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Young supports Oral Cancer Awareness with launch of new Burgundy Disposable Prophy Angle

Tue, Mar 31, 2015

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Source: http://www.dentistryiq.com
Author: DentistryIQ Editors

Screening is the beginning of the end of oral cancer, and Young is joining the Oral Cancer Foundation in empowering hygienists to “Be Part of the Change.”

Hygienists are on the front lines of oral cancer detection, and their involvement in early screening is paramount in the fight against oral cancer. Young is helping to support hygienists and keep oral cancer awareness in the forefront by launching the new Classic Burgundy Petite Web disposable prophy angle just in time for Oral Cancer Awareness Month in April.

In addition to being the signature burgundy color of oral cancer awareness, the Classic Burgundy Petite Web disposable prophy angle packaging acts as a billboard to promote awareness through early detection.

According to the Oral Cancer Foundation, more than 43,000 people are diagnosed with oral cancer in the U.S. each year, and only 57% will survive past five years due to late diagnosis. When found at early stages of development, oral cancer victims have an 80 to 90% survival rate.

Thanks to engagement from the RDH community, we are on the cusp of a major change in this paradigm. With a commitment to screening for oral cancer warning signs during routine prophylaxis procedures, hygienists are helping to save lives through early detection.

“Just doing ‘opportunistic’ cancer screenings during routine dental hygiene procedures would yield tens of thousands of opportunities to catch oral cancer in its early stages. One of our goals is to initiate an effort within the dental community to aggressively screen all patients,” said Brian Hill, executive director of the Oral Cancer Foundation. “Screening for oral cancer during dental examinations will save lives. We are thrilled to partner with Young in launching the Classic Burgundy Petite Web disposable prophy angle to help raise awareness about the early detection of oral cancer.”

To learn more about the Oral Cancer Foundation, visit www.oralcancer.org. To learn more about the new Classic Burgundy Petite Web disposable prophy angle, visit www.youngdental.com.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
 
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Green tea polyphenol helps kill oral cancer cells by destroying mitochondria

Mon, Mar 30, 2015

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Source: www.medicaldaily.com
Author: Chris Weller
First it targeted pancreatic cancer. Now it’s moved onto oral cancer. A new study from Penn State University shows the main antioxidant in green tea, epigallocatechin-3-gallate (EGCG), helps kill cancer cells through the destruction of the cells’ mitochondria.

 

green-tea

While highly effective at eradicating cancer cells, chemotherapy is quickly falling out of practice with doctors who seek targeted treatments. Instead of getting rid of just the harmful cells, chemo attacks healthy cells, which are often found in the hair and the intestines, resulting in the characteristic hair loss and frequent immune system-related illness.

“You don’t see these sorts of side effects with green tea consumption,” said Joshua Lambert, associate professor of food science at Penn State, in a press release. Lambert and his colleagues carried out their study by looking at cell cultures, which they injected with the same amount of EGCG a person would normally have in her saliva after chewing green tea-flavored gum. They saw a number of promising reactions.

“It looks like EGCG causes the formation of reactive oxygen species in cancer cells, which damages the mitochondria, and the mitochondria responds by making more reactive oxygen species,” Lambert explained. Over time, the mitochondria lose even more of its defenses with a breakdown in the expression of antioxidant genes. In their weakened state the cancer cells eventually succumb to EGCG in full, and they die.

This isn’t the first time EGCG revealed its cancer-killing power. In May of last year, scientists from the Los Angeles Biomedical Research Institute (LA BioMed) discovered the compound’s ability to prevent and slow the growth of pancreatic cancer. One of the key enzymes in pancreatic cancer cells is known as LDHA, and prior studies have shown the enzyme inhibitor oxamate is instrumental in destroying LDHA. In similar culture tests, LA BioMed researchers found EGCG rivaled oxamate in its destructive power.

The scientists on either coast share the same goal: getting rid of cancer. Many forms of the disease are rising in prevalence, particularly in developing nations where the Western diet wields a dangerous, processed influence. Lung cancer, for example, recently passed breast cancer as the most fatal form of cancer among women in the developed world. Pancreatic cancer is nearly just as bad. Of the 45,000 diagnoses each year in the U.S., 85 percent of cases are fatal.

For Lambert and his research team, the more immediate goal is to move out of cell cultures. The next step is animal models, so they can see what kind of side effects — if any — EGCG brings. If the mitochondria continue to wither in the compound’s presence, they’ll move a step closer to developing alternative therapies for oral cancer that don’t rely on the wide-scoped forces of chemo.

Source:
Tao L, Park J, Lambert J. Differential prooxidative effects of the green tea polyphenol, (–)-epigallocatechin-3-gallate, in normal and oral cancer cells are related to differences in sirtuin 3 signaling. Molecular Nutrition & Food Research. 2015.

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Researchers ID potential prognostic marker for recurrence of head and neck squamous cell carcinoma

Mon, Mar 23, 2015

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Source: medicalxpress.com
Author: press release

A new study provides the first evidence that the mediator complex subunit 15 (MED15) may play a crucial role in the pathophysiology of head and neck squamous cell carcinoma (HNSCC). MED15 overexpression was found to be associated with higher mortality rates in HNSCC patients with cancer recurrence, particularly in oral cavity/oropharyngeal tumors, according to the study published in The American Journal of Pathology. MED15 overexpression was also associated with heavy alcohol consumption, which is an HNSCC risk factor.

HNSCC is the sixth most common  worldwide and has a high rate of recurrence and early metastatic disease, resulting in approximately 350,000 deaths each year. “Our findings suggest that MED15 may serve as a prognostic marker for HNSCC recurrence and as a therapeutic target in HNSCC patients suffering from recurrences,” said lead investigator Sven Perner, MD, PhD, of the Department of Prostate Cancer Research, Institute of Pathology, and the Department of Otorhinolaryngology at the University Hospital of Bonn (Germany).

Mediator is a multiprotein complex that regulates many signaling pathways. In humans, it consists of 30 subunits including MED15, which has been implicated in breast and , with particular attention being given to its link to transforming growth factor-β (TGF-β) signaling. “The evidence that multiple aberrant pathways account for the progression of HNSCC calls for a much deeper understanding of the effect of molecules involved in these signaling pathways upon HNSCC progression,” noted Dr. Perner.

To investigate the role of MED15 in HNSCC, the researchers analyzed tissues from 113 patients with primary tumors, 30 recurrent tumor tissues, 85 , and 20 control samples of normal squamous epithelial tissue. Using immunohistochemical staining, expression scores were calculated by multiplying staining intensity by the index of immunoreactive cells and categorized as no expression (<0.07), low expression (0.07<0.2), or overexpression (0.2). They found that MED15 was overexpressed in 35% of primary tumors, 30% of lymph node metastases, and 70% of recurrences, in contrast to no or low expression in control samples.

To determine the extent to which MED15 levels correlated with mortality, the investigators performed immunohistochemical analysis of primary tumor tissues from the 108 patients who developed recurrent tumors. They found that the mortality rate (defined as death within 1 to 12 years after first diagnosis) increased from 58% overall to 78% in the subset of patients whose tumors showed MED15 overexpression, with a significant association found between MED15 overexpression and high mortality.

Further investigation revealed that the mortality rate of patients with tumors in the oropharynx or oral cavity was significantly higher than that of patients with tumors in the hypopharynx or larynx. Likewise, the expression of MED15 was found to be higher in oral cavity/oropharyngeal tumors compared with tumors from the hypopharynx or larynx.

The study also investigated whether MED15 levels were associated with any of the risk factors for HNSCC, such as tobacco use, alcohol consumption, or chronic oncogenic human papillomavirus infections. Only heavy alcohol consumption was found to be significantly associated with MED15 overexpression, shedding light on the possible mechanism of action of alcohol’s adverse influence.

Dr. Perner and his co-investigators believe MED15 may be a molecular marker that can be used to predict the risk for development of tumor recurrence or metastases that can help clinicians make early diagnosis and treatment decisions. Support for this hypothesis comes from their observations that in 74% of cases, there was a concordance for the presence or absence of MED15 overexpression in samples from a patient’s primary tumor and corresponding lymph node metastasis. In addition, MED15 expression correlated with high proliferative activity in HNSCC tissues and genetic inhibition of MED15 reduced both cell proliferation and migration. They also found that MED15 was highly expressed in the HNSCC malignant cell lines HSC-3 and SCC-25.

“Such observations indicate that MED15 overexpression is likely to be a clonal event in the progression of HNSCC,” explained Dr. Perner. (A clonal event is a mutation, deletion, or translocation that occurs within a tumor and recurs in a significant proportion of patients.) “These findings regarding MED15 overexpression are particularly significant, as genetic alterations that provide cells with growth advantages and metastatic potential may be present only in subpopulations of cells in the primary tumor, but increase in tissue from metastases and relapsed HNSCC tumors.” He suggests that a MED15 inhibitor may be a future therapeutic option, especially for patients with advanced disease and tumor recurrence.

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Head and neck cancer on rise in young men

Mon, Mar 23, 2015

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Source: www.healthcanal.com
Author: staff

“The head and neck cancers we have found in younger men with no known risk factors such as smoking are very frequently associated with the same HPV virus that causes cervical cancer in women.” said Kerstin Stenson, MD, a head and neck cancer surgeon at Rush and a professor of otolaryngology at Rush University. The cancer develops from an HPV infection, likely acquired several years earlier from oral sex.

“Men are more susceptible to these cancers because they don’t seem to have the same immune response as women and do not shed the virus like women do,” Stenson said.

‘Epidemic proportions’
According to the Centers for Disease Control and Prevention, cancers of the oropharynx (back of the throat, including the base of the tongue and tonsils) are usually caused by tobacco and alcohol, but recent studies show that about 72 percent of oropharyngeal cancers are caused by HPV.

“There has been significant change in the last decade. Overall, head and neck cancers account for approximately 3 to 5 percent of all cancers, but what’s changed in the past decade is the HPV-associated oropharyngeal cancer. It has reached epidemic proportions,” said Stenson.

The American Cancer Society estimates that 45,780 Americans will be diagnosed with cancer of the oral cavity and oropharynx in 2015. If this trend continues, the number of cases of HPV-positive oropharyngeal cancer will surpass the number of cervical cancer cases.

Early detection is key
The current vaccine has been shown to decrease the incidence of HPV-associated cervical infections and cancer. While the same result is anticipated for HPV-associated head and neck cancer, the impact of vaccines on incidence of persistent oral HPV infection and/or HPV associated oropharyngeal cancer has not yet been investigated. We will need about 10-30 more years to see the anticipated effect of the vaccine on HPV-related cancers that could affect people who are now teenagers. Still, head and neck surgeons, medical oncologists and other researchers strongly advocate vaccination of both girls and boys to help prevent all HPV-associated cancers.

“For all individuals, the key is in early detection, as with any cancer,” Stenson said.

In addition to being vaccinated, Stenson stresses the importance of regular visits to the dentist. “Dentists play a key role in detecting oral cancer. You might not see a primary care physician even once a year, but most people see their dentist twice a year. Having regular dental visits can help catch cancers early to help ensure the best outcome.”

The American Dental Association states that 60 percent of the U.S. population sees a dentist every year.

Oral cancer warning signs
The Oral Cancer Foundation presumes that cancer screenings of the existing patient population would yield tens of thousands of opportunities to catch oral cancer in its early stages.

“There is much that can be done for those who are diagnosed with head and neck cancer. Since early detection and treatment is critical, it’s important to see your dentist regularly and to promptly see a medical professional if there are any warnings signs,” Stenson advised. Strategies to improve public awareness and knowledge of signs, symptoms, and risk factors are critical topics for study and may decrease the disease burden of head and neck cancers.

Possible warning signs of oral cancer may include difficulty swallowing, pain when chewing, a white patch anywhere on the inside of your mouth, a lump or sore in the mouth or on the lip that does not heal.

If you notice any of these symptoms, ask your dentist or doctor about it.

Treatment includes surgery for early or low-volume late stage lesions and radiation or chemoradiation for more advanced cancers.

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Asia’s deadly secret: the scourge of the betel nut

Mon, Mar 23, 2015

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Source: www.bbc.com
Author: staff

It is used by almost a tenth of the world’s population. It gives people a buzz equivalent to six cups of coffee and is used variously as a symbol of love, marriage and a cure for indigestion and impotence.

But it is also leading tens of thousands to an early grave.

The culprit? The humble betel nut.

Found across Asia, these nuts are harvested from the Areca palm and are chewed for their warming glow and stimulating properties.

Such is its effectiveness, that alongside nicotine, alcohol and caffeine, betel nuts are believed to be one of the most popular mind-altering substances in the world.

Although used by women and children, the nuts are especially popular among working-age men, who chew to stay awake through long hours of driving, fishing or working on construction sites.

But the short-lived benefits come at a terrible cost.

High rates of oral cancer are destroying the lives of many who buy betel nuts, often decades after their first taste.

Now in Taiwan, where the nuts are affectionately known as ‘Taiwan’s chewing gum’, the government is taking action to curb this centuries-old habit and reduce the thousands of lives lost each year.

Dangerous combination

betel-stained

Regular betel nut chewers stand out from the crowd with their red-stained lips and teeth

The betel nut is a key part of many Asian cultures and can be consumed dried, fresh or wrapped up in a package known as a quid.

Although the exact preparation varies across countries and cultures, the quid is usually a mixture of slaked lime, a betel leaf and flavourings such as cardamom, cinnamon and tobacco.

Worryingly, the International Agency for Research on Cancer lists each ingredient, with the exception of cardamom and cinnamon, as a known carcinogen – or cancer-causing agent.

The slaked lime is seen as a particular problem as it causes hundreds of tiny abrasions to form in the mouth. This is thought to be a possible entry point for many of the cancer-causing chemicals.

“About half of the men here still don’t know that betel nuts can cause oral cancer,” says Prof Hahn Liang-jiunn, an oral cancer specialist at the National Taiwan University Hospital.

“[This is despite] Taiwan’s incidence or mortality rates for oral cancer ranking among the top two or three in the world.”

‘I started chewing because everyone else did’

Like most people, Qiu Zhen-huang, 54, was completely unaware of the risks.

A former gravel company worker, he chewed for ten years. Twenty years after quitting, he developed the disease.

“I started chewing betel nut because everyone at work did it,” says Mr Qiu.
“We shared it with each other to build good relations.”

Three years ago, a small hole developed in his left cheek and in just three months, the tumour grew to the size of a golf ball and completely changed his life.

“Whatever I ate flowed out. I had a gauze pad over it. It hurt,” he said.

“It affected me a lot. I was so ashamed I avoided going out.”

Each year, 5,400 Taiwanese men like Mr Qiu are diagnosed with oral cancer or pre-cancerous lesions and an estimated 80 to 90% of those also chew betel nuts.

An early symptom includes white or red lesions inside the mouth, but this can rapidly progress to grotesque flesh-eating tumours.

Unlike other cancers, these are difficult to hide, leaving sufferers physically and psychologically devastated.

“It’s miserable for them,” says Prof Hahn.

“Sometimes, even after surgery, they still can’t perform basic functions, including expressing emotions through their face because the lower jaw also has to be cut depending on the scale of the cancer.”

Tackling the scourge

The Taiwanese government is offering subsidies in return for cutting down betel nut palms

The Taiwanese government is offering subsidies in return for cutting down betel nut palms

Luckily for Qiu Zhen-huang, his cancer was treated and his cheek reconstructed.

But the Taiwanese government is helping people detect the disease much sooner by providing around one million free screenings and funding programs to help people quit betel nuts for good.

In 2013, these measures helped cut the usage rate among men by nearly half.

The government is also trying to reduce the domestic supply of betel nuts by offering subsidies to farmers to cut down their trees and plant alternative crops.

Other countries such as India and Thailand have also launched campaigns to discourage betel nut chewing.

But there is still a way to go. At a recent presentation to elementary school children of fishing industry workers, nearly all raised their hands when asked whether their parents or relatives chewed betel nuts.

And as the cancer can take up to 20 years to appear, the current changes will have come too late for many people – a fact that Mr Qiu keeps close to his heart.

“I’m one of the luckier ones.”

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Giving chew the boot: Rodeo riders lead oral cancer awareness campaign

Fri, Mar 13, 2015

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Source: mohavedailynews.com
Author: DK McDonald
 

LAUGHLIN — Rodeo professionals Carly Twisselman and Cody Kiser are bringing something extra to their competition at the Avi Stampede PRCA Rodeo this weekend.

They are bringing a message to kids.

The public faces of the “Be Smart, Don’t Start” tobacco use awareness campaign, Twisselman and Kiser are sponsored by The Oral Cancer Foundation.

“We’re the first charity to ever be the exclusive sponsors of any rodeo competitors,” said Brian Hill, founder and executive director of The Oral Cancer Foundation. “We go to the rodeos with Carly and Cody to get the word out to kids. 

“As in most things, if we can catch kids early and can show them good role models like Carly and Cody, who are fierce competitors and great people, they can see that tobacco doesn’t have to be a part of being a great cowboy or cowgirl.”

The Professional Rodeo Cowboys Association and tobacco have a history; until 2009 the PRCA accepted tobacco sponsorship money to fund the sport. 

“Now, the PRCA disassociated itself with spit tobacco companies back in 2009 and they’re no longer financial sponsors of rodeo,” said Hill. “It was really a great thing for PRCA to do. That being said, the people who attend and the competitors themselves still tend to be heavy users of tobacco, spit tobacco and cigarettes.”

Spit tobacco, which can refer to smokeless tobacco, dip, snuff, chew, and chewing tobacco, according to the OCF, can cause gum disease, tooth decay, and white patches and oral lesion that can lead to oral cancer.

“I grew up rodeoing in a huge ranching family in California,” Twisselman said. “I have family members who have had problems with tobacco and I thought being a spokesperson for OCF would be a great way to get the youth out there that look up to rodeo athletes and show them that you don’t have to be smoking or doing drugs to be successful.”

“We’re non-confrontational,” Hill said. “I don’t believe that you convert people to your way of thinking by being anti-everything and getting in their face about it. Our message is directed at kids and usually kids that are too young to have even thought about picking up tobacco. If we can keep them from even starting, we’ve won the battle.”

“When the opportunity came up to do this, I wanted to get into it right away,” Kiser said. “I got involved because I want to make a difference, not only in rodeo but also in young people’s lives. 

“It’s a lot more to it than trying to get people information about oral cancer. It’s trying to change the sport of rodeo. One day, we might be able to have an oral cancer night at a rodeo and everyone will wear maroon. Trying to move rodeo in a positive direction — it would be tremendous to be a part of that.”

“We’re both put in front of thousands of people all the time,” said Twisselman. “What better way to use that exposure than to do good and to show our future generations that this sport isn’t about drugs and alcohol or smoking.”

“After doing this for a while now, I look at other people that are trying to do good in the community,” said Kiser. “It’s changed my outlook on wanting to do more for the community and for other people. It’s opened my eyes to getting involved more.” 

Kiser competes in the men’s bareback bronc riding competition at the Avi Stampede PRCA Rodeo today; Twisselman competes in the women’s barrel racing on Sunday.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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Cure Possible for Some HPV-Positive Oropharyngeal Cancers

Thu, Mar 12, 2015

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Source: www.medscape.com
Author: Fran Lowry

In a subset of patients with human papillomavirus (HPV)-related oropharyngeal cancer, the goal of achieving a “cure” is a realistic one, even in patients who have limited distant metastases, a prospective study has shown.

Of the patients with HPV-positive oropharyngeal cancer and distant metastases, 10% survived more than 2 years after intensive treatment, which the researchers defined as a cure.

The study was presented at the 5th International Conference on Innovative Approaches in Head and Neck Oncology (ICHNO) in Nice, France.

The research was praised by Jean Bourhis, MD, head of the Department of Radiation Oncology at Centre Hospitalier Université Vaudois in Lucerne, Switzerland, and cochair of the ICHNO conference scientific committee.

“This important piece of research adds substantially to what we know about the role and the importance of the human papillomavirus in oropharyngeal cancers and gives real hope of improvement in both diagnosis and treatment to those who are affected by the condition,” he said in a statement.

This study, from a world-leading group of head and neck cancer experts, is very interesting, and related to relevant clinical and interdisciplinary questions,” said Daniel Zips, MD, professor of radiation oncology at the University of Tübingen in Germany.

“HPV status is also important for the management of metastatic disease,” he told Medscape Medical News.

He agrees that for some patients with HPV-positive oropharyngeal cancer, using the researchers’ definition, a cure is possible.

“I also agree that the results from this study might begin to change the view of this disease and provide some hope for patients and their families,” Dr Zips explained.

Distant Metastases Are Main Form of Failure
“The majority of patients with HPV-related oropharyngeal cancer can be cured, but distant metastasis can occur in about 15% of patients. In fact, distant metastasis has become the main form of failure for this patient population,” lead author Sophie Huang, a radiation therapist and assistant professor at the University of Toronto. Dr Huang was a physician in China but is an MRT(T) — a radiation therapist — in Canada.

“When distant metastasis occurs, it is generally viewed as incurable disease. However, long-term survival after distant metastasis has been observed in nasopharyngeal cancer patients, which is another viral-related head and neck cancer, associated with the Epstein–Barr virus. Also, long-term survival in HPV-related OPC patients with distant metastasis has also been reported, but anecdotally,” Dr Huang told Medscape Medical News. “Are these just miracles? And would more miracles be found if we were able to understand how they happen?”

Dr Huang and her colleagues established a prospective database in which they collected data on enough patients to allow them to study how distant metastasis is manifested, how the cancer behaves after distant metastasis, and whether there are any factors that influence survival after distant metastasis.

“We felt that the answers to these questions would help us tailor surveillance strategies for the early detection of distant metastasis and explore optimal management algorithms to improve outcomes,” she explained.

Prospective Follow-up of Patients
The team evaluated 1238 consecutive oropharyngeal cancer patients treated at the Princess Margaret Cancer Centre in Toronto from 2000 to 2011. They identified 88 patients with HPV-related cancer and 54 with smoking-related cancer who were HPV-negative, all with distant metastases.

They assessed the pace of the manifestation of the distant metastases, characteristics, and patient survival, and identified factors that might predict longer survival.

The proportion of patients with distant metastases was similar in the two groups. However, metastases associated with HPV-positive oropharyngeal cancer had a later onset, different characteristics, and longer survival than those associated with HPV-negative oropharyngeal cancer.

Specifically, more than 94% of metastases occurred in the first 2 years after treatment in HPV-negative patients, whereas only a quarter occurred in HPV-positive cancers. In the HPV-positive group, some occurred after 5 years.

“This observation indicates that HPV-related OPC patients who are disease-free for 2 years are not out of the woods. A longer surveillance period for HPV-related OPC patients is needed to detect, and hopefully cure, distant metastases,” Dr Huang said.

Additionally, the researchers found two phenotypes of distant metastases in HPV-positive patients.

The disseminating phenotype is aggressive and spreads to multiple organs in a short period of time. This phenotype was found in 55% of the HPV-positive group but in 0% of the HPV-negative group.

The indolent phenotype is characterized by a few lesions growing at a slow pace, and manifesting as oligometastasis, with five or fewer lesions. In patients with metastases in a single organ, this phenotype was found in 24% of the HPV-positive group and in 26% of the HPV-negative group.

The lung was the most common site for distant metastasis in both groups.

“This indolent phenotype has longer survival and might be curable,” Dr Huang reported.

More HPV-positive than HPV-negative patients were specifically treated for distant metastasis (60% vs 31%)

table1

More HPV-positive patients with distant metastases than HPV-negative patients survived to 3 years (25% vs 15%; P = .01).

“The survival advantage in HPV-positive patients is due to a number of factors. The cancer is more sensitive to radiotherapy and chemotherapy, patients tend to be younger by about 10 years, and they have fewer other health problems, including those caused by smoking. This allows them to receive the more aggressive treatment necessary to eradicate metastatic disease,” Dr Huang explained.

table2

“This research shows that metastatic HPV-positive patients who receive active treatment can survive considerably longer. One of the reasons patients with metastatic disease fail to receive aggressive treatment is due to the physician and patient perception that this is an incurable state. We hope these results will motivate researchers to optimize management strategies for these patients,” Dr Huang said.

“The first distant metastasis site is mostly in the chest region,” she noted. In fact, most of the cured patients had lung metastasis. “Computed tomography of the thorax for the early detection of distant metastases” might enhance the cure rate for this disease, she added.

Future studies should look for ways to identify patients at initial presentation who are at high risk for distant metastasis, and which type of distant metastasis will develop.

“We know there is a degree of correlation between the initial stage and the risk of distant metastasis, but we did not find a strong relationship between this stage and the type of metastasis,” Dr Huang reported. “The intensity of cigarette smoking in the years prior to the time of diagnosis is a possible factor. Being able to identify such relationships could be a huge help in deciding appropriate treatment at an early stage.”

Note:

1. Dr Bourhis, Dr Zips, Dr Huang, have disclosed no relevant financial relationships.
2. 5th International Conference on Innovative Approaches in Head and Neck Oncology (ICHNO): Abstract OC-044. Presented February 13, 2015.

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Study finds how T cells cause inflammation with oral candidiasis

Thu, Mar 12, 2015

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Source: www.drbicuspid.com
Author: Donna Domino, Features Editor

Ohio dental researchers have found a method to study how T cells cause inflammation during oral candidiasis infections, according to a new study in the Journal of Visualized Experiments (February 18, 2015). The discovery could lead to new therapies or drugs that may improve the functioning of weakened immune systems.

Pushpa Pandiyan, PhD, an assistant professor at Case Western Reserve School of Dental Medicine, and colleagues worked on mice to find a new way to model how T cells, the white blood cells critical for the body’s immune system, cause inflammation.

Pandiyan’s previous work focused on isolating different types of oral T cells for study. In the latest study, the researchers injected T cells into genetically engineered immunodeficient mice to test how the cells function when fighting Candida albicans, a fungus found in about 60% of the population but controlled by a functioning immune system.

The infection becomes a particular health problem for people with the HIV/AIDS infection, cancer patients with immune systems weakened by chemotherapy, or those born with no immune defenses.

The researchers investigated how IL-17a (T helper 17, or Th17 cells, a type of T cells that secrete a cytokine) and T regulatory cells (Tregs) controlled the fungal infection and inflammation, respectively.

“Although Th17 cells are required for antifungal immunity, uncontrolled Th17 cells have been implicated with such illnesses as multiple sclerosis, lupus, psoriasis, cancers, and irritable bowel disease,” Pandiyan said in a statement.

The immunodeficient mice were infected with the fungus and injected with Th17 cells. One group of mice was also injected with Tregs.

The group of mice that received both Th17 and Tregs fared better in stopping the infection and thriving during inflammation, the researchers found. The other group of mice that did not receive Tregs lost weight and began to waste away.

The researchers also found the immune system doesn’t work well when the Th17 cells malfunction without appropriate control. “They can set into action a series of immune responses that develop into inflammation and greater health issues,” Pandiyan said.

While Pandiyan studied Th17′s role in fighting C. albicans, other researchers could use the method to study Th17 cell functions in other areas of the body, she noted.

Pandiyan believes the process could lead to identifying and testing new drugs to replace antifungal medicines that have become ineffective as the fungi develop a resistance to them.

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NIH-funded study finds new potential drug targets by uncovering a range of molecular alterations in head and neck cancers

Tue, Mar 10, 2015

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Source: www.nih.gov
Author: Staff
 

Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences — with potentially important clinical implications — in head and neck cancers caused by infection with the human papillomavirus (HPV). HPV is the most common sexually transmitted virus in the United States, and the number of HPV-related head and neck cancers has been growing. Almost every sexually active person will acquire HPV at some point in their lives, according to the Centers for Disease Control and Prevention.

The researchers also uncovered new smoking-related cancer subtypes and potential new drug targets, and found numerous genomic similarities with other cancer types. Taken together, this study’s findings may provide more detailed explanations of how HPV infection and smoking play roles in head and neck cancer risk and disease development, and offer potential novel diagnostic and treatment directions.

The study is the most comprehensive examination to date of genomic alterations in head and neck cancers. The results were published online Jan. 28, 2015 in the journal Nature. TCGA is jointly supported and managed by the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI), both parts of the National Institutes of Health.

The U.S. Food and Drug Administration-approved HPV vaccines should be able to prevent the cancers caused by HPV infection in head and neck cancers and elsewhere, including anal cancer, whose incidence has also been increasing. However, these vaccines work by preventing new infections, and the long interval between infection and cancer development make it important to understand the molecular changes that bring about these HPV-positive head and neck cancers — as well as those that lead to the HPV-negative cancers — and to develop new approaches for treating them.

“The rapid increase in HPV-related head and neck cancers, noticeably in oropharyngeal tumors, has created an even greater sense of urgency in the field,” said D. Neil Hayes, M.D., M.P.H, senior author of the study report and associate professor of medicine at the University of North Carolina (UNC) and the UNC Lineberger Cancer Center at Chapel Hill. Oropharyngeal cancer starts in the oropharynx, which is the part of the throat just behind the mouth. “We’re uncovering differences between tumors with and without HPV infection, and these new data are allowing us to rethink how we approach head and neck cancers.”

In the study, researchers performed genomic analyses on 279 tumors – head and neck squamous cell carcinomas (HNSCC) – from untreated patients. Approximately 80 percent of tumor samples were from individuals who smoked. The majority of samples were oral cavity cancers (61 percent) and larynx cancers (26 percent).

While only about 25 percent of head and neck cancers are linked to HPV infection, TCGA researchers confirmed that many patients with HPV-associated tumors have specific alterations of the gene FGFR3 and mutations in the PIK3CA gene, which are also found in a much broader set of mutations in smoking-related tumors. In contrast, while the EGFR (epidermal growth factor receptor) gene is frequently altered in HPV-negative tumors in smokers, it is rarely abnormal in HPV-positive tumors. Such insights may help in developing potential therapies and biomarkers, noted Dr. Hayes.

Head and neck cancers comprise a constellation of tumors of the mouth, throat, larynx, nasal cavity, salivary gland and elsewhere that have frequently been attributed to tobacco and alcohol use in most patients. Some 90 percent are squamous cell carcinomas, which occur in the surface layers of cells in the body. An estimated 55,000 people developed head and neck cancer in the United States in 2014. Approximately 12,000 Americans die from the diseases each year. Head and neck cancers are common worldwide, with more than 600,000 cases diagnosed each year.

“The rising worldwide incidence of head and neck cancers makes these types of large integrated genomic analyses by TCGA vital to establish a more detailed understanding of disease causes and behavior, and for the development of new treatment approaches,” said NIH Director Francis S. Collins, M.D., Ph.D.

Scientists found that more than 70 percent of head and neck cancers had alterations in genes for growth factor receptors (EGFR, FGFR, IGFR, MET, ERBB2, DDR2), signaling molecules (PIK3CA, HRAS) and cell division regulation (CCND1). These genes may play roles in pathways that control cell growth and proliferation, and for which therapies are either available or in development.

The investigators also discovered new clues about drug resistance in head and neck cancers. They found that genes affecting about 40 percent of such cancers form key parts of a pathway that helps determine cell survival and drug resistance. They showed that extra copies of the genes FADD and BIRC2, or mutations in or the absence of the CASP8gene in smoking-related cancers — all which affect the process of programmed cell death — may underlie the resistance of cancer cells to current treatments. Similarly, the absence of the TRAF3 gene, or extra copies of a gene for the growth-promoting E2F1 protein in HPV-related cancers, may also increase resistance.

The findings showed similarities between head and neck cancer genomes and other cancers, including squamous cell lung and cervical, indicating possible common paths of cancer development, and potential treatment opportunities. “It is surprising to see that head and neck tumor genomes are remarkably similar to cervical and squamous lung cancer genomes. They are from very different organs, but they show similar losses and gains of genetic material across tumors,” Dr. Hayes noted. These common genetic abnormalities belong to a pathway that protects cells from damage and stress.

“These novel findings help establish a genomic map of various head and neck cancers, provide new insights into other similar cancers and may further our understanding of how viruses can impact disease,” said NHGRI Director Eric D. Green, M.D., Ph.D.

“While many head and neck cancers are preventable, they are increasingly common throughout the world, and often challenging to effectively treat over the long term,” said NCI Director Harold Varmus, M.D. “This type of broad analysis provides important new clues for future research and treatment directions.”

The TCGA Research Network has generated data and published analyses on a number of cancers, all of which can be found on the TCGA website, http://www.cancergenome.nih.gov.

TCGA-generated data are freely available at the TCGA Data Portal and CGHub.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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Tufts dental school to add oral medicine residency program

Wed, Feb 25, 2015

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Source: www.drbicuspid.com
Author: DrBicuspid Staff

The Tufts University School of Dental Medicine will begin enrolling students in its new Advanced Education Program in Oral Medicine in July 2016, according to a Tufts Daily article.

The program is a two-year postgraduate certificate with the option for a three-year master’s degree track, according to the university. Teaching students how to treat oral symptoms of various diseases and conditions is the aim of the program.

The program teaches dentists to be responsible for the early detection and diagnosis of oral cancer and other malignancies that manifest in the oral cavity. Dentists will be trained to treat the oral manifestations of infectious diseases, including HIV; autoimmune and immune-related diseases such as lupus; and metabolic disorders such as diabetes.

Bhavik Desai, DMD, PhD, an assistant professor of oral medicine and temporomandibular joint disorder at the Virginia Commonwealth School of Dentistry, will begin as the program director on July 1.

Oral medicine is not yet recognized as a specialty by the ADA; the American Academy of Oral Medicine (AAOM) oversees the discipline and is responsible for certifying dentists in the field, according to Interim Program Director Arwa Farag. The program received accreditation from the Commission on Dental Accreditation (CODA) in August 2014.

The AAOM has encouraged the expansion of training programs, because there are only six other dental schools in the U.S. that offer training in oral medicine.

Only 3% of hospitals with cancer programs have oral medicine specialists, and patients are often directed to other departments that are not trained to handle medical issues such as head and neck cancers.

Residents in the program will work with other clinics such as the Cranofacial Pain Center, which sees 1,500 to 2,000 patients annually and allows residents to gain experience working with patients, according to the article.

Residents will also be required to do hospital rotations at the Tufts Medical Center in departments including internal medicine, hematology, dermatology, and rheumatology. They will also conduct visitations at the University of Massachusetts Memorial Medical Center and other Tufts facilities that serve patients with related needs.

If students choose to continue for a third year, they will do either clinical or laboratory research at the School of Dental Medicine, the Sackler School of Graduate Biomedical Sciences, or the Jean Mayer U.S.D.A. Human Nutrition Research Center on Aging.

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