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Nonsurgical surveillance safe, cost-effective for head, neck cancer

Source: www.healio.com Author: Mehanna H, et al. Patients with head and neck cancer who underwent PET/CT–guided surveillance achieved similar survival outcomes as those who underwent planned neck dissections, according to the results of a prospective, randomized controlled trial. However, surveillance led to fewer surgical operations and complications and appeared more cost-effective than neck dissection, results showed. Patients with head and neck cancer frequently undergo invasive surgery following treatment to remove remaining cancer cells, according to study background. “After treatment, remaining cancer cells play something akin to hide and seek,” Hisham Mehanna, MBChB, PhD, FRCS, chair of head and neck surgery at University of Birmingham and director of the Institute of Head and Neck Studies and Education, said in a press release. “Our study shows that we can hunt them down, find them and remove them effectively.” Mehanna and colleagues sought to define the role of image-guided surveillance compared with planned neck dissection for the management of patients with advanced, nodal head and neck squamous cell carcinoma previously treated with primary chemoradiotherapy. The analysis included data from 564 patients (mean age, 58 years; 82% men) who researchers randomly assigned to PET/CT–guided surveillance (n = 282) performed 12 weeks after the end of treatment or planned neck dissection (n = 282). Oropharyngeal cancer served as the most common cancer subtype (84%). Seventy-five percent of patients had HPV-16–positive disease. Patients assigned surveillance only underwent neck dissection if their PET/CT scans showed incomplete or equivocal response to chemoradiotherapy. The trial was designed to assess [...]

ACS now has a guideline for care of head and neck cancer survivors

Source: www.ajmc.com Author: Surabhi Dangi-Garimella, PhD With an increasing population of head and neck cancer survivors in the United States, the American Cancer Society identified the need to develop survivorship guidelines that can lend support to primary care clinicians and other health practitioners as they care for survivors. With an increasing population of head and neck cancer (HNC) survivors in the United States, the American Cancer Society (ACS) identified the need to develop survivorship guidelines that can lend support to primary care clinicians and other health practitioners as they care for survivors. The guideline emphasizes monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. According to ACS estimates, nearly 3% (436,060) of cancer survivors in the United States have survived a bout of HNC. With these numbers in mind, ACS convened an expert panel that included members with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech language pathology, physical medicine and rehabilitation, nursing, and a HNC survivor who provided a patient perspective. The panel reviewed existing guidelines and research evidence through April 2015, and created recommendations, which the committee has stressed “should be viewed as consensus-management strategies” to assist survivors. While 2081 articles were identified from a preliminary search, only 184 were finally included as evidence base. Published online in CA: A Cancer Journal for Clinicians, the following are some of the key recommendations provided by the guideline for primary care physicians: [...]

Patient survives stage IV, inoperable throat cancer in clinical trial

Source: medicalxpress.com Author: staff It took a white lie to get David Polisini, 79, to a doctor in 2004, after months of being unable to swallow. "Two of my daughters, Toni and Susie, showed up on my back porch and told me to put my jacket on," he says. "They told me we were just going for a ride, but the next thing I knew, we were pulling into the Clermont Mercy Hospital." Polisini says tests ordered in the emergency room uncovered a tumor in his throat. "It was the size of a golf ball," he says, adding that he then scheduled an appointment with his primary care physician, Francis Dumont, MD. "I was then referred to an ear, nose and throat physician within his group who said I needed to see someone at the University of Cincinnati (UC) Cancer Institute." A biopsy was performed, and a diagnosis was confirmed—it was Stage IV cancer. "I began seeing Dr. (Bill) Barrett who explained that I would need to go through very aggressive radiation along with chemotherapy five days a week for three months," he says. "I'd drive myself every day to every visit in my little Miata. The therapy really zapped my strength, but I'm here because of it. "I really don't think I realized how much trouble I was in with Stage IV inoperable cancer, but I knew I had to do what I had to do to get through it." The radiation and chemo regimen was a Phase III [...]

Call for NZ Government to fund HPV vaccine for boys

Source: www.nzherald.co.nz Author: Martin Johnston Throat-cancer patient Grant Munro paid for his son to be vaccinated against the sexually-transmitted HPV virus because the Government has refused. A 58-year-old scientific expert on viruses, he is backing a campaign by doctors calling for the extension of state funding of the controversial HPV vaccine to boys. Dr Munro, whose cancer was linked to HPV infection, says it is a form of discrimination against males that the Government will only pay for girls to have the vaccine. State medicines agency Pharmac said it had decided not to fund the Gardasil vaccine for boys at present, but it is an option for the future. Its advisory committee assigned a low priority to funding it for all males aged 11-19 and high priority for males 9-26 "who self-identify as having sex with other males". In Australia, the vaccine is government-funded for boys and girls. Gardasil can protect against four strains of HPV - human papilloma virus - that can cause pre-cancerous lesions in the genital tract and mouth, and genital warts. It has been offered to New Zealand girls partly to help reduce cervical cancer. Rates of throat-related cancers have risen sharply since the 1980s and HPV, from oral sex, is thought to be the cause. The actor Michael Douglas was treated for tongue cancer caused by HPV and has spoken of the link between HPV and performing oral sex. After Dr Munro was treated for a tonsil tumour that contained evidence of HPV, he paid [...]

Costco Wholesale to stop selling tobacco products at hundreds of locations

Source: www.medicaldaily.com Author: Jaleesa Baulkman Sorry smokers, but you'll have to go someplace other than Costco to get your cigarettes. The New York Daily News reported the retailer has spent the past few years quietly phasing tobacco products out of nearly 300 stores; there are 488 in total. Tobacco smoke has been linked to adverse health effects, such as lung and oral cancer, though that's not why Costco did it. Instead, the company said the decision was more about business than public health. "Tobacco is a very low margin business, tends to have higher theft and is labor intensive in some cases (due to local municipality regulations) — further, we felt we could better use the space to merchandise other items," a spokesman from Costco told The Street. According to The Street, Costco officials first hinted at the ban during a call with analysts, where they said tobacco sales had fallen to a "low double digit." The company hasn’t made an official announcement because "[press releases] are a waste of money." The retail giant’s move is another blow to the tobacco industry, which has seen a significant drop in the percentage of Americans who smoke in the past 50 years. In 2014, the smoking rate hit an all-time low of 17.8 percent, and the rate is still dropping, The Huffington Post reported. Not to mention other retailers have quit selling these kinds of products, too. In 1996, Target was the first large retail store to stop selling cigarettes, citing costs [...]

HPV rates down, CDC credits vaccine

Source: www.thv11.com Author: Winnie Wright Researchers say the rates of a cancer causing virus are on the decline thanks to vaccinations. In recent years, vaccinations have become a hot-button issue for parents and the HPV vaccine was no exception. When the CDC began recommending the Human papillomavirus vaccine in 2006, there was a lot of push back from parents. A new study from the CDC says the rates of HPV infection are down 63 percent among girls ages 14 to 19 in the last decade and it credits the HPV vaccination. The vaccine was very controversial when it hit the main stream 10 years ago, and THV11 wanted to know, have those findings changed parents’ minds about the vaccination? “I think there was a great fear that the HPV Vaccine was some sort of signal to adolescent girls that sex was safe. And that there would be an increase in sexual activity and promiscuity, and in fact, that’s not happened. We’ve seen sort of the opposite,” explained Dr. Gary Wheeler, CMO for the Arkansas Department of Health. HPV is most commonly spread through sex. According to the CDC, an estimated 79 million females aged 14-59 are infected with HPV. 14 million new infections are reported in the U.S. each year. When Gardasil, the HPV vaccine, was introduced in 2006, it was a hard pill for many parents to swallow. The vaccine is especially encouraged for children under the age of 12, because it’s most effective the younger you are. Parents [...]

Blue Jays welcome City of Toronto’s proposed ban on chewing tobacco

Source: www.theglobeandmail.com Author: Robert Macleod and Jeff Gray For years, it was a right of passage at the Toronto Blue Jays’ spring training camp here. Manager John Gibbons would earnestly proclaim that he was finally giving up smokeless tobacco, a personal ban that would usually only last a couple of weeks before he would be seen “dipping” once again. It is a terrible habit, Gibbons will tell you, and that’s the reason he said he would support a City of Toronto proposal to prohibit the use of chewing tobacco at all public parks, baseball fields and hockey rinks. The prohibition would also apply at Rogers Centre, where many of the players openly use chewing tobacco. “Tobacco’s a nasty habit,” Gibbons said. “I did it for a long, long time. I’m not proud of that. And whatever they can do to get rid of it, especially kids from doing any of that, I’m all for it.” Toronto’s proposal to ban chewing tobacco is being spearheaded by Councillor Joe Mihevc, who is chairman of the city’s board of health. Mihevc says he intends to introduce a motion at the board’s March 21 meeting asking that officials study a potential ban that’s being supported by the Canadian Cancer Society and various anti-tobacco groups. “Professional athletes are role models for young people,” he said, “and we need to make sure they are not promoting bad habits or tobacco use as a part of sports culture.” Mihevc cited statistics that show a rising number of [...]

Having a partner increases cancer survival rates: Australian study

Source: www.theaustralian.com.au Author: Sean Parnell People diagnosed with cancer are more likely to die if they do not have a partner, according to a new Australian study. Researchers from Cancer Council Queensland and Queensland University of Technology examined 176,050 cases of the 10 most common cancers in Queensland, diagnosed between 1996 and 2012. They found the chance of death was 26 per cent higher for men who did not have a partner compared to those who did, and 20 per cent higher for women who did not have a partner, across all cancers. “The reasons for higher survival in partnered patients still remains unclear, but are likely to include economic, psychosocial, environmental, and structural factors,” CCQ professor Jeff Dunn said yesterday. “Having a partner has been linked to a healthier lifestyle, greater financial resources and increased practical or social support while undergoing treatment. “Support from a partner can also influence treatment choices and increase social support to help manage the psychosocial effects of cancer.” The increased risk varied depending on the type of cancer. For men without a partner, it ranged from 2 per cent for lung cancer to 30 per cent for head and neck cancer, while for women without a partner it ranged from 2 per cent for kidney and lung cancer to 41 per cent for uterine cancer. “Health professionals managing cancer patients should be aware of the increased mortality risk among unpartnered patients, and tailor follow-up treatment accordingly,” Professor Dunn said. Of the 176,050 patients analysed [...]

Imaging, physical examination find most recurrences of HPV-positive oropharyngeal cancer

Source: www.oncologynurseadvisor.com Author: Kathy Boltz, PhD Posttreatment imaging at 3 months and physical examinations during the 6 months following treatment can detect most recurrences in patients treated with definitive radiation therapy for oropharyngeal cancer caused by human papillomavirus (HPV).1 This research was presented at the 2016 Multidisciplinary Head and Neck Cancer Symposium. A dramatic increase in oropharyngeal squamous cell carcinoma (OPSCC) cases associated with HPV has been reported by the American Cancer Society. Survival rates after definitive radiation therapy have also increased. This has led to the need to determine general time to recurrence and the most effective modes of recurrence detection, to guide standards for optimal follow-up care by oncology teams. This study examined 246 cases of HPV-positive or p16-positive non-metastatic OPSCC treated with definitive radiation therapy at a single, large-volume cancer center between 2006 and 2014. Follow-up care included a PET/CT scan 3 months after completing treatment and physical examinations every 3 months in the first year following treatment, every 4 months in the second year and every 6 months in years 3 through 5. Median follow-up care length for all patients was 36 months. Patient outcomes, including recurrence and survival rates, were calculated using the Kaplan-Meier method from the end of radiation therapy. Most recurrences were detected either by persistent disease appearing on 3-month post-treatment imaging or by patients presenting with symptoms at follow-up examinations. Disease characteristics that increase the likelihood of recurrence include presenting with 5 or more nodes or having level 4 lymph nodes (P [...]

Cancer gene may aid researchers find how immune system can help treat cancer or predict outcomes

Source: immuno-oncologynews.com Author: Daniela Semedo, PhD University of Cincinnati scientists have recently discovered that DEK, a human gene known to cause cancer, can be detected in the plasma of patients with head and neck cancer. DEK may help clinicians understand how a person’s immune system can be used to treat cancer or predict outcomes for patients. The information, titled “The DEK oncogene can be detected in the plasma of head and neck cancer patients and may predict immune response and prognosis,” was presented via poster at the Multidisciplinary Head and Neck Cancer Symposium Feb. 18-20 in Scottsdale, Arizona. “Head and neck cancer remains the sixth most common cancer worldwide,” said Trisha Wise-Draper, M.D., Ph.D., assistant professor in the Division of Hematology Oncology at the UC College of Medicine, in a news release. Wise-Draper is a member of both the Cincinnati Cancer Center and UC Cancer Institute and she was the principal investigator on this study. “Although infection with the human papilloma virus, or HPV, has emerged as a factor for determining outcomes for head and neck squamous cell carcinoma [head and neck cancer], leading to less intense treatment strategies for patients, no plasma biomarkers exist to predict tumor response to treatment or possible relapse,” she said. “One potential plasma biomarker is programmed by the human DEK gene, which has been found to promote cancer. DEK RNA and protein are highly increased in tissue specimens from several tumor types, including head and neck cancer, breast cancer, and melanoma, and antibodies to [...]

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