feeding tube – Oral Cancer News

High rate of severe oral mucositis after IMRT seen in head and neck cancer

Source: www.cancertherapyadvisor.com Author: Andrea S. Blevins Primeau, PhD, MBA Many patients with head and neck cancer develop oral mucositis after intensity-modulated radiation therapy (IMRT), according to a single-center study published in JAMA Network Open. The study also showed that most cases of oral mucositis were severe, and increasing severity of mucositis was associated with a greater likelihood of feeding tube placement, hospitalization, and opiate use. The study included 576 patients who underwent definitive or adjuvant IMRT during 2015-2022. The Oral Mucositis Weekly Questionnaire-Head and Neck Cancer survey was used to categorize the severity of mucositis and throat soreness. Nearly all patients (98.6%) had oral mucositis, and 62.5% developed severe oral mucositis. By the final week of IMRT, 48.6% of patients had difficulty drinking, 56.8% had difficulty swallowing, and 69.4% had difficulty eating. Most patients (76.8%) were consuming a pureed diet and/or had a feeding tube by the end of IMRT. The median time to placing a feeding tube was 32 days from starting IMRT. The proportion of patients with nonprophylactic feeding tube placement was 16.4% of those with severe oral mucositis and 5.6% of those without severe mucositis (P

Oral Cancer Foundation News Team - A2023-10-25T08:24:54-07:00October, 2023|Oral Cancer News|

AI-driven muscle mass assessment could improve care for head and neck cancer patients

Source: medicalxpress.com Author: Dana-Farber Cancer Institute Researchers from Dana-Farber Cancer Institute have found a way to use artificial intelligence (AI) to diagnose muscle wasting, called sarcopenia, in patients with head and neck cancer. AI provides a fast, automated, and accurate assessment that is too time-consuming and error-prone to be made by humans. The tool, published in JAMA Network Open, could be used by doctors to improve treatment and supportive care for patients. "Sarcopenia is an indicator that the patient is not doing well. A real-time tool that tells us when a patient is losing muscle mass would trigger us to intervene and do something supportive to help," says lead author Benjamin Kann, MD, a radiation oncologist in the Department of Radiation Oncology at Dana-Farber Brigham Cancer Center. Head and neck cancers are typically treated with combinations of surgery, radiation, and chemotherapy. The treatments can be curative, but they also can have harsh side effects. Patients sometimes have trouble drinking and eating during and after treatment, leading to poor nutrition and sarcopenia. Sarcopenia is associated with an increased chance of needing a feeding tube, having a lower quality of life, and worse outcomes in general, including earlier death. "Muscle mass is a very important indicator of health," says Kann. "People with more muscle mass are generally healthier and more robust." Doctors can assess muscle mass by analyzing computed tomography (CT) scans of the abdomen or the neck. CT scans of the neck are common and frequent for patients with head and [...]

Oral Cancer Foundation News Team - A2023-08-13T05:04:36-07:00August, 2023|Oral Cancer News|

A shift in focus for head and neck cancer treatment

Source: www.curetoday.com Author: Marijke Vroomen Durning, RN When Cindy Stemple of Westerville, Ohio, noticed a sore on her tongue, the last thing she imagined was that she may have head and neck cancer. After all, she was only 27 years old. She finally went to see her dentist when the sore wouldn’t heal. Since Stemple didn’t have any known risk factors for head and neck cancer, the dentist didn’t expect cancer either. After trying several treatments, they decided it was time for a biopsy. Stemple still wasn’t concerned. “It wasn’t even in the realm of possible things,” she says. “I didn’t even take anybody to the appointment when I got the results and found out it was cancer because it was the furthest thing from my mind.” She received a diagnosis of stage 3 oral squamous cell carcinoma — which is a cancer that occurs in the mouth and/or throat. Tremendous Change in Head and Neck Cancer Historically, head and neck cancer, the seventh most common cancer globally, was predominantly diagnosed in older individuals and was often linked to tobacco and alcohol use. As smoking rates began to decline, so did tobacco- and alcohol-related cases among older individuals. But head and neck cancer rates began rising in another group — younger and middle-aged adults — driven by HPV infections, predominantly HPV type 16, which has been shown to be a clear risk factor for head and neck cancer as well as cervical cancer. HPV-positive oropharyngeal cancers in the United States [...]

Oral Cancer Foundation News Team - A2022-09-21T06:29:44-07:00September, 2022|Oral Cancer News|

Which feeding tubes do head and neck cancer clinicians prefer to use in patients undergoing radiotherapy?

Source: www.oncologynurseadvisor.com Author: Susan Moench, PhD, PA-C A study of the perceptions of health care professionals involved in the care of patients with head and neck cancer undergoing radiation therapy regarding optimal feeding tube practices showed no consensus; however, feeding tube placement was considered important for some patients. This study was published in JPEN Journal of Parenteral Enteral Nutrition. Patients with head and neck cancer frequently undergo intensive treatment that may include a long course of radiation therapy in addition to surgery and chemotherapy. Treatment-related toxicity can involve severe dysphagia and mucositis, as well as reduced food intake and unintentional weight loss; these clinical sequelae can also lead to treatment delays and an increased risk of hospitalization. Clinical practice guidelines include recommendations for early enteral feeding in patients with stage IV disease or hypopharyngeal tumors who are receiving chemoradiotherapy, as well as other patients with head and neck cancer, “depending on factors including their treatment, nutrition status, dysphagia, social support, and food intake.” However, there is no conclusive evidence as to which of the most commonly used feeding tubes — a nasogastric tube (NGT) placed when additional nutritional support is needed or a prophylactic gastrostomy tube (PGT) placed before radiation therapy — is preferable. In this qualitative study, in-depth interviews were conducted with interdisciplinary health care professionals from 4 radiation therapy departments (2 in the United States and 2 in Australia) to evaluate their perspectives and experiences regarding feeding tube practices in patients with head and neck cancer. Of the [...]

Oral Cancer Foundation News Team - A2019-09-14T09:13:13-07:00September, 2019|Oral Cancer News|

Robot that can cut out hard-to-reach throat tumours through patients’ mouths: Pioneering operation reduces need for chemo and radiotherapy

Source: www.dailymail.co.uk Author: Fiona McCrae, Roger Dobson British surgeons are using a cutting-edge robot to remove difficult-to-reach throat tumours – through the mouths of patients. The pioneering operation is designed to dramatically reduce the need for gruelling radiotherapy and chemotherapy, which can leave patients unable to swallow and dependent on a feeding tube for life. With growing numbers of people developing throat cancer, it is more important than ever to have a range of effective treatments that lessen the impact on quality of life, says Asit Arora, consultant head and neck surgeon at Guy’s & St Thomas’ NHS Trust in London. Once most common in elderly people with a history of drinking and smoking, rates of head and neck cancers have soared by 31 per cent in the past 25 years and are now as common in people in their 50s as in those in their 80s. The 90 minute operation is designed to dramatically reduce the need for gruelling radiotherapy and chemotherapy, which can leave patients unable to swallow and dependent on a feeding tube for life Much of the rise is attributed to HPV – a range of viruses that can be passed on during intimate and sexual contact. At least 80 per cent of the adult population carries some kinds of HPV on their skin, although most will never know it. In some cases, HPV can cause skin or genital warts, and other types are a known cause of cervical and anal cancers. HPV can [...]

Oral Cancer Foundation News Team - A2019-03-11T13:59:53-07:00March, 2019|Oral Cancer News|

A Look at Therapy Toxicities & Biology in Head & Neck Cancers

Source: journals.lww.com Author: Valerie Neff Newitt A measure of intrigue and discovery pertaining to head and neck cancer, spiked with compassion for patients struggling against treatment toxicities, helps quench the intellectual thirst of Yvonne Mowery, MD, PhD, Butler Harris Assistant Professor of Radiation Oncology at Duke University Medical Center, Durham, N.C. Splitting time between the clinic and laboratory, Mowery is actively engaged in patient care as well as preclinical, translational, and clinical research. “I hope to get a better understanding of the biology of head and neck cancer and determine pathways that we can target to reduce metastatic spread of the disease and improve responsiveness to available treatments,” she told Oncology Times. Long before reaching her current status as an award-winning investigator, Mowery grew up in Richmond, Va., in the midst of a “completely non-scientific” family. “I was an oddball,” she joked, while recalling her parents' patience with her backyard composting experiments that became so foul-smelling that the health department was contacted. As a kid, her idea of a great present was an encyclopedia of science, and the thing that caught her eye at the toy store was a junior chemistry set. Science was clearly her path when she headed to the University of Virginia. In her sophomore year, Mowery began working in a genetics lab. That's where the lure of fruit flies took hold. “I looked at the development of their reproductive system and found that very interesting,” she recalled. Nearing the completion of her undergraduate education, Mowery debated [...]

Oral Cancer Foundation News Team - A2018-11-04T07:47:45-07:00November, 2018|Oral Cancer News|

Head and neck Cancer: Overcoming Challenges in Treatment

Source: www.curetoday.com Author: staff Itzhak Brook, M.D., M.Sc., shares the story of his initial diagnosis and treatment for cancer of the head and neck, outlining the challenges that came along with treatment, with fellow board member of the Head and Neck Cancer Alliance Meryl Kaufman, M.Ed., CCC-SLP, BRS-S. Transcript: Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: Dr. Brook, can you please share your story about your cancer diagnosis in 2006 and the treatment that followed and also the subsequent surgery that you went through? Itzhak Brook, M.D., M.Sc.: Once I learned I had cancer and my doctors removed it when they had to biopsy, I needed to receive radiation therapy. I did not get any chemotherapy, and the radiation therapy lasted six weeks, five days a week. It was very difficult to experience the radiation, and the side effects start to accumulate within a few days. And I had to deal with inflammation of the mouth, mucositis, difficulty in swallowing and pain in my throat, and I experienced a burning of the skin around the area of radiation, weakness and then difficulty maintaining intake of food. After a while, I could lose weight, and I tried to persevere because I knew that I had to receive the treatment to get better and soldier through it until it was over. Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: Exactly. And some people have such severe side effects from the radiation that they actually require a feeding tube to support them during their treatment. In that case, [...]

Oral Cancer Foundation News Team - A2018-09-04T13:05:32-07:00September, 2018|Oral Cancer News|

Silent no more: Woman lends voice to hope after cancer

Source: health.ucsd.edu Author: Yadira Galindo Singing hymns in church has always brought Cynthia Zamora joy. Today, her once sharp intonation has given way to a raspy voice. But Zamora is thankful that she has a voice at all after spending three months without the ability to utter even one syllable. “I miss going to church and singing with people,” said Zamora. “Although, if I am in the back I'm still singing. I'm just hoping they don't hear what sounds like a 13-year-old pubescent boy back there, because that's how I sound. I know God thinks it's beautiful, so I don't worry about it. I just go on with life.” In 2017, Zamora bit her tongue while sleeping, splitting her tongue nearly in half. She was referred to a specialist when her wound would not heal. They found a 5.4-centimeter tumor that enveloped more than half of her tongue. To save her life, her surgeon, Joseph Califano, MD, delivered grim news: Zamora would have to undergo a glossectomy — the surgical removal of all or part of the tongue. “By the time I saw her she was really having a hard time speaking and swallowing,” said Califano, director of the Head and Neck Cancer Center at UC San Diego Health. “With Cynthia that was a difficult discussion because it was unclear how much tongue we would save and how good the function would be with the remaining tongue that would be preserved.” A multidisciplinary team of experts that included medical oncology, [...]

Oral Cancer Foundation News Team - A2018-07-10T10:03:53-07:00July, 2018|Oral Cancer News|

Praised West Palm attorney fought for many, but is now fighting for his life

Source: www.mypalmbeachpost.com Author: Daphne Duret - Palm Beach Post Staff Writer A knock on a door stopped Richard Tendler mid-sentence. His back straightened almost instinctively in his chair, just as it has at the first sign of every verdict. Two decades as a criminal defense attorney in Palm Beach County have taught the 51-year-old West Palm Beach man to never predict how things will go. “I’ve had cases I thought I won come back guilty,” Tendler had said hours earlier. “Then there were cases I was sure I lost, and the jury would come back not guilty.” Another certainty: Tendler knew was that he would go home a free man that night, regardless of his client’s fate. This time was different. Tendler was seated in an examination room at Moffitt Cancer Center in Tampa, where he is one of 10 patients in an exclusive clinical trial for cancer patients whom other doctors have told to prepare to die. Knocking on the door was Dr. Christine Chung, who is treating Tendler and nine others with an immunotherapy regimen as part of a trial that includes 500 patients in the U.S. and around the world. Chung, the chief of head and neck oncology at Moffitt, was ready to deliver her own verdict — on the results of Tendler’s third six-week cycle. She greeted Tendler’s larger-than-usual entourage that day with polite handshakes and a tight smile. After the first two cycles, she said, the treatments have cut in half the size of one [...]

Oral Cancer Foundation News Team - A2018-06-21T19:59:41-07:00June, 2018|Oral Cancer News|

What University of Toronto researchers are doing to help ‘devastating’ swallowing problems

Source: www.utoronto.ca Author: Jim Oldfield We swallow about 600 times a day, mostly without thinking about it. But swallowing involves dozens of muscles and nerves in the mouth, throat and esophagus, and for people who struggle with the process, the results can be devastating. Malnutrition, dehydration and social isolation are common in people with swallowing trouble. So is depression and aspiration of food that leads to pneumonia. Occasionally, swallowing issues cause choking and sudden death. And a recent U.S. study of hospitalized patients with serious illnesses found that more than half said needing a feeding tube to live was a state equal to or worse than death. Many conditions can cause swallowing problems: stroke, neurodegenerative diseases such as Parkinson’s, and congenital or developmental conditions such as cerebral palsy and cleft palate. People treated for head and neck cancer often develop problems, sometimes years later; and their numbers are growing as cancer survival rates improve. Estimates on the global prevalence of swallowing disorders, which collectively are known as dysphagia, are about eight per cent – almost 600 million people. But there is good news. Before 1980, most patients with complex dysphagia got feeding tubes; today, clinicians can offer videofluoroscopy and other bedside tests to better assess swallowing problems, and less invasive therapies that emphasize exercise and posture. And at the University of Toronto, scientists in the department of speech-language pathology and related fields are starting to answer long-standing questions such as how best to give dysphagia screening tests, which interventions work [...]

Oral Cancer Foundation News Team - A2018-04-11T10:46:01-07:00April, 2018|Oral Cancer News|