quality of life – Oral Cancer News

A shift in focus for head and neck cancer treatment

Source: www.curetoday.com Author: Marijke Vroomen Durning, RN When Cindy Stemple of Westerville, Ohio, noticed a sore on her tongue, the last thing she imagined was that she may have head and neck cancer. After all, she was only 27 years old. She finally went to see her dentist when the sore wouldn’t heal. Since Stemple didn’t have any known risk factors for head and neck cancer, the dentist didn’t expect cancer either. After trying several treatments, they decided it was time for a biopsy. Stemple still wasn’t concerned. “It wasn’t even in the realm of possible things,” she says. “I didn’t even take anybody to the appointment when I got the results and found out it was cancer because it was the furthest thing from my mind.” She received a diagnosis of stage 3 oral squamous cell carcinoma — which is a cancer that occurs in the mouth and/or throat. Tremendous Change in Head and Neck Cancer Historically, head and neck cancer, the seventh most common cancer globally, was predominantly diagnosed in older individuals and was often linked to tobacco and alcohol use. As smoking rates began to decline, so did tobacco- and alcohol-related cases among older individuals. But head and neck cancer rates began rising in another group — younger and middle-aged adults — driven by HPV infections, predominantly HPV type 16, which has been shown to be a clear risk factor for head and neck cancer as well as cervical cancer. HPV-positive oropharyngeal cancers in the United States [...]

Oral Cancer Foundation News Team - A2022-09-21T06:29:44-07:00September, 2022|Oral Cancer News|

Improving head and neck cancer treatment

Source: www.uc.edu Author: Tim Tedeschi, University of Cincinnati News When the medical community finds a treatment for a particular cancer, the work doesn’t stop. Researchers continue to study how treatments can be improved in order to reduce side effects and the possibility of the cancer recurring. University of Cincinnati researchers are leading a new clinical trial to examine if the combination of a more localized radiation treatment and immunotherapy can be a better treatment for patients with recurrent head and neck cancer. Chad Zender, MD, said head and neck cancers include cancers of the tongue, throat, tonsil and larynx, and about 30%-50% of patients treated through surgery and radiation will have their cancer return. Patients often then undergo additional surgery and/or radiation treatments, which can lead to side effects like problems with speech and swallowing. “The quality of life is significantly less in the patients that require [subsequent] surgery and then radiation with or without chemo,” said Zender, professor in the Department of Otolaryngology in UC’s College of Medicine, director of head and neck surgery and principal investigator for the new trial. Precision radiation Zender said the trial will test a more localized radiation delivery method through a radioactive seed, about the size of a grain of rice that emits an intense amount of radiation to the cancer and only minimal radiation outside to other areas. The radioactive Cesium-131 seeds are implanted directly into the operative site during surgery. This approach in early studies appears to give more localized radiation [...]

Oral Cancer Foundation News Team - A2022-02-03T10:44:13-07:00February, 2022|Oral Cancer News|

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|

Halving radiation therapy for HPV-related throat cancer offers fewer side effects, similar outcomes

Source: www.eurekalert.org Author: Mayo Clinic press release Mayo Clinic researchers have found that a 50 percent reduction in the intensity and dose of radiation therapy for patients with HPV-related throat cancer reduced side effects with no loss in survival and no decrease in cure rates. Results of a phase II study were presented today at the 59th Annual Meeting of the American Society for Radiation Oncology in San Diego by Daniel Ma, M.D. a radiation oncologist at Mayo Clinic. "A common approach for treating HPV-related throat cancer is a combination of surgery followed by daily radiation therapy for six to 6½ weeks," says Dr. Ma. "However, the radiation treatment can cause a high degree of side effects, including altered taste, difficulty swallowing, dry mouth, stiff neck and damage to the jaw bone." Dr. Ma says that patients with HPV-related throat cancer tend to be young and, once treated, are likely to live a long time with possibly life-altering side effects from the standard treatment. "The goal of our trial was to see if an aggressive reduction of radiation therapy (two weeks of radiation twice daily) could maintain excellent cure rates, while significantly reducing posttreatment side effects, improving quality of life and lowering treatment costs." Researchers followed 80 patients with HPV-related oropharyngeal squamous cell cancer with no evidence of residual disease following surgery and a smoking history of 10 or fewer pack years. That's the number of years smoking multiplied by the average packs of cigarettes smoked per day. At two [...]

Oral Cancer Foundation News Team - A2017-09-26T07:17:21-07:00September, 2017|Oral Cancer News|

Improved quality of life for head and neck cancer patients with Nivolumab

Source: www.oncnursingnews.com Author: Jason Harris Patients with head and neck squamous cell carcinoma (HNSCC) saw improved or stable quality of life (QOL) scores following treatment with single-agent nivolumab (Opdivo), according to results published in Lancet Oncology.1 In contrast, patients assigned to investigator’s choice of treatment saw clinical meaningful declines, defined as a decrease in ≥10% from baseline, across 8 of 15 (53%) domains on the EORTC QLQ-C30 questionnaire. “The results of CheckMate-141 suggest that nivolumab is the first PD-1 inhibitor, to our knowledge, to show a significant improvement in overall survival, with better tolerability and a quality-of-life benefit, compared with standard therapy for platinum-refractory recurrent or metastatic squamous cell carcinoma of the head and neck,” investigators wrote. “In view of the major unmet need in this population and the importance of maintaining or improving quality of life for patients with recurrent or metastatic squamous cell carcinoma of the head and neck, these data support nivolumab as a new standard of care option in this setting.” Investigators evaluated statistical differences in patient-reported adjusted mean changes from baseline between treatment groups as assessed by the EORTC QLQ-C30, EORTC QLQ-H&N35, and EQ-5D-3L at each time point, and the time to clinically meaningful deterioration per each individual scale’s criteria. Patient assessments were conducted before treatment initiation, at week 9, and then every 6 weeks during the treatment period using the EORTC QLQ-C30, EORTC QLQ-H&N35, and EQ-5D-3L questionnaires. Posttreatment assessments were made at follow-up visits 1 and 2 (35 days give or take 7 days [...]

Oral Cancer Foundation News Team - A2017-07-14T10:56:06-07:00July, 2017|Oral Cancer News|

Head & Neck Cancer Patients Face Social Isolation, Financial Burdens

Source: www.journals.lww.com/oncologytimesAuthor: Robert H. Carlson SCOTTSDALE, Ariz.—Locally advanced head and neck cancer (LAHNC) has high morbidity and is expensive to treat. The cost of the disease, not only in financial burden but also degradation of the patient's quality of life, was highlighted in a recent study from University of Chicago Pritzker School of Medicine. The study, using data from 73 treatment-naïve LAHNC patients, showed that 69 percent relied on one or more lifestyle-altering cost-coping strategies while managing their cancer, including spending savings (62 percent), borrowing money (42 percent), selling possessions (25 percent), and having family members work more hours (23 percent). A more subtle disruption of patients' lives was also identified, that of perceived social isolation— defined as a lack of social support coupled with increased loneliness—as a risk factor for less than optimal medication adherence and use of health care resources during treatment. That meant more days of missed medication, more missed appointments, and longer inpatient hospital stays. The study was presented at the 2016 Multidisciplinary Head & Neck Cancer Symposium, sponsored by the American Society for Radiation Oncology and the American Society of Clinical Oncology. “Physical side effects are not the only ones our head and neck cancer patients endure,” said Sunny Kung, a second-year medical student and lead author on the study. “It is important for physicians to screen for social isolation just as we screen for depression and identify patients with high social isolation so we can intervene earlier on before they experience these negative financial side [...]

Charlotte Parker2016-04-18T17:15:40-07:00April, 2016|Oral Cancer News|

Depressed Head and Neck Cancer Patients Have Lower Survival and Higher Recurrence Risk

Source: www.OncologyNurseAdvisor.comAuthor: Kathy Boltz, PhD Depression is a significant predictor of 5-year survival and recurrence in patients with head and neck cancer, according to a new study published in Pyschosomatic Medicine (doi: 10.1097/PSY.0000000000000256). These findings represent one of the largest studies to report on the impact of depression on cancer survival. Although depression can have obvious detrimental effects on a person's quality of life, its impact on cancer patients is more apparent, explained lead author Eileen Shinn, PhD, assistant professor of Behavioral Science at The University of Texas MD Anderson Cancer Center, in Houston. Increasing evidence shows modest associations between elevated symptoms of depression and greater risk for mortality among patients with lung, breast, ovarian, and kidney cancers. The research team sought to clarify the influence of depression on survival, focusing their analysis on a single cancer type. By limiting the sample set and adjusting for factors known to affect outcome, such as age, tumor size, and previous chemotherapy, they were able to uncover a more profound impact of depression. The researchers followed 130 patients at MD Anderson with newly diagnosed oropharyngeal squamous cell carcinoma (OSCC), a type of cancer in which the tumor originates at the back of the throat and base of the tongue. At the beginning of their radiation therapy, Patients completed a validated questionnaire at the beginning of their radiation therapy to identify symptoms of clinical depression. Researchers monitored the participants, all of whom completed treatment, until their last clinic visit or death, a median period of [...]

Charlotte Parker2015-12-30T18:15:58-07:00December, 2015|Oral Cancer News|

Improving QOL in head and neck cancer as survival improves

Source: www.medscape.com Author: Zosia Chustecka In patients undergoing radiation treatment for head and neck cancer, reducing the radiation to organs not affected by cancer is key to improving quality of life post-treatment. Several studies presented here at the 2014 Multidisciplinary Head and Neck Cancer Symposium described new approaches to sparing radiation delivered to the salivary glands and to the voice box, without any loss of cancer control, but with a reported reduction in adverse effects, such as xerostomia (dry mouth), and an anticipated reduction in loss of voice and speech quality. Improvements in such outcomes are becoming increasingly important as the epidemiology of head and neck cancer is changing, and the increase in human papillomavirus-positive disease means that patients are being diagnosed their 50s and will, in many cases, go on to live for decades after their definitive cancer treatment, researchers commented at a press briefing. Xerostomia can make it difficult to speak, as well as chew and swallow, and can lead to dental problems. "Dry mouth might seem trivial, but it actually has a significant effect on quality of life," commented Tyler Robin, PhD, an MD candidate in his final year at the University of Colorado Medical School in Denver. To reduce this adverse effect, intensity-modulated radiation techniques are already directing the beam away from the parotid gland, which is responsible for stimulated saliva production, for example during eating. But for the rest of the time, saliva is produced unstimulated from the submandibular gland. "This gland actually produces the [...]

Oral Cancer Foundation News Team - A2014-02-28T14:23:04-07:00February, 2014|Oral Cancer News|

Study will evaluate Panitumumab regimen in advanced SCCHN

Source: http://www.onclive.com/ Author: staff Canadian researchers are investigating standard fractionation radiotherapy with concurrent high-dose cisplatin versus accelerated fractionation radiotherapy with panitumumab in patients with locally advanced stage III and IV squamous cell carcinoma of the head and neck (SCCHN). The NCIC Clinical Trials Group has completed accrual for the randomized phase III study, which has a planned sample size of 320 patients with SCC of the oral cavity, oropharynx, larynx, or hypopharynx. The trial was launched in December 2008, and the Data Safety and Monitoring Committee recommended continuing the trial in October 2011. Patients assigned to arm I will undergo standard fractionation radiotherapy once daily, five days a week, for seven weeks; they will also receive cisplatin intravenously over one hour on days 1, 22, and 43 of radiotherapy. Participants assigned to arm II will undergo accelerated fractionation radiotherapy once or twice daily, five days a week, for six weeks; they will also receive panitumumab intravenously over 30-90 minutes one week prior to and on days 15 and 36 of radiotherapy. The primary endpoint is progression-free survival (PFS), while secondary endpoints include overall survival, local and regional PFS, distant metastases, adverse events, swallowing-related quality of life, functional swallowing outcomes, and economic assessments. The FDA has approved panitumumab under the brand name Vectibix for the treatment of patients with metastatic colorectal carcinoma with disease progression on or following chemotherapy regimens containing fluoropyrimidine, oxaliplatin, and irinotecan. Panitumumab is a human IgG2 kappa monoclonal antibody that binds specifically to human epidermal growth factor [...]

Oral Cancer Foundation News Team - A2012-09-11T08:18:26-07:00September, 2012|Oral Cancer News|

Robotic surgery vs. radiation therapy: study will find which better for throat cancer

Source: http://www.windsorstar.com/ Author: Beatrice Fantoni, The Windsor Star In the first trial of its kind in the world, doctors in London, Ont., are comparing robotic surgery and radiation therapy to find out which method helps throat-cancer patients retain speech and swallowing functions - two very important functions that can have a serious effect on quality of life for cancer survivors. Dr. Anthony Nichols and Dr. David Palma of the London Health Sciences Centre are working with 68 test subjects who have cancer of the back of the throat (also known as oropharyngeal cancer) and measuring the swallowing functions of each patient one year after treatment. Because the cure rate for oropharyngeal cancer is pretty good, Nichols said, he and Palma want to focus on how to improve patients' post-treatment quality of life. In Canada, the standard way of treating oropharyngeal cancer is with a combination of radiation and chemotherapy. However, Nichols said, there can be some longterm side-effects with this treatment, such as dry mouth, hearing loss, taste changes and compromised swallowing function. "The side-effects are more than what we'd like," said Palma. "We want to improve the quality of life." Surgery using a robot is a newer treatment that could perhaps be more appropriate for some oropharyngeal cancer patients, Nichols said. London is currently the only site in Canada to offer what is known as transoral robotic surgery. The robot sounds promising, Palma said, and so it warrants more study. "We don't really know if the 'surgery first' approach [...]

Oral Cancer Foundation News Team - A2012-08-03T09:54:30-07:00August, 2012|Oral Cancer News|