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Risk factors for positive surgical margins in salivary gland cancers

Source: www.physiciansweekly.com Author: Craig Bollig, MD An analysis of patients with salivary gland cancers shows that risk factors for positive surgical margins include age, tumor stage, and treatment center. “Salivary gland cancers are rare malignancies in the oropharynx that are primarily treated with surgery because they are relatively resistant to other therapies, such as radiation, chemotherapy, and immunotherapy,” Craig Bollig, MD, explains. “Surgical margins have been associated with cancer recurrence rates and survival in previous studies. However, because these tumors are so rare, there was not much information on risk factors for positive margins in this population prior to this study. Additionally, one of my primary clinical interests is transoral robotic surgery (TORS), which involves using a surgical robot to remove tumors located deep in the throat in a minimally invasive fashion through a patient’s mouth.” According to Dr. Bollig, previous research on the use of TORS in this population was limited, as were data on whether it was associated with similar positive margin rates compared with traditional surgical approaches. For a study published in American Journal of Otolaryngology—Head and Neck Medicine and Surgery, Dr. Bollig and colleagues obtained data from the National Cancer Database on patients with oropharyngeal salivary gland malignancies (OPSGM) from clinical T stages 1 to 4a who underwent surgical resection between 2010 and 2017. The researchers analyzed risk factors for positive surgical margins (PSM) using logistic regression and overall survival (OS) using Kaplan-Meier and Cox proportional hazards models. “Our objectives were to determine the clinical factors [...]

2022-09-06T09:55:57-07:00September, 2022|Oral Cancer News|

Natural remedies for dry mouth (Xerostomia)

Source: www.mskcc.org Author: Memorial Sloan Kettering staff More than 80% of people with cancer experience dry mouth (called xerostomia) after radiation to the head and neck or from certain medicines. Patients can especially experience dry mouth while sleeping. The symptoms of dry mouth — sometimes called “cotton mouth” — should not be ignored. The parched sensation is not only distracting and painful but also can set the stage for infections, cavities, and tooth decay. Additionally, it can interrupt good eating habits that keep you strong and well nourished. “It’s important to take care of mouth dryness because it can affect your health and recovery from cancer,” says Jason Hou, a pharmacist in the Integrative Medicine Service (IMS) at Memorial Sloan Kettering Cancer Center (MSK). “We know what helps dry mouth.” Here, Dr. Hou, who manages MSK’s About Herbs database, offers some natural dry mouth treatments. How To Get Rid of Dry Mouth For dry mouth due to antihistamines, anti-nausea medicines, or pain relievers: Your doctor may be able to switch medications to give you relief. For dry mouth after radiation: There are prescription or over-the-counter treatments that may help, but they come with side effects. What helps dry mouth for you will partly depend on whether you can still make some saliva. It’s a good idea to get evaluated for xerostomia before trying one or more of these home remedies. To Fix Dry Mouth, Make Your Own Mouthwash Dr. Hou suggests making your own mouthwash out of salt and baking [...]

2022-09-06T09:43:11-07:00September, 2022|Oral Cancer News|

Oral health professionals promote ‘value of having a dentist on the cancer care team’

Source: www.healio.com Author: Jennifer Byrne When planning their next steps after a cancer diagnosis, most patients don’t put a trip to the dentist at the top of their to-do list. “When patients are diagnosed with cancer, they just want to put out the fire; they want to address the cancer,” Dalal Alhajji, DMD, MSD, clinical instructor of oral and maxillofacial pathology, radiology and medicine at NYU College of Dentistry, said in an interview with Healio. “That’s when I say, ‘the reason you need to see a dentist is, we want to put out another potential fire — one you might not know about yet.” Alhajji and her colleagues at NYU College of Dentistry are part of a small but growing movement among oral health professionals seeking to close the gap between medical and dental care for patients with cancer. They see dentists as a vital component of any multidisciplinary oncology care team, offering infection treatment, protection of teeth during head and neck radiation treatments, and quality-of-life care for issues such as dry mouth and mouth sores. “I’ve been lucky — the oncologists I work with have been great about referring patients to me because they see the impact it has,” Alhajji said. “They see the value of having a dentist on the cancer care team.” Addressing preventable issues There are several reasons for a patient with cancer to see a dentist prior to initiating cancer treatment, but patients with head and neck cancers and those slated to undergo bone marrow [...]

Sorry, but vaping is wreaking havoc on your oral health

Source: www.bodyandsoul.com.au Author: Jaymie Hooper To mark the start of Dental Health Week, oral medicine specialist Dr Sue Ching Yeoh explains the hidden dangers of vaping – and why it's time to quit. No matter which way you slice it, vaping is just not very good for you. Not only has it been shown to cause an onset of seizures, it’s also been linked to numerous deaths, and vaping liquids containing nicotine are so troubling they were recently banned in Australia. The bad press doesn’t end there, either. While we usually associate tooth decay and gum disease with cigarettes, vaping can also take a significant toll on your oral health. According to Dr Sue Ching Yeoh, an oral medicine specialist and spokesperson for the Australian Dental Association, vaping also changes the composition and balance of your oral flora (bacteria and fungal organisms that live in your mouth), which leads to an increased risk of oral fungal infections. “The most common oral side effects from vaping include dry mouth, burning, irritation, bad taste, bad breath, pain, oral mucosal lesions (lesions that affect the soft lining of the mouth), black tongue and burns,” Dr Yeoh explains. These side effects are a result of the chemicals used in vaping liquids, which are usually created by heating glycerol, glycol and nicotine to extremely high temperatures under intense pressure. “This process produces extremely toxic chemicals such as formaldehyde and acetaldehyde, which are known carcinogens," Dr Yeoh adds. “As the mouth is the first site in [...]

Non-irritating foods to eat when you have mouth sores: what you can do about oral mucositis

Source: www.verywellhealth.com Author: Suzanne Dixon, MPH, RD The loss of appetite is common when undergoing cancer treatment, particularly if you get a common side effect called oral mucositis which causes mouth sores. To ensure proper nutrition to help you heal, you need to find non-irritating foods that you can eat even if you have mouth sores. This article explains why mouth sores occur in people undergoing cancer treatment. It also lists the types of food you can and cannot eat—as well as the way to eat—to better cope with treatment-induced oral mucositis. Over 40% of people undergoing certain cancer treatments will develop oral mucositis. It is most commonly associated with chemotherapy but can also occur with radiation therapy to the head or neck.1 Oral mucositis is an especially common occurrence when exposed to the chemotherapy drugs 5-fluorouracil (5-FU) or Evomela (melphalan). Other chemotherapy drugs can do the same.2 Treatment-induced oral mucositis is the result of the following processes: Whenever cells are damaged by chemotherapy or radiation, they release unstable atoms called free radicals. This, in turn, triggers the release of inflammatory chemicals called cytokines and metalloproteinase that break down a structural protein called collagen, causing tissues to thin and form ulcers. When this occurs in the mouth, natural bacteria quickly colonize the sores, causing infection, inflammation, and pain. The sores can often be extremely painful, making it difficult to eat, talk, and swallow. The sores may even extend into the esophagus that carries food from the mouth to the stomach. [...]

Merck’s Keytruda shores up head and neck case with first-line trial win

Author: Carly Helfand Source: www.fiercepharma.com Merck’s Keytruda may just be on its way to earlier use in head and neck cancer, an area where it once faced some questions. On Wednesday, the New Jersey drugmaker said that in a phase 3 trial in previously untreated patients, Keytruda topped a standard-of-care regimen that includes Eli Lilly’s Erbitux at extending overall survival in patients with tumors expressing a certain level of biomarker PD-L1. The data came from an interim analysis of the trial that also showed Keytruda hadn’t yet met the study’s other primary endpoint, which measures time to cancer progression. But overall survival is often considered the gold standard in cancer trials, and Merck will be taking the win in that department to regulators worldwide. Right now, Keytruda bears an approval in head and neck cancer but only in patients whose disease has worsened on or after chemo. And after snagging that conditional approval, last July it failed to prove that it could extend the lives of patients in that group. As analysts pointed out at the time, though, that miss was narrow, coming just shy of statistical significance. The FDA kept the approval in place, and now, Merck has the data to back it up. If Merck can win a new indication from the FDA, it could gain access to a patient pool that grows by about 63,000 U.S. cases per year. And that's a group Keytruda's rival, Bristol-Myers Squibb’s Opdivo, can't currently treat: Its approval only extends to previously [...]

Thousands of volunteers in the West Midlands join NHS trial to spot deadly cancers

Source: www.england.nhs.uk Author: staff Over 140,000 people, of which almost 18,500 are from the West Midlands, have volunteered to take part in the world’s largest trial of a blood test that can detect more than 50 types of cancer, as part of the latest National Health Service (NHS) drive to catch the disease when it is generally easiest to treat. In just one year since the NHS-Galleri trial began, volunteers from across the country have come forward to have a blood test at mobile clinics in convenient locations, including supermarket and leisure centre car parks and places of worship. Participants will now be invited to attend two further appointments, spaced roughly 12 months apart. The NHS Long Term Plan committed to increasing the proportion of cancers caught early, when they are easier to treat, from half to three in four. NHS ‘one stop shops’ have also already delivered 190,000 additional tests in the Midlands, including for cancer, since the rollout began, with seven community diagnostic centres (CDCs) in the West Midlands offering a range of diagnostic tests and other services closer to patients’ homes, often in the heart of local communities. More CDCs are also in development and will become operational over the next three years. This trial is part of radical NHS action to tackle cancer, that also includes the successful rollout of targeted lung trucks across the country, with thousands of people invited for checks every month in mobile vehicles, and hundreds of cancers diagnosed earlier. Initial research [...]

Study of novel drug combo in head and neck cancer closed after several patient deaths

Source: www.curetoday.com Author: Ryan McDonald MacroGenics Inc. recently announced that it discontinued a phase 2 trial investigating the safety and efficacy of a cancer treatment regimen consisting of enoblituzumab in combination with either retifanlimab or tebotelimab. The regimen was being investigated as a first-line treatment option in patients with recurrent or metastatic squamous cell carcinoma of the head and neck. The company announced that it stopped the trial after conducting an internal review of the safety data. Of the 62 patients treated in the study, seven died while enrolled on the trial. The deaths, according to a news release from MacroGenics may have been linked to hemorrhagic events, which is the loss of blood from a damaged blood vessel. These events, according to information from the Cleveland Clinic, can be minor or major. Some of the major events — such as bleeding in the brain — may lead to the occurrence of a stroke. Investigators assessed the deaths and attributed six of the seven to be associated with disease progression or unrelated to any of the study drugs. However, the investigators determined that one death may have been possibly related to study treatment. The number of deaths reported in the trial were higher than what has been previously reported in additional studies of this patient population, according to the release. The manufacturer noted that it informed the Food and Drug Administration of its decision and told investigators to discontinue enrolling any new patients onto the trial. The investigators, according to [...]

Viome scores FDA breakthrough label for cancer-screening, microbiome-sequencing AI platform

Source: www.fiercebiotech.com Author: Andrea Park The secret to enabling early cancer detection could be hidden in the microbiome, and, now, gut-testing startup Viome has the backing of the FDA to prove it. Viome was initially launched as a direct-to-consumer service that used an artificial intelligence-powered platform to sequence the RNA in an individual’s stool sample to produce insights into their overall health and provide accompanying diet and lifestyle recommendations. More recently, however, the startup has set its sights on using the technology to screen for cancer. In a study published last August, Viome researchers used the platform to analyze saliva samples from oral cancer patients and discovered biomarkers in the resulting analysis that were directly linked to cancer signatures. The diagnostic was able to spot early signs of oral cancer with a sensitivity of about 83%—and over 93% for stage 1 cancers—and a specificity of nearly 98%. As a result of that and other ongoing research, Viome’s saliva test has received the FDA’s breakthrough device designation for use in early screening for oral squamous cell carcinoma and oropharyngeal cancer, both of which are typically only diagnosed in a manual examination and are therefore often overlooked until their later stages. “Today’s standard of care to detect oral and throat cancer is severely outdated. Everyone relies on a primary care clinician to examine their mouths and look for lesions. This subjective and qualitative approach is a key reason why oral and throat cancer are detected at stage three or four, when many [...]

OmniPathology announces the launch of its oropharyngeal HPV PCR test

Source: www.globenewswire.com Author: press release OmniPathology, an independent, physician-owned and operated pathology lab, today announced the launch of a new oral test for human papillomavirus (HPV) that can cause cancer. The Oral HPV Test is a lab-developed test (LDT) performed on a Roche cobas® 6800 and 8800 high-throughput platforms. The Oral HPV Test detects 14 high-risk strains of HPV. It is performed via a throat swab submitted to OmniPathology, a CLIA-certified laboratory in Pasadena, for testing. Patients who test positive are advised to undergo a thorough examination by an ear, nose, and throat (ENT) doctor and may require close follow-up. Detection and removal of early oral and oropharyngeal premalignant lesions can help significantly reduce the risk of progression to cancer. This test will be offered to primary care and GYN physicians, LGBTQIA+ clinics, dentists, oral surgeons, and ENT practices across the country as part of routine examinations of patients. “Launching this oropharyngeal HPV test is an exciting milestone for OmniPathology, especially since this is an underserved area for diagnostic testing. As an organization led by science and driven by service, OmniPathology continues to offer state-of-the-art molecular testing that can impact patient care and enhance the quality of the services our physician clients offer to their patients,” said Mohammad Kamal M.D., founder and CEO of OmniPathology. “We continue to build our testing menu to target sexually transmitted infections and other viral diseases.” Oral HPV has no symptoms and is spread through skin-to-skin contact. Risk factors for oral HPV include oral sex, [...]

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