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High rate of severe oral mucositis after IMRT seen in head and neck cancer

Source: www.cancertherapyadvisor.com Author: Andrea S. Blevins Primeau, PhD, MBA Many patients with head and neck cancer develop oral mucositis after intensity-modulated radiation therapy (IMRT), according to a single-center study published in JAMA Network Open. The study also showed that most cases of oral mucositis were severe, and increasing severity of mucositis was associated with a greater likelihood of feeding tube placement, hospitalization, and opiate use. The study included 576 patients who underwent definitive or adjuvant IMRT during 2015-2022. The Oral Mucositis Weekly Questionnaire-Head and Neck Cancer survey was used to categorize the severity of mucositis and throat soreness. Nearly all patients (98.6%) had oral mucositis, and 62.5% developed severe oral mucositis. By the final week of IMRT, 48.6% of patients had difficulty drinking, 56.8% had difficulty swallowing, and 69.4% had difficulty eating. Most patients (76.8%) were consuming a pureed diet and/or had a feeding tube by the end of IMRT. The median time to placing a feeding tube was 32 days from starting IMRT. The proportion of patients with nonprophylactic feeding tube placement was 16.4% of those with severe oral mucositis and 5.6% of those without severe mucositis (P

White lesions of the oral cavity and oral-systemic health: A review for the dental hygienist

Source: www.rdhmag.com Authors: Ben F. Warner, DDS, MD, MS, Cleverick “C.D.” Johnson, DDS, MS, Gary N. Frey, DDS, Michele White, DDS This review of oral white lesions and their identifying factors can be a guide for dental hygienists to determine whether referral to a specialist is necessary. A complete, periodic oral exam plays a vital role in evaluating the overall health of dental patients. New and established patients’ well-being can be supported by their relationship with the dental team. Any new or existing leukoplakia-type findings can be biopsied, identified, monitored, or referred for appropriate care. These lesions are characterized as white patches or plaques that “cannot be wiped off and cannot otherwise be described clinically as any other disease.”1 Discerning whether an oral white lesion is of concern is dental health-care professionals’ duty. While the majority of oral leukoplakia presents without symptoms and few patients complain of discomfort, a thorough medical history and oral exam are necessary to assure oral health. Dental hygienists are strategically positioned to support optimum patient health by observing relevant clinical findings. We conducted a literature review of commonly found oral white lesions for this article. Dental professionals can observe the clinical features of these lesions and distinguish those that need referral to a health-care specialist. The following are examples of commonly found white lesions observed in the oral cavity. Frictional keratosis Frictional keratosis (figure 1) is a white keratotic lesion on the oral mucosa that results from a chronic mechanical friction by various oral irritants [...]

Researchers develop innovative technique for distinguishing tumor from normal tissue

Source: www.eurekalert.org Author: Mass General Brigham Researchers develop innovative technique for distinguishing tumor from normal tissue The visual and quantitative techniques used – including high-speed cameras to detect changes occurring in a billionth of a second - had an accuracy of 97% across tumor types (liver, brain, tongue, skin, breast, bone and soft tissue) The images show clusters of colorectal cells metastasized to the liver, resected from a patient at Massachusetts General Hospital (MGH) The cells are visible as red, which means longer lifetime, against a background of normal liver tissue in blue/green Mass General Brigham investigators tested their approach using specimens from multiple cancer types, including liver, brain, tongue, skin, breast, bone and soft tissue Their visual and quantitative technique, which combines an injected FDA-approved drug with high-speed cameras to detect changes occurring in a billionth of a second, had an accuracy of 97% across tumor types Removing a patient’s tumor while sparing healthy tissue requires exquisite precision, but often surgeons must rely on their eyes and hands to determine where to cut. A team led by researchers from Mass General Brigham has developed a visualization tool that combines high-speed cameras and fluorescent injection to distinguish tumor tissue from normal tissue across cancer types. The team evaluated the new imaging technology, known as fluorescence lifetime (FLT) imaging, using specimens from more than 60 patients that underwent surgery of various cancers. In a paper published in Nature Biomedical Engineering, the team reported that the technique was over 97 [...]

Oral microbiome connected with mouth sore severity In patients with head and neck cancer

Source: www.curetoday.com Author: Alex Biese Among patients with squamous cell head and neck carcinoma, oral microbiome is associated with severity of oral mucositis (OM), an after-effect of radiotherapy and chemotherapy which effects nearly all patients with head and neck cancer (HNC), according to recent study findings from a team at The University of Texas MD Anderson Cancer Center. “Our study suggests that the oral microbiome plays an important role in the longitudinal patterns of OM and the potential interaction between the oral microenvironment and the development of OM in patients with HNC,” the researchers wrote in a study published in the journal Cancer. Drawing on data from 142 adult patients — 91% male, with an average age of 57.6 years and a mean BMI of 29.1, 80% of whom had oropharyngeal carcinoma and 75% of whom received chemoradiation — newly diagnosed with locoregional squamous cell carcinoma of the head and neck who were treated at MD Anderson Cancer Center between March 2016 and September 2020, researchers collected samples from patients at the baseline prior to treatment, weekly during treatment, during the clinic visit at the conclusion of treatment and after the termination of treatment. The American Academy of Oral Medicine cites high-dose chemotherapy and localized high-dose radiation therapy to the head and neck region as the main risk factors for developing painful mouth sores also referred to as oral mucositis. “These treatments effectively target the rapidly dividing cancer cells, but also inadvertently affect normal healthy cells that rapidly turnover, such [...]

Immunotherapy shows promise as a kinder first-line treatment for advanced head and neck cancers

Source: www.icr.ac.uk Author: staff Oral squamous cancer cell (white) being attacked by two cytotoxic T cells (red). Credit: NIH Immunotherapy can extend the response of some head and neck tumours to treatment, maintaining the anti-tumour effects and preventing them from growing or spreading for longer, a study reports. A new trial shows that amongst patients whose tumours were sensitive to immunotherapy, the treatment could keep their cancer from growing or spreading for longer and with fewer side effects than the previous standard of care therapy. A personalised approach to immunotherapy The findings of the KESTREL trial support the need for a personalised approach to immunotherapy treatments, as although these treatments work for a minority of patients, they can bring significant improvements in quality of life for those who respond. As well as leading to long-lasting responses, the immunotherapy durvalumab, on its own or combined with another immunotherapy called tremelimumab, also led to fewer side effects in people with head and neck cancer which had spread or come back. Fewer than 2 in 10 people on immunotherapy had severe side effects, compared to around half of the patients on the standard of care regimen. An international trial The results from the KESTREL study, led by an international team of researchers including scientists at The Institute of Cancer Research, London, offer hope for the development of kinder first-line treatments for this hard-to-treat cancer. The study was published in Annals of Oncology and was funded by AstraZeneca. Overall, the trial did [...]

Regular dental visits linked to increased survival rate for head, neck cancer patients

Source: www.health.com Author: Kaitlin Sullivan Good oral hygiene could help your chance of survival from head or neck cancer, a new study finds.1 Going to the dentist isn’t just to make your teeth look better—maintaining oral hygiene can impact a variety of overarching health factors. Among them, head and neck cancer. Head and neck cancers include cancers of the throat, mouth, oral cavity, voice box, paranasal sinuses and nasal cavity, neck, and salivary glands. These cancers account for about 4% of cancer diagnoses and deaths in the United States.2 A new study found people who have better oral hygiene in the years before developing cancer may be better off in the long run. According to Jason Tasoulas, MD, DMD, the study’s lead author and a post-doctoral research fellow in otolaryngology-head and neck surgery at the University of North Carolina at Chapel Hill and the Lineberger Comprehensive Cancer Center, visiting the dentist at least every two years is the most important oral hygiene habit when it comes to head and neck cancers. “People who regularly have dentist appointments are more likely to have their cancer detected early,” he told Health, noting that catching cancer early is crucial for outcomes, since cancer that is detected early, before it’s spread, is easier to treat. Routine Dental Visits Contribute to Catching Cancer Early For the new study, Tasoulas and team looked at four studies that together included nearly 2,500 people from eight countries. All had been diagnosed with head and neck squamous cell carcinoma. [...]

2023-09-27T14:04:09-07:00September, 2023|Oral Cancer News|

The dental hygienist’s guide to pathology in patients with oral cancer

Source: www.dentistryiq.com Author: Sandra L. Benavides, RDH Dental hygienists are the unacknowledged heroes in oral health care, diligently working to protect their patients’ oral health. Besides removing plaque and polishing teeth, hygienists can identify early signs of potentially life-threatening conditions, including oral cancer. One of the most common cancers affecting humans across the globe is oral cancer, and early detection can significantly reduce morbidity.1 The key to successful treatment outcomes is early detection and intervention. The dental hygienist's keen eye, skilled hands, and understanding of oral anatomy equip them to identify oral pathology in patients with oral cancer. In 2023, according to the Oral Cancer Foundation, “Close to 54,000 Americans will be diagnosed with oral or oropharyngeal cancer this year. It will cause over 9,750 deaths, killing roughly 1 person per hour, 24 hours per day. Of those 54,000 newly diagnosed individuals, only slightly more than half will be alive in 5 years (approximately 57%). This is a number that has not significantly improved in decades.”2 Following is an overview of what to look for when examining oral cancer patients, how to differentiate typical from atypical findings, and steps to take when pathology is suspected. Understanding oral cancer There has historically been a high death rate associated with oral cancer, not because it is difficult to detect or diagnose, but because it is discovered late in its development. In its early stages, oral cancer can often go undetected by the patient as OC is frequently asymptomatic and likely to cause [...]

2023-09-22T06:39:46-07:00September, 2023|Oral Cancer News|

Oral health woes may lower head, neck cancer survival

Source: www.miragenews.com Author: University of North Carolina Health Care An international study has revealed strong associations between oral health and survival among people diagnosed with head and neck cancer. Specifically, better oral health, as evidenced by the number of natural teeth and dental visits prior to the time of diagnosis, was associated with increased survival. Importantly, those who had more frequent dental visits were more likely to have their cancer diagnosed at an earlier, and less deadly, stage of the disease than those who had few or no dental visits. The study, by researchers at UNC Lineberger Comprehensive Cancer Center and UNC Adams School of Dentistry, Chapel Hill, North Carolina, and Moffitt Cancer Center, Tampa, Florida, in partnership with the International Head and Neck Cancer Epidemiology (INHANCE) consortium, appeared Sept. 19, 2023, in the Journal of the National Cancer Institute. "The INHANCE consortium's patient data allowed us to be as thorough as possible and identify robust associations between oral health and survival," said lead author Jason Tasoulas M.D., DMD, a current Ph.D. candidate. "We assembled a diverse and experienced team to examine records of approximately 2,500 patients from eight countries to carry out our state-of-the-art statistical analyses." Head and neck cancer patients were asked to self-report aspects of their oral health and hygiene, including gum bleeding, tooth brushing frequency and mouthwash use, as well as the number of natural teeth and frequency of dental visits they had during a 10-year period prior to their cancer diagnosis. Those who had frequent [...]

2023-09-19T17:11:02-07:00September, 2023|Oral Cancer News|

Throat cancer is becoming an epidemic, and sex could be why

Source: www.sciencealert.com Author: Hisham Mehanna, Professor, Institute of Cancer and Genomic Sciences, University of Birmingham Over the past two decades, there has been a rapid increase in throat cancer in the west, to the extent that some have called it an epidemic. This has been due to a large rise in a specific type of throat cancer called oropharyngeal cancer (the area of the tonsils and back of the throat). The main cause of this cancer is the human papillomavirus (HPV), which are also the main cause of cancer of the cervix. Oropharyngeal cancer has now become more common than cervical cancer in the US and the UK. HPV is sexually transmitted. For oropharyngeal cancer, the main risk factor is the number of lifetime sexual partners, especially oral sex. Those with six or more lifetime oral-sex partners are 8.5 times more likely to develop oropharyngeal cancer than those who do not practice oral sex. Behavioral trends studies show that oral sex is very prevalent in some countries. In a study that my colleagues and I conducted in almost 1,000 people having tonsillectomy for non-cancer reasons in the UK, 80 percent of adults reported practicing oral sex at some point in their lives. Yet, mercifully, only a small number of those people develop oropharyngeal cancer. Why that is, is not clear. The prevailing theory is that most of us catch HPV infections and are able to clear them completely. However, a small number of people are not able to get rid [...]

2023-09-15T06:24:29-07:00September, 2023|Oral Cancer News|

Deep vein thrombosis as a side effect of cancer: 9 things to know  

Source: www.mdanderson.org Author: Cynthia Demarco The risk of developing blood clots is somewhat higher among cancer patients. This is due both to the inflammatory nature of the disease itself and the therapies used to treat cancer. Deep vein thrombosis (DVT) is one such type of blood clot. It forms in the veins found deep inside muscles and other tissues, and it can be fatal if left untreated. Why are cancer patients more susceptible to DVT? And, can it be prevented? We asked breast medical oncologist Ajit Bisen, M.D., for insight. Why are cancer patients at increased risk for deep vein thrombosis? Our bodies have a natural ability to balance blood clotting with blood flow. But whenever you introduce a variable into the mix, it causes an imbalance that can lead to the development of blood clots, including DVT. Cancer is considered a “hypercoagulable” condition because it’s more likely to lead to blood clots. That’s because both cancer and its treatment often create one or more of the conditions necessary for blood clot formation. Collectively, they’re known as the Virchow triad: a change in blood flow, a blood vessel injury, or a change in the composition of the blood. Cancer causes inflammation, which can make blood more likely to clot. Tumors can cause blockages and issues with blood flow. And surgeries and radiation therapy can cause injuries to tissue, sometimes even at the microscopic level. So, any or all of these could contribute to DVT. Where do cancer patients typically develop [...]

2023-09-15T06:14:35-07:00September, 2023|Oral Cancer News|
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