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Less tough medicine

A spoonful of sugar helps the medicine go down, but not always in the most delightful way for neck cancer patients in remission, leading Boston Medical Center researchers to head a multi-university study on swallowing.
BMC experts are testing a new method of treating dysplasia, an abnormal tissue formation that keeps post-radiation neck and throat cancer patients from swallowing properly, study administrator Gintas Krisciunas said.
The treatment uses an electric stimulator to give neck and throat muscles a low dose of electricity, giving patients the strength and ability to swallow.
‘Many people are looking for and asking for it, and some insurers are now covering it,’ he said. ‘Evidence shows that it may work.’
As neck and throat cancer patients undergo radiation, the healthy tissue in the area often swells and cannot easily move, causing scar tissue deposits, also known as fibrosis, Krisciunas said. Patients also frequently breathe in their food, which causes pneumonia.
Many people experiencing these problems already turn to the stimulator, also known as E-Stim, Krisciunas said.
The BMC study gives patients short doses of electricity and then requires them to swallow, Krisciunas said. Scientific literature posits that the stimulation may actually reverse damage.
‘E-Stim may keep fibrosis from forming, or break it up,’ he said. ‘We’re really interested in finding out how to prevent it.’
The study, which begins recruiting this month, is run in Boston and has other studies taking place across the nation, University of Iowa Medical Center Principal Study Investigator Douglas Van Daele said. The process of creating this trial has spanned over a year and a half.
‘We’ve been shoring up protocols, getting regulatory information and verifying the safety of the patients,’ he said. ‘There was lots of time with institutional review boards, from both the cancer and radiation perspectives.’
UIMC will enroll two or three patients per month for the duration of the enrollment period, which ends in June 2012, Van Daele said.
‘This is totally a voluntary enrollment,’ he said. ‘With that said, we see about 400 new and recurrent cancer patients a year, and two-thirds will have radiation. We can enroll a few a month.’
College of Communication lecturer Tinker Ready said the study hits close to home for her, because her late father experienced swallowing problems for much of his life.
‘After a while, he had to go on a ground food diet,’ she said. ‘It really reduced his quality of life.’
Ready’s father, who moved from an assisted living facility to a nursing home in old age, could not have a true birthday dinner because of his condition, Ready said.
‘For his last birthday, his 84th, he asked for steak,’ she said. ‘When it arrived, it was ground and overcooked. He took a couple of bites and pushed it away.’

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