What is the role of a Speech Language Pathologist in an acute care setting?

Source: www.lhsc.on.ca Author: London Health Sciences Centre A Speech Language Pathologist (S-LP) assesses and manages swallowing and communication. Since these activities are performed by the same set of muscles, an S-LP is able to provide support for both functions. Communication functions include speech, voice, language, and cognitive-communication. S-LPs support expressive abilities (verbal and non-verbal communication) as well as receptive abilities (understanding what other people are saying). We provide low-tech and high-tech communication aids when appropriate, or refer to community services to support as needed. For swallowing, S-LPs help patients with the ability to consume solids and liquids safely and efficiently when experiencing difficulties with the muscles that support this function. “We focus on the quality of life of the patient and do our best to optimize and maximize their abilities in swallowing or communication or both,” explains Suzie Fox, Speech Language Pathologist at London Health Sciences Centre (LHSC). “We work with the patient and take into account their values and wishes so they are able to get the most out of what they eat and drink and how they communicate once they return home.” How can someone lose communication and swallowing functions? A number of conditions may impact swallowing or communication because of changes to our muscles for speaking/eating or the respiratory system. Some examples include: Neurological conditions: stroke, brain injury or tumours, or neuromuscular diseases. Medical conditions: dementia, COPD, congestive heart failure. Surgery: head and neck, esophageal, orthopedic, facial and head trauma, transplant. Cancer: head and neck cancer, brain [...]

First patient dosed with new treatment for breast cancer and other tumors in clinical trial

Source: www.curetoday.com Author: Alex Biese The first patent has been dosed in a clinical trial evaluating a new treatment for breast cancer and other solid tumors. Work is underway on a phase 1/2 trial evaluating STX-478 — an oral drug that can penetrate into the central nervous system (CNS) and inhibit mutant phosphoinositide-3-kinase alpha (PI3Kα) — as a monotherapy for tumors including breast and gynecological cancers and head and neck squamous cell carcinoma (HNSCC), as well as a monotherapy and in combination with approved agents in patients with HR+/HER2- breast cancer, according to a May 2 news release from Scorpion Therapeutics, Inc., the manufacturer behind the novel drug. With approximately 160 participants, all 18 or older with advanced solid tumors, the study launched in April. It is expected to be completed by June 2026, with the aim of evaluating the safety, tolerability, pharmacokinetics (the activity of drugs in the body) and preliminary antitumor activity of STX-478. The trial, per the announcement from Scorpion, is working to determine the safety profile of STX-478 and establish a maximum tolerated does as well as a lower optimal-biologically active dose, if appropriate, as a recommended phase 2 dose as a monotherapy for breast cancer and other solid tumor types, as well as a combination agent in PI3Kα-mutant HR+/HER-2- breast cancer. Scorpion plans to then evaluate STX-478 as a monotherapy treatment for patients with solid tumors with PI3Kα-mutations including breast cancer, gynecological cancers, HNSCC and gastrointestinal cancers. Secondary trial objectives include evaluating the pharmacokinetic profile, [...]

California bill would mandate HPV vaccine for incoming college students

Source: www.cancerhealth.com Author: Rachel Scheier and KFF Health News When she was a college freshman, Joslyn Chaiprasert-Paguio was told by a doctor she had a common sexually transmitted infection called the human papillomavirus but not to worry. Four years later, a few days before her wedding, she was diagnosed with cervical cancer, which caused complications when she became pregnant. She had a hysterectomy eight years later, after the disease returned in 2021. The 38-year-old medical journal editor of Menifee in Riverside County, California, hadn’t been immunized as a teenager because there wasn’t yet a vaccine for HPV, which causes nearly all cervical cancers and a handful of other potentially lethal forms of the disease in men and women. Now, her 10-year-old daughter, Samantha, is scheduled to get her first shot this month. “This is the only vaccine that prevents cancer,” Chaiprasert-Paguio said. [Editor’s note: The hepatitis B vaccine prevents liver cancer.] A bill pending in the California legislature would require schools to notify parents that their kids are expected to be vaccinated for HPV before entering eighth grade, as part of a push to get more children inoculated against the cancer-causing strains of the virus, theoretically before they become sexually active. AB 659 stops short of mandating the vaccine for middle schoolers, as the bill originally proposed. Lawmakers stripped out that provision without any debate, reflecting the contentious nature of school vaccine mandates even in a state with some of the nation’s strictest immunization laws. “Now is a tough time [...]

These microbes found in tumours promote cancer. What if we just kill them?

Source: www.nationalgeographic.co.uk Author: Sanjay Mishra An unfathonable number of bacteria, live in and on our bodies; most providing some benefits. Now researchers have discovered that some species of bacteria are actually protecting cancer cells. This finding could inspire new strategies to fight cancer.Photograph by illustration by Russell Kightley, Science Photo Library Most bacteria living in the human body help us thrive, but recent studies show that some infiltrate tumours, helping them grow, spread, and become more difficult for the immune system to destroy. The human body contains 100 trillion or so microbial cells, almost as many, if not more, than the number of human cells in the body. Bacteria make up most of this microbiome, living in our gut, on our skin, in the respiratory and urogenital tracts, and in mammary glands. A number of recent studies have revealed that bacteria are also present in a wide variety of tumours, where they live not only between cells but even inside them. The bacteria were thought to be taking advantage of a favourable growing environment; scientists had no idea whether these microbes could alter cancer prognosis. Now a study published recently in Nature shows that bacteria in oral and colorectal tumors can directly promote cancer by suppressing the human immune response and helping cancer cells spread more rapidly. An accompanying study published in the journal Cell Reports finds that some anticancer drugs, such as 5-fluorouracil, may be effective because they also kill the bacteria which help the tumour develop. [...]

5 major risk factors for head and neck cancers are within your control

Source: news.llu.edu Author: Lisa Aubry, Loma Linda University Health While head and neck cancers represent a broad category for numerous cancers, a set of five controllable risk factors contribute to most head and neck cancers, says Jared Inman, MD, a head and neck surgical oncologist at Loma Linda University Health. For April’s Head and Neck Cancer Awareness Month, Inman outlines how reducing these five risks in your life can help prevent head and neck cancers. Head and neck cancers, those cancers occurring above the shoulder bones not including brain cancers, occur in the voice box, throat, tongue, mouth, sinus, nose, ear, eyes, as well as other places. Squamous cell cancers are by far the most common types of head and neck cancers, says Inman, and can happen in any location of the head and neck. Therefore, the risk factors and Inman's prevention tips pertain especially to squamous cell cancers. TOBACCO AND ALCOHOL Tobacco, which includes secondhand smoke and smokeless tobacco, is the number one stand-alone risk factor for head and neck cancers, Inman says, with alcohol consumption a close runner-up. Additionally, he says combined tobacco and alcohol use places people at a greater risk of developing these cancers than those who use tobacco or alcohol alone. Most head and neck squamous cell carcinomas of the mouth and voice box are caused by tobacco and alcohol use, according to the National Cancer Institute. “Head and neck cancers are almost always tied to smoking and drinking alcohol,” says Inman. Quitting smoking and [...]

I blamed my ulcers on college stress — until my tongue was removed

Source: nypost.com Author: Brooke Steinberg A college student with ulcers blamed it on stress from exams — but ended up needing to have the majority of her tongue removed and then reconstructed when it turned out to be cancer. Rachel Morton from Edinburgh, Scotland, started noticing ulcers on her tongue in 2019, and initially thought they were a result of stress. “When I’m a bit tired, run down or stressed with exams I seem to be a bit prone to ulcers anyway, so I kind of just put it down to that and starting university,” Morton explained. “I went to the doctor and I’d been given some pain relief tablets, Bonjela and stuff like that.” But after a year, her condition worsened. “I still had them a year later but I wasn’t too worried about it. I had so much other stuff going on in my life and it wasn’t really at the forefront of my mind,” she told Kennedy News and Media. “At the start it was a couple of ulcers, but over the course of a year they got bigger and spread, and covered the whole side of my tongue. They were really red, raw and painful.” Rachel Morton ended up needing to have her tongue removed and reconstructed when her ulcers turned out to be cancer. Kennedy News and Media Morton, now 21, was also experiencing strange symptoms such as extreme tiredness; dry, red and swollen lips; tonsil aches; and abnormal feeling in the left [...]

FDA grants fast track designation to RRx-001 for severe oral mucositis in head and neck cancer

Source: www.onclive.com Author: Chris Ryan The FDA has granted a fast track designation to RRx-001 for the prevention and attenuation of severe oral mucositis associated with chemotherapy and radiation in patients with head and neck cancer, according to a news release from EpicentRx.1 RRx-001, a direct NLRP3 inhibitor and Nrf2 upregulator with anti-inflammatory and antioxidant properties, is also under investigation for the treatment of small cell lung cancer. “The fast track designation is great news for EpicentRx, and it puts us one step closer to a potential treatment for this critical unmet need of oral mucositis with RRx-001,” Tony Reid, MD, PhD, chief executive officer of EpicentRx, stated in a news release. Investigators previously evaluated RRx-001 in the phase 2a PREVLAR trial (NCT03515538). The study evaluated the agent’s efficacy and feasibility in mitigating severe oral mucositis in patients with head and neck cancers who were receiving chemoradiation.2 Findings showed that in patients who experienced severe oral mucositis in the 3 RRx-001 treatment arm, the median duration of severe oral mucositis was 8.5 days, 17 days, and 10 days, in arms 1, 2, and 3 respectively, compared with 24 days in the control arm. When accounting for patients who did not experience severe oral mucositis, the median duration of severe oral mucositis was 5 days for patients in arm 1, 13.5 days for arm 2, 8 days in arm 3, and 18 days in the control arm. The trial enrolled patients at least 18 years of age with pathologically diagnosed stage [...]

HPV testing, p16 IHC may be needed for oropharyngeal cancer trials

Source: www.cancernetwork.com Author: Russ Conroy Human papillomavirus and p16 discordance may correlate with a worse prognosis for oropharyngeal cancer, according to data from an individual patient data analysis. Patients with discordant p16-negative, human papillomavirus (HPV)–positive or p16-positive, HPV-negative oropharyngeal cancer had a significantly worse prognosis compared with patients who had p16-positive and HPV-positive disease and a better prognosis compared with those who have p16-negative and HPV-negative disease. The data suggest the need for routine p16 immunohistochemistry and mandated HPV testing in clinical trials for oropharyngeal cancer, according to findings from the HNCIG-EPIC-OPC individual patient data analysis. The 5-year overall survival (OS) rate was 81.1% (95% CI, 79.5%-82.7%) for patients with p16-positive, HPV-positive disease; 40.4% (95% CI, 38.6%-42.4%) for those with p16-negative, HPV-negative disease; 53.2% (95% CI, 46.6%-60.8%) for those with p16-negative, HPV-positive disease; and 54.7% (95% CI, 49.2%-60.9%) for those with p16-positive, HPV-negative disease. Additionally, 5-year disease-free survival (DFS) was 84.3% (95% CI, 82.9%-85.7%), 60.8% (95% CI, 58.8%-62.9%), 71.1% (95% CI, 64.7%-78.2%), and 67.9% (95% CI, 62.5%-73.7%) for each respective patient group. Investigators of this multi-center, international individual patient data analysis included retrospective and prospective cohorts with a minimum size of at least 100 patients with primary squamous cell carcinoma of the oropharynx. Patients underwent cross-sectional imaging; histological confirmation by biopsy; and treatment with surgery, radiotherapy, chemotherapy, or combination therapy for oropharyngeal cancer. The primary end points of the analysis included OS, DFS, and the proportion of patients in the overall cohort who showed different p16 and HPV result combinations. [...]

New immunotherapy strategies in targeting complexity in the tumor microenvironment

Source: medicalxpress.com Author: International Association for Dental Research A symposium aiming to provide a better understanding of the tumor microenvironment, immune tolerogenic niches at cancer initiation, and novel immunotherapeutic strategies in head and neck cancer patients was featured at the 52nd Annual Meeting & Exhibition of the AADOCR, held in conjunction with the 47th Annual Meeting of the CADR. The AADOCR/CADR Annual Meeting & Exhibition took place at the Oregon Convention Center in Portland on March 15-18, 2023. Cancer immunotherapy has arisen as a promising new treatment modality for head and neck cancer (HNC), built on an increased understanding of tumor immunology over the last two decades. However, it has become clear that not all tumors are created equal when it comes to their immune profiles, and many are resistant to immunotherapy. Thus, there is a need to better understand the complex tumor microenvironment to more accurately determine prognosis and design therapeutic strategies capable of rendering tumors susceptible to immunotherapy and the immunologic effects of conventional therapies. Organized by Simon Young of the University of Texas Health Science Center at Houston, this symposium provided a high-level overview of exciting developments in understanding the tumor microenvironment, both in terms of the complex immunosuppressive mechanics of the extracellular matrix, the creation of an immune tolerogenic niche at cancer initiation, and how novel immunotherapeutic strategies can target the adverse the tumor immune microenvironment in head and neck cancer. A broad spectrum of expertise was represented by featured clinician-scientist speakers: topics included current challenges [...]

Can lymph nodes boost the success of cancer immunotherapy?

Source: medicalxpress.com Author: from University of California, San Francisco Cancer treatment routinely involves taking out lymph nodes near the tumor in case they contain metastatic cancer cells. But new findings from a clinical trial by researchers at UC San Francisco and Gladstone Institutes shows that immunotherapy can activate tumor-fighting T cells in nearby lymph nodes. The study, published in Cell, suggests that leaving lymph nodes intact until after immunotherapy could boost efficacy against solid tumors, only a small fraction of which currently respond to these newer types of treatments. Most immunotherapies are aimed only at reinvigorating T cells in the tumor, where they often become exhausted battling the tumor's cancer cells. But the new research shows that allowing the treatment to activate the immune response of the lymph nodes as well can play an important role in driving positive response to immunotherapy. "This work really changes our thinking about the importance of keeping lymph nodes in the body during treatment," said Matt Spitzer, Ph.D., an investigator for the Parker Institute for Cancer Immunotherapy and Gladstone-UCSF Institute of Genomic Immunology and senior author of the study. Lymph nodes are often removed because they are typically the first place metastatic cancer cells appear, and without surgery, it can be difficult to determine whether the nodes contain metastases. "Immunotherapy is designed to jump start the immune response, but when we take out nearby lymph nodes before treatment, we're essentially removing the key locations where T cells live and can be activated," Spitzer said, [...]

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