Preventing life-altering side effects of cancer treatments

Nearly 10 per cent of all cancers diagnosed every year are in the head and neck. For most patients, treatment comes with long-term side effects. Whether through surgery, chemotherapy or radiotherapy, patients may experience significant changes to the way they eat, talk, hear, breathe or even to their outward appearance.

The degree of severity may vary, but any impediment to critical functioning can give rise to cognitive deficits, depression and other emotional and social limitations for patients and their loved ones.

Of these debilitating side effects, so many patients tell us they just “learn to live with it.” Not content for patients to live this way, Dr. Tony Eskander, head and neck surgical oncologist at Sunnybrook and adjunct scientist at the Institute for Clinical Evaluative Studies, is determined to improve patient outcomes.

Improving HPV-related cancer treatment

Oropharyngeal cancer (cancers of the throat, tonsils or base of tongue) has become the most common head and neck cancer. Up to 80 per cent of these cancers are related to human papillomavirus (HPV), a virus that most people will be exposed to in their lifetime. The number of cases that present each year is rising exponentially.

The good news is that this cancer is very sensitive to radiation and surgery. However, the side effects of treatment can affect quality of life, with dry mouth, difficulty swallowing, eating and more.

Dr. Eskander is exploring how to decrease side effects while maintaining the same high cure rates. He’s spearheading a trial involving two groups: one which will receive surgery and very little (if any) radiation; and another group who will receive low-dose radiation and chemotherapy.

“The normal dose of radiation is 70 grays,” explains Dr. Eskander. “By lowering the dose to 50, or even just 60 grays, the decrease in side effects for patients is substantial.”

Trial recruitment is currently underway. Learn more about the trial details.

Reducing risk of hearing loss

Up to 70 per cent of patients who undergo chemotherapy for head and neck cancer will experience hearing loss. Dr. Eskander and Sunnybrook otologist Dr. Trung Le are working to decrease this debilitating side effect.

They have developed a multi-institutional clinical trial to test the efficacy of a special antioxidant, called N-AcetylCystine. Preliminary evidence suggests injecting this antioxidant directly into the middle ear 30 minutes before a chemotherapy session can substantially reduce the risk of hearing loss from high-dose chemotherapy.

Learn more about donor supported work in the Odette Cancer Program