Imaging technique identifies early metastasis in lymph nodes

Source: www.newswise.com Author: National Institute of Biomedical Imaging and Bioengineering NIBIB-funded researchers have developed a highly sensitive and accurate imaging technique for non-invasive screening of lymph nodes for metastatic cancer. Current practice calls for invasive surgical biopsies to determine whether deadly metastatic cancer cells have invaded the lymph nodes. The new imaging technique – so far tested in mice – offers a rapid and effective tool to noninvasively identify very small numbers of these cells, known as micrometastases, thus detecting cancer’s spread at its earliest stages, which is critical for timely treatment. The work, developed at the University of Texas at Austin and the University of Texas MD Anderson Cancer Center, is reported in the October issue of Cancer Research. The technique uses an imaging approach known as ultrasound-guided photoacoustics combined with nanosensors designed to target and identify metastatic cells in lymph nodes. Richard Conroy, Ph.D., Director of the NIBIB Program in Molecular Imaging elaborates on the technology’s potential: "This work is an excellent example of the development of a cutting edge technology that works very well in an experimental system but also has great potential to change the way we monitor and diagnose cancer metastasis. Identifying the accumulation of cells early in the process with some molecular characterization offers the opportunity for more targeted and effective treatment and fewer side effects.” More than 90% of cancer deaths can be attributed to metastases either directly or indirectly. In current clinical practice, an invasive surgical procedure called sentinel lymph node (SLN) [...]

FDA approve Lymphoseek to evaluate head and neck cancer

Source: www.medicalnewstoday.com Author: Catharine Paddock PhD The US Food and Drug Administration have given the OK for doctors to use Lymphoseek - a radioactive diagnostic imaging agent - to evaluate the spread of squamous cell carcinoma in the body's head and neck region. Lymphoseek (technetium 99m tilmanocept) Injection was approved by the Food and Drug Administration (FDA) in 2013 to help doctors identify lymph nodes closest to primary tumors in patients with breast cancer and melanoma. The receptor-targeted lymphatic mapping agent is marketed by Navidea, a biopharma company based in Dublin, OH. Identification of lymph nodes in cancer is important because they filter fluid that drains from tissue. If this tissue is cancerous then the fluid will contain cancer cells, and testing lymph nodes - via biopsy - for presence of cancer cells helps determine if the cancer has spread. The approval of Lymphoseek for use in head and neck cancer patients means doctors will be able to use the agent to guide testing of sentinel nodes - lymph nodes closest to a primary tumor - allowing for the "option of more limited lymph node surgery in patients with sentinel nodes negative for cancer," say the FDA. In a clinical trial, researchers found that "Lymphoseek-guided sentinel lymph node biopsy accurately determined if the cancer had spread through the lymphatic system." Dr. Libero Marzella, director of the Division of Medical Imaging Products in the federal agency's Center for Drug Evaluation and Research, says: "For some patients with head and [...]

Recurrent head and neck tumors have gene mutations that could be vulnerable to cancer drug

Source: medicalxpress.com Author: staff An examination of the genetic landscape of head and neck cancers indicates that while metastatic and primary tumor cells share similar mutations, recurrent disease is associated with gene alterations that could be exquisitely sensitive to an existing cancer drug. Researchers from the University of Pittsburgh Cancer Institute (UPCI) and Yale University School of Medicine will share their findings during a mini-symposium Sunday at the American Association for Cancer Research Annual Meeting 2014. About 50 percent of patients diagnosed with head and neck squamous cell cancers already have disease that has spread, or metastasized, to the lymph nodes, explained Jennifer Grandis, M.D., distinguished professor and vice chair of research, Department of Otolaryngology, Pitt School of Medicine, and director of the Head and Neck Program at UPCI, partner with UPMC CancerCenter. About 20 to 30 percent of patients thought to be cured of the disease go on to develop recurrent cancer, which typically doesn't respond to standard treatments. "We decided to compare the genetic signatures of tumor cells from primary tumors with those from disease that had spread and cancers that were thought cured but then came back in the hopes of getting some clues about how best to guide therapy in these different settings," Dr. Grandis said. "We found that recurrent cancers might have an Achilles' heel we can exploit to kill them." The team conducted the first whole-exome genetic sequencing study on what Dr. Grandis called its "treasure trove" of frozen patient samples and found similar [...]

Improving QOL in head and neck cancer as survival improves

Source: www.medscape.com Author: Zosia Chustecka In patients undergoing radiation treatment for head and neck cancer, reducing the radiation to organs not affected by cancer is key to improving quality of life post-treatment. Several studies presented here at the 2014 Multidisciplinary Head and Neck Cancer Symposium described new approaches to sparing radiation delivered to the salivary glands and to the voice box, without any loss of cancer control, but with a reported reduction in adverse effects, such as xerostomia (dry mouth), and an anticipated reduction in loss of voice and speech quality. Improvements in such outcomes are becoming increasingly important as the epidemiology of head and neck cancer is changing, and the increase in human papillomavirus-positive disease means that patients are being diagnosed their 50s and will, in many cases, go on to live for decades after their definitive cancer treatment, researchers commented at a press briefing. Xerostomia can make it difficult to speak, as well as chew and swallow, and can lead to dental problems. "Dry mouth might seem trivial, but it actually has a significant effect on quality of life," commented Tyler Robin, PhD, an MD candidate in his final year at the University of Colorado Medical School in Denver. To reduce this adverse effect, intensity-modulated radiation techniques are already directing the beam away from the parotid gland, which is responsible for stimulated saliva production, for example during eating. But for the rest of the time, saliva is produced unstimulated from the submandibular gland. "This gland actually produces the [...]

2014-02-28T14:23:04-07:00February, 2014|Oral Cancer News|

Contralateral submandibular gland-sparing radiation safe, effective in head, neck cancers

Source: helio.comPublished: February 24, 2014  Sparing the contralateral submandibular gland with low doses of radiation therapy appeared safe and effective among patients with locally advanced head and neck cancers, according to study results presented at the Multidisciplinary Head and Neck Cancer Symposium. “Historically ... there has been hesitation to spare the submandibular gland from radiation because there are lymph nodes near the gland that also end up not getting treated,” researcher Tyler Robin, PhD, an MD candidate at the University of Colorado School of Medicine, said in a press release. “While this seems worrisome because head and neck cancer spreads through the lymph nodes, it is well established that the risk of cancer involvement in the lymph nodes near the submandibular gland is exceedingly low, yet the benefit of sparing the gland for a patient’s quality of life is high.” Robin and colleagues evaluated data from 71 patients who underwent contralateral submandibular gland-sparing radiation therapy at the University of Colorado Cancer Center or Memorial Sloan-Kettering Cancer Center. The median age of patients was 55 years. About half of patients were current or former smokers, and half were never smokers. Nearly 50% of patients had lesions involving the base of the tongue. About 80% of patients had N2b or greater disease, and 90% of patients had overall stage IV disease. Researchers classified contralateral submandibular gland sparing as mean radiation doses to the contralateral submandibular gland of ≤39 Gy. The mean radiation dose to the contralateral submandibular gland of all patients in [...]

2014-02-26T15:59:38-07:00February, 2014|Oral Cancer News|

Gland-sparing technique safe in tonsillar, tongue cancers

Source: oncologypractice.com/The Oncology ReportPublished: February 24, 2014By: Neil Osterweil  SCOTTSDALE, ARIZ. – Although radiation oncologists have typically worried that, in patients with oral cancers, leaving contralateral submandibular glands untreated could lead to tumor involvement of nearby lymph nodes, those worries may soon be put to rest, suggest results of a small retrospective study. Among 71 patients with locally advanced cancers of the tongue base or tonsils who underwent radiation therapy that avoided targeting the contralateral submandibular glands, there were no cancer recurrences in contralateral level 1B nodes after a median 27.3 months of follow-up, reported Dr. Tyler Robin of the University of Colorado at Denver, Aurora. "We’re interested in sparing the contralateral submandibular gland because we’re interested in minimizing xerostomia. Xerostomia is a significant morbidity of head and neck cancer radiotherapy, and it has substantial impact on patient quality of life," Dr. Robin said at the Multidisciplinary Head and Neck Cancer Symposium. Intensity-modulated radiation therapy (IMRT) allows treatment beams to be shaped to avoid the parotid glands with no subsequent increase in regional lymph node failures and preservation of parotid salivary flow. But patient-reported xerostomia and quality-of-life outcomes with parotid-sparing techniques have been mixed, Dr. Robin said. "Interestingly, an earlier study looking at predictors of xerostomia found that dose to the submandibular gland was a stronger predictor of xerostomia than dose to the parotids, and this may be because of the role of the submandibular gland in unstimulated salivary flow," he said. The submandibular gland is located near level IB [...]

2014-02-25T17:53:10-07:00February, 2014|Oral Cancer News|

Dental hygienist, consultant detects own oral cancer

Source: www.dentistryiq.com Author: Shelli Castor Dental hygienist and practice-management consultant Barbara Boland discovered at the young age of 41 that she had oral cancer. Boland is now a 10-year cancer survivor, and she hopes her story and experiences will serve to start a continuing dialogue about oral cancer, especially among dental professionals. Boland graduated from Temple University in Pennsylvania in 1982 and has been working as a practice-management consultant for 24 years. In December 2002, she discovered a peculiar white spot on her tongue that she knew she hadn’t noticed before. She kept an eye on the spot for a month, and because it was changing, she showed her tongue to a head and neck surgeon. The surgeon responded that it couldn’t be cancer for various reasons: she didn’t smoke or drink, she was female, and she was “too young” — there was no way the spot could be cancer. While such an almost flippant response to a patient’s concerns seems wildly out of place and unexpected today, Boland notes that 10 years ago, dental and medical professionals were not well-educated on the signs, symptoms, and risk factors of oral cancer. For dental and medical professionals 10 years ago, the most common risk factors included tobacco and alcohol use, age, and the fact that males had a higher incidence of oral cancer than females. Boland fit none of those categories, and so her concerns were not seen as pressing. Still, the spot on her tongue “didn’t feel right” to her. [...]

Researchers find overactive protein among mouth cancer patients

Source: http://www.ibtimes.co.uk/ Author: B.S. Akshaya An overactive protein in mouth cancer encourages tumours to grow fast and scientists claim that the protein will help them to find an effective treatment for the disease. Cancer Research UK scientists have discovered FRMD4A, a protein that is overactive among mouth cancer patients. They claim that just deactivating the protein will help save many lives. A study conducted on mice revealed that when FRMD4A protein is turned on, it helps the cancer cells to group and stick together, but when the protein is deactivated the stickiness of the cell is lost and ultimately it causes cancer cells to die. Scientists have already found some potential drugs that could help them deactivate the protein. “What’s really exciting about this research is that we already have potential drugs that can be used to target this protein or compensate for the effects that it is having,” said Dr Stephen Goldie, researcher at Cancer Research UK, in a statement. “These drugs could offer new options to patients where surgery and chemotherapy have not worked or could be used alongside them. We now need to start trials with these treatments, but we hope this could make a real difference to people with mouth cancer in the future,” he added. Mouth cancer starts anywhere in the oral cavity area like in the cheek lining area, the floor of the mouth, gums or the roof of the mouth (palate). Symptoms of this cancer are chewing problems, mouth sores, speech difficulty, swallowing [...]

2013-07-19T07:41:38-07:00July, 2013|Oral Cancer News|

Spike in oral cancers puzzles experts

Source: www.turnto23.com Author: Victoria Colliver/San Francisco Chronicle Christine Schulz has never visited England, but she speaks with the clipped inflection of a vaguely British accent. It's not an affectation but, rather, the mystifying after-effect of an 18-hour surgery she endured in 2009 to remove about half her tongue due to a cancerous growth that had spread to her lymph nodes. Surgeons used skin from her wrist and upper leg to re-create the missing portions of her tongue. Through long term speech therapy, Schulz, 47, of Hollister, Calif., re-learned how to eat and talk with her reconstructed tongue. If she sounds as if she's from a different country, Schulz isn't complaining. "At the moment I woke up from surgery, I realized exactly what a huge deal it was," she said, describing how she had an incision in her throat to allow her to breathe and was prohibited to speak in her earliest days of healing. Oral cancers, which include those of the mouth and tongue, are most common in men over 60 with a long history of smoking or chewing tobacco, often combined with heavy drinking. But in recent years, a spike in the incidence of oral cancers is being attributed to human papilloma virus or HPV. But Schulz's cancer was neither HPV-- nor tobacco-related. That puts her in a camp of fewer than 7 percent of all oral cancers that have no identifiable cause, according to the Oral Cancer Foundation, an advocacy group based in Newport Beach, Calif. "Surprisingly, a [...]

Interim results from CEL-SCI’s Multikine Phase III study on head and neck cancer

Source: www.news-medical.net CEL-SCI Corporation announced today that an interim review of the safety data from its open label, randomized, controlled, pivotal Phase III study of Multikine (Leukocyte Interleukin, Injection) investigational immunotherapy by an Independent Data Monitoring Committee (IDMC) raised no safety concerns. The IDMC also indicated that no safety signals were found that would call into question the benefit/risk of continuing the study. CEL-SCI considers the results of the IDMC review to be important since studies have shown that up to 30% of Phase III trials fail due to safety considerations and the IDMC's safety findings from this interim review were similar to those reported by investigators during CEL-SCI's Phase I-II trials. Ultimately, the decision as to whether a drug is safe is made by the FDA based on an assessment of all of the data from a trial. IDMCs are committees commonly used by sponsors of clinical trials to protect the interests of the patients in ongoing trials especially when the trials involve patients with life threatening diseases, and when, as in cancer clinical trials, they extend over long periods of time (3-5 years). The committee's membership should include physicians and clinical trial scientists knowledgeable in the appropriate disciplines, including statistics. The CEL-SCI IDMC includes prominent physicians and scientists from major institutions in the USA and abroad who are key opinion leaders in head and neck cancer and who are knowledgeable in all of the disciplines related to CEL-SCI's study, including statistics. The Multikine Phase III study is enrolling [...]

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