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    Laser Treatment Halts Oral Mucositis in Its Tracks

    Mon, May 4, 2015


    Source: www.medscape.com

    Author: Fran Lowry


    Spa-like treatment with a cool, low-level laser, similar to that use

    for wrinkles, vanquishes oral mucositis, one of the most debilitating

    toxicities of cancer therapy.


    “I have been an oncology nurse for over 25 years, and in those 25

    years, there has been nothing that helps prevent or is effective

    against the treatment for oral mucositis, until now,” said Annette

    Quinn, RN, MSN, from the University of Pittsburgh Cancer Institute.


    “Patients say they rank it higher than nausea and vomiting when it

    comes to adverse side effects, especially because we have good

    medications to control nausea and vomiting. But the low-level laser

    works better than we could have hoped,” Quinn told Medscape Medical



    She presented results from a pilot project at the Oncology Nursing

    Society (ONS) 40th Annual Congress in Orlando, Florida.


    Oral mucositis affects virtually all head and neck cancer patients

    undergoing chemo and radiation therapy, and about 75% to 100% of

    patients undergoing stem cell transplantation with whole-body

    irradiation experience some degree of oral mucositis.


    Low-level laser therapy (LLLT) has been used to treat oral mucositis

    for a decade in Europe and South America, but it has not made its way

    to the United States because there is no mechanism for reimbursement,

    Quinn reported.


    She hopes this study will change that.


    “Reimbursement is the main obstacle to its use in the United States,

    but for this study, I was able to secure the treatment through a

    grant. Treating oral mucositis could easily add $20,000 to the cost of

    patient care, but with the laser, we can decrease hospital

    readmissions and the use of pain medication, IV antibiotics, and

    feeding-tube placements. Even though we cannot receive reimbursement,

    laser treatment is still cost-effective,” she said.


    It is thought that LLLT works on the mitochondria to displace the

    nitric oxide that is generated as a result of radiation or

    chemotherapy, and helps to reoxygenate the cells, Quinn explained.


    In the pilot project, 52 patients with head and neck cancer, all

    deemed to be at high risk for oral mucositis, received LLLT 830 nm

    wavelength three times a week, starting the first week of their

    radiation treatment and continuing throughout the course of their

    radiation therapy.


    The initial intent was to see if the laser could control the oral

    mucositis so patients would not be forced to have a break in their

    treatment, Quinn explained.


    “We know that patients who miss 5 days or more of radiation therapy

    have poorer survival, so we wanted to focus on how to get these

    patients through with no treatment breaks. We didn’t realize that we

    would get them through with no mucositis. But we found that the very

    first patient we treated made it all the way through,” she said.


    None of the 52 patients treated with LLLT developed any oral mucositis.


    When oncologists treating stem cell transplantation patients

    discovered these results, they brought 23 of their stem cell

    recipients for LLLT. These patients were treated until their absolute

    neutrophil count was above 1000 cell/nm³.


    Again, results were excellent, although two patients developed grade 3

    oral mucositis.


    “Normally, 100% of stem cell patients develop oral mucositis. It’s

    unbelievable what the therapy has done for oral mucositis,” Quinn noted.


    LLLT Simplicity Itself


    “The treatment is administered immediately after the radiation

    therapy. It takes only about 6 to 8 minutes to administer, and is all

    done extraorally; none of the probes actually go into the mouth unless

    the patient develops a lesion inside the mouth that we need to target

    with the probe,” Quinn explained.

    It is simplicity itself, and it works so incredibly well. We just have

    to get the word out.


    “We do five sites along their face, right along the jaw line, and then

    we do their tongue. The patients love it. We call it their spa time.

    It’s the same laser they use in cosmetics to prevent wrinkles. We have

    not had one patient tell us they want to stop their treatment, and we

    have had no adverse side effects,” she said.


    The learning curve is very slight, Quinn added.


    The training takes about half a day, and learning how to use the

    equipment only takes about 30 minutes. “It’s just cold laser therapy,

    there’s no heating, there’s no cutting. Nothing. It is simplicity

    itself, and it works so incredibly well. We just have to get the word

    out,” she said.


    The poster generated a lot of buzz among the nurses attending the

    Congress, noted Ruth C. Gholz, RN, MSN, from the Cincinnati Veterans

    Administration Medical Center.


    “There was a lot of excitement about the laser to treat oral

    mucositis. So many people were talking about it,” Gholz told Medscape

    Medical News.


    Oral mucositis is a debilitating side effect that challenges us as we

    move forward with patients and providers. Low-level laser therapy has

    been a recognized treatment per guidelines, yet many have limited to

    no experience in its use,” she said.


    Gholz explained that these results challenge “all practices to

    incorporate low-level laser therapy into their armamentarium.”


    “The future is bright as we move forward in maximizing this therapy,”

    she added.


    Ms Quinn and Ms Gholz have disclosed no relevant financial relationships.


    Oncology Nursing Society (ONS) 40th Annual Congress: Abstract 84.

     Presented April 24, 2015.

    Medscape Medical News © 2015  WebMD, LLC Send comments and news tips to news@medscape.net.

    *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

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    Three things you might not know about HPV

    Wed, Apr 29, 2015


    Source: www.huffingtonpost.ca
    Author: Sunnybrook Health Sciences Centre

    April 26 to May 2 is National Immunization Awareness week in Canada. One immunization known for raising a lot of questions is the Human Papillomavirus (HPV) vaccination, provided free of charge in Ontario to girls in grades 8-12, and following provincial schedules across the country.


    While there is lots of information online, at school and at the doctor’s office about HPV, there is still a lot of confusion about what it may mean for your loved ones. Dr. Nancy Durand, gynecologist at Sunnybrook, explains three little-known facts about HPV.

    1) HPV causes cancer in men, too
    When Michael Douglas candidly revealed his oral cancer was caused by HPV, many people expressed surprise.

    Even though HPV has traditionally been thought of as a disease that affects women and mainly causes cervical cancer, men are actually at higher risk of being diagnosed with certain types of HPV-positive cancers than women.

    “It’s not well understood why men are at higher risk for HPV-positive oral cancer, but it does point out that vaccination in men is even more important than we may have previously thought,” says Dr. Durand. Physicians are learning more and more that HPV can also cause other cancers in both women and men, such as anal cancers and head & neck cancers (cancers of the base of the tongue, tonsils and soft palate).

    2) Not all HPV infections lead to cancer
    You’ve probably read some of the (slightly scary) statistics about HPV: Three in four Canadians will get HPV in their lifetime. It can lead to a variety of cancers and cause genital warts, and there is no cure. But should this keep you up at night, worrying about the potentially deadly consequences of HPV?

    Hardly, says Dr. Durand. “Most people who are infected with this virus will clear it — probably 80 per cent of people. It’s the other 20 per cent of people with a persistent infection who may be at risk of cancer, and it’s still only a very small percentage of those people who may go on to develop cancer,” she says.

    Many people never even realize they’ve had an HPV infection, as there are usually no symptoms, and the infection often goes away on its own.

    3) You’re never too old to get the HPV vaccine
    What if you didn’t get the HPV vaccine back in middle school, and now you think it’s too late to get it?

    “Regardless of your age and your onset of sexual activity, we can vaccinate both men and women, and we can see a reduction in disease,” says Dr. Durand.

    It’s actually not too late — the vaccine can still be effective, even in adults who’ve already been sexually active. “Many people think vaccination can only be done before the onset of sexual activity. But regardless of your age and your onset of sexual activity, we can vaccinate both men and women, and we can see a reduction in disease,” says Dr. Durand.

    Anyone, male or female, over the age of nine can be vaccinated. So, if you’ve put off getting the vaccine because you thought you were too old, it’s not too late!

    Note: Co-authored by Sybil Millar, Communication Advisor at Sunnybrook Health Sciences Centre

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    U-M scientists observe deadly dance between nerves and cancer cells

    Wed, Apr 29, 2015


    Source: ns.umich.edu
    Author: Laura Bailey

    In certain types of cancer, nerves and cancer cells enter an often lethal and intricate waltz where cancer cells and nerves move toward one another and eventually engage in such a way that the cancer cells enter the nerves.

    The fluorescence image shows the interaction between the nerve (red) and cancer (green). Image credit: Nisha D’Silva

    The fluorescence image shows the interaction between the nerve (red) and cancer (green). Image credit: Nisha D’Silva

    The findings, appearing in Nature Communications, challenge conventional wisdom about perineural invasion, which holds that cancer cells are marauders that invade nerves through the path of least resistance, said Nisha D’Silva, principal investigator and professor at the University of Michigan School of Dentistry.

    D’Silva’s lab discovered that perineural invasion is actually a much more intricately choreographed biochemical give-and-take between the nerves and the cancer cells.

    “Once head and neck cancer invades the nerves, it is one of the worst things that can happen,” said D’Silva, who also has a joint appointment at the U-M Medical School Department of Pathology and is a member of the U-M Cancer Center’s Head and Neck Oncology program. “It is highly correlated with poor patient survival, and there is no targeted treatment for it because it is not known why some tumors do this and some don’t.”

    Perineural invasion is seen most in head and neck, pancreatic, stomach and colon cancers, and causes severe pain or numbness, tumor spread and recurrence, and loss of function, among other complications.

    D’Silva’s lab found that perineural invasion begins when the nerve releases a stimulus that triggers a specific protein receptor in cancer cells. The receptor activates instructions in the cancer and releases the same stimulus back to the nerve.

    The photomicrograph shows a nerve (central structure) invaded by cancer cells. Image credit: Nisha D’Silva

    The photomicrograph shows a nerve (central structure) invaded by cancer cells. Image credit: Nisha D’Silva

    The nerve recognizes the stimulus, which causes the nerve to ‘reach’ toward the cancer—imagine two dancers recognizing each other across a room and slowly moving closer until they become permanent partners. After this initial pairing up, the loop continues.

    “Basically it’s like they are waltzing,” D’Silva said. “It is a very elegant dance, if you will.”

    It is extremely difficult to study perineural invasion in head and neck cancer, so D’Silva’s lab had to develop a way to observe these interactions in live samples. First, researchers implanted the nerve in chick egg membranes, and after the nerve integrated, they studied the interactions between the nerve and head and neck cancer cells.

    D’Silva said the next steps in the research are to find out, “when and how we can interrupt the dance.”

    The study is called “Galanin modulates the neural niche to favor perineural invasion in head and neck cancer.”

    Christina Scanlon, a recently graduate of the U-M School of Dentistry, is first author on the paper. Other co-authors include: Rajat Banerjee, Ronald Inglehart, Min Liu, Nickole Russo, Amirtha Hariharan, Elizabeth Van Tubergen, Sara Corson and Charlotte Mistretta of U-M Dentistry; and Irfan Asangani and Arul Chinnaiyan of the U-M Medical School.

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    Turmeric spice potential for oral cancer – curcumin quiets HPV

    Wed, Apr 29, 2015


    Source: www.science20.com
    Author: staff

    Turmeric, the familiar yellow spice common in Indian and Asian cooking, may play a therapeutic role in oral cancers associated with human papillomavirus, according to new research published in ecancermedicalscience. One of the herb’s key active ingredients – an antioxidant called curcumin – appears to have a quelling effect on the activity of human papillomavirus (HPV).

    HPV is a virus that promotes the development of cervical and oral cancer. There is no cure, but curcumin may offer a means of future control.

    “Turmeric has established antiviral and anti-cancer properties,” says corresponding author Dr. Alok Mishra of Emory University. “And according to our new findings, we could say that it’s good for oral health too.”

    Mishra’s research group first noted the effect of curcumin on HPV and cervical cancer cells in 2005. The antioxidant slowed the expression of HPV, suggesting that curcumin could control the extent of HPV infection.

    “Since HPV-related oral cancer cases are on the rise, we tested the same hypothesis on oral cancer,” Mishra says. “They turned out to be some very interesting findings.”

    The new research indicates that curcumin turns down the expression of HPV in infected oral cancer cells by downregulating the levels of cellular transcription factors AP-1 and NF-kB.

    These findings could suggest a new therapeutic role for cucurmin in cancer control.

    While Mishra cannot comment on the therapeutic benefits of turmeric in cooking, he says that the use of turmeric and other antioxidants may be good for health in general, and HPV-related oral cancers in particular.

    Citation: Alok Mishra, Rakesh Kumar, Abhishek Tyagi, Indu Kohaar, Suresh Hedau, Alok C Bharti, Subhodeep Sarker, Dipankar Dey, Daman Saluja, Bhudev Das, ‘Curcumin modulates cellular AP-1, NF-kB, and HPV16 E6 proteins in oral cancer’, ecancermedicalscience 22 Apr 2015 DOI: 10.3332/ecancer.2015.525

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    Double the N.I.H. Budget

    Wed, Apr 22, 2015


    Source: NYTimes.com
    Author: Newt Gingrich

    MCLEAN, Va. — NO one who lived through the 1990s would have suspected that one day people would look back on the period as a golden age of bipartisan cooperation. But in some important ways, it was. Amid the policy fights that followed the Republican victories of 1994, President Bill Clinton and the new majorities in Congress reached one particularly good deal: doubling the budget for the National Institutes of Health.

    The decision was bipartisan, because health is both a moral and financial issue. Government spends more on health care than any other area. Taxpayers spend more than $1 trillion a year for Medicare and Medicaid alone, and even more when you add in programs like Veterans Affairs, the Children’s Health Insurance Program and the Indian Health Service.

    Unfortunately, since the end of the five-year effort that roughly doubled the N.I.H. budget by 2003, funding for the institutes has been flat. The N.I.H. budget (about $30 billion last year) has effectively been reduced by more than 20 percent since then. As 92 percent of the N.I.H. budget goes directly to research, one result is that the institutes awarded 12.5 percent fewer grants last year than in 2003. Grant applications, over the same period, increased by almost 50 percent.

    Even as we’ve let financing for basic scientific and medical research stagnate, government spending on health care has grown significantly. That should trouble every fiscal conservative. As a conservative myself, I’m often skeptical of government “investments.” But when it comes to breakthroughs that could cure — not just treat — the most expensive diseases, government is unique. It alone can bring the necessary resources to bear. (The federal government funds roughly a third of all medical research in the United States.) And it is ultimately on the hook for the costs of illness. It’s irresponsible and shortsighted, not prudent, to let financing for basic research dwindle.

    For example, the total cost of care for Alzheimer’s and other dementia is expected to exceed $20 trillion over the next four decades — including a 420 percent increase in costs to Medicare and a 330 percent increase in costs to Medicaid. Even without a cure, the premium on breakthrough research is high: Delaying the average onset of the disease by just five years would reduce the number of Americans with Alzheimer’s in 2050 by 42 percent, and cut costs by a third. And that’s not even counting the human toll on both patients and caregivers (often family members), whose own health may deteriorate because of stress and depression.

    Yet the N.I.H. is spending just $1.3 billion a year on Alzheimer’s and dementia research — or roughly 0.8 percent of the $154 billion these conditions will cost Medicare and Medicaid this year, more than all federal education spending.

    Alzheimer’s isn’t unique: Diabetes, kidney disease, heart disease, cancer, stroke and arthritis all cost enormous sums and cause incredible suffering. But the promise of breakthrough cures and treatments for this disease is amazing. The N.I.H. is funding a clinical study that represents a potential paradigm shift in treatment. Rather than try to eliminate the buildup of plaques in the brain after the onset of dementia, researchers are studying interventions in families with a genetic predisposition to early onset Alzheimer’s to prevent the disease before symptoms even develop.

    The N.I.H. is also pioneering the development of immunotherapies, which are already allowing doctors to spur patients’ immune systems to attack cancer and other diseases rather than relying solely on surgery, radiation and chemotherapy. The N.I.H. recently discovered a vaccine that appears to cure an AIDS-like virus in monkeys. The insights from genetics, personalized medicine and regenerative therapies could potentially lead to substantially longer and healthier lives for many. But to achieve that promise will require a greater budget.

    Representatives Fred Upton, Republican of Michigan and the chairman of the House Energy and Commerce Committee, and Diana DeGette, Democrat of Colorado, have put forward an initiative, 21st Century Cures, to explore ways to promote the discovery of medical breakthroughs as well as access to new technologies. Ms. DeGette and another committee

    member, Michael C. Burgess, Republican of Texas and a physician, have called for requiring the Congressional Budget Office to factor in the savings from preventive health measures when “scoring” the financial impact of proposed legislation, at the request of Congress. In the Senate, Lamar Alexander of Tennessee, Ron Johnson of Wisconsin and Jerry Moran of Kansas, all Republicans, have championed increasing funding for basic research.

    House and Senate negotiators are at work on a budget resolution for the fiscal year that starts on Oct. 1, and the N.I.H. should be a priority. Doubling the institutes’ budget once again would be a change on the right scale, although that increase should be accompanied by reforms to make the N.I.H. less bureaucratic, to give the director more flexibility to focus resources on the most common and expensive health problems, and to place a stronger emphasis on truly breakthrough research.

    We are in a time of unimaginable scientific and technological progress. By funding basic medical research, Congress can transform our fiscal health, and our personal health, too.

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    HPV vaccine may work for people who already had the virus

    Wed, Apr 22, 2015


    Source: time.com
    Author: Alexandra Sifferlin

    A new study underlines the effectiveness of the HPV vaccine, showing the vaccine is protective against the virus on multiple sites on the body, even for women who have been infected in the past.

    TIME.com stock photos

    In a randomized controlled trial—considered the gold standard of scientific research—scientists wanted to know if the HPV vaccine protected against cervical, anal and oral HPV. Daniel C. Beachler, a postdoctoral fellow in the Infections and Immunoepidemiology Branch of the National Cancer Institute (NCI), and his colleagues followed 4,186 women between the ages of 18 to 25 who were either vaccinated with a HPV16/18 vaccine or a control vaccine (a hepatitis A vaccine). Cervical samples from the women were collected at their annual visits and oral and anal samples were collected at a four-year follow-up visit.

    “We were interested in the question of whether the vaccination may protect non-infected sites against HPV infection or re-infection in women who were previously exposed to HPV prior to vaccination,” says Beachler. The study was presented at the American Association for Cancer Research annual meeting.

    The results showed that the efficacy for the vaccine in all three sites was 83% among the women with no evidence of prior HPV exposure and infection, 58% among women with prior HPV exposure, and a 25% among women with active cervical HPV16/18 infection (the percentage was considered nonsignificant). In total, the researchers report that the overall vaccine efficacy was 65% for all sites and 91% for protection in at least two sites.

    Among the women in the trial, some had no evidence of HPV, some had an active HPV infection, and some of the women did not have an active infection but had antibodies for HPV, suggesting that they had been exposed to the virus previously. That’s not uncommon, considering the U.S. Centers for Disease Control and Prevention (CDC) estimates that nearly all sexually active men and women get HPV at some point in their lives.

    The CDC says teen boys and girls who did not start or finish the HPV vaccine series when they were younger should get it, and young women can get the vaccine through age 26 and young men through age 21.

    The CDC says that girls who are already sexually active can still benefit from the vaccine, but it may be less effective since it’s possible they have already been exposed to one or more HPV strains. Still, the CDC says that since young women are not necessarily infected with all types of HPV, they can still benefit from the vaccine. This new study underscores that guidance.

    “[This study] is supportive that there could be some benefit at these older ages,” says Beachler. “Close to 90% of individuals are able to clear an HPV infection on their own. This is not a therapeutic vaccine but it could still help protect from acquisition of new infections.”

    Dr. Miriam Lango, a head and neck cancer surgeon at Fox Chase Cancer Center, says that the new study is some of the “best kind of evidence we have,” in support of vaccinating against HPV in women of that age. “My understanding was always that you get the vaccination before you get the infection and that after you’ve been infected there’s no benefit to having the vaccination,” she says. “That’s really not what the data tells us.” Lango was not involved in the study.

    Beachler noted that at the end of the study, the women in the control arm of the trial were able to get vaccinated against HPV.

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    Medical association says HPV vaccine prevents head and neck cancers

    Wed, Apr 22, 2015


    Source: www.theeagle.com
    Author: Jordan Overturf

    The HPV vaccine has long been touted as a way to prevent cervical cancer. On Monday, the Texas Medical Association said the vaccine also prevents more common head and neck cancers that disproportionately affect white men.

    “I have so many patients, mostly men, affected by this disease, and knowing this is now largely preventable makes prevention efforts more important,” Austin-based oncologist and Texas Medical Association member Dr. Debra Patt said in a statement.

    HPV is the most common sexually transmitted infection, with experts from the Centers for Disease Control and Prevention estimating nearly all sexually active adults will be affected at some point.

    The Texas Medical Association estimates as many as 25,000 people nationwide are diagnosed with HPV-related cancers each year. In recent years, researchers have discovered that 70 percent of head and neck cancers are caused by HPV. The association said cases of cervical cancer, on average, are about 10 percent lower than cases of head and neck cancer. Former Texas Gov. Rick Perry came under fire in 2007 when he attempted to use an executive order to make HPV vaccinations — which require three shots over a six-month period — mandatory for teenage girls.

    Even with one of the two available vaccinations, there is no guarantee the shot will prevent all strains of HPV, said Trisha Sheridan, clinical assistant professor at the Texas A&M Health Science Center College of Nursing.

    “The vaccine protects against the strains that cause a majority of HPV-related cancers and genital warts: HPV strains 6, 11, 16 and 18,” Sheridan said in a February Health Science Center article busting myths about HPV vaccinations. “The HPV vaccines are recommended for girls and boys, ages 11 and 12. While it’s advertised that the vaccines protect against cervical cancer, they also prevent anal, penile and oral cancers caused by the HPV virus,” Sheridan said. “It’s especially important for boys to get, because there’s no current screening for HPV in men. By the time they become aware of the virus, if they ever do, the damage might already be done.”

    The Texas Medical Association in its statement noted that nonsmoking white men between 35 and 55 are four times more likely to be affected by head and neck cancers. Despite the medical advantages, not all parents around the state are buying into the vaccine. According to a 2013 National Immunization Survey, about 48 percent of boys ages 13 to 17 had been vaccinated — about 74 percent of girls in that age range completed the full course of vaccinations.

    The CDC website lists possible side effects of the vaccine to include flu-like symptoms, with some rare life-threatening allergic reactions possible. Sheridan noted that the upside of the vaccine — preventing cancer — is the most important part of the argument for immunizing children against HPV.

    “The vaccine isn’t a license for teens and young adults to be sexually active, nor does it protect against all STIs, so proper sex education is still necessary.”

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    LED Dental Joins With the Oral Cancer Foundation to promote oral cancer early detection initiative

    Wed, Apr 22, 2015


    Source: www.marketwatch.com
    Author: press release

    LED Dental Inc. has announced that the company will be serving as a strategic partner in the Oral Cancer Foundation’s “Be Part of the Change”(TM) program, seeking to promote the importance of routine comprehensive oral screenings and early detection in the fight against oral cancer.

    The Oral Cancer Foundation initiated the “Be Part of the Change”(TM) campaign to help promote a shift in paradigm with regard to the screening for oral cancer, creating a movement toward earlier detection of oral disease. While regular oral screenings are a key tool in the early detection of oral cancer and pre-cancerous lesions, many patients are not receiving routine oral examinations that could potentially locate a serious oral health concern. The Oral Cancer Foundation is working to change the mindset of the oral healthcare industry, making improved oral screening protocols a priority in every dental practice.

    “The best defense any patient has against oral disease and oral cancer is early detection, which is where dental practitioners can effect change,” said Brian Hill, founder and executive director of the Oral Cancer Foundation. “When oral cancer is located in earlier stages, there is higher probability for reduced treatment related morbidity and improved patient outcomes. Our goal is to get healthcare professionals to commit to performing routine comprehensive oral examinations on every patient, especially during hygiene visits and recall appointments.”

    As the manufacturer of the market-leading VELscope® Vx Enhanced Oral Assessment, LED Dental has joined the Oral Cancer Foundation’s cause, providing a free VELscope® Vx system to dental and specialty practices that make a commitment to perform a minimum of three oral screenings per day over a period of three years. Practices will only pay for the consumable asepsis barriers to prevent cross contamination during screenings.

    “We are proud to join with our partners at the Oral Cancer Foundation to reinforce the value of routine comprehensive oral examinations to the overall health of patients,” said Dr. David Gane, CEO of LED Dental’s parent company, LED Medical Diagnostics Inc. “By helping promote this awareness initiative of the Oral Cancer Foundation and providing the VELscope to practices making a pledge to perform screenings, we are definitely taking a step in the right direction in the fight against oral cancer.”

    When used in conjunction with a traditional white-light examination, the VELscope® can aid in the location of oral mucosal abnormalities, including oral cancer and pre-cancer, among other oral health concerns. The VELscope® Vx is used by over 12,000 practices in 23 countries around the world. With over 25 million VELscope® Vx examinations to date, the system is the market-leading adjunctive screening technology.

    For more information about the Oral Cancer Foundation and the “Be Part of the Change”(TM) initiative, please visit www.oralcancerfoundation.org. For more details on LED Medical Diagnostics and the VELscope® Vx, please visit www.velscope.com.

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    Broccoli may prevent oral cancer as clinical tests set to start on humans

    Mon, Apr 20, 2015


    Source: www.mirror.co.uk
    Author: staff

    The much-maligned green vegetable deserves more respect as lab tests show extracts of sulforaphane reduced tumours in mice.


    Broccoli could soon protect people from cancer of the mouth, throat, neck and head in a new treatment known as “green chemoprevention.” Cruciferous vegetables such as broccoli, cabbage and garden cress have a high concentration of sulforaphane.

    Previous studies, including large-scale trials in China, have shown sulforaphane helps mitigate the effects of environmental carcinogens. Now lab tests have shown extracts made from broccoli sprout protected mice against oral cancer.

    American scientists now plan to carry out clinical trial on patients at high risk of a recurrence of head and neck cancer. They will be given capsules containing broccoli seed powder to determine if they can tolerate the regimen and whether it has enough of an impact on their oral lining to prevent cancer.

    Associate professor Dr Julie Bauman of the University of Pittsburgh said: “People who are cured of head and neck cancer are still at very high risk for a second cancer in their mouth or throat, and, unfortunately, these second cancers are commonly fatal.

    “So we’re developing a safe, natural molecule found in cruciferous vegetables to protect the oral lining where these cancers form.”

    The study involved testing sulforaphane in the laboratory when over several months mice predisposed to oral cancer were given the extract and found that it significantly reduced the incidence and number of tumours.

    Professor of medicine Dr Daniel Johnson at Pitt’s School of Medicine said: “The clear benefit of sulforaphane in preventing oral cancer in mice raises hope that this well-tolerated compound also may act to prevent oral cancer in humans who face chronic exposure to environmental pollutants and carcinogens.”

    The research also involved giving 10 healthy volunteers fruit juice mixed with sulforaphane-rich broccoli sprout extract. The volunteers had no ill-effects from the extract and protective changes were detectable in the lining of their mouths, meaning it was absorbed and directed to at-risk tissue.

    These findings were enough to prompt a clinical trial that will recruit 40 volunteers who have been curatively treated for head and neck cancer. Depending on the results larger clinical trials could be carried out.

    Prof Bauman added: “We call this ‘green chemoprevention,’ where simple seed preparations or plant extracts are used to prevent disease.

    “Green chemoprevention requires less money and fewer resources than a traditional pharmaceutical study, and could be more easily disseminated in developing countries where head and neck cancer is a significant problem.”

    Note: The findings were presented at the American Association for Cancer Research Annual Meeting in Philadelphia.

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    HPV Shots for Boys Might Cut Cancer Costs

    Tue, Apr 14, 2015


    Source: MedPageToday.com
    Author: Charles Bankhead

    - Canadian study suggests vaccination would save money by preventing oropharyngeal cancer.

    Widespread vaccination of boys against human papillomavirus (HPV) infection proved to be a cost-saving approach to prevent subsequent head and neck cancer, according to data based on the Canadian health system.

    A 70% immunization rate and 99% efficacy with the quadrivalent vaccine Gardasil might reduce costs by as much as $28 million ($22.2 million U.S.). Reducing uptake and efficacy to 50% still might save $8 million ($6.35 million U.S.), Lillian L. Siu, MD, of Princess Margaret Cancer Center in Toronto, and co-authors reported online in Cancer.

    “According to the findings of this preliminary analysis, HPV vaccination for boys aged 12 years may be a cost-effective strategy in relation to the prevention of oropharyngeal cancer alone, strengthening the cost-effectiveness of a male vaccination program,” the authors concluded. “The argument for funding male HPV vaccination in North America is becoming more compelling given the benefits of reductions in genital warts and anal cancer and the potential benefits for the female population because of increased herd immunity.

    “Prospective data collection for male HPV vaccination and oropharyngeal cancer may validate these findings in the future.”

    The data are consistent with other studies showing cancer benefits for HPV immunization, although the Canadians are the first to suggest that vaccination saves money, U.S. sources told MedPage Today.


    Initial clinical studies of HPV vaccination and national vaccination programs targeted girls and young women. Only recently has the focus expanded to include immunization of adolescent boys. Moreover, proponents of HPV immunization increasingly have emphasized the potential cancer-prevention benefits of preventing HPV infection, which accounts for the majority of new cases of cervical cancer and head and neck cancer (primarily oropharyngeal) cancer, the latter being a male predominant-condition.

    Although nations have begun to include boys in national immunization initiatives (including the U.S.), few studies have examined the cost-effectiveness of HPV vaccination from the perspective of disease (including cancer) prevention in boys and men. To address the issue, Liu and colleagues performed a preliminary cost-effectiveness analysis based on Canadian data.

    On the basis of literature-derived data on HPV-related oropharyngeal cancer in Canadian men, investigators developed a Markov model to compare the costs and effectiveness of immunization with the quadrivalent HPV vaccine versus no immunization. The model was based on a theoretical cohort of 192,940 boys who were 12 years old in 2012.

    Vaccination costs applied to use of the quadrivalent vaccine. Costs associated with oropharyngeal cancer were derived from records of patients treated at the Toronto center from 2000 to 2010 and from data on patients treated throughout Ontario during 1997 to 2007. The primary outcome was the incremental cost per quality-adjusted life year(QALY).

    The model considered two principal scenarios: 70% vaccine uptake and 99% vaccine efficacy and 50% uptake and efficacy. In both scenarios, the comparator was no vaccination.

    Key Findings

    For the 70%/99% scenario, the model yielded a 0.05 QALY and a savings of $145 (~$115 U.S.) per individual as compared with no vaccination. For the 50%/50% scenario, the model showed a gain of 0.023 QALY and a savings of $42 (~$33 U.S.). Extrapolation of the results to the entire nation resulted in potential savings of $8 million to $28 million with the two vaccination scenarios.

    Though limited to the Canadian perspective, the study suggests potentially large savings in the U.S. as well. The average cost of 1 year of care care for a patient with newly diagnosed oropharyngeal cancer is $25,697 in Canada, whereas the cost estimates for the U.S. range from $79,151 for patients with commercial insurance to $59,404 for Medicaid patients to $48,410 for patients covered by Medicare.

    The authors’ model assumed a fixed cost of $400 (~$318 U.S.) for the vaccine, and they acknowledged that the cost of the vaccine has been a limiting factor in the uptake in developed nations. They also acknowledged that the model did not take into account recent increases in the proportion of oropharyngeal cancer attributable to HPV infection.

    The status of immunization for boys has lagged behind that of girls throughout much of the world, primarily because of research priorities surrounding vaccine trials.

    “The data for clinical trials in girls came out a couple of years ahead of the data for boys, so the vaccine wasn’t FDA approved or recommended by anyone for boys,” said Debbie Saslow, PhD, of the American Cancer Society in Atlanta, which supports immunization of boys and girls. “The manufacturer didn’t ask for an indication for boys. If you start out just vaccinating girls, then, of course, there is going to be a big lag in the data.”

    U.S. Perspective

    In the U.S., the situation is changing rapidly, and in some states, the HPV immunization rate for boys has increased dramatically and the gap between the sexes will likely close in the near future, she added. Worldwide, however, the U.S., Canada, and Australia are the only nations that currently support HPV immunization of boys and girls.

    Speaking to the Canadian study results, Saslow said studies have consistently shown that HPV immunization is cost-effective for cancer prevention, but the cost-saving result is something new.

    The Canadian study attempted to address one of the problems inherent in assessing the cancer-prevention potential of HPV immunization in women and men, said Rodney Willoughby, MD, of Children’s Hospital of Wisconsin in Milwaukee.

    “This is essentially an anticancer vaccine,” said Willoughby, who also is a member of the American Academy of Pediatrics’ committee on infectious diseases. “The female cancers [associated with HPV] often have premalignant lesions, which allow you to do very nice, well-powered studies to show remarkable benefit in terms of preventing precancerous lesions in the real-world setting or, even more so, preventing the cancers themselves.

    “The problem with the males is that they have a higher burden of the oropharyngeal cancers, and there is no precancerous marker that allows you to do studies in a short period of time.”

    A lot of the information to support immunization of boys has come from extrapolation, he added. Impetus for the support has come from historically low uptake of the vaccine among girls and growing recognition that boys and girls have a similar risk of infection.

    Although the Canadian and U.S. healthcare systems differ in many respects, the two governments regularly share and discuss healthcare data, so it’s reasonable to assume that the Canadian study is applicable to the U.S., said Willoughby.

    Siu and co-authors disclosed no relevant relationships with industry

    *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

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