osteonecrosis

Reducing RT toxicity in head and neck cancer: recent research context

Source: www.medpagetoday.com Author: Kristin Jenkins, contributing writer, MedPage Today In patients with head and neck malignancies, studies show that the significant acute and long-term toxicities and poor quality of life (QOL) associated with postoperative radiation therapy (PORT) can be improved by selectively reducing larger radiotherapy volumes. This includes treating just one side of the neck. In patients with locally advanced head and neck squamous cell carcinoma (HNSCC), however, locoregional failure rates with the omission of PORT to the pathologically uninvolved neck (PN0) have been less clear. As a result, PORT has historically been delivered to the PN0 neck, with several studies showing high rates of regional control ranging from 95% to 100%. Notably, consensus clinical practice guidelines continue to recommend the use of bilateral irradiation of node-negative necks. However, results from a prospective phase II study in 72 patients with primary HNSCC and high-risk pathology features now suggest that PORT to the PNo neck can be eliminated without sacrificing excellent disease control or QOL. At a median follow-up of 53 months, absolute regional control in the unirradiated neck was 97%, even though 67 patients (93%) had stage III/IV disease and 71% of tumors involved or crossed midline. No patient received contralateral neck PORT, and 17 patients (24%) were treated for the primary neck tumor only, said Wade Thorstad, MD, of Washington University in St. Louis, and colleagues. The 5-year rates of local control, regional control, progression-free survival, and overall survival (OS) were 84%, 93%, 60%, and 64%, respectively, they reported [...]

Oral Cancer Foundation News Team - A2019-11-21T12:57:43-07:00November, 2019|Oral Cancer News|

Dental oncology: Meeting a growing need

Source: Dr.Biscuspid.com The good news is more cancer patients are surviving than ever before. The bad news is it creates new challenges for the medical community to provide adequate and appropriate aftercare and treat the many short- and long-term side effects of cancer treatment. For example, chemotherapy and radiation often cause oral problems such as mucositis, xerostomia, oral and systemic infections, and accelerated caries development. But many dentists refuse to treat cancer patients with these conditions due to the increased risk of osteonecrosis from radiation treatment or bisphosphonate use. Enter Ryan Lee, DDS, MPH, MHA, who is finishing a postgraduate clinical fellowship in dental oncology at Memorial Sloan-Kettering Cancer Center in New York City. He hopes to help solve the shortage of dentists with the training to treat the growing number of cancer patients who need specialized oral care. Ryan Lee, DDS, is one of a handful of dentists specializing in dental oncology. Dr. Lee is one of two fellows in Sloan-Kettering's dental oncology fellowship program, which has been offering the specialty training for at least a decade. "All along I've liked working on medically complex cases with dental needs, so cancer fit into that niche very well," he told DrBicuspid.com. "I've come to realize how much of a growing need it is and how little is available to meet that need," he explained. Currently, only two cancer hospitals offer fellowship training programs for dental oncology: the Memorial Sloan-Kettering Cancer Center and the University of Texas MD Anderson Cancer Center. [...]

Charlotte Parker2012-06-07T10:09:20-07:00June, 2012|Oral Cancer News|

Caring for the oral health of patients battling cancer: oral care before cancer treatment

Source: www.dentistryiq.com/ Author: Dennis M. Abbott, D.D.S. Cancer. The New Oxford American Dictionary defines it as “the disease caused by an uncontrolled division of abnormal cells in a part of the body;” but for the millions of people it has touched, cancer is so much more. Cancer is a constant unwanted companion that opens the door to an unchosen journey and demands to be followed. It affects individuals, families and friends. Cancer changes lives. Beyond the emotional toll it imposes, cancer alters the well-being of those it afflicts. Modern treatment regimens given to combat this disease come with a host of deleterious side effects, many of which occur in the mouth. Dentists, dental hygienists and dental auxiliaries are in a unique and necessary position to make a positive impact in the lives of patients battling cancer Making a difference begins with a desire to help and a willingness to take a risk. It is followed by a commitment to learn about the unique oral health care needs of patients engaged in the fight of their lives and put into practice skills that can literally provide comfort and hope. We, as dental professionals, can and should be a part of a comprehensive cancer care team for an ever-growing number of people facing cancer. Dental Oncology Dental oncology is a focus of dentistry dedicated to meeting the unique dental and oral health care needs that arise as a result of cancer therapy. It is an area of oral medicine devoted to improving [...]

Oral Cancer Foundation News Team - A2012-02-12T08:48:16-07:00February, 2012|Oral Cancer News|

Consider dental issues before beginning cancer treatment

Soure: www.curetoday.com/ Author: Lacey Meyer Dentists advise resolving tooth and gum issues before starting cancer treatment. Bettye Davis admits she has never had very good teeth. But when she received a diagnosis of salivary gland cancer, she was surprised that her oncologist recommended she visit a dentist before beginning radiation treatments to her jaw. “When we first saw her, she still had quite a few teeth, but she had severe periodontal disease and severe bone loss,” says Dennis Abbott, DDS, Davis’ dentist. Knowing radiation would do more damage, he recommended removing the remainder of her teeth and allowing time to heal before she began 33 radiation treatments. “We knew that if we took the teeth out after radiation, we risked the bone not healing well, which would have meant osteonecrosis, dead bone in her mouth, and lots of systemic problems.” According to the National Cancer Institute, eliminating pre-existing dental and mucosal infections and instituting a comprehensive oral hygiene protocol before and throughout therapy can reduce the severity and frequency of oral complications from cancer therapy. Abbott says the NCI recommendations, as well as an increasing number of studies, are bringing more recognition to the importance of dental issues before, during and after cancer treatment. A Proactive Approach Abbott’s goal is to help patients maintain healthy teeth and reduce the risk of future infection with an oral care plan that eliminates or stabilizes disease that could produce complications during or following therapy. These complications can range from irradiated bone and gums [...]

Oral Cancer Foundation News Team - A2011-12-22T15:08:57-07:00December, 2011|Oral Cancer News|

ADA updates guidelines for managing ONJ risk patients

Source: www.drbicuspid.com Author: Rabia Mughal, Contributing Editor A patient receiving antiresorptive therapy for the prevention and treatment of osteoporosis has a low risk of developing osteonecrosis of the jaw (ONJ), and benefits of the medication outweigh the risk of ONJ, according to an advisory statement from the ADA. The statement, "Managing the Care of Patients Receiving Antiresorptive Therapy for Prevention and Treatment of Osteoporosis," is based on a literature review by an advisory committee of the ADA Council on Scientific Affairs and updates ADA's 2008 advisory statement (Journal of the American Dental Association, November 2011, Vol. 142:11, pp. 1243-1251). ONJ associated with antiresorptive agents has mostly been referred to as bisphosphonate-associated ONJ, but nonbisphosphonate antiresorptive agents are now available that also could be associated with ONJ, the panel noted. That is why they refer to the condition as antiresorptive agent-induced ONJ (ARONJ). A relatively new condition, bisphosphonate-associated ONJ, has received tremendous media attention because of a flurry of lawsuits against the makers of Fosamax and Zometa alleging that the medications led to ONJ. These lawsuits have been a factor in raising patients' and dentists' awareness of the condition, according to Helen Ristic, PhD, director of scientific information for the ADA's Division of Science and one of the panelists who contributed to the report. "The first calls the ADA received from dentists about ARONJ were in response to advertisements by lawyers and media reports," she said. Still, much about the condition remains a mystery, in part because there has not been [...]

Oral Cancer Foundation News Team - A2011-11-06T10:10:08-07:00November, 2011|Oral Cancer News|