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Quality of life of patients with tongue cancer 1 year after surgery

Source: www.joms.org Authors: Zhao-hui Yang et al. Purpose: To study the changes and factors affecting the quality of life (QOL) of patients with tongue cancer 1 year after primary surgery. Patients and Methods: A total of 289 consecutive patients with tongue cancer who had undergone primary surgery from 2003 to 2008 at our hospital were recruited. Patient QOL was evaluated using the University of Washington Quality of Life Questionnaire, version 4. Statistical analysis was conducted using a paired-samples t test and multiple stepwise linear regression with Statistical Package for Social Sciences, version 11.5 (SPSS, Chicago, IL). Results: At 1 year after surgery, the appearance, activity, speech, swallowing, shoulder function, salivary, and taste domain scores were significantly lower than the preoperative scores (P

New guidelines emphasize the need for cancer patients to exercise

Source: www.medscape.com Author: Roxanne Nelson In contrast to past advice to cancer patients to rest and avoid activity, the message now is to avoid inactivity. An expert panel convened by the American College of Sports Medicine (ACSM) has concluded that exercise training is safe during and after cancer treatments and can improve physical functioning, quality of life, and cancer-related fatigue. The new ACSM guidelines urge cancer patients to be as physically active as possible both during and after treatment. "The take-home message from the panel that put together the guidelines is to avoid inactivity during and posttreatment," said Kathryn Schmitz, PhD, MPH, associate professor of epidemiology and biostatistics at the University of Pennsylvania School of Medicine in Philadelphia. She presented the guidelines here at the American Society of Clinical Oncology 2010 Annual Meeting. "Dozens of randomized controlled trials in a broad variety of patient populations have established the safety of exercise during treatment and the ability to go from being sedentary to completing 150 minutes of aerobic active over the course of even a single month," she said. "The risk–benefit leans heavily in the direction of getting patients moving and keeping them moving." Exercise Oncology Exercise is an area that is gaining an increasing awareness in the cancer literature, noted Jennifer A. Ligibel, MD, who moderated the session where the guidelines were presented. Dr. Ligibel is from the Dana-Farber Cancer Center in Boston, Massachusetts. "If you had done a search between 1950 and 1979 using the words 'exercise/physical activity' and [...]

Molecular imaging allows individualized ‘dose painting’ for head and neck cancers

Source: www.eurekalert.org Author: public release According to research revealed at Society of Nuclear Medecine's 57th Annual Meeting, a multi-tracer molecular imaging technique using positron emission tomography (PET) provides detailed information about the physiological processes of cancerous tumors—and could one day help radiation oncologists treat head and neck cancers with precision external-beam radiation therapy and improve the outcomes of therapy. "The research that we are conducting with Philips is extending the use of molecular imaging for radiotherapy planning, moving closer to more personalized treatment of hard-to-treat cancers based on the biology of each individual patient's tumor," said Kristi Hendrickson, Ph.D., lead author of the study and medical physicist at the University of Washington Medical Center, Seattle, Wash. "By modeling the data acquired from PET scans, we can potentially reduce damage to surrounding healthy tissue, as well as provide the ability to do 'dose painting,' delivering a highly customized form of radiation therapy for each patient." Cancers of the head and neck are notoriously difficult to treat, not only because of their proximity to sensitive anatomical structures, but also because of their tendency to recur. Researchers are working to find the best way to image these tumors in order to provide the most effective treatment. Several forms of radiation therapy are currently available. An approach called intensity modulated radiation therapy (IMRT) is a sophisticated technique which is used to maximize dose delivery to tumors while sparing adjacent normal tissues such as the salivary glands. This therapy uses an external beam of radiation [...]

Mouth cancer patients ‘ignore’ symptoms

Source: www.dentistry.co.uk Author: staff Many mouth cancer sufferers ignore the first symptoms of the disease and do not seek the advice of a healthcare professional during the early stages – the results of a new study have shown. The research, which interviewed relatively young mouth cancer patients in Scotland, found that most had heard of oral cancer but they didn't think their symptoms were indicative of the life-threatening illness. Furthermore, 40% of participants decided to self manage their symptoms and sought over-the-counter treatments which were suggested by a pharmacist. Chief executive of the British Dental Health Foundation, Dr Nigel Carter says the study further confirms gaps in understanding and awareness of oral cancer. Dr Carter explains: 'Public awareness of oral cancer and the associated risk factors appears to be too low here in the UK. 'An awareness of the risk factors and symptom recognition by the public is a critical issue in determining survival rates, as early detection greatly improves the chances of survival.' Almost 9% of patients who were interviewed had a prior knowledge of oral cancer and the causes such as tobacco and alcohol. However, this prior knowledge was neither instrumental for them to suspect they may have mouth cancer nor did it prompt them to visit a healthcare professional in the first place. None of the interviewees thought it would happen to them. A third of interviewees mentioned their first sign as some kind of 'lump', a few described a ‘white spot' ‘mark' or ‘patch' and two [...]

ASCO: Second study links HPV to mouth cancer outcomes

Source: www.medpagetoday.com/ Author: Michael Smith, North American Correspondent, MedPage Today Human papillomavirus (HPV) infection predicts a better chance of survival in patients with oropharyngeal squamous cell carcinoma, researchers said. In a retrospective analysis of a major radiation therapy trial, more than four-fifths of patients whose tumors were HPV-positive were alive three years after treatment, according to Maura Gillison, MD, PhD, of Ohio State University in Columbus, and colleagues. In contrast, fewer than six of 10 patients with HPV-negative tumors were still alive at the three-year mark, Gillison and colleagues reported online in the New England Journal of Medicine, in an article released to coincide with a presentation at the American Society of Clinical Oncology meeting here. The study follows a report earlier at the meeting that found a similar pattern among patients enrolled in a chemotherapy trial. The virus is, of course, well known to cause cervical cancer. The New England Journal study adds to the evidence that "HPV-positive oropharyngeal squamous-cell carcinoma represents a distinct clinicopathological entity associated with a better prognosis than HPV-negative oropharyngeal squamous-cell carcinoma," said Douglas Lowy, MD, of the NIH, and Karl Munger, PhD, of Brigham and Women's Hospital in Boston. Writing in an accompanying editorial, Lowy and Munger argued that if the diseases are distinct, "their treatment or prevention might benefit from different approaches." One possibility, they said, would be to target HPV proteins to treat the disease in some patients, while prevention might involve vaccination against the virus. Gillison and colleagues looked at the [...]

Evaluation of circulating immune complexes and serum immunoglobulins in oral cancer patients – a follow up study

Source: /www.ijdr.in Author: Sameena Parveen et al. Background: High serum immunoglobulins and circulating immune complexes (IgG, IgM, IgA and CIC) values in patients with cancer have been used as tumor markers. Hence, the aim of the study was to estimate these immunological markers in pre- and post-treatment phases with a follow-up of 3-24 months and to understand the prognostic significance of the same in patients with oral cancer. Materials and Methods: The malignancy group consisted of 56 patients with different stages (AJCC TNM) of oral cancer and 20 healthy control group. Samples were selected at random and subjected for sequential analysis of serum biochemical markers (IgG, IgA, IgM and CIC-circulating immune complexes levels) in the pre- and post-treatment period. Statistical method employed was the paired t test. Results: We observed significant elevated levels of all the immunological markers ( P

ASCO: Mouth cancer patients do better if tumor is HPV-positive

Source: www.medpagetoday.com Author: Michael Smith, North American Correspondent, MedPage Today Patients with cancer of the oropharynx did significantly better if their tumor showed markers of human papillomavirus (HPV), a researcher said. In a retrospective analysis of patients in a large chemotherapy trial, those with HPV-positive tumors had a five-year survival rate of 79% regardless of the type of treatment, according to Marshall Posner, MD, of the Dana-Farber Cancer Institute in Boston. In contrast, those whose tumors were HPV-negative had a five-year survival rate of just 31% -- a difference that was statistically significant at P<0.0001, Posner said in a poster discussion session at the annual meeting here of the American Society of Clinical Oncology. The pattern was similar for progression-free survival, Posner told MedPage Today. The two groups were significantly different in several ways, he said, including age, T-stage, and performance status, suggesting that HPV-positive cancers are a different clinical entity from environmentally driven HPV-negative cancers. One possible clinical implication is that patients with HPV-positive tumors might be treated with lower doses of radiation, since they respond well to treatment, he said. "We might reduce the late consequent toxicity (of radiation) - the scarring, the fibrosis, the dry mouth, the osteo-radionecrosis," he said. He noted that patients with HPV-positive tumors tend to be younger, and thus have longer to live with the consequences of therapy. "If we can reduce those effects, we would do a big boon," he said. The finding comes from an analysis of patients who took part [...]

ASCO: Non-platinum regimen works in head, neck cancer

Source: www.medpagetoday.com Author: Michael Smith, North American Correspondent, MedPage Today A novel non-platinum-based regimen was efficacious in recurrent or metastatic squamous cell head and neck cancer, researchers said. The combination of pemetrexed (Alimta) and bevacizumab (Avastin) yielded a response rate of 30% in a small single-arm trial, according to Athanassios Argiris, MD, of the University of Pittsburgh, and colleagues. The combination also increased the length of time before patients progressed, and increased median overall survival, Argiris and colleagues reported in a poster discussion session at the annual meeting of the American Society of Clinical Oncology here. Patients with recurrent or metastatic disease typically have a poor prognosis, the researchers said, with median survival between six and nine months with standard chemotherapy. But, in other research, adding the monoclonal antibody cetuximab (Erbitux) to platinum-based chemotherapy increased survival, they said. Bevacizumab is a monoclonal antibody that targets the vascular epithelial growth factor (VEGF), which is expressed in squamous cell head and neck cancer; high levels of VEGF correlate with poor outcome, they noted. The researchers hypothesized that the antibody might enhance the activity of pemetrexed, which is a multi-targeted antifolate indicated for malignant pleural mesothelioma and non-small cell lung cancer. To test the idea, they analyzed results of treating 37 patients given 500 mg/m2 of pemetrexed and 15 mg/kg of bevacizumab intravenously every 21 days until disease progression. Patients were also given folic acid and vitamin B12. The primary endpoint of the study was time to progression, they said, but the researchers [...]

ASCO: Antibody improves head and neck cancer results

Source: www.medpagetoday.com Author: Michael Smith, North American Correspondent, MedPage Today A novel antibody improved outcomes for patients with advanced and inoperable squamous cell carcinoma of the head and neck, researchers reported. Combined with radiation or chemoradiation, the substance -- a fully humanized monoclonal antibody dubbed nimotuzumab -- significantly outperformed either modality alone in an open-label randomized trial, according to K. Govind Babu, MD, of Kidwai Memorial Institute of Oncology in Bangalore, India, and colleagues. At the same time, there was little serious toxicity -- such as debilitating skin rash -- attributed to the compound, the researchers reported in a poster discussion session at the annual meeting of the American Society of Clinical Oncology here. It's the first randomized study of the drug to show clinical benefit without the toxicities associated with similar antibodies, the researchers said. In general, neither radiation nor chemotherapy provides a good outcome for patients with inoperable stage III or IVa squamous cell carcinoma of the head and neck. However, substances such as cetuximab (Erbitux) that target the epidermal growth factor receptor (EGFR) -- overexpressed in such tumors -- have improved outcomes. Nimotuzumab, like cetuximab, targets EGFR, but is highly selective for tumor tissues, limiting toxicity, the researchers said. The study enrolled 92 patients, and 76 were evaluable for efficacy. They were treated with radiation or chemoradiation (with cisplatin), with or without nimotuzumab. The substance was given by intravenous infusion of 200 milligrams over a 60-minute period, once a week for six weeks. In group A -- [...]

Cancer will kill 13.2 million a year by 2030: U.N.

Source: www.medscape.com Author: Reuters Health Information Cancer will kill more than 13.2 million people a year by 2030, almost double the number who died from the disease in 2008, the United Nations' cancer research agency said on Tuesday. The International Agency for Research on Cancer (IARC) also said that almost 21.4 million new cases of the disease will be diagnosed annually in 2030. Launching a new database on global incidence of cancer in 2008, the latest year for which figures are available, the IARC said the burden of cancer was shifting from wealthier to poorer nations. "Cancer is neither rare anywhere in the world, nor confined to high-resource countries," it said in a statement. In total, 7.6 million people died of cancer in 2008 and there were an estimated 12.7 million new cases diagnosed. Around 56% of new cancer cases worldwide in 2008 were in developing countries and these regions also accounted for 63% of all cancer deaths, the data showed. IARC director Christopher Wild said the data represented the most accurate available assessment of the global burden of cancer and would help international health policy makers develop their responses. The most commonly diagnosed cancers worldwide in 2008 were lung cancer, with 1.61 million cases, breast cancer, with 1.38 million, and colorectal cancers, with 1.23 million. The most common causes of cancer death were lung (1.38 million), stomach (0.74 million) and liver cancers (0.69 million) The projection for annual death rates of 13.2 million and annual diagnosis of 21.4 million [...]

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