UC trial tests tongue exercises to improve swallowing function after stroke

Source: www.uc.edu Author: Tim Tedeschi Up to three-quarters of all stroke survivors have some form of difficulty swallowing (dysphagia) after a stroke. Dysphagia frequently leads to entry of food or liquid into the lungs and has significant impacts on patients’ overall health and quality of life. In the most severe cases, patients are no longer able to eat or drink at all or can die from aspiration pneumonia. Because eating and drinking are pivotal to participating in life socially, dysphagia can also lead to depression. A new trial at the University of Cincinnati Gardner Neuroscience Institute, funded by a $660,000 National Institutes of Health (NIH) grant, will test an at-home tongue endurance exercise to improve patients’ swallowing function. Research background Speech language pathologist and trial principal investigator Brittany Krekeler, PhD, said swallowing issues can sometimes be a “hidden” disorder, because it is usually secondary to other diseases. “You hurt for these patients when they can’t enjoy eating and drinking, and swallowing disorders can be a burden on family members as well,” said Krekeler, assistant professor and clinician-scientist at the UC College of Medicine’s Dysphagia Rehabilitation Laboratory. “From working with these patients clinically, we see how much it means for patients to be able to eat and drink again.” Krekeler said research into improving swallowing function is relatively new, as historically the problem was addressed by giving feeding tubes to patients with post-stroke dysphagia. But feeding tubes can fall out, can get infected and prevent patients from being able to enjoy [...]

Dysphagia-optimized IMRT for head and neck cancer beneficial to swallowing function

Source: www.oncologynurseadvisor.com Author: Vicki Moore, PhD Treatment with dysphagia-optimized (DO) intensity-modulated radiotherapy (IMRT) improved patient-reported swallowing function in patients with pharyngeal cancer compared with standard IMRT. These results of a phase 3 study were published in the journal Lancet Oncology. Dysphagia-optimized IMRT was found to reduce radiation dose to the throat structures, thereby improving dysphagia and aspiration function compared with standard IMRT. Source: Getty Image “Our findings suggest that reducing dose to the pharyngeal constrictor muscle translates into patient benefit through improved swallowing function,” the study investigators wrote in their report. The phase 3 DARS study (ISRCTN Registry Identifier: ISRCTN25458988) was conducted across radiotherapy centers in the UK and Ireland. Enrolled patients had biopsy-confirmed squamous cell carcinoma of the oropharynx or hypopharynx in addition to meeting certain eligibility criteria. Patients were randomly assigned 1:1 to receive either DO-IMRT or standard IMRT over 6 weeks. The radiotherapy target dose was 65 Gy to the primary and nodal tumor, while the remaining tumor subsite and nodal regions considered at risk of occult microscopic disease had a target dose of 54 Gy. With DO-IMRT, there was a 50-Gy mean dose constraint for the superior and middle pharyngeal constrictor muscle or inferior pharyngeal constrictor muscle residing beyond the high-dose target volume. The primary endpoint of the study was the MD Anderson Dysphagia Inventory (MDADI) composite score at 12 months following treatment in the modified intention-to-treat population, which included patients completing this assessment. In this study, 112 patients were assigned to treatment, with [...]

What is the role of a Speech Language Pathologist in an acute care setting?

Source: www.lhsc.on.ca Author: London Health Sciences Centre A Speech Language Pathologist (S-LP) assesses and manages swallowing and communication. Since these activities are performed by the same set of muscles, an S-LP is able to provide support for both functions. Communication functions include speech, voice, language, and cognitive-communication. S-LPs support expressive abilities (verbal and non-verbal communication) as well as receptive abilities (understanding what other people are saying). We provide low-tech and high-tech communication aids when appropriate, or refer to community services to support as needed. For swallowing, S-LPs help patients with the ability to consume solids and liquids safely and efficiently when experiencing difficulties with the muscles that support this function. “We focus on the quality of life of the patient and do our best to optimize and maximize their abilities in swallowing or communication or both,” explains Suzie Fox, Speech Language Pathologist at London Health Sciences Centre (LHSC). “We work with the patient and take into account their values and wishes so they are able to get the most out of what they eat and drink and how they communicate once they return home.” How can someone lose communication and swallowing functions? A number of conditions may impact swallowing or communication because of changes to our muscles for speaking/eating or the respiratory system. Some examples include: Neurological conditions: stroke, brain injury or tumours, or neuromuscular diseases. Medical conditions: dementia, COPD, congestive heart failure. Surgery: head and neck, esophageal, orthopedic, facial and head trauma, transplant. Cancer: head and neck cancer, brain [...]

Head and neck cancer survivors with dysphagia prone to anxiety, depression

Source: www.oncologynurseadvisor.com Author: Jennifer Larson Symptoms of anxiety and depression are increased in patients with head and neck cancer (HNC) who experience symptoms of dysphagia, according to researchers from the University of Pittsburgh and the University of Pittsburgh Medical Center (UPMC). These findings were published in Oncology Nursing Forum. For this cross-sectional analysis, 228 survivors of head and neck cancer were recruited between October 2018 and January 2020. Participants completed questionnaires that assessed for outcomes such as swallowing dysfunction and symptoms of anxiety and depression. Patient-reported symptoms of dysphagia were measured with the 10-item Eating Assessment Tool (EAT-10), which assessed issues such as difficulties with consistencies, food sticking, coughing, and swallowing-related weight loss. Participants also completed the Generalized Anxiety Disorder-7 (GAD-7) to assess for recent symptoms of anxiety and the Patient Health Questionnaire-8 (PHQ-8) to assess for recent symptoms of depression. Patients who self-reported symptoms of dysphagia were also more likely to report symptoms of anxiety and depression. Overall, 23% of the participants reported symptoms of anxiety and 29% reported symptoms of depression. “When comparing anxiety and depression levels in survivors who reported symptoms of dysphagia versus those who did not, statistical analysis showed a substantial positive correlation between increased swallowing dysfunction and more severe symptoms of anxiety and depression,” the researchers reported. The study was limited by its cross-sectional nature, and a causal association between patient-reported symptoms of dysphagia and psychological distress cannot be inferred by these data. Self-report questionnaires are intended to screen for certain symptoms, not diagnose [...]

Your cancer answers: can nutrition, exercise improve quality of life for head, neck cancer patients?

Source: syvnews.com Author: John Malinowski, Marian Cancer Care Question: How can nutrition and exercise improve quality of life for head and neck cancer patients? Head and neck cancers affect more than 52,000 Americans each year and account for about 5% of new cancer cases worldwide. Treatment of head and neck cancer with concurrent chemo radiotherapy with curative intent may cause side effects leading to deterioration of long-term quality of life and disability that persists years after treatment. Many head and neck cancer patients experience treatment related side effects such as; difficulty swallowing, difficulty with speech, loss of taste or smell and unintended weight loss which often can be attributed to decreased muscle mass. There are a few things that you can do to try helping to maintain your body weight during treatment. Nutrition can be one tool to help ensure you are taking in enough calories and the right nutrients to help your body fight the cancer. Often when undergoing cancer treatments our body has an increased demand of caloric intake. This can be a challenge to increase your calories while undergoing treatment so try eating several smaller meals throughout the day, maybe even every 2-3 hours. With each meal try to incorporate some carbohydrates, fats, and protein. Make sure you are intentional about chewing your food. You can try to chew each bite 50 times or trying to incorporate softer texture foods can make it easier to swallow. Steaming or boiling vegetables rather than eating raw may help. Softer [...]

Top cancer surgeon urges public to get mouth ulcers checked

Source: www.dentistry.co.uk Author: staff A top cancer surgeon is calling on people with mouth ulcers and neck lumps to get their symptoms checked. This follows fears from dentists that mouth cancer cases may have gone undetected as a result of the COVID-19 pandemic. Despite the fact that a new international study suggests patients undergoing surgery for head and neck cancers are at no extra risk when it comes to COVID-19 transmission. Professor Richard Shaw is a consultant and head and neck cancer surgeon at Liverpool University Hospitals NHS Foundation Trust. He is calling on the public to act fast if they notice any symptoms. These include neck lumps, mouth ulcers, mouth or throat lumps, difficulty swallowing and a hoarse voice. Don’t delay ‘We know that it can be scary to come to a hospital or any healthcare setting at the moment. People are putting off that trip to the GP and waiting that bit longer to see if their symptoms go away,’ he said. ‘The findings of this study are really important because we can now assure people who need head and neck cancer surgery that it is safe, even during the pandemic.’ He added: ‘Time is of the essence with head and neck cancer. The sooner it is diagnosed the sooner we can treat it – and if we catch it early then the curative surgery required is much less invasive. ‘My message to anyone concerned about symptoms is to get them looked at by a health professional without [...]

Agusta University Speech Therapy program helps cancer patients with speech and swallowing problems

Source: www.augustachronicle.com Author: Jozsef Papp, Augusta Chronicle After getting surgery in April for cancer of the oral cavity, Lenny Schaeffer was having problems opening his mouth wide enough to eat anything larger than a grape. He went through the whole process: surgery, chemotherapy and radiation therapy. During that process, he lost his ability to open his mouth, and it even affected his speech. An oncologist and his radiation therapist informed him of a new program, speech therapy, at the Georgia Cancer Center at Augusta University that could help him. “What the speech therapy program did is basically give me exercises to do to increase the flexibility that I have in my mouth,” he said. “It allows me to eat better, more kinds of food and also improve speech.” Dr. Sarah Smith, a speech pathologist at the Georgia Cancer Center, said the program is aimed at helping cancer patients like Schaeffer, patients who have cancer of the neck and mouth area and are suffering from exposure to radiation during their treatment. As a National Cancer Center Network Facility, the center was called to have a multidisciplinary approach to treating cancer, Smith said. Smith was moved to the cancer center in the summer, mainly to keep cancer patients from walking from the center to the hospital because of COVID-19. “Treating head and neck cancer is very different than treating other types of disabilities," she said. "When cancer patients come to the cancer center, we offer a variety of providers, right on site, [...]

2020-12-20T20:37:18-07:00December, 2020|Oral Cancer News|

Ask the Doctors: Dysphagia common in elderly

Source: journalstar.com Author: [email protected] Dear Doctor: Why do the elderly often have a hard time swallowing, and sometimes experience a feeling that food is stuck in their throats? I heard there's a procedure to stretch the throat. Does it help? Dear Reader: The condition you're asking about is known as dysphagia, which refers to difficulty in swallowing. Patients may have trouble starting a swallow, or problems with the esophagus, which is the muscular tube that connects the throat with the stomach. The origins of the disorder fall into several basic categories. There are neurological causes, such as stroke, Parkinson's disease, multiple sclerosis, dementia and head injury. Certain muscular conditions can affect the proper functioning of the esophagus. So does obstruction, which can result from a narrowing of the esophagus, or from inflammation. These can be caused by head and neck cancers, radiation therapy, tuberculosis and chronic acid reflux. Although dysphagia can affect people of all ages, you're correct that it's seen more often in older adults. This is commonly due to age-related changes in the body, such as loss of muscle tone, mass and strength, and changes to nerve function. Still, dysphagia is not considered to be a normal sign of aging. Understanding dysphagia starts with the mechanics of swallowing. We tend to think of it as the "gulp" that empties the mouth. But that's just the first step of a complex process. A successful swallow moves the contents of your mouth through the throat, and all the way down [...]

Healthy diet may avert nutritional problems in head, neck cancer patients

Source: medicalxpress.com Author: University of Illinois at Urbana-Champaign At least 90 percent of head and neck cancer patients develop symptoms that affect their ability or desire to eat, because of either the tumor itself or the surgery or radiation used to treat it. These problems, called nutrition impact symptoms, have wide-ranging negative effects on patients' physical and mental health and quality of life. However, patients who eat foods high in antioxidants and other micronutrients prior to diagnosis may reduce their risks of developing chronic nutrition impact symptoms up to one year after being diagnosed with head or neck cancer, according to a recent study led by researchers at the University of Illinois. The scientists analyzed the dietary patterns of 336 adults with newly diagnosed head and neck cancers and these patients' problems with eating, swallowing and inflammation of the digestive tract. This painful inflammatory condition, called mucositis, is a common side effect of radiation treatment and chemotherapy. The mitigating effects of a healthy diet were particularly significant in people who had never smoked and in patients who were underweight or normal weight at diagnosis, who often experience the greatest eating and digestive problems during treatment, said Sylvia L. Crowder, the paper's first author. Crowder is a research fellow in the Cancer Scholars for Translational and Applied Research program, a collaborative initiative of the U. of I. and Carle Foundation Hospital in Urbana, Illinois. "While previous work has established that the presence of nutrition impact symptoms is associated with decreased food [...]

Study: Healthy diet may avert nutritional problems in head, neck cancer patients

Source: news.illinois.edu Author: Sharita Forrest At least 90% of head and neck cancer patients develop symptoms that affect their ability or desire to eat, because of either the tumor itself or the surgery or radiation used to treat it. These problems, called nutrition impact symptoms, have wide-ranging negative effects on patients’ physical and mental health and quality of life. However, patients who eat foods high in antioxidants and other micronutrients prior to diagnosis may reduce their risks of developing chronic nutrition impact symptoms up to one year after being diagnosed with head or neck cancer, according to a recent study led by researchers at the University of Illinois. The scientists analyzed the dietary patterns of 336 adults with newly diagnosed head and neck cancers and these patients’ problems with eating, swallowing and inflammation of the digestive tract. This painful inflammatory condition, called mucositis, is a common side effect of radiation treatment and chemotherapy. The mitigating effects of a healthy diet were particularly significant in people who had never smoked and in patients who were underweight or normal weight at diagnosis, who often experience the greatest eating and digestive problems during treatment, said Sylvia L. Crowder, the paper’s first author. Crowder is a research fellow in the Cancer Scholars for Translational and Applied Research program, a collaborative initiative of the U. of I. and Carle Foundation Hospital in Urbana, Illinois. “While previous work has established that the presence of nutrition impact symptoms is associated with decreased food intake and weight loss, [...]

2019-12-17T09:16:56-07:00December, 2019|Oral Cancer News|
Go to Top