It looks likely that the argument to extend HPV vaccinations to boys has been won, according to the Daily Mail
The article states:
The Government’s Joint Committee on Vaccination and Immunisation (JCVI) had previously concluded it was ‘overwhelmingly’ unlikely that vaccinating boys would be cost-effective. Its conclusions were based in part on a flawed computer model that wrongly assumed HPV caused relatively few cancers in men. But earlier this month the committee accepted new evidence that HPV causes many more cancers in men than previously thought. In particular it causes up to five times as many mouth and throat cancers as had been estimated.
Last August, NALC responded to the JCVI, following their decision not to extend the programme to boys, and made the following comment:
We were surprised by the statistics about oropharyngeal cancer, in particular the low attribution figures of 12.4% (women) and 24.7% (men). Very much larger % are indicated in the Data for Head and Neck Oncology Report 10, published in 2015 by NHS England. It reported that over 70% of the OPSCC patients tested were HPV positive.
Now that they appear to have accepted the arguments of HPV Action and all parts of the head and neck community let’s hope there is a speedy implementation of the programme.
On Thursday we organised a second visit to the National Memorial Arboretum. Since our first trip there were many new memorials to see. Perhaps the most moving was the one from Sapper Support, a charity focused on PTSD, with the sculpture shown above.
Our enjoyment of the day was enhanced by the plentiful sights of nature with terns flying over the River Tame, the nesting coots and Great-Crested Grebes, demoiselle damsel flies in abundance and the Poppy Field in full bloom.
Previously, on Monday, we had a stand at Chesterfield Royal Hospital, with the dual aim of raising awareness of the early signs of head and neck cancer and fundraising for our group. As always there were many interesting conversations.
NICE has now published its updated head and neck cancer guideline. The update was prompted by Professor Hisham Mehanna’s research study PET-NECK. This study investigated the potential of monitoring patients using FDG PET-CT scans to assess lymph node involvement rather than carrying out an automatic neck dissection.
Professor Mehanna and his team deserve congratulations on their practice-changing study which spare patients from unnecessary surgery.
NALC, as it has done for every NICE committee on head and neck cancer, provided the lay members of the committee.
ACCORDING TO THE BBC on 3/6/18:
About 70% of women with the most common form of early stage breast cancer can be spared the “agony of chemotherapy”, researchers say.
It follows trials of a genetic test that analyses the danger of a tumour.
Cancer doctors said the findings would change practice in UK clinics on Monday, and meant women in this group could be treated safely with just surgery and hormone therapy.
As a matter of urgency, research is needed to find similar hormone treatment for patients with cancer at other sites, including head and neck, and if they will have similar benefits.
One of the problems of traditional cancer treatments is the effect they have, not just on the tumour but healthy tissue as well. In the case of head and neck cancer, this leads to problems, such as difficulty in swallowing or dry mouth, which persist for life.
We are only just seeing the introduction of immunotherapies in the treatment of head and neck cancer, mainly in clinical trials. They offer several potential benefits such as no harm to normal tissue and they can be targeted at patients for whom it is most likely that they will work. The side effects during the treatment are also less than seen in conventional chemotherapy.
It has been found that nivolumab increases survival times for patients who have had a relapse after chemo-radioatherapy (CRT) for advanced cancerA. Now a study has been looking at delivering the immunotherapy at the same time as the CRTB. Is it safe? Is it well tolerated by patients? The results of this small-scale study were encouraging. Further studies are now needed to identify the full benefit of the immunotherapy in terms of recurrence and survival.
There are no magic bullets for cancer treatment but immunotherapy continues to be a promising approach for better outcomes for patients.
A Study led by Professor Kevin Harrington, Royal Marsden 2016
B Study led by Professor Maura Gillison, MD Anderson Cancer Center, Texas 2018
HNChelp has been financially sustainable for some years. Our members are generous in their donations, we have two events each year to raise funds and we have supporters like the Rotary Club of Clay Cross. The National Association of Laryngectomee Clubs, NALC, is not in such a situation and needs your support
Recently many schemes have been launched to make donations to a charity when a purchase is made from a variety of online outlets. Amazon has a large share of online sales and if you buy from them you can get a donation to NALC of 0.5% of the value of your purchase .
If you Google “Amazon Smile” and login to your Amazon account, or create a new account, you can choose the charity that benefits from your future purchases. Entering The National Association of Laryngectomee Clubs in the search box will ensure NALC gets a donation every time you use Amazon.
There is a Westminster Hall debate on vaccinating boys against HPV on Wednesday 2 May, 9.30-11am.
You can watch the debate live on Parliament TV.
Data for Head and Neck Oncology (DAHNO) provided vital information about the delivery of treatment for head and neck patients for many years. Though there were flaws and limitations in the completeness of its reports, it gave patients and carers valuable information in assessing the care that was provided.
Since the tenth DAHNO report covering 2014, I have found no audit information about head and neck cancer. HANA took over from DAHNO and collected a limited amount of data in its first year of operation. It was then handicapped by the withdrawal of financial support for its work. I am currently uncertain as to whether the audit is dead or alive.
The DAHNO group was a valuable forum. It had members from all the clinical groups involved in delivering care to head and neck patients, as well as patient, carer and voluntary sector members, such as NALC. The NICE Quality Standards for head and neck, published in 2017, relied upon the evidence that the audit would provide. For example one of the quality standards was about giving patients choice about surgery or other treatment options. Without the audit there is no way of getting information about what is actually happening to patients.
On Tuesday April 3rd the second programme in the BBC series “Hospital” followed some head and neck cancer patients at QMC, Nottingham. It certainly provoked a mixture of emotions. The problems faced by the head and neck team because of shortages of specialist staff have alarming implications for patients. Targets are set for timely treatment with good reason given the prospect for less favourable outcomes if delays occur. On the other hand, one could not fail to be moved by the dedication and work of staff to do the best they could in the challenging circumstances.
QMC has had an excellent reputation in head and neck, with world-renowned clinicians such as Emeritus Professor Patrick Bradley, who was a former NALC patron, Some of our members receive their care at QMC and it continues to have a high reputation. Indeed the trust has extended some services to all of us regardless of some being “out of area”.
NHS staff such as the head and neck team at QMC are being let down. They are not able to deliver the service they want to provide, and which they were able to do a few years ago.
HNChelp now has a twitter account
Many of our contacts and collaborators, such as NALC, HPV Action and NTSP, have accounts.
Twitter provides a medium for supporting them and also adding our own perspective.
It may take a bit of time to get up to speed however!!!!