6/30/2006 Scotland, Great Britain GR Ogden Br Dent J, June 24, 2006; 200(12): 675 Objective: The 2003/04 West of Scotland Cancer Awareness Programme oral cancer campaign was designed to raise public awareness of the signs and symptoms of oral cancer. The objectives of this study were to explore general dental practitioners' (GDPs) awareness and perceptions of the campaign, and its impact on local dental practices. Methods: A self-completing questionnaire was sent to GDPs in the West of Scotland (N = 983) at the conclusion of the public awareness campaign. Results: A response rate of 68.6% was achieved. Most dentists (92%) had heard of the campaign and a large percentage had displayed the promotional materials in their practice. The majority of respondents rated the campaign materials, including a television advertisement, in a very positive manner. Over 40% of dentists reported that, during the active phase of the campaign, patients had asked for information concerning the programme, and 66% indicated that registered patients had asked for advice regarding a specific lesion. Additionally, 41% of dentists reported non-registered patients had attended asking for advice regarding a 'worrying' lesion. Over 60% of dentists had referred a patient during the campaign and 40% of these practitioners indicated an increased referral rate during this period. Conclusions: Most respondents were positive in their assessment of the campaign and reported an increased awareness of oral cancer among patients.
Rate of pathologic complete responses to docetaxel, Cisplatin, and Fluorouracil induction chemotherapy in patients with squamous cell carcinoma of the head and neck
6/30/2006 Boston, MA R Haddad et al. Arch Otolaryngol Head Neck Surg, June 1, 2006; 132(6): 678-81 Objective: To report the rate of pathological complete response after induction chemotherapy with the docetaxel, cisplatin, and fluorouracil (TPF) combination. Design: Retrospective cohort analysis. SETTING: Tertiary care academic cancer center, between June 1999 and May 2004. Patients: Seventy-two patients with newly diagnosed squamous cell carcinoma of the head and neck; 68 (95%) of the patients had stage IV, locally advanced disease. Interventions: Three cycles of induction chemotherapy followed by a biopsy of the primary site. All patients subsequently underwent chemotherapy with 3 cycles of TPF. Main Outcome Measure: Rate of pathological complete response at the primary site after induction chemotherapy with 3 cycles of TPF. Results: Biopsy results were negative for cancer in 64 patients (89%) and positive in 8 patients (11%). The median follow-up was 2 years. In the positive biopsy result group, 2 (25%) of 8 patients died of disease vs 3 (4%) of 64 patients in the negative biopsy result group. Twenty-nine neck dissections were performed; results were positive in 7 patients (all alive with no evidence of disease) and negative in 22 patients (21 alive with no evidence of disease). The overall 2- and 5-year progression-free survival is currently projected at 85% and 85%, respectively; the overall 2- and 5-year survival, at 95% and 90%, respectively. Importantly, T4 presentation did not predict a positive biopsy result at the primary site or a positive neck dissection result (P = .60 [...]
6/27/2007 Portland, OR staff EurekAlert.com Oregon Health & Science University Cancer Institute researchers have developed a Web-based software program that can help head and neck cancer patients better predict their survivability. "This new tool can help us make personalized predictions of conditional survival for an individual patient depending on his or her specific situation," said Sam Wang, M.D., Ph.D., principal investigator, Holman Pathway Resident in the Department of Radiation Medicine, OHSU School of Medicine. Conditional survival is a statistical system that takes into account the age when the patient was diagnosed with cancer and the time elapsed since diagnosis. The new Web-browser software tool, called the regression model, can calculate a patient's conditional survival based on the patient's age, gender, race and tumor site, stage and aggressiveness. The study was recently presented at the annual American Society of Clinical Oncologists. In a previous study researchers, including Wang, demonstrated the concept of conditional survival for head and neck cancer. They showed the longer patients survive after diagnosis and treatment, their better their prognosis. "This is the first time we have the ability to make a customized prediction of conditional survival probability for an individual head and neck cancer survivor, based on his or her specific characteristics," said Wang. The long-term goal is to build similar software tools for other cancers, Wang explained,so that physicians will be able to give cancer patients more individualized prognosis and treatment recommendations. "Now that cancer researchers are beginning to collect more specific information about patients' tumors, [...]
6/24/2006 Chicago, IL Hiroyuki Inoue, MD et al. Arch Otolaryngol Head Neck Surg. 2006;132:662-666 Objective: To assess the impact of modifications to radical neck dissection on postoperative quality of life. Design: Cross-sectional study using a self-administered neck dissection questionnaire and an arm abduction test. Setting: Department of Otolaryngology–Head and Neck Surgery, Kobe University Hospital. Patients: Seventy-four patients who had undergone neck dissection for the treatment of head and neck cancer. Main Outcome Measures: Arm abduction test results and responses to questions on quality of life related to neck dissection. Results: Forty-one patients underwent bilateral neck dissections, and 33 patients underwent unilateral neck dissection. Level V nodes were dissected in 74 necks. Among them, the spinal accessory nerve (SAN) was resected in 29 necks. Patients who had neck dissections that spared the SAN had better shoulder function. When the SAN was preserved, patients without dissection of level IV and V nodes had better scores on measures of pain and constriction of the neck. Sacrifice of the sternocleidomastoid muscle and/or the SAN had a significant effect on daily activities, work, and leisure. The arm abduction test scores and answers to questions regarding shoulder function were significantly correlated. Conclusions: Modifications to radical neck dissection contribute to improvements in the postoperative quality of life after neck dissection. A multicenter study using the arm abduction test and questionnaire used in this study is currently in progress to further evaluate the impact of modifications to radical neck dissection on quality of life after surgery. Authors: Hiroyuki [...]
6/24/2006 Iowa City, IA staff CancerConsultants.com According to the results of a phase II clinical trial conducted in Italy, supplementation with folic acid resulted in the complete disappearance of precancerous changes to the larynx in 28% of patients and partial disappearance of precancerous changes to the larynx in 44% of patients. These results were published in the journal Cancer . Approximately 40,000 people in the U.S. are diagnosed with head and neck cancer every year. Cancers of the head and neck include several types of cancers affecting the nasal cavity and sinuses, oral cavity, nasopharynx (upper part of throat, behind ear), oropharynx (middle part of throat, including soft palate, base of tongue, and tonsils), larynx, and other sites throughout the head and neck. Laryngeal leucoplakia refers to precancerous changes to the larynx. The larynx is the area of the throat that contains the vocal cords. It aids in talking, swallowing, and breathing and is sometimes referred to as the voice box. If untreated, laryngeal leucoplakia can progress to laryngeal cancer. Folate is a water-soluble B vitamin found in fresh fruits and vegetables. Folate, or supplementation with its synthetic form—folic acid—has been thought to play a role in cancer prevention. If confirmed, this would be an important finding since many people in the U.S. are folate deficient. Furthermore, folic acid supplementation is believed to be safe and non-toxic. To evaluate the potential role of folic acid supplementation in the prevention of head and neck cancers, researchers in Italy conducted a phase [...]
Access Pharmaceuticals Announces Clinical Results of MuGard(TM) at a Major Supportive Care Conference
6/24/2006 Dallas, TX press release biz.yahoo.com Access Pharmaceuticals, today announced the clinical results of MuGard(TM) at the 18th International Symposium of the Multinational Association of Supportive Care in Cancer in Toronto, June 22-24. MuGard(TM) is Access' proprietary oral rinse product for the prevention and treatment of oral mucositis, the debilitating side-effect which afflicts more than 20% of cancer patients undergoing radiation and chemotherapy. Access plans to submit a 510(k) application for U.S. marketing approval of MuGard(TM) in the third quarter of this year. "In our clinical study of head and neck cancer patients receiving radiation therapy, 47% of patients using MuGard(TM) had no mucositis," stated Rosemary Mazanet M.D., Ph.D., CEO of Access. "Historically, patients on the same treatment without MuGard(TM) had a high rate of mucositis, with only 7% of patients experiencing no mucositis. In addition, the number of patients with mild to moderate mucositis was statistically reduced as well by the use of MuGard(TM). There is currently no well-accepted treatment for mucositis, and we believe that these results demonstrate that MuGard(TM) should be a valuable supportive care option for cancer patients." The Company is actively seeking marketing partners for this product.
6/24/2006 Menlo Park, CA staff KaiserNetwork.org The Hartford Courant on Wednesday examined how Merck's human papillomavirus vaccine Gardasil could prevent oral cancer, as at least one-quarter of oral cancer cases might be linked to HPV (Waldman, Hartford Courant, 6/21). FDA earlier this month approved Gardasil -- which is given in three injections over six months and will cost $360 -- for sale and marketing to girls and women ages nine to 26. According to Merck, Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18 -- which together cause about 70% of cervical cancer cases -- in women who do not already have HPV. In addition, the vaccine was shown to be about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases (Kaiser Daily Women's Health Policy Report, 6/19). Johns Hopkins University researchers in 2000 found that 25% of 253 people who were living with head and neck tumors were also positive for HPV strain 16. Although no firm connection between sexual practices such as kissing and oral sex has been made, some studies suggest such a connection between being positive for HPV and the tumors, according to the Courant. Cancerous tumors that are positive for strains of HPV most commonly appear in the throat and tonsils and seem to be more responsive to treatment than cancer tumors that are negative for HPV, the Courant reports. [...]
6/24/2006 Gainesville, FL P.L. Sandow et al. This Article Previous investigators have reported deficits in taste acuity in patients following radiation therapy for oropharyngeal cancer. In the present longitudinal study, 13 patients (mean age = 51.6 yrs) received conventional or hyperfractionated radiotherapy (63–76.8 Gy) for primary tumors of the oropharynx. One or both parotid glands and at least two-thirds of the tongue were included in the radiation field. Smell recognition and taste detection thresholds were determined at baseline, 1 month, 6 months, and 1 year post-radiation. Differences for smell recognition and the 4 taste qualities were assessed (independently) at the 4 time intervals, with a one-way ANOVA. Smell recognition was unaffected by radiation. There were significant elevations in thresholds for sweet (p < 0.005), salty (p < 0.005), bitter (p < 0.005), and sour (p< 0.001) during radiation therapy that were restored to baseline levels at 6 months and 1 year after radiation. This study demonstrated that radiation-induced taste deficits can be recovered by 6 months.
6/23/2006 Vancouver, British Columbia, Canada Catherine F. Poh et al. J Can Dent Assoc2006; 72(5):413–6 The first solid evidence that periodic screening of the oral cavity can reduce mortality from oral cancer was published recently in Lancet.1 The article described a large population-based study of about 168,000 participants in India, 87,655 of whom received at least one visual oral screening examination. Over a 9-year period, a 32% reduction in mortality was observed among those screened. These data, along with new advances in screening technologies, support a call to dentists to commit to oral cancer screening as part of routine daily practice. Globally, survival rates for those with oral cancer have changed little over the last 3 decades. The disease is often identified at an advanced stage, significantly reducing the probability of successful treatment. Half of oral cancer patients die within 5 years of diagnosis. Early detection of the disease (stages I and II) is associated with a vast improvement in survival rate; 80% of patients survive for 5 years compared with 20% of those with advanced disease (stages III and IV).2 The typically late diagnosis of oral cancer is ironic because the oral cavity is readily accessible for screening, and visible changes in the mucosa (in most cases) are associated with development of the disease. Oral cancer is frequently preceded by an identifiable premalignant lesion and the progression from dysplasia to cancer occurs over years.3 This should allow clinicians an opportunity to detect early changes. Nevertheless, most oral cancers are [...]
6/22/2006 Sydney, Australia Tom J Vauterin et al. Head Neck, June 16, 2006 Backbround: Among patients with cutaneous squamous cell carcinoma (SCC) of the head and neck, recent studies have shown that those with involvement of the parotid gland also have a high incidence of neck node involvement. Treatment of the neck by either surgery or radiotherapy is therefore recommended among patients with parotid SCC, even if clinical examination is negative. The aim of this study was first to analyze patterns of metastatic spread in the parotid and cervical lymph nodes and then to correlate the pattern of involved nodes with the primary cutaneous site in order to guide the appropriate extent of surgery, should neck dissection be used to treat the neck in patients with parotid SCC. Methods: A cohort of 209 patients with cutaneous SCC of the head and neck and clinically evident regional metastatic disease was reviewed retrospectively from 3 Australian institutions. The distribution of involved nodes was obtained from pathology reports; the anatomic sites of primary cutaneous cancers were then correlated with these findings. Results: Among 209 patients, 171 (82%) had clinical parotid involvement. Of these, 28 had clinical neck disease, whereas 143 had parotid disease alone. Thirty-eight (18%) patients had neck disease only. A total of 199 patients were treated surgically, whereas 10 received radiotherapy alone. Surgery included 172 parotidectomies and 151 neck dissections (93 of which were elective). Primary sites were cheek (21.7%), pinna (20.4%), temple (15.8%), forehead (15.8%), postauricular region (5.9%), neck (5.3%), [...]