Neck response to chemoradiotherapy

Source: Arch Otolaryngol Head Neck Surg. 2009;135(11):1133-1136 Author: Alexander Langerman, MD et al. Complete Radiographic Response Correlates With Pathologic Complete Response in Locoregionally Advanced Head and Neck Cancer Objective: The role of neck dissection following chemoradiotherapy (CRT) for locoregionally advanced head and neck cancer is an area of active debate. Patients who have a complete radiographic response may not need dissection, and the extent of neck dissection necessary for those patients with residual disease is unclear. Design: Retrospective review of data from a prospectively collected database of patients with locoregionally advanced head and neck cancer treated as part of a phase 2 study of induction chemotherapy followed by concurrent CRT. The results of post-CRT neck computed tomography (CT) imaging and pathologic analysis of the neck dissection specimens were compared to evaluate correlation between radiographic and pathologic response. Results: Forty-nine patients underwent 61 hemineck dissections. Overall, 209 neck levels were dissected. Radiologic complete response in the neck was achieved in 39 patients, all of whom had pathologic specimens negative for tumor cells. Ten patients (20%) had a total of 14 neck levels with residual disease on CT imaging. Five (50%) of these 10 patients were found to have residual tumor cells on pathologic analysis. Tumor cells were contained only to those levels found positive on CT imaging; they were present in 7 (50%) of the 14 positive levels. Conclusions: Neck levels with residual disease on post-CRT CT imaging warrant removal. However, neck levels without evidence of disease on post-CRT CT imaging [...]

2009-11-17T19:34:20-07:00November, 2009|Oral Cancer News|

Erbitux recognized by ASCO as a 2009 major cancer advance as first SCCHN treatment to improve survival in 30 years

Source: www.vwd.de Author: press release The American Society of Clinical Oncology (ASCO) has once again recognized Erbitux® (cetuximab) as one of the major clinical cancer advances of 2009. This year Erbitux was selected by ASCO for providing the first significant increase in survival for 30 years in the treatment of patients with first-line recurrent and/or metastatic squamous cell carcinoma of the head and neck(SCCHN).1 ASCO Clinical Advances Report1 The ASCO report, ‘Clinical Cancer Advances 2009: Major Research Advances in Cancer Treatment, Prevention and Screening’, published this week in the Journal of Clinical Oncology, is an independent assessment of the most significant clinical cancer research studies of the past year. Erbitux was singled out for the pivotal first-line SCCHN study, the first randomized trial in 30 years to identify a regimen that increases survival for patients with recurrent and/or metastatic SCCHN. The report commented that, “The ability to improve overall survival with chemotherapy has proven elusive over the last 30 years in several randomized trials comparing different chemotherapy regimens in this setting. Thus, the results of this trial are particularly noteworthy and are changing clinical practice.” This is the second consecutive year that Erbitux has featured in the ASCO ‘Advances’ list.3 In 2008 it was recognized for extending survival in the first-line treatment of NSCLC and for the role of KRAS tumor status in predicting whether patients with newly diagnosed metastatic colorectal cancer will respond to Erbitux.2 “Merck Serono is honored that Erbitux is recognized by ASCO two years in a [...]

2009-11-16T22:39:55-07:00November, 2009|Oral Cancer News|

Terminal cancer patient is given the all clear

Source: www.northamptonchron.co.uk Author: staff A mouth cancer patient who was told he had only a year to live is celebrating after being given the all clear from doctors. In May this year, Brian Barford was given the awful news after he had been referred by a dentist to Northampton General Hospital where he was told he had mouth cancer. The 66-year-old said: "My mouth had been bleeding but I had no other signs. I had no idea – there had been no swelling or anything. "I saw the consultant who said the tumour was too near the vital organs to operate on and there was nothing they could do. It was just a matter of time. "They told me I had around a year to live. "It hit me like a ton of bricks. "I accepted it, though I was never going to give up, but I thought, 'I'm 66, and I've had a good life.'" Mr Barford, from Kings Heath, Northampton, decided to enjoy the time he had left and spend his days with loved ones. He went running, drank beer and, following a two-week course of radiotherapy, took a well-earned holiday with family and friends. On hearing the news Mr Barford had been diagnosed with cancer, colleagues at his former workplace, Phoenix Paving LTD, in Kettering, took their old workmate for a day to remember, watching the cricket at Lord's. With the onslaught of cancer, his weight plummeted from 14 to 11 stone. His wife Susan, aged 56, [...]

2009-11-16T22:10:29-07:00November, 2009|Oral Cancer News|

Smokeless, not safe

Source: www.sltrib.com Author: Tribune editorial Tobacco-product marketers face an uncommon business problem: They have to lure new customers to replace the nearly half-million Americans who are killed by their products each year. These folks are smart or, should we say, devious. They know that some people never start smoking simply because they don't like the smell on their clothing and their breath, or because laws prevent them smoking indoors and they don't want to face the social stigma associated with lighting up outdoors or chewing and spitting. And some smart and determined smokers are able to quit for the same reasons. So, these clever marketers have come up with new tobacco products that smell minty, produce no smoke or need to spit, and can be used discreetly. They claim the new smokeless tobacco isn't aimed at teenagers, but the evidence clearly indicates otherwise. They have catchy names like Snus, Orbs and Stride and come packaged in brightly colored, cell-phone-size containers. Some look and taste like candy. They can be carried and used without parents or teachers catching on. And they contain so much highly addictive nicotine -- triple the amount in cigarettes -- and they're so easy to use, that once a kid gets hooked, he or she usually stays hooked. Even better for tobacco pushers, they often move on to cigarettes once they're addicted, and studies show the younger people are when they start smoking, the harder it is to quit. For tobacco companies, it looks like problem solved. [...]

2009-11-14T12:28:14-07:00November, 2009|Oral Cancer News|

Medicines to deter some cancers are not taken

Source: www.nytimes.com Author: Gina Kolata Many Americans do not think twice about taking medicines to prevent heart disease and stroke. But cancer is different. Much of what Americans do in the name of warding off cancer has not been shown to matter, and some things are actually harmful. Yet the few medicines proved to deter cancer are widely ignored. Take prostate cancer, the second-most commonly diagnosed cancer in the United States, surpassed only by easily treated skin cancers. More than 192,000 cases of it will be diagnosed this year, and more than 27,000 men will die from it. And, it turns out, there is a way to prevent many cases of prostate cancer. A large and rigorous study found that a generic drug, finasteride, costing about $2 a day, could prevent as many as 50,000 cases each year. Another study found that finasteride’s close cousin, dutasteride, about $3.50 a day, has the same effect. Nevertheless, researchers say, the drugs that work are largely ignored. And supplements that have been shown to be not just ineffective but possibly harmful are taken by men hoping to protect themselves from prostate cancer. As the nation’s war on cancer continues, with little change in the overall cancer mortality rate, many experts on cancer and public health say more attention should be paid to prevention. But prevention has proved more difficult than many imagined. It has been devilishly difficult to show conclusively that something simple like eating more fruits and vegetables or exercising regularly helps. [...]

2009-11-14T09:23:01-07:00November, 2009|Oral Cancer News|

Mouth is indicator of overall health, says dental school professor

Source: www.sciencedaily.com Author: staff One day in medical clinics, the big picture of a patient's state of health may be found in little pictures from the mouth, says Li Mao, MD, a new professor at the University of Maryland Dental School. The mouth or oral cavity area is an excellent indicator of the whole body's health, says Mao, who is the chair of the new Department of Oncology and Diagnostic Sciences at the School. Mao recently joined the Dental School to be at the forefront of a movement to retool dental education, he says, to make dentists practice more within the bigger health care community. Future lung cancer prevention trials, for example, could soon be designed so that surface tissues inside the cheek could be checked to detect tobacco-induced damage in the lungs, according to a study led by Mao last year published in the journal Cancer Prevention Research. "We hypothesized that tobacco-induced molecular alterations in the oral epithelium are similar to those in the lungs," says Mao. "This might have broader implications for using the mouth as a diagnostic indicator for general health." University of Maryland Dental School Dean Christian S. Stohler, DMD, DrMedDent, a leader in the movement to retool dental education, says, "I feel that dentists should play a major role in prevention of cancer and Dr. Mao is the leading oral cancer researcher in the country. He crosses the bridge between medicine and dentistry. Being a physician helps expand dental health care and he wants to [...]

2009-11-13T14:11:41-07:00November, 2009|Oral Cancer News|

Advances in radiation therapy enable doctors to improve the quality of treatments for patients with head and neck cancer

Source: www.prnewswire.com Author: press release Noted clinical experts detail recent developments at the annual ASTRO meeting in Chicago Clinical studies suggest that advanced treatments like intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT) are enabling radiation oncologists to enhance post-treatment health-related quality of life for patients with head and neck cancer. In an educational session for radiotherapy professionals, delivered by two noted experts during the annual meeting of the American Society for Radiation Oncology (ASTRO) in Chicago last week, Avraham Eisbruch, M.D., professor at the University of Michigan, discussed how careful implementation of IMRT in the treatment of head and neck cancer can achieve high tumor control rates while minimizing xerostomia, a dry mouth condition that occurs when salivary glands are damaged. Citing a new report summarizing results from RTOG 0022, a multi-institutional study comparing IMRT with earlier forms of treatment for head and neck cancer, Dr. Eisbruch said that IMRT for head and neck cancer achieved important goals in reducing treatment toxicity, notably xerostomia, and in yielding a high tumor control rate of 90%.(1) For patients enrolled in the study and treated with IMRT, only 55% experienced Grade 2 or worse xerostomia at six months after treatment, as compared with 84% of patients treated with earlier forms of radiotherapy -- a reduction of 35%. For the IMRT group, the percentage of patients with Grade 2 or worse xerostomia decreased steadily, to 25% at 12 months and 16% at 24 months. "This kind of improvement over time is not something we [...]

2009-11-13T13:30:22-07:00November, 2009|Oral Cancer News|

U.S. smoking rates remain steady, but vary widely by state

Source: Medical News Author: John Gever National rates of cigarette smoking showed little change in 2008 from a year earlier, the CDC reported, though states vary widely both in rates of current smoking and exposures of nonsmokers to secondhand smoke. Some 20.6% of Americans were current smokers in 2008 (95% CI 19.9% to 21.4%), not significantly different from the 19.8% found in 2007 (95% CI 19.0% to 20.6%) according to the the government's ongoing National Health Interview Survey, detailed by Shanta R. Dube, PhD, and other CDC researchers in the Nov. 13 issue ofMorbidity and Mortality Weekly Report. But analysis of a another data set in MMWR -- the 2008 results from the Behavioral Risk Factor Surveillance System (BRFSS) -- revealed a twofold variation in rates among states. Utah had by far the lowest rate of current cigarette smoking, at 9.2%, followed by California (14.0%), New Jersey (14.8%) and Maryland (14.9%), according to Ann M. Malarcher, PhD, and CDC colleagues. West Virginia led the other end of the list at 26.6%. Other states with current smoking rates of 25% or more included Indiana, Kentucky, and Missouri. West Virginia had several other smoking distinctions. It was the only state in which the current smoking rate was higher among women than men -- 27.1% versus 26.1% -- although the difference was not statistically significant. The BRFSS data showed the Mountain State had the highest rate of home exposure to secondhand smoke among 12 states and territories for which data were available. Some 10.6% [...]

2009-11-13T13:22:58-07:00November, 2009|Oral Cancer News|

Brachial plexus injury may be underreported following radiation therapy in patients with head and neck cancer

Source: www.docguide.com Author: John Otrompke Radiation therapy for head and neck cancer may cause an injury to the brachial plexus nerve network in as many as 20% of patients, researchers stated here at the American Society of Therapeutic Radiology and Oncology (ASTRO) 51st Annual Meeting. The incidence of the condition, characterised by numbness in the arms, inability to use the shoulder, and/or atrophy or retraction of chest muscles, may be underreported, suggesting that healthcare providers devise an avoidance strategy when administering high-dose radiation. "This was the first study that looked at brachial plexus injury and quality-of-life effects in patients for head and neck cancer, because in the past these patients never survived long enough for physicians to notice the symptoms, which include chronic frost-bite sensation in the fingers," said Allen M. Chen, MD, Department of Radiation Oncology, University of California Davis Health System, Sacramento, California, on November 3. The study was originally conceived based on clinical observations, he said. "We would see these patients coming in with these odd symptoms all the time, and we couldn't explain why." The study looked at 196 patients, without prior symptoms of brachial plexopathy, who returned for follow-up after high-dose radiation for head and neck cancer and completed a questionnaire designed to look for symptoms of the injury to brachial plexus, a nerve complex in the arm, chest, and shoulder. Symptoms included pain, numbness and tingling, or motor weakness. Of the patients, 20 (10%) scored positive for injury, with the median onset of the [...]

2009-11-11T19:12:24-07:00November, 2009|Oral Cancer News|

Chemo treatments lengthen lives for head, neck cancer patients

Source: www.privatemdlabs.com Author: Brendan Missett Patients with head and neck cancer receiving a combined treatment of chemotherapy and radiation may live 2.1 years longer than those treated only with radiotherapy, new research suggests. The study, published in the October 27 issue of The Lancet Oncology, separated 966 patients with advanced head and neck cancer into four treatment groups, and examined their progression over 10 years, HealthDay News reports. The four groups designated patients who received radiotherapy alone, two courses of simultaneous chemotherapy and radiotherapy, two courses of chemotherapy after completing radiotherapy, and chemotherapy both during, and after radiotherapy. Researchers found that chemo, given at the same time as radiotherapy, was most effective in reducing deaths and cancer recurrence in head and neck cancer patients who hadn't undergone surgery. Chemotherapy given after radiotherapy was completely ineffective, according to the study. The UK Head and Neck Cancer Group researchers wrote that chemotherapy drugs offer an "inexpensive" method to "considerably improve the likelihood of completing treatment, essential for improving the chances of a cure." According to the American Cancer Society, more than 1,500 people in the U.S. are expected to die of cancer each day in the next year. Doctors recommend an array of imaging tests or lab tests to detect some types of cancer while they are treatable.

2009-11-11T14:29:36-07:00November, 2009|Oral Cancer News|
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