Team approach improves oral cancer outcomes

Source: www.drbicuspid.com Author: Donna Domino, Features Editor Providence Cancer Center in Portland, OR, is one of a growing number of facilities that is working to improve care for patients with oral cancer and head and neck cancers through a multidisciplinary program that brings together a spectrum of treatment providers. To illustrate the challenges many oral cancer patients face, R. Bryan Bell, MD, DDS, medical director of the Oral, Head and Neck Cancer Program at Providence, described the extreme effects the illness and its treatment had on one of his patients. The woman had undergone surgery, chemotherapy, and radiation for her oral cavity cancer. "This was a beautiful 32-year-old woman who had lost all her teeth and couldn't chew," Dr. Bell told DrBicuspid.com. "She had aged about 40 years during treatment, and she just looked awful. But she had no means of affording needed dental rehabilitation, which would have cost about $60,000. People need to see what happens when you don't restore these patients." Dr. Bell used the woman's case to convince officials at Providence Health, which oversees the medical center, of the need for a multidisciplinary approach for these patients. The new cancer treatment center, which opened last month, is a unique collaboration between dental and medical oncology specialists. The center provides coordinated care for oral cancer patients who often need expensive and complex dental rehabilitation, regardless of their ability to pay, according to Dr. Bell. His team includes head and neck surgical oncologists, radiation oncologists, medical oncologists, otolaryngologists, neuro-otologists, [...]

MRI can show jaw invasion of oral cancer

Source: www.medpagetoday.com Author: Charles Bankhead, Staff Writer Oral cancer's spread to the mandible could not hide from a type of MRI that may facilitate more accurate staging and surgical planning, data from laboratory studies suggest. Sweep imaging with Fourier transform (SWIFT) provided fine-detail views of cortical and medullary bone specimens, and the images exhibited good correlation with histopathologic findings. The in-vitro studies did not specifically examine SWIFT's ability to identify early cortical bone invasion by oral cancer. However, the high-quality images obtained from the investigation provide reason for optimism, the researchers reported in the September issue of Archives of Otolaryngology Head and Neck Surgery. "Our study is very promising in that it offers a SWIFT-based MRI technique for accurate assessment of minute changes of cortical and medullary bone in three dimensions without any ionizing radiation," Ayse Tuba Karagulle Kendi, MD, of the University of Minnesota in Minneapolis, and co-authors wrote. "It has the potential to precisely determine the extent of mandibular bone invasion associated with oral carcinoma. This study is a crucial step toward the goal of developing a robust and noninvasive approach for preoperative imaging of mandibular invasion," they added. Carcinoma of the oral cavity often spreads to the mandible, but in many instances does not cross the periosteal layer, obviating the need for mandibulectomy. Limitations of current imaging techniques often preclude determination of bone invasion prior to surgery, the authors noted. MRI and CT have been used most often to evaluate mandibular invasion of oral cancer, but conventional [...]

2011-09-23T16:35:59-07:00September, 2011|Oral Cancer News|

Survival of dental implants in irradiated head and neck cancer patients: a retrospective analysis

Source: HighWire, Stanford University By: A Buddula, DA Assad, TJ Salinas, YI Garces, JE Vloz and AL Weaver Purpose: To study the long-term survival of dental implants placed in irradiated bone in subjects who received radiation for head and neck cancer. Materials and Method: A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 through July 1, 2008. Only patients irradiated with a radiation dose of 50?Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. Results: A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987 to July 2008. The estimated survival at 1, 5, and 10 years was 98.9%, 89.9%, and 72.3%, respectively. Implants placed in the maxilla were more likely to fail than implants placed in the mandible.There was also a tendency for implants placed in the posterior region to fail compared with those placed in the anterior region. Conclusion: Dental implants placed in irradiated bone have a greater risk for failure. Survival is significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior).

2010-11-07T08:23:58-07:00November, 2010|Oral Cancer News|
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