radiation

Gabapentin shows efficacy as opioid alternative for patients with head and neck cancer

Source: www.healio.com Author: Jennifer Byrne For many patients with head and neck cancer, treatment-associated oral mucositis is a source of severe pain. Managing this pain is a priority for physicians and interdisciplinary care teams. Although opioid painkillers historically have been used for this purpose, researchers at Roswell Park Comprehensive Cancer Center investigated the use of gabapentin, a drug used to alleviate nerve pain, as an alternative to narcotics for this patient population. “Virtually all patients will require some type of pain relief or analgesic medication during the course of chemotherapy and radiation,” study author Anurag K. Singh, MD, professor of oncology and director of radiation research at Roswell Park, told Healio. “We’ve been studying better ways to improve pain control in this population because standard narcotics just don’t work that well. Patients tend to use a lot and they still experience pain, but they are sleepier.” A dose-dependent effect In their study, published in Cancer, Singh and colleagues randomly assigned 60 patients with head and neck squamous cell carcinoma to one of two treatment regimens: high-dose gabapentin (2,700 mg daily), progressing sequentially to hydrocodone-acetaminophen and fentanyl when needed (n = 31), or low-dose gabapentin (900 mg daily) progressing to methadone as needed (n = 29). Safety and toxicity served as the study’s primary endpoints. Pain, opioid requirement and quality of life served as secondary endpoints. Results showed no difference in pain between the treatment groups, but more patients in the high-dose gabapentin group did not need an opioid while receiving [...]

Oral Cancer Foundation News Team - A2020-03-13T06:43:56-07:00March, 2020|Oral Cancer News|

Absent p53, oral cancers recruit and reprogram nerves to fuel tumor growth

Source: medicalxpress.com Author: by University of Texas M. D. Anderson Cancer Center Loss of an important tumor-suppressing gene allows head and neck cancer to spin off signals to nearby nerves, changing their function and recruiting them to the tumor, where they fuel growth and cancer progression, researchers from The University of Texas MD Anderson Cancer Center report in the journal Nature today. By cracking the mechanism that launches neuronal invasion of tumors, a known marker of poor prognosis for patients, the team has uncovered possible avenues to block the process, including the use of drugs commonly used to treat blood pressure and irregular heartbeat. "Tons of studies show that patients who have lots of nerves in their tumor are doing worse—recurrence rates are higher, survival is shorter," says co-first author Moran Amit, M.D., Ph.D., assistant professor of Head and Neck Surgery. "Nerve endings found in surgically removed tumors can't be easily characterized or tracked back to their source, so it's been a neglected field, a neglected hallmark of cancer." "When surgeons remove head and neck cancers and find a high degree of nerve invasion, post-surgical radiation sometimes is effective," said co-senior author Jeffrey Myers, M.D., Ph.D., chair of Head and Neck Surgery. "But we really haven't understood whether the tumor was growing into the nerves or the nerve growing into the tumor and what signaling drove those interactions." Co-senior author George Calin, M.D., Ph.D., professor of Experimental Therapeutics and an expert on non-coding RNAs added that the paper "puts together [...]

Oral Cancer Foundation News Team - A2020-02-13T08:56:02-07:00February, 2020|Oral Cancer News|

Study: Healthy diet may avert nutritional problems in head, neck cancer patients

Source: news.illinois.edu Author: Sharita Forrest At least 90% of head and neck cancer patients develop symptoms that affect their ability or desire to eat, because of either the tumor itself or the surgery or radiation used to treat it. These problems, called nutrition impact symptoms, have wide-ranging negative effects on patients’ physical and mental health and quality of life. However, patients who eat foods high in antioxidants and other micronutrients prior to diagnosis may reduce their risks of developing chronic nutrition impact symptoms up to one year after being diagnosed with head or neck cancer, according to a recent study led by researchers at the University of Illinois. The scientists analyzed the dietary patterns of 336 adults with newly diagnosed head and neck cancers and these patients’ problems with eating, swallowing and inflammation of the digestive tract. This painful inflammatory condition, called mucositis, is a common side effect of radiation treatment and chemotherapy. The mitigating effects of a healthy diet were particularly significant in people who had never smoked and in patients who were underweight or normal weight at diagnosis, who often experience the greatest eating and digestive problems during treatment, said Sylvia L. Crowder, the paper’s first author. Crowder is a research fellow in the Cancer Scholars for Translational and Applied Research program, a collaborative initiative of the U. of I. and Carle Foundation Hospital in Urbana, Illinois. “While previous work has established that the presence of nutrition impact symptoms is associated with decreased food intake and weight loss, [...]

Oral Cancer Foundation News Team - A2019-12-17T09:16:56-07:00December, 2019|Oral Cancer News|

Acupuncture prevents radiation induced dry mouth

Source: www.healthcmi.com/ Author: staff Acupuncture reduces the frequency and severity of xerostomia (dry mouth). University of Texas MD Anderson Cancer Center (Houston) and Fudan University Cancer Center (Shanghai) researchers conducted a randomized controlled clinical trial. The phase-three patient and assessor blinded investigation of acupuncture’s effects on head and neck cancer patients receiving radiation therapy demonstrated groundbreaking results. The researchers concluded that acupuncture “resulted in significantly fewer and less severe RIX [radiation-induced xerostomia] symptoms 1 year after treatment vs SCC [standard care control].” [1] Salivary glands may be temporarily or permanently damaged by radiation therapy. There is a high-incidence of RIX, which may lead to complications including difficult or painful swallowing, impairment of the sense of taste (dysgeusia), and dental problems. Other RIX complications may include insomnia and difficulty speaking. The study compared true acupuncture, sham acupuncture, and standard care control groups. True acupuncture produced significantly greater positive patient outcomes than the other groups. Outcome measures were based on a questionnaire, salivary flow, incidence of xerostomia, salivary contents, and quality of life scores. One year after completion of all acupuncture treatments, the true acupuncture group maintained significantly higher patient outcome rates over the standard care and sham groups. All acupuncture treatments were provided by credentialed acupuncturists. The researchers note that their findings are consistent with several prior investigations. True acupuncture patients that received acupuncture three times per week during their six to seven week course of radiation therapy had significantly less dry mouth a year after completion of treatments than standard [...]

Oral Cancer Foundation News Team - A2019-12-13T10:14:28-07:00December, 2019|Oral Cancer News|

Survivorship clinic helps patients with what comes after head and neck cancer

Source: www.pittwire.pitt.edu/ Author: Gavin Jenkins, excerpted from the fall 2019 issue of Pitt Med magazine Jonas Johnson presses his hand on Edward Christopher’s neck. The examination room at the UPMC Head and Neck Cancer Survivorship Clinic is chilly on this June morning as Johnson, chair of the University of Pittsburgh Department of Otolaryngology, glides his fingers along the left side of Christopher’s throat. “Your skin is stiff,” Johnson says. “Scar tissue doesn’t go away.” Five years ago, Christopher was diagnosed with human papillomavirus (HPV) positive cancer on the base of his tongue, left tonsil and the lymph nodes on the left side of his neck. After undergoing surgery to remove the tumors, he received radiation treatment and chemotherapy, followed by another procedure to remove his lymph nodes. When he completed the treatment, he posted a picture on Facebook holding a sign that read “cancer free!” That night, he and his family celebrated with dinner at an Italian restaurant. Christopher felt lucky to be alive and grateful to Pitt doctors. He had no idea how difficult the years to come would be. He credits Marci Lee Nilsen, a nurse who is an assistant professor in Pitt’s School of Nursing, with opening his eyes. In 2016, Johnson and Nilsen created the Survivorship Clinic to help patients like Christopher improve their quality of life after beating head and neck cancer. Most patients grapple with dysphagia—difficulty swallowing—and trismus, commonly known as lockjaw. They might experience a loss of taste, tooth decay, dry mouth and [...]

Oral Cancer Foundation News Team - A2019-11-19T14:11:06-07:00November, 2019|Oral Cancer News|

Oral mucositis: preventing the side effect before undergoing cancer treatment

Source: www.curetoday.com/ Author: Katie Kosko Oral mucositis can be painful and, in some cases, require hospitalization of patients being treated for cancer with chemotherapy and other radiation therapies. However, along with your care team, you can take steps to prevent this uncomfortable side effect. In an interview CURE®, Dr. Alessandro Villa, assistant professor in oral medicine and dentistry at the Harvard School of Dental Medicine, Brigham and Women's Hospital in Boston, spotlighted the number of patients with cancer who are affected by oral mucositis, explained the benefits of two agents approved by the Federal Drug Administration (FDA) for intervention and explored how patients can control the side effect from the comfort of their homes. CURE®: Can you explain what types of cancer treatment cause oral mucositis? Villa: Oral mucositis is an iconic toxicity of cancer therapy and remains one of the most painful and disrupting side effects of radiation therapy and chemotherapy. When I talk about radiation therapy, I talk about patients with head and neck cancer. In these patients, usually 100% receiving radiation therapy develop oral mucositis. We also see mucositis in approximately 60% to 80% of patients who undergo bone marrow transplants. And finally, we see it in 20% to 40% of patients who receive conventional chemotherapy for any cancer. What are the consequences of oral mucositis? Oral mucositis is one of the most painful toxicities in patients receiving radiation therapy to the head and neck. It’s the number one cause of hospitalization in these patients. It can [...]

Oral Cancer Foundation News Team - A2019-11-03T10:21:56-07:00November, 2019|Oral Cancer News|

Radiation for head and neck cancer may cause problems years later

Source: www.usnews.com Author: Steven Reinberg Ten years after radiation treatment for head and neck cancer, some patients may develop problems speaking and swallowing, a new study finds. These problems are related to radiation damage to the cranial nerves, the researchers explained. The condition is called radiation-induced cranial neuropathy. "We had always thought that radiation did not damage cranial nerves because they get treated in every patient with head and neck cancer, and we do not see cranial neuropathy that commonly," said Dr. Thomas Galloway, of the department of radiation oncology at the Fox Chase Cancer Center in Philadelphia. "What our data is suggesting is that a small percentage of people do get cranial nerve damage from treatment, but it occurs after a long latency period," Galloway said. For the study, the researchers collected data on 1,100 patients who had radiation for head and neck cancer between 1990 and 2005. Among these patients, 112 were followed for at least 10 years. Of the 112 patients, 14% developed at least one cranial neuropathy. The median time until the condition was seen was more than seven years. It took some patients more than 10 years to develop the problem, the findings showed. Curing the initial cancer is the most important concern, Galloway said. But these patients need to be followed for the rest of their lives, if possible, he added. The report was published recently in the journal Oral Oncology.

Oral Cancer Foundation News Team - A2019-10-01T13:54:29-07:00October, 2019|Oral Cancer News|

Researchers: Favorable survival, fewer side effects after reduced therapy for HPV-linked head and neck cancer

Source: medicalxpress.com Author: University of North Carolina at Chapel Hill School of Medicine University of North Carolina Lineberger Comprehensive Cancer Center researchers reported that reducing the intensity of radiation treatment for patients with human papillomavirus-associated head and neck cancer produced a promising two-year progression-free survival rate and resulted in fewer side effects. The findings, published in the Journal of Clinical Oncology, were drawn from a phase II clinical trial that included 114 patients with HPV-linked head and neck cancer and a limited smoking history. The researchers reported that they saw a similar progression free survival rate, and that patients experienced fewer long-term side effects in the study compared with patients who received standard intensity treatment in previous studies. "A simple de-intensification strategy of reducing radiation and chemotherapy appears to be as effective at cancer control as the standard seven-week regimen," said UNC Lineberger's Bhishamjit S. Chera, MD, associate professor in the UNC School of Medicine Department of Radiation Oncology. "Furthermore, there were fewer toxicities." For the trial, patients received six weeks of treatment, including a reduced intensity of radiation therapy of 60 Gray with weekly low-dose chemotherapy of cisplatin. The standard of care regimen is seven weeks of treatment 70 Gray and high-dose chemotherapy. The main outcome that the researchers were studying was two-year progression-free survival. On the reduced regimen, researchers found that the two-year progression free survival was 86 percent, compared to a two-year progression free survival reported from other studies using standard treatment doses of 87 percent. Chera [...]

Oral Cancer Foundation News Team - A2019-09-14T09:18:38-07:00September, 2019|Oral Cancer News|

Oral rinse could improve mouth pain associated with radiation therapy

Source: www.specialtypharmacytimes.com Author: staff An oral rinse containing diphenhydramine, lidocaine, and antacids, was found to significantly decrease pain caused by oral mucositis in patients undergoing radiation therapy for head and neck cancer compared with placebo, according to a study published in JAMA. The multi-institution, randomized, double-blind, placebo-controlled phase 3 clinical trial was led by Robert Miller, MD, an emeritus Mayo Clinic radiation oncologist. "Our group published a study in 2012 showing that an oral rinse of doxepin reduced oral mucositis-related pain compared to placebo," Miller said in a press release. "However, there were no large randomized controlled trials studying the potential benefits of magic mouthwash." The researchers evaluated 275 patients between November 2014 and May 2016. The study revealed that treatment with both doxepin and the mouthwash combination significantly reduced pain associated with oral mucositis compared with placebo. The doxepin and mouthwash combination treatment was also well-tolerated by patients, according to the study. "Radiation therapy may cause mouth sores because it is designed to kill rapidly growing cells, such as cancer cells," co-author, Terence Sio, MD, a Mayo Clinic radiation oncologist, said in a press release. "Unfortunately, healthy cells in your mouth also divide and grow rapidly, and may be damaged during radiation therapy, which can cause discomfort. We're glad to have identified a proven method to help treat the discomfort of this side effect."

Oral Cancer Foundation News Team - A2019-05-02T14:02:15-07:00May, 2019|Oral Cancer News|

How do speech-language pathologists support cancer patients?

Source: syvnews.com Author: Aundie Werner Question: What are speech-language pathologists and how do they support cancer patients? It is estimated that about 100,000 people will be diagnosed with a head, neck or thyroid cancer this year. Although this does not grab headlines as often as many other cancers, for those affected the disease and treatment can have a significant impact on their lives. In general, most people survive head and neck cancer; however, side effects of treatment can sometimes be a long-term problem. The support and guidance of a speech-language pathologist (SLP) can do much to help promote recovery and cope with the difficult symptoms of treatment. Ideally, the SLP becomes involved when the patient has been identified as having head and neck cancer before their surgery or before their chemotherapy/radiation protocol. Counseling and education are provided as to the functions of voice, speech and swallowing. Assessment is made to determine the patient’s baseline and to provide guidance as to the patient’s role in their rehabilitation. Frequently, the SLP works with patients who have difficulty eating and drinking. Treatment is based on the cause of the problem: anatomical changes from surgery, decreased saliva, changes in taste, difficulty opening the mouth due to trismus, and problems protecting the airway, which can result in coughing and choking during meals. Maintaining nutrition after surgery and during treatment is necessary to help the body heal. At times, the patient may need to have a feeding tube to help with nutrition when it becomes too [...]

Oral Cancer Foundation News Team - A2019-03-26T11:50:47-07:00March, 2019|Oral Cancer News|