What University of Toronto researchers are doing to help ‘devastating’ swallowing problems

Source: www.utoronto.ca Author: Jim Oldfield We swallow about 600 times a day, mostly without thinking about it. But swallowing involves dozens of muscles and nerves in the mouth, throat and esophagus, and for people who struggle with the process, the results can be devastating. Malnutrition, dehydration and social isolation are common in people with swallowing trouble. So is depression and aspiration of food that leads to pneumonia. Occasionally, swallowing issues cause choking and sudden death. And a recent U.S. study of hospitalized patients with serious illnesses found that more than half said needing a feeding tube to live was a state equal to or worse than death. Many conditions can cause swallowing problems: stroke, neurodegenerative diseases such as Parkinson’s, and congenital or developmental conditions such as cerebral palsy and cleft palate. People treated for head and neck cancer often develop problems, sometimes years later; and their numbers are growing as cancer survival rates improve. Estimates on the global prevalence of swallowing disorders, which collectively are known as dysphagia, are about eight per cent – almost 600 million people. But there is good news. Before 1980, most patients with complex dysphagia got feeding tubes; today, clinicians can offer videofluoroscopy and other bedside tests to better assess swallowing problems, and less invasive therapies that emphasize exercise and posture. And at the University of Toronto, scientists in the department of speech-language pathology and related fields are starting to answer long-standing questions such as how best to give dysphagia screening tests, which interventions work [...]

Woman’s missing jaw regrown by 9 cm after cancer

Source: www.bbc.com Author: staff A woman who lost her jaw to cancer has had it regrown from her own skin and bone. Val Blunden had the bottom of her mouth and chin destroyed by cancer more than two years ago. The 55-year-old was left unable to eat, drink and talk, taking early retirement from her job as a postwoman. Using new treatment, surgeons from Nottingham and Wolverhampton have reconstructed her jaw by "stretching" her own tissue and bone around a frame. Known as distraction osteogenesis, the process has been around for a number of years but never been used in this way before, Dilip Srinivasan, maxillofacial surgeon at Nottingham University Hospitals Trust, said. A frame built at Queen's Medical Centre in Nottingham has acted as "scaffolding", and since an operation in January the jaw has grown 9cm. It is hoped the final surgery to remove the frame will take place in May. Ms Blunden, from Wolverhampton, first found a lump underneath her tongue in January 2015 and following diagnosis has had glands, chin, lower lip and part of her tongue removed. After two previous attempts to reconstruct her jaw using skin grafts failed, and with her being unable to use a prosthetic replacement, she hopes the procedure will improve her life. "Having lived like this for two years I'd begun to accept that this is how life was going to be, but now I'm so much more hopeful for a different future," she said. Mr Srinivasan said: "We have been [...]

HMB/Arg/Gln does not reduce oral mucositis incidence in head and neck cancer

Source: www.oncologynurseadvisor.com Author: James Nam, PharmD The addition of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine (HMB/Arg/Gln) to opioid-based pain control (OBPC) and oral care programs does not effectively prevent chemoradiotherapy (CRT)-induced oral mucositis (OM) in patients with head and neck cancer (HNC), according to a study published in Supportive Care in Cancer. Chemoradiotherapy with a cisplatin-based chemotherapy regimen is the standard of care for patients with HNC, but is associated with a high incidence of CRT-induced OM. OBPC and oral care programs are insufficient in reducing OM incidence; there is a need for additional interventions to prevent and treat OM. For this phase 2 study, researchers treated 35 patients with HNC scheduled to receive definitive or postoperative cisplatin-based CRT with oral or percutaneous endoscopic gastrostomy-delivered HMB/Arg/Gln; all patients underwent OBPC and oral care programs. Results showed that 45.7% (16) of patients developed symptomatic or functional grade 3 or worse OM. Grade 1 or less OM occurred in 51.1% of patients at 2 weeks and in 82.9% of patients at 4 weeks postradiotherapy completion. Clinical examination, however, revealed that 28.6% (10) of patients developed grade 3 or worse OM, and the incidence of grade 1 or less OM was 80.0% and 100% at 2 weeks and 4 weeks after completing radiotherapy, respectively. The most frequently reported adverse events included diarrhea and an increase in blood urea nitrogen, but were easily managed with standard care. Evidence from the study demonstrates that HMB/Arg/Gln does not effectively decrease OM incidence; however, the authors concluded that “the [...]

The Society for Immunotherapy of Cancer highlights immunotherapy during Oral, Head and Neck Cancer Awareness Week

Source: www.prweb.com Author: press release The Society for Immunotherapy of Cancer (SITC) recognizes Oral, Head and Neck Cancer Awareness Week, April 8-15, 2018, in an effort to highlight targeted immunotherapy to treat patients with these types of cancer. To educate and guide patients, SITC provides informative and engaging online education dedicated to cancer immunotherapy through SITC Cancer Immunotherapy connectED. Two head and neck cancer-specific resources are available on SITC connectED: Beyond Chemotherapy for Treatment of Head and Neck Cancer: Developed for patients with head and neck cancers and their care partners, the goal of this online class is to learn about treatment options for the newly diagnosed, treatment after chemotherapy, and questions to ask the patient’s healthcare team. Understanding Cancer Immunotherapy Patient Resource Guide: This guide provides current, medically accurate information on cancer (including head and neck cancers) – intended for patients and caregivers to outline available cancer immunotherapy options, the role of the immune system in this type of cancer treatment and what to expect while undergoing treatment. (free registration required) Aiming to make cancer immunotherapy a standard of care for cancer patients everywhere, these SITC connectED resources educate and guide patients on immunotherapy treatment options for head and neck cancer. For more information, visit the SITC website at sitcancer.org. About SITC Established in 1984, the Society for Immunotherapy of Cancer (SITC) is a nonprofit organization of medical professionals dedicated to improving cancer patient outcomes by advancing the development, science and application of cancer immunotherapy and tumor immunology. SITC [...]

Be your own advocate

Source: www.wvnews.com Author: Mary McKinley The importance of dental care goes beyond cavities — it’s also about preventing cancer. The week of April 8 is National Oral, Head and Neck Cancer Awareness Week, and your dentist or dental hygienist may be your first line of defense against oral cancer. More than 50,000 Americans are expected to be diagnosed with oral or oropharyngeal cancer (cancer of the back of the throat, including the base of the tongue and the tonsils) in 2018, and 350 will be diagnosed in West Virginia alone. Routine dental exams can detect cancer or pre-cancers during the early stages. If you notice a persistent sore or pain, swelling or changes in your mouth, or red or white patches on the gums, tongue, tonsils or lining of the mouth, visit a doctor or dentist so they can examine your mouth more closely. Some people diagnosed with oral cancer have no risk factors, so it’s important for everyone to keep those dental appointments. If you use tobacco, drink alcohol in excess, or have the human papillomavirus (HPV), you have an increased risk for oral cancer. Oral cancer is more common in older adults, particularly men, but oropharyngeal cancer is on the rise in middle-aged, nonsmoking white men between the ages of 35 and 55. The majority of these types of cancer cases are caused by HPV. Take charge of your health and reduce your risk of oral cancer. If you smoke or chew tobacco, quit now (it’s never too [...]

April is National Oral Cancer Awareness Month

Source: www.prnewswire.com Author: press release April marks oral cancer awareness month, and this year the Academy of General Dentistry is calling on dentists and patients to increase dialogue and screenings to address the growing number of oral cancer cases. Nearly 50,000 Americans are diagnosed with oral cancer each year and of those diagnoses, roughly a fifth will result in death*. Oral cancer cases have increased in the past two decades, linked to the spread of oral HPV**. "Oral cancer is often called the silent killer because it silently invades the body during early stages, and patients don't notice symptoms until it is quite advanced," said Manuel Cordero DDS, CPH, MAGD, president, Academy of General Dentistry. "Vaccination against HPV is the first line of defense for young people, but screenings are critical for the broader population. Most people don't realize screenings are part of their six-month dental checkups, and that needs to change." In a 2017 survey, the Academy of General Dentistry found that only 25 percent of Americans view their dentist as an expert on oral cancer screenings – even though screenings are part of regular checkups. "It's time for patients and dentists to talk more openly about oral cancer, starting with screenings, as well as preventative measures like HPV vaccination and not using tobacco," added Dr. Cordero. For more information on oral cancer awareness, and to schedule a dental checkup with screening, visit: www.agd.org/agd-foundation/our-programs/oral-cancer-screenings. * https://oralcancerfoundation.org/facts/

Accurately identifying aggressive head and neck cancers

Source: www.eurekalert.org Author: press release The Case Western Reserve-led research team will analyze computerized images of tissue samples for patterns which could become "biomarkers," or predictors, for determining relative risk for recurrence in one particularly common type of head and neck cancers. Those tumors, known as oropharyngeal cancers, occur primarily at the base of the tongue and in the tonsils. Currently, however, oncologists tend to treat all of these tumors with the same aggressive level of therapy. This is the case even though many of the oropharyngeal tumors which are caused by the human papilloma virus (HPV) tend to have favorable outcome-regardless of treatment-while another subset of the tumors progress and metastasize, or spread. "Right now, it's a one-size-fits-all therapy for all of these patients with HPV head and neck cancers," said Anant Madabhushi, MD, the F. Alex Nason Professor II of Biomedical Engineering, founding director of the CCIPD at the Case School of Engineering and primary investigator in the new research. "There are currently very few validated biomarkers and approaches that are accurate enough to be able to identify which of these cancers are more aggressive or which ones are less aggressive," he said. "That has limited the ability of clinicians to even hold clinical trials to find out if they can de-escalate therapy for some of these patients-or who needs more aggressive therapy." The National Cancer Institute (NCI) recently awarded a $3.15 million, five-year academic-industry partnership grant to Madabhushi and his team to pursue the research and build [...]

A better understanding of how genetics influences responses to mouth cancer drugs could lead to improved treatment

Source: medicalxpress.com Author: provided by Agency for Science, Technology and Research (A*STAR) A single letter DNA mutation is a big determinant of whether patients with advanced oral cancer respond to treatments. Researchers from the National Cancer Centre Singapore (NCCS) and A*STAR who uncovered the mechanisms behind this effect hope their findings will help doctors target treatment more effectively. Oral squamous cell carcinoma (OSCC) is characterized by the uncontrolled growth of thin, scale-like squamous cells in the outer layer of the mouth. Only around 50 per cent of patients who are treated through surgery or radiotherapy are cured, and the average duration of survival of those with advanced OSCC that recurs following treatment is just 6 to 9 months. Epidermal growth factor receptors (EGFRs) play important roles in driving the progression of some OSCCs. Drugs that target them, however, only work in a small number of patients. A 2012 clinical trial led by Daniel Tan at NCCS and A*STAR's Genome Institute of Singapore had found that the EGFR-blocking drug gefitinib worked well in two patients with two copies of the EGFR coding gene with an adenine (A) nucleobase in place of the more common guanine (G) at a particular location. More recently, tests by Gopal Iyer, also at NCCS, and Tan showed that OSCC patient-derived cells with the above A/A genotype were sensitive to gefitinib and erlotinib, another EGFR blocker. Those with the G/G or G/A variants exhibited resistance to the drugs. Editing the DNA of the G/G genotype cells to [...]

Management strategies for oral potentially malignant disorders

Source: www.medscape.com Author: Joel M. Laudenbach, DMD Oral potentially malignant disorders (OPMDs) include oral leukoplakia (OL), oral erythroplakia, oral submucous fibrosis, oral lichen planus, proliferative verrucous leukoplakia, and actinic keratosis. Once an OPMD has been clinically diagnosed, execution of management strategy is critical. When formulating the strategy, healthcare providers should consider histopathology, lesion characteristics (ie, surface texture, unifocal, multifocal), lesion location in the mouth (ie, tongue, floor of mouth), patient risk factor assessment, and a detailed medical/cancer history. In this newly published article, Nadeau and Kerr[1] detail various parameters surrounding evaluation and management of OPMDs. The authors make it clear that OPMDs are challenging, each with their own nuances regarding risk for malignant transformation. For example, when OL is unifocal, nonhomogeneous, nodular, or verrucous, there is a much higher chance of the OL becoming dysplastic (12.63-fold) or demonstrating a focus of carcinoma (8.9-fold) when compared with homogeneous types of OLs.[1] Provider knowledge of these variables is critical when counseling patients about their diagnosis and management options and when selecting interventions along with follow-up care. Although progression to malignancy is difficult to predict with OPMDs, clinicians can account for multiple risk factors such as smoking/alcohol status, high-risk location in the oral cavity, and size of lesion (>200 mm2) to help formulate a tailored management plan for each patient. Consultation with an oral pathologist to discuss the histologic appearance in the context of specific patient history and lesion characteristics can provide additional perspective and/or recommendations. Modifiable oral cavity cancer risks related to [...]

The Sate of Liquid Biopsy

Author:Pam Harrison Date: March 5, 2018 Source: Medscape.com So called "liquid biopsies" — which can detect circulating tumor DNA (ctDNA) in blood samples — are not yet ready for prime time in the diagnosis or management of early-stage or advanced solid tumors, a new expert review concludes. These assays are also not useful, outside of clinical trials, for monitoring patients for minimal residual disease following definitive treatment of cancer, nor for cancer screening, the expert review concludes. The review was prepared jointly by the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) and was published online March 5 in the Journal of Clinical Oncology. "This is an area of great interest to both pathologists and oncologists, [and] it's also an area where we see a lot of commercial advertisement and a lot of enthusiasm from the public," Jason Merker, MD, PhD, cochair of the expert panel, who was representing the CAP, said in a statement. "We thought it was a good time to look at the literature and take an evidence-based approach to various uses for ctDNA assays," he added. "Like all new things in medicine, the use of ctDNA assays in routine cancer care requires evidence of clinical utility. At present, there is insufficient evidence of clinical validity and utility for the majority of ctDNA assays in advanced cancer, including those that interrogate a panel of genes," said Daniel F. Hayes, MD, coauthor of the review, who was representing ASCO. "What is promising is that this area [...]

2018-04-21T11:52:07-07:00March, 2018|Oral Cancer News|
Go to Top