Follow-up by advance practice nurses improves care for patients with head, neck cancer

Source: www.healio.com Author: Anthony SanFilippo The launch of an advance practice nurse outpatient follow-up clinic improved symptom management for high-risk patients with head and neck cancer following radiation therapy, according to findings from a study conducted at Cleveland Clinic. This initiative led to fewer ED visits and hospital admissions, results showed. “These results are significant as they suggest more intensive follow up in high-risk head and neck patients can improve patient outcomes,” Bridgett Harr, CNP, of the department of radiation oncology at Cleveland Clinic, told HemOnc Today. “This intensive symptom management is an important role [advance practice nurses (APNs)] can fill in this and other patient groups by providing consistent, proactive management of symptoms during recovery from treatment. Our study suggests this will lead to improved patient experience, in addition to a reduction in cost to both the patient and health care system as a whole.” Patients with head and neck cancer often undergo radiotherapy or chemoradiotherapy, and many experience debilitating side effects that require ED management or admission to the hospital. In 2014, an APN-led clinic was launched to focus on the acute rehabilitation of patients with head and neck cancer undergoing these therapies. Harr and colleagues sought to evaluate the outcomes and incidence of adverse events among patients treated at an APN clinic compared with historical outcomes. The analysis included data from 25 high-risk patients with head and neck cancer who received care post-treatment at an APN clinic and 24 patients who received standard follow-up care identified using [...]

2015-11-03T10:14:55-07:00November, 2015|Oral Cancer News|

New research opens door to understanding human tonsil cancer



Source: medicalxpress.com Author: staff Researchers at Simon Fraser University and the BC Cancer Agency have developed a groundbreaking method to identify and separate stem cells that reside in the tonsils. Their research, which sheds new light on the fight against oral cancer, is published today in the journal Stem Cell Reports. While stem cells in many other body tissues have been well studied, little is known about these stem cells, says researcher Catherine Kang, a PhD student in the Department of Biomedical Physiology and Kinesiology and lead author of the paper. Ninety per cent of human tonsil cancers show evidence of HPV (human papillomavirus) infection. But little is known about its role in causing these cancers. Researchers suspect it is a key player, as HPV is the major risk factor for cervical cancer. Kang, who is working with BPK professor Miriam Rosin, director of the BC Oral Cancer Prevention Program, and UBC professor Connie Eaves of the Terry Fox Laboratory, was interested in finding out why the tonsil is particularly susceptible to HPV and wondered if it might have something to do with the stem cells of the tissue that coats the tonsils. When she purified these cells and made them incorporate a cancer-causing gene normally transmitted by HPV, the cells grew abnormally in a special tissue culture system, and created what one might imagine what the beginning stages of human tonsil cancer would look like. "This is a very exciting finding, as it is the first stage of human [...]

2015-11-03T10:06:31-07:00November, 2015|Oral Cancer News|

Why groundbreaking new cancer drugs still don’t work for most patients

Source: www.news.doximity.comAuthor: Brady Dennis Immunotherapy, which aims to harness the body's immune system to fight off certain cancers, has received plenty of attention, praise and investment in recent years. Breakthrough treatments for melanoma and other cancers have shown startling results, giving some patients months and often years of life they almost certainly would not otherwise have had. Yet, for all their promise, immune therapies have not produced such dramatic results for the majority of patients. The same drug that causes metastatic melanoma to vanish in one patient might have no effect on another. At best, only one or two patients out of five will respond to immunotherapy treatments -- remarkable numbers compared to past standards, but still far lower than anyone would like. New research published Monday in the journal Nature explores the molecular mechanisms that prevent immunotherapy drugs from working in some patients, and researchers hope the findings will help make the treatments more effective over time. In short, the researchers studied why certain tumors were able to evade immune therapies designed to unleash the body's defenses to fight cancer. They noted that tumors with a high concentration of "T cells," a type of white blood cell essential to the human immune system, were more responsive to the treatments. Tumors with a low number of T cells inside what researchers call the "cancer microenvironment" were far less responsive to the new drugs. "The tumors are acting to protect themselves," said Weiping Zou, a senior author of the study and a professor of surgery, immunology and biology at the University of Michigan's [...]

2015-10-30T12:28:18-07:00October, 2015|Oral Cancer News|

Researchers Find Hookah Smoking Can Lead to Serious Oral Conditions – Equivalent To Smoking 100 Cigarettes

Source: www.multivu.comAuthor: PR Newswire CHICAGO, Oct. 28, 2015 /PRNewswire/ -- According to the Centers for Disease Control and Prevention, 2.3 million Americans smoke tobacco from pipes, and many of those who smoke waterpipes, or hookahs, believe it's less harmful than cigarettes. However, research published in The Journal of the American Dental Association (JADA) suggests hookah smoking is associated with serious oral conditions including gum diseases and cancer. "We found that waterpipe smoking is associated with serious health problems affecting the head and neck region," said study author Teja Munshi, B.D.S., M.P.H of Rutgers University. "The public needs to know they are putting themselves at risk. They should be made aware of the dangers of smoking hookahs." The authors conducted a literature review that focused on waterpipe smoking and head and neck conditions. They found waterpipe smoking to be associated with gum diseases, dry socket, oral cancer and esophageal cancer among other conditions. According to the World Health Organization, smoking a hookah is the equivalent of smoking 100 cigarettes, based on the duration and number of puffs in a smoking session. "This study sheds light on the common misconception that smoking from a waterpipe is somehow safer than smoking a cigarette," said JADA Editor Michael Glick, D.M.D. "Whether you are smoking a cigarette, an e-cigarette, a cigar, or tobacco from a waterpipe, smoking is dangerous not only to your oral health but to your overall health." The American Cancer Society is hosting The Great American Smokeout on November 19, 2015, an annual event that encourages [...]

2015-10-29T12:32:23-07:00October, 2015|Oral Cancer News|

Manitoba expands HPV vaccination program to include boys

Source: www.rapidnewsnetwork.comAuthor: Cody Griffin While most HPV infections go away over time with no treatment, a few can go on to cause cancer. Health Minister Sharon Blady said the province’s vaccine program will be expanded next year to include Grade 6 and Grade 9 boys as part of Manitoba’s cancer strategy. The province will also be doing a catch-up period in grade 9. About 59 percent of the physicians recommended HPV vaccination more often for adolescents who they perceived to be at higher risk for getting an HPV infection, as opposed to recommending it routinely for all adolescents. “Human papillomavirus can cause abnormal cell changes that can lead to cervical cancer, as well as cancer of the vagina, vulva, penis, anus, mouth and throat”, said Dr. Sri Navaratnam, president and CEO, CancerCare Manitoba. A study in Texas found that a more rigorous, information driven outreach program increased the number of children receiving the vaccine, and other recent studies have reinforced the efficacy of the vaccine to prevent cancer and not promote promiscuity among teenagers. Any girl or boy who misses the vaccine in Grade 6 will be eligible to get it in later years free of charge under the province’s “once eligible, always eligible”, program. But now we know it causes cancer in men as well. Gilkey and colleagues found that 27 percent of physicians across the country reported that they do not strongly endorse HPV vaccination, and 26 percent and 39 percent reported that they do not provide timely recommendations [...]

2015-10-23T11:47:34-07:00October, 2015|Oral Cancer News|

Less Is More for HPV Oropharyngeal Cancer Reduced-intensity regimen clears disease in 86% of cases

Source: www.medpagetoday.comAuthor: Charles Bankhead SAN ANTONIO -- Less intense treatment of low-risk human papillomavirus (HPV)-related oropharyngeal cancer achieved a high rate of pathologic complete response (pCR) and favorable patient-reported outcomes, a preliminary trial showed. Overall, 37 of 43 (86%) patients achieved pCR with deintensified chemoradiation, including all but one evaluable primary tumor. The pCR rate was virtually identical to historical rates achieved with standard regimens, according to Bhishamjit Chera, MD, of the University of North Carolina (UNC) at Chapel Hill, and colleagues. Selected patient-reported adverse events peaked during the first 6 to 8 weeks and then declined thereafter. About 40% of patients required feeding tubes for a median duration of 15 weeks, but no patients required permanent feeding tubes, they reported here at the American Society for Radiation Oncology meeting. The regimen consists of lower doses of radiotherapy and concurrent cisplatin, administered over 6 weeks. With high-dose therapy, the radiation protocol requires an additional week. "Though we have limited follow-up, the pathological complete response rate with this reduced-intensity chemoradiotherapy regimen is very high in patients with favorable-risk oropharyngeal squamous-cell carcinoma," Chera said. "The early quality-of-life measurements are encouraging, particularly the data on swallowing. We are optimistic that these results with reduced-intensity treatment will translate into good long-term disease control with less toxicity." The study reflects the current trend and momentum in the management of HPV-positive oropharyngeal cancer, said Zain Husain, MD, of Yale Cancer Center in New Haven, Conn. "This is the second study to show that de-escalation of therapy might [...]

2015-10-21T14:59:53-07:00October, 2015|Oral Cancer News|

Athletes drive increase in high schoolers’ use of smokless tobacco, CDC study shows

Source: www.kyforward.comAuthor: www.kyforward.com web staff High-school athletes are using more smokeless tobacco, even though overall tobacco use among high-school students has declined, according to a study published by the federal Centers for Disease Control and Prevention. We can do more to protect America’s youth from a lifetime of addiction,” Tom Frieden, CDC director, said in a press release. “The fact is, smokeless tobacco products, such as chewing tobacco, snuff or dip, can cause cancer of the mouth, esophagus and pancreas. And the nicotine in these products is harmful to the developing brain. Because we know tobacco-free policies in schools and other public recreational areas work, we must take action now so that our children are safe from these toxins.” Student responses to the national Youth Risk Behavior Survey from 2001 through 2013 show that the share reporting any tobacco use dropped to 22.4 percent from 33.9 percent, and the rate of those smoking combustible tobacco products dropped to 19.5 percent from 31.5 percent. However, those who reported using smokeless tobacco products increased to 8.8 percent from 8.2 percent. The increased use of smokeless tobacco was driven by athletes. The rate among non-athletes remained unchanged at 5.9 percent but has “increased significantly” to 11.1 percent from 10 percent in youth athletes. Researchers suggest that athletes are aware of the adverse consequences of smoking on athletic performance, but may view smokeless tobacco as “less harmful, socially acceptable, or even a way to enhance athletic performance.” The 2013 YRBS found that 26.3 percent [...]

2015-10-19T16:38:45-07:00October, 2015|Oral Cancer News|

Multisite HPV16/18 Vaccine Efficacy Against Cervical, Anal, and Oral HPV Infection

Source: www.oxfordjournal.comAuthors: Daniel Bleacher, Aimee Kreimer, Mark Schiffman, Rolando Herrero, Ana Cecilia Rodriguez, Douglas Lowy, Carolina Porras, John Schiller, Wim Quint, Silvia Jiminez, Mahboobeh Safaeian, Linda Struijk, John Scchussler, Allan Hildesheim, Paula Gonzalez  Background: Previous Costa Rica Vaccine Trial (CVT) reports separately demonstrated vaccine efficacy against HPV16 and HPV18 (HPV16/18) infections at the cervical, anal, and oral regions; however, the combined overall multisite efficacy (protection at all three sites) and vaccine efficacy among women infected with HPV16 or HPV18 prior to vaccination are less known. Methods: Women age 18 to 25 years from the CVT were randomly assigned to the HPV16/18 vaccine (Cervarix) or a hepatitis A vaccine. Cervical, oral, and anal specimens were collected at the four-year follow-up visit from 4186 women. Multisite and single-site vaccine efficacies (VEs) and 95% confidence intervals (CIs) were computed for one-time detection of point prevalent HPV16/18 in the cervical, anal, and oral regions four years after vaccination. All statistical tests were two-sided. Results: The multisite woman-level vaccine efficacy was highest among “naïve” women (HPV16/18 seronegative and cervical HPV high-risk DNA negative at vaccination) (vaccine efficacy = 83.5%, 95% CI = 72.1% to 90.8%). Multisite woman-level vaccine efficacy was also demonstrated among women with evidence of a pre-enrollment HPV16 or HPV18 infection (seropositive for HPV16 and/or HPV18 but cervical HPV16/18 DNA negative at vaccination) (vaccine efficacy = 57.8%, 95% CI = 34.4% to 73.4%), but not in those with cervical HPV16 and/or HPV18 DNA at vaccination (anal/oral HPV16/18 VE = 25.3%, 95% CI = [...]

2015-10-16T10:10:13-07:00October, 2015|Oral Cancer News|

Alternative Tobacco Products as a Second Front in the War on Tobacco

Source: www.jamanetwork.comAuthors: Samir Soneji, PhD; James D. Sargent, MD; Susanne E. Tanski, MD, MPH; Brian A. Primack, MD, PhD Associations Between Initial Water Pipe Tobacco Smoking and Snus Use and Subsequent Cigarette Smoking: Results From a Longitudinal Study of US Adolescents and Young Adults Importance Many adolescents and young adults use alternative tobacco products, such as water pipes and snus, instead of cigarettes. Objective To assess whether prior water pipe tobacco smoking and snus use among never smokers are risk factors for subsequent cigarette smoking. Design, Setting, and Participants We conducted a 2-wave national longitudinal study in the United States among 2541 individuals aged 15 to 23 years old. At baseline (October 25, 2010, through June 11, 2011), we ascertained whether respondents had smoked cigarettes, smoked water pipe tobacco, or used snus. At the 2-year follow-up (October 27, 2012, through March 31, 2013), we determined whether baseline non–cigarette smokers had subsequently tried cigarette smoking, were current (past 30 days) cigarette smokers, or were high-intensity cigarette smokers. We fit multivariable logistic regression models among baseline non–cigarette smokers to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with subsequent cigarette smoking initiation and current cigarette smoking, accounting for established sociodemographic and behavioral risk factors. We fit similarly specified multivariable ordinal logistic regression models to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with high-intensity cigarette smoking at follow-up. Exposures Water pipe tobacco smoking and the use of snus at baseline. Main Outcomes [...]

2015-10-14T12:26:30-07:00October, 2015|Oral Cancer News|

Throat and tongue cancers linked to sexually transmitted virus on the rise

Source: www.theage.com.au Author: Julia Medew The sexual revolution is producing a new wave of throat and tongue cancers among middle-aged people, who are falling victim to a rare side effect of the "common cold of sexually transmitted infections". A growing number of Australians with oropharyngeal cancer are testing positive to the human papillomavirus (HPV), suggesting it has caused their disease rather than smoking or heavy drinking - factors responsible for many head and neck cancers in the past. Oropharyngeal cancer is usually found in the back third of the tongue or the tonsils. In 2014, about 125 Victorians were diagnosed with it. Most were men. An Australian study of 515 patients diagnosed with the condition between 1987 and 2010 found that the proportion of people with an HPV-related diagnosis increased from 20 per cent between 1987 and 1995 to 64 per cent between 2006 and 2010. Over the same period, the proportion of people diagnosed with throat cancer who had never smoked increased from 19 per cent to 34 per cent, suggesting HPV may overtake smoking and drinking as a cause of the cancer in future. American doctors say more oral sex following the sexual revolution of the 1960s probably spread HPV to more people's mouths and throats. Actor Michael Douglas said he believed oral sex was to blame for his HPV-related throat cancer in 2013. But Dr Matthew Magarey​, an ear nose and throat surgeon at Epworth and Peter MacCallum hospitals in Melbourne, said while HPV-related throat cancers were [...]

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