Influences and predictors of long-term quality of life in head and neck cancer survivors

Source: Arch Otolaryngol Head Neck Surg. 2009;135(4):380-384. Authors: Mark W. El-Deiry, MD et al. Objective: To examine the impact of clinical predictors (pretreatment variables) and other influences (treatment and posttreatment variables) on long-term quality of life (QOL) in patients treated for squamous cell carcinoma of the upper aerodigestive tract. We hypothesized that baseline QOL and comorbidity would be predictors of QOL 1 year after treatment. Design: Retrospective cohort study. Setting: Academic Medical Center in Seattle, Washington. Patients: Patients (N = 173) with baseline (pretreatment) and 1-year posttreatment QOL data. Main Outcome Measure: Head and neck–specific QOL scores at 1 year after treatment (as measured by the University of Washington Quality of Life [UW-QOL] scale). Results: We identified strong relationships between 1-year UW-QOL scores and baseline UW-QOL scores (correlation coefficient [Pearson r] = 0.58; P

Robot-assisted surgery for upper aerodigestive tract neoplasms

Surce: Arch Otolaryngol Head Neck Surg. 2009;135(4):397-401. Authors: Bridget A. Boudreaux, MD et al. Objectives: To assess the feasibility and safety of performing robot-assisted resections of head and neck tumors, and to predict which variables lead to successful robot-assisted resection and better functional outcome. Design: Prospective nonrandomized clinical trial. Setting: Academic tertiary referral center. Patients: Thirty-six patients with oral cavity, oropharyngeal, hypopharyngeal, or laryngeal tumors. Intervention: Robot-assisted resection of indicated tumors. Main Outcome Measures: Ability to perform robot-assisted resection, final pathologic margin status, ability to extubate postoperatively, need for tracheotomy tube, and need for gastrostomy tube. Any clinically significant complications were recorded. Results: Thirty-six patients participated in the study. Eight patients had previously been treated for head and neck cancer. Twenty-nine patients (81%) underwent successful robotic resection. Negative margins were obtained in all 29 patients. Twenty-one of 29 patients were safely extubated prior to leaving the operating room. One patient required short-term tracheotomy tube placement. A total of 9 patients were gastrostomy tube dependent (2 preoperatively, 7 postoperatively). Factors associated with successful robotic resection were lower T classification (P = .01) and edentulism (P = .07). Factors associated with gastrostomy tube dependence were advanced age (P = .02), tumor location in the larynx (P

Aspiration, weight loss, and quality of life in head and neck cancer survivors

Source: Arch Otolaryngol Head Neck Surg. 2004;130:1100-1103 Authors: Bruce H. Campbell, MD et al. Objective: To determine associations between objective assessments (swallowing function and weight change) and subjective quality-of-life (QOL) measures. Design: Observational case series using clinical testing and questionnaires. Setting: University hospital-based tertiary clinical practice. Patients: Convenience sample of 5-year survivors of head and neck cancer (62 nonlaryngectomy survivors were studied). Interventions: Objective testing included examination, weight history, videofluoroscopic swallow studies (VFSS), and oropharyngeal swallowing efficiency (OPSE). Subjective testing included QOL questionnaires (University of Washington Quality-of-Life [UWQOL] Scale, Performance Status Scale for Head and Neck Cancer Patients [PSS-HN], Functional Assessment of Cancer Treatment–General [FACT-G] Scales, and Functional Assessment of Cancer Therapy–Head and Neck [FACT-H&N] Scale). Main Outcome Measures: Aspiration (identified by VFSS), weight change, and QOL measures. Results: Aspiration was associated with the decreased QOL scores in chewing, swallowing, normalcy of diet, and additional concerns of the FACT-H&N Scale. No association was found between aspiration and willingness to eat in public, subjective understandability, or any of the FACT-G scales. Of the nonlaryngectomy survivors, 27 (44%) demonstrated some degree of aspiration during VFSS. Associations were found between aspiration, primary tumor T stage, weight change, and OPSE. Aspirators lost a mean of 10.0 kg from precancer treatment weight, while nonaspirators gained a mean of 2.3 kg (P

Samuel Broder: Why Isn’t There a Gardasil for Men?

Source: Author: Samuel Broder, M.D. There's an HPV vaccine for women; why don't men have one? Why was the vaccine against the cancer-causing, sexually transmitted HPV virus not approved for men at the same time it was for women? Is there any reason to think that men and women would react to it differently? Interesting question. First, a little background. Gardasil is a genetically engineered vaccine to immunize girls and women ages 9 to 26 against four types of human papillomavirus (HPV). HPV is the name given to a family of viruses, many of which can be transmitted from one partner to another through sexual activity. HPV may represent the most frequent sexually transmitted infection in the United States. It is estimated that over 6 million people become infected by a sexually related form of HPV every year. Some estimates suggest that over half of all sexually active males and females become infected at one point or another in their lifetimes. Certain types of HPV can sometimes evade the body's immune system and, when they do, establish a state of persistent infection. That in turn may cause certain cancers. Indeed, this is now recognized as the major cause of cervical cancer and related conditions, and vaccines that immunize people against HPV could make a dramatic impact against these diseases. Gardasil is the first vaccine in the United States approved for the prevention of cervical cancer and precancerous cell abnormalities in the cervix and also certain precancerous conditions in the [...]

2009-05-19T15:39:45-07:00May, 2009|Oral Cancer News|

Chewing tobacco use surges among boys

Source: Author: Staff WASHINGTON - Use of snuff and chewing tobacco by U.S. adolescent boys, particularly in rural areas, has surged this decade, a federal agency said in a report on Thursday that raised concern among tobacco control advocates. The use of such smokeless tobacco products increases the risk of oral cancer as well as heart disease and stroke. It leads to nicotine addiction just like cigarette smoking. The report by the U.S. Substance Abuse and Mental Health Services Administration showed a 30 percent increase in the rate of smokeless tobacco use among boys aged 12 to 17 from 2002 to 2007. Use by adults remained stable. In 2007, the report estimated that 566,000 boys in that age group had used chewing tobacco or snuff. "This trend toward more smokeless tobacco use by kids is of great concern," Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids advocacy group, said in a telephone interview. "This is an industry that has a history of targeting kids because they know that's when everybody starts," he added. Among adolescent boys, the rate of use of smokeless tobacco rose from 3.4 percent in 2002 to 4.4 percent in 2007, according to the report. McGoldrick said the increase occurred as smokeless tobacco companies greatly increased their spending on marketing and introduced a new range of products. The findings reiterated the need for the U.S. Food and Drug Administration to have the power to regulate tobacco products, as legislation being considered by [...]

2009-05-19T15:05:12-07:00May, 2009|Oral Cancer News|

Novel therapy may prove effective in treatment Of 30 percent of cancers

Source: Author: staff A ground-breaking Canada-wide clinical trial led by Dr. Katherine Borden, at the Institute for Research in Immunology and Cancer (IRIC) of the Université de Montréal, has shown that a common anti-viral drug, ribavirin, can be beneficial in the treatment of cancer patients. The study demonstrates that ribavirin suppresses the activities of the eIF4E gene in patients. This gene is dysregulated in 30 percent of cancers including breast, prostate, head and neck, colon and stomach cancer. The study, inspired by the exciting discoveries made by Dr. Borden at IRIC, was a joint project between her research group, who monitored molecular events in trial patients, and Dr. Sarit Assouline of the Segal Cancer Centre, Jewish General Hospital, who led the clinical part of the trial. The integration of these two teams made it possible to rapidly move from a research lab to patient tests. The study team targeted the gene by giving trial participants a mimic of its natural target, ribavirin. "Our results are the first to show that targeting eIF4E in humans is clinically beneficial," explains Dr. Borden. "We also found that ribavirin not only blocks eIF4E, it has no side effect on patients." The trial studied patients with M4/M5 acute myeloid leukemia who had undergone several other treatments that had previously failed. "We had striking clinical improvements with even partial and complete remissions," indicated Assouline. Dr. Wilson Miller, director of the Clinical Research Unit, Jewish General Hospital, and co-investigator in the trial added: "It's rare that [...]

Cancers with virus less lethal, study says

Source: Columbus Dispatch ( Author: Misti Crane Oral-cancer patients with tumors that contain human papillomavirus are more likely to survive than those whose cancer does not involve HPV, a study found. The Ohio State Comprehensive Cancer Center doctor who led the new study said future research should focus on the differences between the groups. Dr. Maura Gillison, a medical oncologist and head and neck cancer specialist, shared her findings as part of a preview of studies to be presented at the annual meeting of the American Society of Clinical Oncology in Orlando, Fla., this month. Details of her work were released with a handful of other studies, several of which highlighted an increasing focus on individualized cancer care. Chemotherapy patients are likely to cheer the findings from one of the studies shared yesterday: It found that ginger significantly reduces nausea. A study of patients at 23 private oncology practices compared nausea in those who took a placebo with those who took 0.5-gram, 1-gram and 1.5-gram doses of ginger in capsule form. All of the patients received standard anti-nausea medications. Those who took 0.5-gram or 1-gram doses of ginger reported about a 40 percent reduction in nausea, said lead researcher Julie Ryan of the University of Rochester. The study didn't look at foods or drinks that contain ginger, but Ryan said she suspects ginger in other forms also would be beneficial. She cautioned that some products contain ginger flavoring, not actual dried or fresh ginger. A gram of ground ginger is [...]

Studies find two new methods for curbing nausea of chemotherapy

Source: Author: Shari Roan Chemotherapy could soon become less grueling. Simply adding about half a teaspoon of ginger to food in the days before, during and after chemotherapy can reduce the often-debilitating side effects of nausea and vomiting, a large, randomized clinical trial has found. And a newer type of anti-nausea drug, when added to standard medications, can help prevent such side effects as well. The ginger results will be presented this month at the American Society of Clinical Oncology annual meeting; the drug study was published this week in the Lancet Oncology journal. The findings are significant, cancer experts say, because about 70% of chemotherapy patients experience nausea and vomiting -- often severe -- during treatment. "Chemotherapy has come to be the thing cancer patients fear the most," said Dr. Steven Grunberg, a professor of medicine at the University of Vermont and lead author of the study in the Lancet Oncology. "We've made a huge amount of progress, but we haven't completely solved the problem." In the ginger study, 644 patients, most of them female, from 23 oncology practices nationwide received two standard anti-emetic medications at the time of chemotherapy. They also were given a capsule containing either 0.5 gram, 1 gram or 1.5 grams of ginger, or a placebo capsule. The patients took the capsules containing the placebo or ginger for three days before chemotherapy and three days after the treatment. All of the patients receiving ginger experienced less nausea for four days after chemotherapy, said lead [...]

Tobacco lobby winning in texas

Source: Author: staff An army of tobacco industry lobbyists been hard at work in Texas battling a clean indoor air law and a new formula for taxing spit tobacco. The industry employed 40 lobbyists, seven of whom are former state legislators, to beat back the popular proposals. The smoking ban had gained hard-won support from the state's restaurant association, and enjoyed support among voters, who had already approved public smoking laws in 28 cities within the state. More than half of the Texas House of Representatives had signed on as co-authors of the bill. The other bill would have taxed spit tobacco by weight rather than by retail price, raising an extra $9 million to be put towards paying down the student loans of 450 doctors in exchange for them working in medically underserved areas of the state. Some Republicans argued against the smoking ban by casting smoking as a property right, an industry argument aimed at re-directing attention to secondhand smoke onto a non-health-related topic to help defeat smoking bans. Lobbyists ultimately succeeded in watering down the clean indoor air bill by inserting a slew of exceptions to undermine the intent of the bill, a strategy also linked to the industry: a 1986 Philip Morris strategy document about defeating smoking restrictions states, "Most state and local laws are very stringent when initially proposed. In most cases we are able to water down the final product [so that] penalties are often minimal and the restrictions negligible." Lobbyists stalled the [...]

ASCO: HPV Infection Linked to Better Outcome in Oropharyngeal Cancer

Source:  Author: Michael Smith TORONTO, May 14 -- Patients with oropharyngeal cancer had a 50% lower five-year mortality risk when they also had human papillomavirus (HPV) infection, according to data from a randomized clinical trial. HPV-positive patients had a two-year overall survival of 88% compared with 66% for HPV-negative patients (P<0.001), said Maura Gillison, M.D., of Ohio State University in Columbus. The difference between groups increased with follow-up. HPV infection also was associated with a reduced risk of locoregional recurrence and second cancers, Dr. Gillison reported at a press briefing in advance of the American Society of Clinical Oncology annual meeting. Cancer of the oropharynx arises from two principal causes: chronic use of tobacco and alcohol or HPV infection. Previous studies had suggested that HPV status of a patient's tumor might have prognostic implications. "HPV-positive patients have important associations with other favorable prognostic factors," said Dr. Gillison. "They tend to be younger; they have smaller tumors; they present with better performance status. Therefore, improvement in survival for this patient population may be explained by these factors and not by HPV." To explore the role of HPV status in survival of oropharyngeal cancer, Dr. Gillison and colleagues reviewed data from a randomized clinical trial conducted by the Radiation Therapy Oncology Group. Its principal objective was to compare standard chemotherapy with an investigational regimen. The trial involved 721 patients. Of those, 60% had cancer of the oropharynx and 64% were HPV positive. The two-year results demonstrated a clear survival advantage associated [...]

2009-05-15T16:11:18-07:00May, 2009|Oral Cancer News|
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