Oral Cancer News – Page 166

Palliation Trumps PET in Prolonging Head and Neck Cancer Survival

Source: Elsevier Global Medical News. 2012 Feb 23, D McNamara MIAMI BEACH (EGMN) - Using PET scans to diagnose distant metastasis in patients with advanced head and neck squamous cell carcinoma does not significantly prolong life expectancy, compared with other imaging techniques, according to a retrospective study. Palliative chemotherapy did make a difference, however, significantly increasing life expectancy by 215 days in patients who received it, Dr. Matthew E. Spector and colleagues from the University of Michigan, Ann Arbor, reported at a meeting of the Triological Society. "Over 90% of patients at University of Michigan have at least one PET scan at some point in their treatment," Dr. Spector said. Increased sensitivity is one reason for such widespread adoption of the imaging technique. "We were wondering, while it may be more sensitive to identify distant metastatic disease, was it changing what we were doing?" In a retrospective look at 170 patients with such cancers at their institution, researchers found no significant difference in median survival between patients who had a PET scan (168 days) and those who did not (193 days). Determination of any survival difference was a primary aim of the study. "A lot of studies have looked at PET scans, and we know in up to one-third of cases it may change our decisions," Dr. Spector said. For example, a negative PET scan might mean definitive treatment, whereas a positive PET finding might lead to palliative therapy. However, "no one has looked at the impact of the PET findings on the life expectancy after diagnosis." All patients in the study had a distant metastasis diagnosis. "We found PET was more [...]

Charlotte Parker2012-02-27T11:42:48-07:00February, 2012|Oral Cancer News|

More troops on smokeless tobacco after deployment

Source: Reuters.com The findings, reported in the journal Addiction, follow other studies that have tied deployment and combat to health risks, including higher rates of smoking and drinking. "This adds to the list of things we're learning are associated with combat," said lead researcher Dr. Eric D.A. Hermes, of the Yale University School of Medicine in New Haven, Connecticut. It's not fully clear why some troops take up smokeless tobacco after deployment. But Hermes suspects stress is involved. That's because deployment with combat exposure was linked to a higher risk than deployment alone. And troops with symptoms of post-traumatic stress disorder (PTSD) also had an increased risk. The findings come from the Millennium Cohort Study, an ongoing government project looking at the health effects of military service. Of more than 45,000 personnel followed from 2001 to 2006, 2 percent started using smokeless tobacco during that time. Another 9 percent had already developed the habit, and kept it up. Overall, troops who were deployed but did not see combat were almost one-third more likely to take up a smokeless tobacco habit than their non-deployed counterparts. Those odds were two-thirds to three-quarters higher for troops who were in combat or who deployed multiple times. According to Hermes, those different levels of deployment can be seen as stand-ins for different levels of stress. So it's possible that stress plays a role, he said. Another finding gives weight to that idea. "We also saw a relationship with PTSD symptoms," Hermes said. Just under 4 [...]

Charlotte Parker2012-02-27T10:28:20-07:00February, 2012|Oral Cancer News|

Canadian provinces weighing HPV vaccination of boys

Source: www.cmaj.ca/ Author: Laura Eggertson Provinces weighing the merits of implementing the National Advisory Committee on Immunization's recommendation to offer human papillomavirus (HPV) vaccine to boys and men aged 9–26 are facing a tricky trade-off between benefits and costs. “I think the benefits are there, but the costs are high,” which is a crucial issue for publicly funded programs, says Dr. Monika Naus, medical director of immunization programs and vaccine-preventable diseases for the British Columbia Centre for Disease Control. The National Advisory Committee on Immunization last month recommended extending the human papillomavirus vaccine to boys and men aged 9 to 26 “for the prevention of anal intraepithelial neoplasia (AIN) grades 1, 2, and 3, anal cancer, and anogenital warts”. The move followed on the heels of an October 2011 recommendation from United States Centers for Disease Control and Prevention advisory panel recommendation that HPV vaccine be given to boys aged 11–12 to ward off genital warts, anal cancer and “possibly” head and neck cancer. In deciding whether to proceed, the provinces should note that “the public health and economic burden of AGWs [anogenital warts] in Canada is considerable, particularly among men whose incidence rates and incidence rate ratios compared to females have been increasing in recent years,” the committee stated. The committee’s report also noted that the number of annual cases (and average annual incidence per 100 000) of penile cancer among men in Canada is 127.4 (1.0 per 100 000), while the number for cancer of the anus is [...]

Oral Cancer Foundation News Team - A2012-02-26T10:01:29-07:00February, 2012|Oral Cancer News|

CD4 counts predict chemo response in laryngeal cancer

Source: www.oncologyreport.com/ Author: Miriam E. Tucker Pretreatment CD4 levels predicted response to induction chemotherapy among 97 patients with advanced laryngeal cancer, but not for 66 patients with advanced oropharyngeal cancer, according to a retrospective analysis of data from two clinical trials. The two groups of head and neck cancer patients were enrolled in two identical prospective, phase II trials of induction chemotherapy and organ preservation, in which tumor response after one cycle of cisplatin and 5-fluorouracil was used to select those who would undergo surgery or definitive chemoradiation (J. Clin. Oncol. 2006;24:593-8 in laryngeal cancer; J. Clin. Oncol. 2008;26:3138-46 in oropharyngeal cancer). Several lymphocyte subsets were measured before treatment via routine flow cytometry in peripheral blood in the laryngeal cancer patients, but only CD4 (helper cell) levels were significantly associated with chemotherapy response. Both absolute CD4 counts and CD4 percentages were higher among induction chemotherapy responders than nonresponders (P = .006 and P = .04, respectively). Investigators also saw a trend for responders to have an increased percentage of CD3 cells (P = .13), decreased percentage of CD8 cells (P = .11), and higher CD4/CD8 ratios. "Host immune parameters are important factors in treatment outcome, and may be useful in identifying subsets of patients with cancers that are responsive to organ-preserving therapy," said Dr. Gregory T. Wolf, who presented the data at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. "It is likely that immunobiology of head and neck cancers differ significantly by tumor [...]

Oral Cancer Foundation News Team - A2012-02-26T09:53:59-07:00February, 2012|Oral Cancer News|

Radiotherapy technique significantly reduces irradiation of healthy tissue

Source: www.sciencecodex.com/ Author: staff Researchers at the University of Granada and the university hospital Virgen de las Nieves in Granada have developed a new radiotherapy technique that is much less toxic than that traditionally used and only targets cancerous tissue. This new protocol provides a less invasive but equally efficient cancer postoperative treatment for cases of cancer of the oral cavity and pharynx. The study -conducted between 2005 and 2008- included 80 patients diagnosed with epidermoid cancer of the oral cavity and pharynx, who had undergone lymph node removal. The affected nodes were located by the surgeon during the intervention and classified into different risk levels. Classification allowed physicians to target the areas at a higher risk of recurrence. This way, neck areas at a lower risk of containing residual cancer cells were not irradiated. Researchers achieved both to minimize the side effects of radiotherapy, and to reduce treatment discontinuation, thus achieving the therapy to be more effective. A Highly Toxic Treatment Over 70% of oral and pharynx cancer treated with surgery require supplementary treatment with radiotherapy occasionally associated to chemotherapy, because of the high risk for recurrence and spread through the lymph nodes. Radiotherapy and chemotherapy are highly toxic, mainly due to the ulceration of the mucous membranes lining the oral cavity; toxicity leads may patients to stop the treatment, which significantly reduces the chances of cure. By using the risk map obtained with the collaboration of the surgeon and the pathologist, an individualized treatment was designed and adapted [...]

Oral Cancer Foundation News Team - A2012-02-26T09:44:04-07:00February, 2012|Oral Cancer News|

Cancer patients who smoke report worse pain, symptoms

Source: www.medscape.com/ Author: Kate Johnson Cancer patients who smoke experience more severe symptoms than nonsmoking cancer patients and are also at greater risk of misusing opioids, a new study shows. "Our findings show a profile of higher levels of physical symptoms (pain, fatigue, poor appetite, and insomnia) and psychological symptoms (depression and anxiety) among smokers than non-smokers," report Diane Novy, PhD, from the Pain Management Center at the University of Texas MD Anderson Cancer Center in Houston, Texas, and colleagues. The findings underscore the importance of smoking cessation for this patient population, she told Medscape Medical News, even though it's unclear if there is a causal effect. "We don't know the cause. They may smoke more because of the pain," she said in an interview. However, studies also show that smoking has been known to increase certain types of pain such as back pain, and nerve pain, she added. "If we can motivate them to stop smoking, I think they're better off." The findings were presented here at the American Academy of Pain Medicine (AAPM) 28th Annual Meeting. Pain, Fatigue, Insomnia The study included 486 cancer patients (52% female), with a mean age of 55 years, who were referred to the Pain Management Center for uncontrolled pain. Ninety-four patients were smokers, and the rest (n = 356), classified as nonsmokers, were former smokers or never-smokers. The patients were diagnosed with a wide range of cancers, the most common being gastrointestinal (18.5%), followed by hematologic (15%) and head and neck cancer [...]

Oral Cancer Foundation News Team - A2012-02-26T09:23:53-07:00February, 2012|Oral Cancer News|

UPDATE 1-Swedish Match pushes ahead with snus in the U.S

Source: Reuters.com STOCKHOLM, Feb 22 (Reuters) - Tobacco products group Swedish Match will step up promotion of moist Swedish-style snuff, called snus, in the United States this year where it expect the market to grow faster than its Scandinavian home territory. Snus, a tobacco product put under the lip and sucked, mostly in pouches, is the group's main cash cow, sold mainly in Scandinavia. Swedish Match wants to differentiate itself in the larger U.S. market by growing sales of snus, which is pasteurized and has a different texture and taste to fermented U.S.-style snuff. "During 2012, we will continue to invest for growth. In the U.S. we will expand distribution and invest further in marketing activities ...," said Swedish Match, which is the largest producer of snus in Sweden. The product is banned in the rest of the European Union. Swedish Match, a rival to Altria Group Inc, Reynolds American Inc and BAT., also makes cigars. Marketing costs for snus in the U.S. weighed on fourth-quarter profit, the group said on Wednesday. Operating profit fell to 1.02 billion crowns ($153.6 million) from a year-earlier 1.42 billion, against a mean forecast for 1.03 billion in a Reuters poll of analysts. It said significantly higher international snus investments weighed on the profit margin for snuff and snus, which make up more than half of profit. The margin fell to 45.9 percent from 48.1 percent, well below a forecast for 47.6 percent. As well as aiming at the U.S. market, its venture with [...]

Charlotte Parker2012-02-24T10:27:50-07:00February, 2012|Oral Cancer News|

Timing of Post-TX Imaging Key in Head, Neck Cancer

Source: MedScape Today Summary The investigators report on a systematic review and meta-analysis of 51 studies involving 2335 patients with head and neck squamous cell carcinoma who underwent post-treatment or surveillance with 18F-fluorodeoxyglucose (FDG) PET or FDG-PET/CT. The random-effects model-weighted mean pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detection of residual disease at the primary tumor site were 79.9% (95% CI, 73.7%-85.2%), 87.5% (95% CI, 85.2%-89.5%), 58.6% (95% CI, 52.6%-64.5%), and 95.1% (95% CI, 93.5%-96.5%), respectively. The respective values for detection of residual post-treatment neck nodes were 72.7% (95% CI, 66.6%-78.2%), 87.6% (95% CI, 85.7%-89.3%), 52.1% (95% CI, 46.6%-57.6%), and 94.5% (95% CI, 93.1%-95.7%). In a subgroup analysis on timing of PET after completion of therapy, scans performed after 12 weeks had significantly higher diagnostic performance than scans done within 12 weeks, but only for residual neck nodes and not for residual disease at the primary tumor site. No statistically significant difference in diagnostic accuracy was noted between stand-alone PET and PET/CT. Viewpoint Well-performed systematic reviews and meta-analyses are important contributions to the literature.[1] In this meta-analysis, the diagnostic performance of dedicated PET and PET/CT with FDG was investigated by pooling the data from a relatively large cohort of patients with head and neck cancer who had been treated with chemoradiation. The pooled evidence demonstrated good diagnostic performance for FDG-PET and FDG-PET/CT, regardless of the type of scanner, with very high NPV but somewhat suboptimal PPV; this is due to the nonspecificity of FDG, [...]

Charlotte Parker2012-02-22T09:47:08-07:00February, 2012|Oral Cancer News|

Post-transplant head and neck tumors tallied

Source: www.familypracticenews.com Author: Damian McNamara, Family Practice News Digital Network Patients who have undergone solid organ transplantation are at greater risk for subsequent tumor development, and head and neck cancers can be particularly aggressive, according to results of a single-institution study. Dr. Robert H. Deeb and his associates at Henry Ford Hospital in Detroit studied 3,639 patients who underwent solid organ transplantation between January 1990 and December 2011. By retrospectively searching electronic medical records, they identified 95 people who developed cutaneous, salivary gland, or mucosal malignancies. They found a 2.1% incidence of cutaneous cancers and a 0.5% incidence of noncutaneous head and neck cancers in this population. Despite a relatively low overall 2.6% incidence, there are reasons for concern, Dr. Deeb said at the Triological Society’s Combined Sections Meeting, which was jointly sponsored by the Triological Society and the American College of Surgeons. When cutaneous cancers did occur, they were more aggressive and were associated with shorter 1-year survival rates. Henry Ford Transplant Institute maintains a noncutaneous tumor registry. This allowed the researchers to compare survival and other factors. Compared with the "nontransplant tumor registry in our institution, we found significantly fewer patients were alive at 1 year," Dr. Deeb said. Specifically, 55% of posttransplant patients with these cancers survived to 1 year, compared with 81% of nontransplant patients. There were no significant differences between groups in terms of age, sex, stage at diagnosis, or 5-year survival. More than half (52%) of the patients who developed skin cancers had multiple [...]

Oral Cancer Foundation News Team - A2012-02-19T11:10:20-07:00February, 2012|Oral Cancer News|

To see or not to see

Source: http://www.rdhmag.com/ Author: JoAnn R. Gurenlian From the National Journal fro Dental Hygiene Professionals: Allow me to relay the experience of a patient who has been through trying times lately. The patient is a middle-age female who noticed a small, firm swelling in the right submandibular region. She had never experienced this type of problem before, but since she had an upcoming visit with her family physician, she thought she would mention it. Her family provider told her it appeared to be a swollen lymph node and recommended she schedule an appointment with her dentist in the event that she had an oral infection. Being conscientious about health issues, this patient did have an examination with her dentist. He advised her that it was a swollen lymph node, but that there were no apparent oral health infections. He reviewed causes of swollen lymph nodes and felt that since she was asymptomatic; the node simply represented residual effects from a cold or allergy condition. Over the course of the next year, this patient presented on several occasions to both her family physician and dentist with concerns that the lymph node was getting larger. Both health care providers told her to “forget about it,” or “it was nothing.” She felt uncertain about both individuals at this point, but since they seemed to be in agreement that her condition “was nothing,” she heeded their advice. After several more months and with ever growing concern, the patient presented to her dentist again for further [...]

Oral Cancer Foundation News Team - A2012-02-19T11:00:56-07:00February, 2012|Oral Cancer News|