NEWS A Publication of Vantage Oncology, Tri-State Radiation Oncology Centers - TROC

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1 Congressman Larry Buschon Visits Evansville Cancer Center Nationwide, physicians who provide care to Medicare patients are feeling the impact of significant reimbursement cuts for their services. Members of the local cancer care community warn that deep additional cuts to radiation therapy services threaten patients access to life-saving cancer care. Furthermore, payment reductions could potentially lead to forced facility closures and limited patient access to cutting-edge technologies, which could then result in worsened health outcomes. Pictured left to right: Noah Taylor, MD, Congressman Larry Buschon & Jon Frazier, MD, Medical Director On May 29, Representative Larry Bucshon toured Evansville Cancer Center to meet with the Medical Director, Dr. Jon Frazier, Dr. Noah Taylor, and staff to learn more about radiation therapy offerings in the Evansville area. Dr. Frazier discussed the key role community-based radiation therapy centers have in helping win the war on cancer, as well as the importance of a logical, predictable Medicare reimbursement policy to ensure continued access to state-of-the-art, quality cancer care in the community setting. Rep. Bucshon said that decisions made by the government are money driven, not patient care driven. Dr. Frazier and Dr. Taylor at Evansville Cancer Center agreed that as physicians, we must be the ones to take control to reduce the escalating cost of health care. Rep. Bucshon wants to work with The Radiation Therapy Alliance, the organization that scheduled the facility visit, in Washington to see that legislation put forth is in the best interest of patients and the care they receive. Other topics of discussion during the visit included the new AUA position on PSA testing for prostate cancer, the margins in the declining reimbursement rates, and what will be best for health care and controlling costs moving forward. It was great meeting with the dedicated physicians and staff who are providing highquality service and care to patients at Evansville Cancer Center, Rep. Bucshon said. As a physician, I believe it is important to understand the issues affecting patients access to treatment and the role facilities like this play in delivering care is critical as Congress continues working on effective healthcare reform. Evansville Cancer Center/Vantage Oncology 700 North Burkhardt Road Evansville, IN Ra d i at i o n On c o l o g y NEWS A Publication of Vantage Oncology, Tri-State Radiation Oncology Centers - TROC Vol. 1 No C O N T E N T S Oral, Head and Neck Cancer: What is new and what do we need to know about this disease....pg. 1 2nd Annual Oral, Head and Neck Cancer Screening Conducted...pg. 4 11th Annual Skin Cancer Screening Conducted...pg. 7 Congressman Buschon Visits Cancer Center...pg. 8 Jon D. Frazier, MD, Medical Director & Noah A. Taylor, MD of Therapy Associates Providing Radiation Therapy at: Deaconess Chancellor Center for Oncology 4055 Gateway Boulevard, Newburgh, IN Evansville Cancer Center 700 North Burkhardt Road Evansville, IN Oral, Head and Neck Cancer: What is new and what do we need to know about this disease. Cancers of the head and neck account for 6 percent of all malignancies in the United States, with over 80,000 new cases per year. In this disease, smoking and alcohol abuse are major risk factors. However, Human Papilloma Virus (HPV) infection is now also a major risk factor. Symptoms vary, depending on the site of origin, and can include a sore throat, dysphagia, odynophagia, and hoarseness. On examination, patients often have an identifiable primary site and a palpable neck mass. A multidisciplinary approach is important in treating these patients, given the complexity of the treatment and the acute and long-term complications that result from chemotherapy, radiation therapy, and surgery. Appropriate clinical and radiographic staging is crucial for accurate treatment planning and delivery. In this article, we will examine what we have recently learned about the incidence, signs/symptoms, exam and work-up, and treatment of this disease. Oral, head and neck cancer most commonly refers to squamous cell carcinoma of the tongue (oral and base of tongue), tonsil, and larynx. However, it also includes cancers of squamous and different histologies that arise in the nasal cavity and nasopharynx, sinuses, oral cavity (including lips, buccal mucosa, floor of mouth), thyroid glands, and salivary glands. Cigarette smoking increases the risk of head and neck cancer by 15 times compared to a non-smoker. Combining cigarette smoking and alcohol increases the risk over either one alone. Oral, head and neck cancers tend to form in areas where the tobacco/alcohol has direct contact with the mucosal surface. Over the past 10 years, an increasing number of people with HPV who are young, non-smokers have developed cancer of the tonsils and tongue base, related to oral contact with the virus. Molecular evidence also suggests a role for HPV, particularly HPV-16, in the pathogenesis of a subgroup of squamous-cell carcinomas of the head and neck, and the HPV viral oncogenes E6 and E7 are frequently overexpressed in the oropharynx. HPV DNA has been detected in over 70% of oropharyngeal tumor specimens. Since HPV vaccination is an important strategy to prevent cervical cancer, it would seem logical that HPV-vaccination strategies might be tested as a potential means for preventing HPV-induced head and neck cancers. Although HPV has been associated with non-smoking related cancers, it also has been found to be important in many smoking-related cancers as well. As it has also been found in cervical cancer, smokers have a poor ability to clear the HPV virus and HPV related mutations as opposed to non-smokers, so the combination of smoking and HPV exposure is especially dangerous. Common warning signs of head and neck cancer are a red or white patch in the mouth that lasts more than two weeks (persistent red patches in a high risk patient could indicate cancer 25% of the time), change in voice or hoarseness that lasts more than two weeks, sore throat that dose not subside, pain or swelling in the mouth or neck that does not subside, lump in the neck, ear pain, difficulty swallowing or (Continued on page 2)

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