Head and neck surgeon-scientist: ‘We can make a real difference’

Xiao Zhao, M.D., Ph.D., isn’t exactly sure when it happened, but at some point in his fellowship, he started to realize that UT MD Anderson was different from other hospitals he had been at, both personally and professionally. Every time he spotted a patient or caregiver who looked a little lost, three or four employees would always swoop in and ask how they could help that patient or caregiver. No matter what else was going on, no matter what else those employees had been doing, they set it aside to help patients and family members, every time.

To Zhao, who now works here as a head and neck cancer surgeon and researcher, this was not only emblematic of the type of person who worked at UT MD Anderson but also the type of system those employees created. He knew the institution attracted people who both cared deeply about others and had the passion and knowledge to build infrastructure that allowed time to prioritize these moments.

Making the most of protected research time as a head and neck surgeon scientist

For a physician-scientist like Zhao, time is extremely important, and it’s something he feels is special about UT MD Anderson. Zhao is a member of the Physician-Scientist Training Program, an effort that provides new faculty members who both see patients and conduct research with guidance, funding and protection for 80% of their time for research.

“The Physician-Scientist Training Program is truly so unique to UT MD Anderson,” says Zhao. “Without it, I wouldn’t be able to pursue my latest research projects. As a result, my work is only possible here.”

Now, Zhao has been awarded an R01 grant for $2.25 million from the National Institutes of Health to research what early genetic changes lead to the transformation of precancerous cells into oral squamous cell carcinoma. Joining him in this effort is Peter Van Loo, Ph.D. Renowned for creating the computational tools necessary to understand how a tumor’s DNA has changed over time, Van Loo came from the UK to UT MD Anderson in 2023.

Together, they’ll map the timeline of how suspicious spots in the mouth, known as precancerous oral lesions, evolve into cancer. By understanding how genetic changes enable cell groups to compete and evolve during the earliest stages of oral cancer, the project aims to improve how doctors identify which spots are likely to turn into cancer and to develop better strategies to prevent cancer before it forms. Understanding what genetic changes happen will help them better understand which patients need more monitoring and treatment and which patients won’t actually develop cancer.

Innovating to catch oral cancer before it starts

About 70 million people around the world have an oral premalignant lesion, but not all of them will turn into cancer. It’s critical that doctors determine which ones have a high chance of turning into cancer so they can help those patients as quickly as possible.

Currently, doctors extract tissues using an invasive biopsy, and pathologists examine the tissue under a microscope to assess whether a lesion shows signs that it may progress to cancer. Because it relies on visual assessment of tissue, it does not capture the underlying molecular biology of the cells and can be prone to variations in interpretation. A process called genomic analysis has the potential to provide a deeper level of biological insight by offering additional information about cancer risk and disease progression.

However, genetic testing is not routinely done on premalignant lesions because it is labor-intensive, requires specialized expertise, and can be resource-intensive to implement.

Zhao is working to make that genomic testing less invasive and complicated. Zhao and his team are working to design a non-invasive brush that patients could swipe in their mouths with their primary health care providers. The brush would collect DNA, enabling accurate genomic risk assessment. The development of this groundbreaking brush will be funded by the American Cancer Society’s Accelerator Award, which Zhao received in early 2026.  

Zhao became a head and neck oncology surgeon because he loved helping patients and because he found the particular anatomy he studied so interesting.

“I liked that I could solve problems for patients,” he says.

But after a while, he grew tired of seeing so many patients with late-stage cancers. More than half of oral cancers are developed at a late stage, when they’re difficult to treat and require long and complicated surgeries with extensive reconstruction. They take a long time to recover from, and for some patients, the side effects are enduring.

Zhao has his sights set on finding more cancers earlier, when they’re easier to treat and patients don’t suffer nearly as many side effects.

“If we can catch it early,” he says, “we can make a real difference.”

Learn about research careers at UT MD Anderson.