Is Radiation or Chemoradiation Best for Oropharyngeal Cancer Patients

9/19/2006 India staff MedIndia.com Patients with stage IV oropharyngeal cancer -- a type of cancer that develops in the part of the throat just behind the mouth that assists with breathing, talking, eating, chewing, and swallowing -- are often treated with radiation alone or with chemoradiation. The addition of chemotherapy is usually based on the need for radiotherapy sensitizers and the perceived risk for the spread of cancer cells from the original site to other parts of the body. In the oropharyngeal cancer population with small volume primary disease and moderate metastatic disease in the lymph nodes, the role of chemotherapy is less clear. But, as chemoradiation for oropharyngeal cancer has become more common and survival is stabilizing, the question of long-term function is becoming important. There is an assumption that combined therapy may lead to increased dysphagia, or difficulty in swallowing and feeding tube dependence. This study is a retrospective chart review of all patients presenting at MD Anderson Cancer Center with T1 or T2 tonsil or base of tongue squamous cell carcinoma and N2a or N2b cervical lymph node metastasis between January 2000 and December 2004. Only patients who received their radiation treatment at this institution were included. Charts were reviewed for demographic features, staging information, and method of treatment. When available, pre- and post-treatment swallowing evaluations were analyzed. The functional outcomes for swallowing were the presence or absence of feeding (PFG) tubes, diet status, and swallow evaluation results including dysphagia and aspiration. The two-tailed Fisher exact test [...]

2009-04-12T22:24:52-07:00September, 2006|Archive|

For Some, Airplane Bans on Liquids Are Painful Barriers

9/18/2006 Washington, D.C. Ricardo Alonzo-Zaldivar LA Times (latimes.com) Tens of thousands of patients with oral cancer and other diseases that damage the body's salivary glands are facing stiff barriers to air travel because of new security restrictions on carrying liquids and gels, say patients, health professionals and advocacy groups. Instead of taking a one-hour flight from upstate New York to attend a conference in Washington next month, community college professor Cornelia Rea has decided instead to make a seven-hour road trip. "When the new travel regulations came out, I said, 'OK, that's it -- I'm driving,' " Rea said. "I don't know what I'm going to do for longer trips in the future." An oral cancer survivor, Rea cannot swallow food because of radiation damage to throat tissues. She gets nourishment from liquid injected with a syringe into a small tube in her abdomen. Because her salivary glands were also damaged by radiation treatment, Rea uses sprays and a gel to keep her mouth moist, which helps to prevent infections and other complications. Similar travel problems confront patients with Sjogren's syndrome, an autoimmune disorder that shuts down the tear ducts and salivary glands and can affect other moisture-producing tissues. One Sjogren's patient, who asked not to be identified, said that to make sure a bottle of eyedrops wouldn't be confiscated, she tucked it into her bra before a recent flight. "A lot of our patients are nervous about flying," said Steven Taylor, chief executive of the Sjogren's Syndrome Foundation, based [...]

2009-04-12T22:24:18-07:00September, 2006|Archive|

Recurrence, Mortality Rates Found Higher Among Elderly Patients with Tongue Cancer

9/18/2006 Sweden staff Newswise.com The tongue, a large collection of skeletal muscles found on the floor of the mouth, manages our food for chewing and swallowing, acts as one of the organs of taste in that its surface is covered in taste buds, and assists in forming our speech. One can stick out their tongue as part of a diagnostic examination or to show contempt. Injury or discomfit to the tongue is generally caused by accidental biting or irritation by certain foods or drugs. Medical disorders include a common infection known as “thrush” in which an overgrowth of fungi forms a white film covering the tongue. Intense pain of the entire mouth can also be caused by burning mouth syndrome. Tongue cancer on the other hand does exist and although its incidence is low, the result can be deadly. Tongue cancer begins as a small lump or thick white patch on the tongue that may be painful or tender. With time the lump turns into an ulcer with a firm, raised rim and a center that bleeds easily. If untreated the tumor will grow causing the tongue to become rigid and hard making swallowing and speech difficult. The American Cancer Society tabulated 7,320 new cases for tongue cancer in the United States in 2004, a rate of one in 37,158. Males were afflicted with this disease in two of three cases. For the same year there were an estimated 1,700 estimated U.S. deaths for tongue cancer, with two male deaths [...]

2009-04-12T22:20:44-07:00September, 2006|Archive|

Abnormal Overexpression of p53 is a Predictive Molecular Biomarker of Advexin Efficacy

9/14/2006 Chicago, IL staff Newswise.com A common laboratory test that predicted poor outcome from traditional radiation and chemotherapy treatment for head and neck cancers now has been found to predict a good prognosis with treatment of p53 tumor suppressor gene therapy - making it potentially the first predictive biomarker test for a gene-based drug. Researchers at Introgen Therapeutics, Inc., in Austin, Texas, found that patients with advanced squamous cell carcinoma of the head and neck cancer (SCCHN) whose pre-treatment tumor samples over-expressed p53 protein were significantly more likely to respond to Advexin therapy than those whose tumor showed little p53 protein. Advexin is a gene based drug, injected directly into tumors, which uses an adenoviral vector to deliver the wild type p53 gene to tumor cells. Results were presented at the first meeting on Molecular Diagnostics in Cancer Therapeutic Development, organized by the American Association for Cancer Research. “Not only do we now have a way to predict if the gene therapy is likely to succeed, those patients for which it does work are the hardest patients to treat,” said Laura L. Licato, Ph.D., associate director for Clinical Research at Introgen. “Accumulation of p53 has corresponded with a poor response to traditional therapies, as well as lower survival and a shorter time to disease progression.” “Selecting those who have the best chance of responding to p53 tumor suppressor gene therapy also helps perfect clinical trial testing,” Licato said. The researchers specifically found, in a subset of patients from phase II [...]

2009-04-13T08:07:47-07:00September, 2006|Archive|

Genmab Initiates HuMax-EGFr Pivotal Study In Refractory Head and Neck Cancer

9/14/2006 Copenhagen, Denmark press release PRNewswire.com Genmab A/S announced today it has initiated a Phase III pivotal study with HuMax- EGFr(TM) (zalutumumab) to treat patients with head and neck cancer that is considered incurable with standard treatment. The pivotal study will include a maximum of 273 patients with squamous cell carcinoma of the head and neck (SCCHN) who are refractory to or intolerant of standard platinum-based chemotherapy. "We are eager to begin the HuMax-EGFr pivotal study and are looking forward to starting treatment of these very sick head and neck cancer patients with the aim of increasing their life expectancy," said Lisa N. Drakeman, Ph.D., Chief Executive Officer. About the trial: Patients in the study will be randomized into two treatment groups: HuMax-EGFr in combination with best supportive care or best supportive care alone. Patients treated with HuMax-EGFr in combination with best supportive care will receive an initial dose of 8mg/kg of HuMax-EGFr, followed by weekly infusions of a maintenance dose until disease progression. The maintenance dose will be adjusted as necessary until the patient develops a dose limiting skin rash, up to a maximum dose of 16 mg/kg of HuMax-EGFr. Disease status will be assessed every 8 weeks by CT scan or MRI according to RECIST criteria until disease progression and patients will be followed for survival. The objective of the study is to evaluate the efficacy of HuMax-EGFr in combination with best supportive care as compared to best supportive care alone in terms of overall survival. The primary [...]

2009-04-12T22:18:21-07:00September, 2006|Archive|

Health Science Center surgeon urges early detection for throat cancer

9/14/2006 San Antonio, TX staff San Antonio Business Journal (sanantonio.bizjournals.com) Reflux disease can be an early warning sign for esophageal cancer, according to a local surgeon who specializes in cancer treatments. Dr. Scott Johnson, associate professor of surgery at the University of Texas Health Science Center at San Antonio (UTHSC), says people suffering from reflux disease need to be vigilant in having it treated and checked out. "Esophageal cancer becomes apparent usually in the later stages of disease when it is largely incurable," he says. "Patients may not realize they have a serious problem." Former Gov. Ann Richards died late Wednesday, Sept. 13, from esophageal cancer, which is the fastest rising major cancer in the United States. "I cannot comment on Gov. Richards' specific case, because I was not her physician, but I will tell you that most patients present with symptoms after it is too late to cure them," Johnson says. The National Cancer Institute estimates that 14,550 new cases of esophageal cancer will be diagnosed in 2006 and that the disease will kill 13,770 Americans. Johnson says new treatments, both surgical techniques and medication, are being developed that could ultimately improve the outlook for patients with esophageal cancer. "The key is, if you have gastroesophageal reflux disease or suspect you have it, see your physician regularly and ask him or her about the risk of developing esophageal cancer," Johnson says.

2009-04-12T22:17:54-07:00September, 2006|Archive|

Meeting of Specialty Physicians Expected to Draw More than 8,000 Doctors from Around the World to Toronto September 17-20, 2006

9/14/2006 Toronto, Ontario, Canada press release Newswire.ca More than 8,000 specialized doctors from the community of otolaryngologist-head and neck surgeons will convene at the Metro Toronto Convention Centre (MTCC) September 17-20th for the 2006 Annual Meeting & OTO EXPO of the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF). Specialists from North and South America, Europe, Asia, Africa, and Australia will attend the event to learn about the latest research findings in patient care and to meet exhibitors who develop products related to the specialty. More than 165 scientific research sessions, 200 posters and 400 instruction course hours are among the program highlights. Topics under discussion will include medical disorders such as sinusitis, hearing loss, ear infections, voice disorders, vertigo and loss of balance, and sleep disorders. Additionally, research findings will be unveiled during the meeting regarding the efficacy of plastic surgery, as well as treatment for head and neck cancer, one of the most deadly forms of cancer. The findings from select research presentations will be provided in news releases and offered to the news media on an embargoed basis on or before September 17th. "This annual event embodies our passion for our mission," said AAO-HNS Executive Vice President and Chief Executive Officer, David R. Nielsen, MD. "For the first time since 1932, the community of otolaryngologist-head and neck surgeons will convene outside of the United States for an exciting meeting filled with learning opportunities and camaraderie, creating a new opportunity for growth on multiple levels," he added. [...]

2009-04-12T22:14:00-07:00September, 2006|Archive|

Targeted treatment spurs recovery

9/27/2006 Milwaukee, WI Rebecca S. Smaga www.gmtoday.com On a morning just like any before it, Thomas Dobrient of Cedar Creek was shaving when something out of the ordinary caught his attention. On the left side of his neck, there was a lump. "My wife and my mom decided I should get it checked out right away," said Dobrient, 47. It was September 2002. At Community Memorial Hospital in Menomonee Falls, WI, Dobrient’s general practitioner gave him antibiotics, saying it might be an abscessed tooth, but a week later the lump was no smaller. When they could not perform a biopsy, Dobrient was referred to Froed-tert Memorial Lutheran Hospital. It was there, in a cramped office filled with two doctors, a few students, his wife and his mother that Dobrient first heard talk of "cancer." "It was really weird because we were in a really small room. It was pretty scary," he said. A biopsy confirmed a diagnosis of supraglottic larynx carcinoma and multiple metastatic nodes in the left neck. Dobrient had a tumor at the base of his tongue. His wife, Sandy, remembers being overwhelmed by information. She said the doctors began painting a grim picture. Thomas might lose his tongue. He might never be able to eat or drink normally again. Then, they offered an alternative to immediate surgery. "I was convinced there had to be a better way than cutting out my tongue," said Dobrient. Dian Wang, M.D., Ph.D., and assistant professor of radiation oncology at the Medical [...]

2009-04-13T07:03:28-07:00September, 2006|Archive|

Body size and laryngeal cancer risk

9/12/2006 Oxford, England W Garavello et al. Annals of Oncology 2006 17(9):1459-1463 Background: A few studies have analyzed the role of lifetime anthropometric measures on laryngeal cancer risk. Patient and methods: This relation was investigated using a multicentre case-control study from Italy, conducted between 1992 and 2000, and including 460 incident, histologically confirmed laryngeal cancer cases, and 1088 controls admitted to the same network of hospitals as cases for acute, non neoplastic condition. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were obtained from multiple logistic regression, including terms for major confounding factors, such as physical activity and energy intake. Results: An inverse association with laryngeal cancer risk was found for body mass index (BMI) in both sexes (OR for the lowest compared to the highest quintile was 1.47, 95% CI 0.93–2.33 in men and 8.11, 95% CI 1.38–47.66 in women) and for BMI at age 50 years (OR=1.65, 95% CI 0.88–3.11) in men and 7.84, 95% CI 0.69–88.58 in women). An inverse association was also observed with waist-to-hip ratio (WHR) at diagnosis in men only (OR=4.56, 95% CI 2.62–7.95 for the lowest compared to the highest quintile). Conclusions: This study supports the existence of a relation between leanness and laryngeal cancer risk. In particular, men with less abdominal fat (characterized by a lower WHR) had an increased risk of laryngeal cancer. Authors: W Garavello1,2, G Randi1, C Bosetti1, L Dal Maso3, E Negri1, L Barzan4, S Franceschi5 and C La Vecchia1,6 Authors' affiliations: 1 Istituto di Ricerche Farmacologiche [...]

2009-04-12T22:12:51-07:00September, 2006|Archive|

Epidemiology of head and neck cancer in the United States

9/12/2006 Palo Alto, CA L Davies and HG Welch Otolaryngol Head Neck Surg, September 1, 2006; 135(3): 451-7 Background: Cancer rates of the head and neck are traditionally linked to public health issues. Objective: To describe the epidemiology of head and neck cancer in the United States. Design and Setting: National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program. Results: A total of 75,000 cases of head and neck cancer were diagnosed in 2001. Incidence is rising in thyroid (up 52%), bone (43%) soft tissues (20%), salivary (20%), tongue (16%), tonsil (12%), and nose (12%). Incidence is falling in lip (down 58%), hypopharynx (35%), cervical esophagus (32%), oropharyngeal mucosa (26%), and larynx (26%). There were 30,000 deaths from head and neck cancer in 2001. Mortality has decreased to some degree at all sites except thyroid where it was stable. Conclusion: Many head and neck cancers have changing incidence and mortality rates contrary to expected changes given trends in public health issues. Further investigation of risk factors, diagnostic practices, and management strategies is warranted. Authors' affiliations: VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, Vermont; Division of Otolaryngology and Department of Community and Family Medicine, Dartmouth Medical School.

2009-04-12T22:11:17-07:00September, 2006|Archive|
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