February 2012 – Page 3 – Oral Cancer News

Alcohol withdrawal syndrome worsens cancer surgery outcomes

Source: www.oncologyreport.com/ Author: Damian McNamara Patients with head and neck cancers who develop alcohol withdrawal syndrome perioperatively experience significantly more complications after undergoing surgery, a large database analysis indicates. The presence of withdrawal symptoms was associated with a 25% incidence of postoperative complications, compared with 14% among patients who abused alcohol and 7% among those without alcohol abuse, Dr. Dane J. Genther said at the Triological Society’s Combined Sections Meeting. The risk for wound complications was nearly double in this population (odds ratio, 1.9). Dr. Genther, a resident in otolaryngologyhead and neck surgery at Johns Hopkins Hospital in Baltimore, and his associates used ICD-9 codes in the Nationwide Inpatient Sample discharge database to identify more than 92,000 patients who underwent an ablative procedure for head and neck cancer in 2003-2008. The retrospective, cross-sectional study included patients with malignant oral cavity, laryngeal, hypopharyngeal, and oropharyngeal neoplasms. In a multivariate analysis, alcohol withdrawal syndrome was significantly more likely for patients undergoing a major procedure (OR, 2.0) and was significantly associated with Medicare payer status and a need for additional health care following discharge, Dr. Genther said. The researchers found no significant association between alcohol withdrawal syndrome and increased risk for postoperative infections or in-hospital mortality, but there was a significant increase in hospital stay and related costs associated with the syndrome. Having a major procedure and experiencing alcohol withdrawal contributed approximately $15,000 per admission in 2011 U.S. dollars, Dr. Genther said. The findings point to a need for alternatives to current alcohol [...]

Oral Cancer Foundation News Team - A2012-02-14T22:35:07-07:00February, 2012|Oral Cancer News|

IMRT provides better QOL in head and neck cancers

Source: www.oncologyreport.com/ AUthor: Miriam E. Tucker Intensity-modulated radiotherapy is more expensive than 3-D–conformal radiotherapy is and has not been shown to improve standard outcomes in patients with head and neck cancer. But it results in better quality of life. These findings from two studies presented at the Multidisciplinary Head and Neck Cancer Symposium raise the question: Does improved quality of life justify the greater expense of intensity modulated radiotherapy (IMRT), which has been rapidly adopted for the treatment of head and neck cancer? Because IMRT spares surrounding tissues, it reduces the likelihood of developing xerostomia, noted Dr. Nathan C. Sheets, who presented data on billing charges associated with IMRT, compared with 3-D–conformal radiotherapy (CRT). IMRT is reimbursed at a substantially higher level than CRT, however, and it is unclear how to assess this cost relative to other aspects of care in this population, said Dr. Sheets, a radiation oncology resident at the University of North Carolina, Chapel Hill. A separate study presented by Dr. Allen M. Chen compared quality of life in patients who received IMRT vs. CRT. "There’s very little data to suggest IMRT is better than non-IMRT using traditional end points. But the question is: How do you define ‘better’?" said Dr. Chen, director of the radiation oncology residency training program at the University of California, Davis in Sacramento. "IMRT might not particularly involve better cure rates, but it could make a difference in terms of other end points, such as quality of life, which we all know [...]

Oral Cancer Foundation News Team - A2012-02-12T09:20:40-07:00February, 2012|Oral Cancer News|

Head and neck cancer in Canada: trends 1992 to 2007

Source: oto.sagepub.com/ Authors: Johnson-Obaseki et al. Objectives: The objective of this study was to investigate the changes in the epidemiology (incidence, age at diagnosis, and survival) of head and neck cancers (HNCs) in Canada in the past decade. Study Design: Analysis of a national cancer data registry. Setting: All Canadian hospital institutions treating head and neck cancer. Subjects and Methods. Using Canadian Cancer Registry data (1992-2007), the authors categorized HNCs into 3 groups according to their possible association with human papillomavirus (HPV): oropharynx (highly associated), oral cavity (moderate association), and “other” (hypopharynx, larynx, and nasopharynx), which are not HPV related. They calculated age-adjusted incidence, median age at diagnosis, and survival for each category. Results: Oropharynx tumors increased in incidence over the study time period (annual percent change: 1.50% men, 0.8% women), whereas oral cavity tumors decreased (2.10% men, 0.4% women), as did other HNCs (decreased by 3.0% for men and 1.9% for women). The median age at diagnosis for oropharynx cancer decreased by an average of 0.23 years/y. There was no change for oral cavity tumors but an increase for other HNCs of 0.12 years/y. Survival for patients with oropharynx cancer increased by 1.5%/y but was significant for men only. Survival for patients with oral cavity and other HNCs also increased in men only by 0.9%/y and 0.25%/y, respectively. Conclusion: Oropharynx cancer, which is highly correlated with HPV infection, is increasing in incidence in Canada, with a decreasing age at diagnosis and an improvement in survival. This could have implications [...]

Oral Cancer Foundation News Team - A2012-02-12T09:09:35-07:00February, 2012|Oral Cancer News|

Caring for the oral health of patients battling cancer: oral care before cancer treatment

Source: www.dentistryiq.com/ Author: Dennis M. Abbott, D.D.S. Cancer. The New Oxford American Dictionary defines it as “the disease caused by an uncontrolled division of abnormal cells in a part of the body;” but for the millions of people it has touched, cancer is so much more. Cancer is a constant unwanted companion that opens the door to an unchosen journey and demands to be followed. It affects individuals, families and friends. Cancer changes lives. Beyond the emotional toll it imposes, cancer alters the well-being of those it afflicts. Modern treatment regimens given to combat this disease come with a host of deleterious side effects, many of which occur in the mouth. Dentists, dental hygienists and dental auxiliaries are in a unique and necessary position to make a positive impact in the lives of patients battling cancer Making a difference begins with a desire to help and a willingness to take a risk. It is followed by a commitment to learn about the unique oral health care needs of patients engaged in the fight of their lives and put into practice skills that can literally provide comfort and hope. We, as dental professionals, can and should be a part of a comprehensive cancer care team for an ever-growing number of people facing cancer. Dental Oncology Dental oncology is a focus of dentistry dedicated to meeting the unique dental and oral health care needs that arise as a result of cancer therapy. It is an area of oral medicine devoted to improving [...]

Oral Cancer Foundation News Team - A2012-02-12T08:48:16-07:00February, 2012|Oral Cancer News|

Adaptive radiotherapy may benefit patients with head and neck cancer

Source: News-Medical.net Researchers led by a senior investigator at Hofstra-North Shore LIJ School of Medicine and The Feinstein Institute for Medical Research have released initial findings from a first-of-a-kind clinical trial in adaptive radiotherapy (ART) for head and neck cancer. The trial, sponsored by the National Cancer Institute, provides evidence that ART may benefit patients with less technical difficulty than previously believed. The findings of this trial were released online in advance of publication in the International Journal of Radiation Oncology Biology Physics. Physicians commonly use radiotherapy to treat squamous cell carcinoma of the oropharynx (back of throat). Current standard-of-care treatment is called intensity-modulated radiotherapy, or IMRT. IMRT allows physicians to "sculpt" radiation to fit the anatomy of individual patients. Although appealing, this technique has a crucial Achilles' heel - it is based entirely on a CT or MRI scan taken before actual treatment begins. Since a typical course of radiation treatment for oropharynx cancer lasts 6-7 weeks, standard IMRT cannot compensate for common changes that take place in a patient's body during this time, such as weight loss, shrinkage of tumor, or gradual movement of normal tissues. Recent work suggests that the inability of standard IMRT to keep up with these changes may lead to unanticipated toxicity, or potentially worse, missing of tumor. For this new trial, which was conducted at the University of Texas M.D. Anderson Cancer Center, investigators started patients on standard IMRT. They then took CT scans while patients were lying in the radiation treatment room [...]

Charlotte Parker2012-02-10T10:40:11-07:00February, 2012|Oral Cancer News|

Cisplatin Aids Survival of High-Risk Head and Neck Cancer

Source: Oncology Report Adding chemotherapy to radiotherapy improved 10-year survival of resectable head and neck carcinomas among high-risk patients who had microscopically involved resection margins and/or extracapsular spread of disease – but not in high-risk patients who only had tumor in multiple lymph nodes. The findings come from a long-term update and unplanned subset analysis of 410 evaluable patients from the RTOG (Radiation Therapy Oncology Group) 9501 phase III study, which previously showed no overall survival advantage from the addition of cisplatin chemotherapy to radiation. The new data are "good news," according to lead author Dr. Jay Cooper, director of Maimonides Cancer Center in Brooklyn, N.Y. "We now can eradicate some advanced head and neck tumors that we couldn’t before by adding chemotherapy to radiation therapy. At the same time, we can spare other patients who would not do better with the addition of chemotherapy from its side effects," he said at a head and neck cancer symposium sponsored by the American Society for Radiation Therapy. The RTOG 9501 study randomized 459 patients with high-risk, resected head and neck cancers to receive either radiation therapy of 60 Gy in 6 weeks (RT), or identical radiotherapy plus cisplatin at 100 mg/m2 IV on days 1, 22, and 43 (RT+CT). When reported at a median follow-up of 45.9 months, the locoregional control rate was significantly higher in the combined-therapy group than in the group given radiotherapy alone (hazard ratio for locoregional recurrence, 0.61); disease-free survival was significantly longer with combined therapy (HR [...]

Charlotte Parker2012-02-08T10:06:10-07:00February, 2012|Oral Cancer News|

3D printer provides woman with a brand new jaw

Source: New Scientist An 83-year-old Belgian woman is able to chew, speak and breathe normally again after a machine printed her a new jawbone. Made from a fine titanium powder sculpted by a precision laser beam, her replacement jaw has proven as functional as her own used to be before a potent infection, called osteomyelitis, all but destroyed it. The medics behind the feat say it is a first. "This is a world premiere, the first time a patient‐specific implant has replaced the entire lower jaw," says Jules Poukens, the researcher who led the operation at Biomed, the biomedical research department of the University of Hasselt, in Belgium. "It's a cautious, but firm step." Until now, the largest 3D-printed implant is thought to have been half of a man's upper jawbone, in a 2008 operation in Finland. In this operation, a 3D printed titanium scaffold was steeped in stem cells and allowed to grow biocompatible tissue inside the abdomen of the recipient. Then, in 2009, researchers reported successfully printing copies of whole thumb bones - opening the way for the replacement of smashed digits using information from MRI scans. Poukens' team worked with researchers in Belgium and the Netherlands and a 3D printing firm called Layerwise in Leuven, Belgium, which specialises in printing with ultrastrong titanium to make dental implants (like bridges and crowns) and facial and spinal bone implants. By using an MRI scan of their patient's ailing jawbone to get [...]

Charlotte Parker2012-02-07T20:51:57-07:00February, 2012|Oral Cancer News|

PET/CT Detects Early Recurrence of Head and Neck Cancer

Source: Elsevier Global Medical News Routine use of positron emission tomography/computed tomography scans can detect locoregional recurrences of squamous cell carcinoma of the head and neck before they became clinically apparent, according to a retrospective chart review of 234 patients who had been treated with chemoradiation between 2006 and 2010.  The finding suggests that routine use of positron emission tomography/computed tomography (PET/CT) may improve the outcome of salvage therapy, said Dr. Yasir Rudha, who reported the study at the Multidisciplinary Head and Neck Symposium sponsored by the American Society for Radiation Oncology.  PET/CT was associated with a high false positive rate, which should be considered when ordering radiological exams and biopsies, but a negative post therapy PET scan appears to be an excellent predictor of freedom from future locoregional recurrence, said Dr. Rudha of St. John Hospital/Van Elslander Cancer Center, Grosse Pointe Woods, Mich.  The technology is relatively new, and its use for routine follow-up in patients with head and neck cancer is still controversial, he acknowledged. "Only a few publications have reported the value of PET examination at a fixed time interval after the end of treatment," he said. "PET scan is often ordered in our hospital as a routine surveillance tool following successful completion of treatment."  The review of charts for all 234 patients identified 45 who had achieved clinical no-evidence-of-disease status at the time of post treatment imaging. In this group, PET/CT scanning at 6-9 weeks identified 15 patients with abnormalities that required further evaluation. Of those, eight patients (53%) were [...]

Charlotte Parker2012-02-06T11:45:04-07:00February, 2012|Oral Cancer News|

Head and neck cancer carries substantial comorbidity burden

Source: MedWire News People with head and neck cancer experience a high burden of both acute and chronic comorbidity, shows an analysis of a large Dutch population-based cohort. The researchers therefore advise clinicians to account for patients' comorbidity burden when assessing the risk-benefit profile for different treatment options. Sarah Landis (GlaxoSmithKline, London, UK) and co-workers analyzed information on 1499 patients with squamous cell carcinoma of the head and neck (SCCHN) living in the Netherlands. For each patient they calculated prevalence and incidence rates of eight comorbid conditions: cardiovascular disease, asthma/chronic obstructive pulmonary disease (COPD), liver disease, diabetes, anemia, pneumonia, depression, and other malignant disease. Rates of the same eight conditions were also calculated in a control population of 5996 cancer-free individuals matched for age and gender. Writing in the journal Head and Neck, Landis et al report that the mean age of the SCCHN cohort was 62 years and two-thirds were male. The site of cancer was the oral cavity in 610 patients, the pharynx in 317, and the larynx in 572. The most prevalent comorbidities in patients with SCCHN were cardiovascular disease (41%) and asthma/COPD (12%); the other comorbidities were prevalent in less than 10% of patients. Notably, in the period of 12 months prior to the index date, patients with SCCHN were between two and four times as likely as cancer-free controls to have any of the comorbidities investigated, the authors remark. In terms of incidence, rates of all comorbidities (with the exception of other malignant diseases) were [...]

Charlotte Parker2012-02-06T10:16:32-07:00February, 2012|Oral Cancer News|

UT MD Anderson article offers one roadmap for defining value in health care, earns national award from leading journal

Source: http://www.newswise.com Author: University of Texas M. D. Anderson Cancer Center A team from The University of Texas MD Anderson Cancer Center is receiving a national award for a research article tackling a question vital to the future of health care with reform regulations looming, competition growing and costs rising. The MD Anderson study took on the complex question of defining value in health care and for its paper that outlines one approach, the team has been awarded the 2012 Edgar C. Hayhow Article of the Year Award. Presented by the American College of Healthcare Executives (ACHE), the winning paper appeared in the organization's publication, the Journal of Healthcare Management, in the November/December 2010 issue. The Hayhow Award was created in 1959 as a tribute to the organization's 14th chair and the first practicing administrator to earn a doctoral degree. The award will be presented in March at the ACHE's annual Congress on Healthcare Leadership in Chicago. "The medical community understands how fundamental the concept of value is to improve the quality and delivery of care because it impacts patients, hospitals, physicians, insurance providers and regulators," said Thomas W. Feeley, M.D., professor and head of the Division of Anesthesiology and Critical Care and the corresponding author of the study. "We've been looking at this complex question for many years and our paper outlines an approach that has been successful at MD Anderson and one that, we believe, can be applied throughout our institution. While we don't assert that this approach [...]

Oral Cancer Foundation News Team - A2012-02-03T19:56:16-07:00February, 2012|Oral Cancer News|