Category Archives: Oral Cancer

The Latest News From the Front Line: The Multidisciplinary Head and Neck Cancer Symposium 2016

 

Dr. Hughes enjoyed some February Arizona sunshine while he learned the latest research to help his patients here in Ohio.

Dr. Hughes enjoyed some February Arizona sunshine while he learned the latest research to help his patients here in Dayton.

I personally attended The Multidisciplinary Head and Neck Cancer Symposium along with hundreds of head and neck cancer specialists  from around the world – surgeons, chemo therapists, and radiation therapists – to hear about the latest in state-of-the-art treatment for head and neck cancer patients.

A number of presentations struck me as important for our head and neck cancer patients and their families living in Dayton, Ohio. 

1.  Head and Neck Cancer Patients Can Be Sure that Radiation Therapy in Dayton, Ohio Is Just As Good As At The James Cancer Center  

The key study for Southwestern Ohio head and neck cancer patients came from our own James Cancer Center at the Ohio State University.  The James’ head and neck cancer specialists looked at 333 patients who had their surgery at OSU.  Of these, 139 patients had their radiation at OSU and 194 patients had radiation in their hometown.  The important finding was that there was no difference in survival in those patients who had their radiation at OSU (139 patients) as compared to this patients (194) who underwent radiation therapy at centers closer to home. I have always firmly believed that people do better when they stay close to their support system and when they can live life as normal as possible during treatment.

2. Immunotherapy for Recurrent Head and Neck Cancer Patients 

Dr. Siewert from the University of Chicago School of Medicine reported on the Checkmate 141 trial.  The Checkmate 141 trial looked at a new immune checkpoint inhibitor drug called Opdivo.  Opdivo has been proven to be effective for patients with metastatic malignant melanoma as well as recurrent lung cancer.  Immune checkpoint inhibitors unleash your body’s own immune system to attack your own head and neck cancer, unlike chemotherapy that suppresses your immune system.

Remarkable results were seen with Opdivo in treating patients with recurrent head and neck cancer, that is after surgery, chemotherapy, and radiation therapy.  In fact, so remarkable that the study was halted early because more than 50% of patients with recurrent head and neck cancer responded to Opdivo.  And with few side effects.  More importantly, the effects of Opdivo lasted on average 18 months, far greater than with palliative chemotherapy.

Dr. Siewert reminded us that these patients with recurrent head and neck cancer had been, as he put it, “heavily pretreated.”  That is to say, these patients had many courses of chemotherapy.  These patients already had a suppressed immune system from chemotherapy.  Just imagine if Opdivo would be used as first line therapy for patients with recurrent head and neck cancer.  Dr. Siewert expects rapid approval of Opdivo for recurrent head and neck cancer patients by the FDA. 

3.  Say Goodbye to Stage IV Tonsil/Base of Tongue Cancer For HPV-positive Patients

 Dr. Brian O’Sullivan of the Princess Margaret Hospital in Toronto proposed a new staging system for HPV positive patients with squamous cell carcinoma of the tonsil as well as base of tongue.  His studies showed that chemotherapy and radiation therapy are so good in this patient group that a new classification system is needed for prognosis as well as to guide treatment.  He proposed only 3 new stages.  Stage IV is now reserved for that very rare patient who comes to clinic where the cancer has already spread to other organs, such as lung or liver.

Dr. Chera of the University of North Carolina at Chapel Hill went a step further and proposed that in early stage HPV positive head and neck cancer patients, radiation dose could be reduced from the standard 6-1/2 weeks to 5 weeks with exactly the same results – but with fewer side effects.  Until further studies are done, this reduced radiation dose regimen will be for selected patients with cancer of the tonsil and base of tongue who are non-smokers/non-drinkers and HPV positive. 

If you have any questions about head and neck cancer or if you just want a second opinion, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1. 

It is Reds Opening Day. Not all Baseball Traditions are Good.

Baseball’s Long SmokelessTobacco Tradition

Baseball and tobacco traditionally go hand and hand. With the start of baseball season, the debate is renewed. Last year’s passing of  legend Tony Gwynn renewed the debate about smokeless tobacco and its use by baseball players of all ages.

Smokeless tobacco is referred to as dip, snuff or chew and has been banned in dugouts in high school, college, and professional minor league baseball. However, while Major League Baseball (MLB) recognizes the harmful effects, it is not banned. New commissioner Rob Manfred and Tony Thurmond, a state assembly member in California, are both actively advocating for a culture change by asking the MLB Players Union for a ban. In 2011, with the urging from public groups such as the Campaign for Tobacco-Free Kids, the MLB opened a Tobacco Cessation Center that offers educational sessions to their players and staff about the dangers. They are hoping to break this long standing tradition associated with baseball.

Dr. Donald Marger, Oral, Head and Neck Cancer expert at First Dayton CyberKnife, explains that “the cancer causing chemicals in smokeless tobacco is no different than what is in cigarettes and pipes. While they will not contribute to your risk for lung cancer, there is still danger of cancers of the tongue, floor of mouth, throat, gums, cheeks and lips.” Oral, head and neck cancer affects 55,070 newly diagnosed Americans each year with approximately 12,000 deaths. Other health issues include severe dental problems and the terrible staining of the teeth.

Many MLB players and coaches claim to only use dip while in uniform. They say it is simply a habit and a way to relax and pass the time during a game. David Ortiz of the Boston Red Sox only puts snuff in his mouth while he is at bat. Others admit it is a terrible addiction that they simply cannot break and they wish they had never started.

“Cancer of the oral cavity, besides being potentially fatal, almost invariably results in marked physical deformity, swallowing problems, difficulty with speech and breathing. The primary treatment is radical surgery followed by radiation therapy”, explains Dr. Marger.

The debate is not whether dip is harmful ‑‑ clearly it is. The debate is whether or not we want our children looking up to their baseball all-stars and emulating their behavior. At the thousands of baseball fields around our country you see t-ballers chewing bubble gum, high schoolers spitting seeds and professionals spitting tobacco. Would it have made a difference to Tony Gwynn or the many other baseball players with these cancers if someone had told them to never start? Does it need to remain a part of America’s most beloved sport?

April is Oral, Head and Neck Cancer Awareness month. Our local Support for People with Oral and Head and Neck Cancer  will be offering screenings around Dayton the month of April. You will find Dr. Ed Hughes doing FREE screenings on April 18 at the Levin Family Foundation Celebrating Life Health Fair at Sinclair Community College.

Blog contributed by: Kathy Corbett of First Dayton CyberKnife

 

Debate Over Tobacco in Baseball Heightens

The passing of baseball legend Tony Gwynn has started a much needed debate about smokeless tobacco and its use by baseball players of all ages.

Smokeless tobacco is referred to as dip, snuff or chew and has been banned in dugouts in high school, college, and professional minor league baseball. However, while Major League Baseball (MLB) recognizes the harmful effects, it is not banned. You still see many players use it during games. In 2011, with the urging from public groups such as the Campaign for Tobacco-Free Kids, the MLB opened a Tobacco Cessation Center that offers educational sessions to their players and staff about the dangers. They are hoping to break this long standing tradition associated with baseball.

Dr. Donald Marger, Oral, Head and Neck Cancer expert at First Dayton CyberKnife, explains that “the cancer causing chemicals in smokeless tobacco is no different that in cigarettes and pipes. While they will not contribute to your risk for lung cancer, there is still danger of cancers of the tongue, floor of mouth, throat, gums, cheeks and lips.” Oral, head and neck cancer affects 55,070 newly diagnosed Americans each year with approximately 12,000 deaths. Other health issues include severe dental problems and the terrible staining of the teeth.

Many MLB players and coaches claim to only use dip while in uniform. They say it is simply a habit and a way to relax and pass the time during a game. David Ortiz of the Boston Red Sox only puts snuff in his mouth while he is at bat. Others admit it is a terrible addiction that they simply cannot break and they wish they had never started.

“Cancer of the oral cavity, besides being potentially fatal, almost invariably results in marked physical deformity, swallowing problems, difficulty with speech and breathing. The primary treatment is radical surgery followed by radiation therapy”, explains Dr. Marger.

The debate is not whether dip is harmful ‑‑ clearly it is. The debate is whether or not we want our children looking up to their baseball all-stars and emulating their behavior. At the thousands of baseball fields around our country you see t-ballers chewing bubble gum, high schoolers spitting seeds and professionals spitting tobacco. Would it have made a difference to Tony Gwynn or the many other baseball players with these cancers if someone had told them to never start? Does it need to remain a part of America’s most beloved sport?