An AI oncologist to help cancer patients worldwide

Source: www.sciencedaily.com Author: staff, University of Texas at Austin, Texas Advanced Computing Center Comparison between predicted ground-truth clinical target volume (CTV1) (blue) and physician manual contours (red) for four oropharyngeal cancer patients. The primary and nodal gross tumor volume is included (green). From left to right, we illustrate a case from each site and nodal status (base of tongue node-negative, tonsil node-negative, base of tongue node-positive, and tonsil node-positive).Credit: Carlos E. Cardenas, MD Anderson Cancer Center Before performing radiation therapy, radiation oncologists first carefully review medical images of a patient to identify the gross tumor volume -- the observable portion of the disease. They then design patient-specific clinical target volumes that include surrounding tissues, since these regions can hide cancerous cells and provide pathways for metastasis. Known as contouring, this process establishes how much radiation a patient will receive and how it will be delivered. In the case of head and neck cancer, this is a particularly sensitive task due to the presence of vulnerable tissues in the vicinity. Though it may sound straightforward, contouring clinical target volumes is quite subjective. A recent study from Utrecht University found wide variability in how trained physicians contoured the same patient's computed tomography (CT) scan, leading some doctors to suggest high-risk clinical target volumes eight times larger than their colleagues. This inter-physician variability is a problem for patients, who may be over- or under-dosed based on the doctor they work with. It is also a problem for determining best practices, so [...]

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 [...]

Restaging raises hope against HPV oral cancer

Source: atlantajewishtimes.timesofisrael.com Author: Cady Schulman Jason Mendelsohn was diagnosed with Stage 4 tonsil cancer from HPV in 2014 after finding just one bump on his neck. He survived thanks to a variety of treatments, including a radical tonsillectomy and neck dissection to remove 42 lymph nodes, seven weeks of chemotherapy, radiation and a feeding tube. But if Mendelsohn’s cancer had been discovered today, just four years later, it would have been classified as Stage 1. That’s because HPV-related oral cancers now have a high survival rate through a better response to treatment, said Meryl Kaufman, a speech pathologist specializing in head and neck cancer management who worked for Emory University’s department of head and neck surgery for 10 years. “Cancer staging is taking into account the HPV-related cancers,” said Kaufman, who now owns her own practice. “It was kind of all lumped together. The survival rates for people who have HPV-related cancers are much higher than the typical head and neck cancers associated with smoking and drinking.” For Mendelsohn, finding out that patients with HPV-related cancers likely face easier treatments and higher success rates made him extremely happy. “If I was diagnosed and I heard Stage 1 instead of Stage 4, while it’s still cancer, it would make me feel like I could beat it,” said Mendelsohn, who made a video for his children a month after his diagnosis with advice for their lives after he was gone. “When I hear Stage 4 to Stage 1, I think people have [...]

Positioning during cancer radiation may be key to heart risks

Source: health.usnews.com Author: Mary Elizabeth Dallas, HealthDay Reporter If you have lung or throat cancer, exactly how you are positioned during your radiation treatments may alter your chances of beating the disease. New research suggests that even tiny shifts can mean the radiation may harm organs around tumors in the chest, most notably the heart. "We already know that using imaging can help us to target cancers much more precisely and make radiotherapy treatment more effective," said researcher Corinne Johnson, a Ph.D. student at the Manchester Cancer Research Center in England. "This study examines how small differences in how a patient is lying can affect survival, even when an imaging protocol is used," Johnson explained. "It tells us that even very small remaining errors can have a major impact on patients' survival chances, particularly when tumors are close to a vital organ like the heart." When cancer specialists prepare to perform radiation therapy, they scan the patient's body to determine the exact position and size of the tumor, the researchers explained. Before every treatment that follows, more images are used to ensure that the patient and the tumor are in the same position. For the study, the researchers recruited 780 patients undergoing radiation therapy for non-small cell lung cancer. For each treatment, patients were positioned on the machines and an image was taken to ensure they were lying within 5 millimeters (mm) of their original position. The researchers used the images to assess how precisely the radiation was delivered, and [...]

Early phase clinical trial shows promise for advanced head and neck cancer

Source: www.fredhutch.org Author: Rachel Tompa / Fred Hutch News Service For many survivors of head and neck cancer, the disease — and its treatment — leave a lifelong, unmistakable mark. Surgeries to remove tumors in the mouth, neck or throat often leave patients with disfiguring scars and difficulty speaking or swallowing. Some may not even be able to perform these tasks at all. Carla Stone participated in a clinical trial run by Fred Hutch's Dr. Eduardo Méndez for her advanced head and neck cancer. The experimental approach shrank her tumor down to nothing, sparing her what is typically a disfiguring surgery.Photo by Robert Hood / Fred Hutch News Service When you look at Carla Stone, you might not guess that she was diagnosed with stage 4 head and neck cancer just two years ago. The only visible sign of her disease and treatment — and you have to know what you are looking for — is the tiny dot tattooed on her chest, the marker for the radiation she received to her throat. Stone, a 66-year-old bookkeeper from Monroe, Washington, had ongoing symptoms for nearly two years before her doctors finally detected the tumor that had been growing on the base of her tongue. Her primary care physician dismissed the lump in her neck she found in 2014, Stone said, and a series of doctors kept giving her different antibiotics for the chronic sore throat she developed in early 2016. Eventually, when the antibiotics didn’t work, Stone sought [...]

Living with cancer in the country: Many Wyoming residents must leave home to seek the care they need

Source: trib.com Author: Katie King Bob Overton is all too familiar with the 140-mile stretch of land between Thermopolis and Casper. He and his wife, Sherry, made the two-hour trip in their white pickup dozens of times while Bob was undergoing treatment for lymphoma in 2015. Even with the help of Alan Jackson and Martina McBride’s music, the hours still lagged, with nothing to stare at except endless grassy plains. “That trip is pretty monotonous, and it doesn’t get any better with time,” he recalled. But the couple didn’t have a choice. Their hometown of Thermopolis, population 3,009, doesn’t offer the care Bob needed. And the Overtons aren’t alone. As the least populated state in the country, Wyoming appeals to those in search of space and wilderness. But the peace and quiet comes with drawbacks: Services that urban residents may take for granted, like advanced medical care, aren’t readily available for thousands of people living in small towns and rural areas. Many of those battling cancer in Wyoming subsequently end up seeking treatment in Casper, according to Rocky Mountain Oncology’s Patient Navigator Sam Carrick. She said the center is the only medical facility in the state that offers radiation, chemotherapy and Positron emission tomography scans. Other areas may offer one or two of those services, but many prefer the convenience of a one-stop shop, she said. About 15 percent of their patients are from out-of-town, added Carrick, who is responsible for guiding all patients through the treatment process. She said [...]

2018-02-04T09:47:02-07:00February, 2018|Oral Cancer News|

Cancer survivors are transforming their radiation masks into art

Source: www.artsy.net Author: Ryan Leahey Photos by Ulf Wallin Photography In a Baltimore basement, behind foot-thick walls, there is a room, and in that room there is a table. Every morning, Monday through Friday for seven weeks, my dad entered the room at 7:40 a.m. sharp. I accompanied him there on a few occasions, sitting outside in the waiting room as the door closed behind him. A minute or two would pass, followed by a barely audible buzz, then the door would slide open again and he’d walk out, another radiation treatment X’d off the calendar. My dad’s experience in that room, one of many in the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, will be familiar to other throat cancer patients. A radiation technician bolted him down to the table with the help of a white mesh mask perfectly molded to the contours of his face. Wrapped tightly around his head and neck, the bizarre-looking armature ensured that powerful radiation beams targeted his cancer in the exact same position each session, even as his skin deteriorated and his body mass dropped. Before his first treatment, he had been measured and fitted for his own custom mask. Plastic mesh was draped over his face until it hardened, forming a new face—what some patients call their second skin. For my dad, the object came to symbolize something, just as it symbolizes something for me, our family, and for the countless other people who have survived or helped [...]

Evolving role of surgery in multidisciplinary care for head and neck cancer

Source: www.onclive.com Author: Danielle Bucco Even with the advent of systemic therapeutic advancements to the armamentarium of head and neck cancer, surgery and novel techniques continue to rapidly evolve to effectively treat patients and leave less opportunity for adverse events (AEs). Additionally, the role of the surgeon has changed to be a more integrative role in patient care. “We are more precise and more integrated with other therapeutic modalities,” said Joseph A. Califano, MD. “Together, we work as a team and that is the best way that patients can receive their optimal outcomes. We do not just want to cure their cancer but to get back to function and wellness.” In an interview during the 2017 OncLive State of the Science SummitTM on Head and Neck Squamous Cell Carcinoma, Califano, a professor of surgery at the University of California, San Diego, discussed how surgery factors into modern multidisciplinary care for patients with head and neck cancer. OncLive: Please provide an overview of your presentation on surgery for patients with head and neck cancer. Califano: I discussed the fact that the surgery that we do now for head and neck cancers is very different from what used to be done 15 to 20 years ago. Our ability to do effective surgery is good, but now we can do it in a way that leaves patients with excellent function and cosmetic results. When you see someone walking down the street who has had major head and neck surgery, you wouldn't know it [...]

2017-12-19T09:27:11-07:00December, 2017|Oral Cancer News|

Young men should be required to get the HPV vaccine. It would have saved me from cancer.

Source: www.thedailybeast.com Author: Michael Becker In December 2015, at the age of 47, I was diagnosed with Stage IV oral squamous cell carcinoma. More simply, I have advanced cancer of the head and neck. While initial treatment with grueling chemo-radiation appeared successful, the cancer returned one year later in both of my lungs. My prognosis shifted from potentially curable to terminal disease. The news was shocking and devastating—not just for me, but for my wife, two teenage daughters, and the rest of our family and friends. Suddenly, my life revolved around regular appointments for chemotherapy, radiation therapy, imaging procedures, and frequent checkups. I made seemingly endless, unscheduled hospital emergency room visits—including one trip to the intensive care unit—to address some of the more severe toxicities from treatment. All told, I suffered from more than a dozen side effects related to treatment and/or cancer progression. Some are temporary; others permanent. These include anxiety, depression, distorted sense of taste, clots forming in my blood vessels, dry mouth, weight loss, and many more. My cancer started with a human papillomavirus (HPV) infection, a virus that is preventable with vaccines available for adolescent girls since 2006 and boys starting in 2011. The Food and Drug Administration (FDA) has approved three vaccines to prevent HPV infection: Gardasil®, Gardasil® 9, and Cervarix®. These vaccines provide strong protection against new HPV infections for young women through age 26, and young men through age 21, but they are not effective at treating established HPV infections. It was too [...]

2017-12-01T12:06:13-07:00December, 2017|Oral Cancer News|

Complex cancer decisions, no easy answers

Source: blogs.biomedcentral.com Author: Jeffrey Liu With the many different options now available for the treatment of cancer, it can be very difficult for both clinicians and patients to decide on the best possible treatment strategy, particularly when faced with a complicated cancer. In this blog, Dr Jeffrey C. Liu reflects on the challenges encountered in cancer decision making, particularly when presented with difficult cases. When treating cancer, sometimes the treatment decisions are straightforward and unambiguous. For example, surgery is the treatment of choice for an early, uncomplicated tongue cancer. However, many times, the recommendation for cancer treatment is not straightforward and requires combination treatment – one or more of surgery, radiation or chemotherapy. As a head and neck cancer surgeon, I work with a team to make these treatment decisions, and usually team consensus is achieved. However, when we are faced with the choice of multiple treatments that all have the same chance of cure available, it seems to result in a never ending discussion amongst our team. Take for example an advanced tonsil cancer. These cancers can sometimes be removed first with surgery, a process which removes both the primary cancer and the lymph nodes in the neck. Then, depending on the pathology results, patients may need radiation treatment, chemoradiation or sometimes no further treatment at all. Meanwhile, chemoradiation alone, and no surgery, is an excellent option. Whether the patient receives surgery or no surgery, the chance of cure is pretty much the same. However, based on the need [...]

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