Consequences of mucositis-induced treatment breaks and dose reductions on head and neck cancer treatment outcomes

12/4/2007 Houston, TX DI Rosenthal J Support Oncol, October 1, 2007; 5(9 Suppl 4): 23-31 Patients with head and neck cancer (HNC) receiving radiation therapy (RT) alone or with concurrent chemotherapy (CRT) often develop mucositis that may lead to unplanned treatment interruptions and/or chemotherapy dose reductions. Some RT schedules have included planned treatment breaks to allow normal tissues to recover from these toxicities. These decreases in treatment intensity, however, may reduce rates of locoregional tumor control and survival. Any treatment gaps allow for tumor repopulation, which may also promote regrowth of chemotherapy-resistant populations. Therefore, any potential benefits of high-intensity therapy may be lost due to interruptions in RT or reduced chemotherapy dose intensity, unless the treatment intensity is sufficient to offset interval tumor repopulation. Most patients undergoing RT alone and virtually all undergoing CRT--particularly those with HNC--will develop mucositis, which doubles the risk of reduction in treatment intensity and can increase the rate of hospitalization and the use of feeding tubes or total parenteral nutrition. Many of these patients with severe mucositis will require a break in treatment or change in administration schedule to alleviate symptoms. Effective prophylaxis or treatment could reduce the probability of treatment breaks and dose reductions and thus improve outcomes. Author's affiliation: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 0097, Houston, TX 77030, USA

2009-04-16T09:39:42-07:00December, 2007|Archive|

UVA Program Improves Health Of Cancer Patients

12/3/2007 Charlottesville, VA Cheryn Stone 19News (www.charlottesvillenewsplex.tv) A program through the UVa Cancer Center is saving patients money and making a big difference in their health. Doctors are giving away free nutritional supplements to patients. Doctors say this can really decrease weight loss, and it's getting patients the calories that are critical to their health. Through surgeries, radiation, and chemo, weight loss can be a big problem for patients fighting cancer. Dr. Paul Read with UVa Radiation Oncology says, "there's a lot of quality of life data that says if cancer patients lose weight that's a very good sign that a they are not going to feel well, they're not going to feel fit, and they may not be able to tolerate these treatments we put them through." Nutritional supplements can help the patients get through it. Dr. Read adds, "there's also data that suggest that if patients don't lose weight and they can get through their treatments as we initially prescribe them, we'll have a better chance of curing them." So now doctors at the UVa Cancer keep cases of Ensure on hand to hand out to patients. "We saw a real need to help many of our patients who are having nutritional problems get through their treatments by supplying them with nutrition in our clinic," Dr. Read says. Three years and 2,500 cases of Ensure later, UVa doctors have given out 21 million calories so far. Doctors say sometimes drinks like these are all patients can drink for [...]

2009-04-16T09:39:13-07:00December, 2007|Archive|

Iditarod winner and cancer survivor

12/3/2007 web-based article staff google-sina.com Lance Mackey beat cancer back in 2001 and on Tuesday he won the Iditarod Trail Sled Dog Race in Nome, Alaska. Mackey was diagnosed with neck cancer in 2001 and received surgery and radiation for his treatment. Lance owns a kennel named Lance Mackey’s Comeback Kennel. He indeed made a comeback, he has back to back wins in the Iditarod Trail Sled Dog Race and the Yukon Quest International Sled Dog Race. Mackey’s status as a cancer survivor and champion musher will inspire other people with cancer, said Christine Schultz, 42, of Nome, a medical social worker who stood out in subzero temperatures with co-workers from Norton Sound Regional Hospital to watch Mackey cross the finish line. “I think it gives people hope they can overcome cancer and live their dreams,” she said. Don’t ever doubt I can’t do something,” Mackey said in Nome after his win. “I lived through cancer.” OCF Note: This is a news story that we picked up off the general newswires. We put it here to show other cancer patients that even after a battle with this disease, that life can be more than survival, it can be good and that they can return to a full life. It is about cancer, not about the Iditarod. We have been contacted by advocates for the dogs used in these races, detailing the hard and sometimes harsh life, and sometimes even cruel manner in which they are treated. We are not endorsing [...]

2009-04-16T09:38:52-07:00December, 2007|Archive|

Lack of Association of Alcohol and Tobacco with HPV16-Associated Head and Neck Cancer

12/2/2007 web-based article Katie M Applebaum et al. J Natl Cancer Inst, November 27, 2007 Background: Human papillomavirus type 16 (HPV16) seropositivity and alcohol and tobacco use have been associated with risk of head and neck squamous cell carcinoma (HNSCC). However, it is less clear whether HPV16 influences HNSCC risk associated with alcohol and tobacco use. Methods: Incident cases of HNSCC diagnosed between December 1999 and December 2003 were identified from nine medical facilities in Greater Boston, MA. Control subjects were frequency matched to case subjects on age, sex, and town of residence. A total of 485 case subjects and 549 control subjects reported information on lifetime smoking and alcohol consumption and provided sera, which was used to determine presence of HPV16 antibodies. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of HNSCC risk by alcohol consumption (drinks per week: <3, 3 to <8, 8 to <25, >/=25) and smoking (pack-years: none, >0 to <20, 20 to <45, >/=45), adjusting for age, sex, race, education, and HPV16 serology. Polytomous logistic regression was used to estimate odds ratios and 95% confidence intervals for the association of HPV16 serology, alcohol consumption, and tobacco use in site-specific analyses. All statistical tests were two-sided. Results: The strongest risk factors by tumor site were smoking for laryngeal cancer, alcohol for cancer of the oral cavity, and HPV16 for pharyngeal cancer. For pharyngeal cancer, risk increased with increasing alcohol consumption (OR(>/=25 versus <3 drinks per week) = 5.1, 95% [...]

2009-04-16T09:37:57-07:00December, 2007|Archive|

A Survey of the Current Approaches to Diagnosis and Management of Oral Premalignant Lesions

12/2/2007 web-based article Joel B. Epstein et al. J Am Dent Assoc, Vol 138, No 12, 1555-1562. Background: Early diagnosis of oral premalignant lesions (OPLs) and oral squamous cell carcinoma facilitates treatment with less aggressive approaches and results in a better prognosis. The authors conducted a study to identify current practices in the diagnosis and management of these oral lesions by oral medicine professionals. Methods: The authors sent a questionnaire to 176 diplomates of the American Board of Oral Medicine and asked them to complete the questionnaires and return them by mail. Results: The initial clinical approach taken by most of the responders included visual examination, elimination of possible local causes and two-week follow-up. Adjuvant clinical tests included toluidine blue, oral brush biopsy and exfoliative cytology. If there was no clinical improvement after two weeks, most responders recommended that a biopsy be performed. Induration, red component, nonhomogeneous surface and ulceration were characteristics of lesions that increased the responders’ decisions to perform a biopsy. Lesion symptoms and location also contributed to their decisions to perform a biopsy. Follow-up more frequently than twice a year was recommended for red lesions, lesions with histologically confirmed dysplasia or both. Most clinicians recommend a biopsy during follow-up of an OPL whenever the lesion changes in appearance. Conclusions: The findings of this survey may provide background for initial guidelines to be used by oral practitioners to diagnose and manage OPL. Clinicians’ awareness of the complexity of OPL diagnosis and management is important, and referral to an [...]

2009-04-16T09:37:34-07:00December, 2007|Archive|

New Radiation Treatment is Better for Throat Cancer Patients, Research Shows

12/1/2007 Denver, CO Regina Sass People'sMediaCompany (www.associatedcontent.com) Researchers at the University of Iowa Department of Radiation Oncology and Department of Otolaryngology - Head and Neck Surgery are recommending new, intensity-modulated radiation therapy for treating a variety of throat cancers, saying that it can improve the patient's quality of life better than the conventional radiation therapy. Oropharyngeal - throat - cancer, originates in the part of the throat - oropharynx.- just after the mouth. It can also be in the tonsils and th back of the tongue. Squamous cell carcinomas, which originate in from the cells that make up the lining of the mouth and throat make up in excess of 90% of oropharyngeal cancers. Lately, the cancer has been occurring in a growing number of younger patients as well as in nonsmokers The aim of the study was to get a comparison of the health related quality of life in the patients who were treated with the conventional CRT and the new IMRT. With the CRT, two or three beams of radiation are aimed at the tumor, but the surrounding tissues and organs such as the oral cavity and salivary glands, receive that same high dose as the tumor. In some of the patients, the salivary glands are totally destroyed and patients can also develop severe dryness in the mouth and a poor quality of life. On the other hand, the IMRT uses multiple radiation beams and they are broken down into what they call beamlets. This gives the radiation [...]

2009-04-16T09:37:06-07:00December, 2007|Archive|

As cigarette sales dip, new products raise concerns

12/1/2007 web-based article Wendy Koch USA Today (www.usatoday.com) The Marlboro Man, that cigarette-smoking icon of the tobacco industry, is more than a half-century old. If he were conceived today, there might not be just a cigarette dangling from his mouth. He might also have, tucked into his pocket, a cellphone-size container holding a dozen pouches of snus Snus? It rhymes with "goose," (cynics might say "noose"), and is a Swedish type of smokeless tobacco that's not your grandfather's dip or chew. Snus comes in teabag-like pouches that a user sticks between the upper lip and gum, leaves there for up to 30 minutes and discards without spitting. As no-smoking laws sweep the nation and cigarette sales continue to fall, Big Tobacco is alarming the public health community by devising other ways to try to make tobacco appealing. With smokeless products representing the only booming part of the U.S. tobacco market, snus is an effort to boost sales with a product that — unlike most smokeless ones — doesn't require users to spit out the residue. Snus also represents something more: an attempt to move smokeless tobacco beyond stereotypical users such as baseball players and rodeo cowboys, and into offices or restaurants where people want a nicotine fix but can't light up. "This is a growth strategy for us," says Bill Phelps, spokesman for Philip Morris USA, the nation's biggest tobacco company and maker of Marlboro, the top-selling cigarette. In Dallas this month, Philip Morris is launching its first smokeless product [...]

2009-04-16T09:36:39-07:00December, 2007|Archive|
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