radiation

Immunotherapies gaining traction in head and neck cancers

Source: www.targetedonc.com
Author: Greg Kennelty

An explosion of immunotherapies is on the horizon for patients with metastatic head and neck cancer, specifically as phase III trials begin to report findings for PD-1 inhibitors. This upcoming wave of new therapies places importance on understanding optimal treatment settings and adverse events associated with these therapies.

In late January, the phase III CheckMate-141 trial investigating the anti–PD-1 agent nivolumab was stopped early, due to a substantial improvement in the primary endpoint of overall survival (OS). The drug was put up against the investigator’s choice of cetuximab (Erbitux), methotrexate, or docetaxel following progression on a platinum-based therapy.

At this time, data from the study have not yet been released but are being prepared for future presentation. Findings from the study are being discussed with the FDA and other health authorities.

In addition to nivolumab, the PD-1 inhibitor pembrolizumab (Keytruda) demonstrated encouraging activity in patients with with advanced PD-L1–positive esophageal carcinoma during the phase Ib KEYNOTE-028 study. Additionally, the agent was effective for patients with squamous cell carcinoma of the head and neck in the phase I KEYNOTE-012 study.

In the head and neck cancer population, the objective response rate with pembrolizumab was 24.8% in 117 evaluable patients. Tumor shrinkage was experienced by 56% of patients and another 25% had stable disease. The response rate seen with pembrolizumab was similar, regardless of HPV infection status. In those with HPV-positive disease, the ORR was 20.6% compared with 27.2% in the negative group.

To gain further insight, Targeted Oncology spoke with head and neck cancer expert Barbara Burtness, MD, professor of Medicine (Medical Oncology), Clinical Research Program Leader, Head and Neck Cancers Program, co-director, Developmental Therapeutics Research Program, Yale Cancer Center.

TARGETED ONCOLOGY: Can you give us an overview of where immunotherapy is currently in head and neck cancer?

BURTNESS: The first trials for immunotherapy in head and neck cancer began two or three years ago and we now have sufficient reason to believe that these therapies are going to be active in the cancer. For example, there is the KEYNOTE-012 trial, which was a trial of pembrolizumab given to an expansion cohort of either HPV-positive or HPV-negative head and neck cancer. The response rate there was about 25%.

There is some reason to believe that if either PD-L1 or PD-L2 are expressed, that that would predict for a higher response rate. There are now phase III trials going forward for both platinum-refractory disease and for first-line patients looking at pembrolizumab compared with chemotherapy.

There are also data with MEDI4736, which if a patient is expressing PD-L1, appears to have a pretty high response rate of about 50% in a small group of patients. There are currently ongoing trials looking at the combination of MEDI4736 with tremelimumab, though we don’t have any data on that just yet.

Then there are novel strategies people have for trying integrate immunotherapy with standard treatment. We have some reason to believe that when head and neck cancer is treated with radiation there is upregulation in tumor-infiltrating lymphocytes and PD-L1. There are trials now moving forward that are integrating immune checkpoint inhibitors together with chemoradiation, or taking patients who have completed their chemoradiation but have persistent disease and exposing them to pembrolizumab in that setting.

The last thing is there is some evidence that siltuximab can upregulate a co-stimulatory molecule, CD137. There are some trials looking at co-targeting EGFR and CD137.

TARGETED ONCOLOGY: What are the side effects in immunotherapy?

BURTNESS: The one thing community oncologists should be aware of is toxicities. As these drugs roll out, these toxicities that will be present are a lot different to manage than the usual cytotoxic agent toxicities. There are a lot of unusual or unexpected side effects that are autoimmune in nature.

The most common toxicity is fatigue. Across all the patients with head and neck cancer who received pembrolizumab, about 17% of them had grade 3 or 4 toxicities. This is a lot easier to tolerate than chemotherapy or chemoradiation. The other things that you might look for are pneumonitis, nephritis, pancreatitis with diabetic symptoms, thyroiditis, and a variety of unusual autoimmune side effects.

TARGETED ONCOLOGY: What do you see as the overall potential for immunotherapy in head and neck cancer?

BURTNESS: Everybody with biomarker expression of either the ligands or the targets in this pathway is likely to be exposed to these drugs in the future. The challenge for us is going to be to figure out, for those patients who are not PD-L1 expressing or who don’t have tumor-infiltrating lymphocytes, other ways that we can prime patients for immunotherapy with our standard treatments. It’s speculative – it’s not something that people are doing in clinics now, but the first trials of those approaches are starting.

There is also ADXS11-001 that is fused to the E7 oncogene from HPV. The idea is that that would increase antigenic presentation and then the immune checkpoint inhibitor could potentially be more effective. That treatment is still in phase I.

February, 2016|Oral Cancer News|

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

Source: www.OncologyNurseAdvisor.com
Author: 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 5 years.

“The results of this study were quite intriguing, showing depression was a significant factor predicting survival at 5 years, even after controlling for commonly accepted prognostic factors,” said senior author Adam Garden, MD, professor, Radiation Oncology. Furthermore, depression was the only factor shown to have a significant impact on survival.

Patients who scored as depressed on the questionnaire were 3.5 times less likely to have survived to the 5-year interval compared with those who did not score as depressed. The degree of depression was also found to be significant, as every unit increase on this scale indicated a 10% higher risk for reduced survival.

The results were replicated with a different psychological health survey and were not influenced by how soon following diagnosis the depression assessment was done.

OSCC is diagnosed in 10 000 to 15 000 Americans each year. Major risk factors known to be associated with OSCC include smoking and tobacco use, alcohol consumption, and human papillomavirus (HPV) infection. Incidence of OSCC has doubled in the last 20 years due to increasing HPV infection rates, noted Shinn.

Neither alcohol nor tobacco use, also surveyed in this group, had a significant impact on survival. HPV infection status, when available, also did not appear correlated.

Despite a high cure rate, normally 60% to 80%, recurrence rate of disease is unusually high in these patients (approximately 30%). The researchers also investigated a potential link between depression and disease recurrence.

“When we controlled for all variables, depression was linked with a nearly 4 times higher risk of recurrence,” said Shinn. In addition, never smokers had a 73% lower chance of recurrence, compared with current smokers. Those were the only two factors associated with cancer recurrence.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

December, 2015|Oral Cancer News|

Poison’s Rikki Rockett Reveals He Is Battling Oral Cancer

Source: www.loudwire.com
Author: Chad Childers
 

Poison drummer Rikki Rockett revealed during an appearance on the Eddie Trunk Live radio show that he’s completed nine rounds of chemotherapy and seven weeks of radiation treatments after being diagnosed with oral cancer this past summer and that he’ll find out in February if the treatments were successful.

Rockett told Trunk (as transcribed by Blabbermouth), “[In] June, I kind of got sick. I had this horrible cold, sore-throat thing, and they were scoping me and they were doing biopsies, and nothing was coming up. And finally a doctor at USC did a biopsy and took a look and he said, ‘I believe you have oral cancer.’ And what it was is a tumor at the base of my tongue … This is very similar to Bruce Dickinson, very similar to Michael Douglas, similar to Tom Hamilton, as far as I know; I don’t know the details of his. And two adjacent lymph nodes that it kind of … Normally, it does spread to the lymph nodes; that’s typical. That’s how you find out you have it ninety percent of the time.”

According to the Rockett, his doctor told him that it was a very treatable cancer, but was “a son of a bitch to treat.” He was then told that he would either have to undergo radiation and chemotherapy at the same time or undergo surgery, but even if he chose the latter, he might still have to do radiation and chemotherapy.

Rockett revealed that it was tough, explaining, “I did thirty-five rounds of radiation; it was five days a week for seven weeks, and that kicks your dick into the dirt. But I went, ‘Okay, this is what I’m gonna do. I wanna beat it, so I’m just gonna go head first into this. I’m gonna set myself up where every single day, I do something positive for my health. I’m gonna work out one day, I’m gonna go to therapy one day.’”

He continued, “At the end of the day, it was really the worst thing that you can go through, for me. I’ve had a decent life, you know what I mean? I mean, we all go through our stuff. I’m not saying my life is a bed of roses, but I’m not a war veteran who got this too. I didn’t get my leg blown off and get cancer. Those guys are the guys that are really the heroes and paying for it. So for me, it was just a battle that I had to get through, and I got to the point where I couldn’t really talk. I had, I think, sixteen canker sores in my mouth at one time. And it’s, like, if you could take your throat and turn it inside out and sunburn it… I had to use this stuff called Magic Mouthwash just to drink the water. It hurt so bad, I couldn’t… And I’m still on a liquid diet.”

As for his decision to keep his cancer treatment quiet, the rocker revealed, “I wanted to see how I would do with [the treatment]. And I didn’t want people to maybe come down to USC and [take] spy photos, like TMZ guys or something like that. And I didn’t want anybody talking to my family about it or anything like that. It’s, like, you wanna forget about it when you can. So when I first start to talk about it, [I didn’t want it to be a situation where] I’d be at the mall, and I’m playing with my little girl or something, and somebody would go, like, ‘Hey, man, how’s the throat doing?’ It’s, like, ‘I just forgot about it for the last forty-five minutes and now you had to remind me.’ And everybody has a horror story. ‘Oh, you have cancer? My mom had cancer. She died from it.’ I don’t wanna hear anybody’s horror stories.”

Rockett revealed that all signs are that he’s responded well to the treatment and that he’s hoping to get good news when he goes for his PET scan in February. “I’m just gonna try to put that out of my mind for now and just continue to get better and feel better,” says Rockett. “There’s nothing that looks like it’s there anymore. They’ve gone down, they’ve looked at my throat… But it’s swelled up and it’s hard to tell, but it looks like it’s in remission.”

During the chat, Rockett revealed that his tongue cancer was caused by HPV, which is currently the number one cause of oral cancer.

While Poison were out of action during 2015, Rockett kept busy with the self-titled debut album from his band Devil City Angels.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

December, 2015|Oral Cancer News|

Cetuximab plus RT linked with high toxicity in head and neck cancer

Source: www.cancernetwork.com
Author: Anna Azvolinsky, PhD

The combination of radiation therapy plus the EGFR inhibitor cetuximab had higher rates of acute toxicity among patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) compared with radiation therapy plus the chemotherapy cisplatin, according to results of a phase II trial based in Italy. Efficacy was similar with both combination therapies.

According to Stefano Maria Magrini, MD, professor of radiotherapy at the Università degli Studi di Brescia in Italy, and colleagues, this is the first clinical trial to directly compare radiation therapy plus cetuximab to a chemoradiation regimen for SCCHN.

The results of the randomized trial are published in the Journal of Clinical Oncology.

Cetuximab was approved in combination with radiation therapy by the US Food and Drug Administration in 2006 for the treatment of unresectable SCCHN.

Despite a goal of recruiting 130 patients, only 70 patients were recruited between 2011 and 2014.

The 1- and 2-year overall survival rates were 75% and 68% in the cetuximab arm compared with 78% in the cisplatin arm. The 1- and 2-year local control rates were 64% and 53% in the cetuximab arm and 84% and 80% in the cisplatin arm, yet the differences between arms were not statistically significant (P = .073), reflecting the inadequate statistical power of the relatively small trial.

Compliance in both treatment arms was relatively low. Only 28% of patients in the cetuximab arm and 20% of patients in the cisplatin arm received at least 7 cycles of therapy.

Patients in the radiation therapy plus cetuximab arm experienced more serious adverse events including severe cutaneous toxicity of grade 3 or higher. Four patients in the cetuximab arm developed infectious complications that led to septic shock and three of the patients died after the end of treatment. An additional patient died from respiratory failure caused by aspiration pneumonia.

Patients in the cisplatin arm had more frequent hematologic toxicities compared to patients in the cetuximab arm and one patient died from adverse events possibly related to treatment.

“The incidence of both the infusion reactions and of the other severe adverse events does not allow to consider cetuximab a safer and easy-to-use alternative to standard chemotherapy regimens,” wrote the study authors.

Based on the study results, larger prospective trials are needed to understand which SCCNH patients would best benefit from radiation therapy plus cetuximab regimen.

In an accompanying editorial, Roy H. Decker, MD, PhD, associate professor of therapeutic radiology at the Yale School of Medicine in New Haven, Connecticut, and colleagues highlighted the limitations of the current trial but look forward to results from ongoing studies to clarify the role of cetuximab in the treatment of SCCHN.

“We continue to selectively consider the use of cetuximab-based radiation therapy in patients with otherwise-favorable, low-risk disease—p16-positive, T1–T3 N0–N2b with a smoking history of less than 10 pack-years,” wrote the editorial authors.

December, 2015|Oral Cancer News|

Head, Neck Cancer Patients May Be at Higher Risk for Suicide: Study

Source: www.health.usnews.com
Author: Robert Preidt
 

THURSDAY, Nov. 12, 2015 (HealthDay News) — Head and neck cancer patients may be at raised risk for suicide, new research suggests.

However, the overall risk is still small, the findings showed.

The study included over 350,000 patients in the United States diagnosed with head and neck cancer between 1973 and 2011. Of those patients, 857 died by suicide.

The investigators found that the suicide rate among head and neck cancer patients was three times higher than in the general population. And suicide rates were higher among patients treated with radiation alone compared to surgery alone.

Suicide rates were highest among those with cancers of the lower part of the throat, including the larynx (“voice box”) and hypopharynx, at five times and 12 times higher, respectively, than in the general population.

“This may be linked to these anatomic sites’ intimate relationship with the ability to speak and/or swallow. Loss of these functions can dramatically lower patients’ quality of life,” Dr. Richard Chan Woo Park, of Rutgers New Jersey Medical School, and colleagues wrote.

“It is possible that the increased rates of tracheostomy [breathing tube] dependence and dysphagia [difficulty swallowing] and/or gastrostomy [feeding] tube dependence in these patients are . . . factors in the increased rate of suicide observed,” the authors added.

The study was published online Nov. 12 in the journal JAMA Otolaryngology–Head & Neck Surgery.

“While there is a considerable body of research that examines survival outcomes for patients with head and neck cancer, additional research and effort should also be devoted to the psychological toll that the cancer, treatments and resulting morbidity have on patients,” the researchers concluded.

Suicide is the 10th leading cause of death in the United States and cancer patients are at increased risk for suicide, the study authors pointed out in a journal news release.

More information

The American Cancer Society offers resources on coping with cancer.

Copyright © 2015 HealthDay. All rights reserved.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

November, 2015|Oral Cancer News|

Marathoner Harriette Thompson, 92, runs to her own inspiring rhythm

Source: http://espn.go.com/
Author: Lynn Olszowy

Harriette Thompson has found a clever way to pass the time when she runs marathons. The classically trained concert pianist imagines her favorite pieces of music.

“When I’m in a place that might be pretty boring, I run to some music in my mind,” she explained. “I hardly know I’m running when I’m thinking about that.”

92_marathoner

Over the weekend, musical thoughts helped Thompson run into the history books for the second year in a row. Last year, she broke the marathon record by a woman over 90 by more than two hours. On Sunday, she became the oldest woman to ever complete a marathon at the age of 92 years, 65 days.

Two days later, she had a spring in her step.

“I feel like a million dollars right now,” Thompson said Tuesday from her home in a Charlotte, North Carolina, retirement community. “I think it must do something to your life system or something that makes you feel up on top of the world after you’ve done a marathon.”

Throughout her 7 hours, 24 minutes and 36 seconds of running, she had Russian composer Sergei Rachmaninoff and his Prelude in D Major keeping her company.

“It’s fun to just think about it because I think it’s one of his most beautiful preludes,” she said over the phone Tuesday.

But there was something else that occupied Thompson’s mind while she ran the 26.2 miles of Sunday’s San Diego Rock ‘n’ Roll Marathon.

“I also think about all the ways I’m working to help other people,” she said.

Thompson has run 16 marathons to raise money for the Leukemia & Lymphoma Society as part of Team in Training. In all, she’s garnered more than $100,000 in donations.

“It makes me very grateful to all the people who have been so generous,” she said. “Every year, when I write my little letter asking my friends [to donate], they keep saying, ‘I thought last year was your last one.'”

This year, Thompson says she had extra motivation to run. After she lost her husband of 67 years to cancer in January, her eldest son, Sydnor Thompson III, was diagnosed with colon cancer.

“I have so much incentive because now I’m really trying to help get that research done so that maybe it will help my son get over his cancer,” she said.

“It’s humbling,” said Sydnor, 61, a pastor in suburban Charlotte. “I don’t know of any child who has ever been loved more than I’ve been loved by my mother.”

“I’m just praying that he’ll get better real fast,” adds Thompson. “The fact [I set] a record, that’s great, but that’s not my main reason.”

In fact, when Thompson first took up running at age 76, she never dreamed of setting any records. She didn’t even think she’d run a marathon. She signed up for her first marathon in 1999 figuring she’d walk the length of the course.

“But when I got out to San Diego, everybody was running, so I started to run,” she said.

Today she credits running with keeping her going all these years, though she has overcome obstacles of her own.

In 2010, while battling an aggressive form of oral cancer — which ate away the roof of her mouth — she was told she had only three months to live, two years at best. Thompson didn’t let that prognosis stop her from running the San Diego marathon that year or the two years that followed. She did take a break in 2013 when the cancer treatment proved too taxing.

And for the past year, she has received radiation treatment for squamous cell carcinoma on her legs. She wore white tights during this year’s race to cover the open wounds she still has from the treatment.

“I was really pleased my legs didn’t hurt me during the run,” she said.

“I don’t think people realize how serious the burns are on her legs,” Sydnor said. “She just endures and pushes through.”

The San Diego marathon is the only marathon she’s ever run because of its commitment to the Leukemia & Lymphoma Society, and the people who run the marathon are just as loyal to Thompson.

“As people would go by, they would say, ‘C’mon Harriette,'” she said. “At least 10 people told me they signed up to run the marathon because they read about me.”

Thompson’s biggest supporter at the race was one of her five children, Brenny, who ran alongside his mother.

“I have to have a lot of energy [to run], so he kept feeding me,” she said. “One time someone brought me a muffin.”

And when someone wanted a picture, Brenny, 56, was there as a safeguard.

“My son was protecting me from having me stop,” Thompson said. “He’d say, ‘You need to take some selfies.'”

“Even though she’s not moving that fast, she definitely has a rhythm,” said Brenny, who runs a real estate company in Charlotte.

Keeping rhythm is something Thompson has done all her life. She actually credits her background as a pianist for her being able to endure the tedium of marathon after marathon, year after year.

“The discipline you have to have when you’re a pianist certainly does play into doing another chore like running,” she said.

Thompson has every intention of running for as long as she can, and knowing she’s making a difference is what’s really music to her ears.

“I think at my age if I can do anything to help somebody, I’m amazed,” she said.

A Disorder That’s Hard to Swallow

www.usnews.com
Source: www.usnews.com
Author: Anna Medaris Miller

 

Ed Steger’s​ last meal was a bowl of soup in Las Vegas. “I remember it all too clearly, as if it were yesterday,” he says. But it wasn’t yesterday – it was 2006. “Life is very different” now, says Steger, a 63-year-old former program manager in Houston.

Steger was diagnosed with head and neck cancer​ in 2005. In addition to 36 rounds of radiation and eight regimens of chemotherapy, he underwent six surgeries, including one that replaced a portion of his pharynx and removed parts of his left jawbone, tongue, epiglottis and soft palate.

“The part that makes it odd is that I’m alive after having four recurrences,” Steger says. The part that makes it distressing is that he can’t eat solid foods.

“There are many case studies I’ve seen where patients have said [their] swallowing disorder is the worst part of their disease – and I believe this to be true,” says Steger, who’s president of the National Foundation of Swallowing Disorders. His daily diet consists of four 8-ounce cans of the nutritional drink Boost Plus, along with two to four bottled​ Starbucks Frappuccinos, which he buys at his local supermarket. “It’s a very boring diet that allows me to maintain my weight,” says Steger, who’s 5 feet 10 inches tall and 155 pounds.

It’s unknown how many people have dysphagia, or difficulty swallowing, but the condition can be caused by any one of 30 diverse health events, Steger says. While his dysphagia is a result of surgery, other people have difficulty swallowing due to neurological conditions such as Parkinson’s disease or stroke, digestive disorders including acid reflux or head injuries. Children with developmental disabilities like autism also often have dysphagia.

“[Dysphagia] isn’t a disease, it’s a sign or an outcome of a disease,” says James Coyle​, an associate professor in the University of Pittsburgh’s School of Health and Rehabilitation Sciences who specializes in treating adults with swallowing disorders.

Difficulty swallowing can also be a part of normal aging, suggests research led by Teresa Lever​, an assistant professor of otolaryngology at the University of Missouri School of Medicine. But that doesn’t mean it’s without consequence. For example, people with dysphagia are at risk for choking, dehydration, malnutrition and pneumonia, which can be triggered when food or drink enter the lungs.

“If you can’t walk, you don’t die. If your skin looks horrible, you don’t die. But if you can’t eat and drink, you die,” Lever says. “[Swallowing] is a vital biological function that is a hugely overlooked contribution to morbidity and mortality.”

Aiming to Eat and Drink Again

How clinicians treat dysphagia depends on its cause. If, for example, the condition is brought on by a stroke that paralyzes one side of the throat, a swallowing specialist like a speech-language pathologist first ​might use an imaging test to identify what exactly is going wrong, and then coach the patient on ways to tilt his or her head while eating in order to better prevent food from getting into the airway.​ Such “compensatory strategies,” Coyle says, are “more or less exploiting either gravity or using the change in position to redirect the swallowed material more efficiently and with better airway protection.”

Steger, for one, was trained to swallow by holding his breath, reclining and “letting the liquid flow” down the back of his esophagus and avoiding the airway. “When I swallow, I need to concentrate very hard,” he says.

Mouth and throat exercises can also help patients boost their swallowing abilities. One mouthpiece-like device called SwallowSTRONG, for instance, senses how hard the patient pushes the tongue against the roof of the mouth and progressively guides him or her in resistance exercises.​ “It’s like weightlifting,” Coyle says. “You start off doing low levels of exercise, and we increase the targets every two weeks until the tongue is stronger.”

Other exercises use a similar technique but to improve respiratory function rather than tongue strength. When patients blow against progressively increasing resistance, for example, they’ll develop a better cough reflex. That, in turn, will make it more likely that any food particles or liquids inhaled into the airways will be expelled and not enter the lungs to cause harm, Coyle says. “Dysphagia doesn’t always go away,” he says. “Sometimes we have to teach the person to swallow differently, sometimes we have to beef up other parts of the body to compensate for the fact that the swallowing isn’t going to get better.”

If dysphagia is caused by dementia or another condition that compromises someone’s ability to learn, clinicians must defer to environmental or dietary modifications like prescribing a diet of thickened liquids. The route is a last resort, Coyle says, since “gobs of studies” show that people don’t like thickened liquids, don’t drink them and therefore, are at risk for dehydration.

“All of our cases aren’t successful,” he says, “but when we do have a successful case, it’s so rewarding – the ability to restore a person’s ability to eat and drink.”

Food is Secondary

If Steger woke up tomorrow without dysphagia, he’d eat a T-bone steak grilled with Lawry’s spice, a baked potato with all the fixings and crème brulee for dessert.​ But what he’d look forward to most is going to a restaurant with friends, ordering anything he wants and keeping pace with his companions. “The food is secondary at this point,” he says.

Living with dysphagia isn’t just a medical risk, but can also hamper one’s quality of life and mental health. People with the condition can feel isolated not only because they avoid social eating situations, but also because many of them have medical conditions that affect their voices and compromise their communication. In the support groups for people with Parkinson’s that Steger sometimes attends, the participants, many of whom have dysphagia, “are embarrassed to go out, they’re ashamed, it’s sad,” he says.

One of his goals is to boost funding for dysphagia research, which is slow-going since major funding organizations like the National Institutes of Health are more focused on the diseases that underlie the condition, Steger says. “[Swallowing] is never top of mind when you have head and neck cancer or Parkinson’s until it happens to you,” he says .​But a focus on swallowing itself is not trivial since, for example, hospital patients with dysphagia stay in the hospital 40 percent longer than patients without it, Coyle says. “It’s very important to identify early.”

It’s also important to dedicate resources to the disorder since it will affect more and more people as the population ages, Lever says. She’s now working to identify traits that protect mice – and hopefully, people – from developing dysphagia as they grow old. “Now that we can diagnose dysphagia, we can identify which mouse models have it, and then we can use those mouse models to try to understand what is going wrong to cause dysphagia,” she says. That, in turn, “can then give [us] some targets for treatment.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Factors linked with better survival in oral cancer identified

Source: www.cancertherapyadvisor.com
Author: staff

Factors associated with improved survival in oral cavity squamous cell cancer (OCSCC) include neck dissection and treatment at academic or research institutions, according to a study published in JAMA Otolaryngology-Head & Neck Surgery.

Alexander L. Luryi, from the Yale University School of Medicine in New Haven, Conn., and colleagues analyzed correlations between treatment variables and survival in patients with stages I and II OCSCC. Data were included for 6,830 patients.

The researchers found that five-year survival was 69.7 percent. Treatment factors that correlated with improved survival on univariate analysis included treatment at academic or research institutions, no radiation therapy, no chemotherapy, and negative margins (all P < 0.001).

Improved survival was also seen in association with neck dissection (P = 0.001). Treatment at academic or research institutions correlated with increased likelihood of receiving neck dissection and decreased likelihood of receiving radiation therapy or having positive margins.

Neck dissection and treatment at academic or research institutions correlated with improved survival on multivariate analysis (hazard ratios, 0.85 and 0.88, respectively), while compromised survival was seen for positive margins, insurance through Medicare, and adjuvant radiation therapy or chemotherapy (hazard ratios, 1.27, 1.45, 1.31, and 1.34, respectively).

“Overall survival for early OCSCC varies with demographic and tumor characteristics but also varies with treatment and system factors, which may represent targets for improving outcomes in this disease,” the authors write.

Reference
Luryi, Alexander L., BS, et al. “Treatment Factors Associated With Survival in Early-Stage Oral Cavity Cancer: Analysis of 6830 Cases From the National Cancer Data Base.” JAMA Otolaryngology – Head & Neck Surgery. doi:10.1001/jamaoto.2015.0719. [epub ahead of print]. May 14, 2015.

Band Announces Iron Maiden Singer is Battling Tongue Cancer

Source: usatoday.com
Author: Maria Puente

 

Iron Maiden singer Bruce Dickinson is being treated for cancer of the tongue, the heavy metal band announced on its website Thursday. But it was caught early, seven weeks of chemotherapy and radiation have just been completed, and a full recovery is expected, the announcement said. “Bruce is doing very well considering the circumstances and the whole team are very positive,” it concluded.

The announcement said that before Christmas, Dickinson visited his doctor for a routine check-up. This led to tests and biopsies, which revealed a small cancerous tumor at the back of his tongue.

“As the tumor was caught in the early stages, the prognosis thankfully is extremely good,” the announcement said. “Bruce’s medical team fully expect him to make a complete recovery with the all-clear envisaged by late May.

“It will then take a further few months for Bruce to get back to full fitness. In the meantime we would ask for your patience, understanding and respect for Bruce and his family’s privacy until we update everyone by the end of May.”

Dickinson, 56, joined the British megastar band in the early 1980s, and is also a commercial airline pilot. Iron Maiden’s hits include Run to the Hills and The Number of the Beast.

Last year, the band announced that Clive Burr, former drummer with Iron Maiden, had died in his London home in March. He was 56 and had multiple sclerosis.

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
February, 2015|Oral Cancer News|

Patients undergoing radiation therapy benefit from animal assisted therapy

Source: radiationtherapynews.com
Author: staff

According to a recent study published in the Journal of Community and Supportive Oncology, therapy dogs can help improve the emotional state of some cancer patients undergoing radiation therapy.

The study, developed by Mount Sinai Beth Israel researchers, found that cancer patients who are undergoing intensive multi-modal concomitant radiation therapy together with chemotherapy for gastrointestinal, head and neck cancers, benefited from therapy dog’s visits in terms of their emotional well-being and life quality, even during therapy phases where physical decline was more pronounced.

This research was funded by The Good Dog Foundation, a provider of professionally trained therapy dogs, Zoetis, an animal health company and the Pfizer Foundation.

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“This study is the first such definitive study in cancer, and it highlights the merits of animal- assisted visits using the same scientific standards as we hold for the cancer treatment itself. It shows the importance of an innovative environmental intervention during cancer treatment,” Stewart B. Fleishman, MD, principal investigator and Founding Director of Cancer Supportive Services at Mount Sinai Beth Israel, said in a news release. “Having an animal-assisted visit significantly improved their quality of life and ‘humanized’ a high-tech treatment,” he said. “Patients said they would have stopped their treatments before completion, except for the presence of the certified Good Dog Foundation therapy dog and volunteer handler.”

“Thanks to this rigorously designed study, we now have strong evidence that pet therapy is an effective tool to help cancer patients get through challenging treatments,” added Gabriel A. Sara, MD, Medical Director, Infusion Suite at Mount Sinai Roosevelt, and Assistant Clinical Professor of Medicine, Icahn School of Medicine at Mount Sinai.

Researchers evaluated the outcome of certified therapy animal-assisted visits on patient’s life quality as they were undergoing multi-modal treatment for head and neck and gastrointestinal cancers. A total of 37 patients completed the study, receiving 15 to 20 minutes of animal-assisted visits every day throughout 6 weeks.

Most patients received 30 radiation therapy treatments in addition to their chemotherapy sessions, and presented signals of fatigue, fear, weight loss, and many patients had feeding tubes.

The results showed that patients significantly increased their social and emotional well-being.

“There is mounting evidence in human and veterinary medicine that the emotional bond between people and companion animals can have a positive impact of emotional and physical health,” J. Michael McFarland, DVM, DABVP, Zoetis group director of Companion Animal Veterinary Operations, said in the news release. “These new results help advance our understanding of the value of animal-assisted therapy in cancer treatment and point to the ways the oncology and animal health communities can work together in supporting cancer patients achieve the best possible treatment outcomes.”

Rachel McPherson, Executive Director and Founder of The Good Dog Foundation added, “We are excited to see the results of this peer-reviewed study, which bears out scientifically what we have seen for more than sixteen years at The Good Dog Foundation, which is that highly trained and fully certified therapy dogs can provide critical healing services to help change cancer patients’ experiences for the better as they receive treatment.”

January, 2015|Oral Cancer News|