2016 – Page 9 – Oral Cancer News

The burden of cancer isn’t just cancer

Source: www.news.doximity.comAuthor: Carolyn Y. Johnson Money is low on the list of things most people want to think about after a doctor says the scary word "cancer." And it's not just patients — physicians also want to weigh the best treatment options to rout the cancer, unburdened by financial nitty gritty. But a growing body of evidence suggests that, far from crass, ignoring cost could be harmful to patients' health. In the age of $10,000-a-month cancer drugs and health plans that shift more of the cost of health care onto patients, research suggests we've been underestimating one of cancer's real harms: "financial toxicity." The financial difficulties that stem from dealing with cancer can lead people to avoid or delay care or drugs, studies suggest, and also may cause stress that can lead to mental and physical health problems. "When people are diagnosed, it behooves the provider to assess their financial risk at baseline — to find out if they’re at risk, and if they are, to be very aggressive with getting them to financial planning, to patient assistance programs to reduce their likelihood of having financial devastation," said Scott Ramsey, a health economist and physician at the Fred Hutchinson Cancer Research Center in Seattle who showed in 2013 that people with cancer are 2.65 times more likely to file for bankruptcy than people without cancer. "We think unless you do, it’ll be hard to keep people from ending up in this situation." For years, the evidence has accrued that cancer patients experience greater financial challenges than other groups of sick people. A study in the Journal of Clinical Oncology found [...]

Charlotte Parker2016-04-11T10:54:10-07:00April, 2016|Oral Cancer News|

Study supports immunotherapy/radiation combo in head and neck cancer

Source: www.onclive.com Author: Laura Panjwani There may be potential synergy between radiation therapy, given with or without chemotherapy, and immune checkpoint inhibitors in patients with squamous cell carcinoma of the head and neck (SCCHN), according to results of a prospective study. The study, which was presented at the the 2016 Multidisciplinary Head and Neck Cancer Symposium in February 2016, examined blood samples from 16 consecutive patients with SCCHN undergoing curative-intent radiation therapies. Samples were obtained at week 1 and week 6 to 7. Patients received a median of 70 Gy for disease in the oropharynx (n = 12, 75%), nasopharynx (n = 2, 12%), larynx (n = 1, 6%), or oral cavity (n = 1, 6%). The majority of patients had stage IV disease that was metastatic to regional lymph nodes and received concurrent platinum-based chemotherapy. The analysis found that, during radiation treatment, circulating CD8-positive T-effector cells increased (P = .01), as did CD4-positive PD-1–positive cells (P = .02), CD8-positive LAG3-positive cells (P = .02), and regulatory T cells (P = .04). sPD-L1 levels also increased, mirroring increases in CD8-positive T cells over the course of therapy (P = .047). While the extent to which these systemic changes reflect changes in the tumor microenvironment is unknown, the study authors noted that these findings support the “complex immunologic effects of fractionated chemoradiation therapy and mechanisms for potential synergy between chemotherapy, radiation treatment, and immunotherapy in SCCHN.” To learn more about the impact of the research, OncLive spoke to one of the [...]

Oral Cancer Foundation News Team - A2016-04-11T08:00:24-07:00April, 2016|Oral Cancer News|

Forgotten patients: New guidelines help those with head-and-neck cancers

Source: www.fredhutch.org Author: Diane Mapes and Sabrina Richards Stigma, isolation and medical complexity may keep patients from getting all the care they need; recommendations aim to change that. Like many cancer patients, Jennifer Giesel has side effects from treatment. There’s the neuropathy in her hands, a holdover from chemo. There’s jaw stiffness from her multiple surgeries: an emergency intubation when she couldn’t breathe due to the golf ball-sized tumor on her larynx and two follow-up surgeries to remove the cancer. And then there’s hypothyroidism and xerostomia, or dry mouth, a result of the 35 radiation treatments that beat back the cancer but destroyed her salivary glands and thyroid. “I went to my primary care doctor a couple of times and mentioned the side effects,” said the 41-year-old laryngeal cancer patient from Cleveland, who was diagnosed two years ago. “She was great but she didn’t seem too knowledgeable about what I was telling her. She was like, ‘Oh really?’ It was more like she was learning from me.” Patients like Giesel should have an easier time communicating their unique treatment side effects to health care providers with the recent release of new head-and-neck cancer survivorship guidelines. Created by a team of experts in oncology, primary care, dentistry, psychology, speech pathology, physical therapy and rehabilitation (with input from patients and nurses), the guidelines are designed to help primary care physicians and other health practitioners without expertise in head-and-neck cancer better understand the common side effects resulting from its treatment. The goal is [...]

Oral Cancer Foundation News Team - A2016-04-11T07:48:09-07:00April, 2016|Oral Cancer News|

Increased frequency of unknown primary SCC linked to HPV–positive disease

Source: www.healio.com Author: staff The occurrence of HPV–positive unknown primary squamous cell carcinoma of the head and neck has significantly increased in recent years, according to the results of a retrospective study. HPV–positive unknown primary squamous cell carcinoma (UPSCC) appeared most prevalent among younger men. UPSCC of the head and neck is comparatively rare, accounting for approximately 4% of squamous cell carcinomas. Trends, frequency and detection rates of UPSCCs have not been studied in the context of HPV tumor status. Carole Fakhry, MD, MPH, associate professor of oncology and otolaryngology–head and neck surgery at Johns Hopkins School of Medicine, and colleagues conducted a retrospective study to observe the frequency of UPSCC over time, and to evaluate the proportion of UPSCCs that are HPV positive. Researchers accessed a case series of 84 patients (mean age, 57.3 years; range, 29-80; 88.1% men) with UPSCC treated at Johns Hopkins Hospital between January 2005 and June 2014. They determined HPV tumor status through p16 immunohistochemical analysis or through high-risk HPV DNA in situ hybridization, when clinically available. The researchers observed an increase in the frequency of UPSCC over time (P for trend = .01). The trend appeared significantly higher during the most recent calendar periods (14 cases during 2005-2008 vs. 39 cases during 2012-2014; P = .03). A total of 90.7% of patients (n = 69) had HPV–positive tumors. These patients appeared more likely to be men (91% vs. 42.9%; P = .005) and younger (56.1 years vs. 67.7 years; P = .002) than [...]

Oral Cancer Foundation News Team - A2016-04-11T07:26:51-07:00April, 2016|Oral Cancer News|

Suicide: A Major Threat to Head and Neck Cancer Survivorship

Source: www.jco.ascopubs.comAuthors: Nosayaba Osazuwa-Peters, Eric Adjei Boakye, and Ronald J. Walker , Mark A. Varvares TO THE EDITOR: The article by Ringash that was recently published in Journal of Clinical Oncology provided a compelling narrative of both the improvements made in head and neck cancer survivorship, as well as the challenges created by longer-term treatment and associated toxicities. There are currently at least 280,000 head and neck cancer survivors in the United States. As the article by Ringash stated, the upturn in head and neck cancer survivorship in the last three decades has coincided with the emergence of human papilloma virus-positive oropharyngeal cancer, as well as a decrease in tobacco use in the general population. These make it a challenge to isolate survival gains as a function of improved therapy from the natural prognostic value of a diagnosis of human papilloma virus-positive oropharyngeal cancer. Whatever the case, the fact that more than one-quarter million Americans are currently alive after a diagnosis of head and neck cancer means there needs to be a more deliberate effort in longer-term management of treatment-related toxicities, some of which are lifelong. We agree with Ringash’s conclusion that new models of care need to be developed in response to the significant quality-of-life issues faced by patients with head and neck cancer. The Institute of Medicine publication From Cancer Patient to Cancer Survivor: Lost in Transition, also cited by Ringash, called for a clear individualized survivorship plan for cancer patients. There is a serious need for this model to [...]

Charlotte Parker2016-03-24T15:06:02-07:00March, 2016|Oral Cancer News|

Nonsurgical surveillance safe, cost-effective for head, neck cancer

Source: www.healio.com Author: Mehanna H, et al. Patients with head and neck cancer who underwent PET/CT–guided surveillance achieved similar survival outcomes as those who underwent planned neck dissections, according to the results of a prospective, randomized controlled trial. However, surveillance led to fewer surgical operations and complications and appeared more cost-effective than neck dissection, results showed. Patients with head and neck cancer frequently undergo invasive surgery following treatment to remove remaining cancer cells, according to study background. “After treatment, remaining cancer cells play something akin to hide and seek,” Hisham Mehanna, MBChB, PhD, FRCS, chair of head and neck surgery at University of Birmingham and director of the Institute of Head and Neck Studies and Education, said in a press release. “Our study shows that we can hunt them down, find them and remove them effectively.” Mehanna and colleagues sought to define the role of image-guided surveillance compared with planned neck dissection for the management of patients with advanced, nodal head and neck squamous cell carcinoma previously treated with primary chemoradiotherapy. The analysis included data from 564 patients (mean age, 58 years; 82% men) who researchers randomly assigned to PET/CT–guided surveillance (n = 282) performed 12 weeks after the end of treatment or planned neck dissection (n = 282). Oropharyngeal cancer served as the most common cancer subtype (84%). Seventy-five percent of patients had HPV-16–positive disease. Patients assigned surveillance only underwent neck dissection if their PET/CT scans showed incomplete or equivocal response to chemoradiotherapy. The trial was designed to assess [...]

Oral Cancer Foundation News Team - A2016-03-24T09:07:04-07:00March, 2016|Oral Cancer News|

ACS now has a guideline for care of head and neck cancer survivors

Source: www.ajmc.com Author: Surabhi Dangi-Garimella, PhD With an increasing population of head and neck cancer survivors in the United States, the American Cancer Society identified the need to develop survivorship guidelines that can lend support to primary care clinicians and other health practitioners as they care for survivors. With an increasing population of head and neck cancer (HNC) survivors in the United States, the American Cancer Society (ACS) identified the need to develop survivorship guidelines that can lend support to primary care clinicians and other health practitioners as they care for survivors. The guideline emphasizes monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. According to ACS estimates, nearly 3% (436,060) of cancer survivors in the United States have survived a bout of HNC. With these numbers in mind, ACS convened an expert panel that included members with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech language pathology, physical medicine and rehabilitation, nursing, and a HNC survivor who provided a patient perspective. The panel reviewed existing guidelines and research evidence through April 2015, and created recommendations, which the committee has stressed “should be viewed as consensus-management strategies” to assist survivors. While 2081 articles were identified from a preliminary search, only 184 were finally included as evidence base. Published online in CA: A Cancer Journal for Clinicians, the following are some of the key recommendations provided by the guideline for primary care physicians: [...]

Oral Cancer Foundation News Team - A2016-03-24T08:59:09-07:00March, 2016|Oral Cancer News|

Patient survives stage IV, inoperable throat cancer in clinical trial

Source: medicalxpress.com Author: staff It took a white lie to get David Polisini, 79, to a doctor in 2004, after months of being unable to swallow. "Two of my daughters, Toni and Susie, showed up on my back porch and told me to put my jacket on," he says. "They told me we were just going for a ride, but the next thing I knew, we were pulling into the Clermont Mercy Hospital." Polisini says tests ordered in the emergency room uncovered a tumor in his throat. "It was the size of a golf ball," he says, adding that he then scheduled an appointment with his primary care physician, Francis Dumont, MD. "I was then referred to an ear, nose and throat physician within his group who said I needed to see someone at the University of Cincinnati (UC) Cancer Institute." A biopsy was performed, and a diagnosis was confirmed—it was Stage IV cancer. "I began seeing Dr. (Bill) Barrett who explained that I would need to go through very aggressive radiation along with chemotherapy five days a week for three months," he says. "I'd drive myself every day to every visit in my little Miata. The therapy really zapped my strength, but I'm here because of it. "I really don't think I realized how much trouble I was in with Stage IV inoperable cancer, but I knew I had to do what I had to do to get through it." The radiation and chemo regimen was a Phase III [...]

Oral Cancer Foundation News Team - A2016-03-21T06:41:27-07:00March, 2016|Oral Cancer News|

Call for NZ Government to fund HPV vaccine for boys

Source: www.nzherald.co.nz Author: Martin Johnston Throat-cancer patient Grant Munro paid for his son to be vaccinated against the sexually-transmitted HPV virus because the Government has refused. A 58-year-old scientific expert on viruses, he is backing a campaign by doctors calling for the extension of state funding of the controversial HPV vaccine to boys. Dr Munro, whose cancer was linked to HPV infection, says it is a form of discrimination against males that the Government will only pay for girls to have the vaccine. State medicines agency Pharmac said it had decided not to fund the Gardasil vaccine for boys at present, but it is an option for the future. Its advisory committee assigned a low priority to funding it for all males aged 11-19 and high priority for males 9-26 "who self-identify as having sex with other males". In Australia, the vaccine is government-funded for boys and girls. Gardasil can protect against four strains of HPV - human papilloma virus - that can cause pre-cancerous lesions in the genital tract and mouth, and genital warts. It has been offered to New Zealand girls partly to help reduce cervical cancer. Rates of throat-related cancers have risen sharply since the 1980s and HPV, from oral sex, is thought to be the cause. The actor Michael Douglas was treated for tongue cancer caused by HPV and has spoken of the link between HPV and performing oral sex. After Dr Munro was treated for a tonsil tumour that contained evidence of HPV, he paid [...]

Oral Cancer Foundation News Team - A2016-03-21T06:32:24-07:00March, 2016|Oral Cancer News|

Costco Wholesale to stop selling tobacco products at hundreds of locations

Source: www.medicaldaily.com Author: Jaleesa Baulkman Sorry smokers, but you'll have to go someplace other than Costco to get your cigarettes. The New York Daily News reported the retailer has spent the past few years quietly phasing tobacco products out of nearly 300 stores; there are 488 in total. Tobacco smoke has been linked to adverse health effects, such as lung and oral cancer, though that's not why Costco did it. Instead, the company said the decision was more about business than public health. "Tobacco is a very low margin business, tends to have higher theft and is labor intensive in some cases (due to local municipality regulations) — further, we felt we could better use the space to merchandise other items," a spokesman from Costco told The Street. According to The Street, Costco officials first hinted at the ban during a call with analysts, where they said tobacco sales had fallen to a "low double digit." The company hasn’t made an official announcement because "[press releases] are a waste of money." The retail giant’s move is another blow to the tobacco industry, which has seen a significant drop in the percentage of Americans who smoke in the past 50 years. In 2014, the smoking rate hit an all-time low of 17.8 percent, and the rate is still dropping, The Huffington Post reported. Not to mention other retailers have quit selling these kinds of products, too. In 1996, Target was the first large retail store to stop selling cigarettes, citing costs [...]

Oral Cancer Foundation News Team - A2016-03-21T06:26:25-07:00March, 2016|Oral Cancer News|