Tackling the complications from oral cancer and treatment

Source: www.medscape.com Author: Tara Haelle Complications from oral cancer and the toxic effects of treatment — including demineralization, caries, fibrosis, candidiasis, pain, sensitivity, and aesthetic concerns — can continue long after any evidence of cancer is apparent, experts reported at the World Dental Congress 2019. One of the major toxic effects is changes in saliva, said Joel Epstein, DMD, director of cancer dentistry at the Cedars Sinai Health System in Los Angeles and director of dental oncology at the City of Hope Comprehensive Cancer Center in Duarte, California. Another problem area — one that is often ignored — is taste, he told Medscape Medical News. And toxic effects are common, he added, citing one study that showed that 16% of patients experienced dental toxicity in the year after undergoing radiotherapy. The rates increased to 36% after 3 years, 55% after 5 years, and 74% after 7 years. For patients undergoing cancer therapy, dentists should look at overall oral hygiene, decay prevention, lip lubrication, dental emergencies, and oral mucosal infections, Epstein told the audience during his presentation on the management of patients with oral cancer, both during and after treatment. Fortunately, there are a lot of things that dentists can help with, he pointed out. For example, fluoride can be used to promote mineralization and chlorhexidine rinse can be used to reduce cariogenic bacteria. And photobiomodulation therapy, or low-level laser light therapy, can be used for the prevention of mucositis, which can be particularly painful, he added. Pain related to oral [...]

2019-12-04T09:04:47-07:00December, 2019|Oral Cancer News|

Study finds how T cells cause inflammation with oral candidiasis

Source: www.drbicuspid.com Author: Donna Domino, Features Editor Ohio dental researchers have found a method to study how T cells cause inflammation during oral candidiasis infections, according to a new study in the Journal of Visualized Experiments (February 18, 2015). The discovery could lead to new therapies or drugs that may improve the functioning of weakened immune systems. Pushpa Pandiyan, PhD, an assistant professor at Case Western Reserve School of Dental Medicine, and colleagues worked on mice to find a new way to model how T cells, the white blood cells critical for the body's immune system, cause inflammation. Pandiyan's previous work focused on isolating different types of oral T cells for study. In the latest study, the researchers injected T cells into genetically engineered immunodeficient mice to test how the cells function when fighting Candida albicans, a fungus found in about 60% of the population but controlled by a functioning immune system. The infection becomes a particular health problem for people with the HIV/AIDS infection, cancer patients with immune systems weakened by chemotherapy, or those born with no immune defenses. The researchers investigated how IL-17a (T helper 17, or Th17 cells, a type of T cells that secrete a cytokine) and T regulatory cells (Tregs) controlled the fungal infection and inflammation, respectively. "Although Th17 cells are required for antifungal immunity, uncontrolled Th17 cells have been implicated with such illnesses as multiple sclerosis, lupus, psoriasis, cancers, and irritable bowel disease," Pandiyan said in a statement. The immunodeficient mice were infected with [...]

Prevalence and Treatment Management of Oropharyngeal Candidiasis in Cancer Patients: Results of the French Candidoscope Study

Source: RedJournal.org Purpose The aim of this pharmaco-epidemiological study was to evaluate the prevalence of oropharyngeal candidiasis (OPC) in cancer patients treated with chemotherapy and/or radiotherapy. Methods and Materials Signs and symptoms of OPC were noted for all patients. Antifungal therapeutic management was recorded in OPC patients. Patients receiving local antifungal treatments were monitored until the end of treatment. Results Enrolled in the study were 2,042 patients with solid tumor and/or lymphoma treated with chemotherapy and/or another systemic cancer treatment and/or radiotherapy. The overall prevalence of OPC was 9.6% (95% confidence interval, 8.4%–11.0%] in this population. It was most frequent in patients treated with combined chemoradiotherapy (22.0%) or with more than two cytotoxic agents (16.9%). Local antifungal treatments were prescribed in 75.0% of OPC patients as recommended by guidelines. The compliance to treatment was higher in patients receiving once-daily miconazole mucoadhesive buccal tablet (MBT; 88.2%) than in those treated with several daily mouthwashes of amphotericin B (40%) or nystatin (18.8%). Conclusion OPC prevalence in treated cancer patients was high. Local treatments were usually prescribed as per guidelines. Compliance to local treatments was better with once-daily drugs. This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

2011-09-20T10:51:07-07:00September, 2011|Oral Cancer News|

Routine oesophageal screening recommended for patients previously treated for head and neck cancer

Source: www.docguide.com Author: Kristina Rebelo Patients who have been treated for head and neck cancer (HNCA) should be screened for oesophageal pathologies about 3 months out whether they are symptomatic or not, according a poster presentation here October 4 at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting 2009. Oesophageal pathology is extremely common in patients who have been treated for HNCA, according to the researchers. "When we talk about HNCA, the 5-year survival rate for this cancer is 50%," Peter C. Belafsky, MD, Head and Neck Oncological Surgery, University of California at Davis, and the Voice and Swallowing Center, Davis, California, told DocGuide. "We took a look at the oesophagus in patients after treatment for head and neck cancer and we did oesophagoscopy and biopsy, as indicated, on all of them. We successfully performed the oesophagoscopy on all 100 patients without complication and we had only 13% of the entire cohort who had a normal examination." The study included 100 patients who had chemoradiation and underwent follow-up oesophagoscopy. Patient demographics, symptom surveys, treatments received, reflux medications prescribed and oesophageal findings were prospectively determined. Findings on oesophagoscopy included stricture (22%), candidiasis (9%), peptic oesophagitis (67%), Barrett's (8%), and new primary tumours -- 1 hypopharynx, 2 oesophageal, and 1 stomach (4%); 13% had a normal oesophagoscopy. The mean age of the cohort was 64 years and 74% were male. The mean time between the cessation of treatment and endoscopy was 40 months and 77% of the HNCA [...]

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