Forgotten patients: New guidelines help those with head-and-neck cancers

Source: www.fredhutch.org Author: Diane Mapes and Sabrina Richards Stigma, isolation and medical complexity may keep patients from getting all the care they need; recommendations aim to change that. Like many cancer patients, Jennifer Giesel has side effects from treatment. There’s the neuropathy in her hands, a holdover from chemo. There’s jaw stiffness from her multiple surgeries: an emergency intubation when she couldn’t breathe due to the golf ball-sized tumor on her larynx and two follow-up surgeries to remove the cancer. And then there’s hypothyroidism and xerostomia, or dry mouth, a result of the 35 radiation treatments that beat back the cancer but destroyed her salivary glands and thyroid. “I went to my primary care doctor a couple of times and mentioned the side effects,” said the 41-year-old laryngeal cancer patient from Cleveland, who was diagnosed two years ago. “She was great but she didn’t seem too knowledgeable about what I was telling her. She was like, ‘Oh really?’ It was more like she was learning from me.” Patients like Giesel should have an easier time communicating their unique treatment side effects to health care providers with the recent release of new head-and-neck cancer survivorship guidelines. Created by a team of experts in oncology, primary care, dentistry, psychology, speech pathology, physical therapy and rehabilitation (with input from patients and nurses), the guidelines are designed to help primary care physicians and other health practitioners without expertise in head-and-neck cancer better understand the common side effects resulting from its treatment. The goal is [...]

ACS now has a guideline for care of head and neck cancer survivors

Source: www.ajmc.com Author: Surabhi Dangi-Garimella, PhD With an increasing population of head and neck cancer survivors in the United States, the American Cancer Society identified the need to develop survivorship guidelines that can lend support to primary care clinicians and other health practitioners as they care for survivors. With an increasing population of head and neck cancer (HNC) survivors in the United States, the American Cancer Society (ACS) identified the need to develop survivorship guidelines that can lend support to primary care clinicians and other health practitioners as they care for survivors. The guideline emphasizes monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. According to ACS estimates, nearly 3% (436,060) of cancer survivors in the United States have survived a bout of HNC. With these numbers in mind, ACS convened an expert panel that included members with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech language pathology, physical medicine and rehabilitation, nursing, and a HNC survivor who provided a patient perspective. The panel reviewed existing guidelines and research evidence through April 2015, and created recommendations, which the committee has stressed “should be viewed as consensus-management strategies” to assist survivors. While 2081 articles were identified from a preliminary search, only 184 were finally included as evidence base. Published online in CA: A Cancer Journal for Clinicians, the following are some of the key recommendations provided by the guideline for primary care physicians: [...]

‘Where you’re treated matters’ in terms of cancer survival

Source: www.eurekalert.org A study of older patients with advanced head and neck cancers has found that where they were treated significantly influenced their survival. The study, led by researchers at Fred Hutchinson Cancer Research Center and published in the March 1 online edition of Cancer, found that patients who were treated at hospitals that saw a high number of head and neck cancers were 15 percent less likely to die of their disease as compared to patients who were treated at hospitals that saw a relatively low number of such cancers. The study also found that such patients were 12 percent less likely to die of their disease when treated at a National Cancer Institute -designated cancer center. "Where you're treated matters," said corresponding author Eduardo Méndez, M.D., an assistant member of the Clinical Research Division at Fred Hutch. Méndez and colleagues also hypothesized that patients with head and neck squamous cell carcinomas (HNSCCs) who were treated at high-volume hospitals would be more likely to receive therapy that complies with National Comprehensive Cancer Network guidelines due to the complexity of managing these cancers. Surprisingly, this was not the case, the researchers found. According to an American Cancer Society estimate, 52,610 Americans were newly diagnosed with head and neck cancer in 2012. Many patients are diagnosed with locally advanced disease that has spread to the lymph nodes, which carries a much poorer prognosis compared to early stage disease. Patients with advanced disease require multidisciplinary management by a collaborative team comprised of [...]

Stricter conflict-of-interest guidelines proposed for all professional medical associations

Source: www.medscape.com Author: Deborah Brauser Current guidelines on conflicts of interest between industry and professional medical associations (PMAs) should be updated with stronger recommendations and adopted by all PMAs, according to an article published in the April 1 issue of the Journal of the American Medical Association. "PMAs play an essential role in defining and advancing health care standards," write David J. Rothman, PhD, president of the Institute on Medicine as a Profession and Bernard Schoenberg Professor of Social Medicine at the College of Physicians and Surgeons at Columbia University, New York City, and colleagues. "Their conferences, continuing medical education courses, practice guidelines, definitions of ethical norms, and public advocacy positions carry great weight with physicians and the public. Because many PMAs receive extensive funding from pharmaceutical and device companies, it is crucial that their guidelines manage both real and perceived conflicts of interests." However, the authors write, the current PMA policies are not uniform and "lack stringency." The authors have identified several conflict-of-interest areas and have suggestions for new short- and long-term guidelines to address them. "The recommendations are rigorous and would require many PMAs to transform their mode of operation and perhaps to forgo valuable activities. To maintain integrity, sacrifice may be required." 10 Recommended Guidelines The 10 recommended guidelines cover general budget support from industry, national and regional conventions, industry funds for research by PMAs and members, industry funds for fellowships and training programs, guidelines committees, industry support of PMA publications, product endorsements, affiliated foundations, conflicts of [...]

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