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Cancer drug shortage is forcing doctors to decide which patients get treatment

Source: abcnews.go.com Author: Mary Kekatos Just six weeks ago, Greg DeStefano began a new chemotherapy combination. The 50-year-old, from Northbrook, Illinois, had recently been diagnosed with his fourth round of cancer and doctors were hopeful the medication would treat the tumors growing in his neck. DeStefano was responding well, but then, in late May, he got a call from his doctor and was told one of the three drugs he was receiving -- carboplatin -- was under a global shortage and because of the way the hospital had to prioritize treatments, he wouldn't be qualified to receive it anymore. "We're frustrated because not only are we dealing with cancer, now we have to deal with a drug shortage of a pretty critical drug," DeStefano told ABC News. DeStefano's experience is similar to thousands across the United States of patients either having delayed treatment or being unable to receive treatment because of cancer drug shortages. At least 11 oncology medications are currently in short supply, according to an ABC News analysis of data from the U.S. Food and Drug Administration. Among them are carboplatin, used to treat ovarian and head and neck cancer; azacytidine, which treats a form of leukemia; and dacarbazine, used to treat skin cancer. "We've experienced drug shortages, intermittency, my entire career, it has always been a challenge," Julie Kennerly-Shah, associate director of pharmacy at The Ohio State University Comprehensive Cancer Center, told ABC News. "The past six months have been the most challenging in my career for [...]

Medicare patients with HSNCC fare better than younger counterparts

Source: www.ajmc.com Author: Jaime Rosenberg Patients of Medicare age have favorable outcomes when it comes to head and neck cancer, say new study findings published in Head & Neck. The researchers of the study write that their findings suggest many patients are waiting to seek cancer diagnosis or treatment until becoming eligible for Medicare. Deemed the “Medicare” effect, patients aged 65 years who had Medicare coverage had an increased incidence of head and neck squamous cell carcinoma (HNSCC) but were less likely to receive a late-stage diagnosis and had lower mortality rates compared with their slightly younger counterparts on Medicaid or who were uninsured. “Cumulatively, this suggests a backlog of undiagnosed head and neck cancers within the near-elderly population, which take advantage of their new Medicare benefits to be diagnosed at early stage, treated with more surgery, and go onto to have better survival,” explained the researchers. “Prior studies have demonstrated an increase in the utilization of basic medical services, including cancer screenings and general exams, after patients become eligible for Medicare.” HNSCC accounts for approximately 3% of new cancer diagnoses in the United States each year and is generally diagnosed in patients aged 60 to 70 years. With cases often found during routine physicals or after experiencing symptoms such as dysphagia or voice changes, the researchers highlighted the importance of access to both primary care doctors and specialists. Drawing on data from the Surveillance, Epidemiology, and End Results (SEER) database, the researchers found that patients aged 65 years had [...]

Speech-language pathology’s role in head and neck cancer, voice and oral-maxillofacial surgery

Source: mmheadlines.org Author: Michigan Medicine staff The management of voice and breathing disorders is a subspecialty of speech-language pathology (SLP). Disorders of the voice and breathing can occur across the lifespan from infants to the elderly. The causes of voice disorders are extremely broad and may be congenital or acquired. These include physiologic or anatomic pathology of the upper airway from underlying neurologic conditions, trauma, head/neck cancer or ineffective voice production strategies. As we age, changes in the underlying substructure of the larynx may also result in changes to the voice. An estimated 30% of adults may experience challenges associated with a voice disorder. The quality-of-life impact of voice disorders can result in social isolation as well as interfere with an individual’s ability to engage in their profession and avocational activities. Breathing disorders include chronic cough and throat clearing, symptomatic shortness of breath without a primary pulmonary cause, and other functional conditions of the upper airway such as paradoxical vocal fold motion disorder, in which the vocal folds move in inappropriate ways and interfere with breathing. Prior to therapy, patients require a comprehensive examination of the larynx and other aspects of the vocal apparatus to help inform the plan of care. The management of head and neck disorders is another subspecialty of speech-language pathology. Head and neck SLPs typically see patients ranging in age from teens to adults. Patients are often seen in conjunction with surgeons/physicians for collaborative evaluation and individually for evaluation and treatment. Head and neck SLPs provide [...]

Head and neck cancer: Additional chemotherapy increases survival rate for older patients

Source: www.dental-tribune.com Author: Franziska Beir, Dental Tribune International Head and neck cancer is the sixth most common cancer worldwide and results in approximately 450,000 deaths per year. As a result of demographic change, the proportion of older patients with this type of cancer is continuously increasing, and these patients are under-represented in clinical trials. The question of whether older patients should be treated with chemotherapy or drug therapy—in addition to radiotherapy—can cause controversy, and the association with higher survival rates has remained unclear. A large-scale international study involving University of Leipzig Medical Center and 12 other university hospitals has now proved the effectiveness of this combined treatment. Cancer treatment for older patients is more individualised compared with that for younger patients, owing to an increasing prevalence of frailty, comorbidities and a higher vulnerability to chemotherapy-related toxic effects. Standardised treatment for head and neck cancer either entails surgical removal of the tumour followed by radiotherapy or organ-preserving radiotherapy in combination with chemotherapy. The latter treatment is especially controversial, and there has been a lack of clinical data to determine the best option. The study involved 12 university hospitals in Europe and the US. The researchers analysed data from 1,044 older patients (65 years or older) with head and neck cancer of the oral cavity, pharynx or larynx. Between 2005 and 2019, 234 of these patients were treated with radiotherapy alone and 810 with radiotherapy in combination with either chemotherapy (677) or an alternative drug therapy with an antibody against a growth [...]

Researchers find link between obesity and oral cancer immune escape

Source: www.dental-tribune.com Author: staff Researchers from the University of Michigan Rogel Cancer Center and School of Dentistry have recently reported that obesity is responsible for helping to establish a tumour microenvironment that promotes tumour progression. The study found that excessive saturated fat accumulation affects certain oral cancers’ ability to evade attacks from the immune system, thus promoting immune escape and thereby increasing tumour burden. “We tend to think about the increased risks for gastro-intestinal tumours, breast cancer, pancreatic cancer and ovarian cancer when it comes to obesity,” lead author Dr Yu Leo Lei, an associate professor of dentistry in the Department of Periodontics and Oral Medicine at the university, said in a press release. “Multiple recent prospective cohorts involving millions of individuals from several continents revealed a previously underappreciated link between obesity and oral cancer risks,” he continued. The team found that saturated fatty acids can block the stimulator of interferon genes (STING) pathway, which is induced by cytosolic DNA and promotes antigen-presenting cell maturation by inducing a protein called NLRC3. Discussing the findings of the study, he noted: “Myeloid cells in obese mice were insensitive to STING agonists and were more suppressive of T-cell activation compared to the myeloid cells from lean hosts.” This, in turn, weakened anti-tumour immunity in the tumour microenvironment. Obesity is a common comorbidity in cancer patients. According to the Centers for Disease Control and Prevention, more than 684,000 obesity-associated cancers occur in the US each year. Recent studies found that oral cancer patients who [...]

HPV vaccine: Some studies say one and done might be better

Source: www.cnn.com Author: Jen Christensen, CNN This week, at the World Health Organization’s 76th World Health Assembly, health leaders from nearly 100 countries will join with thousands of others who have signed off on a global initiative to eliminate cervical cancer. Globally, cervical cancer is the fourth most common type of cancer in women, according to WHO, but many cases are completely preventable with the human papillomavirus vaccine. HPV is a group of more than 200 related viruses. Many don’t cause any symptoms at all. Some strains cause warts, and some cause cancer. The HPV vaccine protects against the strains that cause most HPV-related cancers. “Vaccines are bringing the dream of eliminating cervical cancer within reach,” WHO Director-General Tedros Adhanom Ghebreyesus said in his remarks to the World Health Assembly on Monday. The vaccine is recommended for children because it works best before someone has been exposed to the virus. HPV is often spread through sexual contact, and the US Centers for Disease Control and Prevention says that almost every sexually active person who is not vaccinated will get HPV at some point. The vaccine’s introduction to the US in 2006, along with more regular screening, has led to a notable drop in cervical cancer cases and deaths in the US, according to the American Society of Clinical Oncology. Cervical cancer rates among the first American generation to get vaccinated have dropped significantly. Among women ages 20 to 24, cervical cancer incidence rates declined 65% from 2012 through 2019, according [...]

Mayo Clinic Minute: Innovative technology to treat head and neck cancers

Source: www.telegraphherald.com Author: Deb Balzer, Mayo Clinic News Network In the U.S., HPV is linked to about 70% of throat and mouth cancers. And more than 70% of those cancers are diagnosed in men, according to the Centers for Disease Control and Prevention. Treatment for throat and mouth cancers, also referred to as oropharyngeal or head and neck cancers, depends on location and stage of the cancer as well as other factors. Dr. Phillip Pirgousis, a Mayo Clinic head and neck surgeon, says patients now have safer, less invasive surgical treatments for head and neck cancers available to them thanks to innovative technology. “The tonsils in the back of the throat and the lymph node tissue in the back of the tongue,” Pirgousis says. And cancers in these two locations can be a challenge. “Many of the challenges are often related to the location of the primary tumor because the throat and voice box area are very difficult to get access to,” he says. That’s where innovation with robotics allows for better tumor visualization, better lighting and better outcomes in terms of complete tumor removal. “We’re talking about big, open surgeries versus minimally invasive surgeries where we can access these difficult locations with making facial incisions,” he says. “And having less impact on breathing, speaking, swallowing and communicating. The surgical robot has improved the ability for us to not only completely remove tumors, but to remove them safely,” Pirgousis says. Transoral robotic surgery Transoral robotic surgery is a minimally invasive [...]

Researchers identify new metric to articulate relationship between nerve density and oral cancer

Source: www.bitemagazine.com.au Author: staff US researchers have identified a new metric to articulate the relationship between nerve density and oral cancer. The study—by researchers at the University of Michigan Rogel Cancer Center and the School of Dentistry, and published in Clinical Cancer Research—investigated normalised nerve density to translate previous mechanistic studies into a context that could be used in the clinic. “We are recognising more and more that there’s a very dynamic interaction between nerves and cancer cells in the tumour microenvironment,” senior author Dr Nisha D’Silva said. The team looked at how the density of nerves within a tumour tied with the tumour’s growth. The oral cavity has several regions, each with different functions. The way each area receives nerves is distinct; the nerves in the inside of the cheek have a different role and are fewer than nerves on the tongue. Given these variations, looking at nerve density of the tumour without considering the normal innervation of the different areas in the oral cavity and each individual’s variation to assess whether a tumour is aggressive leaves an inaccurate picture. To account for this, the team created a standardised metric for nerve density to clarify the variation in distribution of nerves in the oral cavity, called normalised nerve density, and showed its importance in tumour progression. Most of the work was done with human tissue, and the team then validated the findings using a mouse model. They used adjacent tissue to compare and determine a ‘normalised’ density for different [...]

These tiny worms can smell cancer in your pee

Source: www.euronews.com Author: Aylin Elci N-Nose uses nematode worms and urine to screen cancer in patients. - Copyright Courtesy Hirotsu Bio Science Scientists say the humble roundworm can sniff out cancer cells and could help save lives by spotting tumours at a very early stage. Japanese start-up Hirotsu Bio Science is shaking up early cancer screening with the help of an unlikely ally: tiny worms. Instead of relatively invasive and expensive methods such as endoscopies, surgeries or blood tests, the company only needs a urine sample to detect early-stage cancer (0 to 1) in patients. “We usually go to hospital when we start feeling something strange in our body,” Eric di Luccio, Chief Technology Officer at Hirotsu Bio Science, told Euronews Next. “That’s when the cancer is detected, but it’s usually at an advanced stage and the odds of getting out of it alive will depend on the cancer, but sometimes it's bad,” he added, calling primary cancer screening in urine samples a “game changer”. While cancer is “detected” in patients who have symptoms, screening, on the other hand, is conducted on healthy patients. According to a recent report by the American Cancer Society, both of these actions are among the reasons why deaths linked to the disease are decreasing. Nobel Prize worms and smelly cancers Hirotsu Bio Science’s flagship product, N-Nose, is a non-invasive invasive cancer screening process that uses tiny worms’ olfactory sense to find cancer in urine samples. The Caenorhabditis elegans or C. elegans is [...]

Multidisciplinary treatment approaches for oral cavity cancer

Source: dailynews.ascopubs.org Author: Mindy Tanzola, PhD An Education Session at the 2023 ASCO Annual Meeting will focus on the treatment of oral cavity cancer, one of the most common types of head and neck cancer worldwide. The session will feature experts from medical, radiation, and surgical oncology to address all 3 treatment modalities, said Session Chair Ali Hosni, MBBCh, MSc, PhD, of Princess Margaret Cancer Center in Canada. The session will take place on June 4. Although oral cavity cancer is diagnosed in more than 300,000 individuals worldwide each year,1 it receives less attention than other subsets of head and neck cancer, Dr. Hosni said, highlighting a need for education. In addition, oral cavity cancer often involves all 3 treatment modalities, which means there is a need for collaborative multidisciplinary care that also integrates the patient into treatment planning. Role of Sentinel Lymph Node Biopsy In his update on surgical approaches for oral cavity cancer, Stephen Y. Lai, MD, PhD, FACS, a head and neck cancer surgeon at The University of Texas MD Anderson Cancer Center, will first discuss the role of sentinel lymph node biopsy (SLNB) for these patients. Dr. Lai explained that lymph node metastases are sometimes found in patients with early-stage oral cavity cancer (T1-2) who are thought to be node-negative based upon imaging studies and clinical examination. However, evidence has shown that active management through elective neck dissection is associated with higher rates of overall survival and disease-free survival versus “watchful waiting” and therapeutic neck dissection.2 [...]

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