New Guidelines for Head & Neck Cancer Reirradiation

Source: PhysciansWeekly.com Recurrent and second primary head-and-neck squamous cell carcinomas arising within or close to previously irradiated areas are a significant clinical challenge. The American College of Radiology published appropriateness criteria for recurrent head and neck cancer after prior definitive radiation. Recurrent and second primary head-and-neck squamous cell carcinomas (HNSCC) arising within or close to previously irradiated areas are a significant clinical challenge. Salvage surgical resection is the standard of care, but reirradiation is the only potentially curative treatment when surgery is not an option. Reirradiation is more challenging than initial treatment because of the side effects of prior therapy and concerns about the risks of high cumulative radiation doses to normal structures. Multi-institutional trials and large single institutional experiences have demonstrated that aggressive reirradiation, most often with chemotherapy, is feasible and provides durable locoregional control in some patients. An Expert Consensus on Reirradiation In the August 1, 2011 International Journal of Radiation Oncology * Biology * Physics, the American College of Radiology (ACR) published appropriateness criteria for recurrent head and neck cancer after prior definitive radiation. The ACR expert panel recommended that patient evaluation and reirradiation for HNSCC be performed at a tertiary care center with a head and neck oncology team that is equipped with the resources and experience to manage the complexities and toxicities of retreatment. Evaluation of Patients with Head & Neck Cancer Patient evaluation is important in assuring only appropriate patients are offered reirradiation. Evaluation should include careful restaging imaging, a detailed history and assessment [...]

2012-08-20T10:43:31-07:00August, 2012|Oral Cancer News|

Robotic surgery vs. radiation therapy: study will find which better for throat cancer

Source: http://www.windsorstar.com/ Author: Beatrice Fantoni, The Windsor Star In the first trial of its kind in the world, doctors in London, Ont., are comparing robotic surgery and radiation therapy to find out which method helps throat-cancer patients retain speech and swallowing functions - two very important functions that can have a serious effect on quality of life for cancer survivors. Dr. Anthony Nichols and Dr. David Palma of the London Health Sciences Centre are working with 68 test subjects who have cancer of the back of the throat (also known as oropharyngeal cancer) and measuring the swallowing functions of each patient one year after treatment. Because the cure rate for oropharyngeal cancer is pretty good, Nichols said, he and Palma want to focus on how to improve patients' post-treatment quality of life. In Canada, the standard way of treating oropharyngeal cancer is with a combination of radiation and chemotherapy. However, Nichols said, there can be some longterm side-effects with this treatment, such as dry mouth, hearing loss, taste changes and compromised swallowing function. "The side-effects are more than what we'd like," said Palma. "We want to improve the quality of life." Surgery using a robot is a newer treatment that could perhaps be more appropriate for some oropharyngeal cancer patients, Nichols said. London is currently the only site in Canada to offer what is known as transoral robotic surgery. The robot sounds promising, Palma said, and so it warrants more study. "We don't really know if the 'surgery first' approach [...]

Western University profs to test robotic treatment of throat cancer

Source: metronews.ca Author: Josh Elliott Western University professors David Palma and Anthony Nichols will lead a first-ever study to see if robotic surgery can treat throat cancer while avoiding the long-term side effects that come with chemotherapy and radiation. Transoral robotic surgery (TORS) allows doctors to use miniature robotic arms to operate in tight spaces where human hands can’t fit. London has the only TORS program in Canada. Early stage oropharyngeal cancer patients will be randomly assigned standard radiation care, or the new TORS treatment. Doctors will measure long-term side effects and quality of life following both treatments. Oropharyngeal cancer affects the back of the throat. Radiation therapy is effective at controlling the cancer, but some patients still suffer long-term side effects such as dry throat, difficulty swallowing, and hearing loss. “In the U.S., TORS is being used readily in the treatment of oropharyngeal cancer, in spite of the lack of high-level evidence supporting the use,” said Nichols, a head and neck cancer surgeon at London Health Sciences Centre. Palma, a radiation oncologist at LHSC, says the Western study will compare TORS treatment to traditional radiation therapy. “Before we can implement TORS, we need to prove that it meets that standard: Are the cure rates just as good, and are the side effects less?” Nichols sees reason for optimism: “Early studies of TORS show it holds promise to provide good disease control, as well as offer good speech and swallowing outcomes for patients.”

A New Treatment’s Tantalizing Promise Brings Heartbreaking Ups and Downs

Source: The New York Times Beth McDaniel’s oncologist, a bear of a man, hugged her and twirled her around. “Holy cow, Beth!” Dr. John J. Gohmann exclaimed. For the first time since a rare cancer appeared eight years before, her lymph nodes had shrunk to a normal size, her skin was no longer bright red and inflamed, and the itchiness that plagued her had subsided. Mrs. McDaniel, the 69-year-old wife of a retired corporate executive, had gambled on the ultimate in personalized medicine, an approach known as whole genome sequencing, and it seemed to be paying off. Scientists had compared the entire genetic sequences of the tumor cells invading her body with those in her healthy cells, searching for mutated tumor genes that could be thwarted by drugs approved for other cancers or even other diseases. That had led them to give her an expensive drug approved just a month earlier for melanoma patients. It had never been given to anyone with a blood cell cancer like hers. In theory, the drug should have killed her. Instead, it seemed to have halted or even reversed her cancer. But would it last? And what would it mean if it did not? In the end, Mrs. McDaniel’s journey to the edge of genetics research turned out to be a decidedly mixed experience. It was hard — much harder than anyone in her family had imagined — to get the sequencing and analysis done. It was breathtaking to see the results, which indicated [...]

2012-07-09T09:31:57-07:00July, 2012|Oral Cancer News|

Facing the facts: HPV-associated head and neck cancers get a second look

Source: www.curetoday.com Author: Charlotte Huff Kevin Pruyne knew he didn’t fit the stereotype of a hard drinker or heavy smoker who one day develops an oral cancer. The 52-year-old mechanic had been working a three-week stint in a remote section of northern Alaska, repairing trucks on an oil field, when he noticed a hard lump beneath his jaw while shaving. For nearly three months, as Pruyne was prescribed antibiotics for a possible infection and then later shuttled between physician specialists, he kept hearing the same thing: the lump could not be cancer. Pruyne only occasionally consumed alcohol and had never smoked. His wife, Kathy, began researching her husband’s symptoms, which included repetitive throat clearing, a nagging sensation that something was lodged in his throat and ringing in his ears. And the lump, which looked like the top half of an egg, felt solid to the touch. This wasn’t some inflamed lymph node from a lingering head cold, Kathy Pruyne says. “He had every symptom [of cancer], but nobody would listen to me.” Pruyne received a diagnosis of stage 4 oral cancer, which started with a tumor at the base of his tongue. He had already begun chemotherapy when he learned that researchers had discovered an association between the human papillomavirus (HPV) and increasing rates of oropharyngeal cancers. He asked that his tissue be tested; the results came back positive. Pruyne says he wanted to know whether his cancer was caused by HPV because “the prognosis is considerably better with HPV-positive cancer.” [...]

Perspectives on Coping Among Patients With Head and Neck Cancer Receiving Radiation

Source: MedScape News Today Abstract and Introduction Abstract Purpose/Objectives: To describe coping among patients with laryngeal and oropharyngeal cancer during definitive radiation with or without chemotherapy. Research Approach: Qualitative content analysis conducted within a larger study. Setting: Two radiation oncology outpatient clinics in Baltimore, MD. Participants: 21 patients with oropharyngeal or laryngeal cancer. Methodologic Approach: Interviews with open-ended questions were conducted during treatment. Questions covered topics such as coping during treatment, treatment-related issues, and resources. Main Research Variables: Coping, treatment, and coping resources. Findings: Patients' self-assessments suggested they were coping or that coping was rough or upsetting. Issues that required coping varied over four time points. Physical side effects were problematic during and one month after treatment completion. Patients used coping to manage the uncertainties of physical and psychological aspects of their experience. Family and friend support was a common coping strategy used by patients, with the intensity of side effects corresponding with the support provided across time points. Conclusions: Findings confirm previous research, but also provide new information about ways in which patients with head and neck cancer cope with their illness experience. Emergent themes provide insight into patients' feelings, issues, and assistance received with coping. Interpretation: Patients with head and neck cancer need education on the amount and severity of side effects and should be appraised of potential difficulties with scheduling, driving, and other logistic issues. Patients also should be informed of helpful types of support and coping strategies. Additional research is needed to expand the findings related [...]

2012-06-27T10:08:59-07:00June, 2012|Oral Cancer News|

Darwin’s Principles Say Cancer Will Always Evolve to Resist Treatment

Source: ScienceDaily.com According to researchers at Moffitt Cancer Center, cancer is subject to the evolutionary processes laid out by Charles Darwin in his concept of natural selection. Natural selection was the process identified by Darwin by which nature selects certain physical attributes, or phenotypes, to pass on to offspring to better "fit" the organism to the environment. As applied to cancer, natural selection, a key principle of modern biology, suggests that malignancies in distinct "microhabitats" promote the evolution of resistance to therapies. However, these same evolutionary principles of natural selection can be applied to successfully manage cancer, say Moffitt researchers who published an opinion piece in a recent issue of Nature Reviews Cancer. "Understanding cancer as a disease starts with identifying crucial environmental forces and corresponding adaptive cellular strategies," said Robert A. Gatenby, M.D., chair of the Department of Diagnostic Imaging. "Cancer is driven by environmental selection forces that interact with individual cellular adaptive strategies." Cancer cell development, like any natural selection (or Darwinian) process, is governed by environmental selection forces and cellular adaptive strategies, the authors wrote. Investigating cancer and its proliferation through genetic changes and ignoring the adaptive landscape is most likely futile. Under "selective pressure" of chemotherapy, in this case the "adaptive landscape," resistant populations of cancer cells invariably evolve. The authors say that tumors can be thought of as "continents" populated by multiple cellular species that adapt to regional variations in environmental selection forces. Their strategy in offering this metaphor, they wrote, is to "integrate microenvironmental [...]

2012-06-22T12:53:19-07:00June, 2012|Oral Cancer News|

Facing the Facts: HPV-Associated Head and Neck Cancers Get a Second Look

Source: CureToday.com HPV causes surge in oral cancer rates. Kevin Pruyne knew he didn’t fit the stereotype of a hard drinker or heavy smoker who one day develops an oral cancer. The 52-year-old mechanic had been working a three-week stint in a remote section of northern Alaska, repairing trucks on an oil field, when he noticed a hard lump beneath his jaw while shaving. For nearly three months, as Pruyne was prescribed antibiotics for a possible infection and then later shuttled between physician specialists, he kept hearing the same thing: the lump could not be cancer. Pruyne only occasionally consumed alcohol and had never smoked. His wife, Kathy, began researching her husband’s symptoms, which included repetitive throat clearing, a nagging sensation that something was lodged in his throat and ringing in his ears. And the lump, which looked like the top half of an egg, felt solid to the touch. This wasn’t some inflamed lymph node from a lingering head cold, Kathy Pruyne says. “He had every symptom [of cancer], but nobody would listen to me.”   Kevin Pruyne, with his wife, Kathy, is hopeful his HPV-positive oral cancer will be cured. Photo by Rick Bacmanski. Pruyne received a diagnosis of stage 4 oral cancer, which started with a tumor at the base of his tongue. He had already begun chemotherapy when he learned that researchers had discovered an association between the human papillomavirus (HPV) and increasing rates of oropharyngeal cancers. He asked that his tissue be tested; the results came [...]

2012-06-20T12:05:38-07:00June, 2012|Oral Cancer News|

Allentown woman who lost jaw to cancer shares anti-smoking message

Source: LehighVallyLive.com People often stare at Christine Brader. Sometimes strangers ask the Allentown woman what happened to her. She tells them, "I used to smoke." Tobacco users flinch when they hear her response, Brader says. Smoking led to oral cancer, which eventually cost the 49-year-old all of her teeth and part of her lower jaw.Brader has had three bouts with the disease since her first diagnosis five years ago, but is now cancer free. "I have to go through life disfigured, all because I made a bad decision and smoked," she says. Brader doesn't want others to follow in her footsteps, so she is working with Tobacco Free Northeast Pennsylvania to spread the word about the dangers of smoking. The organization serves a 10-county area, including Lehigh and Northampton, spokeswoman Alice Dalla Palu said. Brader recently shared her story in a radio advertisement broadcast during the week of World No Tobacco Day, which was May 31. In the ad -- part of the Centers for Disease Control "Tips from Former Smokers" campaign -- she describes preparing liquid meals and consuming them through a feeding tube. Last year, Brader appeared in a TV commercial for Truth, a national smoking prevention campaign that targets youth. BREAK THE HABIT: Call 1-800-784-8669 or visit tobaccofreene.com to get help quitting smoking. She started smoking at 16 to fit in with her peers and continued for 28 years. Brader quit cold turkey at 44 after learning in June 2007 that the growth inside her cheek was cancer. [...]

2012-06-18T10:03:27-07:00June, 2012|OCF In The News, Oral Cancer News|

Cannabis chewing gum targets oral side effects

Source: Author: staff The company Medical Marijuana has acquired a 50% stake in CanChew, a cannabinoid (CBD)-based chewing gum developed as a pharmaceutical delivery mechanism to relieve pain, xerostomia, and other side effects of disease and disease treatment. The acquisition gives Medical Marijuana worldwide exclusive rights to develop, manufacture, market, and distribute both tetrahydrocannabinol (THC) and non-THC hemp-derived cannabinoid-infused chewing gum to medical marijuana consumers, according to the company. The U.S. Food and Drug Administration currently considers non-THC based hemp products to be "food-based" and therefore legal without a medical marijuana license. Cannabinoids have had positive effects in clinical trials on neuralgic pain, multiple sclerosis, and spinal cord injuries, nausea and vomiting from chemotherapy and radiation treatment, as well as palliative treatment of various cancers and HIV/AIDS, the company stated. According to Sanammad, the company that developed CanChew, the gum can: Alleviate acute and chronic pain Diminish nausea and vomiting, as well as cachexia, which is a syndrome common in cancer patients on chemotherapy that causes appetite loss and loss of weight and muscle-mass Enhance appetite Improve muscle relaxation, coordination, and mobility Diminish xerostomia Promote fresh breath and maintain oral hygiene "Functional chewing gum is well-established as an effective way to deliver pharmaceutical active ingredients," said Michael Llamas, president of Medical Marijuana. "A great example is Nicorette. Within 10 minutes of chewing Nicorette gum, the consumer's symptoms of nicotine withdrawal begin to ease. Our formulations also have an exceedingly safer side-effect profile compared to the currently available analgesics such as [...]

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