The MATH score piece was interesting. I have seen all sorts of studies attempting to shake prognostic markers out of the data, and wonder if we're not looking at the same thing in different ways. The presentation PowerPoint didn't, for example, show any other tumor characteristics - size, in particular.

The humidifier presentation, on the other hand, made me very pleased that I found OCF when I did, and knew to purchase a humidifier when my husband was undergoing therapy. Not as good as the fancy machine in the article, but very much better than nothing.
Maria

So Paul, since you mentioned the PEG� here we go, PEG WAR TIME!!!!

The latest data shows that some individuals definitely have to have a PEG tube, they just can't get through things without it. That's just a FACT. New data - patients that get them ahead of time, or patients that wait till their doctors decide that they have just lost too much body weight to go without it any longer, (usually about the end of week three of treatment) have the same outcomes as it related to survival, though obviously one group had greater weight loss during treatment. Apparently in the long view that weight loss did not impact ultimate outcome. Now the really new stuff, PEG users had slightly higher rates of dysphasia than no PEG users. Yup, I actually said it.

There are some caveats to that. The first is that IF the PEG user did swallowing exercises / physical throat therapy during PEG time, they had the same rate of dysphasia as non PEG users. Validating the "if you don't use it you can lose it" school of thought. So if you are going to have to PEG because of weight loss, then you better keep up with swallowing exercises, even though they are a pain in the rear (throat). My personal belief is that like me some people HAVE TO GO THE PEG ROUTE, but I am totally convinced they can offset any swallowing issues if they will just do the swallowing exercise protocol. Data now supports that. I personally think there is a big issue here, and that is patient compliance. I didn't want to do so many things during the worst parts of my treatment and this is one more MUST DO thing on the list. Staying after oral hygiene, hydration, swallowing exercises, taking meds on time, record keeping, and the list goes on� no just sleeping the days away during treatment if you want to avoid some QOL issues when it is all said and done.

It was well established that IMRT has the potential (in another study that was discussed in private conversations but not presented here) to reduce radiation to the nerves that control the swallowing reflex, reducing the post treatment dysphagia issues. Radiated nerves = swallowing issues regardless of PEG or no PEG. So tumor location and how the treatment radiation is mapped can cause dysphagia regardless of PEG or not.

I am curious if vomiting exercises the swallow muscles. I know it's not the same from the perspective of pharyngeal parastolsis but it would make sense the process keeps some of the muscles working. And yes, I ask with a straight face. :|

Thanks for the info Brian, and Peg Wars lol. I can relate to the Must Do list, which I sometimes translate into Don't Do, and probably one of the worst patients as far as compliance goes, even if I know better, but for doing so, I pay for it. I still have my 2nd peg, for a number of reasons, more for a back-up as opposed to really needing it now, but did use it during recent surgery, treatment for additional nutrients, hydration. I'm still down about 70lbs from my pre-cancer weight, not going back either, but did gain back 45lbs at my current weight from my lowest, actually was more, but lost 25lbs since the summer unintentionally.

My goodness Brian. The one I would least expect to light a match around the open gas can. :-)

Maybe it's been a long day, so I got no energy to join the scuffle. What about some sources to read on a rainy day?
Also, is loss of speech the dysphasia you mention?

Many folks have swallow issues and do dilation and have various issues with food sticking and aspiration sort of stuff. It is pretty hard to recollect many posts describing loss of voice unless it is related to trach kinds of things.

If we are talking about loss of voice, personally, based on anecdotal reference, it is not much of a argument to add to the PEG discussion, in that the occurrence is so rare. Now, if the data shows that swallow issues are related to PEG, then let's hit the octagon!!!!!!!!!!

Don, this is in the OCF News Feed from the symposium regarding effects of Chemoradiation and speech with oropharyngeal patients:

http://oralcancernews.org/wp/effect...nd-speech-quality-of-hn-cancer-patients/

Uptown, I don't think that counts. Muscle memory which accounts for things like great aerobatic pilots or even riding a bicycle is different than an involuntary muscle reflex. The brain is part of it, both conscious and unconscious. The nerves and muscles get accused to a repeated movement and that allows you to do with subconsciously exactly the same way each time.