Evaluation of parotid gland function following intensity modulated radiation therapy for head and neck cancer

Source: Cancer Res Treat, April 1, 2006; 38(2): 84-91 Authors: SH Lee et al. Purpose: This study was undertaken to determine the parotid gland tolerance dose levels following intensity modulated radiation therapy (IMRT) for treating patients who suffered with head and neck cancer. Materials and Methods: From February 2003 through June 2004, 34 head and neck patients with 6 months of follow-up were evaluated for xerostomia after being treated by IMRT. Their median age was 59 years (range: 29~78). Xerostomia was assessed using a 4-question xerostomia questionnaire score (XQS) and a test for the salivary flow rates (unstimulated and stimulated: USFR and SSFR, respectively). The patients were also given a validated LENT SOMA scale (LSS) questionnaire. Evaluations were performed before IMRT and at 1, 3 and 6 months after IMRT. Results: All 34 patients showed significant changes in the XQS, LSS and Salivary Flow rates (USFR and SSFR) after IMRT. No significant changes in the XQS or LSS were noted in 12 patients who received a total parotid mean dose of 3,100 cGy, significant increases in the XQS and LSS were observed. The USFR and SSFR from the parotid glands in 7 patients who received 2,750 cGy were significantly lower than the baseline values at all times after IMRT. Conclusion: We suggest that the total parotid mean dose should be limited to

2009-09-29T21:26:45-07:00September, 2009|Oral Cancer News|

IsoRay announces Cornell Medical Center adopts Cesium-131 to treat head and neck cancer

Source: www.businesswire.com Author: press release IsoRay, Inc. (Amex: ISR) announced today that on August 5, 2009, Dr. Bhupesh Parashar from the Department of Radiation Oncology, Dr. David Kutler of the Department of Otorhinolaryngology, and Dr. Jason Spector of the Department of Plastic Surgery at Weill Cornell Medical Center performed the world’s first Cesium-131 implant for a recurrent head and neck cancer (buccal mucosa). The implant was performed using Vicryl®-embedded seeds on a 66-year-old patient who had received a full course of radiation to the head and neck several years ago. Cesium-131 was chosen for its short half-life and the higher dose rate. The patient tolerated the implant procedure well, and has had no adverse effects that can be attributed to the use of Cs-131 seeds. There is no evidence of cancer recurrence to date. Dr. Parashar stated, “We are very pleased to date with this patient’s progress. Having Cs-131 with its combination of short half-life and high energy gave us another option for treating this patient’s recurring buccal mucosa cancer.” Dr. Dattatreyudu Nori, the Chairman of the Department of Radiation Oncology at Weill Cornell Medical Center, and a pioneer in the field of brachytherapy, performed some of the initial Cesium-131 prostate implants in 2005. Until now clinical experience with Cesium-131 has been focused on prostate cancer and ocular melanoma. However, Cesium-131 has been cleared by the FDA for use in the treatment of malignant disease (e.g., prostate, ocular melanoma, head and neck, lung, brain, breast, etc.) and may be used [...]

2009-09-29T04:12:27-07:00September, 2009|Oral Cancer News|

Tips on managing the rash associated with EGFR inhibitors

Source: OncologySTAT (www.oncologystat.com) Author: OncologySTAT Editorial Team Nurses at Duke University Hospital in Durham, NC, have developed a treatment algorithm for the rash that frequently occurs with use of epidermal growth factor receptor (EGFR) inhibitors. “We want to help sustain patients so they can continue to get their therapy and maintain their quality of life,” Kimberly Bishop, RN, BSN, OCN, said at the Oncology Nursing Society 34th Annual Congress. For mild rash that doesn’t affect activities of daily living or quality of life, the algorithm recommends a topical cream—hydrocortisone and/or clindamycin or metronidazole. “At our institution, we use MetroCream [metronidazole cream] as our primary topical agent,” Ms. Bishop said. For moderate rash, an oral antibiotic is added, most commonly doxycycline 100 mg twice daily. “We reassess [patients] every 2 weeks to see what the rash looks like, and encourage patients to call to let us know if there is a change in the rash,” she said. Ms. Bishop described the rash as very red, often starting as a macular reaction and progressing to a pustular abscess-like rash that becomes ulcerated. “The rash itself is not infectious but can lead to a secondary superinfection from scratching. That’s why antibiotic therapy is important,” she said. For severe rash, the recommendation is to hold the EGFR inhibitor therapy and reassess within 1 to 2 weeks, continue with the antibiotic, and also add a Medrol Dosepak (oral methylprednisolone packaged to provide a tapering dose). Ms. Bishop warned that “any time you put steroid cream [...]

2009-09-28T03:53:00-07:00September, 2009|Oral Cancer News|

Brave dad has face rebuilt with bones from own body following cancer fight

Source: Author: Dad Tim Gallego feels like a new man after having his face rebuilt from different parts of his body. Financial adviser Tim, 46, had 16 operations to reshape his face after he was hit with disfiguring mouth cancer. Bones from his ribs and hips were used to form a new nose and jaw. Arteries from his legs were moved to his neck and skin from his wrists was grafted on to his lower face. The father of three joked yesterday: “I seem to be running out of a supply of body parts. And because of the changes people I know don’t recognise me. “They just look at me and wonder what happened but the only people who actually come forward to to ask are young children.” Tim, supported by wife Katie, has now made a full recovery after his eight-year ordeal. He was unable to talk for a year and could not eat or drink for two weeks after one operation. He was first diagnosed when he went to his doctor with sinus problems. Tests revealed he had a large tumour behind his nose. He underwent a 21-hour operation and his head ballooned to the size of a basketball. Months of radiotherapy followed before he started the long process of rebuilding his face bit by bit. And within a week of being diagnosed Katie found out she was pregnant with their first child, Imogen. Tim, from Poundbury, Dorset, said: “I looked like a monster but I’ve always been positive and [...]

2009-09-28T03:50:33-07:00September, 2009|Oral Cancer News|

Speaking and swallowing seems to be possible post tonsil cancer surgery

Source: www.healthjockey.com Author: staff Cancer of the tonsil is said to be one among the head and neck cancers. It apparently develops in the part of the throat just behind your mouth, called the oropharynx. Smoking and consuming alcohol may increase the risk for tonsil cancer. After a tonsil cancer surgery, it is believed that patients cannot speak or eat properly. But a new method for reconstructing the palate post surgery for tonsil cancer apparently preserved the capability of the patients to speak clearly and devour majority of the foods. This technique was developed at the University of Michigan Comprehensive Cancer Center. Tonsil cancer apparently develops in the back of the throat, which could mean that surgery could contain parts of the palate, the tongue and the jaw. In conventional reconstruction efforts, a huge round piece of tissue was apparently taken to plug the hole left when the tumor is supposedly detached. But this apparently damages the way the palate and tongue function, and may not reinstate the intricate mechanism of the throat that may enable an individual to speak and swallow. Study author Douglas Chepeha, M.D., M.S.P.H., associate professor of otolaryngology head and neck surgery and director of the microvascular program at the University of Michigan Health System, commented, “This is the area that triggers swallowing, that separates the mouth from the nasal cavity. It affects speech and eating – typically, patients have difficulty eating when they have this kind of tumor and undergo surgery. We can remove the [...]

2009-09-27T18:21:04-07:00September, 2009|Oral Cancer News|

Lilly Erbitux cancer drug not worth price, U.S. scientists say

Source: www.bloomberg.com Author: Lisa Rapaport Eli Lilly & Co.’s tumor-fighter Erbitux doesn’t prolong lung cancer patients’ lives enough to justify its $80,000 cost, U.S. scientists said in commentary published today. Erbitux added to other cancer drugs extends survival about 1.2 months more than chemotherapy alone, making the price too high for a “marginal benefit,” commentary in the Journal of the National Cancer Institute said. Erbitux, which Lilly markets with Bristol-Myers Squibb Co., generated $1.3 billion last year as treatment approved for other malignancies. The high price of some of the newest cancer medicines are coming under scrutiny as part of an effort by lawmakers and health officials to rein in overall medical costs. President Barack Obama has set aside $1.1 billion in the U.S. economic stimulus bill to study the comparative effectiveness of treatments for cancer and other diseases. “We must avoid the temptation to tell a patient that a new drug is available if there is little evidence that it will work better than established drugs that could be offered at a miniscule fraction of the cost,” wrote the commentators, Tito Fojo with the National Cancer Institute and Christine Grady at the National Institutes of Health. Lilly, of Indianapolis, and marketing partner Bristol- Myers, of New York, withdrew an application to extend the Erbitux’s use to lung tumors in February after the Food and Drug Administration questioned differences in American and European versions of the treatment. $10,000 a Month The authors projected that Erbitux costs $80,000 based on a [...]

2009-09-27T11:35:34-07:00September, 2009|Oral Cancer News|

New tool helps dentists detect oral cancer

Source: www.nbcdfw.com Author: Ashante Blaize Nationwide, an average of one person dies every hour from oral cancer, which is called a silent killer because it is difficult to detect and advances quickly, a Plano dentist said. Just two short months ago, Janet Kiser's relationship with her dentist, Dr. Frank Rabinowitz, changed. He's now more than just a D.D.S. to Kiser. After he detected a tumor growing inside the roof of her mouth, Kiser calls him a lifesaver. "The description of people who would typically have that kind of tumor was someone who chewed tobacco, or smoked a pipe, or at least smoked something," said Kiser. Kiser said she didn't do any of those things. The fear was she could have oral cancer. "Its a very invasive cancer. It's very fast growing and it's not always looked for," said Rabinowitz. Thanks to a new device called VELscope, Rabinowitz was able to take a more in depth look at Kiser's growth. "We got it and then we called Janet and asked her to come in, if I could look at her growth in her mouth with the VELscope," said Rabinowitz. "We are looking for tissues that may have changed." After using the device's ultraviolet light, Rabinowitz was able to pin point the size and growth of the tumor, take a picture of it, and send it to the oral surgeon who would remove Kiser's tumor. "The surgeon told me that he could actually see better margins and determine how much of the [...]

2009-09-27T11:30:22-07:00September, 2009|Oral Cancer News|

37% of U.S. teen girls got HPV vaccine

Source: www.medscape.com Author: Daniel J. DeNoon More than one in three U.S. teen girls has had at least one shot of Gardasil, a CDC survey shows, but only 18% of girls got the three shots needed for protection. The survey includes girls vaccinated through 2008, two years after Gardasil's approval. A second HPV vaccine, GlaxoSmithKline's Cervarix, is expected to be approved this year. Gardasil, from Merck, protects against the four strains of the sexually transmitted human papillomavirus (HPV) that cause most cases of cervical cancer and genital warts. But other HPV strains also cause these diseases, so even vaccinated women still need regular Pap exams. Gardasil's acceptance varied widely by state. More than half of all teen girls aged 13 to 17 had at least one shot of the HPV vaccine in six states: Arizona, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont. Fewer than one in five girls got the vaccine in three states: Georgia, Mississippi, and South Carolina. Coverage was highest in Rhode Island (54.7%) and New Hampshire (54.4%) and lowest in Mississippi (15.8%) and Georgia (18.5%). Cervical cancer is more common in women of Hispanic descent and in people living below the poverty level. Perhaps because the Vaccines for Children (VFC) program provides the expensive vaccine to uninsured children, girls in these groups had higher rates of coverage than other girls. The CDC reported results of the survey in today's issue of Morbidity and Mortality Weekly Report. Source: MMWR, Sept. 17, 2009; vol 58: pp 997-1001.

2009-09-25T12:57:21-07:00September, 2009|Oral Cancer News|

Port Coquitlam dentist hopes to save a life with a Velscope

Source: www.bclocalnews.com Author: Diane Strandberg A Port Coquitlam dentist is offering to do more than fix cavities and polish teeth. Dr. Glenn Keryluk wants to save a life. He's purchased an oral cancer screening device he expects will shortly become standard equipment in all dentist offices and he is offering to screen patients referred to by local doctors. "It's the latest and greatest in cancer detection," Keryluk says of the Velscope, a hand-held device that shines a blue light on oral lesions that could be cancerous. Manufactured by a White Rock-based company, the Velscope can show abnormal tissue below the surface, even before it becomes apparent to the clinicians' eye. Healthy tissue glows green under the light but cancerous tissue looks black. Being able to detect oral cancer early is key to surviving the disease because the longer the cancer is around the more likely it will spread to nearby organs. Keryluk held a free screening day for patients at his office at 2099 Lougheed Highway recently and is cutting standard fees for the procedure or waving them entirely for people without dental coverage. The procedure is painless, takes only a few minutes and a photograph of the lesion taken by the machine can be sent to a physician for follow-up. "If you catch it early it could be that a person's life is saved. I just want people to be aware of the technology out there," Keryluk said. He's only seen two cases of oral cancer in 20 years [...]

2009-09-25T12:36:26-07:00September, 2009|Oral Cancer News|

Identification of highly radiosensitive patients may lead to side effect-free radiotherapy

Source: www.ecancermedicalscience.com Author: staff An international group of scientists has taken the first step on the road to targeting radiotherapy dosage to individual patients by means of their genetic characteristics, a radiation oncologist told Europe’s largest cancer congress, ECCO 15 – ESMO 34, in Berlin today. Professor Dirk de Ruysscher, from Maastricht University Medical Centre, Maastricht, The Netherlands, said that his team’s work might provide the basis for personalised radiotherapy in which, with a simple blood test, doctors may be able to select the optimal radiation dose for a particular patient. The team of scientists from The Netherlands, Belgium, Germany, and Canada studied a group of patients with hypersensitivity to radiation therapy, drawn from the largest world-wide database available – the European Union-funded Genetic pathways for the prediction of the effect of irradiation (GENEPI) study, which integrates biological material with patient data and treatment specifications. The database included information from more than 8000 European patients. “Part of this project is the establishment of a sub-database in which very rare patient characteristics are brought together with the hypothesis that their genetic traits will enable the characterisation of molecular pathways related to radio-sensitivity,” explained Professor de Ruysscher. “A major problem for radiation oncologists at present is that we are bound by the need to avoid damage to normal tissues. This means that the dose of radiation generally used is governed by the response of the most radiosensitive patients, and this may lead to many patients receiving lower than optimal doses, hence affecting [...]

2009-09-25T07:51:01-07:00September, 2009|Oral Cancer News|
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