Every day, Mount Sinai’s Eric M. Genden, MD, MHA, meets patients with oral cancer or related complications who have been told that nothing can be done to help them. These are the patients Dr. Genden, the Isidore Friesner chair and professor of Otolaryngology-Head and Neck Surgery at the Icahn School of Medicine at Mount Sinai, is most passionate about.
“When I am confronted with a struggling patient who has been turned away, I think of it as an opportunity to innovate—to find creative ways to treat their disease in a way that preserves vital functions like swallowing or speech,” says Dr. Genden, a world leader in his field. “When we do that, we can positively change their lives.”
This commitment to creativity informs everything Dr. Genden does at Mount Sinai. He is recognized as the first surgeon to perform a successful human trachea transplant. That achievement, in 2021, led to the launch of the Institute for Airway Sciences at Mount Sinai to advance new therapies for patients with sinus, laryngotracheal airway and lung diseases. He was also the first to perform a successful jaw transplant using a donor jaw and the patient’s marrow.
Dr. Genden and team performing thyroid surgery at The Mount Sinai Hospital.
Dr. Genden, senior associate dean for Clinical Affairs, and professor of Neurosurgery and Immunology at Icahn Mount Sinai, has gained international recognition as a leader and innovator in the management of oropharyngeal cancers and microvascular reconstruction of the head and neck. He is also director of Mount Sinai’s Head and Neck Institute-Center of Excellence for Head and Neck Cancer, building a surgical team that treats more head and neck oncology patients than any other hospital system in New York. The Mount Sinai Hospital is nationally ranked for Ear, Nose and Throat by “U.S. News and World Report®.” Dr. Genden says these achievements reflect both his and Mount Sinai’s commitment to innovation.
“This is a place where people are interested in pushing the boundaries of what is possible,” he says. “That culture feeds on itself, because it attracts others who want to be progressive in solving problems instead of doing business as usual.”
Under Dr. Genden’s leadership, the department has developed signature initiatives, all centered on advancing patient care:
Pioneering Transoral Robotic Surgery
Dr. Genden performed the first transoral robotic surgery (TORS) in New York in 2008. Since then, Mount Sinai has built its pioneering TORS program into the largest in the country. This minimally invasive procedure allows surgeons to remove tumors and any affected lymph nodes through the mouth, precisely targeting tumors in the back of the throat, tonsils and base of the tongue. Patients who undergo TORS recover faster, spend less time in the hospital and have better cosmetic and functional outcomes. They are also more likely to retain speech and swallowing functions than with open surgery.
“In the past, these tumors presented a significant challenge to reach, and traditionally were removed by surgeons through a large facial incision,” Dr. Genden notes. “However, the advent of robotic technology brought about a paradigm shift in the removal of tumors and the benefits it delivers to patients.”
Developing the “Liquid Biopsy”
Faced with patients who present with telltale signs of human papillomavirus (HPV) associated head and neck cancer, Mount Sinai is using a new technology, “liquid biopsy,” for diagnosis and treatment, in addition to standard tools. This blood assay—which Mount Sinai has been testing since 2020 with its developer, Naveris—can detect circulating tumor tissue-modified viral HPV DNA. “With a simple blood draw, we can confirm our suspicions of HPV-associated disease, which is invaluable given the current HPV epidemic we are experiencing,” Dr. Genden says.
The tool also helps physicians make more informed treatment decisions. “In some cases, we can spare patients radiation or chemotherapy after robotic surgery based on the liquid biopsy results we see, putting that in our back pocket for when we really need it,” he explains. “That ability to treat patients based on the presence of disease and not a protocol has changed what we can do for them in a dramatic way.”
Leading Treatment of HPV-Associated Throat Cancer
Cases of oral and oropharyngeal (back of the throat, base of the tongue, tonsils and soft palate) cancer have been rising nationwide, especially among men ages 35 to 55. Traditionally, most cases of oral cancer stemmed from smoking and drinking. Today, about 70 percent of these cancer cases are caused by HPV. Mount Sinai treats more HPV-associated oral and oropharyngeal cancers than any other facility in New York City, with an outstanding 85 percent cure rate.
Dr. Genden and his team are looking at the potential of using artificial intelligence to reach an even higher rate by identifying mutations in tumors that could be targeted with therapies, as well as gaining more insight into which patients are more likely to respond to particular treatments. They are also exploring the role of the microbiome in the development of cancer to see whether changes in nutrition could reduce the risk of this disease.
Dr. Genden is a pioneer in transoral robotic surgery,
a minimally invasive approach that allows patients
to recover faster and have better functional and cosmetic outcomes.
Dr. Genden almost forged a different path in his life. He first enrolled at Columbia University, where he majored in economics with plans to become an economist, until a biology course inspired second thoughts. “I did not do particularly well in that course,” he admits. “But I was fascinated by it, so I had a decision to make, ‘Do I pursue something I love, even if it is more challenging, or do I pursue something that comes easily to me?’ Ultimately, I chose my passion.”
After enrolling at Rockefeller University to earn a Ph.D. in molecular biology, he realized that while he enjoyed research, he was motivated to care for patients and joined what was then the Mount Sinai School of Medicine.
Following a head and neck residency at Washington University and Barnes-Jewish Hospital, Dr. Genden returned to Mount Sinai for a fellowship in head and neck oncology and microvascular reconstructive surgery and has remained at Mount Sinai ever since, rising to chair of his department in 2004. Today, he leads a dedicated faculty that is preparing a new generation to approach oral cancer in creative ways. This includes an innovative program that will weave together surgical and research training. “We want to develop surgeon-scientists who are dedicated to researching innovative approaches to disease and transferring these innovations to patient care,” he explains. “That ability to move between those two realms is how you push care forward.”
“If you find what you love, you will love what you do,” Dr. Genden says. “That is the guiding light. And when you do that, you will see great accomplishments.”
To learn more, go to www.mountsinai.org/headandneck, the Head and Neck Institute-Center of Excellence.
To make an appointment, call 212-241-9410. For physicians referring patients, call 800-TO-SINAI.
