Oral Cancer News – Page 194 – The Oral Cancer Foundation News Archive

Palifermin Decreases Severe Oral Mucositis of Patients Undergoing Postoperative Radiochemotherapy for Head and Neck Cancer: A Randomized, Placebo-Controlled Trial

Source: Journal of Clinical Oncology Purpose: Radiochemotherapy of head and neck cancer causes severe mucositis in most patients. We investigated whether palifermin reduces this debilitating sequela. Methods: We conducted a multicenter, double-blind, randomized, placebo-controlled trial in 186 patients with stages II to IVB carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx. Patients received 60 or 66 Gy after complete (R0) or incomplete resection (R1), respectively, at 2 Gy/fraction and five fractions per week. Cisplatin 100 mg/m2 was administered on days 1 and 22 (and on day 43 with R1). Patients were randomly assigned to receive weekly palifermin 120 μg/kg or placebo from 3 days before and continuing throughout radiochemotherapy. Trained evaluators performed oral assessments twice weekly. The primary end point was the incidence of severe oral mucositis (WHO grades 3 to 4). Overall survival and time to locoregional progression were also assessed. Analysis was by intention to treat. Results: Severe oral mucositis was seen in 47 (51%) of 92 patients administered palifermin and 63 (67%) of 94 administered placebo (P = .027). Palifermin decreased the duration (median, 4.5 v 22.0 days) and prolonged the time to develop (median, 45 v 32 days) severe mucositis. Neither patient-reported mouth and throat soreness scores nor treatment breaks differed between treatment arms. After median follow-up of 32.8 months, 23 deaths (25%) had occurred in both treatment arms, and disease had recurred in 25 (27%) and 22 (24%) of palifermin- and placebo-treated patients, respectively. Conclusion: Palifermin reduced the occurrence of severe oral mucositis in [...]

Oral Cancer Foundation News Team - A2011-06-14T09:57:52-07:00June, 2011|Oral Cancer News|

Certain head and neck cancer patients benefit from second round of treatment

Source: www.eureka.org Author: press release A new study has determined predictors that can better identify patients who will benefit from a potentially toxic second course of treatment, which offers a small but real chance of cure in select patients with head and neck cancer. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings could help guide treatment decisions for head and neck cancer patients. Radiation is often used to treat patients with head and neck cancer. If their cancer reappears, they have limited treatment choices: chemotherapy is not curative, and surgery can be curative but is often not possible. Chemotherapy and a second course of radiation have previously been shown to be another option. Joseph Salama, MD, formerly of the University of Chicago, and his colleagues conducted an analysis of prior studies to determine how patients tolerate this second round of treatment and which patients benefit the most from it. The investigators analyzed data from 166 patients with head and neck cancer who received a first round of radiation followed by a second round plus chemotherapy because their cancer recurred or they developed a new tumor. The second course of treatment could cure approximately 25 percent of patients at two years, but it was quite toxic. (Some patients lost the ability to speak or swallow. In addition, approximately 20 percent of patients died from treatment-related complications.) Certain patients benefited from the treatment over others. Those who were cancer-free for a longer period of time, [...]

Oral Cancer Foundation News Team - A2011-06-13T21:30:52-07:00June, 2011|Oral Cancer News|

Is there a relationship between coffee and tea intake and head and neck cancers?

Source: EBD- Evidence Based Dentistry Data sources Pooled individual-level data from nine case–control studies of head and neck cancers, including 5,139 cases and 9,028 controls. Study selection Nine case-control studies were selected from the International Head and Neck Cancer Epidemiology (INHANCE) consortium pool of 33 studies, which included information on coffee (caffeinated and decaffeinated) and tea drinking and cancer of the oral cavity and pharynx. Seven studies also included information on laryngeal cancer. Data extraction and synthesis Data from individual studies were checked for inconsistencies and pooled in a standardised way into a common database, including a range of sociodemographic, behavioural, lifestyle and health information. Data on consumption across studies were then converted into cups of de/caffeinated tea or coffee per day. The association between head and neck cancers and caffeinated coffee, decaffeinated coffee or tea intake was assessed by estimating the odds ratios (OR) and the corresponding 95% confidence intervals (95% CI) using a two-stage random-effects logistic regression model with the maximum likelihood estimator. Pooled ORs were also estimated with a fixed-effects logistic regression model. In addition, a test for heterogeneity among studies was conducted. Results Caffeinated coffee intake was inversely associated with the risk of cancer of the oral cavity and pharynx: the ORs were 0.96 (95% CI, 0.94–0.98) for an increment of one cup per day and 0.61 (95% CI, 0.47–0.80) in drinkers of >4 cups per day versus non-drinkers. This latter estimate was consistent for different anatomic sites (OR, 0.46; 95% CI, 0.30–0.71 for oral cavity; [...]

Oral Cancer Foundation News Team - A2011-06-13T09:58:16-07:00June, 2011|Oral Cancer News|

Targeting Cancer Treatment

Source: Medical News Today Cancer treatment is depending more and more today on specific factors of a patient's tumor, including gene mutations, or proteins that are commonly typical of certain cancer cells, rather than focusing on where in the body the cancer started. Before, treatment was based on finding where in the body the cancer originated, such as the breast or lung. Targeted therapy is all about the cancer's genes, tissue environment that contributes the tumor's growth and survival, and its proteins. Nowadays, cancer therapy is designed to interfere with a signal that tells the cancer cells not to die or tells it to divide, while before, chemotherapies had the goal of interfering with cancer cells as division was already underway, when the cells were dividing into new ones. The human body is made of various types of cells, including skin cells, brain cells, or blood cells. Each one has a specific function. Cancer occurs when healthy cells change and start growing out of control; they eventually form a tumor - a mass. A benign tumor is noncancerous, whereas a malignant one is cancerous, it can spread to other parts of the body. Cancer cells either divide too quickly or do not die when they should do Specific genetic mutations within a cell change the way it behaves. When the genes that control cell division mutate (change), they can multiply too quickly; the cell has become cancerous. Cells are genetically programmed to die, when the specific genes that tell the [...]

Oral Cancer Foundation News Team - A2011-06-13T09:47:33-07:00June, 2011|Oral Cancer News|

Study Confirms Major Side Effects Years After Cancer Treatment

Source: Medical News Today When people finish treatment for cancer, they want to bounce back to their former vital selves as quickly as possible. But a new Northwestern Medicine study - one of the largest survivor studies ever conducted - shows many survivors still suffer moderate to severe problems with pain, fatigue, sleep, memory and concentration three to five years after treatment has ended. "We were surprised to see how prevalent these symptoms still are," said study co-investigator Lynne Wagner, an associate professor of medical social sciences at Northwestern University Feinberg School of Medicine and a clinical health psychologist at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. "This is one of the first looks at what's really happening for survivors in terms of symptoms and treatment among community-based treatment settings across the U.S." The persistent pain in survivors who are cancer-free and no longer receiving any treatment is particularly puzzling, Wagner noted, because good treatment exists. "It seems we haven't come a long way in managing pain despite a lot of medical advances, " she said. "This is eye opening. It tells us we need to be better in clinical practice about managing our survivors' pain." Wagner presented the findings June 4 at the 2011 American Society of Clinical Oncology Annual Meeting in Chicago. Sunday is National Cancer Survivors Day. Cancer survivors seem to slip through the cracks in healthcare in terms of getting treatment for their pain and other symptoms. "We don't have a great system [...]

Oral Cancer Foundation News Team - A2011-06-13T09:33:38-07:00June, 2011|Oral Cancer News|

Head and Neck Cancer Patients Benefit in Multidisciplinary Clinics

Source: Journal of Clinical Oncology Head and neck cancer (HNC) is a multidisciplinary condition. Multi-modality treatment is standard, especially the use of chemoradiation. Proper imaging (CT, MRI and PET), more accurate pathologic assessment and thoroughly tailored treatment plans that limits radiation fields and doses and take into consideration surgical options that minimize morbidity (endoscopic and robotic procedures) are essential. Furthermore, dental, swallowing, speech, nutritional, financial and social support are also cornerstones in this comprehensive approach. However, the most important function might be the role of the nurse navigator in order to offer true coordinated care for our patients. Within William Beaumont Oncology Network we initiated multi-disciplinary clinics for HNC in January 2010 in which our specialists meet the patients together after discussion at the tumor board to streamline management. Methods: In this initial analysis we studied 15 randomly chosen patients’ way through our health care system in 2009, and compared with 15 randomly chosen patients in 2010, after the initiation of the Multi-Disciplinary Clinic. All patients had biopsy verified HNC, the vast majority being squamous cell carcinomas, and were stage III or stage IV. The radiation techniques were unchanged during study and treating physicians remained the same as well. Results: The first group of patients that did not go through our multi-disciplinary clinic had a mean time of 59 days (range 4-156) from pathologic diagnosis to start of radiation. Corresponding mean time for patients going through the multi-disciplinary clinics was 33 days (range 18-86), a decrease of 44%. Conclusions: Coordinated [...]

Oral Cancer Foundation News Team - A2011-06-13T09:22:14-07:00June, 2011|Oral Cancer News|

New Legislation may Weaken FDA’s Regulation of Cigarettes

Source: The Los Angeles Times The U.S. Food and Drug Administration barely had time to start regulating cigarettes before legislation was introduced to weaken its authority. The Family Smoking Prevention and Tobacco Control Act was passed in 2009 with sweeping majorities in both houses; its primary goal was to reduce the terrible toll that smoking takes on Americans' health, especially by discouraging young people from taking up the habit. The law gave the FDA the authority to regulate the advertising and packaging of cigarettes, along with ingredients such as nicotine and flavorings that affect how easily the public is drawn into smoking and how addictive the habit is once started. As required in the law, for example, the FDA banned candy flavorings in cigarettes, which make the product more appealing to underage smokers and young adults. But now that the agency is taking meaningful steps against smoking, Rep. Denny Rehberg (R-Montana) has added an amendment to the agriculture appropriations bill that would restrict the FDA's authority over cigarettes and a host of other matters. Currently, the FDA is considering whether to ban one of the most popular and profitable ingredients — menthol — but Rehberg's amendment would keep it from taking that action. No longer would the FDA be able to consider a substance's tendency to attract smokers or make cigarettes more addictive. Rather, the FDA could only ban or limit ingredients that are found to make the cigarette physically more harmful than existing products. Menthol has not been found [...]

Oral Cancer Foundation News Team - A2011-06-09T09:58:11-07:00June, 2011|Oral Cancer News|

New Strategies used to Identify Changes in Head and Neck Cancers

Source: GenomeWeb Daily News By Andrea Anderson CHICAGO– Researchers are making progress using high-throughput strategies to find previously unappreciated genetic and epigenetic quirks in head and neck cancer — including changes that may prove useful for diagnosing and tracking disease. Johns Hopkins University head and neck cancer research director David Sidransky described some of the work during an education session on molecular biology, targets, and pathways involved in head and neck cancer at the American Society of Clinical Oncology annual meeting here yesterday. Speaking during the same session, JHU oncologist Christine Chung and the University of Chicago's Ezra Cohen touched on strategies for targeting the types of mutations previously reported in head and neck cancer and the rationale behind targeted therapeutics already being tested or considered for the disease, respectively. Past studies have uncovered muted DNA methylation across the genomes of several cancer types, Sidransky explained, though methylation is also bumped up at specific sites in certain tumor types. Consequently, he said, researchers are using strategies such as real-time quantitative methylation-specific PCR (real-time QMSP) to look at methylation shifts in head and neck squamous cell carcinoma. In particular, he described work comparing methylation patterns in saliva and serum samples from individuals with HNSCC to those in samples from more than 800 apparently healthy individuals who are considered 'at-risk' of the disease because of smoking status and other exposures. At least two genes — KIF1A and EDNRB — seem to be more highly methylated in samples from those with HNSCC than [...]

Oral Cancer Foundation News Team - A2011-06-08T09:14:07-07:00June, 2011|Oral Cancer News|

HPV related oral cancers continue to increase in the US

Source: International Medicine News CHICAGO – Human papillomavirus infection was firmly linked to the recent rise in oropharyngeal cancers in the United States, based on data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. If current trends continue, the incidence of HPV-related oral cancers will soon surpass that of cervical cancers, senior author Dr. Maura Gillison reported at the annual meeting of the American Society of Clinical Oncology. The incidence of HPV-positive oropharyngeal cancers increased 225% – from 0.8 per 100,000 to 2.8 per 100,000 – between 1988 and 2004, the researchers found. At the same time, the incidence rate for HPV-negative oropharyngeal cancers, which are strongly related to tobacco and alcohol use, declined by 50% – from 2.0 per 100,000 to 1.0 per 100,000. Consequently, the overall incidence of oropharyngeal cancers increased 28%. Even by the conservative estimate that 70% of oropharyngeal cancers in 2020 will be HPV positive, the annual number of HPV-positive oral squamous cell carcinomas (8,653 cases) is expected to surpass cervical cancers (7,726 cases). Further, the majority will occur among men (7,426 cases), said Dr. Gillison, a medical oncologist and the Jeg Coughlin Chair in Cancer Research at Ohio State University Comprehensive Cancer Center in Columbus. Changes in sexual behavior among recent birth cohorts and increased oral HPV exposure probably influenced the increases in incidence and prevalence, Dr. Gillison speculated. Having a high lifetime number of sexual partners is a known risk factor for HPV infection. Although the rise in oral cancers [...]

Oral Cancer Foundation News Team - A2011-06-06T10:23:24-07:00June, 2011|Oral Cancer News|

Cellular p16 localization and survival outcomes in head and neck cancer.

Source: ASCO.org Background: Head and neck squamous cell carcinoma (HNSCC) constitutes approximately 3-5 percent of all cancers. Recent data suggest an increasing incidence rate among younger people who are often non-smokers and non-drinkers, which are believed to be caused by human papillomavirus (HPV) infection. HPV positive tumors are typically found in the oropharynx and have better response to treatment and better disease outcome despite more advanced nodal stages. Therefore, HPV-positive HNSCCs represent a unique clinical subgroup with a separate tumor entity. Methods: Patients treated for HNSCC from 2002 to 2006 at UNC hospitals and had banked tissue available were eligible for this study. Tissue microarrays (TMA) were generated in triplicate. Immunohistochemical (IHC) staining for p16 was performed and scored separately for nuclear staining and cytoplasmic staining. Human papilloma virus (HPV) staining was also carried out using monoclonal antibody E6H4. P16 expression, HPV status and other clinical features were correlated with progression-free (PFS) and overall survival (OS). Results: 135 patients had sufficient sample for this analysis. Median age of diagnosis was 57 years (range 20-82), with 68.9% males, 8.9% never smokers and 32.6 % never drinkers. 3 year OS rate and PFS rate was 63.0% and 54.1% respectively. Based on the p16 staining score, patients were divided into three groups: high nuclear any cytoplasmic staining group (HNAC), low nuclear low cytoplasmic staining group (LNLC) and low nuclear high cytoplasmic staining group (LNHC). HNAC and LNLC groups had significantly better overall survival than LNHC groups with hazard ratios of 0.01 and 0.37 [...]

Oral Cancer Foundation News Team - A2011-06-03T12:35:21-07:00June, 2011|Oral Cancer News|