Monthly Archives: March 2014

After-effects of oral cancer surgery forces patients into unemployment and depression

Source: economicvoice.com
Author: Economic Voice Staff
 

Cancer Patients are being forced into unemployment due to the after-effects of surgery and higher levels of depression.

Research into head and neck cancer patients discovered the rate of those employed fell by more than 40 per cent five years after diagnosis, where only one in three managed to secure work. They also reported unemployed cancer survivors had lower social well-being and higher depression scores

For those cancer sufferers out of work prior to diagnosis, their reasons for not returning to work also included the knock-on effect of surgery as well as dangerous levels of alcohol consumption.

Figures from Cancer Research UK reveal more than 331,000 people were diagnosed with cancer in 2011 – around 910 every day. According to mouth cancer campaigners, the problems are exacerbated for mouth cancer patients.

Previous research identified mouth cancer survivors face a diminished quality of life. Survivors reported poor oral function, resulting in persistent eating problems and long term depression. More than half of respondents (51.6 per cent) reported problems with eating, while on average one in four survivors who lived for five or more years still experienced speech problems.

It was a similar story when it came to a patient’s physical and mental health, with more than a third (36.7 per cent and 39.3 per cent respectively) recording low functionality after the five year analysis.

According to Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, the study highlights the problems mouth cancer sufferers face on a daily basis.

Dr Carter said: “The results of the study show the scale of the problems cancer patients have to live with. For mouth cancer patients, the corrective surgery required to remove cancerous cells often leaves physical and emotional scars that can take years to heal.

While all cancer patients require a great deal of care, those recovering from mouth cancer clearly suffer from the after-effects of surgery, both physically and mentally. It can take a prolonged period of time to eat solid foods, learn to speak again, swallow without feeling discomfort and even breathe properly. In some cases, mouth cancer patients will experience these for the rest of their lives.

That is why early detection of this disease is so important. Most people with mouth cancer present late as stage 4 – the most advanced stage where time is of the essence in potentially saving a life and reducing the need for invasive surgery.

Warning signs for the disease include ulcers that do not heal within three weeks, red and white patches in the mouth and unusual lumps or swellings. If you spot any of these, or are unsure if it’s something normal or otherwise, our advice is crystal clear – if in doubt, get checked out.”

The research identified 55 head and neck cancer patients under the age of 60 who had survived more than two years. Each patient completed a survey including subscales from the Functional Assessment of Cancer Therapy (FACT) instrument, the Miller Behavioural Style Scale, the General Perceived Self-Efficacy Scale, the Patient Health Questionnaire-9 (PHQ-9) and the Hornheider Fragebogen-short version measuring need for psychological interventions.

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

March, 2014|Oral Cancer News|

Jim Kelly’s toughest game: Fighting oral cancer

Source: www.foxnews.com
Author: Dr. Manny Alvarez

Jim Kelly, the Hall of Fame quarterback who played for the Buffalo Bills until 1996, is one of the greatest football players that I have ever seen. During his football career, I followed him closely and was always in awe of his athletic abilities, his leadership qualities and his love of family.

Unfortunately, Jim Kelly is currently battling a second recurrence of oral cancer and has been scheduled to undergo surgery in an attempt to control the disease. His wife, Jill, told the Associated Press that her 54-year-old husband’s cancer is aggressive and beginning to spread.

I’ve been following Jim Kelly’s health struggles and have been thinking about him, praying that he gets better. It is easy to think of some humans as immortal – especially when you’re looking at an individual as physically fit as Jim Kelly. But we tend to forget that sometimes nature has a unique plan for all of us.

However, Jim Kelly’s struggles can serve as a reminder for us all to be vigilant about our health. Jim Kelly is suffering from oral cancer, which doesn’t get the attention that it deserves, despite the fact that 42,000 new cases will be diagnosed in 2014, according to the National Cancer Institute.

Oral cancers are any cancers occurring in the oral cavity, which starts in your throat and extends all the way to your lips. The sad part about this disease is that oral cancers are typically not identified early, which severely reduces survival rates.

The early signs of oral cancer are often missed because lesions are small, painless and often not irritating – especially in tongue cancers or cancers of the gums. But, as the cancer grows, these lesions become ulcerated, causing burning and severe tenderness in the affected areas. Because of the vascular nature of the mouth and throat, many of these cancers tend to metastasize, making matters much worse.

Some risk factors for oral cancer include tobacco use, excessive alcohol consumption and exposure to some strains of the humanpapilloma virus (HPV). HPV has also been linked to cervical cancers in women.

One very important fact to know about oral cancer is that diagnoses of the disease have increased every year for the past five years, according to The Oral Cancer Foundation. That is why it’s so important for people to schedule regular appointments with their dentist – and to make sure they get examined for signs of oral cancer.

If you catch oral cancers early, the survival rate can be over 80 percent. Treatments for oral cancer often include surgery, in addition to radiation and chemotherapy. Yet, once the tumor has metastasized, it can be very challenging for doctors to control or remove it.

Please join me in wishing Jim Kelly all our love and support, and keep his family in our hearts.

March, 2014|Oral Cancer News|

Beaumont Researchers: biomarkers predict effectiveness of radiation treatments for head and neck cancer

Source: www.healthcanal.com
Author: staff

An international team of researchers, led by Beaumont Health System’s Jan Akervall, M.D., Ph.D., looked at biomarkers to determine the effectiveness of radiation treatments for patients with squamous cell cancer of the head and neck. They identified two markers that were good at predicting a patient’s resistance to radiation therapy. Their findings were published in the February issue of the European Journal of Cancer.

Explains Dr. Akervall, co-director, Head and Neck Cancer Multidisciplinary Clinic, Beaumont Hospital, Royal Oak, and clinical director of Beaumont’s BioBank, “Radiation therapy is a common treatment for people with squamous cell cancer of the head and neck. However, it’s not always well-tolerated. It can take two months, resulting in lots of side effects. Some of these complications are permanent. Before my patient goes down that path, I really want to know if their tumors are going to respond to radiation. That’s where the patient’s biomarkers can shed some light. If not, we can look at other treatment options – saving time, possible risk for complications and expense.”

A biomarker is a gene or a set of genes or its products, RNA and proteins, that researchers use to predict a key clinical issue such as diagnosis, prognosis, and response to treatment, choice of treatment or recurrence. Biomarker studies can provide a bridge between emerging molecular information and clinical treatment. Biomarkers may also lead to personalized treatment, in contrast to protocol-based medicine of today.

“Personalized treatment decisions based on biomarkers go beyond traditional cancer staging classifications. Individualized treatment plans could reduce morbidity and potentially improve survival by avoiding treatment failures,” says Dr. Akervall. “There is reason to believe that a better understanding of the biological properties of these tumors, as measured in the patient’s pre-treatment biopsies, may lead us to predict the response to radiation therapy and concurrent chemoradiation, thus allowing for tailored patient-specific treatment strategies.”

The study followed two groups of patients. In the first group, researchers screened 18,000 genes and identified five distinct markers. The second group was larger and confirmed these findings and two of them in particular. Two markers were good at predicting whether or not radiation-based therapy would be effective.

Adds Dr. Akervall, “While our findings are encouraging, and a step toward personalized medicine, we hope to do more of this research with a larger, randomized trial.”

According to the National Cancer Institute, most cancers of the head and neck usually begin in the squamous cells that line the moist surfaces of the mouth, nose and throat. Three risk factors identified with squamous cell carcinomas of the head and neck include – tobacco and alcohol use, as well as infection with cancer-causing types of human papillomavirus or HPV.

The team was comprised of researchers from University Hospital in Lund, Sweden; Van Andel Institute in Grand Rapids; and Beaumont Health System.

About Beaumont Research
BioBank, located within Beaumont’s Research Institute, is a center focused on developing innovative methods for early detection of disease and personalized treatment plans through leading edge analysis techniques and state-of-the-art technologies. Biomarkers from tissue, blood or fluids, are used to develop the next generation of care management, taking it from bench to bedside.

The Beaumont Research Institute has 1,100 active laboratory and clinical studies involving 82,000 patients that are funded by government, foundation and commercial grants. The Research Institute has an annual operating budget of $33.8 million.

March, 2014|Oral Cancer News|

Anti-seizure medications prevent cancer

Source: guardianlv.com
Author: Lindsey Alexander

A recent report came out from the journal Cancer indicating a new finding that anti-seizure medications might prevent some forms of cancer. Drugs like valporic acid (Depakote), are one form of prescription in this classification. Though also used as a mood-stabilizer, Depakote can prevent seizures from occurring, and has been investigated for cancer prevention.

These particular anti-seizure medications have been found to inhibit genetic changes that lead to cancer of the head and neck. The study included nearly 440,000 veterans, including 27,000 who were taking valporic acid for various disorders including post-traumatic stress disorder, bipolar disorder, seizures, and migraines. The overall findings suggested that veterans who were on the prescription were 34 percent less likely to develop cancers of the head and neck, than those who were not taking the drug.

The risk decreased in those subjects who took higher doses or for longer periods of time.

Dr. Johann Brandes with Atlanta Veterans Affairs Medical Center was the team leader of this study. He claims that this 34 percent statistic means 16,000 new cases, and between 3,000 and 4,000 cancer deaths can be prevented every year. Though there is a strong association, the study did not form a direct cause-and-effect relationship between cancer prevention and anti-seizure medications.

The National Cancer Institute describes cancers of the neck and head as usually squamous cell cancers that line mucosal surfaces inside the head and neck. This can affect the mouth, the throat, and the nose. This is a carcinoma that can begin in the salivary glands, and can contain many different types of cells that can in turn also become cancerous.

Valporic acid was found not to have any impact on lung, bladder, prostate, or colon cancers.

The Mayo Clinic currently says there is no proven way to prevent throat cancer. A person can restrict the amount of alcohol consumed, avoid smoking, chose a healthy diet to stick to (which includes plentiful amounts of fruits and vegetables), and protect against the human papilloma virus (HPV). Even though the HPV vaccine is recommended by the Mayo Clinic, other sources warn against the shot.

Christina England from Vactruth claims 140 people as of 2013 were lost due to the HPV vaccine, commonly referred to as Gardasil. Statistics from the Vaccine Adverse Event Reporting System (VAERS) listed many more side-effects than deaths, however. In 2013, the VAERS recorded nearly 1,000 people physically disabled, 10,000 people made a visit to the ER, and 3,000 were hospitalized among many others severe, and sometimes life-threatening side-effects.

The American Academy of Otolaryngology mentions three people in history who suffered from either oral, head, or neck cancer.

Babe Ruth, born in 1895, played for the National Baseball League and held a record of 60 home runs in one season. He was diagnosed just before retirement with nasopharyngeal carcinoma, which metastasized and later killed him.

Ulysses S. Grant was a Civil War leader and the 18th President of the United States. He came down with a cancer of the right tonsillar pillar, which was at the base of the tongue. This was referred to as a malignant squamous epithelioma. His death was referred to a slow and painful illness.

Today, however, he could have been treated and perhaps saved with inventions such as the aspiration pump, radiotherapy, surgery, and even a tracheotomy.

Sigmund Freud was also a victim of cancer. Freud was an Austrian psychoanalytic psychologist. He suffered from multiple health disorders and smoked heavily. He had cancer in the jaw, and was diagnosed at the age of 67. Treatment continued for 16 years, and he underwent many surgeries–one of which included the merging of the nasal cavity and the mouth. He died in 1939 from heart failure, cancer, and morphine overdose.

Researchers in medicine are discovering new ways of preventing cancer, and treating cancer, ranging many disciplines. Recent findings suggest future studies are necessary to determine a more substantial link between cancer prevention and anti-seizure medications. However, people are now able to consider yet another preventative measure that might prove helpful.

March, 2014|Oral Cancer News|

Archaeologists discover human remains that provide earliest complete example of a human with cancer

Source : Durham University
Author: Staff & Students

 

Archaeologists have found the oldest complete example in the world of a human with metastatic cancer in a 3,000 year-old skeleton.

The findings are reported in the academic journal PLOS ONE today (17 March).

The skeleton of the young adult male was found by a Durham University PhD student in a tomb in modern Sudan in 2013 and dates back to 1200BC.

Analysis has revealed evidence of metastatic carcinoma, cancer which has spread to other parts of the body from where it started, from a malignant soft-tissue tumour spread across large areas of the body, making it the oldest convincing complete example of metastatic cancer in the archaeological record.

The researchers from Durham University and the British Museum say the discovery will help to explore underlying causes of cancer in ancient populations and provide insights into the evolution of cancer in the past. Ancient DNA analysis of skeletons and mummies with evidence of cancer can be used to detect mutations in specific genes that are known to be associated with particular types of cancer.

Even though cancer is one of the world’s leading causes of death today, it remains almost absent from the archaeological record compared to other pathological conditions, giving rise to the conclusion that the disease is mainly a product of modern living and increased longevity. These findings suggest that cancer is not only a modern disease but was already present in the Nile Valley in ancient times.

Lead author, Michaela Binder, a PhD student in the Department of Archaeology at Durham University, excavated and examined the skeleton. She said: “Very little is known about the antiquity, epidemiology and evolution of cancer in past human populations apart from some textual references and a small number of skeletons with signs of cancer.

“Insights gained from archaeological human remains like these can really help us to understand the evolution and history of modern diseases.

“Our analysis showed that the shape of the small lesions on the bones can only have been caused by a soft tissue cancer even though the exact origin is impossible to determine through the bones alone.”

The skeleton is of an adult male estimated to be between 25-35 years old when he died and was found at the archaeological site of Amara West in northern Sudan, situated on the Nile, 750km downstream of the country’s modern capital Khartoum. It was buried extended on his back, within a badly deteriorated painted wooden coffin, and provided with a glazed faience amulet as a grave good.

Previously, there has only been one convincing, and two tentative, examples of metastatic cancer predating the 1st millennium BC reported in human remains. However, because the remains derived from early 20th century excavations, only the skulls were retained, thus making a full re-analysis of each skeleton, to generate differential (possible) diagnoses, impossible.

Co-author, Dr Neal Spencer from the Department of Ancient Egypt and Sudan at the British Museum, said: “From footprints left on wet mud floors, to the healed fractures of many ancient inhabitants, Amara West offers a unique insight into what it was like to live there – and die – in Egyptian-ruled Upper Nubia 3200 years ago.”

The skeleton was examined by experts at Durham University and the British Museum using radiography and a scanning electron microscope (SEM) which resulted in clear imaging of the lesions on the bones. It showed cancer metastases on the collar bones, shoulder blades, upper arms, vertebrae, ribs, pelvis and thigh bones.

The cause of the cancer can only be speculative but the researchers say it could be as a result of environmental carcinogens such as smoke from wood fires, through genetic factors, or from infectious diseases such as schistosomiasis which is caused by parasites.

They say that an underlying schistosomiasis infection seems a plausible explanation for the cancer in this individual as the disease had plagued inhabitants of Egypt and Nubia since at least 1500BC, and is now recognised as a cause of bladder cancer and breast cancer in men.

Michaela Binder added: “Through taking an evolutionary approach to cancer, information from ancient human remains may prove a vital element in finding ways to address one of the world’s major health problems.”

The tomb, where the skeleton was found, appears to have been used for high-status individuals from the town, but not the ruling elite, based on the tomb architecture and aspects of funerary ritual.

The tomb’s architecture is evidence of a hybrid culture blending Pharaonic elements (burial goods, painted coffins) with Nubian culture (a low mound to mark the tomb).

The well preserved pottery recovered from the tomb provides a date within the 20th Dynasty (1187-1064BC), a period when Egypt ruled Upper Nubia, endured conflicts with Libya and while pharaohs such as Ramses III were being buried in the Valley of the Kings.

The research was funded by the Leverhulme Trust and the Institute of Bioarchaeology Amara West Field School, with the permission of the National Corporation of Antiquities and Museums in Sudan.

 

 *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

March, 2014|Oral Cancer News|

Unilateral radiation benefited patients with advanced tonsil cancer

Source: www.healio.com
Author: staff

Unilateral radiotherapy was associated with effective regional control in patients with advanced tonsil cancer, according to study results presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium. Additionally, the results supported previous findings that suggest the primary tumor location, not the extent of ipsilateral neck lymph node involvement on the tumor side of the neck, governs the disease risk in the contralateral side of the neck.

Researchers evaluated 153 consecutive patients diagnosed with squamous cell carcinoma of the tonsil who were treated with surgical removal and postoperative intensity-modulated radiation therapy.

Forty-six of the patients underwent unilateral radiotherapy. Of these patients, 72% were male. The average patient age was 59 years. Current or former smokers comprised 61% of the study population.

Lateralized primary tumors were confirmed in 40 (87%) of the patients. Two (4%) patients had non-lateralized tumors. Lateralization could not be retrospectively ascertained in four patients (9%).

The cancer stages for these patients were distributed as follows: TX, 2%; T1, 44%; T2, 41%; and T3, 13%. Lymph node involvement stages were as follows: N0, 11%; N1, 13%; and N2, 76%.

The patients underwent radiation doses of 60 Gy to 66 Gy to the postoperative bed and involved neck, and 52 Gy to 54 Gy to the elective region in 30 to 33 fractions using a simultaneous integrated boost technique. Concurrent chemotherapy was administered to 30 of the 46 patients. The median follow-up period was 2.8 years (range, 0.4-8.7 years).

Researchers reported no local or regional recurrences. Four patients (9%) developed distant metastasis, and two developed second primary cancers.

The findings suggest that, for suitable patients, radiation volume can be safely reduced, sparing these patients adverse effects and potential toxicity, according to study investigator Wade Thorstad, MD, chief of head and neck cancer services and associate professor of radiation oncology at Washington University School of Medicine.

“All treatments for cancer — surgery, radiation therapy, chemotherapy — although effective, can cause temporary and/or permanent toxicity that can affect long-term quality of life,” Thorstad said in a press release. “Our research indicates that for appropriately selected patients with tonsil cancer, the volume of radiation therapy necessary to control the cancer can be significantly reduced, therefore reducing the side effects and toxicity of radiation while maintaining a high rate of tumor control.”

March, 2014|Oral Cancer News|

New study shows a rise in smokeless tobacco sales, especially among youth

Source: UMass Medical School Communications (http://www.umassmed.edu/news)
Author: Sandra Gray

 

The number of smokeless tobacco products sold in Massachusetts is soaring, as are the levels of nicotine packed into many of them, according to a new analysis from UMass Medical School and the Massachusetts Department of Public Health (DPH).

“Nationwide, cigarette smoking control has been very successful and we have experienced a steady decline, but that success is being offset by the increased use of smokeless tobacco products, especially by youth,” said UMMS statistical scientist Wenjun Li, PhD. Dr. Li, associate professor of medicine in the Division of Preventive and Behavioral Medicine, co-authored the paper with colleagues from the DPH.

Published in the journal Tobacco Control, the study examines ten years of product data (from 2003 to 2012) that Massachusetts law requires tobacco manufacturers provide to the DPH. Notable findings include a nearly 30 percent increase in the number of moist snuff products and a nearly sixfold increase in the number of snus products sold in Massachusetts; these increases correlate with rising use among high school students.

Nationwide, more than one in eight males in the 12th grade uses smokeless tobacco. In Massachusetts, use among high school students has more than doubled since 2001. A wide variety of smokeless tobacco products on the market include newer inventions like dissolvable lozenges, snus and moist snuff, many of them flavored and colorfully packaged to appeal to youth, along with more traditional forms used by adults including chewing tobacco and dry snuff.

Researchers were particularly interested in unionized, or free nicotine, the form that is most easily absorbed in the mouth. The amount of free nicotine and how it is delivered in both smokable and smokeless tobacco products is associated with a product’s addictive potential—and is determined by modifiable design features as well as the amount of nicotine contained naturally in the tobacco leaf.

They found that while nicotine levels varied, free nicotine increased for several manufacturers. Li and DPH lead author and research analyst Doris Cullen,MA, believe that these as-yet inexplicable variations in nicotine content support the argument that free nicotine levels are controlled in the manufacturing process, and suggests that manufacturers are manipulating products’ addictive potential.

“The current success in tobacco control is very likely undermined without government surveillance, regulation and widespread public disclosure of nicotine levels in these products,” said Cullen.

“Smokeless products are easier for youth to access and use than cigarettes, and harder for parents to monitor,” said Li. “Even though they have less nicotine than cigarettes, more of that nicotine is readily absorbed, making snus and moist snuff a gateway to nicotine addiction and, possibly, future smoking.”

While the study did not focus on smokeless tobacco marketing, he noted that packaging products to look like candy also suggests that the tobacco industry is specifically targeting youth.

“This study supports that the tobacco industry’s manipulation of product design extends to smokeless products,” said corresponding author Lois Keithly, PhD, director of the DPH’s Massachusetts Tobacco Cessation and Prevention Program. “Considering the potential risk for nicotine addiction associated with the use of smokeless tobacco products, and the aggressive marketing of these products, it is critical to continue and expand surveillance of smokeless products at the state and national levels.”

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy. 

March, 2014|Oral Cancer News|

Humidifying mouth, throat during radiotherapy cuts mucositis

Source: www.drbicuspid.com
Author: staff

Head and neck cancer (HNC) patients who received daily humidification of the mouth and throat during radiation therapy treatment spent nearly 50% fewer days hospitalized to manage their side effects, such as mucositis, according to research presented at the recent Multidisciplinary Head and Neck Cancer Symposium in Scottsdale, AZ.

Mucositis, inflammation and ulceration of the mouth and throat, is a painful side effect of radiation therapy that can negatively affect patients’ quality of life. Using humidification is based on the fact that moisturizing wounds generally helps them heal faster, according to the researchers.

The study by the Trans Tasman Radiation Oncology Group (TROG) evaluated 210 HNC patients in New Zealand and Australia from June 2007 to June 2011.

Patients in the phase III trial were randomized to institutional standard of care (control group) or humidification. The humidified air was delivered through the nose via a plastic interface (mask-type apparatus) that can be worn by patients while sleeping or sitting.

Patients began humidification on the first day of radiation therapy and continued until the ulceration in their mouth and throat had resolved. On average, humidification patients spent 57% as many days in the hospital to manage side effects, compared with the controls (control = 4.1 days, humidification = 2.3 days).

The humidifier group also resumed close-to-normal eating patterns at significantly higher rates three months after radiotherapy.

Only 43 patients (42%) of the patients in the humidification group met the defined benchmark of humidification compliance and were able to contribute to the per protocol analysis; the mean average use of humidification for these patients was 3.6 hours per day (range of use = 0 to 14 hours/day).

The functional mucositis score — based on clinician assessment of patients’ mucositis symptoms — was reduced among patients who met humidification compliance benchmarks. The proportion of compliant humidification patients who didn’t require a feeding tube also increased.

The results are encouraging because humidification was favored across clinician-reported outcomes, patient-reported outcomes, and independent data such as hospitalizations, the researchers noted.

The next step is to work at increasing the number of patients who use humidifiers effectively, they said.

Note:
The 2014 Multidisciplinary Head and Neck Cancer Symposium was sponsored by the American Society for Radiation Oncology (ASTRO), the American Society of Clinical Oncology (ASCO), and the American Head & Neck Society (AHNS).

March, 2014|Oral Cancer News|

App for cancer patients puts rehabilitation at their fingertips

Source: globalnews.ca
Author: staff

A new app will make therapy more accessible for survivors of head and neck cancers. Developed at the Misericordia hospital and the University of Alberta, the portable swallowing therapy unit will help patients with swallowing impairments complete their rehab in the comfort of their own home. Video available here.

The technology will help patients understand what their muscles are doing while they swallow. The app will take two years to develop and test, and the Alberta Cancer Foundation has agreed to fund it – $1.9 million over the next five years.

Dr. Jana Rieger, the lead researcher on the project, said it will give patients more independence in their rehabilitation, in contrast to traditional therapy. Traditional swallowing therapy requires patients come to the hospital three to four times a week to use the large rehabilitation equipment.

“What ends up happening is probably only about 10 per cent of patients who could benefit from this type of therapy actually come in and get it,” said Rieger.

“There’s lots of people out there living with swallowing disorders that we aren’t getting to as clinicians.”

The app is combined with an adhesive sensor under the jaw and a pendant that rests on the patient’s chest. The pendant speaks wirelessly to the app and it can send the patient’s data to health-care professionals anywhere in the province. The technology has a few settings that the patient can set to motivate them to complete the therapy.

“Things like progress bars, goal-setting, how many times a day you’ve practiced, how many swallows you’ve done, were your swallows today as good as the ones you did yesterday,” Reiger said

“The progress bar might tell them that you’re only at about 55 per cent so you need to try a little harder. Or maybe you need to hold the swallow for a little longer.”

Linda Neill, a mouth cancer survivor, thinks the app has a lot of potential.

“I think it would be super beneficial,” she said, highlighting the privacy provided by using the app.

The app is being funded through the Alberta Cancer Foundation.

March, 2014|Oral Cancer News|

Experimental EGFR inhibitor added nothing but rash

Source: www.oncologypractice.com
Author: Neil Osterweil, Oncology Report Digital Network

The addition of the experimental targeted agent zalutumumab to primary curative chemoradiation for head and neck cancers did not improve locoregional control, disease-specific survival, or overall survival at 3 years of follow-up.

The only thing that zalutumumab added to therapy was a skin rash in the large majority of patients who received it, reported Dr. Jens Overgaard, of the department of experimental clinical oncology at Aarhus University, Denmark.

Response to zalutumumab, a monoclonal antibody targeted to the epidermal growth factor receptor (EGFR), was not related to tumor human papillomavirus 16 (HPV/p16) status or to chemoradiotherapy, Dr. Overgaard reported at the Multidisciplinary Head and Neck Cancer Symposium.

The results of the DAHANCA 19 trial echo those of the RTOG (Radiation Oncology Therapy Group) trial 0522, which found no benefit from the addition of the EGFR inhibitor cetuximab (Erbitux) to accelerated cisplatin-based chemoradiotherapy, said Dr. Paul Harari, an invited discussant from the University of Wisconsin, Madison.

“Where I think we have a lot of unanswered questions is acknowledging how little we actually understand about EGFR biology, despite now 40 years of progressive knowledge,” Dr. Harari said.

“We’re now seeing very clearly in molecular and clinical correlate studies that the more we suppress the EGFR, the more we see collateral overexpression of additional RTKs [receptor tyrosine kinases], including members of the HER family, such as HER-3, that enable an escape mechanism for tumors that become resistant to EGFR inhibition,” he said.

Dr. Overgaard and his colleagues in the Danish Head and Neck Cancer Group conducted an open-label, phase III trial in which 619 patients with nonmetastatic squamous cell carcinomas of the larynx, oropharynx, hypopharynx, or oral cavity were randomly assigned to received 66-68 Gy of accelerated radiotherapy with or without zalutumumab 8 mg/kg weekly, with the first dose given a week before the start of radiation. The radiation was given concomitantly with the radiosensitizer nimorazole and, in patients with involved lymph nodes, cisplatin.

A total of 301 patients who received zalutumumab and 307 controls were included in the final intention-to-treat analysis.

At 3-year follow-up, there were no significant differences in either the primary endpoint of locoregional control (76% in zalutumumab-treated patients and 77% of controls) or in the secondary endpoints of disease-specific survival (82% and 85%, respectively) or overall survival (72% and 79%), Dr. Overgaard reported at the symposium, cosponsored by the American Society for Radiation Oncology and the American Society of Clinical Oncology.

Overall, patients who were positive for the HPV/p16 biomarker fared better than p16-negative patients, with an odds ratio for the probability of local control in negative patients of 0.52 (95% confidence interval, 0.36-0.73; P value not reported).

However, regardless of HPV 16 status, the addition of zalutumumab made no difference in the primary endpoint.

In a proportional hazard analysis, factors significantly associated with worse outcomes included worse World Health Organization performance status, higher disease stage, nodal involvement, and HPV/p16 negative status.

Although zalutumumab was generally well tolerated, 94% of patients who received it developed a rash, and of this group, 29% had grade 3 or 4 rash. In all, 11% of patients assigned to zalutumumab had to stop the drug because of rash.

Note:
The trial was sponsored by the Danish Head and Neck Cancer Group. Dr. Overgaard reported having no financial disclosures. Dr. Harari has received research funding from Amgen.

March, 2014|Oral Cancer News|