//THE ONLINE Nurse
Clinical Practice Guidelines for Head and Neck Cancer
This 116-page PDF document contains the latest version of the National Comprehensive Cancer Network clinical practice guidelines for all head and neck cancers. Tumor and cancer types covered in these guidelines include: ethmoid sinus, maxillary sinus, and salivary gland tumors; cancers of the lip, oral activity, oropharynx, hypopharynx, glottix larynx, and nasopharynx; occult primary cancer; unresectable head and neck cancer; and recurrent head and neck cancer. The guidelines also discuss a multidisciplinary team approach, support modalities, radiation techniques, and the principles of systemic therapy. Each type of cancer features several pages of branching charts that begin with a description of standard workup, split into different clinical stages, and link to different treatment charts to follow for each specific clinical stage of the disease, with both primary and adjuvant treatments presented. In-depth explanations of the diseases and associated treatments can be found in the “Discussion” section toward the end of the document.
//THE EDUCATED PATIENT®
The Oral Cancer Foundation
The Oral Cancer Foundation (OCF) is a nonprofit organization dedicated to fighting oral cancer through prevention, research, advocacy, education, and patient support. The OCF Website provides up-to-date oral cancer news and information, including articles on disease statistics, diagnosis, treatment, restoration and rehabilitation, dental issues, emotional aspects, and how the disease is connected to tobacco and the human papillomavirus. In the “People” section, patients can read about historical and current celebrities, athletes, and politicians who were diagnosed with oral cancer. Under “Products,” patients can find lists of recommended publications and oral care products, as well as links to where they can be purchased. The OCF Website also has a multimedia library of podcasts and videos, a list of other online resources, and a patient/survivor forum.
What You Need to Know About Oral Cancer
According to the National Cancer Institute (NCI), more than 21,000 men and 9000 women are diagnosed with oral cancer each year, most of whom are >60 years of age. Oral cancers develop in the oral cavity or oropharynx (the part of the throat at the back of the mouth). The NCI offers a comprehensive, printable online booklet, What You Need to Know About Oral Cancer. The literature is highly useful for patients and nurses. The vast list of oral cancer topics covered in the booklet includes Risk Factors, Symptoms, Treatment, Second Opinion, Nutrition, Reconstruction, Rehabilitation, Follow-up Care, Sources of Support, and Taking Part in Cancer Research. To help healthcare professionals and patients understand the content, the booklet includes illustrated diagrams of the cancer areas and a glossary of terms. The booklet also includes a list of questions patients can ask their doctors. To order a hardcopy of the booklet directly from the NCI, call (800) 422-6237.
Survival and quality of life of patients with oral and oropharyngeal cancer at 1-year follow-up of tumor resection
Journal: Journal of Applied Oral Science
Authors: Biazevic MG, Antunes JL, Togni J, et al
Purpose: This study’s goal was to evaluate changes in the survival and quality of life of patients who underwent surgical excision of oral and oropharyngeal squamous cell carcinoma. The study included 47 patients who were treated between 2006 and 2007 at a Brazilian healthcare unit that specialized in head and neck surgery. The authors of the study reviewed hospital files and administered the University of Washington Quality of Life questionnaire prior to and 1 year following surgery.
Results: One year after surgery, 7 patients had dropped out of the cohort, 15 had died, and 25 completed the questionnaire again. The study found that the risk of death was associated with having regional metastasis before undergoing surgery and tumor size of T3 or T4. The survivors presented with significantly lower overall and domain-specific ratings of quality of life, the largest reduction being chewing (74.0 before surgery and 34.0 after 1 year), and the only increase being anxiety (from 36.0 to 70.7). The authors concluded that this study may contribute to the development of interventions designed to reduce functional limitations in patients treated for oral and oropharyngeal cancer.
Vitamin D - celecoxib therapy
Study Type: Interventional
Age/Sex Requirements: 18-85 years (None)
Sponsor: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00953849
Purpose: This phase II study will be testing an immunotherapeutic approach for the treatment of oral cancer. The treatment consists of the COX-2 inhibitor celecoxib and vitamin D given for 3 weeks between diagnosis and surgical treatment. The theory behind the study is that the treatment will lessen the immune inhibitory environment and mature cells that can stimulate T-cell reactivity against oral cancer cells. The study has
4 arms: vitamin D alone, celecoxib alone, vitamin D with celecoxib, and no intervention. The primary outcome measure of the study will be increased dendritic cell levels and T-cell activity.