NYU study shows oral cancer pain may predict likelihood of cancer spreading

Source: www.ada.org Author: Mary Beth Versaci An oral cancer patient's pain intensity score could predict cancer metastasis, helping with future testing options and surgical decision-making, according to a study from the New York University College of Dentistry. The authors of "Oncogenes Overexpressed in Metastatic Oral Cancers from Patients with Pain: Potential Pain Mediators Released in Exosomes," published in September by Scientific Reports, an open-access journal from Nature Research, used a questionnaire to document the pain experienced by 72 oral cancer patients before oral cancer surgery. While most patients reported some pain, those with the most pain were more likely to have cancer that had spread to lymph nodes in the neck, suggesting patients with less pain were at lower risk of metastasis, according to the study. "While we need to undertake a follow-up study, our current data reveal that a patient's pain intensity score works as well as the current method — depth of invasion, or how deeply a tumor has invaded nearby tissue — as an index to predict metastasis," lead author Aditi Bhattacharya, Ph.D., said in an NYU news release about the study. To help understand why metastatic cancers are more painful, the researchers looked for differences in gene expression in metastatic cancers from patients with high levels of pain and nonmetastatic cancers from patients not experiencing pain and identified 40 genes that were more highly expressed in painful metastatic cancers, suggesting those genes are associated with oral cancer metastasis and mediate cancer pain, according to the study. [...]

2020-11-14T11:08:36-07:00November, 2020|Oral Cancer News|

Tackling the complications from oral cancer and treatment

Source: www.medscape.com Author: Tara Haelle Complications from oral cancer and the toxic effects of treatment — including demineralization, caries, fibrosis, candidiasis, pain, sensitivity, and aesthetic concerns — can continue long after any evidence of cancer is apparent, experts reported at the World Dental Congress 2019. One of the major toxic effects is changes in saliva, said Joel Epstein, DMD, director of cancer dentistry at the Cedars Sinai Health System in Los Angeles and director of dental oncology at the City of Hope Comprehensive Cancer Center in Duarte, California. Another problem area — one that is often ignored — is taste, he told Medscape Medical News. And toxic effects are common, he added, citing one study that showed that 16% of patients experienced dental toxicity in the year after undergoing radiotherapy. The rates increased to 36% after 3 years, 55% after 5 years, and 74% after 7 years. For patients undergoing cancer therapy, dentists should look at overall oral hygiene, decay prevention, lip lubrication, dental emergencies, and oral mucosal infections, Epstein told the audience during his presentation on the management of patients with oral cancer, both during and after treatment. Fortunately, there are a lot of things that dentists can help with, he pointed out. For example, fluoride can be used to promote mineralization and chlorhexidine rinse can be used to reduce cariogenic bacteria. And photobiomodulation therapy, or low-level laser light therapy, can be used for the prevention of mucositis, which can be particularly painful, he added. Pain related to oral [...]

2019-12-04T09:04:47-07:00December, 2019|Oral Cancer News|

Head and neck Cancer: Overcoming Challenges in Treatment

Source: www.curetoday.com Author: staff Itzhak Brook, M.D., M.Sc., shares the story of his initial diagnosis and treatment for cancer of the head and neck, outlining the challenges that came along with treatment, with fellow board member of the Head and Neck Cancer Alliance Meryl Kaufman, M.Ed., CCC-SLP, BRS-S. Transcript: Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: Dr. Brook, can you please share your story about your cancer diagnosis in 2006 and the treatment that followed and also the subsequent surgery that you went through? Itzhak Brook, M.D., M.Sc.: Once I learned I had cancer and my doctors removed it when they had to biopsy, I needed to receive radiation therapy. I did not get any chemotherapy, and the radiation therapy lasted six weeks, five days a week. It was very difficult to experience the radiation, and the side effects start to accumulate within a few days. And I had to deal with inflammation of the mouth, mucositis, difficulty in swallowing and pain in my throat, and I experienced a burning of the skin around the area of radiation, weakness and then difficulty maintaining intake of food. After a while, I could lose weight, and I tried to persevere because I knew that I had to receive the treatment to get better and soldier through it until it was over. Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: Exactly. And some people have such severe side effects from the radiation that they actually require a feeding tube to support them during their treatment. In that case, [...]

2018-09-04T13:05:32-07:00September, 2018|Oral Cancer News|

Suicide: A Major Threat to Head and Neck Cancer Survivorship

Source: www.jco.ascopubs.comAuthors: Nosayaba Osazuwa-Peters, Eric Adjei Boakye, and Ronald J. Walker
, Mark A. Varvares TO THE EDITOR: The article by Ringash that was recently published in Journal of Clinical Oncology provided a compelling narrative of both the improvements made in head and neck cancer survivorship, as well as the challenges created by longer-term treatment and associated toxicities. There are currently at least 280,000 head and neck cancer survivors in the United States. As the article by Ringash stated, the upturn in head and neck cancer survivorship in the last three decades has coincided with the emergence of human papilloma virus-positive oropharyngeal cancer, as well as a decrease in tobacco use in the general population. These make it a challenge to isolate survival gains as a function of improved therapy from the natural prognostic value of a diagnosis of human papilloma virus-positive oropharyngeal cancer. Whatever the case, the fact that more than one-quarter million Americans are currently alive after a diagnosis of head and neck cancer means there needs to be a more deliberate effort in longer-term management of treatment-related toxicities, some of which are lifelong. We agree with Ringash’s conclusion that new models of care need to be developed in response to the significant quality-of-life issues faced by patients with head and neck cancer. The Institute of Medicine publication From Cancer Patient to Cancer Survivor: Lost in Transition, also cited by Ringash, called for a clear individualized survivorship plan for cancer patients. There is a serious need for this model to [...]

2016-03-24T15:06:02-07:00March, 2016|Oral Cancer News|

Cancer patients who smoke report worse pain, symptoms

Source: www.medscape.com/ Author: Kate Johnson Cancer patients who smoke experience more severe symptoms than nonsmoking cancer patients and are also at greater risk of misusing opioids, a new study shows. "Our findings show a profile of higher levels of physical symptoms (pain, fatigue, poor appetite, and insomnia) and psychological symptoms (depression and anxiety) among smokers than non-smokers," report Diane Novy, PhD, from the Pain Management Center at the University of Texas MD Anderson Cancer Center in Houston, Texas, and colleagues. The findings underscore the importance of smoking cessation for this patient population, she told Medscape Medical News, even though it's unclear if there is a causal effect. "We don't know the cause. They may smoke more because of the pain," she said in an interview. However, studies also show that smoking has been known to increase certain types of pain such as back pain, and nerve pain, she added. "If we can motivate them to stop smoking, I think they're better off." The findings were presented here at the American Academy of Pain Medicine (AAPM) 28th Annual Meeting. Pain, Fatigue, Insomnia The study included 486 cancer patients (52% female), with a mean age of 55 years, who were referred to the Pain Management Center for uncontrolled pain. Ninety-four patients were smokers, and the rest (n = 356), classified as nonsmokers, were former smokers or never-smokers. The patients were diagnosed with a wide range of cancers, the most common being gastrointestinal (18.5%), followed by hematologic (15%) and head and neck cancer [...]

2012-02-26T09:23:53-07:00February, 2012|Oral Cancer News|

Many Head and Neck Cancer Survivors Face Eating Problems

Source: HealthDay News Persistent pain, eating problems and depression are the most common problems experienced by long-term survivors of head and neck cancer, a new study finds. In the study, published in the Jan. 16 online issue of the journal Archives of Otolaryngology -- Head & Neck Surgery, researchers looked at 337 people who were diagnosed with head and neck cancer from 1995 to 2004 and survived at least five years. More than 50 percent of the survivors had problems eating because of poor throat functioning, 28.5 percent had symptoms of depression and more than 17 percent had substantial pain, the researchers found. However, when the long-term survivors were compared to age-matched people in the general population, their average general health was similar, Dr. Gerry Funk, of the University of Iowa Hospitals and Clinics in Iowa City, and colleagues explained in a journal news release. The investigators also found that pain and diet in the first year after cancer treatment were the strongest independent predictors of five-year, health-related quality-of-life outcomes. Problems with mouth and throat function in head and neck cancer survivors can be due to factors such as neuromuscular changes, anatomic deficits after surgery, pain and dental problems, the researchers noted. "Early interventions addressing eating issues, swallowing problems and pain management will be a crucial component in improving this patient population's long-term quality of life, especially in those who are functioning poorly one year after diagnosis," the study authors concluded. This story was also covered in a narrative form [...]

2012-01-18T13:54:28-07:00January, 2012|Oral Cancer News|

Trying to improve oral cancer treatment

Source: abclocal.go.com Author: staff It's a journey that can begin in the mirror or at the dentist's office. A small lesion in the mouth or throat can turn out to be oral cancer. Notoriously known to be unpredictable, these cancers are hard to treat, but some young doctors at the New York University's School of Dentistry are working to change that. Oral cancers take one American life every hour and it's because the unpredictability is a challenge. One person's cancer might be slow growing and another's wildly aggressive. It is impossible to tell which it is. The NYU researchers are trying to decipher their instruction codes, their genomics. If doctors know which way the cancer is going, it can be stopped. Halima Mohammed always carries water she constantly needs to drink. She is also a big consumer of fruits and vegetables. The reason: for nine years she has been fighting an oral cancer. "I can't have solid food so I get my nutrition from juices and most of these foods, especially the cabbage and the broccoli, are cancer fighting foods," she said. The cancer has had a huge impact on her life. She's already lost part of her tongue. "It is from my research one of the most painful type of cancers that you can have and I'm not diminishing cancer and the types of cancer, there is a constant pain, constant pain," said Mohammed. "It makes masticating difficult, swallowing difficult. You cannot have your favorite food anymore." But, Mohammed [...]

2011-09-23T16:16:45-07:00September, 2011|Oral Cancer News|

Trans-oral robotic surgery has all the right stuff to remove head & neck cancers

Source: inventorspot.com Author: T Goodman Historically, surgical removal or oral and throat cancers have not allowed patients to go back to living their normal daily lives. Oral cancer removals caused severe pain, particularly ugly scarring, and an inability to eat, speak, or swallow normally. Even breathing problems might result. But now along comes TORS, the robot with the right stuff. Just over a dozen hospitals in the U.S. currently have the TORS, which stands for Trans-Oral Robotic Surgery. The system uses the da Vinci Surgical System, which has developed since the mid 90's to arguably be the most successful robotic surgery system in the world. It employs tiny robotic surgical instruments, operated from a command station by the appropriately trained human surgeon who maneuvers the robot's 'arms' and instruments.   As with other da Vinci procedures, TORS has the benefits of being less invasive, with fewer complications and shorter hospital stays. There is less blood loss, little scarring, and fewer temporary and permanent side effects, such as loss of speech or swallowing ability. Generally, there is no need to begin cancer therapy with radiation, which would increase the discomfort and recovery time. Tamer A. Ghanem, M.D., Ph.D., director of Head and Neck Oncology and Reconstructive Surgery Division in the Department of OtolaryngologyHead & Neck Surgery at Henry Ford Hospital in Detroit, says that with TORS, "Surgeons operate with greater precision and control using the TORS approach, minimizing the pain, and reducing the risk of possible [...]

2011-09-02T19:22:47-07:00September, 2011|Oral Cancer News|

Smoking may worsen pain for cancer patients

Source: www.medscape.com Author: Fran Lowry Patients with cancer who continue to smoke despite their diagnosis experience greater pain severity than their counterparts who quit or who have never smoked, according to new research published in the January 2011 issue of Pain. Not only is their pain more severe, but it interferes more with their activities of daily living, lead author Joseph W. Ditre, PhD, a clinical psychologist at Texas A & M University in College Station, told Medscape Medical News. "Many smokers, when they get cancer, feel that smoking is one of the only pleasures they have left to them and refuse to quit," he said in an interview. "But our research suggests that quitting has definite benefits. It’s one more thing that doctors can tell their patients to help them stop smoking." Continued smoking has been associated with an increased risk of developing a second primary tumor, reduces the effectiveness of treatment, and is associated with poorer survival rates, Dr. Ditre said. "The subtext for this is that smoking can also worsen cancer-related symptoms and treatment side effects, such as pain and fatigue." "About 75% of people with advanced-stage cancer report moderate to very severe pain, so it is a very big factor in terms of the disease course, and yet there is surprisingly little research on this topic," he added. Dr. Ditre, who led this work while he was earning his doctorate at the University of South Florida and Moffitt Cancer Center in Tampa, told Medscape Medical News [...]

Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy

Source: 7thspace.com Author: staff Pain is common in head and neck cancer (HNC) patients and may be attributed to the malignancy and/or cancer treatment. Pain mechanisms and patient report of pain in HNC are expected to include both nociceptive and neuropathic components. Purpose: The purpose of this study was to assess the trajectory of orofacial and other pain during and following treatment, using patient reports of neuropathic pain and nociceptive pain and pain impact. Methods: 124 consecutive HNC patients receiving radiation therapy (RT) (95 men, 29 women; mean age: 54.7 +/- 12.3 years) participated in a patient-reported outcome (PRO) assessment. Patients completed the McGill Pain Questionnaire three times during therapy and 3 months following study entry. Results: The majority of patients related their pain to the tumor and/or cancer treatment. Whereas 59% reported their pain to be less severe than they expected, 29% were not satisfied with their level of pain despite pain management during cancer therapy. Worst pain was 3.0 +/- 1.3 on a 0- to 5-point verbal descriptor scale. Pain intensity was present at entry, highest at 2-week follow-up, declining towards the end of treatment and persisting at 3-month follow-up. The most common neuropathic pain descriptors chosen were aching (20%) and burning (27%); nociceptive words chosen were dull (22%), sore (32%), tender (35%), and throbbing (23%), and affective/evaluative descriptors were tiring (25%) and annoying (41%). 57% of patients reported continuous pain, and combined continuous and intermittent pain was reported by 79% of patients. Conclusions: This study provides evidence [...]

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