Fitness
Combining intensity modulated radiation therapy with chemo-radiation offers benefits for oropharyngeal cancer patients
IMRT is advanced therapy that closely conforms the radiation dose to the size, shape and location of the tumor to minimize complications in surrounding healthy tissues. The researchers compared outcomes between combining chemotherapy with IMRT versus combining chemotherapy with conventional radiotherapy techniques.
Combining intensity-modulated radiotherapy (IMRT) with chemotherapy to treat locally advanced oropharyngeal (head and neck) cancer improves long-term health-related quality of life (HRQOL) outcomes by sparing the swallowing and salivary organs, according to a study by researchers at the University of Michigan.1
IMRT is advanced therapy that closely conforms the radiation dose to the size, shape and location of the tumor to minimize complications in surrounding healthy tissues. The researchers compared outcomes between combining chemotherapy with IMRT versus combining chemotherapy with conventional radiotherapy techniques.
“Our study shows that patients with locally advanced head and neck cancer treated with chemo-radiation using swallowing and salivary-organ sparing IMRT techniques experienced stable or improved health-related quality of life outcomes six years later,” said Avraham Eisbruch, MD, from the Department of Radiation Oncology, University of Michigan. “This contrasts significantly with prior reports about HRQOL outcomes after chemo-radiation using conventional radiation therapy techniques. The long-term benefits and reduced side effects for IMRT patients included less dry mouth, fewer swallowing difficulties, and greater freedom from dependence on feeding tubes.”
In September 2013, Eisbruch, along with lead study authors Jeffrey Vainshtein, MD, Dominic Moon, MD, and several other colleagues enrolled 40 patients in a long-term health-related quality of life study, which required them to complete questionnaires regarding long-term outcomes and side effects. All of the patients had been treated for stage III/IV oropharyngeal cancer between May 2003 andJanuary 2011 using chemo-IMRT swallowing and salivary-organ sparing techniques. The median follow-up after chemoradiation treatment was 6.5 years. At the time of this study, all patients were free of head and neck cancer.
While chemo-radiation therapy (CRT) has long been considered the standard-of-care for patients with locally advanced head and neck cancer, CRT using traditional radiotherapy techniques often caused severe side effects, such as dry mouth and swallowing difficulties, resulting in feeding tube dependence and other complications that reduced the quality of life. Conversely, patients in this study who were treated with swallowing and salivary organ-sparing chemo-IMRT reported, more than 6 years after treatment, that they were experiencing stable or improved health-related quality of life outcomes, with the majority of patients experiencing freedom from feeding tubes (97.5%), dry mouth, and swallowing problems (95%).
“Although this study was small in size, it contains some of the first really long-term data we have to show that, by using swallowing- and salivary structure-sparing chemo-IMRT to treat locally advanced head and neck cancer, we can significantly impact our patients’ post-treatment quality of life,” Eisbruch said. “Future advances in swallowing and salivary organ-sparing chemo-IMRT techniques may enable us to improve health-related quality of life outcomes even more.”
1Vainshtein, JM, et al. Long-term quality of life after swallowing and salivary-sparing chemo-intensity modulated radiation therapy in survivors of human papillomavirus-related oropharyngeal cancer. International Journal of Radiation Oncology • Biology • Physics. 2015; 91 (5): 925–933.
Fitness
Treatment options to help overcome knee pain for sports enthusiasts
“Sports-related pain should be evaluated quickly, especially when it’s difficult to put weight on the knee, swelling occurs or there is restricted range of motion,” said Dr. Alexander Meininger, orthopedic surgeon and MACI consultant.
Millions of people experience chronic pain, with knee pain among the most common. Athletes and active adults know the impact activities like running and skiing can have on their knees, but when chronic knee pain makes it difficult to do those activities, or even day-to-day tasks like walking up the stairs, people may often face challenges.
According to the journal “Cartilage,” unlike other tissues, cartilage does not repair itself and, without proper treatment, can worsen over time and become more difficult to treat. However, options like FDA-approved knee cartilage repair surgery MACI (autologous cultured chondrocytes on porcine collagen membrane) uses a patient’s cells to help repair cartilage defects and may help alleviate knee pain.
“Sports-related pain should be evaluated quickly, especially when it’s difficult to put weight on the knee, swelling occurs or there is restricted range of motion,” said Dr. Alexander Meininger, orthopedic surgeon and MACI consultant.
Justin Keys, a former patient of Meininger and avid skier, knows that the long-term outcomes of knee cartilage surgery can be worth the short-term sacrifices. After several injuries, including an ACL injury, Keys struggled with most activities except walking on flat, paved surfaces. After consulting with Meininger, Keys chose knee cartilage repair to help get back to his active lifestyle.
Keys considered whether to manage the injury as-is or choose MACI and undergo rehabilitation to potentially get back to his favorite activities in the future. He knew he could no longer use short-term relief methods and had to address his pain with a treatment to help provide lasting relief.
For athletes like Keys who want to fix knee pain, it’s important to consider these steps:
Discuss Options with Your Doctor
Patients should talk to their doctors and undergo an MRI to help assess the internal structures of the knee. Meininger recommends patients and their doctors discuss options for long-term knee restoration health, preserving function for future decades and recognizing the short-term sacrifice.
Set Yourself Up for Success
Experts like Meininger suggest patients take steps ahead of surgery to help their recovery.
“The important thing is to be as fit as possible and use the preseason months to undergo surgery and rehab,” Meininger said.
Patients can take steps to prep their home for recovery, which may include:
- Bringing necessities down from hard-to-reach shelves
- Moving furniture to ensure clear pathways
- Installing shower safety handles to minimize potential falls
The Road to Rehab and Recovery
Rehabilitation takes time and everyone’s experience is unique. It can be as much of a mental challenge as it is physical. Committing to a physical therapy regime, staying hydrated and eating well are important aspects to support recovery. Patients should talk to their doctors with questions and before starting any exercises.
IMPORTANT SAFETY INFORMATION
Do not use if you are allergic to antibiotics such as gentamicin or materials from cow or pig; have severe osteoarthritis of the knee, other severe inflammatory conditions, infections or inflammation in the bone joint and other surrounding tissue or blood clotting conditions; had knee surgery in the past 6 months, not including surgery for obtaining a cartilage biopsy or a surgical procedure to prepare your knee for a MACI implant; or cannot follow a rehabilitation program post-surgery.
Fitness
6 Exercise safety tips
Now, as social restrictions ease, you may find yourself stepping up your workouts, whether you’re training for an event or working to improve your game in a recreational league.
In the wake of the COVID-19 pandemic, many Americans are more aware of their health and wellness. Now, as social restrictions ease, you may find yourself stepping up your workouts, whether you’re training for an event or working to improve your game in a recreational league.
Sprains, strains and injuries can happen to even the most seasoned athletes. When you’re testing your limits, even a minor injury can alter your performance. Consider products and supports like these from the CURAD Performance Series product line, available at Walmart and Amazon, to help you get back in the game quickly and safely.
Find more resources to support your fitness journey at CURAD.com.
Keep Dirt and Germs Away
The more active you are, the harder it can be to find a bandage that stays with you all day or all game long.
Spray Away Sore Spots
Controlling mild pain can help keep you at the top of your game, and a topical analgesic works fast to heal common pain brought on by fitness and exercise, such as pain in knees, feet, shoulders and backs.
Put Pain in the Past
When recovery becomes the name of the game and pain relief is needed after daily workouts or bodily injuries. Cold packs work to heal bruises, reduce swelling and relieve headaches and general pain points while microwavable heat packs provide satisfying heat therapy to address sore and stiff joints, muscle cramps and tension.
Reduce Impact of Knee Strain
Weak, injured or arthritic knees can come from many sources, including tendonitis and a wide range of conditions that result in strain or overuse. An adjustable band can provide support for on-field sports and during workouts or everyday activities.
Manage Pain and Relieve Pressure
If you participate in endurance and strength exercises or certain sports, you may ask a lot of your joints. Kinesiology tape can be configured a multitude of ways to help reduce pain and improve blood circulation, as well as relieve tension and pressure.
Control Back Strain
When your back is strained, your body and performance can suffer. A mild or moderate sprain can benefit from strong support and compression.
Fitness
Exercise can provide relief for dry, itchy eyes
A significant increase in tear secretion and tear film stability after participating in aerobic exercise can be another remedy for relieving dry, itchy eyes.
A team led by researchers from the University of Waterloo discovered that a significant increase in tear secretion and tear film stability after participating in aerobic exercise can be another remedy for relieving dry, itchy eyes.
Every time we blink, our eyes are covered in tear film—an essential protective coating necessary for maintaining healthy ocular function. Healthy tear film comprises three layers–oil, water, and mucin–that work together to hydrate the ocular surface and protect against infection-causing irritants like dust or dirt.
When any part of the tear film becomes unstable, the ocular surface can develop dry spots, causing eye symptoms like itchiness or stinging and burning sensations.
“With so much of our activity tied to screen usage, dry eye symptoms are becoming increasingly common,” said Heinz Otchere, a PhD candidate in vision science at Waterloo. “Instead of having to use eye drops or other alternative treatments, our study aimed to determine if remaining physically active can be an effective preventative measure against dryness.”
Fifty-two participants were divided into two groups—athlete and non-athlete—to participate in an exercise session. Participants in the athlete group exercised at least five times per week, while non-athlete participants exercised no more than once per week. Researchers, which included experts from the University of Cape Coast in Ghana, performed visual examinations before and five minutes after each exercise session, where tear secretion and tear break-up time were assessed.
While participants in the athlete group showed the largest increase, Otchere says all participants experienced a meaningful boost in tear quantity and tear film stability after the exercise session.
“It can be challenging for people to regularly exercise when the demand is there to work increasingly longer hours in front of screens,” Otchere said. “However, our findings show physical activity can be really important for not just our overall well-being, but for our ocular health too.”
The study, Differential effect of maximal incremental treadmill exercise on tear secretion and tear film stability in athletes and non-athletes, was co-authored by Otchere, the University of Cape Coast’s Samuel Abokyi, Sekyere Nyamaah, and Michael Ntodie, and Ghana’s Our Lady of Grace Hospital’s Yaw Osei Akoto. It was recently published in the Experimental Eye Research journal.
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