Two decades earlier for locally advanced laryngeal cancer total laryngectomy and postoperative radiotherapy was standard of care. Now Radiotherapy with concurrent chemotherapy is considered standard care for patients desiring laryngeal preservation, and total laryngectomy is reserved for recurrent or residual disease as salvage therapy. The advantage of chemo radiation is larynx is preserved in 60-70% patients with better locoregional control. The drawback of primary chemo radiation, if there is recurrent or residual tumor then conservative laryngeal surgery cannot be performed as spread of tumor is very unpredictable and post operative complications are very high so ultimately patient end up undergoing total laryngectomy and losing natural voice.
A 62 year old patient diagnosed as squamous cell carcinoma larynx (supraglottic) cT3N1M0 (i.e. malignant lesion in the supraglottic larynx with fixation of ipsilateral vocal cord with ipsilateral enlarged level II lymph node [upper jugular]).The metastatic workup was within normal limits. The case was discussed in the tumor board and planned for concurrent chemo-radiation .The patient tolerated the treatment well but symptoms still persisted. After a month of this treatment patient was evaluated by CT scan neck which showed lesion in the supraglottis with post radiotherapy changes, flexible laryngopharyngoscopy revealed lesion in the left supraglottis with post RT changes. Biopsy was taken, reported as squamous epithelium with post RT changes. PET CT scan revealed FDG avid lesion in the larynx and hypopharynx. Rigid Direct laryngoscopy was done under GA which revealed lesion in the left sided supraglottis with extension to left hypopharynx .Biopsy report was a moderately differentiated squamous cell carcinoma.
Patient was planned for salvage surgery and underwent Total laryngopharyngectomy with patch pectoralis major pharyngoplasty with Left RND and right Lateral neck dissection with deltopectoral flap reconstruction for skin defect and Provox I voice prosthesis insertion .The patient’s postoperative recovery was uneventful. After 4weeks deltopectoral flap final insetting was done. The final histopathology report was moderately differentiated squamous cell carcinoma with minimal thyroid cartilage invasion, all margins were negative and a single lymph node was positive. No evidence of a leak was found after gastrograffin swallow after 15 days. Patient is on regular follow up doing fine and is able to communicate well using Provox voice prosthesis. The course of disease in this patient would support that
In summary larynx preservation, and a chemo-radiation regimen should be prescribed to patients who has good performance status, who is eager to be in this regimen and is ready for regular intensive follow up .The salvage laryngectomy is part of the protocol because if this is not done then overall survival is poorer than primary laryngectomy followed by radiotherapy. This can only be done by an experienced trained person in a comprehensive cancer care institution where all this expertise is available under one roof and coordination and planning can be done.
Posts tagged ‘Radiation’
Chemotherapy involves a regimen of drugs that have the ability to kill cancer cells and stop them from spreading. Chemotherapy can do several things. One is relieving cancer symptoms, such as pain. Another is controlling the cancer, slowing its growth. A third is curing the cancer, eliminating all evidence of cancerous cells.
It is often used in conjunction with another common technique, radiation therapy. This one uses energy expelled from X-rays, gamma rays and neutrons to shrink tumors and, hopefully, kill cancer cells. An external machine might shine radiation on the body or radioactive material might be placed inside the body near cancer cells.
Most of us know of the side effects, which can be significant and impair quality of life. You might have a few side effects, or if you’re lucky, none at all. The problem is that chemotherapy and radiation may affect healthy cells along with the targeted cancer cells. For that reason, it can cause symptoms such as fatigue, pain, hair loss, nausea, vomiting, anemia, nervous-system problems, infections, problems in the mouth, gums and throat, diarrhea, constipation, kidney/bladder problems, muscle problems, skin and nail effects, flu-like symptoms and a nonexistent libido.
Supplements to Consider
This article is about how to improve that quality of life by minimizing the impact of side effects. And you could find relief. Many supplements and herbs show promise in reducing your side effects and boosting your comfort, and many of them are part of Chinese medicine. Here they are, along with the chemotherapy or radiation side effects that they could help eliminate.
Glutamine
This supplement has been found beneficial in people taking the chemo drug “5-FU,” specifically helping reduce diarrhea. A dose of 18 grams (g) per day could reduce symptoms of diarrhea and reduce damage to your intestines.7
Probiotics
These “friendly” bacteria are housed in supplements that truly help the digestive system. A study of 164 chemo patients found that a probiotic capsule reduced gastrointestinal side effects.8 Another study of 200 people on radiation found that probiotics significantly improved diarrhea.9
Colostrum
This supplement has shown some early potential for limiting gastrointestinal side effects from chemo.
Chamomile
Mouthwash made with chamomile helps prevent mouth sores in chemo patients. A cream made from chamomile may be a soothing therapy for radiation-induced skin sores.
Aloe
Soap made with aloe gel protects the skin from radiation damage – so says a study of 75 patients.10 Aloe is also an excellent topical treatment for any skin problems caused by cancer treatment.
Beta-carotene/Vitamin E
These two antioxidant vitamins could prevent mouth sores caused by cancer treatment.
Ginger
This is a great natural way to relieve the nausea that chemotherapy drugs cause. It is particularly effective for those on the drug “8-MOP.”11
Calendula
A cream made from calendula flowers could help protect the skin during radiation therapy. In fact, compared to a standard treatment, calendula is more effective.12
Zinc
Radiation near the mouth could alter your sense of taste. Using zinc supplements could counteract this symptom.
Proteolytic Enzymes
Radiation to the pelvic area can trigger nausea, vomiting and fatigue. Symptoms could be reduced when you take proteolytic enzymes, such as papain and bromelain.
N-acetylcysteine
This supplement has shown promise for treating side effects of the chemo drug “ifosfamide.”
Fish Oil
Because they’re high in the omega-3 acid “DHA,” these supplements may decrease side effects of the drug “irenotecan.”
Melatonin
This natural hormone, in supplement form, has promise in reducing side effects of many chemo drugs.
Coenzyme Q10
This popular supplement may prevent heart damage that can be caused by the drug “doxorubicin.”
Most appropriate and effective treatment for you depends on many factors, including: – type of cancer stage and grade, hormone levels, such as cancer, estrogen, estrogen-positive or negative status of proteins, such as cancer, HER2-positive or negative , age and physical menopausal status.
SurgeonMost breast cancer treated with surgery to try to remove all the tumor cells. O (mastectomy) or partial (lumpectomy), breast cancer will be eliminated.
ChemotherapyChemotherapy in the whole body (systemic) treatment. In this case it is recommended that if there is an increased risk of cancer recurrence, such as enlargement.
RadiotherapyRadiotherapy is very effective and widely used method for treating breast cancer. Generally after surgery and / or chemotherapy, but can be, especially when the tumor is larger or heavier work in the hotel. Radiotherapy may be administered after surgery in the breast tissue, or other chest wall after a mastectomy. The goal of radiotherapy is to destroy microscopic cancer cells remained in the area after the operation.
How can I provide?
Radiation therapy uses photons are generally issued for the entire breast, and also other areas in the lymph nodes of the armpit (the vagina), bone (supraclavicular – SCF) or the sternum (between the dairy chain – MS). Many women last week of treatment with an electronic amplifier for the location of the tumor bed alone. Chest radiotherapy can be given in 15 to 30 procedures, depending on the factors mentioned above. In general, once daily, Monday through Friday.
Patient
For radiation, you go to bed nursing administration is committed to a strong trend towards the sternum is positioned horizontally on a stretcher therapy. Breast Board considered difficult and some patients a little annoying, but please, tell him the radiologist in planning meetings, if you can help. Depending on the type of treatment, or should one or both hands above her head because radiation can be planned and effective treatment. Once after the surgery arm and shoulder can overcome stress and difficult decisions in difficult situations. It is therefore important to exercise regularly practiced hands, because you have a medical team to promote flexibility and displacement.
Side effects of radiotherapy for cancer
The most common side effects of radiotherapy to the chest as a skin reaction and fatigue. If we look at the side of this page, you will learn the best methods to solve problems.
Here are some other recommendations to control and reduce the volume of the response of radiotherapy in skin cancer.
* Your skin will feel most vulnerable and pain around the nipple and the edge of the breast (especially if you have a bra cup size C or later). This is because the skin is naturally sensitive to sunlight and can work on the road creates a rebound type of reaction folds. For help with this, it is important not to use the bracket time and for several weeks after treatment with radiotherapy and cable works like a rubber directly onto the skin – this in turn makes it sensitive and irritable. If you can go without a bra, do it because it would be better for your skin. But if you can not go braless choose one that is smooth, wide and comfortable.
Scientists and research agencies have been studying the effect of cell phone radiation on users for many years, but when in May 2011, the World Health Organization announced that there was a link between cell phones and cancer, online Canada pharmacy decided to join the debate.
Research has been going on for four years linking cell phone radiation and brain cancer. The earlier conducted short-term studies were not able to provide sufficient evidence that suggested brain cancer was possible. However, extended studies conducted on people using mobile phones for more than 10 years revealed that they had a higher risk of getting brain tumors especially on the side where mobile phones were regularly held.
Recent evidence comes in the form of a documentary called, “Is Your Cellphone Killing You?” that contains interviews with worldwide scientists and experts, social awareness groups, and users who have experienced some form of discomfort of sickness arising out of electromagnetic radiation caused by excessive usage of cell phones. Online Canada pharmacy decided to read further into how much effect it would have on general health and whether chances of a global public health crisis were really on the cards.
The European Parliamentary Committee has already gone on record asking people to be wary of excess usage of cell phones to minimize electromagnetic radiation exposure. Children are required to be especially wary of getting addicted to the technology, as long-term usage would extend through their life, unless drastic measures are taken to reduce the effects of radiation in the longer run. The warning is real. People have to be wary of technology being introduced without health and safety issues.
The documentary actually questions regulations being implemented in New Zealand but effectively highlights a common problem existing across the globe. The pharmacy industry and people in general need to know whether the risk being highlighted can be backed by solid evidence. The question is not whether regulatory bodies will join hands in announcing the danger to the world like the WHO, but also whether a streamlined process is possible similar to what we see in drug monitoring by bodies like the FDA and Health Canada.
It is better to verify the real danger posed to future generations. The first step was taken way back in the 1990s by the International Society for Research on Cancer (IARC) in the form of a multinational case study. It took several years for the body to complete its investigation, and finally when the results were to be declared in the year 2009, it was held back because the methodology used was questioned by scientists in determining whether real risk existed in terms of developing cancer.
The debate has not ended. People will ask questions whether cellphones are safe to use. At present, studies cannot present solid evidence, but caution is warranted when we consider increase in lifestyle diseases. It is time to lead a more healthy life and indulge in activities that do not require the use of technology. Online Canada pharmacy can provide effective Canadian prescription drugs; and people can buy Imitrex and lifestyle related drugs, but an exercise regimen combined with simple living will go a long way in avoiding medication.
IMRT Treatment In India
Intensity Modulated Radiation Therapy
Intensity modulated radiation therapy (IMRT) is a powerful cancer-fighting technology. Annually, Mayo Clinic radiation oncologists treat more than 200 patients using IMRT…
How It Works
A more standard radiation therapy called three-dimensional conformal radiation therapy (3-D CRT) uses digital diagnostic imaging, computers and special software to conform the radiation beam to the shape of the tumor. IMRT is the latest advance in 3-D CRT technology. IMRT involves the use of varying intensities of hundreds of small radiation beams to produce dosage distributions that are more precise (conformal) than those possible with 3-D CRT.
In intensity modulated radiation therapy (IMRT), very small beams, or beamlets, are aimed at a tumor from many angles. During treatment, the radiation intensity of each beamlet is controlled, and the beam shape changes hundreds of times during each treatment. As a result, the radiation dose bends around important healthy tissues in a way that is impossible with other techniques. Because of the complexity of these motions, physicians use special high-speed computers, treatment-planning software, diagnostic imaging and patient-positioning devices to plan treatments and control the radiation dose during therapy….
Advantages of IMRT
The advantages of IMRT, compared to traditional radiation therapies, include : –
1) Decreased radiation to normal sensitive surrounding tissue 2) Decreased chance of harming normal cells 3) Higher radiation dosage to cancer cells 4) Precise radiation distribution 5) Increased chance of destroying cancer cells…
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