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This article reviews the development of practical and theoretical teaching of surgical management of throat cancer, from the dialectic of the Middle Ages to computer simulation of the 21st century. This work is essentially based on original historical publications, analysed from secondary references relevant to the interpretation of the original texts. The literature search was essentially conducted in the "bibliothèque universitaire de médecine de Tours", the "bibliothèque inter-universitaire de médecine de Paris", the "Assistance publique-Hôpitaux de Paris archives" and the "bibliothèque nationale de France". PubMed was used for the most recent references. The search terms focused on surgical training, the history of otorhinolaryngology and throat cancer. Up until the 19th century, throat cancer surgery training was provided by general surgeons. The otorhinolaryngology specialty was created at the turn of the 20th century: throat cancer surgery became a subspecialty, but certain university obstacles prevented the creation of formal throat cancer surgery training. In the 20th and 21st century, throat cancer surgery training was enhanced by technical innovations as well as ethical imperatives. The principle of mentoring, essential in surgical training, has remained a constant feature throughout the ages, regardless of the scientific progress described in this historical review.

Objectives: To differentiate squamous cell hyperplasia (SCH) (benign) from squamous cell carcinoma (SCC) malignant) using textural features extracted from CT images and thereby, facilitate the preoperative medical diagnosis and treatment of throat cancers without the need for sample biopsies. Methods: In total, 100 throat cancer patients were selected for this retrospective study. The cases were collected from the Second Hospital of Jilin University, Changchun, China, from June 2017 to January 2019. The patients were separated into a training and validation cohort consisting of 70 and 30 cases, respectively. The Artificial Intelligence Kit software (A.K. software) was used to extract the radiomics features from the CT images. These features were further processed using the minimum redundancy maximum relevance (mRMR) and least absolute shrinkage and selection operator (LASSO) methods to obtain a subset of optimal features. The radiomics model was validated based on area-under-the-curve (AUC) values, accuracy, specificity, and sensitivity using the R-studio software. Results: The diagnostic accuracy, specificity, PPV, NPV, and AUC values obtained for the training cohort was 0.91, 0.9, 0.93, 0.9, and 0.96 CT angiography (CTA), 0.93, 0.93, 0.95, 0.90, and 0.96 computed tomography normal (CTN), and 0.92, 0.87, 0.91, 0.96, and 0.96 CT venogram (CTV). These values were subsequently confirmed in the validation cohort. Conclusion: The radiomics-based prediction model proposed in this study successfully differentiated between SCH and SCC throat cancers using CT imaging, thereby facilitating the development of accurate preoperative diagnosis based on specific biomarkers and cancer phenotypes.

BACKGROUND AND OBJECTIVE Laryngectomy is usually associated with olfactory dysfunction. How do laryngectomees personally experience and feel about this change? MATERIALS AND METHODS In cooperation with the Bundesverband der Kehlkopfoperierten (German Association of Throat Cancer Patients) and together with laryngectomized patients, a new questionnaire was created and distributed via the regional offices according to the population sizes of the federal states (n = 293) for the first time in spring 2018. The questionnaire covers patient characteristics and daily life without a larynx, as well as the specific areas of smell and taste, albeit without differentiation between ortho- and retronasal olfaction. The items were designed to be answered using patient-friendly visual rating scales, multiple-choice answers, and free text. RESULTS Return rate was 198/293 (67.6%). Median age of all participants was 69 years (48-88). Overall life situation was rated by 99/198 (50%) participants as "good" or "very good." The primary subjective impairment for the patients was loss of voice (137/198, 69.1%) and loss of olfaction (113/198, 59.1%). Adaption to life without a larynx has been completed within a maximum of 3 years for 161/198 (81.3%) patients. Principally, 127/198 (64.1%) affirmed being able to smell and 176 of 198 (88.9%) being able to taste; however, only 29/198 (14.6%) rated their sense of smell and 109/198 (55.1%) their sense of taste as "good" or "very good." Most frequently detected smell sensations were perfume (141), smoke (126), and feces (99). Univariate analysis showed a significant (p

Cancer is a universal and non communicable disease that affects people without regard to race, gender, socio economics status or culture1. Cancer is the second most common killer disease in the world.2. Oral health is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, other diseases and disorders that limit individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing. The most common oral diseases are oral cancer, dental cavities, periodontal (gum) disease, oral infectious diseases, trauma from injuries, and hereditary lesions4. Researchers in oral cancer believe that early diagnosis of oral carcinoma greatly increases the probability of cure and survival rates in addition to minimizing impairment and deformity. Identification and rectification of pre disposing factors will reduce the risk of oral cancer.The structured teaching programme could effectively increase the knowledge and attitude of adults with pre cancerous oral lesions (cases) regarding oral cancer which help the adults to reduce the level of dependence in smoking and smokeless tobacco and also acceptance of treatment and thus reduce the prevalence of oral cancer. Awareness about the devastating consequences of tobacco use and exposure to smoke need to spread to protect the lives of the ignorant and to give the present and future generation a healthy life.

Worldwide and also in the Netherlands there is an increasing human papillomavirus (HPV)-attributable oropharyngeal cancer incidence. This type of cancer is more common at a younger age than the classical oropharyngeal cancer, which is usually caused by smoking and excessive drinking. Most often, the tumor occurs in the tonsils and at the base of the tongue. This study explored the level of knowledge of dentists about oropharyngeal cancer, its association with the human papillomavirus and their willingness to play a role in prevention. 7.364 digital questionnaires were sent to oral health-care providers and data from 607 dentists was analyzed. 48% of knowledge questions were answered correctly by more than half of the respondents. Significantly more female caregivers were aware of the relationship between HPV and oropharyngeal cancer and the availability of an HPV vaccine. Respondents considered it important that the relationship between HPV and oropharyngeal cancer is discussed with patients and that a protocol is developed that is useful in screening for mouth and throat cancer.Wereldwijd en ook in Nederland is er een toename van de incidentie van humaan papillomavirus geassocieerde orofarynxkanker. Deze kanker komt op jongere leeftijd vaker voor dan de klassieke orofarynxkanker die meestal wordt veroorzaakt door roken en overmatig alcoholgebruik. De tumor komt vooral voor in de tonsillen en de tongbasis. In dit onderzoek is gekeken naar de kennis van tandartsen over orofarynxkanker, de associatie ervan met het humaan papillomavirus en de bereidheid om te adviseren over preventieve maatregelen. Er werden 7.364 digitale vragenlijsten naar mondzorgverleners verstuurd en data van 607 tandartsen werden geanalyseerd. Van de kennisvragen werd 48% door meer dan de helft van de respondenten correct beantwoord. Significant meer vrouwen waren op de hoogte van de associatie tussen het virus en orofarynxkanker en de beschikbaarheid van een vaccin. Respondenten vonden het belangrijk dat de relatie tussen humaan papillomavirus en orofarynxkanker met patiënten wordt besproken en wensten een protocol dat bruikbaar is bij de screening op mondholte- en keelkanker.

Background Oropharyngeal squamous cell carcinoma (OPSCC) is associated with high mortality. Human papillomavirus (HPV) infection is a significant risk factor for OPSCC. Utilities are fundamental values representing the strength of individuals’ preferences for specific health-related outcomes. Our study aim was to work in partnership with Indigenous communities in South Australia to develop, pilot test and estimate utility scores for health states related to HPV, HPV vaccination, precursor OPSCC and its treatment, and early stage OPSCC among Indigenous Australians. Methods Development and pilot testing of hypothetical HPV and OPSCC health states, specifically through the lens of being Indigenous Australian, was conducted with an Indigenous Reference Group. Six health states were decided upon, with utility scores calculated using a two-stage standard gamble approach among a large convenience sample of Indigenous Australians aged 18+ years residing in South Australia. The rank, percentage of perfect health and utility score of each health state was summarised using means, and medians at 12 months and lifetime duration. Potential differences by age, sex and residential location were assessed using the Wilcox Rank Sum test. Results Data from 1011 participants was obtained. The mean utility scores decreased with increasing severity of health states, ranging from 0.91–0.92 in ‘screened, cytology normal, HPV vaccination’ and ‘screened, HPV positive, endoscopy normal’, to less than 0.90 (ranging from 0.87–0.88) in lower grade conditions (oral warts and oral intraepithelial neoplasia) and less than 0.80 (ranging from 0.75–0.79) in ‘early stage throat cancer’. Higher utility scores were observed for ‘screened, cytology normal and HPV vaccination’ among younger participants (18–40 years), for ‘early stage invasive throat cancer’ among females, and for ‘oral intraepithelial neoplasia’ and ‘early stage invasive throat cancer’ among metropolitan-dwelling participants. Conclusion Among a large sample of Indigenous Australians, utility for oral HPV infection and OPSCC decreased with severity of health states. Older participants, as well as males and those residing in non-metropolitan locations, had decreased utility for high-grade cytology and early invasive cancer states. Our findings are an important contribution to cost-utility and disease prevention strategies that seek to inform policies around reducing HPV infection and OPSCC among all Australians.

Transoral robotic surgery (TORS) is an established treatment for many subsites of Head and Neck cancer. With the improved flexibility and access of the single-port (SP) robotic system, tumors within the distal upper aerodigestive tract can now be reached and successfully treated with all the published advantages of transoral endoscopic surgery. Here in we offer the first published surgical technique for SP TORS for resectable hypopharyngeal carcinoma. The video presented demonstrates many important aspects utilizing the enhanced robotic system, including adjustments of the semi-flexible endoscope and use of the third transoral surgical instrumentation. As previously reported, TORS hypopharyngectomy should be considered for resectable tumors to improve upon the deleterious effects of open surgical resection or chemoradiation therapy.

Relevance. Throat cancer is the most widespread malignant tumor of a throat and makes about 3% of all malignant tumors of the person. Bleedings at throat cancer is the most difficult and dangerous complication posing direct threat to life of the oncological patient. An intervention is usually characterized by the expressed painful syndrome in a zone of surgical access for patients with surgical pathology of ENT organs. For that reason, using of gel polymeric dressing means is the most modern and effective. Analgesic action is noted in the area of a postoperative wound within the first 60 - 90 minutes after imposing of such bandage. Aim of research is to determine efficiency of multifunctional depot-system of the prolonged action on a gel basis of Kolegel-ADL of various degree of viscosity at a tamponade of a throat and trachea for elimination of a local hemorrhage. Materials and methods. Koletes-ADL dressing was used at treatment of 39 patients with malignant tumors of a throat. Patients arrived in the emergency order with bleedings from a throat, were on hospitalization in acute hospital No. 1, Voronezh. A morphological variety of malignant tumors of this localization took place. The control group has included 19 people with similar destructive and tumorous processes complicated by bleeding treatment of which was carried out by the standard technique. Results. As criteria of a convalescence considered the speed of reduction of the reactive phenomena in a wound and maturing of young granulations. Such characteristics like high viscosity of hydrogel dressing means, elastic consistency, entered into its structure antiseptics and local anesthetic allow to use it as tampon for a long period. One of essential advantages of use of Kolegel-ADL is creation a barrier impeding penetration of an infection into a skull cavity. The local anesthetic of Lidokin entered into structure of dressing means allows us stop a pain syndrome for a long time that reduces the need for parenteral introduction of anesthetics. Gauze-based dressings were used in the control group. There was injury to the wound surface when changing bandages, and the remains of gauze fibers in the wound led to inflammation. Conclusion. Multifunctional depot-system on a gel basis can be recommended as local antiedematous, haemostatic, antiseptic and anesthetic for local treatment of wound process in otorhinolaryngology, for therapy and prevention of purulent complications of wound surfaces of patients with oncological pathology of the throat complicated by bleeding.

Squamous cell carcinoma is the most common type of throat cancer. Treatment options comprise surgery, radiotherapy, and/or chemo(immuno)therapy. The salivary microbiome is shaped by the disease, and likely by the treatment, resulting in side effects caused by chemoradiation that severely impair patients’ well-being. High-throughput amplicon sequencing of the 16S rRNA gene provides an opportunity to investigate changes in the salivary microbiome in health and disease. In this preliminary study, we investigated alterations in the bacterial, fungal, and archaeal components of the salivary microbiome between healthy subjects and patients with head and neck squamous cell carcinoma before and close to the end point of chemoradiation (“after”). We enrolled 31 patients and 11 healthy controls, with 11 patients providing samples both before and after chemoradiation. Analysis revealed an effect on the bacterial and fungal microbiome, with a partial antagonistic reaction but no effects on the archaeal microbial community. Specifically, we observed an individual increase in Candida signatures following chemoradiation, whereas the overall diversity of the microbial and fungal signatures decreased significantly after therapy. Thus, our study indicates that the patient microbiome reacts individually to chemoradiation but has potential for future optimization of disease diagnostics and personalized treatments.

The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing dramatically and is conclusively linked to increasing rates of human papillomavirus (HPV) infection. HPV-related oropharyngeal cancers have been shown to occur in a unique demographic group and show favorable oncologic outcomes compared with HPV-negative OPSCC. There has been a paradigm shift in the treatment of early-stage OPSCC, with most patients now undergoing primary surgery in the United States. Transoral robotic surgery is associated with excellent oncologic and functional outcomes in the treatment of OPSCC and is increasingly being used for a broader range of oropharyngeal indications.

Background: The current guideline does not recommend upper gastrointestinal evaluation for patients with a positive fecal immunochemical test (FIT) and negative colonoscopy results. However, this indication was based on low-quality evidence as data on this issue are very limited. We assessed the risk of proximal cancers (oral or throat, esophageal, stomach, and small intestine cancers) after negative or positive FIT results in the Korean National Cancer Screening Program (NCSP). Methods: Using the NCSP databases, we collected data on participants who underwent FIT between 2009 and 2011. Participants were classified based on FIT results and colorectal cancer (CRC) diagnosed within 1 year after FIT as FIT&minus, (n = 5,551,755), FIT+/CRC&minus, (n = 368,553), and FIT+/CRC+ (n = 12,236). Results: The incidence rates of overall proximal cancers in FIT&minus, FIT+/CRC&minus, and FIT+/CRC+ patients within 1, 2, and 3 years after FIT were 0.38%, 0.68%, and 2.26%, 0.57%, 0.93%, and 2.74%, and 0.79%, 1.21%, and 3.15%, respectively. After adjusting confounding variables, the risks of esophageal, stomach, and small intestine cancers as well as overall proximal cancers within 1, 2, and 3 years after FIT were higher in FIT+/CRC&minus, patients than those in FIT&minus, patients. However, the risk of oral or throat cancer did not differ between FIT&minus, and FIT+/CRC&minus, patients. The risks for oral or throat cancer and small intestine cancer were higher in FIT+/CRC+ patients than those in FIT+/CRC&minus, patients. Conclusions: In this population-based study, FIT+/CRC&minus, patients were at higher risk for esophageal, stomach, and small intestine cancers than were FIT&minus, patients, suggesting that positive FIT results were associated with these cancers.

Esophageal squamous cell carcinoma (ESCC) is more prevalent than esophageal adenocarcinoma in Asia, especially in China, where more than half of ESCC cases occur worldwide. Many studies have reported that the automatic detection of lymph node metastasis using semantic segmentation shows good performance in breast cancer and other adenocarcinomas. However, the detection of squamous cell carcinoma metastasis in hematoxylin‐eosin (H&E)‐stained slides has never been reported. We collected a training set of 110 esophageal lymph node slides with metastasis and 132 lymph node slides without metastasis. An iPad‐based annotation system was used to draw the contours of the cancer metastasis region. A DeepLab v3 model was trained to achieve the best fit with the training data. The learned model could estimate the probability of metastasis. To evaluate the effectiveness of the detection model of learned metastasis, we used another large cohort of clinical H&E‐stained esophageal lymph node slides containing 795 esophageal lymph nodes from 154 esophageal cancer patients. The basic authenticity label for each slide was confirmed by experienced pathologists. After filtering isolated noise in the prediction, we obtained an accuracy of 94%. Furthermore, we applied the learned model to throat and lung lymph node squamous cell carcinoma metastases and achieved the following promising results: an accuracy of 96.7% in throat cancer and an accuracy of 90% in lung cancer. In this work, we organized an annotated dataset of H&E‐stained esophageal lymph node and trained a deep neural network to detect lymph node metastasis in H&E‐stained slides of squamous cell carcinoma automatically. Moreover, it is possible to use this model to detect lymph nodes metastasis in squamous cell carcinoma from other organs. This study directly demonstrates the potential for determining the localization of squamous cell carcinoma metastases in lymph node and assisting in pathological diagnosis., XXX

Aż 70–85% nowotworów krtani i krtaniowej części gardła jest rozpoznawanych w wysokim sta-dium zaawansowania, stanowiąc duże wyzwanie diagnostyczno-terapeutyczne i wpływając na złe wyniki leczenia. Chorzy ze zmianami zaawansowanymi, w stadium III i IV, kwalifikowani są do pierwotnego leczenia chirurgicznego lub chemioradioterapii – w zależności od stopnia zaawanso-wania choroby, czynników złego rokowania i preferencji chorego. Brakuje jednak wypracowanych wiarygodnych standardów kwalifikacji do leczenia, które pozwoliłyby na ustanowienie jednolitych zaleceń terapeutycznych oraz poprawę wyników leczenia w tej grupie chorych.

WHO defined Oral health a state of being free from any pain originated from mouth and face, oral and throat cancer, oral infection and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing. Ethiopia ratio of dentists: population is 1:1,268,000. WHO recommend that, it needs to shift the oral health management away from the old paradigm of dentistry treatment and surgery-based approach? Emphasize prevention and health promotion in impoverished regions

Oral health is defined by the World Health Organization as “a state of being free from any pain originated from mouth and face, oral and throat cancer, oral infection and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeingâ€

In this study, a next-generation sequencing strategy on 16S ribosomal RNA (16S rRNA) gene was employed to analyze 70 oral samples from 32 patients with throat cancer, nine patients with vocal cord polyp, and 29 healthy individuals (normal controls). Using this strategy, we demonstrated, for the first time, that the salivary microbiota of cancer patients were significantly different from those of patients with a polyp and healthy individuals. We observed that the beta diversity of the cancer group was divergent from both the normal and polyp groups, while alpha-diversity indices such as the Chao1 estimator (P = 8.1e-05), Simpson (P = 0.0045), and Shannon (P = 0.0071) were significantly reduced in cancer patients compared with patients containing a polyp and normal healthy individuals. Linear discriminant analysis (LDA) and Kruskal–Wallis test analyses and real-time quantitative polymerase chain reaction (qPCR) verification test revealed that the genera Aggregatibacter, Pseudomonas, Bacteroides, and Ruminiclostridium were significantly enriched in the throat cancer group compared with the vocal cord polyp and normal control groups (score value >2). Finally, diagnostic models based on putatively important constituent bacteria were constructed with 87.5% accuracy [area under the curve (AUC) = 0.875, 95% confidence interval (CI): 0.695–1]. In summary, in this study we characterized, for the first time, the oral microbiota of throat cancer patients without smoking history. We speculate that these results will help in the pathogenic mechanism and early diagnosis of throat cancer.

Throat precancer detection using fluorescence from human saliva is reported here. It may be noted that accessing the throat for investigation is cumbersome and use of saliva as a diagnostic medium may ease the process. The study has been conducted on three groups of patients: oral squamous cell carcinoma (OSCC), dysplasia, and normal (control). An in-house developed compact set-up has been used for fluorescence measurements. The compact system consist of a 375 nm laser diode, collimating lens, long pass filter, fibers, and cuvette holder. Major and minor bands of flavin adenine dinucleotide (FAD) and porphyrin are observed in the spectra. A receiver operating characteristic (ROC) analysis has been used to evaluate the diagnostic performance. Area under the spectra has been chosen for discrimination among the groups and is able to differentiate OSCC to normal, dysplasia to normal, and OSCC to dysplasia with sensitivities 100% (48/48), 92% (32/35), 77% (37/48), and specificities 96% (50/52), 96% (50/52), 89% (31/35) with the accuracy of 98%, 94% and 82% respectively. Sensitivity and specificity, when differentiating OSCC to normal and dysplasia to normal, are significantly large, which indicates that human saliva may be an excellent diagnostic medium for early detection of throat cancer.

Purpose Despite high rates of cigar use among youth, little information exists about how cigar warnings are received by youth. We examined believability of different cigar warning messages with different sources among adolescents in a national phone survey. Methods Adolescents (aged 13–17 years) in the US (N = 1,125; total response rate, 66%) were randomized to receive one of three health messages ("cigar smoking can cause cancers of the mouth and throat, even if you do not inhale," "cigar smoking can cause lung cancer and heart disease," and "cigars are not a safe alternative to cigarettes") and one of four warning sources (Food and Drug Administration, Surgeon General, Centers for Disease Control and Prevention, and no source). Believability was assessed with "how believable is this warning," and responses were dichotomized for "not at all or somewhat" versus "very." Results Weighted logistic regression results indicated that most youth found the cigar warnings very believable (60.5%). Messages about mouth and throat cancer (regardless of inhalation) and the safety of cigars in comparison to cigarettes were rated as significantly less believable than messages about lung cancer and heart disease related to cigars. There were no significant differences by source or other demographics. However, youth susceptible to using cigarettes were less likely to report the cigar warnings to be very believable. Conclusions The messages of cigar warning labels are not viewed as equally believable among adolescents. Future studies should examine how youth process messages about health effects of cigars and the impact of different cigar warnings on youth experimentation with and use of cigars.

I view mainly as dumb luck the way I dodged the magic bullet of opioid dependence during my treatment for throat cancer 6 years ago. My doctors forewarned that radiation and chemotherapy together wreak havoc on throat tissues. I was sent home with a quart of pink liquid and a recommendation to use it preventively, just before I felt that pain might be coming on. They guaranteed I would need it. No one mentioned any other options for pain management. I never needed the painkillers. One factor may be a cautionary view toward medication passed down in my natal family. Another may have been my use of multiple self-care and integrative methods and practitioners before, during, and after treatment. A friend who underwent a similar throat cancer treatment protocol who also took advantage of multiple integrative therapies had such pain that she needed ultimately to find her way to her new normal through a foggy tunnel of opioid dependency. My family joked that the grace that kept me from opioids could be chalked ...

The author, a practicing physician, was diagnosed with throat cancer and lost his vocal cords. He endured the side effects of radiation, repeated surgeries, and the effects of prolonged hospitalizations; confronted medical mistakes and discrimination after losing his vocal cords; and struggled to regain his speech and find new meaning and purpose for his life. Facing the hardship and trials of becoming a laryngectomee illustrated to him how dependent and helpless a patient can become. Being unable to speak, eat, and breathe normally, while dealing with a potentially terminal illness, makes the patient very vulnerable, both physically and emotionally. A skillful, competent, error-free, empathetic, and caring approach that recognizes what the patient is experiencing can expedite recovery and well-being and help the patient return to a productive and meaningful life.

Colorectal cancer and throat cancer are the world’s most prevalent neoplastic diseases, and a serious threat to human health. Plant triterpene glycosides have demonstrated antitumor activity. In this study, we investigated potential anticancer effects of mogroside IVe, a triterpenoid glycoside from monk fruit, using in vitro and in vivo models of colorectal and laryngeal cancer. The effects of mogroside IVe on the proliferation of colorectal cancer HT29 cells and throat cancer Hep-2 cells were determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and the expression levels of p53, phosphorylated ERK1/2, and MMP-9 were analyzed by western blotting and immunohistochemistry. The results indicated that mogroside IVe inhibited, in a dose-dependent manner, the proliferation of HT29 and Hep-2 cells in culture and in xenografted mice, which was accompanied by the upregulation of tumor suppressor p53, and downregulation of matrix metallopeptidase 9 (MMP-9) and phosphorylated extracellular signal-regulated kinases (ERK)1/2. This study revealed the suppressive activity of mogroside IVe towards colorectal and throat cancers and identified the underlying mechanisms, suggesting that mogroside IVe may be potentially used as a biologically-active phytochemical supplement for treating colorectal and throat cancers.

Human Papilloma Virus (HPV) is a virus from the Papilloma virus family that affects human skin and the moist membranes that line the body, such as the throat, mouth, feet, fingers, nails, anus and cervix [1]. There are over 100 types, of which 40 can affect the genital area. Most known HPV types cause no symptoms to humans. Some, however, can cause verrucae (warts), while a small number can increase the risk of developing several cancers, such as that of the cervix, penis, vagina, anus and oropharynx (oral part of the pharynx - throat cancer). HPV strand 16 and 18 are well known for causing the advanced of Cervical Cancer (CC). Currently, integrated electrodes (IDEs) are implemented in various sensing devices including surface acoustic wave (SAW) sensors, chemical sensors as well as current MEMS biosensors. IDEs have been optimized for a variety of sensing applications including biosensors sensors, acoustic sensors, and chemical sensors. However, optimization for cancer cell detection has yet to be report...

Throat cancer has always struck people's imagination. This type of cancer affects some of the patient's most essential physiological functions: speaking, swallowing and breathing. At advanced stages, radical surgery is disabling. The impact of a mutilated larynx corresponds to a very real trauma that is both individual and social. Our aim is to define how a total laryngectomy (TL) is represented by both the surgeon and the patient. The history of TL makes it possible to understand the changes that were needed for the key players in the subject to impose or accept this operation. Without doubt, the implementation of the "cancer plan" in the early 2000s was a major turning point in the management of patients with neoplasia. Increased awareness among the elite, encouraged by the mobilisation of patients and their families, is the explanation for the new role played by TL in 2008. The progress made in medical and surgical techniques, modifications to the patient-carer relationship and the appearance of the concept of Quality of Life are all themes that have changed the approach to this operation and the management of patients undergoing a TL.

Objective To study incidence rates (Is) of oral cavity and pharynx-throat cancer in adults age 20+ years from 1973 to 2003, and to estimate how many of these cancers occurred in the United States in 2003. Study design We used data and software from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program to generate age-adjusted Is, reported as cases per 100,000 person-years. Results For oral cancer, the Is for young men were stable, and Is at ages 40+ years declined by one third after the mid 1980s. Is declined by one third in women ages 40 to 74, but increased in the youngest and oldest groups. In 2003 there were 10,432 cases of oral cavity cancer among persons age 20+ years in the United States, and there were 12,157 cases of pharynx-throat cancer. Conclusion The Is of cancers of the oral cavity and pharynx-throat are stable or declining for men and women in most age groups. Of the nearly 30,000 malignant neoplasms occurring in the SEER “oral cavity-pharynx” category in 2003, almost three quarters (21,455) were detectable during a routine oral examination.

Laryngeal neuroendocrine carcinoma (LNEC) is a rare malignancy with various subtypes, each with different characteristics. Classification of these subtypes is used to delineate treatment and management, as most are clinically aggressive with poor prognosis. This study analyzes the characteristics and survival outcomes of LNEC using population-based data.Analysis of a population-based tumor registry.Academic medical center.The Surveillance, Epidemiology, and End Results (SEER) database (1973-2011) was queried for LNEC cases. Data analyzed included patient demographics, incidence, treatment modality, and survival.In total, 257 LNEC cases were extracted from the SEER database. Sixty-three percent were male, and the mean age of diagnosis was 61.9 years. Most cases were located in the supraglottis (62.6%), were of the small cell carcinoma (52.9%) histologic subtype, and were grade IV (40.9%) and American Joint Committee on Cancer (AJCC) stage IV (59.4%). Surgery and radiotherapy were used as treatment modalities in 38.3% and 59.8% of patients, respectively. Overall 5-year disease-specific survival (DSS) for all LNEC was 30.2%, with lower grade, lower AJCC stage, and treatment with surgery having higher 5-year DSS.LNEC often presents as an aggressive tumor at an advanced stage and has poor survival outcomes. Poor prognostic factors include high histologic grade, advanced stage disease, and not undergoing surgical resection. LNEC may be best treated depending on its histologic differentiation, with surgery being beneficial for early grade tumors while radiotherapy is inconclusive in its benefit for late-stage disease.

Background: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignan- cies with a mean survival time of 6 months regardless of treatment. Aim: To present a case of lo- cally advanced anaplastic thyroid carcinoma with long-term survival. A 10-year literature review of locally advanced ATC with long-term survival (more than 2 years) is also presented. Case pres- entation: We present a case of locally advanced anaplastic thyroid carcinoma (ATC) with tracheal invasion in a 67-year-old elderly Chinese man who was treated with radical surgery encompassing total thyroidectomy, neck dissection and tracheal resection followed by adjuvant radiotherapy. Long-term disease-free survival is more than 7 years to date. Conclusion: The prognosis of ATC remains poor as it is characterized by aggressive and extensive disease at presentation, the inabil- ity in most patients to perform radical enough surgery in order to achieve clear margins, high morbidity of complete extirpation and limited response to radiotherapy or chemotherapy. How- ever, if complete surgical resection is possible, patients should be treated aggressively with a combination of surgery and adjuvant radiotherapy.

266 Nurse Prescribing 2013 Vol 11 No 6 © 2 01 3 M A H ea lth ca re L td studies of 1,316 patients with oral cancer found that 57% of them were HPV-16 positive. HPV-16 is responsible for the majority of throat cancers. An advanced search on Pubmed using the words 'HPV', 'throat cancer' and 'oral sex' in Pubmed did not bring up any articles, but a less specific search bought up a recent article from researchers from the George Washington University where they claim that many people are unaware that HPV can cause oral cancers. Dr Gypsyamber D'Souza, from the Johns Hopkins School of Public Health, explained at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago, Illinois, that throat cancers that arise from HPV do not appear to raise the risk for domestic partners of the same cancer. Her team carried out a pilot study which showed that the prevalence of HPV among partners/spouses of an affected patient was approximately 7%, no different from that of the general population. The team found that HPV-16 subtype was present in just 2% of female partners and 0% of male partners. Of the partners/spouses who underwent a visual oral exam, none had cancer or pre-cancer. D'Souza explains Human papilloma virus, cancer, and sex

Richard I. Shader, MD “Loose lips sink ships.” I remember that phrase from my childhood during World War II. I knew what it meant, but as kids, we used to say it laughingly while making silly faces with floppy lips. We regularly saw these words on posters made by the United States Office of War Information; the wording originated from the War Advertising Council. Many years later, when learning about the mental status exam, I was exposed for the first time to the proverb: “The tongue is the enemy of the neck.” For many people, even those who easily interpret “People who live in glass houses should not throw stones,” this proverb was a little too abstract. Taken together, the overall message from these phrases is clear—your mouth can get you or others into big trouble. What has this to do with cervical cancer? My lips may not be loose, but my associations often are. The word cervix is Latin for neck. One way to spread the human papilloma virus (HPV), the virus responsible for nearly all cases of cervical cancer, is through oral sex—a behavior not uncommon among teens and other age cohorts. The link between oral sex and HPV-caused mouth and throat cancer is reasonably well supported by data. The link between oral sex and cervical cancer is still ambiguous. How can many HPV-caused cancers be prevented? Vaccination of preteens and teens provides the most hope, particularly for cervical cancer. An old adage clearly applies here—“A stitch in time saves nine.” Consistent with this view, 13 months ago, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommended the use of 9-valent HPV vaccine *; it is now the third HPV vaccine available in the United States, and it protects against nine strains of the virus. Unfortunately, this effective strategy for HPV prevention is still not as widely in use as it should be in the United States or elsewhere in the world. This is the second time our Update theme focuses on cervical cancer, underscoring the challenge of tackling this disease. Sadly, it is the last contribution from our former Topic Editor and current Guest Editor, Linda R. Duska, MD. Dr. Duska is leaving our editorial team because of the responsibilities and demands of her new position as Associate Dean for Clinical Research at the University of Virginia School of Medicine. We at Clinical Therapeutics thank her for her contributions and wish her the best in her new role. Dr. Duska’s final Update sheds light on aspects of prevention, detection, and treatment of cervical cancer. Greater use of vaccination in both girls and boys will certainly reduce the occurrence of this sometimes-deadly disease. Detection and diagnosis are enhanced by improved cytologic methods. Better treatment outcomes may be achieved through the adjunctive use of antibodies, such as programmed cell death inhibitors (PD-1 and PD-L1 inhibitors), agents that allow the immune system to reduce or halt cancer growth. Dr. Duska is leaving us with much to think about and reasons to be hopeful about conquering this widely occurring cancer.

Summary Objective To compare the diagnostic yield, safety, and cost of biopsies of laryngopharyngeal tumor performed in an office setting with those performed in the operating room (OR) under general anesthesia. Study Design This was a retrospective review of patients’ records at Boston Medical Center from 2006 to 2008. Methods In-office biopsies were performed using flexible digital videolaryngoscopy with cup forcep biopsies taken via the working channel in patients in whom cancer was strongly suspected. Patients whose in-office biopsies were nondiagnostic or suspected to be falsely negative were taken to the OR for biopsy under general anesthesia and served as the control group. Results Twelve patients fit the selection criteria and had in-office biopsies attempted. One patient could not tolerate the in-office biopsy. Seven of the 11 in-office biopsies performed were diagnostic for squamous cell carcinoma. The average cost (facility and professional otolaryngology charges) for an in-office biopsy was $2053.91. Five of these patients required further biopsy in the OR at an average cost (charges for surgeon, OR, anesthesia, and recovery room) of $9024.47. There were no significant complications reported for any of the procedures. Conclusions In patients with strongly suspected laryngopharyngeal cancer, in-office cup forcep biopsies were 64% diagnostic. When compared with the OR, in-office cup biopsies of laryngopharyngeal tumor are safe and considerably more cost-effective. Although 36% of patients required operative biopsies, the cost would have been considerably higher in this cohort if all patients had gone to the OR for biopsies.

The author presents his personal experiences as a physician who had several surgical procedures to remove pyriform sinus squamous cell carcinoma, which included laryngectomy. He recently published a book that captures the three years of his life that followed his throat cancer diagnosis and tells his story of facing and dealing with medical and surgical treatments and adjusting to life afterwards. The editorial highlights some of the book's features that relate to the important role of head and neck surgeons in the care of patients with cancer.

Purpose: The initial purpose was to find more expedient ways for learning to eat for personal rehabilitation. The secondary purposes were to inform other radiation therapy patients and to inform clinicians and therapists involved in rehabilitation of throat cancer patients.Method: This is an account of personal experiences of the author who is a throat cancer survivor. This rehabilitation engineer, and his social worker wife, systematically sought and found more effective ways for learning to eat again.Results: More effective approaches for discovering, preparing, presenting and consuming food by recovering throat cancer patients were identified.Conclusion: The rehabilitation process for patients with radiation damage to the throat can be enhanced through simple methods and dedicated efforts of the patients themselves.

BACKGROUND AND OBJECTIVE Anaesthesiologists are regularly faced with difficult tracheal intubation. The objective of the study was to evaluate the feasibility and tolerability of tracheal intubation with the Bonfils intubating fibrescope in awake adult patients with predicted difficult intubation undergoing cancer surgery in an ear, nose and throat unit. METHODS Intubation was performed under local anaesthesia and remifentanil sedation with spontaneous ventilation. The primary endpoint was the proportion of intubations which met the following quality requirements: successful intubation (≤ 2 attempts and duration

This manuscript presents my personal experiences as a physician undergoing radiation therapy for throat cancer. I describe the physical and emotional effects of the radiation treatment and how I coped with them. The side effects that emerged during of the radiation treatment included: fatigue, mental cloudiness, pain and dryness in my throat, food aversion, inability to taste, and skin burning around the neck. It is my hope that both patients and health care providers will benefit from reading my personal story. I hope that my perspectives will assist individuals who undergo radiation treatment cope better with them. It is also my hope that health care professionals who care for these patients will gain insight into what their patients experience and feel so that they would be able to better assist them during this difficult time.

Objective To search for markers of nasopharyngeal carcinoma (NPC) for diagnosis. Design and methods Using gas chromatography and mass spectrometry, we evaluated 51 serum metabolites in 49 NPC, 37 throat cancer patients and 40 healthy controls. High metabolites were selected and confirmed in NPC tissues. Sensitivity and specificity were appraised for 53 NPC diagnoses. Results Metabolic profiling revealed that kynurenine, N-acetylglucosaminylamine, N-acetylglucosamine and hydroxyphenylpyruvate increased in NPC patient sera. Their sensitivity and specificity were respectively 79% and 71%, 78% and 69%, 83% and 68%, 84% and 73% for NPC diagnosis. These increases were confirmed in NPC cells. Four metabolites gradually increased from stage I to stage III. After radiotherapy, four metabolites decreased gradually, and tended to a normal level, and were associated with rate of tumor reduction. Conclusion The results reveal that kynurenine, N-acetylglucosaminylamine, N-acetylglucosamine and hydroxyphenylpyruvate are potentially markers of NPC for diagnosis and therapy.

Hepatocellular carcinoma is a common primary hepatic malignancy in the Asian countries. The prognosis of metastatic hepatocellular carcinoma is very poor if left untreated. Despite the rare occurrence, sinonasal metastasis of hepatocellular carcinoma usually implies an advanced disease stage with dismal outcome. Herein we present a case of metastatic hepatocellular carcinoma involving the nasal cavity. This 55-year-old male patient refused standard therapy after the diagnosis of hepatocellular carcinoma. After a palliative excision for the nasal tumor, the patient died of multiple metastatic diseases. A special consideration should be given to such unusual manifestations of extrahepatic metastases. Promptly clinical evaluation and appropriate intervention for symptomatic palliation are necessary for these terminally ill patients.

Background To assess tumor control and survival of the patients with laryngeal cancers who received chemoradiation or radiotherapy alone as definitive treatment. Material and Methods Patients with laryngeal cancers who received organ-saving treatment were enrolled in this trial. Results In 147 cases, chemoradiotherapy was administered in 61 patients. Twelve cases were excluded from the analysis because of the treatment interrupt or death. Fifty eight cases had early-staged disease. In median time of follow up (9.9 months), mean overall survival and mean disease free survival were 51 months and 37 months in early lesions, and 30 months and 17 months in locally advanced tumors, respectively. Local control rate was 60% in early-staged and 43.5% in locally advanced cases. The mean total radiation dose significantly affected the tumor control in chemoradiation group. Conclusion It seems that radiotherapy or chemoradiation can be appropriate alternative to total laryngectomy in laryngeal cancers.

When Sylvia Khuzwayo’s husband died on Valentine’s Day in 1998, her doctor said the cause was throat cancer. But she suspected that wasn’t true. Months later, the doctor admitted her husband had died of AIDS, and that she was HIV-positive too with a CD4 count of 210 — which means she was

{#article-title-2} Editors' Note: In a Beijing hospital last September, an otolaryngologist was stabbed 17 times by a dissatisfied throat cancer patient. A week later, in central China, angry relatives attacked hospital security guards with metal rods. In 1 month alone, 20 doctors throughout the country were killed or severely injured by disgruntled patients or their family members and most people believe the situation is getting worse. The state of neurology in China, and medical practice there in general, is experiencing a dichotomy, as described in the article by Drs. Shi and Jia, “Neurology and neurologic practice in China.” While some aspects of the field progress with breathtaking speed, others have been disintegrating just …

Importance Head and neck cancer (HNC) is responsible for substantial morbidity, mortality, and cost in the United States. Early detection and lifestyle risk factors associated with HNC, both determinants of disease burden and outcomes, are interrelated with public knowledge of this disease. Understanding of current public knowledge of HNC is lacking. Objective To assess awareness and knowledge of HNC among US adults. Design, Setting, and Participants Online survey of 2126 randomly selected adults in the United States conducted in 2013. Interventions Online survey administration. Main Outcomes and Measures Subjective and objective assessment of knowledge of HNC including symptoms, risk factors, and association with the human papillomavirus. Results Self-reported respondent knowledge of HNC was low, with 66.0% reporting that they were “not very” or “not at all” knowledgeable. This did not vary significantly with tobacco use ( P = .92), education ( P = .053), sex ( P = .07), or race ( P = .02). Regarding sites comprising HNC, 22.1% of respondents correctly identified throat cancer, 15.3% mouth cancer, and 2.0% cancer of the larynx, with 21.0% incorrectly identifying brain cancer as HNC. Regarding symptoms, 14.9% of respondents identified “red or white sores that do not heal,” 5.2% “sore throat,” 1.3% “swelling or lump in the throat,” and 0.5% “bleeding in the mouth or throat.” Smoking and chewing or spitting tobacco were identified by 54.5% and 32.7% of respondents as risk factors for mouth and throat cancer, respectively. Only 0.8% of respondents identified human papillomavirus (HPV) infection as a risk factor for mouth and throat cancer, but specific questioning revealed that 12.8% were aware of the association between HPV infection and throat cancer whereas 70.0% of respondents were aware of the vaccine targeting HPV. Conclusions and Relevance Self-reported and objective measures indicate that few American adults know much about HNC including risk factors such as tobacco use and HPV infection and common symptoms. Strategies to improve public awareness and knowledge of signs, symptoms, and risk factors may decrease the disease burden of HNC and are important topics for future research.