quality of life – Page 2 – Oral Cancer News

Western University profs to test robotic treatment of throat cancer

Source: metronews.ca Author: Josh Elliott Western University professors David Palma and Anthony Nichols will lead a first-ever study to see if robotic surgery can treat throat cancer while avoiding the long-term side effects that come with chemotherapy and radiation. Transoral robotic surgery (TORS) allows doctors to use miniature robotic arms to operate in tight spaces where human hands can’t fit. London has the only TORS program in Canada. Early stage oropharyngeal cancer patients will be randomly assigned standard radiation care, or the new TORS treatment. Doctors will measure long-term side effects and quality of life following both treatments. Oropharyngeal cancer affects the back of the throat. Radiation therapy is effective at controlling the cancer, but some patients still suffer long-term side effects such as dry throat, difficulty swallowing, and hearing loss. “In the U.S., TORS is being used readily in the treatment of oropharyngeal cancer, in spite of the lack of high-level evidence supporting the use,” said Nichols, a head and neck cancer surgeon at London Health Sciences Centre. Palma, a radiation oncologist at LHSC, says the Western study will compare TORS treatment to traditional radiation therapy. “Before we can implement TORS, we need to prove that it meets that standard: Are the cure rates just as good, and are the side effects less?” Nichols sees reason for optimism: “Early studies of TORS show it holds promise to provide good disease control, as well as offer good speech and swallowing outcomes for patients.”

Oral Cancer Foundation News Team - A2012-07-18T06:09:13-07:00July, 2012|Oral Cancer News|

IMRT provides better QOL in head and neck cancers

Source: www.oncologyreport.com/ AUthor: Miriam E. Tucker Intensity-modulated radiotherapy is more expensive than 3-D–conformal radiotherapy is and has not been shown to improve standard outcomes in patients with head and neck cancer. But it results in better quality of life. These findings from two studies presented at the Multidisciplinary Head and Neck Cancer Symposium raise the question: Does improved quality of life justify the greater expense of intensity modulated radiotherapy (IMRT), which has been rapidly adopted for the treatment of head and neck cancer? Because IMRT spares surrounding tissues, it reduces the likelihood of developing xerostomia, noted Dr. Nathan C. Sheets, who presented data on billing charges associated with IMRT, compared with 3-D–conformal radiotherapy (CRT). IMRT is reimbursed at a substantially higher level than CRT, however, and it is unclear how to assess this cost relative to other aspects of care in this population, said Dr. Sheets, a radiation oncology resident at the University of North Carolina, Chapel Hill. A separate study presented by Dr. Allen M. Chen compared quality of life in patients who received IMRT vs. CRT. "There’s very little data to suggest IMRT is better than non-IMRT using traditional end points. But the question is: How do you define ‘better’?" said Dr. Chen, director of the radiation oncology residency training program at the University of California, Davis in Sacramento. "IMRT might not particularly involve better cure rates, but it could make a difference in terms of other end points, such as quality of life, which we all know [...]

Oral Cancer Foundation News Team - A2012-02-12T09:20:40-07:00February, 2012|Oral Cancer News|

What accounts for racial differences in head/neck cancer?

Source: www.drbicuspid.com Author: DrBicuspid Staff Why are African-Americans more likely than Caucasians not only to be diagnosed with head and neck cancer, but also to die from the disease? While the answer isn't a simple one, differences in lifestyle, access to care, and tumor genetics may be partly to blame, according to a new study from Henry Ford Hospital. The study, which was presented September 14 at the American Academy of Otolaryngology - Head and Neck Surgery Foundation's annual meeting in San Francisco, also found that African-Americans are more likely to be past or current smokers, one of the primary risk factors for head and neck cancer. "We're really trying to understand why African-Americans with head and neck squamous cell carcinoma do so poorly," said lead author Maria Worsham, PhD, director of research in the department of Otolaryngology - Head and Neck Surgery at Henry Ford, in a news release. "Using a comprehensive set of risk factors that are known to have some bearing on the disease, we're able to gain a better understanding of what contributes to racial differences and work to help improve patient care." This year alone, it's estimated that 52,140 new cases of head and neck cancer will be diagnosed, and roughly 11,460 will die in 2011 from oral cavity and pharyngeal and laryngeal cancers, she and her team members noted. African-Americans are more likely to be diagnosed with late-stage head and neck squamous cell carcinoma (HNSCC) and have a worse five-year survival rate than Caucasians. [...]

Oral Cancer Foundation News Team - A2011-09-19T19:21:47-07:00September, 2011|Oral Cancer News|

Study findings may change surgical practice

Source: www.digitaljournal.com Author: press release Currently, about 30 per cent of patients who receive oral surgery have their cancer recur. But a new, Canada-wide surgical trial using a new approach to remove tumours and pre-cancerous cells from the mouths of those diagnosed with early-stage oral cancer offers new hope for patients. The Terry Fox Research Institute (TFRI) announces the launch of a $4.7 million Pan-Canadian Phase III clinical trial aimed at improving outcomes for patients undergoing surgery for oral squamous cell cancers. The Canadian Optically Guided Approach for Oral Lesions Surgical Trial (The COOLS Study) has the potential to revolutionize clinical practice here and around the world for this kind of cancer. "Our investment in this promising study is our response to a serious clinical concern expressed by head and neck surgeons across Canada and it has the potential to change surgical practices for cancer of the mouth nationally and internationally," said Dr. Victor Ling, TFRI President and Scientific Director. Using a new surgical approach guided by an existing hand-held light tool, the surgeons, pathologists, and scientists involved in this nine-centre study will determine whether recurrence is reduced when they shift the surgical field for the removal of tumours or pre-cancerous cells in the mouth. The surgeons will use fluorescence visualization (FV) or "blue light" provided by the optical aid rather than traditional white light to determine the tissue to be removed. Under the blue light, normal tissue generates a fluorescence which is absent in tumour or pre-cancerous tissue. The [...]

Oral Cancer Foundation News Team - A2011-05-27T05:26:01-07:00May, 2011|Oral Cancer News|

Larynx preservation studies should consider treatment impact

Source: www.internalmedicinenews.com Author: Sara Freeman, Internal Medicine News Digital Network Almost one-quarter of patients who had been given induction chemotherapy before radiotherapy for head and neck cancer experienced long-term swallowing difficulties, with another 15% experiencing voice disabilities that correlated with the mobility of the vocal cords. Long-term data from the GORTEC (Groupe Oncologie Radiothérapie Tête et Cou) 2000-01 larynx preservation trial also show that approximately two-thirds of long-term head and neck cancer survivors experienced severe problems with sticky saliva and dry mouth, which were in turn linked to nutritional problems. These findings, reported May 9 at the European Society for Therapeutic Radiation Oncology (ESTRO) Anniversary Conference, further confirm that studies looking at the effects of chemoradiotherapy on the larynx in head and neck cancer need to consider prospective assessment of laryngeal function, rather than just looking at anatomical preservation, according to a French radiation oncologist. Dr. Gilles Calais of the Centre Hôpitalier Régional et Universitaire de Tours (France) presented data from a prospective analysis of 61 patients who had participated in the original 213-patient GORTEC 2000-01 trial. He also presented updated results from the trial using a recently developed composite end point. "Larynx preservation can be achieved for most of our [head and neck] patients by using three different strategies: induction chemotherapy, concomitant [chemoradiotherapy], or alternating chemoradiotherapy," Dr. Calais observed. Indeed, larynx preservation is a possibility in approximately 80% of patients, he said. However, anatomical preservation does not mean that laryngeal function is maintained, especially with respect to the ability [...]

Oral Cancer Foundation News Team - A2011-05-21T14:31:34-07:00May, 2011|Oral Cancer News|

Oral Cancer Foundation breaks records in April’s Awareness and Screening Month

Source: MSNBC News Author: staff Oral cancer is an insidious disease that too often is not discovered until very late in its development, as it might not produce symptoms the average person may notice. By then treatments are less effective, and because of late discovery in far too many patients, it has a five year survival rate of only about 57%, much lower than cancers we commonly hear about. Oral cancer has existed outside the awareness of much of the public, yet it will take one life, every hour of every day in the U.S. This year the combination of unprecedented efforts by the relatively small, non-profit Oral Cancer Foundation, a coalition of strategic partners they formed, and a dose of celebrity power, created what might be called a perfect storm; and one that potentially will change public awareness of one of the few cancers that is actually increasing in incidence in the U.S. For thirteen years in a row, April has been oral cancer awareness month nationally. More than 85% of all head and neck cancers are oral and oropharyngeal disease. Historically, a loose coalition of stakeholders in the disease has mustered about 200 screening events in April in facilities ranging from large institutions to individual dental offices around the country. Those participants opened their doors for at least a half-day to opportunistically screen members of the public in their communities for free, to find early stage disease, and to raise public awareness. This year the Oral Cancer Foundation, [...]

Oral Cancer Foundation News Team - A2011-06-16T12:46:56-07:00May, 2011|OCF In The News, Oral Cancer News|

Quality of life of patients with tongue cancer 1 year after surgery

Source: www.joms.org Authors: Zhao-hui Yang et al. Purpose: To study the changes and factors affecting the quality of life (QOL) of patients with tongue cancer 1 year after primary surgery. Patients and Methods: A total of 289 consecutive patients with tongue cancer who had undergone primary surgery from 2003 to 2008 at our hospital were recruited. Patient QOL was evaluated using the University of Washington Quality of Life Questionnaire, version 4. Statistical analysis was conducted using a paired-samples t test and multiple stepwise linear regression with Statistical Package for Social Sciences, version 11.5 (SPSS, Chicago, IL). Results: At 1 year after surgery, the appearance, activity, speech, swallowing, shoulder function, salivary, and taste domain scores were significantly lower than the preoperative scores (P

Oral Cancer Foundation News Team - A2010-06-19T09:25:36-07:00June, 2010|Oral Cancer News|

New guidelines emphasize the need for cancer patients to exercise

Source: www.medscape.com Author: Roxanne Nelson In contrast to past advice to cancer patients to rest and avoid activity, the message now is to avoid inactivity. An expert panel convened by the American College of Sports Medicine (ACSM) has concluded that exercise training is safe during and after cancer treatments and can improve physical functioning, quality of life, and cancer-related fatigue. The new ACSM guidelines urge cancer patients to be as physically active as possible both during and after treatment. "The take-home message from the panel that put together the guidelines is to avoid inactivity during and posttreatment," said Kathryn Schmitz, PhD, MPH, associate professor of epidemiology and biostatistics at the University of Pennsylvania School of Medicine in Philadelphia. She presented the guidelines here at the American Society of Clinical Oncology 2010 Annual Meeting. "Dozens of randomized controlled trials in a broad variety of patient populations have established the safety of exercise during treatment and the ability to go from being sedentary to completing 150 minutes of aerobic active over the course of even a single month," she said. "The risk–benefit leans heavily in the direction of getting patients moving and keeping them moving." Exercise Oncology Exercise is an area that is gaining an increasing awareness in the cancer literature, noted Jennifer A. Ligibel, MD, who moderated the session where the guidelines were presented. Dr. Ligibel is from the Dana-Farber Cancer Center in Boston, Massachusetts. "If you had done a search between 1950 and 1979 using the words 'exercise/physical activity' and [...]

Oral Cancer Foundation News Team - A2010-06-18T08:17:43-07:00June, 2010|Oral Cancer News|

Radiation planning reduces dysphagia in oropharyngeal cancer

Source: www.medscape.com Author: Nick Mulcahy In patients with oropharyngeal cancer, modifying radiotherapy to spare swallowing structures appears to be an effective strategy to reduce the long-term dysphagia that accompanies chemoradiotherapy, according to a small longitudinal study. Importantly, the strategy did not come at the expense of locoregional control, report investigators in a study published online April 26 in the Journal of Clinical Oncology. Dysphagia has emerged as perhaps the most important late adverse effect in this setting, supplanting xerostomia, said the study's senior author, Avraham Eisbruch, MD, professor of radiation oncology at the University of Michigan Medical School and Comprehensive Cancer Center in Ann Arbor. "Aggressive chemoradiotherapy approaches produce more dysphagia than in the past," he told Medscape Oncology. Meanwhile, the late adverse effect of xerostomia is on the wane, because the use of intensity-modulated radiotherapy (IMRT) has allowed radiation oncologists to spare most patients' salivary glands from radiation, he said. To address the problem of dysphagia, Dr. Eisbruch and colleagues at the University of Michigan used IMRT in combination with chemotherapy. Their treatment planning for 73 patients with stages III to IV oropharyngeal cancer included sparing any swallowing structure that did not have tumor involvement. The structures included pharyngeal constrictors, glottic and supraglottic larynx, and esophagus. One year after concurrent chemotherapy and IMRT, all 73 of the patients had either absent or minimal observer-rated dysphagia (scores, 0 to 1), with the exception of 4 people: 1 who was feeding-tube dependent and 3 who required a soft diet. The results [...]

Oral Cancer Foundation News Team - A2010-05-19T20:47:25-07:00May, 2010|Oral Cancer News|

Clinical and dosimetric factors associated with a prolonged feeding tube requirement in patients treated with chemoradiotherapy (CRT) for head and neck cancers

Source: Annals of Oncology, doi:10.1093/annonc/mdp268 Authors: A. S. Gokhale et al. Background: Patients treated with chemoradiotherapy (CRT) for head and neck cancers often require feeding tubes (FTs) due to toxicity. We sought to identify factors associated with a prolonged FT requirement. Patients and methods: We retrospectively reviewed 80 patients treated with CRT for head and neck cancers. The pharyngeal constrictors (PCs), supraglottic larynx (SGL), and glottic larynx (GL) were contoured and the mean radiation doses and the volumes of each receiving >40, 50, 60, and 70 Gy (V40, V50, V60, and V70) were determined. Results: A total of 33 of 80 patients required a FT either before or during the course of CRT. Fifteen patients required the FT for ≥6 months. On univariate analysis, significant factors associated with a prolonged FT requirement were mean PC dose, PC-V60, PC-V70, SGL dose, SGL-V70, and advanced T3–T4 disease. Multivariate analyses found both PC-V70 and T3-T4 disease as significant factors .The proportions of patients requiring a FT ≥6 months were 8% and 28% for treatment plans with PC-V70 <30% and ≥30%, respectively. Conclusions: Increased radiation dose to the PCs is associated with a higher risk of a prolonged FT need. Dose sparing of the PC muscles may reduce this risk. Authors: A. S. Gokhale1, B. T. McLaughlin2, J. C. Flickinger1, S. Beriwal1,*, D. E. Heron1, R. L. Ferris3, J. Johnson3, M. K. Gibson2, A. Argiris2 and R. P. Smith1 Authors' affiliatons: 1 Department of Radiation Oncology 2 Division of Hematology–Oncology, Department of Medicine 3 [...]

Oral Cancer Foundation News Team - A2009-07-15T13:03:53-07:00July, 2009|Oral Cancer News|