Kentucky cancer center emphasizes patients’ quality of life

Source: www.drbicuspid.com Author: Donna Domino, Features Editor The James Graham Brown Cancer Center at the University of Louisville is among a growing number of facilities working to improve care for head and neck cancer (HNC) patients through collaborative care programs that bring together a spectrum of oncology specialists. The center provides multidisciplinary treatment for HNC patients using novel techniques that decrease the debilitating side effects of radiation and chemotherapy. The clinic also conducts research and clinical trials with targeted therapies that aim to restore patients' oral functions. Kentucky has a higher rate of HNC than the U.S. average, which provides a large patient pool for the many clinical trials that the center conducts, according to Zafrulla Khan, DDS, MS, professor and director of maxillofacial/oncologic dentistry in the center's HNC clinic. "That's what happens when you mix tobacco and bourbon," Dr. Khan noted. Intraoral radiation shields Some of the center's novel treatment techniques involve using intraoral radiation shields during brachytherapy radiotherapy procedures to prevent the tongue and nearby oral areas from getting irradiated while minimizing mucositis and xerostomia, Dr. Khan explained. Intraoral radiation shields prevent the tongue and nearby oral areas from getting irradiated while minimizing mucositis and xerostomia "We put catheters right into tumors so they can deliver the radiotherapy in the mouth with high-density therapy machines rather than doing an external beam," he said. The clinic also uses a surgical obturator, a prosthetic device that enables patients to speak and swallow following surgery for maxillary sinus cancer. [...]

2013-02-20T07:32:57-07:00February, 2013|Oral Cancer News|
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Seed planted in cancer research

Source: www.ivanhoe.com A cancer diagnoses usually means radiation therapy that will not only affect the tumor, but healthy cells as well. New approaches to cancer treatment have been tested and, according to data, one approach is working. The new procedure for treating solid tumors with radiation was highly effective and minimally toxic to healthy tissue in a mouse model of cancer. Brachytherapy is a technique for treating solid tumors, including prostate cancer, which involves the surgical implantation of radioactive seeds within a patient’s tumor. The seeds expose the tumor cells to high level of radiation while minimizing the negative side effects. However, brachytherapy has its limitations, said Wenge Liu, M.D., Ph.D., and associate research professor of biomedical engineering at Duke University in Durham, NC. “The most prominent factor is the need for survival implantation and removal of the seeds.” So the doctor and his team set out to eliminate the need for surgery. They did this by generating an injectable substance called a polymer that was attached to a source of radioactivity and spontaneously assembled into a radioactive seed after being injected into the tumor. “We believe that this approach provides a useful alternative to existing brachytherapy, which requires a complicated surgical procedure to implant the radioactive seeds,” Liu said. “Moreover, these injectable seeds degrade after the radiation is exhausted so they do not need to be surgically removed.” The tumors were eradicated by a single injection in 67 percent of the mice that received the treatment after being transplanted [...]

2012-11-20T19:16:41-07:00November, 2012|Oral Cancer News|
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Clinicians support the necessity of neck dissection because of high risk of recurrence in oral cancer patients

Source: HighWire Stanford University PURPOSE: In head and neck cancer, the most important prognostic factor is the presence or absence of neck metastasis. Although still debated in the published data regarding the "wait and see" policy for Stage T1-T2 oral cancer, a large number of clinicians support the necessity of neck dissection, especially in cases of oral tongue carcinoma, because of the poor prognosis and high risk of recurrence. The aim of the present study was to summarize and quantify the incidence of occult metastasis in oral cancer treatment at the oral and maxillofacial surgery department, Rambam Medical Center, in the past 10 years. PATIENTS AND METHODS: A total of 142 neck dissections performed at our department in the past 10 years (1998 to 2009) and a series of 68 patients (44 men and 22 women) treated for Stage T1N0 or T2N0 oral cancer were included in the present retrospective study. All patients underwent surgical resection of the oral cancer and selective neck dissection of the ipsilateral side. RESULTS: Occult lymph node metastases were detected in 11 patients (16% overall, 9 in the tongue, 1 in the buccal mucosa, and 1 in the gingiva of the mandible). The frequency of occult metastasis from tongue carcinoma was 34% (9 of 26 cases). The 5-year survival rate in the present study was 78.9%. In patients who underwent chemotherapy, radiotherapy, brachytherapy, or a combination of the 3 after surgical management, the overall survival rate decreased significantly to 22.5% (P = .006, log-rank test). [...]

2011-05-23T12:23:20-07:00May, 2011|Oral Cancer News|
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Age is not a limiting factor for brachytherapy for carcinoma of the node negative oral tongue in patients aged eighty or older

Source: 7thspace.com Author: Hideya Yamazaki et al Purpose: To examine the role of brachytherapy for aged patients 80 or more in the trend of rapidly increasing number. Methods: We examined the outcomes for elderly patients with node negative oral tongue cancer (T1-3N0M0) treated with brachytherapy. The 21 patients (2 T1, 14 T2, and 5 T3 cases) ranged in age from 80 to 89 years (median 81), and their cancer was pathologically confirmed. All patients underwent definitive radiation therapy, with low dose rate (LDR) Ra-226 brachytherapy (n=4; median 70Gy), with Ir-192 (n=12; 70Gy), with Au-198 (n=1) or with high dose rate (HDR) Ir-192 brachytherapy (n=4; 60 Gy). Eight patients also underwent external radiotherapy (median 30 Gy). The period of observation ranged from 13 months to 14 years (median 2.5 years). We selected 226 population matched younger counterpart from our medical chart. Results: Definitive radiation therapy was completed for all 21 patients (100%), and acute grade 2-3 mucositis related to the therapy was tolerable for patients with good performance status. Local control (initial complete response) was attained in 19 of 21 patients (90%). The 2-year and 5-year local control rates were both 91%, (100% for T1, 83% for T2 and 80% for T3 tumors after 2 years). The cause-specific survival rate was 83% and the regional control rate 84% at the 2-years follow-up. However, 12 patients died because of intercurrent diseases or senility, resulting in overall survival rates of 55% at 2 years and 34% at 5 years. Conclusion: Age is not [...]

2010-12-10T09:00:06-07:00December, 2010|Oral Cancer News|
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Radiation safety a priority at Johns Hopkins

Source: www.nccn.org Author: Megan Martin, Communications Manager Recent media coverage surrounding treatment errors that have occurred in radiation therapy has only intensified discussions about the need to improve safety for patients with cancer. Joseph Herman, MD, a radiation oncologist at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and a featured panelist at the upcoming NCCN 2010 Patient Safety Summit, recently spoke with NCCN about policies Hopkins has implemented to ensure the safety of their radiation therapy patients. Radiation safety, an issue that has always received great attention at Hopkins, came to the forefront a few years ago as Hopkins was looking to develop a new program for high dose rate intraoperative radiation therapy (IORT) – delivered through brachytherapy – and discovered that there were no clear standard guidelines or quality indicators for how to develop such a program. “Safety is of particular concern in this type of treatment because due to the high dose of radiation being emitted, clinicians cannot remain in the same room as the patient, a specific cause of anxiety for anesthesiologists,” said Dr. Herman. Using a patient simulator, the team walked through a variety of practice scenarios, identified areas for concern, and developed strategies to address potential safety issues. For example, Hopkins now uses cameras to monitor patient vital signs in the room and also has pre-measured medications available that can be delivered via a pole from another room – basically a “long-distance” method of treatment. Furthering their aim to identify points in the [...]

2010-08-29T08:00:00-07:00August, 2010|Oral Cancer News|
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High dosage brachytherapy obtains excellent results in head and neck tumors

Source: www.health.am/cr Author: staff High-dosage perioperative brachytherapy (applied within the surgical process) obtains excellent results in the treatment of head and neck tumours, at the same time as reducing the period of radiation. These are the conclusions of research undertaken jointly by three Departments at the University of Navarra Hospital and which was published in the latest issue of Brachytherapy, official journal of the American Society of Brachytherapy. The work describes the application of this new radiotherapy technique to 40 patients between 2000 and 2006. Given the size of the sample, the article is a description of the greatest number of patients treated with high-dosage brachytherapy for head and neck tumours in world medical literature. According to results, after a seven-year follow-up, the illness was controlled in 86% of the cases and the percentage of survival was 52%. In concrete, the research focused on the treatment of tumours in the oral cavity, those affecting the tongue and the floor of the mouth, and those in the oropharyngeal region, such as tumours of the tonsils. Involved in the study was a multidisciplinary team of seven specialists from three departments at the University of Navarra Hospital: the Radiotherapy Department, the Department of Oral and Maxillofacial Surgery and the Ear, Nose and Throat Department. Intensifying radiation dosage As is known, brachytherapy is a radiotherapy treatment involving the placing of radioactive sources within the tumour or nearby. In the case in hand, the work analysed the application of brachytherapy as complementary post-surgery treatment, explained [...]

2009-03-30T19:22:09-07:00March, 2009|Oral Cancer News|
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Current status and perspectives of brachytherapy for head and neck cancer

Source: Int J Clin Oncol, February 1, 2009; 14(1): 2-6 Author: H Shibuya Brachytherapy delivers a high radiation dose to a limited volume while sparing surrounding normal tissues. In head and neck cancer, severe soft-tissue damage and bone damage to the mandible has decreased markedly since the introduction of computer dosimetry and the use of spacers during treatment. For the curative treatment of head and neck cancer, the selection of brachytherapy sources from among the several linear and small permanent implant sources available, not only according to the tumor site but also according to the patient's physical and mental condition is important. Following the successful treatment of early head and neck cancer by brachytherapy, two major problems and one minor problem may confront the physician. The major problems are neck node metastasis and a second primary cancer of the respiratory tract or upper digestive tract, and the minor problem is radiation-induced cancer. Author's affilation: Department of Radiology, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

2009-02-27T09:56:47-07:00February, 2009|Oral Cancer News|
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