Posted on 09/04/2023 6:50:36 PM PDT by ConservativeMind
Researchers say diagnostic delays frequently occur in patients with undiagnosed head and neck cancer (HNC) and are calling for improved dissemination of current clinical practice guidelines in a new paper.
Researchers found that undiagnosed HNC patients with neck swelling and other symptoms are frequently prescribed antibiotics, rather than following current clinical guidelines recommending evaluation for cancer, which can delay diagnosis and complicate treatment for their cancer.
Sean Massa, M.D. says diagnostic delays can translate into requiring more aggressive treatments with more toxicities and a lower cure rate.
"ENT doctors usually are quite familiar with this cancer diagnosis and can use their training and tools to parse out whether it be symptoms caused by cancer or some other cause," Massa said. "But it's much more challenging for primary care doctors to make that determination, and I worry that this knowledge is not being disseminated to the broader medical community."
Researchers analyzed temporal trends, associated factors and diagnostic times between antibiotic prescribing before HNC diagnosis. They found that the number of patients receiving antibiotics leading up to cancer diagnosis has not changed after the release of clinical practice guidelines. Researchers say they hope to see that rate decrease.
In this cohort study of 7,811 patients with HNC, 15.6% received an antibiotic within three months of HNC diagnosis, resulting in a statistically significant 21.1% longer time to HNC diagnosis. This prescribing rate was static over the study period, and specific clinical and oncologic factors were associated with higher antibiotic prescription rates.
(Excerpt) Read more at medicalxpress.com ...
Head and neck cancers are very aggressive and difficult to treat. You have to stop them as soon as possible.
If skin cancer, Mohs is considered the best treatment.
“If skin cancer, Mohs is considered the best treatment.”
A decades long friend just went through the Mohs and some other therapy.
One of his daughters is a long time RN, and she made the diagnosis, which was confirmed by an ENT doc.
He seems to be doing okay with the exception of low energy!
Yep. I had melanoma in 1998. I went to my primary care for something else, and while I was there I mentioned the mole on my earlobe that looked like it was growing. He sent me to a dermatologist who removed it and sent it for eval. I was in the military at the time and was scheduled to move (New Mexico to England.)
I was driving across the country when the results came back. We had 5 days of travel time and with 3 small kids, we were using them all. This poor doctor is trying to track me down and is contacting my family, my wife's family, my old squadron, anyone he can think of. (Cell phones were just starting to get more popular, but I had never had one.)
We finally arrive to visit family, and my mother (a nurse) had managed to pry the diagnosis out of him, so she was like "Do whatever he says. Take care of it right now." But it's late Friday night and I can't reach anyone. Finally on Saturday the doctor tracked me down and told I had to get a flight to San Antonio because that was the only military hospital that did MOHS surgery.
My assignment was canceled (no longer medically qualified), so I still joke that I drove 5000 miles and flew another 3000 miles to move to a house two blocks away.
It has been 25 years and no recurrence.
He sent me to a general surgeon who took a needle biopsy and all that came out was clear fluid. He was optimistic this may be a “brancial cleft cyst”. Went to surgery to have it removed as the area had filled up again. Turns out the fluid was benign, but the “cyst” was a fully engaged lymph node and a couple neighboring ones, and it was squamous cell cancer. What a curious diagnosis.
Lived in Akron Ohio. This general surgeon had no idea where the “origin” of the cancer was —but said I should start chemo, radiation and have surgery. Screw that noise, I was able to get into Cleveland Clinic. First appt. for an evaluation included a team of an Oncologist, Radiologist and an ENT. They wanted to do biopsies of my mouth, tonsils, esophagus, tongue the whole works. I've never smoked or drank....but the ENT said I had the tonsils of a 60 year old smoker. He told the other two docs that the origin of my cancer was the left tonsil.
When I asked him “how do you know” he said that there was a vein distended on the tonsil surface that told him there was a tumor underneath. Underwent the biopsies and yes, the cancer was in the left tonsil. So, January 2, 1992 I started radiation, and 2 rounds of 96 hour chemo delivered i the hospital.
After all that was done (early March) I was schedule for surgery. All the docs said that since I was already opened up and had surgery done they couldn't evaluate whether that surgeon had gotten everything. So, in early April I had a radical neck dissection which took all the lymph nodes on the left side, the muscle, the jugular vein and fat tissue. All that is really left are the major blood vessels, major nerves, tendons, etc. The radiation did destroy my saliva glands and thyroid. A water bottle has been my permanent companion since I finished radiation and chemo.
But —I'm on this side of the dirt and celebrating 31 years cancer survival. This is not a blood cancer, so only a visual check by the ENT is all I have to ensure everything looks “normal”. The Doc said he has seen rarer cancers in younger people, and attributed it to toxins in the environment. I wonder if he's changed him mind 30+ years later.
I was one of those “kids” that was exposed to nuclear atmospheric testing in the mid 50’s so I wonder......
a dentist discovered a lesion in my mouth. For 3 years I went to an ENT about every 9 months for a biopsy. Third year it came back malignant. I had to go through surgery, but fortunately it was stage 1 and I didn’t need chemo or radiation. But the surgeon asked me why they didn’t just remove it before it became malignant and spread. GOOD QUESTION.
what is “Mohs”?
31 years, congratulations! That radiation really does the damage. I’m on a head/neck cancer forum and some folks end up on permanent feeding tubes or lose ability to speak.
So, before he would remove the tooth, I had to be in a hyperbaric chamber for 40 hours, 2 hours at a time as the forced 100 percent oxygen actually grows new blood vessels. Underwent that, had the tooth removed (the surgeon was happy to see good blood flow) and another 10 hours afterward to speed healing. Luckily, I haven't had to do anything else like that. The new blood vessel growth is considered permanent. Had the treatment at Mt. Vernon hospital in No. Virginia.
What is Mohs surgery?
Mohs surgery is a method for treating skin cancer lesions. During this procedure, the surgeon removes thin layers of skin one layer at a time and examines each layer under a microscope to determine if any cancer remains.
This procedure continues until only cancer-free tissue remains.
What is Mohs surgery?
Mohs surgery is a method for treating skin cancer lesions. During this procedure, the surgeon removes thin layers of skin one layer at a time and examines each layer under a microscope to determine if any cancer remains.
This procedure continues until only cancer-free tissue remains.
Thanks.
p
https://www.foxnews.com/health/merkel-cell-carcinoma-disease-killed-jimmy-buffett-what-know-illness
this is a “rare” and very aggressive cancer that has “suddenly” become more prevalent...like in the past few years.... /s
He joined me on niacin 2 1/2 years ago. A few months later his haircutter of 15 years asked him if he had gotten implants. No, he said, why? His bald spot had grown back.
Not long afterward he noticed the return of nearly 100% of his visual field in the affected eye. The cholesterol that had been clogging the capillaries in the retina had apparently been dissolved by the niacin.
That is an amazing recovery and it should provide hope to others that maladies are not only a one-way street.
There can be hope that bad situations can still turnaround. This is part of what I try to show with these breaking medical studies.
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