The Head and Neck Cancer Alliance brings to you its updated and refreshed quarterly e-newsletter.

HNCA News Bulletin

July 2016

A Letter from Holly Boykin, HNCA Executive Director

Each day, I learn more about the strength and sorrow of oral, head and neck cancer patients and their caregivers. I also acquire a better understanding of the science of cancer, treatment of cancer, possible causes of cancer and the prevention of cancer.

Today, as a society, we are also faced with addressing a new population of oral, head and neck cancer patients. In the past, these cancer patients were older adults and avid smokers. However, more and more younger adults, between the ages of 30-55, are now being diagnosed with HPV-related oropharyngeal cancer.

As I learn more about the topics above, I become increasingly encouraged about Immunotherapy and new targeted therapies being developed to address these cancers. Starting with this newsletter and the next many months on our website, headandneck.org, HNCA will provide an educational series on Immunotherapy to better educate the oral, head and neck cancer community on what it is and what it isn’t, clinical trials, potential future therapies and access to these treatments.

Due to the hard work of many volunteers and the support of corporate partners, the Head and Neck Cancer Alliance (HNCA) is expanding our programs. Our goal is to become a one-stop-shop for patients, loved ones and family members seeking information on oral, head and neck cancers worldwide, and we are taking steps to achieve this goal.

Each and every day, HNCA dedicates itself to advancing prevention, early detection, treatment and rehabilitation of oral, head and neck cancer through public awareness, research, advocacy and survivorship.

Immunotherapy and the Head and Neck and Oral Cavity



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What it is:

Immunotherapy is a class of medications used to treat cancer by altering an individual’s own immune system. They can act by inducing and enhancing the immune response. Such medicines are now used to treat human cancers, providing an additional approach to control disease.

What it isn’t:

Unlike standard chemotherapies and radiation therapy that can affect both tumor cells as well as the body’s normal cells, immunotherapies directly interacts with the host’s immune system in order to enhance the personal fight against the cancer. The goal of this approach is to utilize the body’s natural defense system to eradicate disease, while trying to minimize side effects.

Syringe 2There are a number of different types of immunotherapies. The immune checkpoint inhibitors are a prominent class of immunotherapies and represent a breakthrough in cancer care. These medications act through the programmed cell death receptor by blocking the immune checkpoints. Normal cells have ligands that binds to the cell death receptor to allow the immune response know that it is not harmful to the body. In most cancer cells, it produces an abundant amount of ligand that also will bind to the cell death receptor of the T-cells. The ligand is a protein that suppressed the immune response and therefore, allows the mutated cell to evade the body’s immune system from destroying it and grow rapidly into a tumor. Examples include antibodies against (programed cell death protein 1 pathway) PD-1 and the ligand PD-L1 (ex: nivolumab, pembrolizumab).

Antibodies to the cytotoxic T-lymphocyte associated antigen-4 (CTLA-4) are another type of immunotherapy and to date these agents have shown remarkable impact upon malignant melanoma. CTLA-4 downregulates the activated T-cells and when they are blocked by antibodies, the T-cell remains active, allowing it to attack the tumor cell. CTLA-4 is currently approved for treatment of melanoma and non-small-cell lung cancer. Both antibody types have similar function to regulate the T-cell activity but contrasts based on its location, variation of expression, timing and etc. A recent trial showed impact in head and neck cancer and these agents are under continuing study in multiple other cancer types, as single therapies, combination immunotherapies and combined with other cancer therapies. It is expected that these medications will become common treatment in many different cancers.

These new therapies are associated with some side effects. While immunotherapy appears to have a good overall benefit-to-risk profile, the most common immune-related side effects are dermatologic and appear to be similar between products. They tend to be mild and manageable with supportive local care, but sometimes more aggressive care might be needed.  While these side effects can be troublesome, compare them with those seen in commonly used chemotherapies such as mouth pain (mucositis), dry mouth, taste change, nausea, hair loss, damage to kidney and nerves, and bone marrow suppression.

Risk factors for immunotherapy toxicity are not well characterized but may include increased risk by age, gender, and presence of prior autoimmune conditions. Combined immune therapies increase risk of dermatological side effects and may be associated with increased severity of side effects. Nevertheless, the side effect profile for immunotherapy typically is more favorable than most chemotherapies and/or radiation.

How do you minimize side effects with immunotherapy?

Dose modification, delay in schedule and discontinuing therapy are often considered, but the goal of prevention and management of side effects is to treat the dermatological, oral and other side effects while continuing immunotherapy for the greatest effect upon the cancer. Management may include skin moisturizing and prevention of dehydration, reduced local irritation (avoid tight fitting clothing, wearing light, wicking fabrics), avoiding sun exposure. Washing skin with soap and water can also be helpful. To minimize oral side effects options include good basic oral care, mouth rinses and hydration, avoiding rough abrasive foods, and removal of sharp and potentially irritating dental surfaces.

Dermatologic and oral treatment such as local anti-inflammatory/Immunosuppressive therapy may include steroids (therapy topical/systemic), as well as medications to reduce itching (hydroxyzine, diphenhydramine) and pain. For severe reactions, anti-TNF medications (eg: infliximab) may be considered.

Article contributors include HNCA Board Members:  Joel Epstein, M.D., Michael Moore, M.D., Erza Cohen, M.D., and Cherie-Ann Nathan, M.D. 

The article is the first in a series on Immunotherapy Treatments.

2016 Oral, Head and Neck Awareness Week® Sets Screening Record

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Early detection is key to having the best outcome for all cancers. For Oral, Head and Neck Cancers, early detection also provides more treatment opportunities that are less invasive and have the best opportunity for success.

HNCA hosted its 19th Annual Oral, Head and Neck Cancer Awareness Week® (OHANCAW), April 10-16, 2016 and set a record for the number of screening sites, as well as individuals screened, during the week-long national/international event.

In April 2016, HNCA in partnership with hospitals, community health centers and dental offices, held more than 400 events worldwide that conducted FREE oral, head and neck screenings. The events also offered HNCA educational materials and recommended individuals for further testing and examination if warranted.

“It is our goal to continuously grow and deliver quality OHANCAW® educational activities and screenings. As HNCA’s hallmark logoprogram, OHANCAW® has saved hundreds of lives through early detection. We thank the thousands of volunteers and clinicians, who enthusiastically commit their time, to support their communities by hosting an OHANCAW® screening,” said Holly Boykin, HNCA’s Executive Director. “In 2017, we will celebrate OHANCAW’s 20th Anniversary and look forward to another banner year.”

HNCA wishes to acknowledge Lilly Oncology, Bristol-Myers Squibb and Merck for their support of the 2016 OHANCAW.

Unfortunately, individuals are diagnosed with oral, head and neck cancers every day, therefore, if your organization wants to host a screening – we support events throughout the year. To register, go to www.headandneck.org.

MARK YOUR CALENDAR!


2017 ORAL HEAD AND NECK AWARENESS WEEK®

Jessica Tar, Actress, Artist & Survivor Becomes HNCA Spokesperson

Singer, songwriter, actress and oral cancer survivor Jessica Tar has recently become a HNCA spokesperson with the hopes of educating millions about oral, head and neck cancers. Her mission is to educate young adults that oral, head and neck cancers are NOT a disease of old people or only caused by smoking.

One of Jessica Tar’s biggest fears about the surgery to treat her tongue cancer was the possibility of losing her ability to speak clearly, which would prevent her from pursuing a career in acting and singing. Dr. Jatin Shah, a world renowned surgeon and HNCA Board Member was given the task of treating Ms. Tar and limiting the impact on her quality of life and future career aspirations. A few months after the procedure at Memorial Sloan Kettering, Jessica was ready to start performing again.

HNCA Online Support Community Available


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HNCA is proud to offer a free online community via our partner Inspire for individuals, and their loved ones, who are facing oral, head and neck cancers. This free online community offers peer-to-peer support and a safe environment to connect with others experiencing or who have experienced the diagnosis, treatments and outcomes of oral, head and neck cancers.
The Head and Neck Cancer Alliance Online Support Community is a place of encouragement, hope, and advice providing comfort for patients, family members, friends, and healthcare professionals looking for ways to better understand the impact of oral, head and neck cancers.
You can start or respond to discussions in the community, upload photos and search for specific topics to find other members who share the same interests.
To become a member of Inspire you need to register for an account. Click here and it will take you to the HNCA support community registration page. After you complete the registration form, Inspire will send you an email to activate your account.

Smashing Cancer and Supporting Those in Treatment

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The 7th Annual Smash Cancer Tennis Tournament welcomed nearly 190 tennis players, who competed in singles and doubles play, during the three-day tournament this past May. A United States Tennis Association social-sanctioned event, players with ratings of 3.0 Althea Gibson Tennis Center at Empire Park, Wilmington, NC.

Proceeds from the tennis tournament and the silent auction help fund the HNCA Gas Card Program. In all, Smash Cancer has dedicated more than $100,000 towards needed transportation for oral, head, and neck cancer patients to offset costly transportation expenses to and from treatments and medical appointments.

As Smash Cancer continues to develop, the tournament organizers find ways to include so many interested in participating and supporting those facing cancer. This year wheelchair athlete Billy Eno joined the competition and contended in both singles and up/down play.

The medical staff from Medical University of South Carolina once again hosted a free day-long oral, head and neck screening for participants, fans and volunteers, in which hundreds were screened.

The 2017 tournament will be scheduled in early May 2017. HNCA will be sure to provide updates, via social media and on headandneck.org, once the date is solidified.

HNCA and the NBA Partner to Slam Dunk Cancer

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In 2015, Donnie Walsh, an Indiana Pacers Executive, served as a HNCA spokesperson to educate the public on oral, head and neck cancers. His passion created an opportunity for HNCA to participate in the National Basketball Association’s NBA Cares program, specifically the NBA Fit initiative.
In 2016, HNCA hosted an awareness event with the Boston Celtics, Cleveland Cavaliers, Indiana Pacers and the Orlando Magic. Thank you to Merck and Lilly Oncology for supporting these events which also provided an opportunity to honor local cancer survivors and their physicians.
We are thankful that the NBA leadership took the pro-active stance of educating their employees and offered a screening event during this year’s OHANCAW®. In partnership with our NY Chapter, Mount Sinai Hospital physicians conducted more than 100 individualized screenings at NBA Headquarters and their satellite office in New Jersey.

Get Involved and Support Our Efforts

YOU have the power to help fund research, raise awareness and advocate for access to care.

Interested in contributing your time or supporting HNCA? We offer numerous opportunities to get involved:

  • Organize an event in your community;
  • Become a Corporate Partner of events and/or patient-focused or clinician education programs;
  • DONATE – your unrestricted gift is key to supporting our mission and the most critical programs – To DONATE online click here.
  • Clinicians – partner with our organization and host a screening in your community.

For more information on the Head and Neck Cancer Alliance, click here.

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