head and neck cancer – Page 11

Cancer Patients Who Smoke Report Worse Pain, Symptoms

Source: MedScapeToday.com February 24, 2012 (Palm Springs, California) — Cancer patients who smoke experience more severe symptoms than nonsmoking cancer patients and are also at greater risk of misusing opioids, a new study shows. "Our findings show a profile of higher levels of physical symptoms (pain, fatigue, poor appetite, and insomnia) and psychological symptoms (depression and anxiety) among smokers than non-smokers," report Diane Novy, PhD, from the Pain Management Center at the University of Texas MD Anderson Cancer Center in Houston, Texas, and colleagues. The findings underscore the importance of smoking cessation for this patient population, she told Medscape Medical News, even though it's unclear if there is a causal effect. "We don't know the cause. They may smoke more because of the pain," she said in an interview. However, studies also show that smoking has been known to increase certain types of pain such as back pain, and nerve pain, she added. "If we can motivate them to stop smoking, I think they're better off." The findings were presented here at the American Academy of Pain Medicine (AAPM) 28th Annual Meeting. Pain, Fatigue, Insomnia The study included 486 cancer patients (52% female), with a mean age of 55 years, who were referred to the Pain Management Center for uncontrolled pain. Ninety-four patients were smokers, and the rest (n = 356), classified as nonsmokers, were former smokers or never-smokers. The patients were diagnosed with a wide range of cancers, the most common being gastrointestinal (18.5%), followed by hematologic (15%) and [...]

Charlotte Parker2012-02-28T17:43:34-07:00February, 2012|Oral Cancer News|

Timing of Post-TX Imaging Key in Head, Neck Cancer

Source: MedScape Today Summary The investigators report on a systematic review and meta-analysis of 51 studies involving 2335 patients with head and neck squamous cell carcinoma who underwent post-treatment or surveillance with 18F-fluorodeoxyglucose (FDG) PET or FDG-PET/CT. The random-effects model-weighted mean pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detection of residual disease at the primary tumor site were 79.9% (95% CI, 73.7%-85.2%), 87.5% (95% CI, 85.2%-89.5%), 58.6% (95% CI, 52.6%-64.5%), and 95.1% (95% CI, 93.5%-96.5%), respectively. The respective values for detection of residual post-treatment neck nodes were 72.7% (95% CI, 66.6%-78.2%), 87.6% (95% CI, 85.7%-89.3%), 52.1% (95% CI, 46.6%-57.6%), and 94.5% (95% CI, 93.1%-95.7%). In a subgroup analysis on timing of PET after completion of therapy, scans performed after 12 weeks had significantly higher diagnostic performance than scans done within 12 weeks, but only for residual neck nodes and not for residual disease at the primary tumor site. No statistically significant difference in diagnostic accuracy was noted between stand-alone PET and PET/CT. Viewpoint Well-performed systematic reviews and meta-analyses are important contributions to the literature.[1] In this meta-analysis, the diagnostic performance of dedicated PET and PET/CT with FDG was investigated by pooling the data from a relatively large cohort of patients with head and neck cancer who had been treated with chemoradiation. The pooled evidence demonstrated good diagnostic performance for FDG-PET and FDG-PET/CT, regardless of the type of scanner, with very high NPV but somewhat suboptimal PPV; this is due to the nonspecificity of FDG, [...]

Charlotte Parker2012-02-22T09:47:08-07:00February, 2012|Oral Cancer News|

HPV a gender-neutral killer

Source: DailyPress.com Socially conservative lawmakers will likely repeal Virginia's requirement that schoolgirls get vaccinated against a sexually transmitted virus called HPV that can, and now will, kill many of them. They're repealing it in the name of sexual abstinence, family values and apple pie. In the name of keeping government out of private health-care decisions — and, yes, they say that with a straight face. A body count doesn't bother them. Virtually all cervical cancer is caused by the human papillomavirus, which infects about 80 percent of sexually active adults by age 40. Most don't even know they have it. But, in some women, the virus mutates cells lining the cervix, turning them into cancerous lesions. About 12,000 women each year are diagnosed with cervical cancer, and 4,000 of them will die of it, according to the National Cancer Institute. This vaccine would prevent nearly all that cancer. All that death. Yet for moral reasons, not medical, the GOP-controlled House voted last month to eliminate the state's 2007 requirement that girls receive the vaccine before enrolling in sixth grade. (The vaccine is most effective before the onset of sexual activity.) The bill now goes to the GOP-controlled Senate, where it's also expected to pass. Lawmakers in Richmond weren't swayed by appeals to conscience, to logic or to medicine. They didn't care that the law already allows parents to decline the vaccine for their child for any reason whatsoever. They even rejected an amendment by a socially conservative colleague, Del. Chris [...]

Charlotte Parker2012-02-15T10:16:31-07:00February, 2012|Oral Cancer News|

Adaptive radiotherapy may benefit patients with head and neck cancer

Source: News-Medical.net Researchers led by a senior investigator at Hofstra-North Shore LIJ School of Medicine and The Feinstein Institute for Medical Research have released initial findings from a first-of-a-kind clinical trial in adaptive radiotherapy (ART) for head and neck cancer. The trial, sponsored by the National Cancer Institute, provides evidence that ART may benefit patients with less technical difficulty than previously believed. The findings of this trial were released online in advance of publication in the International Journal of Radiation Oncology Biology Physics. Physicians commonly use radiotherapy to treat squamous cell carcinoma of the oropharynx (back of throat). Current standard-of-care treatment is called intensity-modulated radiotherapy, or IMRT. IMRT allows physicians to "sculpt" radiation to fit the anatomy of individual patients. Although appealing, this technique has a crucial Achilles' heel - it is based entirely on a CT or MRI scan taken before actual treatment begins. Since a typical course of radiation treatment for oropharynx cancer lasts 6-7 weeks, standard IMRT cannot compensate for common changes that take place in a patient's body during this time, such as weight loss, shrinkage of tumor, or gradual movement of normal tissues. Recent work suggests that the inability of standard IMRT to keep up with these changes may lead to unanticipated toxicity, or potentially worse, missing of tumor. For this new trial, which was conducted at the University of Texas M.D. Anderson Cancer Center, investigators started patients on standard IMRT. They then took CT scans while patients were lying in the radiation treatment room [...]

Charlotte Parker2012-02-10T10:40:11-07:00February, 2012|Oral Cancer News|

Head and neck cancer carries substantial comorbidity burden

Source: MedWire News People with head and neck cancer experience a high burden of both acute and chronic comorbidity, shows an analysis of a large Dutch population-based cohort. The researchers therefore advise clinicians to account for patients' comorbidity burden when assessing the risk-benefit profile for different treatment options. Sarah Landis (GlaxoSmithKline, London, UK) and co-workers analyzed information on 1499 patients with squamous cell carcinoma of the head and neck (SCCHN) living in the Netherlands. For each patient they calculated prevalence and incidence rates of eight comorbid conditions: cardiovascular disease, asthma/chronic obstructive pulmonary disease (COPD), liver disease, diabetes, anemia, pneumonia, depression, and other malignant disease. Rates of the same eight conditions were also calculated in a control population of 5996 cancer-free individuals matched for age and gender. Writing in the journal Head and Neck, Landis et al report that the mean age of the SCCHN cohort was 62 years and two-thirds were male. The site of cancer was the oral cavity in 610 patients, the pharynx in 317, and the larynx in 572. The most prevalent comorbidities in patients with SCCHN were cardiovascular disease (41%) and asthma/COPD (12%); the other comorbidities were prevalent in less than 10% of patients. Notably, in the period of 12 months prior to the index date, patients with SCCHN were between two and four times as likely as cancer-free controls to have any of the comorbidities investigated, the authors remark. In terms of incidence, rates of all comorbidities (with the exception of other malignant diseases) were [...]

Charlotte Parker2012-02-06T10:16:32-07:00February, 2012|Oral Cancer News|

Newer radiation technology improves head and neck cancer patients’ long-term quality of life

Source: Eurekalert.org Patients treated with IMRT for head and neck cancer report an increasingly better quality of life post-treatment when compared to patients receiving other forms of radiation therapy, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM. Intensity modulated radiation therapy, or IMRT, is a highly specialized form of external beam radiation therapy that allows the radiation beam to better target and conform to a tumor. It is a newer treatment that has become widely adopted for treating head and neck cancer. Prior studies have shown that IMRT decreases the probability of radiation therapy related side effects, including dry mouth and chewing and swallowing problems, but no study has been conducted to measure long-term quality of life in head and neck cancer patients treated with various forms of radiation therapy. Investigators from the University of California, Davis, School of Medicine, prospectively administered the University of Washington Quality of Life instrument, a standardized, previously validated questionnaire that patients complete after radiation therapy, to 155 patients undergoing treatment for cancers of the head and neck and analyzed the scores over time. Fifty-four percent of patients were initially treated with IMRT and 46 percent were treated with non-IMRT techniques. The researchers showed that the early quality of life gains associated with IMRT not only are maintained but become more magnified over time. At one-year post-treatment, 51 percent of IMRT patients rated their quality of life as very good or outstanding compared [...]

Charlotte Parker2012-01-27T11:29:03-07:00January, 2012|Oral Cancer News|

Grape seed extract kills head and neck cancer cells, leaves healthy cells unharmed

Source: Colorado Cancer Blog Nearly 12,000 people will die of head and neck cancer in the United States this year and worldwide cases will exceed half a million. A study published this week in the journal Carcinogenesis shows that in both cell lines and mouse models, grape seed extract (GSE) kills head and neck squamous cell carcinoma cells, while leaving healthy cells unharmed. “It’s a rather dramatic effect,” says Rajesh Agarwal, PhD, investigator at the University of Colorado Cancer Center and professor at the Skaggs School of Pharmaceutical Sciences. It depends in large part, says Agarwal, on a healthy cell’s ability to wait out damage. “Cancer cells are fast-growing cells,” Agarwal says. “Not only that, but they are necessarily fast growing. When conditions exist in which they can’t grow, they die.” Grape seed extract creates these conditions that are unfavorable to growth. Specifically, the paper shows that grape seed extract both damages cancer cells’ DNA (via increased reactive oxygen species) and stops the pathways that allow repair (as seen by decreased levels of the DNA repair molecules Brca1 and Rad51 and DNA repair foci). “Yet we saw absolutely no toxicity to the mice, themselves,” Agarwal says. Grape seed extract kills head and neck squamous cell carcinoma cells while leaving healthy cells unharmed (image courtesy of Flickr user Anders Ljungberg) Again, the grape seed extract killed the cancer cells but not the healthy cells. “I think the whole point is that cancer cells have a lot of defective pathways and they [...]

Charlotte Parker2012-01-27T11:17:39-07:00January, 2012|Oral Cancer News|

Oral temperature changes in head and neck cancer patients predicts side effect severity

Source: American Society for Radiation Oncology The abstract, "Pilot study of functional infrared imaging for early detection of mucositis in locally advanced head and neck cancer reated with chemoradiotherapy," will be presented at the Head and neck Society Meeting in Arizona today. This is a synopsis of that presentation. Slight temperature increases of the oral mucus membranes early in a head and neck cancer patient's chemotherapy and radiation therapy (chemoradiotherapy) treatment is a predictor of severe mucositis later in treatment, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM. Mucositis, or mouth sores, is a common side effect of chemoradiotherapy for head and neck cancer that is painful and can be very severe. Physicians cannot predict which patients will have mild mucositis or severe mucositis that would require narcotic pain medication, nutritional support and/or feeding tubes. Researchers in this study hypothesized that using sensitive thermal imaging technology to measure temperature changes of less than one-tenth of a degree early in treatment could predict the severity of mucositis later in treatment. This knowledge could allow for early intervention and potential changes in therapy using a technology that is simple, harmless and non-invasive. Patients receiving chemoradiotherapy underwent baseline and weekly thermal imaging of their oral mucus membranes. All patients displayed an increase in temperature and severe mucositis was found in 53 percent of patients. "If we could predict which patients were going to suffer the greatest toxicity, we could proactively make changes to [...]

Charlotte Parker2012-01-26T15:32:36-07:00January, 2012|Oral Cancer News|

Oral Sex Cancer Virus More Common in Men Than Women, Study Finds

Source: Bloomberg.com About 10 percent of men and 3.6 percent of women are orally infected with human papillomavirus, which is acquired through oral sex and can cause cancer. There are two peaks in the age people are infected -- 30 to 34 and 60 to 64, according to the study published today in the Journal of the American Medical Association. The virus is linked to throat cancer, and is becoming a more common cause of the disease as Americans quit smoking. The virus, called HPV, is the most-common sexually transmitted virus in the U.S., where half the population will be infected at some time in their lives, according to the Centers for Disease Control and Prevention. It is known to cause cervical, vulvar, vaginal, penile and anal cancer. The higher HPV infection rate in men explains why their head and neck cancer rates are greater, said Maura Gillison, a professor at the Ohio State University College of Medicine in Columbus. “This provides pretty strong evidence that the higher infection rate is the reason why,” said Gillison, the study’s lead author, in a telephone interview. “This is a jumping board for additional research.” Besides sex, other demographics associated with oral HPV infection include age, lifetime number of sex partners, and the number of cigarettes smoked each day. The research is the first population-based study to examine how many men and women were infected, Gillison said. Existing Vaccines Though Merck & Co.’s Gardasil and GlaxoSmithKline Plc (GSK)’s Cervarix target genital HPV, it’s [...]

Charlotte Parker2012-01-26T10:10:18-07:00January, 2012|Oral Cancer News|

Fatal Infusion Reactions to Cetuximab: Role of Immunoglobulin E–Mediated Anaphylaxis

Source: Journal of Clinical Oncology To the Editor: In Journal of Clinical Oncology, Tronconi et al1 report a fatal hypersensitivity reaction to cetuximab in a 63-year-old patient with metastatic colon cancer and outlined a 0.1% incidence of death in the literature. We greatly acknowledge the authors' desire to communicate the risk of fatal anaphylactic reaction with cetuximab. Over the past 2 years in our center in Tours, France, four instances of grade 4 anaphylactic reactions occurred in patients treated for head and neck cancer (locally advanced or metastatic), with one immediately fatal; another patient died within 5 days (unpublished data). Seven lethal anaphylactic reactions were registered in a pharmacovigilance survey in France, based on spontaneous declarations (Grandvuillemin et al, manuscript in preparation). Anaphylaxis to cetuximab is a problem that merits serious clinical attention. In the authors' words, “the pathogenic mechanisms underlying the development of this phenomenon remain to be elucidated.”1 They raise the hypothesis of immunoglobulin E (IgE) –independent mechanisms, even in the context of a paradoxic atopic history. Moreover, Tronconi et al suggest that the field “search for reliable risk factors that can facilitate the safe selection of patients as candidates for cetuximab-based treatment.”1 These comments are quite surprising, because they do not integrate major contributions that have been previously published. Indeed, it has been known for 3 years that anaphylaxis to cetuximab is the result of antidrug IgE antibodies present in patient serum before therapy.2 These IgE antibodies are directed against galactose-α-1, 3-galactose (α3Gal) residues, present in the [...]

Charlotte Parker2012-01-19T10:24:57-07:00January, 2012|Oral Cancer News|