A/Prof Richard Gallagher OAM

Hi Richard Gallagher’s my name and I’m a head and neck surgeon at St Vincent’s Hospital where I have been working since 1998. My practice is located at St Vincent’s Private Hospital, and I also work at The Kinghorn Cancer Centre where I currently hold the position of Chair, St Vincent’s Head & Neck Cancer Multidisciplinary Team (MDT). My research and investigation into clinical trials is also performed at The Kinghorn Cancer Centre.

I finished my surgical training in 1995 and following that I did further training in head and neck cancer surgery. At the present time my practice is mainly looking after patients with cancer and head and neck cancer and looking after patients with complex airway problems. In 2011 I went and did further training in the United States in Philadelphia at the University of Pennsylvania in transoral robotic surgery. So that surgery’s used mainly for patients who have cancers at the back of the throat and oropharynx and is particularly useful for patients who have cancers due to the human papillomavirus or HPV. So that’s a large number of patients at the present time. On the campus I am the Director of the Head and Neck Cancer Service at St Vincent’s.

Mission

My mission is to challenge the status quo of treatment of patients with head and neck cancer and complex airway disease. My vision is for a health system which provides world class care to both private and public patients regardless of whether they live in urban or regional parts of Australia. My strategy is build the most measurably robust Head and Neck Cancer Service in NSW which focusses beyond short term treatment outcomes to long term quality of life for patients and their loved ones. This requires a commitment to patient care, clinical excellence, research and clinical trials, and raising awareness of the HPV related oropharyngeal cancer epidemic.

Why the Head and Neck?

Head and neck surgery has always been my passion. To me the head and neck make up the most complex and beautiful anatomy in the human body. Head and neck disease can be incredibly confronting because it can affect our most basic functions – how we breathe, how we talk, how we eat and drink, and how we look. When I did my training it was the men and women coping with treatment for advanced head and neck disease who stayed in my memory.

Surgeon and Advocate

I call myself a head and neck oncologist because not all my patients require surgery. I am hugely proud to be part of the fantastic head and neck multidisciplinary team (MDT) which I chair at St Vincent’s. Our Head and Neck MDT has been running since the 1950s and is attended by a range of experts in surgery, radiotherapy, chemotherapy as well as our dentists, dietitians, speech pathologists, social worker, cancer care coordinators, and nurses.

One of the most rewarding surgeries I perform is complex airway surgery in adults. I am regularly referred patients with severe narrowing of the larynx and trachea (subglottic and tracheal stenosis). These require both endoscopic and open surgical management. To date I have performed over 150 cricotracheal resections for subglottic stenosis. The results for patients are life changing.

Head and neck cancer patients can have fantastic outcomes if they are treated early and in high volume centres. I am hugely frustrated when patients come to me with advanced disease or have been poorly managed. Sometimes all I can do is perform salvage surgery which buys time but at enormous cost to how patients look, talk, and swallow. Raising awareness of head and neck disease is what led me to taking on the role of Director of Cancer Services of St Vincent’s Health Network in 2015.

Apart from poor awareness, head and neck disease also faces the challenge of the emerging epidemic of human papillomavirus (HPV) oropharyngeal cancers. These are viral related cancers not due to smoking or drinking alcohol. They involve the lymphoid tissue of the tonsils and tongue base. The good news is that most HPV oropharyngeal cancers respond well to treatment and we are seeing excellent long term outcomes where patients are completely cured of cancer.