14 DAY TRIAL // A team of researchers with the Comprehensive Cancer Center at the University of Michigan (U-M) determined in a new study that surgery is by far the more effective course of treatment in addressing instances of oral cancers, a subtype of head and neck cancer.
In the investigation, scientists carried out a comparative analysis of how patients fared when they received surgery first, as opposed to when they received chemotherapy first. Test subjects in the first group fare significantly better than their counterparts in the second group, the team reveals.
Details of the research appear in the latest issue of the scientific journal JAMA Otolaryngology Head and Neck Surgery, EurekAlert reports. In treating larynx cancer, for example, standard protocols dictate that patients first receive a dose of chemo to assess their responses to the drug cocktail.
The work was carried out on 19 test subjects suffering from advanced oral cavity cancer. However, the team stopped the experiment ahead of time because of the very poor results the group got when receiving chemotherapy first.
“To a young person with tongue cancer, chemotherapy may sound like a better option than surgery with extensive reconstruction. But patients with oral cavity cancer can't tolerate induction chemotherapy as well as they can handle surgery with follow-up radiation,” says Douglas Chepeha, MD, MSPH.
“Our techniques of reconstruction are advanced and offer patients better survival and functional outcomes,” adds the expert, who is a professor of otolaryngology at the U-M Medical School, and also the author of the new study.
One of the reasons why the chemotherapy-first approach may have such abysmal results is that the mouth is a very sensitive area, where the immune system plays a critical role. Since chemo suppresses the immune system altogether, negative outcomes are more likely.
“Despite the proven success of this strategy in laryngeal cancer, induction chemotherapy should not be an option for oral cavity cancer, and in fact it results in worse treatment-related complications compared to surgery,” Chepeha explains.
This study is important because tongue cancer, for example, affects nearly 13,600 people annually in the United States alone. Around 2,000 patients die from the disease, according to statistics from the American Cancer Society.