surgery

Sylvester surgeons perform first removal of throat cancer in south Florida using surgical robot

Source: www.healthcanal.com Author: staff Surgeons from the Department of Otolaryngology at UHealth – the University of Miami Health System have performed the first removal of throat cancer in South Florida using a surgical robot. The operation was performed March 22nd at the University of Miami Hospital by Francisco Civantos, M.D., associate professor of otolaryngology and member of the Head and Neck Cancer Site Disease Group at Sylvester Comprehensive Cancer Center, and Giovana Thomas, M.D., associate professor of otolaryngology and member of the Head and Neck Cancer Site Disease Group at Sylvester. They were accompanied by Raymond J. Leveillee, M.D., professor of urology, who is an experienced urologic robotic surgeon. Traditional surgery for various head and neck cancers requires large incisions – extending from the lip, across the chin and to the neck before entering the mouth or throat. Numerous times surgeons need to cut through the lower jaw and move aside vital nerves to gain access to the back of the mouth and throat. By using the da Vinci® Surgical System, surgeons insert the slender instruments into the mouth to reach the base of the tongue, tonsils, and throat. "As a surgeon," says Civantos, "using a surgical robot allows for greater precision and dexterity to remove cancerous tumors from tight spaces in the mouth and throat." The University of Miami Hospital's da Vinci® System consists of robotic arms that replicate a surgeon's motions. Throughout a robot-assisted surgery, patients are positioned as they would be during laparoscopic surgery, with surgical team [...]

Oral Cancer Foundation News Team - A2010-04-10T10:28:38-07:00April, 2010|Oral Cancer News|

With cancer, let’s face it: words are inadequate

Source: nytimes.com Author: Dana Jennings We’re all familiar with sentences like this one: Mr. Smith died yesterday after a long battle with cancer. We think we know what it means, but we read it and hear it so often that it carries little weight, bears no meaning. It’s one of the clichés of cancer. It is easy shorthand. But it says more about the writer or speaker than it does about the deceased. We like to say that people “fight” cancer because we wrestle fearfully with the notion of ever having the disease. We have turned cancer into one of our modern devils. But after staggering through prostate cancer and its treatment — surgery, radiation and hormone therapy — the words “fight” and “battle” make me cringe and bristle. I sometimes think of cancer as a long and difficult journey, a quest out of Tolkien, or a dark waltz — but never a battle. How can it be a battle when we patients are the actual battleground? We are caught in the middle, between our doctors and their potential tools of healing and the cell-devouring horde. We become a wasteland, at once infested by the black dust of cancer and damaged by the “friendly fire” of treatment. And ordinary language falls far short of explaining that keen sense of oblivion. As a patient, it’s hard to articulate how being seriously ill feels. In a profound way, we are boiled down to our essential animal selves. We crave survival. We long [...]

Oral Cancer Foundation News Team - A2010-03-18T14:19:46-07:00March, 2010|Oral Cancer News|

Lymphedema common in head and neck cancer

Source: www.medpagetoday.com Author: Charles Bankhead, Staff Writer, MedPage Today Treatment of head and neck cancer causes potentially severe lymphedema, which responds to complete decongestive therapy in most cases, a retrospective chart review showed. The most severe lymphedema occurred in patients treated with surgery and radiation therapy, followed by definitive surgery alone. Complete decongestive therapy led to clinical improvement in a majority of the patients, including 83% of those treated with surgery alone. "Lymphedema is vastly under-recognized and under-reported in patients with head and neck cancer," Jan S. Lewin, PhD, of M.D. Anderson Cancer Center in Houston, said in an interview at the Multidisciplinary Head and Neck Cancer Symposium (MHNCS). "The lymphedema can be just as severe as what's seen after treatment of breast and other types of cancer. Lymphedema in patients with head and neck cancer can be terribly disfiguring and cause severe functional problems." "Complete decongestive therapy leads to clinically significant improvement in most patients, whether it's performed in a clinic or at home," she added. Available evidence suggests that fewer than half of patients with head and neck cancer develop lymphedema after treatment. However, cosmetic and functional sequelae can be severe, including problems with speaking, eating, airway obstruction, and drooling, as well as self-image. As compared with lymphedema in other cancers, a paucity of information exists about the presentation and treatment of the condition in patients with head and neck cancer, said Lewin. In an effort to add to the information base, she and her colleagues retrospectively reviewed [...]

Oral Cancer Foundation News Team - A2010-03-13T12:45:20-07:00March, 2010|Oral Cancer News|

Transoral robotic surgery showed good oncologic, functional outcomes

Source: Author: Christen Haigh Patients with head and neck cancers treated with transoral robotic surgery — or TORS — had good disease control, disease free survival (DFS) and overall survival (OS), according to the findings of a preliminary study presented at the Multidisciplinary Head and Neck Cancer Symposium in Chandler, Ariz. “Disease control and survival rates using TORS appeared to be equivalent or near equivalent to those rates reported with chemoradiation, but with TORS, we need better functional outcome,” Eric Genden, MD, chief of the division of head and neck oncology at Mount Sinai Medical Center, New York, said during the presentation of the results. To determine the role of TORS in the treatment of oropharyngeal cancer, researchers prospectively evaluated patterns of failure, survival and functional outcomes of 25 patients treated with TORS and compared them with that of 12 patients treated with combined chemoradiation. The one-year locoregional control was 95%; distant control was 96%; DFS was 86% and OS was 86%. There was one local failure, one distant failure, one second primary failure and one comorbid death. Patients who received TORS had less acute toxicity two weeks after treatment vs. patients who received chemoradiotherapy. The TORS group had better eating ability than the chemoradiotherapy group (74% vs. 52%) and had improved diet vs. the chemoradiotherapy group (43% vs. 20%). Thus, TORS was associated with a higher overall functional oral intake scale score vs. that of the chemoradiotherapy group (5.3 vs. 3.2). Both groups had a score of 100% for [...]

Oral Cancer Foundation News Team - A2010-03-05T07:43:24-07:00March, 2010|Oral Cancer News|

Best face forward

Source: www.curetoday.com Author: Lacey Meyer When 16th-century astronomer Tycho Brahe lost part of his nose in a duel, his options for a prosthesis were limited — he donned a folded metal plate in the shape of a nose to cover his missing anatomy. Today, patients with head and neck cancer, who may lose bone, skin, teeth or cartilage as a result of cancer surgery, find that the focus is not only on cancer control, but also on facial restoration with specialists who see the process as not only functional but also aesthetic. For past patients, the evolved approach to treatment with a multidisciplinary team of specialists, each concentrating on a certain area within the full scope of maxillofacial prosthetic rehabilitation, can be life-changing. Joseph Huryn, DDS, says he has patients who were recluses for years, unaware of facial prostheses as a possibility. “It changes their life incredibly,” says Huryn, chief of dental service at Memorial Sloan-Kettering Cancer Center in New York City. Depending on head and neck cancer location, size and treatment, maxillofacial prostheses can be intra-oral (within the mouth) or extra-oral (outside of the mouth). Maxillofacial prosthodontists can fabricate prostheses ranging from a resection appliance — used to replace part of the lower jaw — to an auricular (ear) prosthesis or an orbital prosthesis replacing the eye and surrounding tissues including the eyelid, socket and sometimes part of the cheek and nose. Professionals in anaplastology — the art and science of creating artificial anatomy — specialize in the fabrication [...]

Oral Cancer Foundation News Team - A2009-12-24T09:12:26-07:00December, 2009|Oral Cancer News|

FDA clears transoral robotic surgery – developed at Penn –for tumors of mouth, throat and voice box

Source: www.healthcanal.com Author: staff A minimally invasive surgical approach developed by head and neck surgeons at the University of Pennsylvania School of Medicine has been cleared by the U.S. Food and Drug Administration (FDA). The da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, California) has been cleared for TransOral Otolaryngology surgical procedures to treat benign tumors and selected malignant tumors in adults. Drs. Gregory S. Weinstein and Bert W. O’Malley, Jr. of the University of Pennsylvania School of Medicine’s Department of Otorhinolaryngology: Head and Neck Surgery founded the world’s first TransOral Robotic Surgery (TORS) programat Penn Medicine in 2004, where they developed and researched the TORS approach for a variety of robotic surgical neck approaches for both malignant and benign tumors of the mouth, voice box, tonsil, tongue and other parts of the throat. Since 2005, approximately 350 Penn patients have participated in the world’s first prospective clinical trials of TORS. These research trials compromise the largest and most comprehensive studies of the technology on record. “TORS has dramatically improved the way we treat head and neck cancer patients, completely removing tumors while preserving speech, swallowing, and other key quality of life issues,” said Bert O’Malley, Jr., MD, professor and chairman of Penn Medicine’s Department of Otorhinolaryngology:Head and Neck Surgery. “It is very exciting that a concept conceived at PENN, evaluated in pre-clinical experimental models at Penn, tested in clinical trials at Penn, and then taught to key surgeons and institutions both within the U.S. and internationally has been officially [...]

Oral Cancer Foundation News Team - A2009-12-19T23:10:00-07:00December, 2009|Oral Cancer News|

Q&A: treating larynx cancer with chemotherapy alone

Source: www2.mdanderson.org/cancerwise Author: Cancerwise Blogger In certain cases, cancer of the larynx (voicebox) can be treated successfully with chemotherapy alone, according to a recent study at M. D. Anderson. Chris Holsinger, M.D., assistant professor in the Department of Head and Neck Surgery, was co-author of the study, which is the first of its kind in the United States. He answers questions about this groundbreaking research that may provide hope for some patients. How has the treatment for larynx cancer evolved over the past few decades? Thirty years ago, the only option for cancer of the larynx, also called laryngeal cancer was surgical removal of part of the larynx. In the 1970s, treatment moved away from surgery and more toward radiation. Then we began to combine radiation and chemotherapy. What are some of the disadvantages of treating cancer of the larynx with radiation? Radiation can have side effects, especially long-term toxicity. In many patients, the cancer returns. Sometimes, radiation therapy saves the larynx and trachea (windpipe), but they do not work as well. This requires some patients to have a tracheotomy (a surgical procedure that makes an incision in the trachea to open a direct airway) or gastrostomy (surgical opening into the stomach). If patients who have radiation need surgery later, they often have more surgical complications and lower survival rates. What inspired you to look at treating larynx cancer with chemotherapy? While the treatment of larynx cancer was evolving in the United States, another story was unfolding in Paris. Two [...]

Oral Cancer Foundation News Team - A2009-12-02T21:12:25-07:00December, 2009|Oral Cancer News|

A 25-year analysis of veterans treated for tonsillar squamous cell carcinoma

Source: Arch Otolaryngol Head Neck Surg, November 1, 2009; 135(11) Authors: JJ Jaber et al. Objective: To determine the recurrence and survival outcome based on treatment date, type of treatment, stage of disease, and comorbidity and the recurrence and survival differences based on smoking status as a surrogate for human papillomavirus status in veterans treated for tonsillar squamous cell carcinoma (SCC). Design: Outcome cohort study. Setting: Tertiary care Department of Veterans Affairs hospital. Patients: A consecutive sample from 1981 through 2006 of 683 patients treated for oropharyngeal SCC was screened, and 141 patients with tonsillar SCC without distant metastatic spread and a minimum of 2 years of follow-up were included. Main outcome measures: Disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Results: Disease-free survival was significantly better in cohort II (treated during or after 1997) compared with cohort I (treated before 1997) (2- and 5-year DFS, 82% vs 64% and 67% vs 48%; P = .02). Disease-specific survival was better in the surgical vs nonsurgical group (2- and 5-year DSS, 77% vs 46% and 67% vs 30%; P

Oral Cancer Foundation News Team - A2009-11-28T08:01:30-07:00November, 2009|Oral Cancer News|

Human papillomavirus infection and cancers of the oropharynx

Source: www.ajho.com Author: Robert Haddad, MD Dana Farber Cancer Institute, Boston, MA The author was invited to contribute his thoughts on the topic of human papillomavirus and cancers of the oropharynx. Squamous cell carcinoma of the head and neck (SCCHN) is a major public health problem, affecting nearly half a million individuals worldwide each year. These cancers can arise from the oral cavity, oropharynx, nasopharynx, hypopharynx and larynx.1 Treatment of head and neck cancer is often multidisciplinary, involving chemotherapy, radiation therapy, and surgery. Patient symptoms can include a sore throat, ear pain, odynophagia, or hoarseness. Most patients will present with stage III or IV disease. The major risk factors are smoking tobacco and alcohol abuse. A large number of patients diagnosed with oropharynx cancer, however, have no history of smoking or drinking, and increasing epidemiological, molecular, and clinical evidence suggests that high-risk human papillomavirus (HPV), especially HPV-16, account for the development of these cancers.2-5 Most individuals are unaware of their infection and have no symptoms. HPV is one of the more common virus groups in the world, and more than 80 types of HPV have been identified. Some types (eg, HPV 6 and 11) are known to cause benign conditions such as genital warts, while other types (eg, HPV 16 and 18) are known to be associated with malignant, cancerous transformation. Although different types of HPV are known to infect different parts of the body, HPV usually infects the epithelial cells of skin and mucosa. The epithelial surfaces include all [...]

Oral Cancer Foundation News Team - A2009-10-13T21:15:33-07:00October, 2009|Oral Cancer News|

Prospective analysis of outcomes and complications of 300 consecutive microvascular reconstructions

Source: Arch Facial Plast Surg. 2009;11(4):235-239 Authors: Michael J. Nuara, MD; Cara L. Sauder, MA, CCC-SLP; Daniel S. Alam, MD Objective: To prospectively follow up patients requiring microvascular reconstruction of head and neck defects to determine preoperative factors predictive of surgical complications. Methods: A prospectively collected database comprising 300 consecutive microvascular head and neck reconstructions performed by a single surgeon (D.S.A.) in a tertiary care hospital over a 6-year period was reviewed in a retrospective manner. Data collected included preoperative medical and surgical history (presence of documented cardiac disease, diabetes mellitus, and hypertension) and previous cancer treatment (surgery or radiation therapy). Postoperative data, including early or late complications, hematocrit during hospitalization, and functional status, were also collected. A multiple linear regression was used to identify predictors of surgical complications and secondarily crossed to determine the strength of the prediction. Statistical significance was set at P = .05. Results: Patients were stratified into 4 groups based on (1) previous radiation therapy, (2) previous surgery, (3) no previous radiation therapy or surgery, and (4) both previous radiation therapy and previous surgery, with an increased predictability of complications with both. Diabetes also added to the predictability of complications, with a smaller effect. Cardiac disease and hypertension were not predictive. Conclusions: Previous radiation therapy and surgery are positive predictors for wound complications after microvascular reconstruction. Diabetes may add further risk in this setting. Author Affiliations: Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio (Drs Nuara and Alam); and Division of Otolaryngology, University of [...]

Oral Cancer Foundation News Team - A2009-09-22T06:16:25-07:00September, 2009|Oral Cancer News|