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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 [...]

2012-02-14T22:35:07-07:00February, 2012|Oral Cancer News|
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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 [...]

2012-02-12T09:20:40-07:00February, 2012|Oral Cancer News|
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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 [...]

2012-02-12T09:09:35-07:00February, 2012|Oral Cancer News|
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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 [...]

2012-02-12T08:48:16-07:00February, 2012|Oral Cancer News|
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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 [...]

2012-02-03T19:56:16-07:00February, 2012|Oral Cancer News|
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Tumeric and Curcumin offer powerful anti-cancer health benefits naturally

Source: www.sacbee.com Author: staff Commonly used in many Eastern countries, tumeric has been found to suppress cancer growth and reduce brain tumors by an astounding 81% without evidence of toxicity. While the benefits of turmeric are just coming to light within the mainstream and alternative media, it has been known for quite some time that this inexpensive spice can profoundly improve biological function. Curcumin, a natural phenol and derivative of turmeric, may be responsible for many of these effects -- particularly the anti-cancer benefits. Used by ancient Chinese and Indian systems of medicine, curcumin has been shown to reduce brain tumor size by 81% in 9 out of 11 studies. With the research published in the July edition of the Journal of Nutritional Biochemistry, scientists found that curcumin dramatically decreased the size of brain tumors by 81% in 9 out of 11 studies without evidence of toxicity. Additional research has found that turmeric and curcumin also inhibit the spread of cancer by actually blocking a key enzyme responsible for its growth. Given chewable curcumin supplements containing 1,000 milligrams of curcumin each, 21 study participants with head and neck cancer experienced a halt in cancer spread after intake. Conducted by the UCLA, the results were examined by an independent lab in Maryland which confirmed that curcumin supplements ultimately stopped the spread of malignant cancer cells. Curcumin gives turmeric its unique color, and each 100 grams of turmeric contains 3 to 5 grams of the compound. Some health experts believe that turmeric [...]

2012-02-03T19:49:29-07:00February, 2012|Oral Cancer News|
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Cisplatin aids survival of high-risk head and neck cancer

Source: www.oncologyreport.com Author: Miriam E. Tucker 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 [...]

2012-02-03T19:44:50-07:00February, 2012|Oral Cancer News|
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Squamous cell subgroups respond differently to treatment

Source: www.medscape.com Author: Nancy A. Melville A long-term follow-up of patients with head and neck squamous cell carcinoma suggests that only certain high-risk subgroups benefit from radiation plus chemotherapy. This information will spare patients who will not benefit from undergoing the additional treatment. According to the study, presented here at the 2012 Multidisciplinary Head and Neck Cancer Symposium, patients with microscopically involved resection margins and/or extracapsular spread of disease had a lower risk for cancer recurrence with radiation plus chemotherapy 10 years later, whereas those with tumors in multiple lymph nodes did not benefit from combination treatment; they fared better with radiation alone. "The clinical implication of these findings is that the high-risk group of patients is not as homogenous a group as we believed it was before the study started," lead author Jay S. Cooper, MD, director of the Maimonides Cancer Center, in Brooklyn, New York, told Medscape Medical News. Dr. Cooper and his colleagues analyzed 10 years of follow-up data from the Radiation Therapy Oncology Group (RTOG) 9501/Intergroup phase 3 trial, which examined 410 patients with high-risk resected head and neck cancers. The patients were considered high risk for cancer recurrence because they had microscopically involved resection margins, extracapsular spread of disease, or multiple lymph node involvement. "The allocation was equally divided [according to treatment regimen] at the beginning of the study; the groups were not intended to be balanced for the different [risk] factors," Dr. Cooper said. "We thought they were all equally important." The treatment regimen [...]

2012-01-28T08:34:43-07:00January, 2012|Oral Cancer News|
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Erlotinib dose doubled for smokers with head/neck cancer

Source: www.oncologyreport.com Author: Miriam E. Tucker Giving smokers a higher, short-course dose of erlotinib before definitive surgery for squamous cell carcinoma of the head and neck resulted in favorable responses for the first patients evaluated in a small pilot study. Investigators gave 300 mg of erlotinib (Tarceva) to smokers daily and 150 mg daily to nonsmokers who had a waiting period of more than 14 days before scheduled surgery for head and neck cancer. Seven of the 10 patients evaluated so far had partial responses and 3 had stable disease, according to a poster presented at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. The study was based on recent data in non–small cell lung cancer (NSCLC) patients showing that smokers metabolize erlotinib, an epidermal growth factor receptor (EGFR) inhibitor, twice as quickly as do nonsmokers (J. Clin. Oncol. 2009;27:1220-6), said lead author Dr. Mercedes Porosnicu of Wake Forest Baptist Medical Center in Winston Salem, N.C. That study established the maximum tolerated dose of erlotinib at 300 mg daily in NSCLC patients who smoke. Dr. Poroniscu’s presentation included the case study of a smoker with a very large oral cavity tumor protruding through his lips. He was described as being in significant pain and unable to eat or chew. The first CT scan showed a tumor of at least 8 cm and there was "significant metabolic activity" on PET scan. "At 6 days of erlotinib treatment, his tumor was obviously smaller and he could [...]

2012-01-28T08:25:19-07:00January, 2012|Oral Cancer News|
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Head and neck cancer in transplant patients: For better or worse?

Source: medicalxpress.com Author: Henry Ford Health System staff Transplant patients who develop head and neck cancer are more likely to be non-smokers and non-drinkers, and less likely than their non-transplant counterparts to survive past one year of diagnosis, according to a new study from Henry Ford Hospital in Detroit. As part of a 20-year review, Henry Ford researchers found cancers of the throat, tonsils and mouth may be more aggressive in transplant recipients as the result of long-term immunosuppressive therapy required to prevent solid organ rejection. Transplant patients in the study who developed skin cancer in the head and neck region were more likely to have multiple lesions, compared to the general public. In all, 2.6% of transplant patients in the study developed some form of head and neck cancer. While the risk for developing head and neck cancer is small, the study serves as an important reminder to all transplant recipients to be vigilant about any changes to their skin, as well as persistent sore throat, ear pain or swallowing issues – all signs of head and neck cancer. "The benefits of organ transplantation and immunosuppressive therapy still outweigh the risk of transplant patients developing head and neck cancer," says study author Robert Deeb, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford. "Still, our study highlights that head and neck cancer arising in transplant patients warrants the need for regular screenings and aggressive treatment." The study will be presented Jan. 28 in Miami Beach at [...]

2012-01-28T08:19:08-07:00January, 2012|Oral Cancer News|
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