Oral health professionals promote ‘value of having a dentist on the cancer care team’

Source: www.healio.com Author: Jennifer Byrne When planning their next steps after a cancer diagnosis, most patients don’t put a trip to the dentist at the top of their to-do list. “When patients are diagnosed with cancer, they just want to put out the fire; they want to address the cancer,” Dalal Alhajji, DMD, MSD, clinical instructor of oral and maxillofacial pathology, radiology and medicine at NYU College of Dentistry, said in an interview with Healio. “That’s when I say, ‘the reason you need to see a dentist is, we want to put out another potential fire — one you might not know about yet.” Alhajji and her colleagues at NYU College of Dentistry are part of a small but growing movement among oral health professionals seeking to close the gap between medical and dental care for patients with cancer. They see dentists as a vital component of any multidisciplinary oncology care team, offering infection treatment, protection of teeth during head and neck radiation treatments, and quality-of-life care for issues such as dry mouth and mouth sores. “I’ve been lucky — the oncologists I work with have been great about referring patients to me because they see the impact it has,” Alhajji said. “They see the value of having a dentist on the cancer care team.” Addressing preventable issues There are several reasons for a patient with cancer to see a dentist prior to initiating cancer treatment, but patients with head and neck cancers and those slated to undergo bone marrow [...]

The potential of e-learning interventions for AI-assisted contouring skills in radiotherapy (E33046)

Source: www.iaea.org Author: Kamal Akbarov The International Atomic Energy Agency (IAEA) is launching a new Coordinated Research Project (CRP) aimed at investigating the potential of artificial intelligence (AI) to enhance contouring skills in radiotherapy, especially focusing on increasing accuracy of delineation of organs at risk in head and neck cancers. Radiation oncology has evolved rapidly in recent decades in terms of innovations in treatment equipment, volumetric imaging, information technology and increased knowledge in cancer biology. New delivery technologies and associated imaging modalities have enabled highly optimized precision radiation therapy and contributed to improvements in tumor control and cancer patient cure. The selection and contouring of target volumes and organs at risk (OARs) has become a key step in modern radiation oncology. Concepts and terms for definition of gross tumor volume, clinical target volume and OARs have been continuously evolving and have become widely disseminated and accepted by the international radiation oncology community. However, clinical research from single institutions and multicentre experiences has provided evidence for major variations in contouring for both target volumes and OARs. In recent years, AI-based methods, such as deep learning, have improved auto-segmentation drastically. It is generally believed that the use of such tools will lead to lower the inter-observer variation and time savings for clinical staff. A wide palette of commercial deep learning-based auto-segmentation solutions are emerging with the promise of leveraging the aforementioned benefits. While the objective performances for deep learning-based auto-segmentation in retrospective studies are very promising, the actual clinical benefit is largely [...]

Throat cancer survivors don’t have to sacrifice ability to swallow and taste

Source: southfloridahospitalnews.com Author: staff Tamarac resident Kenneth Goff was home shaving morning when he felt a small lump on the left side of his neck. “There was no pain, no nothing, but I could feel it by the way the razor moved,” said the 58-year-old father of five and grandfather of eight. “It wasn’t visible at all, but I could feel it right below the jaw line.” After a CT scan at Broward Health Medical Center in August 2020, Goff was diagnosed with HPV-mediated squamous cell carcinoma, a type of throat cancer. This cancer is similar to what actors Michael Douglas and Stanley Tucci have battled. The treatment of HPV-related oropharyngeal squamous cell carcinoma may include surgery, radiation, chemotherapy or combination of the treatments. Ryan H. Sobel, M.D., a head and neck surgical oncologist at Broward Health Medical Center, prescribed radiation to treat Goff’s isolated neck mass. Prior to radiation treatment, Dr. Sobel performed a submandibular, or saliva gland transfer, an intricate surgery only a handful surgeons across the country are skilled at performing. He is currently the only surgeon utilizing this technique in Broward and Palm Beach counties. Dr. Sobel strategically relocated one of Goff’s saliva glands. It was moved about three inches from the right side of his throat to under the chin to place it out of direct range of the damaging effects of radiation. Patients diagnosed with throat cancer face a difficult choice: treat the cancer with radiation and risk losing their ability to swallow and [...]

2022-02-24T15:03:37-07:00February, 2022|Oral Cancer News|

Improving head and neck cancer treatment

Source: www.uc.edu Author: Tim Tedeschi, University of Cincinnati News When the medical community finds a treatment for a particular cancer, the work doesn’t stop. Researchers continue to study how treatments can be improved in order to reduce side effects and the possibility of the cancer recurring. University of Cincinnati researchers are leading a new clinical trial to examine if the combination of a more localized radiation treatment and immunotherapy can be a better treatment for patients with recurrent head and neck cancer. Chad Zender, MD, said head and neck cancers include cancers of the tongue, throat, tonsil and larynx, and about 30%-50% of patients treated through surgery and radiation will have their cancer return. Patients often then undergo additional surgery and/or radiation treatments, which can lead to side effects like problems with speech and swallowing. “The quality of life is significantly less in the patients that require [subsequent] surgery and then radiation with or without chemo,” said Zender, professor in the Department of Otolaryngology in UC’s College of Medicine, director of head and neck surgery and principal investigator for the new trial. Precision radiation Zender said the trial will test a more localized radiation delivery method through a radioactive seed, about the size of a grain of rice that emits an intense amount of radiation to the cancer and only minimal radiation outside to other areas. The radioactive Cesium-131 seeds are implanted directly into the operative site during surgery. This approach in early studies appears to give more localized radiation [...]

2022-02-03T10:44:13-07:00February, 2022|Oral Cancer News|

New MSK radiation approach means fewer side effects for more patients with HPV-related head and neck cancer

Source: www.mskcc.org Author: Memorial Sloan Kettering Cancer Center Robert Rosenfeld thought the lump he felt in his neck in late 2018 was just a symptom of a cold that wouldn’t go away. He visited an ear, nose, and throat specialist who saw nothing upon first examination, but Robert knew something was wrong and asked for a CT scan. The specialist called him with the bad news: It was almost certainly cancer. A biopsy confirmed he had stage 2 cancer at the base of his tongue and 2 nearby lymph nodes. The tumor was positive for the human papillomavirus (HPV). Robert, then a 69-year-old car salesman on Long Island, met with cancer doctors near his hometown of Hauppauge, New York, to learn about treatment options. He realized he faced a tough road: Standard treatment would be 7 weeks of radiation, during which he also would receive 3 rounds of chemotherapy. The standard radiation dose would likely cause mouth sores, difficulty swallowing, dry mouth (from damage to salivary glands), loss of taste, and nausea. Robert wanted a second opinion, and his medical oncologist strongly recommended Memorial Sloan Kettering Cancer Center. When Robert called, he was able to get in to see radiation oncologist C. Jillian Tsai the very next day. “When I met Dr. Tsai, she was amazing,” Robert says. “She told me what I was up against but also that the cancer I had was curable.” There was another major plus: Dr. Tsai was able to offer a significantly reduced radiation [...]

Using artificial intelligence to help cancer patients avoid excessive radiation

Source: medicalxpress.com Author: by Case Western Reserve University A Case Western Reserve University-led team of scientists has used artificial intelligence (AI) to identify which patients with certain head and neck cancers would benefit from reducing the intensity of treatments such as radiation therapy and chemotherapy. The researchers used AI tools similar to those they developed over the last decade at the Center for Computational Imaging and Personal Diagnostics (CCIPD) at Case Western Reserve. In this case, they asked the computer to analyze digitized images of tissue samples that had been taken from 439 patients from six hospital systems with a type of head and neck cancer known as human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPCSCC). The computer program successfully identified a subset of patients who might have benefited from a significantly reduced dose of radiation therapy. While that analysis was retrospective—meaning the computer analyzed data from patients in which the eventual outcome was already known—the researchers said their next step could be to test its accuracy in clinical trials. Their research was published recently in the Journal of the National Cancer Institute. The work was led by Anant Madabhushi, CCIPD director and the Donnell Institute Professor of Biomedical Engineering at the Case School of Engineering, along with Germán Corredor Prada, a research associate in the CCIPD lab. 'Overtreating patients' Although most others with HPV-driven cancer would still benefit from aggressive treatment—along with patients whose cancer was unrelated to the virus—the researchers said their study revealed a significant group was [...]

Treatment paradigms are shifting for locally advanced HPV-positive head and neck cancers

Source: www.onclive.com Authors: Kaveh Zakeri, MD, MAS, Nancy Y. Lee, MD The standard of care for patients with locally advanced head and neck squamous cell carcinomas does not substantially differ according to human papillomavirus (HPV) status in the National Comprehensive Cancer Network guidelines.1 Resectable tumors can be treated with surgery followed by adjuvant therapy. Alternatively, definitive chemoradiation therapy with cisplatin is the other dominant treatment paradigm. Incidence of HPV-associated oropharyngeal squamous cell carcinoma has increased rapidly and is associated with higher overall survival (OS) compared with cancers caused by smoking and alcohol.2,3 Given the unique biology of HPV-associated oropharyngeal disease, a separate staging system was developed for these tumors.4 HPV-associated oropharyngeal cancers are more radiosensitive and chemosensitive than cancers caused by smoking and alcohol, yet the traditional treatment paradigms—including high doses of radiation and chemotherapy—were developed prior to the epidemic of HPV-associated disease. De-escalation of therapy has been proposed for HPV-associated oropharyngeal cancer based on data demonstrating high OS and progression-free survival (PFS).5 De-escalation of therapy has been investigated for both definitive surgical and chemoradiation therapy paradigms. Most de-escalated approaches focus on selecting patients according to clinical features, such as disease stage and smoking status, whereas personalized de-escalation reduces treatment intensity for patients according to treatment response. Transoral Robotic Surgery Followed by Adjuvant Radiotherapy Transoral robotic surgery (TORS) is a minimally invasive approach that reduces morbidity compared with traditional, open surgery for patients with oropharyngeal cancers. TORS is a standard of care option for patients with resectable tonsil or base [...]

2021-11-23T08:16:08-07:00November, 2021|Oral Cancer News|

Patterns of care for incarcerated head and neck cancer patient receiving radiation: a single-center retrospective descriptive cohort study

Source: www.docwirenews.com Author: DocWire News Abstract: Purpose/Objective(s): United States (US) have the highest incarceration rate in the world. In the context of the US justice system, many inmates are older than 55 years of age and as such are at an increased risk of cancer development. Additionally, largely due to mass incarcerations, correctional control is associated with significant racial disparities, further layering the complexity of the prison population’s health. The purpose of this study was to describe patterns of care in incarcerated head and neck (H&N) cancer patients who received radiation treatment (RT) as a part of the management of their malignancy. Materials/Methods: Following IRB approval, a total of 44 charts of patients who were imprisoned for at least a part of their radiation treatment were manually reviewed. The variables extracted included demographic data (age, race, gender), vital status, tumor site, stage, social history, cancer history, RT purpose, RT plan details (start, end, duration, dose, fractionation, completion as prescribed, concurrent systemic treatment), weight loss, surveillance (loss to follow-up) and oncologic outcomes (tumor recurrence.) Data was summarized using descriptive statistics. Results: A total of 41/44 inmates were males (93%), 13/44 (29.5%) were African American. Median age at diagnosis was 49.5 years (range 27-68). A total of 21/44 tumors (47%) were oropharyngeal tumors, followed by 9 laryngeal tumors (20%). A total of 41 patients (93%) had a previous smoking history (median 20 pack years), and 30 (68%) had documented history of alcohol abuse. Most common treatment purpose was post-operative (47%) followed by [...]

Chemotherapy and radiation therapy issues: What audiologists need to know

Source: journals.lww.com Author: A. Croutch, Carl AuD With hearing loss, tinnitus, and imbalance as among the numerous side-effects of cancer treatment,1 audiologists play a critical role in monitoring patients receiving chemotherapy and radiation therapy. Sensorineural hearing loss (SNHL) attributed to chemotherapy and radiation therapy is usually permanent, making audiometric monitoring essential to detect its early occurrence.2 Cisplatin, carboplatin & radiation therapy Chemotherapy is used to treat cancer, control the growth and spread of cancer cells, and ease cancer symptoms. Cisplatin and carboplatin are two common antineoplastic agents used to treat testicular, ovarian, breast, esophageal, lung, and head and neck cancers among others. Besides hearing loss, these can cause other side effects including kidney, gastrointestinal disorders, allergic reactions, decreased immunity to infections, and hemorrhaging. Cisplatin was first found to have cytotoxic properties in the 1960s, and in 1978 was the first platinum compound approved by the FDA for cancer treatment.3 On the other hand, carboplatin is less potent than cisplatin and does have fewer side effects, especially on kidney problems.3 Both drugs work by interfering with DNA repair mechanisms causing DNA damage and inducing apoptosis in cancer cells. Cancerous cells cannot limit cell division as do normal cells. Normal cells cease dividing when they encounter similar cells whereas cancerous cells do not. The effectiveness of chemotherapy is determined by its ability to damage the RNA or DNA that gives the cell instructions to copy itself. The cells will die if they are unable to divide. The more quickly they are dividing, [...]

2021-09-09T06:48:49-07:00September, 2021|Oral Cancer News|

A challenge to chew on: eating and drinking after cancer treatment

Source: www.curetoday.com Author: Dara Chadwick, Heal Exercise has always been part of Scott Wieskamp’s life. But after cancer treatment, the longtime runner and marathoner added a new element to his training regimen — exercises to strengthen and maintain his swallowing muscles. "Every day while I’m driving to work, I open my mouth like I’m yawning to stretch all my facial muscles as much as I can,” says Wieskamp, 62, who lives just outside Lincoln, Nebraska. “I take my tongue and put it under the back of my lower teeth and push as hard as I can to exercise my tongue muscles. There’s about half a dozen things I do for a few minutes every day.” Four years ago, Wieskamp was treated for oral cancer caused by the human papillomavirus. The aggressive treatment, which included 39 radiation sessions and several doses of the chemotherapy drug cisplatin, knocked out the cancer. But it also left Wieskamp unable to eat, and he lost 15 pounds in a matter of weeks. “As you get radiation in the neck and throat area, it becomes painful to swallow,” he says. “I quit doing all that. I quit eating, quit swallowing — I couldn’t even drink.” Because he was unable to get adequate nutrition, his doctors inserted a feeding tube so Wieskamp wouldn’t have to swallow. The tube stayed in place throughout his two months of treatment and for about a month after, he says. Although his nutrition improved, Wieskamp says he was left with another problem: [...]

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