The New Face of Oral Cancer

Source: nursing.advanceweb.comBy Jonathan BassettPosted on: April 22, 2013   For decades tobacco was the primary cause of oral cancer but a more insidious culprit has emerged.  Jerry Wilck had no reason to suspect anything. Why would he? He only smoked for a couple of years and gave it up more than 40 years ago. He didn't drink excessively, didn't have a family history of cancer, and took good care of himself. In fact, maybe the only reason the 59-year-old consulted an oral surgeon about the small sore on his tongue - the result of a habit of running this particular spot along his teeth - was that there happened to be such a specialist right there in his office. Wilck was a general practice dentist in Langhorne, Pa., and particularly attuned to anomalies of the soft tissues of the mouth. His oral surgeon took no chances and ordered a biopsy. Wilck was "floored" the night in March 2005 when the lab report arrived by fax from the oral pathology department at Temple University in Philadelphia - squamous cell carcinoma. Wilck immediately consulted with John Ridge, MD, PhD, FACS, chief of head and neck surgery at Temple's Fox Chase Cancer Center. After surgical removal of part of his tongue and lymph nodes from his neck, along with a round of physical and speech therapy, Wilck is now cancer free and has full use of his jaw, throat and voice. "I was lucky," confessed Wilck, who retired from practice in 2009 and now spends a [...]

2013-06-10T12:26:21-07:00June, 2013|OCF In The News, Oral Cancer News|

The effect of treating institution on outcomes in head and neck cancer

Source: American Academy of Otolaryngology - Head and Neck Surgery Alexandria, VA — Patients with head and neck cancer receiving radiation treatment at an academic center have a higher survival rate than those receiving treatment at a community center, according to a study in the December 2012 issue of Otolaryngology–Head and Neck Surgery. "Despite similar rates of treatment completion and rate of treatment breaks between groups, patients treated in academic centers had more advanced cancer but better survival," the authors state in their conclusion. The study evaluated differences in patient characteristics, treatment, and cancer outcomes in the head and neck cancer population at the University of Minnesota from 2002 through 2008. Data were gathered on demographics, general medical data, tumor variables, insurance type, marital status and health behaviors. The study analyzed 355 patients with mucosal head and neck cancer treated with radiation therapy from 2002 to 2008. One hundred forty-five (41%) received radiation treatment at community hospitals, and 210 (59%) were treated at academic hospitals. Within the academic hospitals group, 197 underwent radiation at the University of Minnesota, and 13 received radiation at an alternative academic center. Both treatment groups shared similar characteristics in regard to sex, comorbidity, marital status, work status, insurance, and alcohol use. However, the community group had more current smokers and slightly older patients on average. Patients in the academic group were more likely to live in an urban location and had a higher median income. Patients undergoing radiation treatment at university centers had significantly more advanced [...]

2012-12-07T12:47:56-07:00December, 2012|Oral Cancer News|

Palliation Trumps PET in Prolonging Head and Neck Cancer Survival

Source: Elsevier Global Medical News. 2012 Feb 23, D McNamara MIAMI BEACH (EGMN) - Using PET scans to diagnose distant metastasis in patients with advanced head and neck squamous cell carcinoma does not significantly prolong life expectancy, compared with other imaging techniques, according to a retrospective study. Palliative chemotherapy did make a difference, however, significantly increasing life expectancy by 215 days in patients who received it, Dr. Matthew E. Spector and colleagues from the University of Michigan, Ann Arbor, reported at a meeting of the Triological Society. "Over 90% of patients at University of Michigan have at least one PET scan at some point in their treatment," Dr. Spector said. Increased sensitivity is one reason for such widespread adoption of the imaging technique. "We were wondering, while it may be more sensitive to identify distant metastatic disease, was it changing what we were doing?" In a retrospective look at 170 patients with such cancers at their institution, researchers found no significant difference in median survival between patients who had a PET scan (168 days) and those who did not (193 days). Determination of any survival difference was a primary aim of the study. "A lot of studies have looked at PET scans, and we know in up to one-third of cases it may change our decisions," Dr. Spector said. For example, a negative PET scan might mean definitive treatment, whereas a positive PET finding might lead to palliative therapy. However, "no one has looked at the impact of the PET findings on the life expectancy after diagnosis." All patients in the study had a distant metastasis diagnosis. "We found PET was more [...]

2012-02-27T11:42:48-07:00February, 2012|Oral Cancer News|

Connected nodes in throat cancer signal poor prognosis

Source: OncologyNurseAdvisor.com The presence of “matted” lymph nodes in persons with oropharyngeal squamous cell carcinoma (SCC)—that is, nodes that are connected together—was associated with a 3-year survival rate of 69%, compared with 94% among patients without matted nodes. Such a marker could help clinicians identify patients who are at heightened risk for metastasis and who might benefit from additional systemic therapy. Conversely, a person without matted nodes could be a candidate for less therapy, which would in turn reduce uncomfortable side effects. The study, led by Matthew E. Spector, MD, a resident in the department of otolaryngology – head and neck surgery at the University of Michigan Health System in Ann Arbor, focused on 78 previously untreated persons with stage III or IV oropharyngeal SCC. All patients were undergoing chemotherapy in combination with intensity-modulated radiation therapy (IMRT) as part of a clinical trial. The 3-year disease-specific survival rate for the 16 patients presenting with matted nodes was 69%, compared with 94% among the 61 other patients. Matted nodes were found to be a poor prognostic factor independent of tumor classification, human papillomavirus (HPV) status, epidermal growth factor receptor (EGFR), and smoking status. Matted nodes did appear to be an especially strong indicator of increased risk among HPV-positive persons, despite the fact that these patients had better overall outcomes than did those who were HPV-negative. The best outcomes were seen among HPV-positive nonsmokers. The investigators, who reported their findings in Head & Neck, say the reasons for the survival differences between [...]

2012-02-01T17:10:52-07:00February, 2012|Oral Cancer News|

Transoral robotic surgery gets FDA approval

Source: Medgadget Author: Staff The FDA has given the go ahead for surgeons to use robotic surgery for procedures in the throat and nearby regions by going through the mouth. In effect, this is a new indication for the Da Vinci Surgical System from Intuitive Medical, as it is the only robot of its type that can be used to perform the procedures. The transoral applications of robotic surgery have been developed at the University of Pennsylvania School of Medicine, where a special center was created to study the subject. Drs. Gregory S. Weinstein and Bert W. O’Malley, Jr. of the University of Pennsylvania School of Medicine’s Department of Otorhinolaryngology: Head and Neck Surgery founded the world’s first TransOral Robotic Surgery (TORS) program at Penn Medicine in 2004, where they developed and researched the TORS approach for a variety of robotic surgical neck approaches for both malignant and benign tumors of the mouth, voice box, tonsil, tongue and other parts of the throat. Since 2005, approximately 350 Penn patients have participated in the world’s first prospective clinical trials of TORS. Head and neck tumor treatments often involve a combination of surgery, radiation therapy, and chemotherapy. In many cases, surgery offers the greatest chance of cure; yet conventional surgery may require an almost ear-to-ear incision across the throat or splitting the jaw, resulting in speech and swallowing deficits for patients. In comparison, the minimally invasive TORS approach, which accesses the surgical site through the mouth, has been shown to improve long term [...]

2010-01-15T19:49:17-07:00January, 2010|Oral Cancer News|
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