“Immunotherapy is keeping me alive” – John’s story

Source: www.icr.ac.uk Author: John Dabell On his daughter’s second birthday in 2009, John Dabell was diagnosed with advanced head and neck cancer. He went through extensive surgery and treatment and was on the road to recovery when he was diagnosed with cancer again – this time, a tumour in his throat. John was told he didn’t have long to live. But then he started immunotherapy. Here, he talks about its incredible impact and the opportunity it’s given him to spend more time with his wife and daughter. The first red flag telling me something was wrong was when my tongue started to swell. I soldiered on because I didn’t think there was anything sinister going on. That was a mistake. I started having difficulty eating and swallowing, but I put that down to my throat being sore. I was also extremely tired, but I had a young daughter at home and was busy being a primary school teacher. After about a month, things hadn’t improved. I found that I couldn’t utter my words in the same way and things started to get painful. Then my tongue inflated, and I went to see my GP, who recommended I see my dentist. My dentist immediately referred me to a head and neck specialist at the Queen’s Medical Centre in Nottingham. My life changed forever A biopsy and MRI scan revealed that I had a tumour growing inside my tongue and it was stage four head and neck cancer. This knocked me for [...]

Tackling side effects in head and neck cancer treatment – the end of the road for hyperbaric oxygen?

Source: Cancer Research UK Date: May 2, 2019 Author: Katie Roberts Some side effects appear years after cancer treatment. That’s the case for one side effect of radiotherapy for head and neck cancer, called osteoradionecrosis. This painful condition results from damage to the jaw bone, which often doesn’t heal properly and can cause bone fractures or even bone death. It can develop without an obvious trigger, but it’s often linked to dental work like tooth extractions or implants. And it can happen even if the dental work is carried out 20 years after radiotherapy. Professor Richard Shaw, a Cancer Research UK-funded head and neck surgeon at the University of Liverpool, treats the difficult condition quite frequently through reconstructive surgery. Shaw says that these procedures are often bigger and harder than patients’ original cancer surgery, because they’ve already had so much treatment in that area. For that reason, researchers have looked for ways to prevent osteoradionecrosis from developing. And that’s where hyperbaric oxygen comes in. It started with a small trial in the 80s, which has influenced the way doctors prepare patients for dental surgery ever since. But new Stand Up To Cancer trial data, led by Shaw and published in the International Journal of Radiation Oncology, shows the hyperbaric oxygen hype may have been a bit premature. The trial of hyperbaric oxygen Back in the 1980s, a small trial in the US showed that giving hyperbaric oxygen before dental surgery could reduce the risk of osteoradionecrosis developing. What is hyperbaric oxygen therapy? Hyperbaric oxygen treatment involves [...]

2019-05-06T10:21:09-07:00May, 2019|Oral Cancer News|

Long-term implant failure in patients treated for oral cancer by external radiotherapy: a retrospective monocentric study

Source: Journal of Oral Medicine and oral Surgery, JOMOS Date: October 10th, 2018 Authors: Aline Desoutter, Sophie Deneuve, Sophie-Charlotte Condamin and Anne-Gaëlle Chaux-Bodard Abstract Introduction: The placement of dental implants in irradiated bone has allowed functional rehabilitation for many oral cancer patients. Nonetheless, there is only few data about implant failure in irradiated tissues and their consequences. This retrospective study aims to highlight the rate and circumstances of implant failure. Material and method: Patients treated with external radiotherapy for oral carcinoma and who received dental implants were included. Patients reconstructed with free bone flaps were excluded. Results: Eighteen patients were included. Forty implants were placed between 2004 and 2007, 8 failed, of whom one osteoradionecrosis was observed. Time interval between radiotherapy and implantation was 44.6 (6–182) months. Mean dose was 51.8 (50–66) Gy. Discussion: In the series, the implant failure rate is 20%, which corroborates the literature's data. Failures occur more often for doses over 50 Gy. The placement of dental implant in irradiated bone leads to soft tissue complications but also increases the risk of osteoradionecrosis. The recent reimbursement of dental implants in oral cancer patients by the National Social Health system will probably increase the indications. Multidisciplinary staffs should be aware of benefit/risk ratio for each patient. Introduction Dental implants in patients treated for upper aerodigestive tract (UADT) cancers have facilitated the functional and aesthetic rehabilitation of patients whose postoperative anatomy did not allow for the placement of conventional prostheses. Several studies have been conducted and the success rates have varied [...]

2018-10-16T13:03:44-07:00October, 2018|Oral Cancer News|

Oral cancer patient fights Medicare for coverage

Source: Dr.Biscuspid.com By Donna Domino, Features Editor November 6, 2012 -- Hank Grass has so far successfully fought his submandibular cancer. But the retired policeman is now facing bankruptcy in his losing battle to get Medicare to cover the oral surgeries, dental treatments, and dentures he needs following radiation treatment. The 77-year-old had his salivary gland removed after doctors found cancer at the base of his tongue three years ago. But the radiation and chemotherapy damaged his teeth and gums so much that he had to have all but three of his bottom teeth extracted. Recently, Grass needed periodontal surgery to treat an infection he developed in his mandible from radiation treatments. After Hank Grass developed submandibular cancer, radiation therapy caused osteoradionecrosis, requiring the extraction of all but three of his bottom teeth. All images courtesy of Hank Grass. So far, Grass has spent $8,000 for the dental treatment and dentures, but Medicare won't reimburse him, saying his dental work was not medically necessary and is cosmetic. And since Medicare has refused payment, Grass' insurance company also has refused to cover the dental procedures. "I've been through a living hell," he told DrBicuspid.com. "We're pinching pennies; we're in bankruptcy." Five doctors -- including his dentist, oncologist, oral surgeon, and the doctor who administered chemotherapy -- submitted letters confirming that Grass' dental procedures were directly related to his cancer treatments. But it was to no avail, he said. "You don't have to be a rocket scientist to look at all the [...]

2012-11-07T12:40:04-07:00November, 2012|Oral Cancer News|

Proper dental care for cancer patients: why it is important

Source: newcanaan.patch.com Author: Alan B. Sheiner DDS Common side effects from radiation therapy are not stressed enough in dental schools, but they can be managed and even prevented. A few weeks ago, I was contacted by a retired physician with whom I had not spoken for a number of years since he retired from practice to become a “gentleman farmer” in the country. While I was happy to hear from him, his news was not so good. He was calling because he had been treated for base of tongue cancer and his teeth were “coming apart”. His cancer treatment consisted of chemotherapy and radiation therapy. Unfortunately, he somehow “slipped through the cracks” and his oral cavity was now suffering from some of the side effects of the cancer therapy – fortunately he is currently cancer free. The oral cavity, one of the most complex and visible organ systems in the body, is invariably compromised as a result of treatment for head and neck cancer. Whether the malignancy is to be treated by surgery, radiation therapy, chemotherapy or a combination of these modalities, the function, if not also the form, of the oral cavity will be impacted. Aside from the obvious physical changes after cancer surgery to the head and neck region, there are issues which usually accompany radiation therapy to the head and neck region. There may be side effects from cancer therapy, some of which can be devastating, but preventable or manageable with proper precautions and care. The most [...]

New Guidelines for Reirradiation of Head and Neck Cancer

Source: Medscape News Today When head and neck cancer recurs and surgery is not an option, reirradiation provides the only potentially curative option. However, because the tumor often recurs in the same place or very close to tissue that has already been irradiated, this treatment approach represents a "significant challenge." For this reason, it should be handled at a tertiary-care center, according to a new guideline issued by the American College of Radiology. Specifically, it stipulates that the tertiary center should have a head and neck oncology team that is equipped with the resources and the experience to manage the complexities and toxicities of retreatment. In the guideline, published in the International Journal of Radiation Oncology, Biology and Physics, a panel of experts outline appropriateness criteria for various clinical scenarios that arise with such patients. It provides a consensus on how patients should be managed. "This is an important document because it is the first set of guidelines for the potentially curative treatment of patients who have regrowth of head and neck tumors. It provides a consensus on how patients should be managed," coauthor Madhur Kumar Garg, MD, said in a statement. Dr. Garg is from the Department of Radiation Oncology at Montefiore Medical Center, in the Bronx, New York, where about a dozen reirradiation procedures are performed annually. Commitment to Retreatment Retreatment is justified because clinical trial results have shown that local treatment improves overall survival, the panel of experts notes. However, they emphasize that, before a commitment to [...]

Simulation of scattering dffects of irradiation on surroundings using the example of titanium dental implants: a Monte Carlo approach

Source: International Journal of Cancer Research and Treatment Authors: REINHARD E. FRIEDRICH1, MANUEL TODROVIC2 and ANDREAS KRÜLL2 Correspondence to: Professor R.E. Friedrich, Oral and Maxillofacial Surgery, Eppendorf Medical Center, University of Hamburg, Martinist. 52, D-20246 Hamburg, Germany. Tel: +49 40428033259, Fax: +49 428038120, email:[email protected] Abstract Occasionally, head and neck cancer patients treated with high-energy X-rays and gamma rays have titanium dental implants. The aim of this study was to calculate alterations in the irradiated bone caused by a foreign body, representing a titanium implant in size and physical qualities, using a stochastic (Monte Carlo) simulation. A clinical linear accelerator was simulated using BEAM/EGS4. The calculations showed that the presence of an implant results in differences of the dose distribution all around the implant. Titanium dental implants in the field of irradiation were capable of causing significant radiation scattering. The risk for dose enhancement was notably important for the bone in direct contact with the foreign body. Therapists involved in radiation planning should consider the impact of dental implants on the radiation beam as a putative cause of osteoradionecrosis.

2010-07-01T14:56:38-07:00July, 2010|Oral Cancer News|
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