Head and Neck Cancer: Clinical Trials in Recurrent Cancer

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Guest: Dr. Terry Day – Otolaryngology

Host: Dr. Linda Austin

Dr. Linda Austin: I am Dr. Linda Austin and I am talking today with Dr. Terry Day, who is a Head and Neck Surgeon at the Hollings Cancer Center at the Medical University of South Carolina. Dr. Day, I know you have a lot of experience with patients with tumors of the head and neck and you are doing some very interesting research now along several different lines with lots of studies going on at Hollings, what about though for patients who have a head or neck cancer who have already had some treatment, but the treatment hasn’t worked as well as one might like?

Dr. Terry Day: Well, that’s a great question and unfortunately, we confront that problem all too frequently and people with advanced or recurrent head and neck cancer often are told that they aren’t any more options and it’s unfortunate because I think it then requires the patient or their family members to seek out options that do exist and clinical trials do offer that opportunity and for these people what I recommend is that they are seen initially by multidisciplinary program where there is a surgeon or radiation oncologist and a medical oncologist, all in the same clinic and they decide what might be the best option for these patients. For example, one of our clinical trials that we have open right now is using an agent that has been used in some preclinical studies in other countries, but this is the first time it has been used in the United States and had such success in the other countries that the study was allowed to be opened for patients in the United States, so what usually happens is that these people that have had treatment with either chemotherapy or radiation or surgery and the cancer of their mouth or throat or neck comes back may be told there is not much else they can do. Well, this is the perfect situation for this new agent that may offer an effect in these cancers and what we usually do is we do a full evaluation and make sure that they fit the criteria for the study and then they come in weekly to the clinic and it’s just an agent that is injected directly into the tumour and the area is numbed up so that there is no pain associated with the injection and it is used then to treat the tumour directly and we have been very excited to offer this and we have had a number of people from around the country contact us interested in coming here for the treatment.

Dr. Linda Austin: What kinds of tumors can you treat with this agent in this clinical trial, obviously it’s still in the investigational phase and so you can't make any promises, but what kinds of tumors typically do you use this for?

Dr. Terry Day: These tumors are termed squamous cell carcinoma and this is the most common cancer that might arise in the tongue or the voice box or the throat and sometimes it may spread to lymph nodes in the neck and any of these areas can be treated if they have failed traditional treatments and the standard treatments that often include chemotherapy, radiation therapy, or surgery and when they come back or if they don’t go away, then we will offer this agent to those patients.

Dr. Linda Austin: How long does the treatment program lasts?

Dr. Terry Day: The treatment program can continue if they are having a good response to the treatment, we will continue to treat them weekly and oftentimes this can go on for weeks and weeks and fortunately, we found that the first dosage was safe enough and this trial has now gone on to the second, a little bit stronger dose and hopefully, we will see even better effects from the stronger dose.

Dr. Linda Austin: Can you inject this in multiple tumors in a same patient?

Dr. Terry Day: Yes, certain people that have multiple areas that the cancer has come back, it is allowed to inject more than one tumor. It does require very specific criteria and their protocol is very specific to the individual patient so that there is no harm done and the patient is protected from any toxicity whenever possible.

Dr. Linda Austin: So if somebody is hearing this and they are interested in this either for themselves or for a loved one, what should they do next?

Dr. Terry Day: Well, I would look at the website at "http://www.muschealth.com" and search for clinical trials or they can call the Head and Neck Tumor Clinical Trial Coordinator, Christina Wilhoit at 843-792-8876 and of course definitely ask your physician if there are other options for treatment of this disease.

Dr. Linda Austin: And I might also add her email address, it is wilhoit@musc.edu and again that number is (843) 792-8876 and again this is a clinical trial for patients with advanced squamous cell carcinoma of the head or neck, who have not had a good response or who have had a recurrence after a previous treatment. Dr. Day, thank you so much for talking with us today.

Dr. Terry Day: Thank you very much.

Announcer: If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection at (843) 792-1414.


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