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Revolutionary cancer tool can halve time some patients need radiotherapy

Source: www.nzherald.co.nz Author: Joe Pinkstone, Daily Telegraph UK A revolutionary cancer tool that can halve the time some patients need to be subjected to radiotherapy has been developed by British experts and is 99.9 per cent accurate. Head and neck cancers are notoriously tricky to tackle as the tumour and the patient's face often change shape during treatment due to significant weight loss. More than 12,000 people in the UK are diagnosed with head or neck cancer every year and the treatment involves being blasted with radiation to shrink a tumour while the patient lies motionless inside a mask that protects healthy tissue. "When I started training, we basically laid someone down on the bed, put a plastic mask on them and took some X-rays from the front and the side," Prof Kevin Harrington, head of radiotherapy and imaging at the Institute of Cancer Research and a consultant oncologist, told The Telegraph. "We would then blast away at them every day for six or seven weeks, treating the same area irrespective of the fact that during the treatment the patient would lose up to 10 per cent of their body weight. "Their body would shrink, the shape of the area we were radiating would shrink and as they subsided and lost weight the position of their head would slightly change and we wouldn't adjust one iota to that, we just carried on the way we were." In an ideal world, Harrington said, scans would be done every day to create [...]

Gabapentin may cut opioid needs for oral mucositis pain during radiotherapy

Source: medicalxpress.com Author: staff For patients receiving concurrent chemoradiotherapy for squamous cell carcinoma of the head and neck, higher doses of gabapentin are well tolerated and associated with delayed time to first opioid use for additional pain control during radiotherapy (RT), according to a research letter published online May 18 in JAMA Network Open. Sung Jun Ma, M.D., from the Roswell Park Comprehensive Cancer Center in Buffalo, New York, and colleagues performed a secondary analysis of two clinical trials involving 92 patients receiving concurrent chemoradiotherapy for nonmetastatic squamous cell carcinoma of the head and neck and prophylactic oral gabapentin (titrated to 900 mg versus 2,700 mg daily in one study and 3,600 mg daily in the other study). The researchers found that most patients tolerated gabapentin per protocol. The time to first opioid use for additional pain control was greatest in the 3,600-mg cohort in the multivariable competing risks model. The smallest proportion of patients requiring opioids during RT was seen in the 3,600-mg cohort compared with the 900-mg and 2,700-mg cohorts (37.5, 93.1, and 61.3 percent, respectively). Compared with the 3,600-mg cohort, the odds of feeding tube placement were significantly greater during RT in the 2,700-mg cohort; the odds were not significantly greater in the 900-mg cohort. "Although gabapentin, 3,600 mg, daily has been adopted as the standard regimen of the Roswell Park Comprehensive Cancer Center, additional studies are warranted to further investigate its role in pain control," the authors write.

New discovery could help combat side effects of cancer immunotherapy

Source: news.liverpool.ac.uk Author: staff Researchers in Liverpool and the US have made a breakthrough that could lead to improved immunotherapy treatments for some cancer patients. Their findings, which have been published in Nature, provide critical clues to why many immunotherapies trigger dangerous side effects – and point to a better strategy for treating patients with solid tumours, such as head and neck cancers. The work was led by Professor Christian Ottensmeier, Professor of Immuno-Oncology at the University of Liverpool and a Consultant Medical Oncologist at The Clatterbridge Cancer Centre, and Professor Pandurangan Vijayanand at the La Jolla Institute for Immunology in California. Immunotherapy side effects While immunotherapy has revolutionised the world of cancer treatment, long term disease control is achieved in only around 20 to 30 percent of patients with solid cancers. Immunotherapy can also come at a cost as many patients develop serious problems in their lungs, bowel, and even skin during treatment. These side effects can be debilitating and may force physicians to stop the immunotherapy. When head and neck patients started showing adverse side effects during an immunotherapy trial sponsored and funded by Cancer Research UK’s Centre for Drug Development in a number of cancer centres across the UK, the researchers went back through the data and worked with patient samples to see what went wrong. The patients had been given an oral cancer immunotherapy called a PI3Kδ inhibitor, which are new to the cancer immunotherapy scene, but hold promise for their ability to inhibit “regulatory” T [...]

Gene mutations that contribute to head and neck cancer also provide ‘precision’ treatment targets

Source: www.sciencedaily.com Author: Medical College of Georgia at Augusta University About one-fifth of often deadly head and neck cancers harbor genetic mutations in a pathway that is key to normal cell growth, and scientists report those mutations, which enable abnormal cancer cell growth, can also make the cancer vulnerable. Keys to targeting that vulnerability include individualized genomic analysis to identify a patient's specific mutation, and finding the drugs that directly target it, investigations that should be given more attention in cancer therapy development, they report in a review article in the journal NPJ Genomic Medicine. The MAPK pathway is a "signaling hub" for cells important to the usual development of the head and neck region, and activating key pathway constituents, like the genes MAPK1 and HRAS, is known to drive the growth of a variety of cancers, says Dr. Vivian Wai Yan Lui, molecular pharmacologist and translational scientist at the Georgia Cancer Center and Medical College of Georgia and the paper's corresponding author. But the mutations in the genes in the MAPK pathway that enable tumor growth can also make it sensitive to drug therapy, says Lui. While a lot of discovery is still needed to find more mutations in the MAPK pathway and the drugs that target them, Lui says they are among the most logical treatment targets for this tough-to-treat cancer. As she speaks, she is looking in her lab for drugs that kill head and neck primary tumors from patients, and at the genetics behind how they [...]

Rebuilding a jaw in a day

Source: www.eurekalert.org Author: Cedars-Sinai Medical Center Patients who lose a part of their jaw — whether from injury, infection, disease, or as a side effect of cancer treatment—can have the missing jawbone replaced through reconstruction. But most are left with a life-altering dilemma: Their new jaw is missing its teeth. That isn’t the case, however, for those treated by Cedars-Sinai’s “jaw-in-a-day” team. The team—a partnership between Cedars-Sinai and the Los Angeles Center for Oral & Maxillofacial Surgery—is one of just a handful across the country performing a relatively new procedure where patients receive a jaw replacement complete with dental implants in one surgery. “People who have a traditional jaw reconstruction get a new jawbone, but it isn’t very functional,” said oral/maxillofacial surgeon Steven Kupferman, DMD, MD. “The jaw is meant to talk and chew, and without teeth, it can’t do those things as well.” A Tricky Reconstruction In the traditional jaw-replacement procedure—called fibula free flap surgery—the surgeon replaces the damaged jawbone with a section of bone cut from the fibula, the outer bone in the lower leg, which can be removed without compromising the patient’s ability to walk. It is possible for patients to have dental implants added to the jaw in a separate procedure, but head and neck surgeon Jon Mallen-St. Clair, MD, PhD, who has performed many fibula free flap procedures, said that rarely happens. “The patient may be worn out from going through that major reconstruction operation,” Mallen-St. Clair said. “And the oral surgeon could be worried [...]

Could blocking or deleting a protein help prevent common oral cancers?

Source: www.eurekalert.org Author: Boston University The most common head and neck cancer—oral squamous cell carcinoma—often starts off, as many other cancers do, quite innocently. Perhaps as a little white patch in the mouth or a small red bump on the gums. Easy to ignore, to downplay. But then something changes, and the little blotch becomes more ominous, starts growing, burrowing into connective tissue. Patients who are lucky enough to see a dentist before things take a nasty turn have a shot at being able to prevent the lesions from turning cancerous—or can at least make sure treatment starts when it’s most effective. But for those who aren’t that lucky, the outlook can be bleak: the five-year survival rate of oral squamous cell carcinoma (OSCC) is around 66 percent. More than 10,000 Americans die of oral cancer every year; smokers and drinkers are hardest hit. Now, researchers at Boston University’s Henry M. Goldman School of Dental Medicine have found that dialing back—or even genetically deleting—a protein that seems to spur the cancer’s growth might help limit a tumor’s development and spread. They say their findings make the protein, an enzyme called lysine-specific demethylase 1, a potential “druggable target”—something that doctors could aim chemo and immuno-oncology therapies at to take down a tumor. The study was published in February in Molecular Cancer Research. Given that at least one-third of Americans don’t visit a dentist regularly, according to the Centers for Disease Control and Prevention, the discovery could be a future lifesaver for [...]

Researchers find new treatment combo effective for head and neck cancer

Source: nocamels.com Author: Simona Shemer Israeli researchers have helped to develop a new treatment combination for patients with advanced or metastatic head and neck cancer (HNC). The treatment, which uses both a targeted drug and immunotherapy following a certain sequence and within a specific time frame, blocks a signaling pathway that suppresses the immune system and keeps it from fighting tumor cells. The research was conducted by an international team of scientists led by PhD student Manu Prasad in the laboratory of Prof. Moshe Elkabets of the Faculty of Health Sciences at the Ben-Gurion University of the Negev. Their findings were just published in the Journal for ImmunoTherapy of Cancer in a study co-authored by Israeli, Chinese, French, German, and US researchers. The researchers targeted an aggressive type of HNC which is driven by the hyperactivation of a specific signaling pathway that will not allow the immune system to kill tumor cells. This was found in more than 40 percent of HNC cases. Head and neck cancers include cancer in the larynx (voice box), throat, lips, mouth, nose, and salivary gland, or malignant tumors that arise from the lining of the head and neck regions. The treatments currently available treatments are ineffective, Prof. Elkabets tells NoCamels. HNC develops in multiple sites on a person and existing treatments, which include chemotherapy, radiation, and immunotherapy have a relatively low response rate of about 20 percent. The average survival rate for patients in Stage III or IV of the disease is only about [...]

Grim reaper tattoo used in throat cancer reconstruction

Source: www.bbc.co.uk Author: staff Surgeons used skin from a man's arm - including a tattoo of the grim reaper - to reconstruct his tongue and voice box in a life-saving operation. Colin Reilly from Bristol, had to record his own voice before surgery in case he lost the ability to speak in the operation to remove a tumour. As part of the operation his jaw had to be split and the lower half of his face reconstructed when it was completed. Mr Reilly said there is "not enough" he can do for the hospital that saved him. Mr Reilly, 50, was diagnosed with throat cancer in 2020 and an endoscopy found a tumour at the back of his tongue. Between October and December 2020 he underwent six weeks of radiotherapy and was fed through a tube, but it became clear the tumour was very advanced and without treatment Mr Reilly would have six months to live. The grim reaper tattoo was taken from his forearm Mr Reilly amazed doctors when he was able to speak soon after the surgery Ear, nose and throat specialist Dr Oliver Dale said he was willing to carry out the surgery at the Bristol Royal Infirmary, despite the position of the tumour making the surgery high risk - with the chance Mr Reilly would not be able to speak or eat again. "Mr Dale was amazing," said Mr Reilly. "He told us that he believed he could do the surgery, despite [...]

Can liquid biopsy predict oropharyngeal cancer recurrence?

Source: www.medscape.com Author: Liam Davenport A liquid biopsy test may accurately predict recurrence of human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) earlier than standard clinical and imaging assessments, a new analysis indicates. Of 80 patients who tested positive for circulating tumor tissue-modified viral (TTMV)-HPV DNA during surveillance, 74% (n = 59) had no other evidence of disease or had indeterminate disease status. And of those patients, 93% (n = 55) "later had proven recurrent, metastatic disease on imaging and/or biopsy," according to Glenn Hanna, MD, from the Dana-Farber Cancer Institute, Boston, who presented the results February 24 at the 2022 Multidisciplinary Head and Neck Cancers Symposium. "This is the first study to demonstrate broad clinical utility and validity of the biomarker in HPV-driven oropharyngeal cancer," Hanna said in a press release. Although patients with HPV-driven OPSCC generally have favorable outcomes, up to 25% will experience recurrence after treatment. Posttreatment surveillance currently relies on physical examinations and imaging, but Hanna and colleagues wanted to determine whether a routine circulating cell-free TTMV-HPV DNA test could detect occult recurrence sooner. Hanna and colleagues analyzed the records of 1076 patients with HPV-driven OPSCC at 118 sites in the US who had completed therapy more than 3 months previously and undergone an TTMV-HPV DNA test (NavDx, Naveris) between June 2020 and November 2021. The results of the test, which used ultrasensitive digital droplet PCR to identify HPV subtypes 16, 18, 31, 33, and 35, were compared with subsequent clinical evidence of OPSCC via nasopharyngolaryngoscopy, [...]

Throat cancer survivors don’t have to sacrifice ability to swallow and taste

Source: southfloridahospitalnews.com Author: staff Tamarac resident Kenneth Goff was home shaving morning when he felt a small lump on the left side of his neck. “There was no pain, no nothing, but I could feel it by the way the razor moved,” said the 58-year-old father of five and grandfather of eight. “It wasn’t visible at all, but I could feel it right below the jaw line.” After a CT scan at Broward Health Medical Center in August 2020, Goff was diagnosed with HPV-mediated squamous cell carcinoma, a type of throat cancer. This cancer is similar to what actors Michael Douglas and Stanley Tucci have battled. The treatment of HPV-related oropharyngeal squamous cell carcinoma may include surgery, radiation, chemotherapy or combination of the treatments. Ryan H. Sobel, M.D., a head and neck surgical oncologist at Broward Health Medical Center, prescribed radiation to treat Goff’s isolated neck mass. Prior to radiation treatment, Dr. Sobel performed a submandibular, or saliva gland transfer, an intricate surgery only a handful surgeons across the country are skilled at performing. He is currently the only surgeon utilizing this technique in Broward and Palm Beach counties. Dr. Sobel strategically relocated one of Goff’s saliva glands. It was moved about three inches from the right side of his throat to under the chin to place it out of direct range of the damaging effects of radiation. Patients diagnosed with throat cancer face a difficult choice: treat the cancer with radiation and risk losing their ability to swallow and [...]

2022-02-24T15:03:37-07:00February, 2022|Oral Cancer News|
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