New surgical approach can remove throat tumor and rebuild trachea

Source: Author: staff Using a novel surgical approach, it's possible to rebuild the trachea and preserve a patient's voice after removing an invasive throat tumor, according to a new report from Henry Ford Hospital in Detroit. This case study is the first of its kind to not only document a successful technique to create a fully functional trachea, or windpipe, but also report a rare type of malignant tumor in an adult's trachea. Most commonly, this type of tumor is seen in newborns and very rarely occurs in the neck, says lead study author Samer Al-Khudari, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford Hospital. "In this case, the patient's tumor had spread to the trachea, thyroid gland, muscles around the thyroid gland and nerves in the area," says Dr. Al-Khudari. According to head and neck cancer surgeon Tamer A. Ghanem, M.D., Ph.D., who led the Henry Ford surgical team, the easiest approach would have been to remove the trachea and the voice box, given the tumor's proximity to the larynx and other surrounding structures. With this method, however, the patient would no longer be able to speak or swallow normally. Instead, the surgical team took another approach. Using tissue and bone from the patient's arm, they were able to reconstruct the trachea, restoring airflow through the trachea and saving the patient's voice. "We had to think outside the box to not only safely remove the tumor, but to allow for optimum functional outcome," says [...]

Stephen Strasburg attempts to quit smokeless tobacco

Source: Author: Adam Kilgore Like any other high school kid, Stephen Strasburg wanted to emulate the major league baseball players he watched on television. He mimicked their actions down to the last detail. He rolled his pants up to reveal high socks, wore wristbands at the plate and, during downtime, opened tins of chewing tobacco and pinched some in his lower lip. Years later, having developed a powerful addiction, Strasburg regrets ever trying smokeless tobacco. Last fall, Tony Gwynn - his college coach at San Diego State and one of those players he grew up idolizing - began radiation treatments for parotid cancer, a diagnosis Gwynn blamed on using smokeless tobacco. In the wake of Gwynn's cancer diagnosis, Strasburg has resolved to quit smokeless tobacco while he recuperates from Tommy John surgery. He doesn't want to face the myriad health risks borne from tobacco use, and he doesn't want kids who want to be like him to see him with a packed lower lip. Strasburg conflates many activities with dipping, and he has yet to eradicate the habit. But he is determined he will. "I'm still in the process of quitting," Strasburg, 22, said. "I've made a lot of strides, stopped being so compulsive with it. I'm hoping I'm going to be clean for spring training. It's going to be hard, because it's something that's embedded in the game." Smokeless tobacco has long been entrenched in baseball. In the 1980s, wads of it bulged in batters' cheeks. More recently, [...]

Lightning rod for head and neck cancer

Source: Author: staff They say lightning never strikes the same place twice—unless, of course, that place is a lightning rod. An enzyme called UROD acts like a lightning rod for cancer cells, drawing radiation and chemotherapy toward specific spots in diseased tissue, a new study in mice and humans reports in Science. The findings suggest that UROD—identified for the first time in this paper as a key player in human cancer--could help decrease treatment side effects for people with head and neck cancer, the eighth most common cancer worldwide. Despite many advances over the last few decades, the toxic side effects associated with current therapies have made for disappointing outcomes in many patients. Head and neck tumors are often found near critical organs, so destroying the diseased tissue is often a delicate challenge that could lead to life-threatening conditions. Here, Emma Ito and colleagues show that targeting UROD can selectively enhance the effects of radiation and chemotherapy in head and neck tumors, while minimizing toxicity to normal tissues. By focusing therapy toward specific parts of tissue, lower doses of radiation and chemotherapeutic drugs could potentially be administered to patients without compromising treatment efficacy. Uroporphyrinogen decarboxylase or UROD is an enzyme involved in the production of a molecule called heme, which is vital for all of the body's organs (though it is most abundant in the blood, bone marrow, and liver). Heme is an essential component of iron-containing proteins called hemoproteins, including hemoglobin, the protein that carries oxygen in the [...]

Lean body mass gain in patients with head and neck squamous cell cancer treated perioperatively with a protein- and energy-dense nutritional supplement containing eicosapentaenoic acid

Source: Author: HG Weed et al. Background: Cancer-associated weight loss may be mediated by an inflammatory response to cancer. Eicosapentaenoic acid (EPA) may suppress this response. Methods: Beginning no later than 2 weeks before surgery, patients with head and neck cancer and with weight loss, who were undergoing major resection with curative intent consumed a protein- and energy-dense nutritional supplement containing EPA from fish oil, in addition to usual diet or tube feed. Results: Thirty-one subjects consumed an average of 1.8 containers/day before surgery and 1.5/day during hospitalization (per container: 300 kilocalories, 16 grams (g) protein, 1.08 g EPA). Seventy percent of subjects maintained or gained weight before hospital admission. Mean weight gain was 0.71 kg at admission and 0.66 kg at discharge. At discharge lean body mass increased by 3.20 kg (p

Reducing xerostomia through advanced technology

Source: The Lancet Oncology Radiation-related xerostomia has been the most significant and disabling side-effect of radiotherapy for head and neck cancer for more than 50 years. With the PARSPORT trial, reported in The Lancet Oncology, the largest and best designed of several randomised trials focusing on xerostomia, radiation oncologists and their partners in physics and dosimetry should take pride that significant progress has been made. Before the introduction of intensity-modulated radiotherapy (IMRT), more than 80% of survivors experienced substantial dry mouth syndrome and associated effects on dental health, swallowing, taste, and quality of life. By contrast, Nutting and colleagues report about 25% of 2-year survivors had significant clinician-rated xerostomia. Taken together with two randomised trials of IMRT for nasopharyngeal cancer, there is now compelling evidence of the power of advanced technology in reducing toxicity from head and neck radiotherapy. Can even better use of technology help us to further reduce xerostomia? The parotid glands provide watery saliva during eating, which is largely replaceable by consuming more water or lubricants. The submandibular, sublingual, and minor salivary glands provide mucinous saliva, associated with the resting sense of moisture and dry mouth symptoms. Future work should systematically explore the prioritisation of different components of the salivary gland system. A clinical benefit from sparing the submandibular glands may be seen, beyond that seen by sparing the parotid glands. The mean dose delivered to the minor salivary glands within the oral cavity has also been reported to be a significant factor in patient-reported xerostomia. Further possibilities include gland repair [...]

Detection of squamous cell carcinoma and corresponding biomarkers using optical spectroscopy

Source: Author: H. Wolfgang Beumer, MD et al. Objectives: Investigate the use of optical reflectance spectroscopy to differentiate malignant and nonmalignant tissues in head and neck lesions and characterize corresponding oxygen tissue biomarkers that are associated with pathologic diagnosis. Study Design: Cross-sectional study. Setting: Tertiary Veterans Administration Medical Center. Subjects and Methods: All patients undergoing panendoscopy with biopsy for suspected head and neck cancer were eligible. Prior to taking tissue samples, the optical probe was placed at 3 locations to collect diffuse reflectance data. These locations were labeled “tumor,” “immediately adjacent,” and “distant normal tissue.” Biopsies were taken of each of these respective sites. The diffuse reflectance spectra were analyzed, and biomarker-specific absorption data were extracted using an inverse Monte Carlo algorithm for malignant and nonmalignant tissues. Histopathological analysis was performed and used as the gold standard to analyze the optical biomarker data. Results: Twenty-one patients with mucosal squamous cell carcinoma of the head and neck were identified and selected to participate in the study. Statistically significant differences in oxygen saturation (P = .001) and oxygenated hemoglobin (P = .019) were identified between malignant and nonmalignant tissues. Conclusion: This study established proof of principle that optical spectroscopy can be used in the head and neck areas to detect malignant tissue. Furthermore, tissue biomarkers were correlated with a diagnosis of malignancy. Authors: 1. H. Wolfgang Beumer, MD1 2. Karthik Vishwanath, PhD2 3. Liana Puscas, MD1,3 4. Hamid R. Afshari, DDS5 5. Nimmi Ramanujam, PhD2 6. Walter T. Lee, MD1,3 Authors' [...]

Oncologists must discuss all options in advanced cancer: ASCO policy

Source: By: Zosia Chustecka January 28, 2011 — A new policy statement from the American Society of Clinical Oncology (ASCO) aims to improve communication with, and decision making for, patients with advanced cancer (defined as incurable disease). It calls for a change in paradigm for advanced cancer care and a new approach in which all available treatment options are discussed from the very beginning. The statement was published online on January 24 in the Journal of Clinical Oncology. "While improving survival is the oncologist's primary goal, helping individuals live their final days in comfort and dignity is one of the most important responsibilities of our profession," ASCO president George Sledge, MD, said in a statement. "Oncologists must lead the way in discussing the full range of curative and palliative therapies to ensure that patients' choices are honored," he said. New Paradigm of Care This new approach "requires stepping back from the paradigm of applying one line of therapy after the other and focusing primarily on disease-directed interventions," say the authors, comprised of a panel of oncologists and specialists in palliative care. "Instead, we need to move toward developing a treatment plan that is consistent with evidence-based options (including disease-directed and palliative care), and the patients' informed preferences for how we pursue and balance these options throughout the course of illness," they add. Conversations about all of the options that are available must be started earlier, and they must be more thorough, the panel insists. "These conversations should be going on [...]

Cytotoxicity of thymus vulgaris essential oil towards human oral cavity squamous cell carcinoma

Souce:International Journal of Cancer Research and Treatment Serkan Sertel, Tolga Eichhorn, Peter K. Plinkert and Thomas Efferth Abstract Background: Oral cavity squamous cell carcinoma (OCSCC) accounts for 2% to 3% of all malignancies and has a high mortality rate. The majority of anticancer drugs are of natural origin. However, it is unknown whether the medicinal plant Thymus vulgaris L. (thyme) is cytotoxic towards head and neck squamous cell carcinoma (HNSCC). Materials and Methods: Cytotoxicity of thyme essential oil was investigated on the HNSCC cell line, UMSCC1. The IC50 of thyme essential oil extract was 369 μg/ml. Moreover, we performed pharmacogenomics analyses. Results: Genes involved in the cell cycle, cell death and cancer were involved in the cytotoxic activity of thyme essential oil at the transcriptional level. The three most significantly regulated pathways by thyme essential oil were interferon signaling, N-glycan biosynthesis and extracellular signal-regulated kinase 5 (ERK5) signaling. Conclusion: Thyme essential oil inhibits human HNSCC cell growth. Based on pharmacogenomic approaches, novel insights into the molecular mode of anticancer activity of thyme are presented.

Diagnostic chip may help hearts, cut costs

Souce: By: Mike Williams Rice University technology in human trials to spot cardiac disease, cancer, drug abuse Heart disease is a silent killer, but new microchip technology from Rice University is expected to advance the art of diagnosis. During National Heart Health Month, Rice Professor John McDevitt will discuss the potential of this technology to detect cardiac disease early at the annual meeting of the American Association for the Advancement of Science (AAAS) in Washington, D.C., Feb. 17-21. Cardiac disease is the focus of one of six ongoing major clinical trials of Rice's programmable bio-nano-chips (PBNCs). PBNCs combine microfluidics, nanotechnology, advanced optics and electronics to enable quick, painless diagnostic tests for a wide range of diseases at minimal cost. Current clinical trials employ PBNCs to test more than 4,000 patients for signs of heart disease, ovarian cancer, prostate cancer, oral cancer and drug abuse. Versions to test for HIV/AIDS and other diseases are also in development. "Too often, the first time people know they're suffering from heart disease is when it kills them," said McDevitt, Rice's Brown-Wiess Professor of Chemistry and Bioengineering, who will participate in a global health seminar at AAAS. "With this test, we expect to save lives and dramatically cut the recovery time and cost of caring for those who suffer from heart ailments," said McDevitt, a pioneer in the creation of microfluidic devices for biomedical testing. He anticipates the PBNCs, when manufactured in bulk, will cost only a few dollars each. PBNCs analyze a patient's [...]

Martin Duffy, 70; Marathon fixture went extra mile

Source: By: Bryan Marquard The morning he died, during what turned out to be his last hour or so of life, Martin Duffy got up and ran through his daily regimen of stretching, push-ups, and sit-ups. Several months before, cancer had kept him from adding to his extraordinary streak of 40 consecutive Boston Marathons, but he was used to forging ahead when his body said stop. Take one particular Marathon, probably his 26th. Afterward, he learned he had competed with a broken foot. Realizing at the 2-mile mark that something was amiss, “I divided that race into sections of 6 miles, with each segment a challenge to get through,’’ he told the Globe in 2000. “And somehow I did.’’ In 2009, Mr. Duffy’s string of consecutive completed Boston Marathons was recorded as the third-longest in history when he ran his 40th and final race a few months after being diagnosed with tongue cancer induced by the human papilloma virus. He was 70 when he died Nov. 29 in his Belmont home. Runners often sought advice from Mr. Duffy, given his experience, and he didn’t stop at simply offering tips on how and where to train. An economist who advised businesses and helped them develop strategies, he was still in touch with friends and clients in his final days. “He went in to work the week before he passed away,’’ said his wife, Rusty Stieff. And that was after treatment had left Mr. Duffy no longer able to speak. Instead, he [...]

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