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 [...]

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

Facing the Facts: HPV-Associated Head and Neck Cancers Get a Second Look

Source: CureToday.com HPV causes surge in oral cancer rates. Kevin Pruyne knew he didn’t fit the stereotype of a hard drinker or heavy smoker who one day develops an oral cancer. The 52-year-old mechanic had been working a three-week stint in a remote section of northern Alaska, repairing trucks on an oil field, when he noticed a hard lump beneath his jaw while shaving. For nearly three months, as Pruyne was prescribed antibiotics for a possible infection and then later shuttled between physician specialists, he kept hearing the same thing: the lump could not be cancer. Pruyne only occasionally consumed alcohol and had never smoked. His wife, Kathy, began researching her husband’s symptoms, which included repetitive throat clearing, a nagging sensation that something was lodged in his throat and ringing in his ears. And the lump, which looked like the top half of an egg, felt solid to the touch. This wasn’t some inflamed lymph node from a lingering head cold, Kathy Pruyne says. “He had every symptom [of cancer], but nobody would listen to me.”   Kevin Pruyne, with his wife, Kathy, is hopeful his HPV-positive oral cancer will be cured. Photo by Rick Bacmanski. Pruyne received a diagnosis of stage 4 oral cancer, which started with a tumor at the base of his tongue. He had already begun chemotherapy when he learned that researchers had discovered an association between the human papillomavirus (HPV) and increasing rates of oropharyngeal cancers. He asked that his tissue be tested; the results came [...]

2012-06-20T12:05:38-07:00June, 2012|Oral Cancer News|

Suicide Rates Among Oral Cancer Patients on the Rise

Source: Dr.Bicuspid.com May 23, 2012 -- Suicide rates among patients with oral cavity and oropharyngeal (OC/OP) cancer have increased significantly over the past three decades, particularly among male patients during the first year after diagnosis. As many as half of patients with head and neck cancer suffer from depression, among the highest of all oncology patients (Clinical Advances in Hematology & Oncology, June 2009 Vol. 7:6, pp. 397-403). However, despite documented high rates of depression and suicide among patients with head and neck cancer, studies examining suicide and other noncancer-related deaths in patients with OC/OP have not been published. Brian Hill, executive director of the Oral Cancer Foundation, survived stage 4 bilateral cervical lymph node metastases from oropharyngeal cancer. This gap prompted researchers from the New York Eye and Ear Infirmary, New York Medical College, and Peking University to analyze 32,487 patients with OC/OP cancer using the Surveillance, Epidemiology, and End Results cancer registry data for 1980-1984, 1990-1994, 2000-2003, and 2004-2007 (Archives of Otolaryngology-Head & Neck Surgery, January 2012, Vol. 138:1, pp. 25-32). They found that from 1980-1984 to 2004-2007, deaths from suicide increased by 406.2% (p = .01), while cardiovascular disease-related and pneumonia-related deaths decreased by 45.9% (p < .001) and 42.9% (p = .009), respectively. Risk factors for mortality included age (55-64), marital status, advanced tumor stage, and tumor location. The researchers also calculated standardized mortality ratios (SMRs) for suicide, cardiovascular disease, and pneumonia and compared them with patient demographic and clinical characteristics. The risk of death from [...]

2012-05-24T10:21:11-07:00May, 2012|OCF In The News, Oral Cancer News|

Actor’s Diagnosis Puts Spotlight on Oral Cancer

Source: DrBicuspid.com May 9, 2012 -- Actor Michael Douglas' recent revelation that he has stage IV oropharyngeal cancer has highlighted the growing incidence of oral cancer, and experts say dentists can help stem the alarming increase of the disease by checking for it during routine examinations. The actor's cancer includes a walnut-sized tumor at the base of his tongue, and he will require radiation therapy, chemotherapy, and surgery. Douglas says his doctors told him he has an 80% survival rate if it hasn't spread to his lymph nodes. While tobacco was the prime cause of oral cancer in the past, recent studies have attributed the steady increase of the disease to the human papillomavirus (HPV). There are approximately 130 versions of HPV but only nine cause cancers, and the HPV16 version causes almost half of the oral cancers in the U.S., said Brian Hill, executive director of the Oral Cancer Foundation. "Tobacco is no longer the only bad guy," he told DrBicuspid.com. “HPV16 is increasing in incidence as the causative etiology, and if it continues on this trend line, it will replace tobacco as the primary cause of oral cancers." Dentists can play a key role in catching the disease in its early stages if they check for it during examinations, Hill pointed out. "But many dentists think it's such a rare disease that they don't bother to screen for it," he said. "Most Americans have never even heard of oral cancer, but it's not as rare or uncommon as [...]

2012-05-17T09:43:19-07:00May, 2012|Oral Cancer News|

Actor Michael Douglas Partners With Oral Cancer Foundation For Early Detection PSA Campaign

LOS ANGELES, May 14, 2012 /PRNewswire-USNewswire/ -- Actor and producer Michael Douglas has donated his time to help create a television public service announcement (PSA) on behalf of the Oral Cancer Foundation (OCF), a non-profit organization dedicated to helping those affected by the disease. The PSA will support the Foundation's efforts to educate the public about the need for annual screenings to catch oral cancers in their early, most survivable stages. The public service announcement will begin airing in June, and will continue to air nationwide through summer and autumn. Approximately 40,000 people in the US will be newly diagnosed with oral cancer in 2012. This includes those cancers that occur in the mouth itself, in the very back of the mouth known as the oropharynx, and on the exterior lip of the mouth. There are two distinct pathways by which most people come to oral cancer. One is through the use of tobacco and alcohol, and the other is through exposure to the HPV-16 virus (human papilloma virus version 16), a newly identified etiology, and the same virus which is responsible for the vast majority of cervical cancers in women. While oral cancer has historically been linked to tobacco and alcohol use, this is not simply a smoker's disease any longer. New data shows that the fastest-growing segment of newly diagnosed cases is now young, non-smokers. Most startling, is the fact that while many other cancers have been in decline in recent years, the occurrence of oral / oropharyngeal [...]

2012-05-14T19:59:49-07:00May, 2012|OCF In The News, Oral Cancer News|

Radiotherapy May Be Enough for HPV-Positive Throat Cancer

Source: Medscape Today May 11, 2012 (Barcelona, Spain) — Radiotherapy alone might be just as effective as more toxic regimens in the treatment of light smokers or nonsmokers with human papillomavirus (HPV)-positive advanced oropharyngeal carcinomas, according to research presented here at ESTRO 31: European Society for Radiotherapy and Oncology 2012 Annual Conference. "Moderately accelerated radiotherapy as a single modality may be a safe and presumably morbidity-sparing treatment strategy for these patients," said Pernille Lassen, MD, a resident in medical and radiation oncology at Aarhus University Hospital in Denmark. "What we are suggesting — knowing that it's not randomized and knowing that it's not a very large series — is that perhaps we don't need to treat these patients with chemotherapy and all the other things that we do," she told Medscape Medical News. We're "not recommending one treatment over another; this is a contribution to the ongoing debate. But [we're] showing that we really cure a lot of patients with radiotherapy alone in this select group of nonsmokers or light smokers and HPV positivity." The researchers examined 181 patients from the Danish Head and Neck Cancer Group (DAHANCA) database who had advanced oropharyngeal cancer that had metastasized to the lymph nodes or beyond (stage III and IV). Cumulative smoking history was categorized as greater than or less than 10 pack-years (1 pack-year is equivalent to 20 cigarettes per day for 1 year), and pretreatment tumor immunohistochemistry was assessed on the basis of HPV-associated p16 expression (positive or negative). "p16 expression is a striking [...]

2012-05-11T10:55:04-07:00May, 2012|Oral Cancer News|

HPV Cancer Hits 8,000 Men, 18,000 Women a Year

Source: WebMD.com HPV cancer isn't just a female problem, new CDC figures show. Although HPV causes 18,000 cancers in women each year, it also causes 8,000 cancers in men, the CDC calculates. To get the figures, CDC researchers analyzed data collected from 2004 to 2008 in two large cancer registries. HPV, human papillomavirus, is the cause of nearly all cervical cancers. But that's obviously not the only cancer caused by this sexually transmitted virus. HPV also causes about two-thirds of mouth/throat (oropharyngeal) cancers, 93% of anal cancers, and more than a third of penile cancers. Men are four times more likely than women to get HPV mouth/throat cancer, while women are more likely than men to get HPV anal cancer. Clearly, HPV is not just a female problem. Yet it was only last year that one of the two FDA-approved HPV vaccines was recommended for teen boys. Gardasil was recommended for girls in 2006; Cervarix was recommended for girls in 2009. "HPV vaccines are important prevention tools to reduce the incidence of non-cervical cancers," the CDC notes in a report in the April 20 issue of Morbidity and Mortality Weekly Report. "Transmission of HPV also can be reduced through condom use and limiting the number of sexual partners." HPV vaccines are most effective when given before people become sexually active. Yet in 2010, less than a third of teen girls had received all three doses of HPV vaccines. Numbers aren't yet available for boys. The slow uptake of the vaccine [...]

2012-04-25T11:21:53-07:00April, 2012|Oral Cancer News|

Prognostic Significance of HPV Status in Oropharyngeal Cancer

OncologySTAT Editorial Team Dr. Maura Gillison is Professor of Medicine, Epidemiology, and Otolaryngology at Ohio State University in Columbus. OncologySTAT: The results of the Radiation Therapy Oncology Group (RTOG) 0129 trial showed that the human papillomavirus (HPV) is an independent prognostic factor in oropharyngeal cancer. Could you tell us about the rationale for this study? Dr. Gillison: Over the last 10 years, our research has shown that cancers of the oropharynx are actually 2 completely different diseases that can look quite similar. One subset is caused HPV infection, and the other is more closely associated with long-term use of alcohol and tobacco. Initial studies suggested that the presence of HPV in a patient’s tumor had prognostic significance, but study limitations made that conclusion dubious. We set out to determine whether or not HPV was indeed an independent prognostic factor in head and neck cancer. To show whether there was a direct relationship between HPV infection and head and neck cancer, we needed to prospectively study a uniformly treated and uniformly staged patient population. Thus, we used the study population from the trial conducted by the RTOG. We divided the patients into 2 groups—those whose tumors were caused by HPV and those whose tumors were not—and we compared survival outcomes for the 2 groups. The results showed that HPV status was the single most important predictor of patient outcome, even more so than disease stage and other well-known prognostic factors such as performance status and presence of anemia. In fact, after [...]

2012-04-18T10:16:03-07:00April, 2012|Oral Cancer News|

Maura L. Gillison, M.D., Ph.D., Receives AACR’s Richard and Hinda Rosenthal Memorial Award

Source: AACR News CHICAGO — The American Association for Cancer Research will award Maura L. Gillison, M.D., Ph.D., with the 36th Annual AACR Richard and Hinda Rosenthal Memorial Award during the AACR Annual Meeting 2012, held here March 31 – April 4. Gillison is receiving this award in recognition of her significant contributions to the understanding of the role of human papillomavirus (HPV) in head and neck cancers. Gillison’s award lecture, “Clinical implications of HPV in head and neck cancers,” will take place at 10 a.m. CT on Wednesday, April 4 in room S100 of the McCormick Place Convention Center. “It is an honor to be the recipient of this award,” said Gillison. “Our team strives to generate data that will improve the lives of individuals affected by head and neck cancers, and this is a wonderful validation that we are on the right track.” This award is designed to provide incentive to young investigators early in their careers. It was established in 1977 by the AACR and the Rosenthal Family Foundation to recognize research that has made, or promises to make, a notable contribution to improved clinical care in the field of cancer. Gillison is a professor of medicine, epidemiology and otolaryngology and the Jeg Coughlin Chair of Cancer Research at Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus, Ohio. She is also adjunct faculty at The Johns Hopkins University School of Medicine, in Baltimore, Md. Her [...]

2012-03-23T09:31:04-07:00March, 2012|Oral Cancer News|

Epidermal Growth Factor Receptor and the Changing Face of Oropharyngeal Cancer

Source: Journal of Clinical Oncology To the Editor: In their article, Chaturvedi et al1 document the rise in human papillomavirus (HPV) –associated cancers as a proportion of squamous cell carcinomas of the oropharynx over the last 25 years. The contemporary figures are mirrored by two recent British studies2,3 demonstrating that the majority of oropharyngeal cancers are now HPV related. In the accompanying editorial,4 Mroz et al rightly highlight the importance of evaluating HPV vaccination for both men and women in the light of these data and lament the lack of significant improvement in the outcomes for non–HPV-associated head and neck cancers. However, they also suggest that the benefit of targeting epidermal growth factor receptor (EGFR) through concurrent cetuximab may be confined to HPV-associated tumors. Although EGFR expression per se does not correlate closely with response to cetuximab, there is increasing evidence of an inverse correlation between p16INK4A expression (as a marker of HPV association) and EGFR expression shown by immunohistochemistry.5,6 Though suppressed by viral oncogenes, HPV-associated tumors retain wild-type P53,7 and patients with this tumor type have demonstrated excellent survival with existing protocols such as concurrent chemoradiotherapy or surgery with postoperative radiotherapy. Conversely, non-HPV tumors, harboring a range of mutations,8 may respond less well to DNA-damaging agents, but patients with these tumors might benefit from the addition of concurrent EGFR blockade to radiotherapy. Data from the recent SPECTRUM (Study of Panitumumab Efficacy in Patients With Recurrent and/or Metastatic Head and Neck Cancer) study of adding another EGFR-targeting monoclonal antibody, panitumumab,9 [...]

2012-03-09T10:34:29-07:00March, 2012|Oral Cancer News|
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