Oral Cancer News – Page 210 – The Oral Cancer Foundation News Archive

Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial

Source: www.thelancet.com Authors: Dr Christopher M Nutting FRCR et al. Background: Xerostomia is the most common late side-effect of radiotherapy to the head and neck. Compared with conventional radiotherapy, intensity-modulated radiotherapy (IMRT) can reduce irradiation of the parotid glands. We assessed the hypothesis that parotid-sparing IMRT reduces the incidence of severe xerostomia. Methods: We undertook a randomised controlled trial between Jan 21, 2003, and Dec 7, 2007, that compared conventional radiotherapy (control) with parotid-sparing IMRT. We randomly assigned patients with histologically confirmed pharyngeal squamous-cell carcinoma (T1—4, N0—3, M0) at six UK radiotherapy centres between the two radiotherapy techniques (1:1 ratio). A dose of 60 or 65 Gy was prescribed in 30 daily fractions given Monday to Friday. Treatment was not masked. Randomisation was by computer-generated permuted blocks and was stratified by centre and tumour site. Our primary endpoint was the proportion of patients with grade 2 or worse xerostomia at 12 months, as assessed by the Late Effects of Normal Tissue (LENT SOMA) scale. Analyses were done on an intention-to-treat basis, with all patients who had assessments included. Long-term follow-up of patients is ongoing. This study is registered with the International Standard Randomised Controlled Trial register, number ISRCTN48243537. Findings: 47 patients were assigned to each treatment arm. Median follow-up was 44·0 months (IQR 30·0—59·7). Six patients from each group died before 12 months and seven patients from the conventional radiotherapy and two from the IMRT group were not assessed at 12 months. At 12 months xerostomia side-effects were reported in [...]

Oral Cancer Foundation News Team - A2011-02-04T12:18:59-07:00February, 2011|Oral Cancer News|

Wrong way to go smoke-free

Source: Newsobserver.com By: Joseph G.L. Lee CHAPEL HILL -- So, now R.J. Reynolds Tobacco Company wants to help smokers "break free" from tobacco? That statement should make parents, health care providers and smokers nervous. Last month, Reynolds promoted its Camel Snus (a "spit-free" tobacco pouch) with advertisements in national magazines that read "If you've decided to quit tobacco use, we support you," under a large "2011 Smoke-free Resolution" banner. Reynolds then offered its smoke-free snus as the solution. For smokers, the majority of whom try to quit every year, the message should be to quit tobacco use, not to substitute one form of cancer for another. No safe form of tobacco use exists. Smokers who try tobacco snus products are at high risk of becoming addicted to both cigarettes and snus, thus continuing or even adding to their risk for lung, bladder, breast, cervical, oral and pancreatic cancer. In addition to running these misleading ads in People, Time and Rolling Stone, R.J. Reynolds is continuing a long-standing practice of targeting vulnerable populations such as young people, African-Americans and gays and lesbians. Last year, research in the medical journal Pediatrics implicated Reynolds' "Camel No. 9" campaign in an increase in smoking among young teenage girls. The tobacco industry has long targeted African-Americans by focusing on marketing and so-called "corporate social responsibility" strategies to buy favor with civil rights organizations. Researchers at the University of California, San Francisco estimated that the approximately $25 million in tobacco industry corporate philanthropy that funded African-American [...]

Oral Cancer Foundation News Team - A2011-02-03T12:09:00-07:00February, 2011|Oral Cancer News|

Jimmy Bradley is being treated for oral cancer

Source: NY Times Author: Sam Sifton Jimmy Bradley, the chef and an owner of the Red Cat and the Harrison, two restaurants in Manhattan, said he is recovering from oral cancer, and will not be moving forward with plans to open J & S Food Hall in the Nolitan Hotel. “It’s a bad break,” he said in a telephone interview on Tuesday morning, his voice only slightly thicker than its usual laconic drawl. “But long-term the prognosis is pretty good. I just think at this point the best thing for me is to concentrate on my health and on the livelihood of the 100 people I already have working for me, not on hiring 50 people for a new business.” Mr. Bradley, 43, said that in late October his dentist spotted a tumor in the center of his tongue. He sought four subsequent opinions from oncologists, and underwent surgery to remove the growth at Mount Sinai Medical Center in Manhattan on Nov. 17. Three days later, he said, he returned to the kitchen of the Harrison, where he had recently started cooking again. Radiation treatments for the cancer are ongoing. “I was super bummed for the first month or so,” Mr. Bradley said. He struggled to regain his ability to speak, and was terrified that he would lose his ability to taste. Some of his palate has already returned, he said. “Every day is a little better,” he said. “It’s like being a little kid and learning again what coffee tastes like, or [...]

Charlotte Parker2011-02-04T06:18:19-07:00February, 2011|Oral Cancer News|

Tobacco industry adapts to world of fewer smokers

Source: The Tennessean Author: Anita Wadhwani By any name or variety you choose — call it snuff, dip, chew or plug — smokeless tobacco is making a comeback, and Tennessee farmers, factory workers and consumers are playing a major role in the renewed buzz. Farmers here and in Kentucky who once made a good living off raising burley tobacco for cigarettes have had to eliminate 40 percent of acreage devoted to that crop as demand has declined, while farmers who cultivate the dark tobacco used for chewing have been able to expand their fields by 22 percent in three years. Now, the massive marketing muscle of the nation's biggest tobacco companies — Altria Group and its subsidiary Philip Morris USA, which owns the 100-year-old U.S. Smokeless Tobacco Co. factory within view of the state Capitol, and R.J. Reynolds, which runs its smokeless operations out of a Memphis factory — are battling for market dominance. Together, the two manufacturers already control 90 percent of the American smokeless tobacco sector with brands such as U.S. Smokeless' Skoal and R.J. Reynolds' Kodiak. They're competing with new fruit- and mint-flavored products (some packaged to look like miniature cigarette packs) to attract a new generation of consumers and entice ex-smokers looking for nicotine- infused alternatives. Former cigarette smokers like Dave Kenner, 31, a construction worker making a pit stop at a West Nashville convenience store last week, said he switched to Red Seal Wintergreen smokeless because heavily taxed cigarettes cost too much — nearly $300 [...]

Charlotte Parker2011-02-04T12:24:02-07:00February, 2011|Oral Cancer News|

New surgical approach can remove throat tumor and rebuild trachea

Source: www.news-medical.net Author: staff Using a novel surgical approach, it's possible to rebuild the trachea and preserve a patient's voice after removing an invasive throat tumor, according to a new report from Henry Ford Hospital in Detroit. This case study is the first of its kind to not only document a successful technique to create a fully functional trachea, or windpipe, but also report a rare type of malignant tumor in an adult's trachea. Most commonly, this type of tumor is seen in newborns and very rarely occurs in the neck, says lead study author Samer Al-Khudari, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford Hospital. "In this case, the patient's tumor had spread to the trachea, thyroid gland, muscles around the thyroid gland and nerves in the area," says Dr. Al-Khudari. According to head and neck cancer surgeon Tamer A. Ghanem, M.D., Ph.D., who led the Henry Ford surgical team, the easiest approach would have been to remove the trachea and the voice box, given the tumor's proximity to the larynx and other surrounding structures. With this method, however, the patient would no longer be able to speak or swallow normally. Instead, the surgical team took another approach. Using tissue and bone from the patient's arm, they were able to reconstruct the trachea, restoring airflow through the trachea and saving the patient's voice. "We had to think outside the box to not only safely remove the tumor, but to allow for optimum functional outcome," says [...]

Oral Cancer Foundation News Team - A2011-02-04T12:27:54-07:00January, 2011|Oral Cancer News|

Stephen Strasburg attempts to quit smokeless tobacco

Source: www.washingtonpost.com Author: Adam Kilgore Like any other high school kid, Stephen Strasburg wanted to emulate the major league baseball players he watched on television. He mimicked their actions down to the last detail. He rolled his pants up to reveal high socks, wore wristbands at the plate and, during downtime, opened tins of chewing tobacco and pinched some in his lower lip. Years later, having developed a powerful addiction, Strasburg regrets ever trying smokeless tobacco. Last fall, Tony Gwynn - his college coach at San Diego State and one of those players he grew up idolizing - began radiation treatments for parotid cancer, a diagnosis Gwynn blamed on using smokeless tobacco. In the wake of Gwynn's cancer diagnosis, Strasburg has resolved to quit smokeless tobacco while he recuperates from Tommy John surgery. He doesn't want to face the myriad health risks borne from tobacco use, and he doesn't want kids who want to be like him to see him with a packed lower lip. Strasburg conflates many activities with dipping, and he has yet to eradicate the habit. But he is determined he will. "I'm still in the process of quitting," Strasburg, 22, said. "I've made a lot of strides, stopped being so compulsive with it. I'm hoping I'm going to be clean for spring training. It's going to be hard, because it's something that's embedded in the game." Smokeless tobacco has long been entrenched in baseball. In the 1980s, wads of it bulged in batters' cheeks. More recently, [...]

Oral Cancer Foundation News Team - A2011-01-31T19:50:01-07:00January, 2011|Oral Cancer News|

Lightning rod for head and neck cancer

Source: www.physorg.com Author: staff They say lightning never strikes the same place twice—unless, of course, that place is a lightning rod. An enzyme called UROD acts like a lightning rod for cancer cells, drawing radiation and chemotherapy toward specific spots in diseased tissue, a new study in mice and humans reports in Science. The findings suggest that UROD—identified for the first time in this paper as a key player in human cancer--could help decrease treatment side effects for people with head and neck cancer, the eighth most common cancer worldwide. Despite many advances over the last few decades, the toxic side effects associated with current therapies have made for disappointing outcomes in many patients. Head and neck tumors are often found near critical organs, so destroying the diseased tissue is often a delicate challenge that could lead to life-threatening conditions. Here, Emma Ito and colleagues show that targeting UROD can selectively enhance the effects of radiation and chemotherapy in head and neck tumors, while minimizing toxicity to normal tissues. By focusing therapy toward specific parts of tissue, lower doses of radiation and chemotherapeutic drugs could potentially be administered to patients without compromising treatment efficacy. Uroporphyrinogen decarboxylase or UROD is an enzyme involved in the production of a molecule called heme, which is vital for all of the body's organs (though it is most abundant in the blood, bone marrow, and liver). Heme is an essential component of iron-containing proteins called hemoproteins, including hemoglobin, the protein that carries oxygen in the [...]

Oral Cancer Foundation News Team - A2011-01-31T19:39:01-07:00January, 2011|Oral Cancer News|

Lean body mass gain in patients with head and neck squamous cell cancer treated perioperatively with a protein- and energy-dense nutritional supplement containing eicosapentaenoic acid

Source: highwire.stanford.edu Author: HG Weed et al. Background: Cancer-associated weight loss may be mediated by an inflammatory response to cancer. Eicosapentaenoic acid (EPA) may suppress this response. Methods: Beginning no later than 2 weeks before surgery, patients with head and neck cancer and with weight loss, who were undergoing major resection with curative intent consumed a protein- and energy-dense nutritional supplement containing EPA from fish oil, in addition to usual diet or tube feed. Results: Thirty-one subjects consumed an average of 1.8 containers/day before surgery and 1.5/day during hospitalization (per container: 300 kilocalories, 16 grams (g) protein, 1.08 g EPA). Seventy percent of subjects maintained or gained weight before hospital admission. Mean weight gain was 0.71 kg at admission and 0.66 kg at discharge. At discharge lean body mass increased by 3.20 kg (p

Oral Cancer Foundation News Team - A2011-01-31T19:30:59-07:00January, 2011|Oral Cancer News|

Reducing xerostomia through advanced technology

Source: The Lancet Oncology Radiation-related xerostomia has been the most significant and disabling side-effect of radiotherapy for head and neck cancer for more than 50 years. With the PARSPORT trial, reported in The Lancet Oncology, the largest and best designed of several randomised trials focusing on xerostomia, radiation oncologists and their partners in physics and dosimetry should take pride that significant progress has been made. Before the introduction of intensity-modulated radiotherapy (IMRT), more than 80% of survivors experienced substantial dry mouth syndrome and associated effects on dental health, swallowing, taste, and quality of life. By contrast, Nutting and colleagues report about 25% of 2-year survivors had significant clinician-rated xerostomia. Taken together with two randomised trials of IMRT for nasopharyngeal cancer, there is now compelling evidence of the power of advanced technology in reducing toxicity from head and neck radiotherapy. Can even better use of technology help us to further reduce xerostomia? The parotid glands provide watery saliva during eating, which is largely replaceable by consuming more water or lubricants. The submandibular, sublingual, and minor salivary glands provide mucinous saliva, associated with the resting sense of moisture and dry mouth symptoms. Future work should systematically explore the prioritisation of different components of the salivary gland system. A clinical benefit from sparing the submandibular glands may be seen, beyond that seen by sparing the parotid glands. The mean dose delivered to the minor salivary glands within the oral cavity has also been reported to be a significant factor in patient-reported xerostomia. Further possibilities include gland repair [...]

Oral Cancer Foundation News Team - A2011-01-31T14:08:42-07:00January, 2011|Oral Cancer News|

Detection of squamous cell carcinoma and corresponding biomarkers using optical spectroscopy

Source: oto.sagepub.com Author: H. Wolfgang Beumer, MD et al. Objectives: Investigate the use of optical reflectance spectroscopy to differentiate malignant and nonmalignant tissues in head and neck lesions and characterize corresponding oxygen tissue biomarkers that are associated with pathologic diagnosis. Study Design: Cross-sectional study. Setting: Tertiary Veterans Administration Medical Center. Subjects and Methods: All patients undergoing panendoscopy with biopsy for suspected head and neck cancer were eligible. Prior to taking tissue samples, the optical probe was placed at 3 locations to collect diffuse reflectance data. These locations were labeled “tumor,” “immediately adjacent,” and “distant normal tissue.” Biopsies were taken of each of these respective sites. The diffuse reflectance spectra were analyzed, and biomarker-specific absorption data were extracted using an inverse Monte Carlo algorithm for malignant and nonmalignant tissues. Histopathological analysis was performed and used as the gold standard to analyze the optical biomarker data. Results: Twenty-one patients with mucosal squamous cell carcinoma of the head and neck were identified and selected to participate in the study. Statistically significant differences in oxygen saturation (P = .001) and oxygenated hemoglobin (P = .019) were identified between malignant and nonmalignant tissues. Conclusion: This study established proof of principle that optical spectroscopy can be used in the head and neck areas to detect malignant tissue. Furthermore, tissue biomarkers were correlated with a diagnosis of malignancy. Authors: 1. H. Wolfgang Beumer, MD1 2. Karthik Vishwanath, PhD2 3. Liana Puscas, MD1,3 4. Hamid R. Afshari, DDS5 5. Nimmi Ramanujam, PhD2 6. Walter T. Lee, MD1,3 Authors' [...]

Oral Cancer Foundation News Team - A2011-01-29T11:07:44-07:00January, 2011|Oral Cancer News|