Botulinum Toxin Treatment for Cancer-Related Disorders: A Systematic Review

Innovative implications of botulinum toxin in head and neck cancer: Exploring novel opportunities and future prospects

Head and neck cancer (HNC) represents a significant global health challenge, with over 660,000 annual diagnoses and a mortality rate exceeding 49 %, making it the seventh most common cancer worldwide. Current standard treatments, including surgery, radiation, and chemotherapy, often result in significant side effects, underscoring the need for innovative and personalized therapeutic approaches. In recent years, botulinum toxin (BoNT) has emerged as a transformative adjunctive therapy in HNC management. Initially recognized for its neuromuscular blocking properties, BoNT has expanded its applications to alleviate complications such as sialorrhea, gustatory sweating, and neuropathic pain associated with HNC treatment. Beyond symptomatic relief, emerging evidence suggests that BoNT may influence tumor biology by modulating the tumor microenvironment, disrupting nerve-cancer interactions, and altering key molecular pathways to inhibit tumor growth and metastasis. This article explores BoNT's achievements and therapeutic potential in treating HNC, examining its molecular mechanisms, clinical efficacy, and implications for future research. By elucidating BoNT's role in symptom management and its potential as an anti-tumor agent, this review highlights a promising avenue for advancing personalized medicine and improving outcomes for HNC patients.

The Esthetic Use of Botulinum Toxins in Cancer Patients: Providing a Foundation for Future Indications

Advances in oncological treatments have improved the survival rates of cancer patients but have often resulted in significant physical changes that negatively impact their self-esteem and psychological well-being. Cancer patients frequently ask esthetic practitioners to perform procedures to address such changes. However, practitioners often hesitate to satisfy such requests due to lacking guidelines or recommendations. The use of botulinum toxins (BoNTs) for esthetic purposes has shown significant promise in improving the quality of life for cancer patients. This review explores the broad application of BoNTs in many medical branches, focusing on oncology. A substantial amount of literature shows that BoNTs are safe and effective as a type of adjunctive therapy compared to classical cancer treatments. We provide our expert opinion that the use of BoNTs for esthetic purposes is safe for cancer patients and even recommended for those whose mood is influenced by the worsening of their physical appearance. Careful patient selection and interdisciplinary collaboration are essential to the safe integration of BoNTs into cancer care.

Management of Lower Urinary Tract Symptoms during the Treatment for Non-Muscle Invasive Bladder Cancer

PURPOSE OF REVIEW

This narrative review aims to report upon the existing treatment evidence and strategies for managing lower urinary tract symptoms (LUTS) during treatment, including transurethral resection and intravesical therapy. This review also attempts to examine novel approaches to mitigate treatment-related lower urinary tract symptoms and improve treatment adherence.

RECENT FINDINGS

There is sparse but promising evidence in improving LUTS secondary to intravesical therapy. Oral agents including phenazopyridine and hyaluronic acid, Bacillus Calmette-Guerin dose reduction, and emerging therapies including beta-3 agonists as well as Onabotulinumtoxin A injections all have demonstrated encouraging improvement in LUTS in limited research. Although recent literature explores new medications and potential strategies for managing intravesical therapy-related LUTS, further research is required to establish efficacy and new consensus on treatment strategies. Further research is also required to establish effective LUTS mitigation strategies with other emerging intravesical therapy regimens.

The Potential Therapeutic Effects of Botulinum Neurotoxins on Neoplastic Cells: A Comprehensive Review of In Vitro and In Vivo Studies

A systematic review of the literature found fifteen articles on the effect of a botulinum toxin on neoplastic cell lines and eight articles on in vivo neoplasms. The reported in vitro effects rely on high doses or the mechanical disruption of cell membranes to introduce the botulinum neurotoxin into the cell cytoplasm. The potency of the botulinum neurotoxin to intoxicate non-neuronal cells (even cell lines expressing an appropriate protein receptor) is several orders of magnitude lower compared to that to intoxicate the primary neurons. The data suggest that the botulinum toxin disrupts the progression of cancer cells, with some studies reporting apoptotic effects. A majority of the data in the in vivo studies also showed similar results. No safety issues were disclosed in the in vivo studies. Limited studies have suggested similar anti-neoplastic potential for the clostridium difficile. New modes of delivery have been tested to enhance the in vivo delivery of the botulinum toxin to neoplastic cells. Careful controlled studies are necessary to demonstrate the efficacy and safety of this mode of anti-neoplastic treatment in humans.

Treatment of Primary Axillary Hyperhidrosis with Two Doses of Botulinum Toxin A-Observational Study

Hyperhidrosis (HH) is defined as the production of more sweat than is necessary for its thermoregulatory function, negatively affecting patients' quality of life and interfering with their social, work and family life. In this context, the aim of thisstudy was to evaluate the efficacy of two different doses of botulinum toxin type A (50 or 100 units) in each axilla in severe primary axillary hyperhidrosis. A descriptive, observational, cross-sectional and post-authorisation study was conducted onpatients referred to our department.Thirty-one patients with severe primary axillary hyperhidrosis were included, some of whom received more than one infiltration during the follow-up period, performing a total of 82 procedures. They were assigned by simple random sampling to two types of treatment: infiltration of 50 or 100 units (U) of botulinum toxin A per axilla.Hyperhidrosis severity was assessed using the Hyperhidrosis Disease Severity Scale (HDSS), and quality of life was assessed using the Dermatology Life Quality Index (DLQI) questionnaire. Onabotulinum toxin A infiltration reduced the severity of hyperhidrosis and improved the quality of life of the treated patients, with no significant differences between the two groups.