dry mouth

Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial

The Lancet Oncology, Early Online Publication, 13 January 2011 Dr Christopher M Nutting FRCR a b , James P Morden MSc b, Kevin J Harrington FRCR a b, Teresa Guerrero Urbano PhD c, Shreerang A Bhide FRCR a, Catharine Clark PhD d, Elizabeth A Miles MPhil e, Aisha B Miah FRCR a, Kate Newbold FRCR a, MaryAnne Tanay MSc a, Fawzi Adab FRCR f, Sarah J Jefferies FRCR g, Christopher Scrase FRCR h, Beng K Yap FRCR i, Roger P A'Hern MSc b, Mark A Sydenham BSc b, Marie Emson BSc b, Emma Hall PhD b, on behalf of the PARSPORT trial management group† Summary Background Xerostomia is the most common late side-effect of radiotherapy to the head and neck. Compared with conventional radiotherapy, intensity-modulated radiotherapy (IMRT) can reduce irradiation of the parotid glands. We assessed the hypothesis that parotid-sparing IMRT reduces the incidence of severe xerostomia. Methods We undertook a randomised controlled trial between Jan 21, 2003, and Dec 7, 2007, that compared conventional radiotherapy (control) with parotid-sparing IMRT. We randomly assigned patients with histologically confirmed pharyngeal squamous-cell carcinoma (T1—4, N0—3, M0) at six UK radiotherapy centres between the two radiotherapy techniques (1:1 ratio). A dose of 60 or 65 Gy was prescribed in 30 daily fractions given Monday to Friday. Treatment was not masked. Randomization was by computer-generated permuted blocks and was stratified by centre and tumor site. Our primary endpoint was the proportion of patients with grade 2 or worse xerostomia at 12 months, as assessed by [...]

Oral Cancer Foundation News Team - A2011-01-17T11:52:14-07:00January, 2011|Oral Cancer News|

Featured clinical trial: electroacupuncture for radiation-induced chronic dry mouth

Source: www.cancer.gov/ncicancerbulletin Author: staff Name of the Trial Randomized Pilot Study of Electroacupuncture for Chronic Radiation-induced Xerostomia in Patients with Head and Neck Cancer (MAYO-MCS285). See the protocol summary 1. Why This Trial Is Important Head and neck cancers are often treated with external-beam radiation therapy 2. Although this treatment can be effective in controlling head and neck tumors, it may cause side effects 3 that can compromise a patient’s quality of life. Chronic dry mouth, also called xerostomia, is common among patients treated with radiation to the head and neck. This condition results from damage to the glands that produce saliva. Chronic dry mouth can have a major impact 4 on quality of life by causing pain and discomfort, affecting the ability to sleep, altering taste, and/or increasing the likelihood of dental problems. Some drugs are available for xerostomia induced by radiation therapy, but many patients experience only a partial improvement or no benefit at all. The drug amifostine 5 can help protect the salivary glands of some head and neck cancer patients from radiation damage, but this drug cannot be used in all patients. Some studies have suggested that acupuncture 6 can help relieve the sensation of mouth dryness in cancer patients who have undergone head and neck radiation therapy. Based on these studies and other evidence, researchers at the Mayo Clinic in Scottsdale, AZ, are investigating the ability of a procedure called electroacupuncture to help improve the production of saliva and the quality of life of patients [...]

Oral Cancer Foundation News Team - A2010-07-31T08:00:30-07:00July, 2010|Oral Cancer News|

Advanced type of cancer radiation reduces side effects, but impact on controlling cancer is unclear

Source: www.sunherald.com Author: press release An advanced type of cancer radiation is more successful than traditional radiation in avoiding "dry mouth" when treating head and neck cancers, but it is unknown whether the treatment is better or worse at reducing the size of tumors, according to a new comparative effectiveness review funded by HHS' Agency for Healthcare Research and Quality. The report finds that intensity-modulated radiation therapy (IMRT) leads to fewer cases of xerostomia, commonly known as dry mouth, than other types of radiation. Xerostomia, a potential side effect to radiation when salivary glands are damaged, can affect basic functions like chewing, swallowing and breathing; senses such as taste, smell and hearing; and can significantly alter a patient's appearance and voice. However, the report did not find evidence that IMRT is more successful than any other kind of radiation therapy in reducing tumors. Many scientists consider IMRT to be theoretically better able to target cancerous cells while sparing healthy tissues, but more research is needed, the report said. The comparative effectiveness review, Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer, was authored by the Blue Cross and Blue Shield (BC/BS) Association, Technology Evaluation Center in Chicago. "The development of new technologies to treat cancer has been one of the true success stories of American medical research," said AHRQ Director Carolyn M. Clancy, M.D. "This report provides patients and their doctors with more information about these advances, which they can use to make more informed choices about [...]

Oral Cancer Foundation News Team - A2010-05-27T21:12:29-07:00May, 2010|Oral Cancer News|

Radiotherapy: the unsung hero of cancer care, say experts

Source: news.oneindia.in Author: staff Experts at the world's leading cancer charity have said that radiotherapy, which is a crucial cancer treatment, is often the unsung hero of cancer care. Although surgery is often the first-line of treatment and anti-cancer drugs make more headlines, radiotherapy zaps cancer cells, complements chemotherapy, relieves symptoms and shrinks tumors before surgery. In fact, four out of ten cancer patients who have beaten the disease receive the treatment at some point - and 120,000 people in the UK benefit from radiotherapy every year. But despite its benefits, it still has a slightly scary reputation, possibly because as it destroys cancer cells with a beam of high-energy rays, radiotherapy - like other cancer treatments - can also damage healthy cells. The treatment can lead to unpleasant reactions on the skin, tiredness, hair loss and mouth ulcers. But over the last 20 years huge strides have been made to improve radiotherapy and reduce these side effects. According to Cancer Research UK, decades of research into improving radiotherapy have made it more effective, sophisticated and targeted than it has ever been - and side effects have been reduced. Just last year, Dr Chris Nutting presented early results from a Cancer Research UK-funded radiotherapy trial called PARSPORT, run by The Institute of Cancer Research and The Royal Marsden Hospital. The trial tested a new cutting edge radiotherapy technique called intensity modulated radiotherapy (IMRT), as mentioned in the video above. Doctors found they were able to target the tumour more accurately [...]

Oral Cancer Foundation News Team - A2010-04-20T08:34:47-07:00April, 2010|Oral Cancer News|

Nutritional sciences investigator wins NIH challenge grant

Source: uanews.org (University of Arizona) Author: Jeff Harrison Kirsten Limesand's research focuses on how to restore salivary gland function in cancer patients. Each year approximately 40,000 people in the U.S. are diagnosed with some form of head and neck cancer. The majority of those patients will have surgery to remove the tumors, followed by one or more rounds of radiation therapy to kill any lingering cancer cells. A common side effect of radiation to this area is damage to the adjacent, normal salivary glands. Patients commonly experience a dry mouth that can lead to oral sores and infections, cavities, difficulty chewing and swallowing food and loss of taste. Kirsten Limesand, an assistant professor of nutritional sciences in the University of Arizona College of Agriculture and Life Sciences, has received a two-year NIH Challenge Grant worth nearly $1 million to study this problem. Specifically, Limesand is examining the role of autophagy in salivary glands in response to radiation therapy. Autophagy is an ongoing process where cells digest and recycle their proteins and organelles. This helps starving cells break down and redirect components from non-essential to essential cell functions. The process and the mechanics behind it are not well understood, but autophagy appears to have some role in preventing and fighting disease and infection. It also, in some cases, could make those problems worse. Side effects from radiation therapy begin within a few days and can continue for one to two years. Because saliva is essential for maintaining oral health, salivary gland [...]

Oral Cancer Foundation News Team - A2010-04-14T07:19:19-07:00April, 2010|Oral Cancer News|

Time-released muco-adhesive patch more effective than oral rinse for xerostomia

Source: www.news-medical.net/news Author: press release A newly developed time-released muco-adhesive patch for treating oral health conditions, including the widespread condition of dry mouth (xerostomia), has been shown to be more effective than a leading oral rinse, according to a newly-published study. As increasing segments of the population consume more medications (one of the leading causes of dry mouth), the results of this study could potentially help provide relief for millions of Americans. Chronic dry mouth impacts the quality of life and for some, can be debilitating. Published in the March 2010 issue of Quintessence International, the study found that chronic dry mouth sufferers can now get a statistically significant reduction of mouth dryness from a new time-released muco-adhesive patch (OraMoist Dry Mouth Patch), compared with the leading oral rinse which has been on the market for nearly two decades. Overall, patients with xerostomia treated with the muco-adhesive patch reported a statistically significant reduction in mouth dryness sensation with elevated salivary flow rate (150%) after just 30 minutes, which was considered clinically outstanding by the study authors, since the product does not contain any cholinergic agonist, a drug often used to treat dry mouth. OraMoist, a new time-released, non-drug formula, not only outperformed the mouthwash, one of the most often used delivery formats for treating dry mouth, but unlike dry mouth sprays, rinses or gels, which need to be applied frequently – sometimes every 20 minutes – OraMoist works to increase moisture and help restore a healthy oral environment for hours [...]

Oral Cancer Foundation News Team - A2010-03-23T18:26:50-07:00March, 2010|Oral Cancer News|

Group acupuncture to relieve radiation induced xerostomia: a feasibility study

Source: Acupuncture in Medicine 2009;27:109-113 Author: Richard Simcock et al. Background: A distressing complication of radiotherapy treatment for head and neck cancer is xerostomia (chronic oral dryness). Xerostomia is difficult to treat conventionally but there are reports that acupuncture can help. We conducted a feasibility study to examine the acceptability of a standardised group acupuncture technique and adherence to group sessions, together with acceptability of the objective and subjective measurements of xerostomia. Methods: 12 males with established radiation induced xerostomia were treated in three groups of four. Each received eight weekly sessions of acupuncture using four bilateral acupuncture points (Salivary Gland 2; Modified Point Zero; Shen Men and one point in the distal radial aspect of each index finger (LI1)). Sialometry and quality of life assessments were performed at baseline and at the end of treatment. A semi-structured interview was conducted a week after completing the intervention. Results: Adherence to and acceptability of the treatment and assessments was 100%. There were objective increases in the amounts of saliva produced for 6/12 patients post intervention and the majority also reported subjective improvements. Mean quality of life scores for domains related to salivation and xerostomia also showed improvement. At baseline 92% (11/12) patients reported experiencing a dry mouth "quite a bit/very much" as compared to 42% (5/12) after the treatment. Qualitative data revealed that the patients enjoyed the sessions. Conclusion: The pilot study shows that a standardised group technique is deliverable and effective. The tools for objective and subjective assessment are appropriate [...]

Oral Cancer Foundation News Team - A2009-09-06T15:57:33-07:00September, 2009|Oral Cancer News|

Taste and smell disorders caused by cancer or treatments add to patients’ problems

Source: www.oncologynursingnews.com Author: Delicia Yard Although the mechanisms underlying abnormalities in the senses of taste and smell in cancer patients are unknown, such disturbances clearly decrease quality of life for the majority of cancer patients—and clinicians need to be aware of the problem in order to help a person's recovery. This is the word from a study recently published in The Journal of Supportive Oncology (2009;7:58-65). Jae Hee Hong, PhD, Pinar Omur-Ozbek, PhD, Brian T. Stanek, and coinvestigators from Wake Forest University Comprehensive Cancer Center and Virginia Tech's food science and technology department and biomedical engineering school conclude, “Oncologists who understand the types and causes of taste and olfactory abnormalities may be better prepared to discuss and empathize with these negative side effects.” Altered sensory perception can undermine a person's struggle against cancer by causing malnutrition and anxiety. One study cited by Dr Hong and colleagues found that malnutrition, not malignancy, was the primary cause of morbidity in 20% of cancer patients. Dr Hong and colleagues explain that disorders of taste and odor can result from cancer itself or from cancer treatments, with 68% of chemotherapy patients reporting such problems. But the specific causes of these alterations often remain unidentified. How Senses Go Bad According to the researchers, problems with taste and smell break down into 3 categories: loss of sensitivity, distorted perception, and hallucination. The abnormalities may take the following forms: • absence of taste perception (ageusia) or odor perception (anosmia) • reduced sensitivity to taste perception (hypogeusia) or [...]

Oral Cancer Foundation News Team - A2009-08-19T12:07:17-07:00August, 2009|Oral Cancer News|

GlaxoSmithKline to acquire the leading dry mouth brand, Biotene

Source: www.marketwatch.com Author: press release GlaxoSmithKline Consumer Healthcare announced today that it has reached an agreement with Laclede, a privately held company, to purchase the leading Dry Mouth brand Biotene(R) for $170 million. The transaction is subject to regulatory review by competition authorities in the United States and Europe, and is expected to complete by early 2009. "The acquisition of Biotene extends our portfolio in therapeutic oral healthcare to include a proven treatment for Dry Mouth," said John Clarke, President, GSK Consumer Healthcare. "This opportunity leverages our global capability with dental and medical professionals and is a further step towards our goal in GSK of building and growing a diversified healthcare business." Biotene is the world's number one dentist and hygienist-recommended Dry Mouth product for the growing population that suffers from this condition. Biotene is a brand in strong growth, with global sales in 2007 of around $50 million up 17%. Approximately 65% of the brand's current sales are in the United States. Dry Mouth, a condition known as Xerostomia, is a significant health issue associated with chronic medical conditions that include diabetes, rheumatoid arthritis, Sjogren's syndrome and Parkinson's disease. Additionally, cancer chemotherapy or radiation treatment, as well as any of more than 400 medications that, as a side-effect, can cause Dry Mouth. Globally, Dry Mouth is as prevalent as dental sensitivity, affecting around one-in-five adults. Biotene joins a world-class portfolio of Oral Healthcare Brands, including: - Aquafresh(R), Odol-med(R), Binaca(R), a leading range of toothpastes, toothbrushes, mouthwashes and whitening products [...]

Oral Cancer Foundation News Team - A2008-10-22T13:40:35-07:00October, 2008|Oral Cancer News|