head and neck cancer – Page 12

Many Head and Neck Cancer Survivors Face Eating Problems

Source: HealthDay News Persistent pain, eating problems and depression are the most common problems experienced by long-term survivors of head and neck cancer, a new study finds. In the study, published in the Jan. 16 online issue of the journal Archives of Otolaryngology -- Head & Neck Surgery, researchers looked at 337 people who were diagnosed with head and neck cancer from 1995 to 2004 and survived at least five years. More than 50 percent of the survivors had problems eating because of poor throat functioning, 28.5 percent had symptoms of depression and more than 17 percent had substantial pain, the researchers found. However, when the long-term survivors were compared to age-matched people in the general population, their average general health was similar, Dr. Gerry Funk, of the University of Iowa Hospitals and Clinics in Iowa City, and colleagues explained in a journal news release. The investigators also found that pain and diet in the first year after cancer treatment were the strongest independent predictors of five-year, health-related quality-of-life outcomes. Problems with mouth and throat function in head and neck cancer survivors can be due to factors such as neuromuscular changes, anatomic deficits after surgery, pain and dental problems, the researchers noted. "Early interventions addressing eating issues, swallowing problems and pain management will be a crucial component in improving this patient population's long-term quality of life, especially in those who are functioning poorly one year after diagnosis," the study authors concluded. This story was also covered in a narrative form [...]

Charlotte Parker2012-01-18T13:54:28-07:00January, 2012|Oral Cancer News|

Review Finds Evidence Lacking for Dry Mouth Remedies

Source: Medscape Today December 28, 2011 — There is not enough evidence to recommend any topical therapies for dry mouth, but that does not mean that they do not work, according to investigators who published a review of research on the therapies online December 4 in the Cochrane Library. "There was very little evidence," said Helen Worthington, PhD, a professor of evidence-based care at the University of Manchester, United Kingdom. Dr. Worthington and colleagues scoured the literature for randomized controlled trials of topical therapies for dry mouth, or xerostomia. They found 36 studies of treatments such as lozenges, sprays, mouth rinses, gels, oils, chewing gum, and toothpaste. Xerostomia often results from treatments for head and neck cancer that damage the salivary glands, as well as from Sjögren's syndrome, an autoimmune disorder that also damages these glands. It is also a common adverse effect of many medications. The authors cite an estimated prevalence of dry mouth of about 20% in the general population. This percentage may be increasing because people are living longer and suffering from more chronic illnesses for which the treatments can have xerostomia as an adverse effect. It is possible to feel the sensation of dry mouth without having a clinically reduced saliva flow, the researchers point out. The treatments in the review broke down into 2 broad categories: saliva substitutes, in which some other substance is intended to perform the role of the patient's own saliva, and saliva stimulants, which are intended to activate the patient's own [...]

Oral Cancer Foundation News Team - A2011-12-28T15:56:36-07:00December, 2011|Oral Cancer News|

Quality-of-Life Outcomes in Transoral Robotic Surgery

Source: SAGE Journals Online Abstract Objective. To report long-term, health-related quality-of-life (HRQOL) outcomes in patients treated with transoral robotic surgery (TORS). Study Design. Prospective, longitudinal, clinical study on functional and HRQOL outcomes in TORS. Setting. University tertiary care facility. Subjects and Methods. Patients who underwent TORS were asked to complete a Head and Neck Cancer Inventory before treatment and at 3 weeks and 3, 6, and 12 months postoperatively. Demographic, clinicopathological, and follow-up data were collected. Results. Sixty-four patients who underwent TORS were enrolled. A total of 113 TORS procedures were performed. The mean follow-up time was 16.3 ± 7.49 months. The HRQOL was assessed at 3 weeks and at 3, 6, and 12 months, with a response rate of 78%, 44%, 41%, and 28%, respectively. TORS was performed most frequently for squamous cell carcinoma (88%). There was a decrease from baseline in the speech, eating, aesthetic, social, and overall QOL domains immediately after treatment. At the 1-year follow-up, the HRQOL scores in the aesthetic, social, and overall QOL domains were in the high domain. Patients with malignant lesions had significantly lower postoperative HRQOL scores in the speech, eating, social, and overall QOL domains (P < .05). Patients who underwent adjuvant radiation therapy or chemotherapy and radiation therapy had lower postoperative scores in the eating, social, and overall QOL domains (P < .05). Conclusion. The preliminary data show that patients who undergo TORS for malignancies and receive adjuvant therapy tend to have lower HRQOL outcomes. TORS is a promising, minimally [...]

Oral Cancer Foundation News Team - A2011-12-27T10:58:43-07:00December, 2011|Oral Cancer News|

A Planned Neck Dissection is Not Necessary in All Patients with N2-3 Head-and-Neck Cancer After Sequential Chemoradiotherapy

Source: DocGuide.com PURPOSE: To assess the role of a planned neck dissection (PND) after sequential chemoradiotherapy for patients with head-and-neck cancer with N2-N3 nodal disease. METHODS AND MATERIALS: We reviewed 90 patients with N2-N3 head-and-neck squamous cell carcinoma treated between 1991 and 2001 on two sequential chemoradiotherapy protocols. All patients received induction and concurrent chemotherapy with cisplatin and 5-fluorocuracil, with or without tirapazamine. Patients with less than a clinical complete response (cCR) in the neck proceeded to a PND after chemoradiation. The primary endpoint was nodal response. Clinical outcomes and patterns of failure were analyzed. RESULTS: The median follow-up durations for living and all patients were 8.3 years (range, 1.5-16.3 year) and 5.4 years (range, 0.6-16.3 years), respectively. Of the 48 patients with nodal cCR whose necks were observed, 5 patients had neck failures as a component of their recurrence [neck and primary (n = 2); neck, primary, and distant (n = 1); neck only (n = 1); neck and distant (n = 1)]. Therefore, PND may have benefited only 2 patients (4%) [neck only failure (n = 1); neck and distant failure (n = 1)]. The pathologic complete response (pCR) rate for those with a clinical partial response (cPR) undergoing PND (n = 30) was 53%. The 5-year neck control rates after cCR, cPR→pCR, and cPR→pPR were 90%, 93%, and 78%, respectively (p = 0.36). The 5-year disease-free survival rates for the cCR, cPR→pCR, and cPR→pPR groups were 53%, 75%, and 42%, respectively (p = 0.04). CONCLUSION: In our [...]

Oral Cancer Foundation News Team - A2011-12-13T10:52:02-07:00December, 2011|Oral Cancer News|

UI professors: HPV editorial misses the mark

Source: The Daily Iowan The Nov. 29 editorial "Recommend Pap smears, not vaccines, to prevent cervical cancer" completely missed the mark with regard to HPV vaccines. We are researchers and clinicians at the University of Iowa who study and treat HPV and other infectious diseases. It is disturbing to think that the article might dissuade individuals from getting a safe and effective vaccine that can prevent cancer. First of all, it has been conclusively demonstrated that the vaccines are effective at preventing HPV infection. Cervical cancer is caused by HPV. Additionally, cancers of the head and neck are linked to HPV, including cancers in males. It has been clearly shown that the vaccines prevent the development of precursors to cervical cancer. In the editorial, Dr. Diane Harper was quoted as saying, "If doctors tell patients that this vaccination will prevent cancer, they're telling them a lie." This statement from Dr. Harper is simply misleading. In the vaccine studies, non-treatment of precursor lesions in the placebo group in the context of a clinical trial was considered unethical, and therefore, any precursor lesions were treated. Subsequent development of cancer in the placebo group was prevented by the required ethical treatment. Thus, the trials could not evaluate prevention of advanced cancer, per se. Because it takes cervical cancer a long time to develop, it will take about 15 more years to have data on incidence rates of cervical cancer from a large vaccinated general population. Because the vaccines prevent HPV infection and HPV-associated [...]

Oral Cancer Foundation News Team - A2011-12-08T10:31:17-07:00December, 2011|Oral Cancer News|

Lymphedema Common After Head and Neck Cancer

Source: Elsevier Global Medical News SAN FRANCISCO (EGMN) - Lymphedema is highly common and a source of considerable morbidity among patients who undergo treatment for head and neck cancer, finds a cross-sectional study among 103 survivors. Fully three-fourths had developed some degree of lymphedema, according to results presented at the annual Oncology Congress presented by Reed Medical Education. The more severe it was, the more likely patients were to have symptoms, functional impairments, and poorer quality of life. Disease and treatment-related factors such as high radiation dose and combined surgery and radiation therapy were risk factors for the development of lymphedema. "This is the first study that we are aware of in the United States of this depth to systematically examine lymphedema" in this population, noted lead investigator Jie Deng, Ph.D., R.N., O.C.N., a postdoctoral fellow at the Vanderbilt University, Nashville, Tenn. "Health care professionals should be aware that lymphedema is a frequent late effect in the head and neck cancer population," she advised. "We need to educate patients about the risk of lymphedema prior to treatment, during treatment, and posttreatment, and we need to conduct external and internal examinations to evaluate related signs and symptoms at each clinic visit." Patients found to have any signs or symptoms should be referred for lymphedema assessment. Furthermore, "it's very important we have very detailed documentation so we can follow up on patients' treatment effect and also identify potential issues in this population," Dr. Deng stressed. "An interdisciplinary approach is needed to [...]

Oral Cancer Foundation News Team - A2011-12-06T10:29:30-07:00December, 2011|Oral Cancer News|

Predictors of survival in mucosal melanoma of the head and neck.

Source:MedScape.com Jethanamest D; Vila PM; Sikora AG; Morris LG Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, USA. BACKGROUND: The head and neck is the most common site of mucosal melanoma, a cancer with poor prognosis. In contrast to cutaneous melanoma, mucosal melanoma of the head and neck (MMHN) is uncommon, with limited data regarding outcomes and prognostic factors drawn from small, single-institution case series. In order to identify factors predictive of survival, we analyzed MMHN outcomes in a large US cohort. METHODS: MMHN cases (n = 815) diagnosed in the USA between 1973 and 2007 were analyzed in the Surveillance, Epidemiology, and End Results registry, and cause of death was individually determined in 778 (95.5%) cases. Kaplan-Meier survival analysis and Cox proportional hazards regression were used to analyze prognostic variables. RESULTS: Disease-specific survival status was determined in 778 (95.5%) cases. The 5- and 10-year rates of overall survival (OS) were 25.2 and 12.2%; disease-specific survival (DSS), 32.4 and 19.3%. On multivariable analysis, anatomic primary site was an independent predictor of OS and DSS, with tumors in the nasal cavity and oral cavity associated with survival superior to tumors in the nasopharynx and paranasal sinuses. Age > 70 years, tumor size, nodal status, and distant metastasis status were additional independent predictors of poorer survival. CONCLUSIONS: In this large cohort of patients with MMHN, we have identified several novel factors robustly predictive of overall and melanoma-specific survival. This news story was resourced by the Oral Cancer Foundation, and [...]

Oral Cancer Foundation News Team - A2011-11-14T18:04:18-07:00November, 2011|Oral Cancer News|

Although Most Smokers Want to Quit… Only a Fraction Actually Do

Source: The Wall Street Journal Author: Betsy McKay More than two-thirds of American smokers want to quit, but only a fraction actually do, underscoring a need for more services, messages, and access to medications to help them kick the habit, according to a new government report out today. Nearly 69% of adult smokers wanted to quit in 2010 and more than half tried, but only 6.2% succeeded, according to the Centers for Disease Control and Prevention. Those who try to quit can double or triple their chances with counseling or medications, but most of those who did try to quit in 2010 didn’t use either. Nor did they receive advice on how to quit from a doctor. The findings suggest more needs to be done to help smokers quit — particularly certain segments of the population with low quit rates, said Tim McAfee, director of the public health agency’s Office on Smoking and Health, in an interview. Nearly 76% of African-American smokers wanted to quit last year, and 59% tried — well above the national average, said McAfee. But a mere 3.2% succeeded, which is the lowest rate among measured races and ethnicities. American smokers with college degrees had a far higher rate of success at quitting — 11.4% — than smokers with fewer than 12 years of schooling, who had only a 3.2% success rate. Still, McAfee said, there are some encouraging signs. For example, the percentage of young adults between the ages of 25 and 44 who want to [...]

Charlotte Parker2011-11-11T15:22:32-07:00November, 2011|Oral Cancer News|

FDA Approves Cetuximab for Late-Stage Head and Neck Cancer

Source: The Oncology Report The Food and Drug Administration on Nov. 7 approved cetuximab as an initial treatment of late-stage head and neck cancer in combination with chemotherapy. Cetuximab, marketed as Erbitux by Bristol-Myers Squibb, is an epidermal growth factor receptor (EGFR) antagonist, administered as an intravenous infusion. Previously, it was approved in combination with radiation therapy for the initial treatment of locally or regionally advanced squamous cell carcinoma. It was also approved for use alone in patients with recurrent locoregional disease or metastatic disease whose disease has progressed following platinum-based chemotherapy. The newly approved indication is for the treatment of these recurrent or metastatic patients as an initial therapy in combination with platinum-based therapy with 5-fluorouracil (5-FU), a BMS spokesperson said. (At press time, the company had not yet issued a statement on the approval.) Erbitux was initially approved in 2004 to treat EGFR-positive late-stage colon cancer after patients stopped responding to chemotherapy and was approved in 2006 for the treatment of head and neck cancer. The newly approved indication is for "recurrent locoregional disease or metastatic squamous cell carcinoma of the head and neck in combination with platinum-based therapy with 5-FU," according to the revised label, posted on the FDA Web site. The two previously approved indications for head and neck cancer were for "locally or regionally advanced squamous cell carcinoma of the head and neck in combination with radiation therapy," and for "recurrent or metastatic squamous cell carcinoma of the head and neck progressing after platinum-based therapy. [...]

Oral Cancer Foundation News Team - A2011-11-09T11:05:16-07:00November, 2011|Oral Cancer News|

FDA Approves Cetuximab for Metastatic Head and Neck Cancer

Source: MedScape News Today The US Food and Drug Administration (FDA) has approved cetuximab (Erbitux, Bristol-Myers Squibb ) for use in combination with chemotherapy for the treatment of metastatic head and neck cancer. Data show that when combined with cisplatin-based chemotherapy, cetuximab improved overall survival, compared with chemotherapy alone. According to the researchers, this is the first time in 3 decades — since cisplatin was first used in head and neck cancer — that any regimen has improved on its success. The improved survival that was seen after cetuximab was added to the regimen (at a median of 2.7 months) is "therefore notable." Cetuximab was approved in the United States in 2004 for the treatment of epidermal growth-factor receptor–positive late-stage colon cancer in patients who no longer responded to chemotherapy. In 2006, it was approved for use in combination with radiation therapy for the treatment of locally or regionally advanced squamous cell carcinoma of the head and neck. This latest approval expands on that to cover metastatic head and neck cancer. The ability of cetuximab "to extend the lives of patients with head and neck cancer is an important tool for oncologists, who often rely on a multitreatment approach for patients," said Richard Pazdur, MD, director of the Office of Hematology and Oncology Drug Products in the FDA's Center for Drug Evaluation and Research, in a statement." Given the aggressive nature of head and neck cancers that cannot be treated with surgery and radiation, it is important that patients have [...]

Oral Cancer Foundation News Team - A2011-11-08T12:00:48-07:00November, 2011|Oral Cancer News|