Chemotherapy and radiation therapy issues: What audiologists need to know

Source: journals.lww.com Author: A. Croutch, Carl AuD With hearing loss, tinnitus, and imbalance as among the numerous side-effects of cancer treatment,1 audiologists play a critical role in monitoring patients receiving chemotherapy and radiation therapy. Sensorineural hearing loss (SNHL) attributed to chemotherapy and radiation therapy is usually permanent, making audiometric monitoring essential to detect its early occurrence.2 Cisplatin, carboplatin & radiation therapy Chemotherapy is used to treat cancer, control the growth and spread of cancer cells, and ease cancer symptoms. Cisplatin and carboplatin are two common antineoplastic agents used to treat testicular, ovarian, breast, esophageal, lung, and head and neck cancers among others. Besides hearing loss, these can cause other side effects including kidney, gastrointestinal disorders, allergic reactions, decreased immunity to infections, and hemorrhaging. Cisplatin was first found to have cytotoxic properties in the 1960s, and in 1978 was the first platinum compound approved by the FDA for cancer treatment.3 On the other hand, carboplatin is less potent than cisplatin and does have fewer side effects, especially on kidney problems.3 Both drugs work by interfering with DNA repair mechanisms causing DNA damage and inducing apoptosis in cancer cells. Cancerous cells cannot limit cell division as do normal cells. Normal cells cease dividing when they encounter similar cells whereas cancerous cells do not. The effectiveness of chemotherapy is determined by its ability to damage the RNA or DNA that gives the cell instructions to copy itself. The cells will die if they are unable to divide. The more quickly they are dividing, [...]

2021-09-09T06:48:49-07:00September, 2021|Oral Cancer News|

New cancer treatments may be on the horizon – thanks to success in mRNA vaccine trial

Source: www.goodnewsnetwork.org Author: Andy Corbley A personalized, mRNA vaccine, given to patients with particular kinds of aggressive cancers could leverage the immune system of the patient to kill the cancer on its own, and in doing so usher in a new epoch of cancer treatment. Messenger RNA (ribonucleic acid) vaccines were what sparked the COVID-19 vaccine drives, as Pfizer and Moderna adapted the technology to create an emergency treatment to train the body to fight off the viral spike protein. What most of us won’t know however, is that the mRNA vaccines were originally in development for aggressive cancer types. Molly Cassidy, a mother studying for the Arizona Bar exam, is living proof that while the approach isn’t a panacea, it can clear away some of the most dreadful and fast cancers we know of. After being diagnosed with head and neck cancer, she underwent surgery and chemotherapy. However it was only ten days after finishing chemo that she found a marble-like bump on her collarbone from the cancer’s swift return. Later examinations found it had spread from her ear all the way to her lungs, and she was told to get her affairs in order. Cassidy was told she was eligible to join a clinical trial at the University of Arizona, testing an mRNA vaccine personalized to the cancer mutations of the host. By 27 weeks, Cassidy had received nine vaccine doses paired with an immunotherapy drug, and her CT scans were clear: the cancer had left her body. [...]

2021-09-07T05:46:03-07:00September, 2021|Oral Cancer News|

Recognizing and treating oral leukoplakia in primary care

Source: www.clinicaladvisor.com Authors: Christina Alvarez, PA-C, Corinne I. Alois, MS, PA-C, Louise Lee, EdD, MHA, PA-C Oral leukoplakia is a common premalignant condition most commonly identified in the smoking patient population. Once oral leukoplakia is diagnosed, the fundamental goal is to minimize progression towards invasive carcinoma through the use of various treatment methods such as traditional scalpel excision, cryotherapy, and carbon dioxide (CO2) laser therapy. Epidemiology and Pathogenesis of Oral Leukoplakia Leukoplakia is defined as a white, painless, plaque most commonly occurring on the buccal mucosa, lateral tongue, or floor of the mouth.1 Leukoplakia is considered one of the most common oral potentially malignant disorders (OPMDs) with an estimated worldwide prevalence of 1.5% to 2.6%.1 This premalignant condition, which can lead to oral cancer, particularly squamous cell carcinoma, presents with various transformation rates ranging from 0.1% to 17.5%.2 Due to variability in transformation to malignancy, identification, treatment, and monitoring is imperative. The etiology of oral leukoplakia is multifactorial and many cases are considered idiopathic; however, several strong risk factors are associated with this condition, the most common being chronic exposure to all forms of tobacco products, which cause mucosal irritation over time.1,2 Prolonged use of tobacco products is attributed to the conversion of normal cells to hyperplasia, dysplasia, and eventually carcinoma in situ or invasive carcinoma. It is reported that leukoplakia is 6 times more common in smokers than nonsmokers.1 Oral leukoplakia is most commonly seen in men aged 40 years and older, particularly after years of chronic tobacco use.1,2 [...]

2021-09-05T08:19:58-07:00September, 2021|Oral Cancer News|

Study: HPV vaccination will reduce throat and mouth cancers, but overall impact will take 25-plus years to see

Source: www.newswise.com Author: Johns Hopkins Bloomberg School of Public Health Vaccinations against human papillomavirus (HPV), a major cause of throat and back of mouth cancers, are expected to yield significant reductions in the rates of these cancers in the U.S., but will not do so until after 2045, according to a new modeling study from researchers at the Johns Hopkins Bloomberg School of Public Health. HPV is the most common sexually transmitted infectious virus worldwide. HPV infections are often silent, and while most infections clear, some are chronic and can trigger cancers including mouth and throat (oropharyngeal), and cervical cancer because they disrupt DNA and inhibit tumor-suppressor proteins in the cells they infect. Although there is no cure for existing HPV infections, new infections are preventable with vaccines, the first of which entered use in the U.S. in 2006. In the new study, the Bloomberg School researchers analyzed national databases on oropharyngeal cancer cases and HPV vaccinations, and projected the impact of HPV vaccination on the rates of these cancers in different age groups. They estimated that the oropharyngeal cancer rate would nearly halve between 2018 and 2045 among people ages 36–45. However, they also projected that the rate in the overall population would stay about the same from 2018-2045, due to still-rising rates of these cancers in older people, where most of these cancers occur. The study appears online September 2 in JAMA Oncology. “We estimate that most of the oropharyngeal cancers from 2018 to 2045 will occur among [...]

2021-09-03T12:26:37-07:00September, 2021|Oral Cancer News|

Immunotherapy for HPV+ head and neck cancer: Awakening the force within

Source: medicalxpress.com Author: Emory University A new study from scientists at Emory Vaccine Center and Winship Cancer Institute of Emory University reports that the immune cells that are the major targets of immune checkpoint inhibitors are present in tumors from head and neck cancer patients. The study focuses on head and neck tumors that are positive for human papillomavirus (HPV), which is becoming one of most common types of head and neck cancers treated in the Western world. The results are scheduled for publication in Nature. It suggests checkpoint inhibitors, which have transformed the treatment of several types of cancer, could be uniquely effective against this type of head and neck cancer. The results also indicate that the experimental approach of therapeutic vaccination for HPV+ cancer could be broadened to include more elements of the virus, to potentially trigger a broader and stronger immune response. Researchers from Rafi Ahmed's lab at Emory Vaccine Center collaborated with the co-directors of the Winship Head and Neck Cancers working group, oncologists Nabil Saba, MD and Mihir Patel, MD, to obtain samples from patients with head and neck tumors early in the course of treatment. "About five years ago, we began to have an influx of patients that sought out our center for surgical treatment," Patel says. "We often heard some variation of a similar story: I was sick with cold-like symptoms and once that resolved this I noticed swelling in a lymph node on the side of my neck. Stories like this made [...]

2021-09-02T20:07:01-07:00September, 2021|Oral Cancer News|

AI can lend a hand in diagnosis, prognosis of oral SCC

Source: www.auntminnie.com Author: Erik L. Ridley, AuntMinnie.com staff writer Radiology and pathology artificial intelligence (AI) algorithms can help in diagnosing and assessing the prognosis of oral squamous cell carcinoma (SCC), according to a literature review published August 19 in JAMA Otolaryngology -- Head & Neck Surgery. After reviewing published studies in the literature on the use of AI with pathology and radiology images in patients with oral SCC, researchers from the University of Hong Kong concluded that the technology yielded good classification accuracy. "The successful use of deep learning in these areas has a high clinical translatability in the improvement of patient care," wrote the authors, led by first author Chui Shan Chu and senior author Dr. Peter Thomson, PhD. In radiology applications for oral SCC, a convolutional neural network (CNN) was able to predict disease-free survival with 80% accuracy, sensitivity, and specificity from PET images, the researchers reported. Another CNN showed lower performance -- 66.9% sensitivity, 89.7% specificity, and 84% accuracy -- when used on CT for predicting disease-free survival. A deep-learning algorithm also yielded 90% sensitivity for detecting lymph node metastasis from oral SCC on CT. In addition to providing prognosis predictions, AI could help facilitate personalized treatment from CT images, according to the researchers. One model was 76% accurate for predicting xerostomia, or dry mouth, an adverse effect of radiotherapy caused by toxicity. Another study determined that radiation dose distribution is the most crucial factor for predicting toxicity. The researchers noted that, to the best of their [...]

UAB adds personalized touch to cancer treatment with adaptive radiation

Source: www.uab.edu Author: Bob Shepard They are calling it radiation oncology’s contribution to personalized medicine. — called by some the holy grail of radiation therapy — has come to the University of Alabama at Birmingham O’Neal Comprehensive Cancer Center in the form of the newest radiation delivering tool, a system called Ethos from Varian. Simply put, a linear accelerator is the machine that is used to deliver radiation therapy to destroy a tumor. In standard radiation therapy, the medical team uses sophisticated imaging to pinpoint the location of a tumor, then develops a precise approach to target that tumor with radiation. “Patients typically get a CT scan so the radiation team can map out their strategy, a process that can take one to two weeks,” said Dennis Stanley, Ph.D., an assistant professor and medical physicist in the UAB Department of Radiation Oncology. “Then, most patients get radiation for around six weeks, usually five days a week.” But in that time from initial CT screening to the end of treatment, things can change. “A patient’s anatomy can change over this time period,” Stanley said. “Weight gain or loss, shifting of tissues following eating and drinking. Anatomy can change as quickly as day-to-day.” Adaptive therapy simply means the radiation plan can adapt to those changes. The Ethos system is the first machine that can quickly scan a patient while they are on the treatment table prepping for their next treatment, and allow for fine-tuning of the already established treatment plan. Instead of [...]

The British start-up that’s given Val Kilmer his voice back

Source: www.dailymail.co.uk Author: Jonathan Chadwick for MailOnLine A British artificial intelligence (AI) company has recreated Hollywood actor Val Kilmer's voice – with amazingly realistic results. London-based firm Sonantic used the actor's voice recordings from throughout his career, which were fed to their AI to create the lifelike yet artificial mock-up. Film producers could potentially use the tool – described as 'Photoshop for voice' – for voiceovers if they have a role in mind that would be suited to Kilmer's tones. Kilmer, whose career has spanned nearly four decades, has starred in blockbusters such as Top Gun, Willow, The Doors, Tombstone and Batman Forever. But after undergoing a tracheotomy in 2014 as part of his treatment for throat cancer, Kilmer's voice is now barely recognisable. Val Kilmer, pictured here in 2019, underwent a tracheotomy in 2014 as part of his treatment for throat cancer and now speaks with a voice box. Getty Images Luckily, Kilmer himself is also able to use the AI tool in his personal life, to help him communicate, rather than relying on a voice box to speak. The artificial voice, which speaks in the first person as Kilmer in Sonantic's video, could easily be mistaken for the real thing. Praising the results, the real Val Kilmer said: 'I’m grateful to the entire team at Sonantic who masterfully restored my voice in a way I’ve never imagined possible. As human beings, the ability to communicate is the core of our existence and the effects from throat [...]

Study explores the effect of graphic warning labels on cigarette packaging among US smokers

Source: www.news-medical.net Author: Reviewed by Emily Henderson, B.Sc Purchase a pack of cigarettes in Australia and be prepared to be accosted with graphic warning labels depicting the dangers of tobacco use - including images of gangrene of the foot, a newborn with a breathing tube and throat cancer. "Graphic warning labels are used in more than 120 countries to counter marketing that promotes cigarette smoking. We wanted to know what effect such cigarette packaging would have on United States smokers," said David Strong, professor at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego. Graphic warning labels were mandated by the United States Congress in 2009 but implementation has been stopped pending the outcome of legal challenges to the law by the tobacco industry. In a paper published online in JAMA Network Open on Aug. 4, 2021, Strong and colleagues at UC San Diego Moores Cancer Center, California State University San Marcos, San Diego County Public Health Services, and San Diego State University, demonstrated that graphic warning labels are effective reminders of the negative health consequences of smoking. "Graphic warning labels caused daily smokers in the United States to perceive cigarettes to be less positive and it increased their concerns about the health effects of smoking on both themselves and their loved ones," said corresponding-author John P. Pierce, Distinguished Professor at the Herbert Wertheim School of Public Health. The study manufactured special cigarette packs that incorporated the graphic warning labels used on [...]

Val Kilmer’s kids describe watching their father battle throat cancer in ‘Val’: ‘It’s incredibly difficult’

Source: www.yahoo.com Author: Ethan Alter·Senior Writer, Yahoo Entertainment It's not easy for any child to watch their parent battle a serious illness. But it can be an even bigger challenge when that parent is also a public figure with an innately curious fanbase. That's the situation that Jack and Mercedes Kilmer have lived with for the past few years as their father — Top Gun star Val Kilmer — has waged a public and private battle with throat cancer. Kilmer's health struggles, which have affected his ability to speak, are put on full view in the highly personal new documentary Val, premiering on Aug. 6 on Prime Video. His adult children associate produced and appear extensively in the film, which includes footage of the actor at some of the lowest moments in his illness. "It's incredibly difficult," Mercedes Kilmer tells Yahoo Entertainment about watching her father in those moments. "Especially for him because his work is his voice. [Because of] his training as an actor... he has such a natural faculty for speech, and I don't think he honestly would have survived... were it not for his dedication to developing that muscle of his voice." Since Kilmer now speaks with the aid of a voice box following his recent tracheotomy, Jack Kilmer acts as his father's voice in Val. The younger Kilmer narrates his dad's life story as it plays out via home movies shot by Kilmer on his various movie sets, alongside new footage filmed by directors Leo Scott [...]

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