Reduced Radiation Dose After Surgery May Improve Survival Rates in HPV-Related Throat Cancer

Author: Darlene Dobkowski, MA Source: www.curetoday.com A recent study demonstrated that a lower dose of radiation after surgery for HPV-related throat cancer may provide a greater benefit than a higher dose of radiation with chemotherapy. Transoral robotic surgery followed by low-dose radiation may reduce treatment intensity and improve long-term quality of life compared to usual care, which consists of high-dose radiation and chemotherapy, in patients with HPV-associated throat cancer, recent study findings demonstrate. Positive results from the E3311 study led by the ECOG-ACRIN Cancer Research Group may have been related to the ability of researchers to categorize patients by risk before undergoing surgery. “The study was very helpful in that it gave us a big national sample of people getting transoral surgery,” said Dr. Barbara Burtness, a professor of medicine at Yale School of Medicine, lead of the Head/Neck Cancer Research Program at Yale and a co-leader of the Developmental Therapeutics Program at the Yale Cancer Center, in an interview with CURE®. “It helped us to understand if our rules for deciding who was low risk, intermediate risk and high risk reflected the real natural biology of the cancer. I think that they gave us the first signs that with pathologic staging in HPV-associated cancer, you can actually reduce the intensity of the postoperative treatment. So we actually reported extremely remarkable results.” Increased Incidence of HPV-Associated Throat Cancer Over the past few decades, there has been an increase in throat cancer associated with HPV, which is usually transmitted through sexual [...]

2022-01-21T09:37:46-07:00January, 2022|Oral Cancer News|

New MSK Radiation Approach Means Fewer Side Effects for More Patients with HPV-Related Oral Cancer

Source: Memorial Sloan Kettering Cancer Center Date: January 20th, 2022 Robert Rosenfeld thought the lump he felt in his neck in late 2018 was just a symptom of a cold that wouldn’t go away. He visited an ear, nose, and throat specialist who saw nothing upon first examination, but Robert knew something was wrong and asked for a CT scan. The specialist called him with the bad news: It was almost certainly cancer. A biopsy confirmed he had stage 2 cancer at the base of his tongue (classified as oral cancer) and 2 nearby lymph nodes. The tumor was positive for the human papillomavirus (HPV). Robert, then a 69-year-old car salesman on Long Island, met with cancer doctors near his hometown of Hauppauge, New York, to learn about treatment options. He realized he faced a tough road: Standard treatment would be 7 weeks of radiation, during which he also would receive 3 rounds of chemotherapy. The standard radiation dose would likely cause mouth sores, difficulty swallowing, dry mouth (from damage to salivary glands), loss of taste, and nausea. Robert wanted a second opinion, and his medical oncologist strongly recommended Memorial Sloan Kettering Cancer Center. When Robert called, he was able to get in to see radiation oncologist C. Jillian Tsai the very next day. “When I met Dr. Tsai, she was amazing,” Robert says. “She told me what I was up against but also that the cancer I had was curable.” There was another major plus: Dr. Tsai was able [...]

2022-01-20T13:36:01-07:00January, 2022|Oral Cancer News|

New MSK radiation approach means fewer side effects for more patients with HPV-related head and neck cancer

Source: www.mskcc.org Author: Memorial Sloan Kettering Cancer Center Robert Rosenfeld thought the lump he felt in his neck in late 2018 was just a symptom of a cold that wouldn’t go away. He visited an ear, nose, and throat specialist who saw nothing upon first examination, but Robert knew something was wrong and asked for a CT scan. The specialist called him with the bad news: It was almost certainly cancer. A biopsy confirmed he had stage 2 cancer at the base of his tongue and 2 nearby lymph nodes. The tumor was positive for the human papillomavirus (HPV). Robert, then a 69-year-old car salesman on Long Island, met with cancer doctors near his hometown of Hauppauge, New York, to learn about treatment options. He realized he faced a tough road: Standard treatment would be 7 weeks of radiation, during which he also would receive 3 rounds of chemotherapy. The standard radiation dose would likely cause mouth sores, difficulty swallowing, dry mouth (from damage to salivary glands), loss of taste, and nausea. Robert wanted a second opinion, and his medical oncologist strongly recommended Memorial Sloan Kettering Cancer Center. When Robert called, he was able to get in to see radiation oncologist C. Jillian Tsai the very next day. “When I met Dr. Tsai, she was amazing,” Robert says. “She told me what I was up against but also that the cancer I had was curable.” There was another major plus: Dr. Tsai was able to offer a significantly reduced radiation [...]

Squamous cell carcinoma: A pathology case report follow-up

Author: Stacey L. Gividen, DDS Source: www.dentistryiq.com Remember that case about the pathology on the right posterior lateral border of the tongue that had some “meat” to it? The lesion was small, caused no discomfort, and would have gone on to be something much worse had it not been caught early. What was the definitive? Well, as suspected, it was cancer—squamous cell carcinoma (SCC) to be exact. Refreshers regarding pathology are always good for us, so take a quick second and read up on this type of cancer that is more common than you think. Chances are, you’ve diagnosed this before; if you haven’t, keep looking because at some point in your career, you will. Stats/General Information 1 What is SCC? It’s an end-stage alteration in stratified squamous epithelium, beginning as an epithelial dysplasia until the dysplastic epithelial cells breach the basement membrane and invade the connective tissue. Another common name is epidermoid carcinoma. SCC represents 3% of all cancer in males, 2% in females. The survival rate is 50% SCC is the most common malignant neoplasm of the oral cavity, representing approximately 90% of all oral cancers. Etiologic factors: Tobacco habit, Alcohol consumption Viruses Actinic radiation Immunosuppression Nutritional deficiencies Preexisting diseases Chronic irritation. Treatment 1 Clinical staging of the head and neck using the TNM system (T = primary tumor; N = regional lymph node; M = distant metastasis). There is a specific system for the oral cavity. Treatment is by surgical excision, radiation therapy, and if extensive enough, [...]

2022-01-16T11:12:45-07:00January, 2022|Oral Cancer News|

Multimedia education platform appears effective in head and neck cancer

Source: www.cancernetwork.com Author: Ariana Pelosci Use of a multimedia education platform appeared to compliment traditional education methods and provide complementary information on treatment and recovery for those with head and neck cancer. Multimedia education platforms appear to be effective in conveying information on treatment, recovery process, mental health, family life, and supplementary services for patients with head and neck cancer, according to a study (NCT04048538) published in JAMA Otolaryngology Head and Neck Surgery. Patients who were given information via the education platform had an 11.3-point (Cohen d = 1.02; control group score, 61.1 of 80; treatment group score, 72.4 of 80) difference in 1 month in postoperative satisfaction. Despite both patients groups reporting to have received an adequate amount of information with regard to their disease, those in the treatment arm reported having more satisfaction with information regarding medical tests, treatments, and other services. “This randomized clinical trial found that use of a multimedia patient education platform increased patient satisfaction in individuals who were undergoing head and neck surgery. Leveraging novel information technologies during the perioperative period is a feasible, accessible, and effective intervention to address existing inadequacies in traditional, clinician-led surgical counseling,” the investigators wrote. At baseline, 121 patients completed the evaluations. Among this population, 100 patients, including 50 in the treatment and 50 in the control arm, completed the postoperative questionnaire 1 month following surgery and were included in the statistical analysis. Patients had similar characteristics between groups, but those in the control arm had fewer patients who [...]

Alcohol should have cancer warning labels, say doctors and researchers pushing to raise awareness of risk

Source: www.cbc.ca Author: Ioanna Roumeliotis & Brenda Witmer · CBC News It's not a secret, but it may as well be. Few Canadians know the truth, and few may want to hear it: alcohol, any amount of alcohol, can cause cancer. There is no safe amount, and the calls to inform Canadians are growing. "Even drinking one drink a day increases your risk of some cancers — including, if you're a woman, breast cancer — but also cancers of the digestive system, the mouth, stomach," said Tim Stockwell, a senior scientist with the Canadian Institute for Substance Use Research at the University of Victoria. "The risk increases with every drink you take." Alcohol has been classified as a Group 1 carcinogen (carcinogenic to humans) for decades by the International Agency for Research on Cancer (IARC). It's right up there with tobacco and asbestos. Alcohol is also a top cause of preventable cancer after smoking and obesity. But the vast majority of Canadians have no idea of the risk. Stockwell wants to change that, and he and other health experts are advocating for cancer warning labels on alcohol containers. People need to know, he says, that though there are other genetic and lifestyle factors that contribute to developing cancer, every drink comes with a risk. "The risk from alcohol, it's a dose response. The bigger and more frequent the dose, the higher your risk." Kathy Andrews had no idea that the wine she enjoyed most nights before she got pregnant was [...]

Using artificial intelligence to help cancer patients avoid excessive radiation

Source: medicalxpress.com Author: by Case Western Reserve University A Case Western Reserve University-led team of scientists has used artificial intelligence (AI) to identify which patients with certain head and neck cancers would benefit from reducing the intensity of treatments such as radiation therapy and chemotherapy. The researchers used AI tools similar to those they developed over the last decade at the Center for Computational Imaging and Personal Diagnostics (CCIPD) at Case Western Reserve. In this case, they asked the computer to analyze digitized images of tissue samples that had been taken from 439 patients from six hospital systems with a type of head and neck cancer known as human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPCSCC). The computer program successfully identified a subset of patients who might have benefited from a significantly reduced dose of radiation therapy. While that analysis was retrospective—meaning the computer analyzed data from patients in which the eventual outcome was already known—the researchers said their next step could be to test its accuracy in clinical trials. Their research was published recently in the Journal of the National Cancer Institute. The work was led by Anant Madabhushi, CCIPD director and the Donnell Institute Professor of Biomedical Engineering at the Case School of Engineering, along with Germán Corredor Prada, a research associate in the CCIPD lab. 'Overtreating patients' Although most others with HPV-driven cancer would still benefit from aggressive treatment—along with patients whose cancer was unrelated to the virus—the researchers said their study revealed a significant group was [...]

Molecular profiling identifies potential prognostic biomarker for treatment response in HNSCC

Source: www.ajmc.com Author: Matthew Gavidia Human papillomavirus surrogate marker p16 was identified as a potential prognostic biomarker for standard-of-care immune checkpoint blockade therapy response in non-oropharyngeal head and neck squamous cell carcinoma. Real-world overall survival among patients with oropharyngeal squamous cell carcinoma (OPSCC) and non-OP head and neck squamous cell carcinoma (HNSCC) differed significantly based on the presence of the human papillomavirus (HPV) surrogate marker p16, with further implications identified regarding time on treatment with immune checkpoint blockade (ICB) therapies. Findings were published in Cancers. Identified as the sixth most common cancer worldwide with incidence expected to increase by 32% in the next 2 decades, patients with recurrent and/or metastatic HNSCC typically have a poor prognosis. Although diagnosis of HNSCC is typically related to tobacco and alcohol use, incidence of HPV-associated HNSCC has risen substantially, in which those positive for the virus whose HNSCC stems in the oropharynx have exhibited better survival outcomes. Researchers sought to further investigate the association of HPV and/or its surrogate marker p16 with response to standard-of-care ICB therapies in patients with OPSCC and non-oropharyngeal (non-OP) HNSCC. “We also investigated other potential biomarkers and mutations that may predict improved response to ICB in both HPV-positive and -negative patients with HNSCC,” they added. Patients registered in the Caris Life Sciences CODEai database with non-OP HNSCC and OPSCC were recruited and identified by comprehensive molecular profiling to be positive or negative for p16. In total, 2905 HNSCC (OPSCC, n = 948) cases were identified. Of those tested for [...]

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 [...]

“Sleeping” cancer cells could prevent tumour metastasis

Source: www.drugtargetreview.com Author: Anna Begley (Drug Target Review) Researchers at Icahn School of Medicine at Mount Sinai, US, have developed a new therapeutic approach by preventing the growth of metastatic tumours in mice to force cancer cells into a dormant state in which they are unable to proliferate. They hope that their findings will lead to new treatments that prevent the recurrence or spread of various cancer types, including breast cancer and head and neck squamous cell carcinoma (HNSCC). In a previous study, scientists discovered that the ability of cancer cells to remain dormant is controlled by a protein called NR2F1. This receptor protein can enter the cell nucleus and turn numerous genes on or off to activate a programme that prevents the cancer cells from proliferating. NR2F1 levels are usually low in primary tumours but are elevated in dormant disseminated cancer cells. Levels of the NR2F1 protein then decline once more when cancer cells start proliferating again and form recurrent or metastatic tumours. “We therefore thought that activating NR2F1 using a small molecule could be an attractive clinical strategy to induce cancer cell dormancy and prevent recurrence and metastasis,” explained Dr Julio Aguirre-Ghiso. In the new study, detailed in the Journal of Experimental Medicine (JEM), the researchers used a computer-based screening approach to identify a drug, named C26, that activates NR2F1. The researchers found that treating patient-derived HNSCC cells with C26 boosted the levels of NR2F1 and arrested cell proliferation. The researchers then tested whether C26 would prevent metastasis [...]

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