggles after treatment, which can radically change their appearance or control over muscles for swallowing and talking. Kejner said one of her goals is to get patients “as close to their baseline as we can,” so that they feel comfortable going out in public and participating in social activities.

To that end, she’s always interested in advancing treatments and innovations in care – even if those innovations involve new medicines and medical treatment, rather than surgical intervention.

“One of my favorite sayings is ‘Respect tradition but embrace innovation,’” she said. “So you realize the lessons and techniques that we have had for years and marry those with advances in technology and the cutting edge of science. Research is probably one of the most important aspects in cancer care because that's how we push the envelope. That's how we figure out better ways to take care of people and get them back on their feet, get them back out to be with their families and to enjoy life again.”

Kejner’s past research has delved into health disparities and outcomes in larynx cancer patients. She’s also involved in a clinical trial studying a therapeutic vaccine in combination with immunotherapy.

For all of those reasons, she likes being at an NCI-designated cancer center housed within an academic medical center.

“At academic centers, you tend to attract people who are really passionate about learning and research and teaching,” she said. “I think it's the innovation that's available when you have academics coming together.”

“We're big dorks,” she laughed. “We get really excited about these things, you know. We text each other about papers.”

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