mucositis – Page 2 – Oral Cancer News

A Look at Therapy Toxicities & Biology in Head & Neck Cancers

Source: journals.lww.com Author: Valerie Neff Newitt A measure of intrigue and discovery pertaining to head and neck cancer, spiked with compassion for patients struggling against treatment toxicities, helps quench the intellectual thirst of Yvonne Mowery, MD, PhD, Butler Harris Assistant Professor of Radiation Oncology at Duke University Medical Center, Durham, N.C. Splitting time between the clinic and laboratory, Mowery is actively engaged in patient care as well as preclinical, translational, and clinical research. “I hope to get a better understanding of the biology of head and neck cancer and determine pathways that we can target to reduce metastatic spread of the disease and improve responsiveness to available treatments,” she told Oncology Times. Long before reaching her current status as an award-winning investigator, Mowery grew up in Richmond, Va., in the midst of a “completely non-scientific” family. “I was an oddball,” she joked, while recalling her parents' patience with her backyard composting experiments that became so foul-smelling that the health department was contacted. As a kid, her idea of a great present was an encyclopedia of science, and the thing that caught her eye at the toy store was a junior chemistry set. Science was clearly her path when she headed to the University of Virginia. In her sophomore year, Mowery began working in a genetics lab. That's where the lure of fruit flies took hold. “I looked at the development of their reproductive system and found that very interesting,” she recalled. Nearing the completion of her undergraduate education, Mowery debated [...]

Oral Cancer Foundation News Team - A2018-11-04T07:47:45-07:00November, 2018|Oral Cancer News|

Supportive care for patients with head and neck cancer

Source: www.oncnursingnews.com Author: Melissa A. Grier, MSN, APRN, ACNS-BC Supporting a patient during cancer treatment is a challenge. From symptom management to psychosocial considerations, each patient’s needs vary and must be reevaluated frequently. This is especially true for patients with head and neck cancer. Head and neck cancers often result in serious quality of life issues. Surgical resection of the affected area can cause disfigurement that not only affects function (eating, drinking, speaking, etc) but also leads to self-image concerns and depression. Radiation therapy and chemotherapy may cause a variety of unpleasant adverse effects, including burns, xerostomia, dental caries, and mucositis. Below are some considerations to help guide nursing care for this patient population. CALL FOR REINFORCEMENTS National Comprehensive Cancer Network guidelines recommend early involvement of a dentist, a dietitian, and a speech therapist to help address pre- and posttreatment concerns and preserve quality of life for people with head and neck cancer. The benefits of multidisciplinary collaboration for these complex cases are many but may also result in confusion and information overload for your patient. As the healthcare team provides care, you can help explain the rationale for interventions and assist them with keeping track of recommendations. Additionally, you have a team of experts you can call on when specific issues present themselves during treatment. KEEP AN EYE OUT A lot goes on in the life of a patient with head and neck cancer, which means everyday activities like oral and skin care may fall a little lower on [...]

Oral Cancer Foundation News Team - A2018-05-08T08:16:44-07:00May, 2018|Oral Cancer News|

Update on head and neck cancers, HPV: creating public awareness

Source: www.dentistryiq.com Author: Maria Perno Goldie, RDH, MS Public awareness of head and neck cancer (HNC) is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV).1 The online survey of 2,126 randomly selected adults in the United States. Most respondents lacked understanding of the organs or tissues affected by head and neck cancer, with 21% incorrectly identifying brain cancer as head and neck cancer. Only 0.8% of respondents identified HPV infection as a risk factor for mouth and throat cancer, but more were aware of the vaccine. The investigators projected that extensive HPV vaccination could prevent almost 9,000 cases of oropharyngeal cancer yearly. The conclusion was that self-reported and objective measures indicate that few American adults know much about HNC including risk factors such as tobacco use and HPV infection and common symptoms. Strategies to improve public awareness and knowledge of signs, symptoms, and risk factors may decrease the disease burden of HNC and are important topics for future research. The American Dental Association has a pamphlet titled “Get the Facts About Mouth and Throat Cancer.”2 Human papillomavirus type 16 (HPV-16) is a major contributory factor in oropharyngeal squamous cell carcinoma (OPSCC). The detection of primary OPSCC is often delayed due to the complicated anatomy of the oropharynx. One study examined the possibility of HPV-16 DNA detection in pretreatment and posttreatment plasma and saliva and its possible role as a marker of [...]

Oral Cancer Foundation News Team - A2014-09-17T19:26:13-07:00September, 2014|Oral Cancer News|

Doxepin rinse relieves pain in patients with radiation-related oral mucositis

Source: www.onclive.com Author: Lauren M. Green Doxepin rinse may prove to be a viable option for the relief of pain associated with oral mucositis (OM) in patients with head and neck cancers, according to findings of a phase III trial. This randomized, double-blind, placebo-controlled trial, conducted under the auspices of the Alliance for Clinical Trials in Oncology cooperative group, enrolled 155 patients who were being treated at 26 cancer centers across the country between December 2010 and May 2012. To be eligible, patients were undergoing radiotherapy to a minimum planned dose of 50 Gy and experiencing OM-related pain ≥4 on a 0 to 10 scale. Participants were randomized 1:1 to receive either doxepin (25 mg diluted to 5 mL with 2.5 mL of sterile or distilled water) on day 1, then crossing over to a placebo on a subsequent day (arm A), or placebo on the first day followed by the doxepin preparation (arm B). Patients in both arms were instructed to swish the solution in their mouth for 1 minute, gargle, and expectorate. The study’s primary endpoint was a reduction in pain as measured by the pain scale’s area under the curve (AUC), using assessments based on the Oral Mucositis Daily and Weekly Questionnaires–Head and Neck Cancer, administered at baseline and at 5, 15, 30, 60, 120, and 240 minutes for each treatment arm. Patients were allowed to leave after the first hour, instructed to complete the questionnaires at 2- and 4-hour intervals, and received telephone reminders. Researchers reported [...]

Oral Cancer Foundation News Team - A2014-05-24T09:06:18-07:00May, 2014|Oral Cancer News|

Humidifying mouth, throat during radiotherapy cuts mucositis

Source: www.drbicuspid.com Author: staff Head and neck cancer (HNC) patients who received daily humidification of the mouth and throat during radiation therapy treatment spent nearly 50% fewer days hospitalized to manage their side effects, such as mucositis, according to research presented at the recent Multidisciplinary Head and Neck Cancer Symposium in Scottsdale, AZ. Mucositis, inflammation and ulceration of the mouth and throat, is a painful side effect of radiation therapy that can negatively affect patients' quality of life. Using humidification is based on the fact that moisturizing wounds generally helps them heal faster, according to the researchers. The study by the Trans Tasman Radiation Oncology Group (TROG) evaluated 210 HNC patients in New Zealand and Australia from June 2007 to June 2011. Patients in the phase III trial were randomized to institutional standard of care (control group) or humidification. The humidified air was delivered through the nose via a plastic interface (mask-type apparatus) that can be worn by patients while sleeping or sitting. Patients began humidification on the first day of radiation therapy and continued until the ulceration in their mouth and throat had resolved. On average, humidification patients spent 57% as many days in the hospital to manage side effects, compared with the controls (control = 4.1 days, humidification = 2.3 days). The humidifier group also resumed close-to-normal eating patterns at significantly higher rates three months after radiotherapy. Only 43 patients (42%) of the patients in the humidification group met the defined benchmark of humidification compliance and were able [...]

Oral Cancer Foundation News Team - A2014-03-23T13:26:37-07:00March, 2014|Oral Cancer News|

SSRI Prevents Depression in Head, Neck Cancer

Source: MedPage TodayBy Salynn Boyles, Contributing WriterPublished: June 21, 2013 Prophylactic escitalopram cut the incidence of depression in head and neck cancer patients by more than 50% and improved quality of life, a clinical trial showed. Significantly fewer patients taking the antidepressant developed depression, when compared with those on placebo (10% vs 24.6%; stratified log-rank test, P=.04), according to a study in the June 20 issue of JAMA Otolaryngology Head and Neck Surgery. "Depression is very common among patients with this disease, but it is not easy to predict who will become depressed at the beginning of treatment," University of Nebraska Medical Center professor of head and neck oncology William Lydiatt, MD, told MedPage Today. "That's why the prevention paradigm may offer considerable benefit at an acceptable risk." As many as half of head and neck cancer patients develop clinical depression within months of their diagnosis and suicide rates are among the highest in patients with a medical illness, Lydiatt noted. "The burden of treatment is extensive and frequently includes dysphagia, disfigurement, voice alterations, mucositis, need for tracheostomy and feeding tubes, fatigue and depression," the researchers wrote. They chose the generic version of the popular SSRI Lexapro for the trial to give patients an affordable treatment option that's well tolerated in the elderly. The randomized, double-blind trial included 148 newly diagnosed head and neck cancer patients entering treatment who did not yet have a diagnosis of depression. The patients were stratified by sex, site of disease, stage, and primary modality of [...]

Charlotte Parker2013-06-21T14:10:07-07:00June, 2013|Oral Cancer News|

Kentucky cancer center emphasizes patients’ quality of life

Source: www.drbicuspid.com Author: Donna Domino, Features Editor The James Graham Brown Cancer Center at the University of Louisville is among a growing number of facilities working to improve care for head and neck cancer (HNC) patients through collaborative care programs that bring together a spectrum of oncology specialists. The center provides multidisciplinary treatment for HNC patients using novel techniques that decrease the debilitating side effects of radiation and chemotherapy. The clinic also conducts research and clinical trials with targeted therapies that aim to restore patients' oral functions. Kentucky has a higher rate of HNC than the U.S. average, which provides a large patient pool for the many clinical trials that the center conducts, according to Zafrulla Khan, DDS, MS, professor and director of maxillofacial/oncologic dentistry in the center's HNC clinic. "That's what happens when you mix tobacco and bourbon," Dr. Khan noted. Intraoral radiation shields Some of the center's novel treatment techniques involve using intraoral radiation shields during brachytherapy radiotherapy procedures to prevent the tongue and nearby oral areas from getting irradiated while minimizing mucositis and xerostomia, Dr. Khan explained. Intraoral radiation shields prevent the tongue and nearby oral areas from getting irradiated while minimizing mucositis and xerostomia "We put catheters right into tumors so they can deliver the radiotherapy in the mouth with high-density therapy machines rather than doing an external beam," he said. The clinic also uses a surgical obturator, a prosthetic device that enables patients to speak and swallow following surgery for maxillary sinus cancer. [...]

Oral Cancer Foundation News Team - A2013-02-20T07:32:57-07:00February, 2013|Oral Cancer News|

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 [...]

Charlotte Parker2012-06-27T10:08:59-07:00June, 2012|Oral Cancer News|

Dental oncology: Meeting a growing need

Source: Dr.Biscuspid.com The good news is more cancer patients are surviving than ever before. The bad news is it creates new challenges for the medical community to provide adequate and appropriate aftercare and treat the many short- and long-term side effects of cancer treatment. For example, chemotherapy and radiation often cause oral problems such as mucositis, xerostomia, oral and systemic infections, and accelerated caries development. But many dentists refuse to treat cancer patients with these conditions due to the increased risk of osteonecrosis from radiation treatment or bisphosphonate use. Enter Ryan Lee, DDS, MPH, MHA, who is finishing a postgraduate clinical fellowship in dental oncology at Memorial Sloan-Kettering Cancer Center in New York City. He hopes to help solve the shortage of dentists with the training to treat the growing number of cancer patients who need specialized oral care. Ryan Lee, DDS, is one of a handful of dentists specializing in dental oncology. Dr. Lee is one of two fellows in Sloan-Kettering's dental oncology fellowship program, which has been offering the specialty training for at least a decade. "All along I've liked working on medically complex cases with dental needs, so cancer fit into that niche very well," he told DrBicuspid.com. "I've come to realize how much of a growing need it is and how little is available to meet that need," he explained. Currently, only two cancer hospitals offer fellowship training programs for dental oncology: the Memorial Sloan-Kettering Cancer Center and the University of Texas MD Anderson Cancer Center. [...]

Charlotte Parker2012-06-07T10:09:20-07:00June, 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|