1/24/2005 J Huston J Hum Nutr Diet, December 1, 2004; 17(6): 577-8 The Time Out Project at Barts and the London NHS Trust is designed to allow allied health professionals (AHP) to develop their research skills. This is done by funding a locum to cover an AHP's post for 10 working days to allow them to undertake a mini research project. Background: Head and neck cancer (HNC) patients are at high risk of nutrition-related problems due to the nature of their disease and the side effects of cancer treatment. Emergency admissions to hospital for nutrition-related and dehydration problems are common in this group of patients due to difficulties associated with administering nutrition and fluids. The aim of this project was to examine the efficacy of prophylactic gastrostomy tubes in HNC patients undergoing cancer therapy. The objectives were to review current literature relating to the use of feeding tubes in such patients and to develop guidelines on which group of patients benefit from prophylactic placement of a gastrostomy. Method: The Medline database, 1996 to February 2003, was searched for relevant papers. Other papers cited in these were also used, if they were pertinent to the project. Medline was also searched between 1966 and March 2003 for any randomized controlled trials in this clinical area. The Cochrane Database was reviewed to see whether any systematic reviews relating to the subject matter were available. Inclusion criteriaExclusion criteriaStudies looking at enteral feeding in HNC patientsStudies looking at total parenteral nutrition, immunonutrition or jejunal feedingStudies [...]

1/24/2005 HealthDayNews The U.S. Food and Drug Administration has approved the Amgen intravenous drug Kepivance (palifermin) to prevent mucositis, a common side effect among blood cancer patients who have chemotherapy before bone marrow transplants. Patients with mucositis, characterized by debilitating, painful sores in the lining of the mouth and throat, often have trouble eating, drinking and swallowing. Some 11,000 adults with hematologic cancers -- including non-Hodgkin's lymphoma, Hodgkin's disease, leukemia and multiple myeloma -- have bone marrow transplants each year, Amgen said. The new drug works to stimulate the growth of cells in the mouth and throat that protect tissue from the harmful effects of chemotherapy and/or radiation. The most common side effects of Kepivance use were skin rash, tingling sensations in the mouth and throat, and an increase in certain blood proteins that signal pancreatic irritation. None of these conditions is considered serious, the FDA said. as reported by rednova.com

1/24/2005 S Choi, DL Schwartz, DG Farwell, M Austin-Seymour, and N Futran Arch Otolaryngol Head Neck Surg, November 1, 2004; 130(11): 1308-12 Objective: To determine whether external beam radiation therapy (XRT), administered either before or after surgery, increases the rate and/or severity of local postoperative complications in patients with head and neck cancer who undergo microvascular free flap reconstruction. DESIGN: Retrospective cohort study. Setting: University of Washington Medical Center, Seattle, a tertiary care hospital. Patients: A total of 100 consecutive patients underwent fibular free flap reconstruction of the mandible. The study cohort was divided according to radiation treatment status: (1) no XRT (28 patients), (2) preoperative XRT (37 patients), and (3) postoperative XRT (35 patients). The median follow-up after surgery was 11 months (range, 1-89 months). Main Outcome Measures: Rate and severity of local postoperative complications. Results: Fifty-four patients (54%) had at least 1 postoperative complication. There were no differences among the 3 XRT subgroups in the overall proportion of patients with complications of any severity (15 [54%] of 28 patients in the no XRT group, 24 [65%] of 37 patients in the preoperative XRT group, and 16 [46%] of 35 patients in the postoperative XRT group; P = .26, chi(2) analysis). There were also no differences seen when mild and severe complication rates were specifically examined (P = .58 and P = .10, respectively). No case of complete flap loss was observed. We noted no significant correlations between the rate of postoperative complications and the following covariates: total radiation [...]

1/24/2005 Carlisle, PA Leah Farr www.cumberlink.com Marty Frost hit a low point in his life last year. In July, he was diagnosed with mouth cancer. Then in October doctors discovered he also had throat cancer. Frost began a long — and sometimes extremely painful — treatment plan that included surgery and 31 radiation treatments. However, the pain was eased with his discovery of reiki, a therapy that he says gives him rest and renewed hope. Frost and other cancer patients are finding that yoga, massage therapy and reiki, a gentle touch long practiced in Eastern cultures to promote relaxation and energy, can help improve their quality of life. They can receive these complementary therapies at the Carlisle YWCA through a nine-month pilot program funded by a grant from the Carlisle Area Health and Wellness Foundation. Designed for people in all stages of the disease - from those who are newly diagnosed to anyone 18 months post treatment - "this program can be like an oasis for people in the middle of treatment," reiki practitioner Gigi Jantos says. It also "empowers the individual to participate fully in their recovery" as well as "improves their sense of physical and emotional well-being." The treatments are known as complementary therapies because they are not a substitute for proven medical treatment. "The main goal of the program is to improve the life quality," Jantos says. The medical benefits include reducing anxiety, stress, pain, nausea and fatigue. Other options The American Cancer Society estimates that more [...]

1/24/2005 William M. Mendenhall J. Clin. Oncol. published 1 November 2004, 10.1200/JCO.2004.09.959 The presentation of osteoradionecrosis (ORN) after radiotherapy (RT) for head and neck cancer varies from small, asymptomatic bone exposures that may remain stable for months to years or heal with conservative management, to severe necroses necessitating surgical intervention and reconstruction. The risk of developing ORN depends on a number of factors, including primary site, T stage, proximity of the tumor to bone, dentition, type of treatment (external beam RT, brachytherapy, surgery, and chemotherapy), and RT dose. Other factors that probably influence the likelihood of developing ORN include the nutritional status of the patient and continued tobacco or alcohol abuse. The mandible is the most common site of ORN, probably because it is often necessary to deliver a high RT dose to tumors near the mandible and possibly also because the blood supply may be less abundant than that of the maxilla. Although patients treated with definitive RT for oral cavity malignancies are more likely to experience minor or moderate bone complications compared with those treated with surgery and adjuvant RT, the likelihood of severe ORN is probably similar after either treatment strategy.2,3 Patients in whom the RT portals include only the angle or ramus of the mandible, such as those with laryngeal or hypopharyngeal cancers, have a very low likelihood of experiencing severe ORN. Edentulous patients probably have a lower risk of developing ORN than dentulous patients. Patients with poor dentition whose teeth will be in the high-dose [...]

1/22/2005 editorial staff Anticancer Research Journal reported by Cancer Weekly via NewsRx.com Resveratrol. It may be a mouthful to pronounce, but new research suggests the importance of choosing foods like cranberries that naturally contain this anticancer compound. Researchers have linked resveratrol to the prevention of a wide variety of types of cancer including: -Breast Cancer -Prostate Cancer -Lymphoma -Leukemia -Colon Cancer -Pancreatic Cancer -Gastric Cancer -Melanoma -Lung Cancer -Liver Cancer -Thyroid, Head and Neck Cancers -Ovarian and Endometrial Cancers A research team led by Dr. Bharat Aggarwal at the University of Texas MD Anderson Cancer Center, in conjunction with Dr. Navindra Seeram of the UCLA Center for Human Nutrition, David Geffen School of Medicine, published their review article in a recent issue of the journal Anticancer Research. According to Seeram, "We reviewed over seventy previous studies examining resveratrol's ability to cause cancer cells to stop from spreading and in fact cause cell death in existing cancer cells. Foods containing this compound - like grapes, peanuts, cranberries and other berries - belong in a healthy diet." In vitro (studies conducted in a test tube or outside a living organism) and animal studies comprised the majority of the research reviewed by Seeram and Aggarwal, though several of the leukemia studies were in vivo (inside the animal). The research points to anti-inflammatory and antioxidant effects of resveratrol as well. In addition to helping with cancer prevention, cranberries pack a powerhouse of protective properties that may prevent a number of other conditions. The antiadhesion [...]

1/22/2005 editorial staff Obesity, Fitness & Wellness Week via NewsRx.com Surgeons at Montefiore Medical Center are using a new form of treatment for cancer of the larynx that allows for quicker recovery and shorter hospital stays, and saves the voice box so patients retain the ability to speak. "We have found that our Endoscopic Laser Laryngectomy procedure is much more effective in terms of preserving a better quality of life for patients with cancer of the larynx," said Richard Smith, MD, the ear, nose and throat surgeon pioneering the new surgical procedure at Montefiore. "Because this procedure is much less invasive we can also do it on much older patients with better outcomes." "By using a laser light beam that cuts like a scalpel, we do the surgery by going in through the mouth," Smith said. "That means there's no open wound, and no tracheotomy (a breathing tube in the neck) is needed - so we can save the voice box." Before using a laser, standard procedures for treating the cancer were by radiation, chemotherapy and traditional open wound surgery. The larynx, or voice box, is located in the neck and has three important functions: it forms a portion of the air passageway through which we breathe, and it protects the lungs from food by closing when we eat, and is the source of our voice function. According to the American Cancer Society, about ten thousand new cases of cancer of the larynx are reported annually in the United States. [...]

1/22/2005 E.M. Genden Oral Oncol, 2004;40(10):979-984). The complications of free flap transfers for head and neck reconstruction after cancer surgery have been reviewed. "The reported success rate of microvascular free flap reconstruction ranges between 95% and 97%," surgeons in Italy explained. "However, when complications occur, they must be identified early and managed efficiently because there is a narrow window of opportunity to salvage potential flap failure." "While technical advances in instrumentation and magnification have improved overall success rates, the rare complication may prove devastating for the patient, his/her hospital stay, and the optimum rehabilitation," noted E.M. Genden and colleagues at the University of Udine. "Complications of microvascular free tissue transfer may occur at the recipient site or at the donor site," according to the report. "Complications occurring at the recipient site are largely a result of vessel thrombosis while complications occurring at the donor site may result from many causes, ranging from infection to those related to the harvesting of the flap." "Irrespective of the site of the complication, it is essential that complications be recognized and addressed early in their course to prevent or minimize devastating consequences," the researchers concluded. Source: as reported by Medical Devices & Surgical Technology Week via NewsRx.com

1/21/2005 Jemal, A. CA: A Cancer Journal for Clinicians, January/February 2005; vol 55: pp 10-30 2005 Prediction: 1,500 Cancer Deaths Every Day Cancer has surpassed heart disease to become the leading cause of death in the U.S., according to new statistics released today by the American Cancer Society. The group predicts that 1,372,910 Americans this year will hear the words "you've got cancer." And, the group says, in 2005 cancer will kill 570,280 Americans -- more than 1,500 a day. Despite cancer's spot as America's No. 1 cause of death, the overall U.S. cancer death rate actually has been going down. Why? More widespread cancer screening and better cancer treatment, says Elizabeth Ward, PhD, director of surveillance research for the American Cancer Society. "We can say with confidence that both are occurring," Ward tells WebMD. "The declines in the cancer mortality rate are due to earlier detection and to improvements in treatment." Lung Cancer Still Top Cancer Killer Lung cancer is still the top cause of cancer death. It's the cause of one-third of cancer deaths in men and of one-fourth of cancer deaths in women. But the U.S. campaign against tobacco use has had an effect. Lung cancer deaths among men are dropping. And after years of increases, lung cancer deaths are leveling off among women. Breast cancer causes a third of all cancers in women. It's their second leading cause of cancer death. But here, too, death rates are going down -- again largely due to more women [...]

1/21/2005 New York, NY Journal of Clinical Oncology 2005;23:88-95 reported by cancerpage.com Chemotherapy combined with chemoradiotherapy allows organ preservation in patients with advanced resectable cancer of the tongue or hypopharynx, according to a report in the January 1st issue of the Journal of Clinical Oncology. The base of the tongue and hypopharynx are good candidates for organ preservation because of the potential compromise of speech and swallowing resulting from surgery, the authors explain. Dr. Susan G. Urba from University of Michigan Medical Center, Ann Arbor, and colleagues investigated the benefits of two cycles of induction chemotherapy followed by chemoradiotherapy for responders in a phase II trial of 59 patients with advanced resectable cancer of the tongue base (n=37) or hypopharynx (n=22). Fifty-eight percent had stage IV and 42% had stage III disease. Seventy-eight percent of the patients had a 50% or greater response to induction chemotherapy at their primary tumor site, the authors report. Of the 43 patients that went on to receive concurrent chemoradiotherapy, 32 (54%) achieved a documented histologic complete response, the results indicate, and 9 additional patients achieved a complete clinical response, but did not undergo the recommended biopsies. Overall, the researchers note, 44 patients (75%) were deemed organ preservation successes; they did not require salvage surgery of the primary tumor immediately following completion of the treatment because of their excellent responses to therapy. Apart from one death attributed to the induction chemotherapy, the report indicates, the treatment was well tolerated, the researchers report. The 3-year overall [...]