November 2008 – Page 3 – Oral Cancer News

Analysis of prognostic factors in patients with oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with systemic chemotherapy

Source: Arch Otolaryngol Head Neck Surg. 2008;134(11):1196-1204 Authors: Paola A. G. Pedruzzi, MD et al. Objective: To assess the prognostic significance of several factors in oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with chemotherapy. Design: Retrospective study. Setting: Erasto Gaertner Hospital, Curitiba, Brazil, and A. C. Camargo Hospital, São Paulo, Brazil. Patients: A total of 361 patients treated for squamous cell carcinoma from January 1, 1990, to December 31, 2001. Interventions: Radiotherapy alone or with chemotherapy. Main Outcome Measures: Disease-free survival, overall survival, and treatment response. Results: Most tumors were located at the tonsil (46.8%) or base of the tongue (28.0%) and were at clinical stage III or IV (92.8%). Treatment response was associated with Zubrod scale score, weight loss, number of comorbidities, symptom-severity and Piccirillo stages, hemoglobin level, tumor site, macroscopic appearance of the tumor, and clinical stage. The 5-year overall survival rate was 17.6% and disease-free survival rate was 16.2%. The significant prognostic variables were age; Zubrod scale score; weight loss; comorbidities; Berg, Piccirillo, and symptom-severity staging; involvement of adjacent soft-tissue areas and bone; lymph node mobility; clinical stage; and radiotherapy doses. The multivariate analysis showed Zubrod scale score, symptom-severity staging system, Berg staging system, comorbidities, and radiotherapy dose as independent prognostic factors. Conclusion: A combination of clinical factors, such as symptoms, patients' general status, weight loss, and comorbidities, leads to a relevant stage of clinical severity that can be associated with the TNM stage as predictors of survival in oropharyngeal carcinoma. Authors: Paola [...]

Oral Cancer Foundation News Team - A2008-11-18T03:43:52-07:00November, 2008|Oral Cancer News|

7 Facts you need to know about HPV and Gardasil

Source: www.usnews.com Author: Bernadine Healy M.D. As women—and soon men—gain access to the new Merck vaccine Gardasil, which targets the sexually transmitted human papillomavirus, the Centers for Disease Control and Prevention has stepped up efforts to identify the 25,000 or more cancers primarily associated with HPV that increase the burden of cancer in the United States each year. As reported in the November 15 supplement to the journal Cancer, the latest figures include 10,846 patients with invasive cancer of the cervix, followed by 7,360 with cancers of the mouth, particularly the tonsils and the back of the tongue. In addition, there are 3,018 cancers of the anus, 2,266 of the vulva, and 828 of the penis. To the CDC, these are baseline numbers to track the life-threatening consequences of HPV infection. To sexually active young people, this report should be a wake-up call. The hows and whys of catching contagious warts and cancer through sex should be part of every parent's birds-and-bees talk, every school's sex-ed curriculum, and—most of all—all young people's thinking about their own sexual vulnerability. Here are seven need-to-know facts: 1. Infected boys and men are silent carriers of HPV, spewing out their contagion in body fluids. With some strains, visible warts on the genitals bud off fresh virus. 2. Infected girls and young women (particularly vulnerable to infection because of a still-developing cervix) also shed abnormal cells bearing virus into Pap smears, tests that sexually active women should have yearly. The atypical cells usually clear in [...]

Oral Cancer Foundation News Team - A2008-11-18T03:34:59-07:00November, 2008|Oral Cancer News|

LSUHSC Public Health contributes to estimate of HPV-related cancers

Source: www.canceraids.org Author: staff Professor Vivien Chen, PhD,. Associate Professor Xiao Cheng Wu, MD, PhD and Assistant Professor Edward Peters, DMD, SM, ScD, at LSU Health Sciences Center New Orleans School of Public Health contributed five papers to the largest most comprehensive assessment of the burden of human papillomavirus (HPV)-associated cancers in the United States to date. The report, “Assessing the Burden of Human Papillomavirus (HPV)-Associated Cancers in the United States (ABHACUS),” is available now online and will be published in the November 15, 2008 supplement to the journal Cancer. The publication reports that 25,000 cases of HPV-associated cancers were diagnosed in 38 states and the District of Columbia from 1998-2003. These include cancers of the cervix, vagina, vulva, penis, anus, oral cavity and oropharynx. Human papillomaviruses comprise about 100 different types, more than 30 of which are sexually transmitted. As the data were collected prior to the development of the HPV vaccine, they will provide baseline incidence rates to determine the effectiveness of the vaccine as well as cervical cancer screening programs in reducing the incidence of HPV-associated cancers and precancers. The most comprehensive analysis studied data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) cancer registries, including the Louisiana Tumor Registry at LSU Health Sciences Center New Orleans, and the Centers for Disease Control’s National Program of Cancer Registries. The papers on which the LSUHSC public health faculty are co-authors are Incidence of in situ and invasive vulvar cancer in the US, 1998-2003 (p 2865-2872), [...]

Oral Cancer Foundation News Team - A2008-11-16T11:40:36-07:00November, 2008|Oral Cancer News|

High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: Results of a survey in EORTC institutes

Source: Radiother Oncol, October 30, 2008 Author: Christian Giro et al. Objective: Examination of the rate of grade III or grade IV radiation dermatitis during treatment of head and neck cancer (HNC) with radiotherapy (RT) and concurrent cetuximab in EORTC centres. Materials and Method: A questionnaire was sent to all members of the EORTC Radiation Oncology Group and Head and Neck Group (111 institutions) to evaluate the widespread use of cetuximab and radiotherapy in HNC and to estimate the frequency of grades III and IV skin reactions in the radiation portals associated with this protocol. Co-morbidities, RT schedules and co-medications were also recorded. Results: We received responses from 28 institutions in 11 countries. A total of 125 HNC patients from 15 institutions were treated with cetuximab and concurrent RT. Information about the skin reactions was available from 71 patients. Of these 36 had no grade III/IV adverse effects in the RT field, 15 had a grade III and 20 had grade IV radiation dermatitis. No detectable relation of grades III and IV radiation dermatitis with co-morbidities such as liver insufficiency or renal dysfunction was found. Conclusion: According to the results of the questionnaire, grade III/IV radiation dermatitis is observed in 49% of HNC patients treated with cetuximab and concurrent RT. A systematic clinical monitoring of cutaneous side effects during RT plus cetuximab is advised to ensure the safety of this protocol. Authors: Christian Giro, Bernhard Berger, Edwin Bolke, I Frank Ciernik, Frederic Duprez, Laura Locati, Sophie Maillard, Mahmut Ozsahin, Raphael [...]

Oral Cancer Foundation News Team - A2008-11-16T11:29:22-07:00November, 2008|Oral Cancer News|

Re-irradiation with concurrent chemotherapy in recurrent head and neck cancer: a decision analysis model based on a systematic review

Source: Clin Otolaryngol, August 1, 2008; 33(4): 331-7 Authors: V Paleri and CG Kelly Objectives: Local recurrence is the major cause of treatment failure in head and neck cancer patients after radiation or combined therapy. If surgically unresectable, management involves supportive care or chemotherapy with palliative intent. Recent studies have assessed the role of re-irradiating these patients with concurrent chemotherapy (CTReRT) and have reported improved local control. The aim of this study was to perform a decision analysis model comparing quality adjusted life years (QALYs) between patients undergoing CTReRT and best supportive care for radio-recurrent head and neck squamous cancer. Design: Outcome data from recent reviews on the topic were used. A decision analysis model was generated. An expert panel arrived at a consensus to assign utility values for the various health state outcomes when CTReRT is administered for recurrent cancer, or in the setting of palliative care for these patients. Main Outcome Measures: Quality adjusted life years from the decision analysis model. RESULTS: Patients who do not suffer a severe complication following CTReRT were assigned by the expert panel to have a utility value of 0.7, and those who suffered one, a utility value of 0.6. A value of 1.0 equates to perfect health and 0 to death. The utility value assigned in the setting of good palliation was 0.8, with 0.6 given when symptom control was less than optimal. The model showed superior QALYs for the CTReRT arm of approximately 5 weeks (20 weeks versus 15 weeks for [...]

Oral Cancer Foundation News Team - A2008-11-16T11:17:31-07:00November, 2008|Oral Cancer News|

Doctors warn of HPV link to developing oral cancer

Source: Tampa Bay Online (www2.tbo.com) Author: staff Ten years ago, most of Brian Nussenbaum's oral cancer patients were men older than 60 who used tobacco and drank heavily. Today, his patients look different, as does the risky behavior that seems to be leading to their cancer. Nussenbaum, an ear, nose and throat doctor at Washington University in St. Louis, estimates 70 percent of his cancer patients have tumors on the back of their tongues and tonsils caused by human papillomavirus-16. Most of those patients are between ages 45 and 55. About half are women. And experts suspect that all of them - men and women - got the HPV from oral sex. "We know now that 98 percent of cervical cancer is caused by HPV, and mostly HPV-16," he says. "But no one talks about how you can also get mouth cancer from it." Researchers at Johns Hopkins Kimmel Cancer Center reported a link between HPV and these specific throat cancers in 2000. The increase in HPV oral cancer stems from a shift in sexual behaviors, combined with a dramatic decrease in the number of tonsillectomies performed. Cancer from the HPV virus often develops on the tonsils. In a Johns Hopkins study, researchers concluded that people with HPV infections were 32 times more likely to develop oral cancer than those without HPV. These findings have ramifications for anyone who is sexually active. Parents have another reason to think hard about whether they want their adolescent daughters, and perhaps even sons, [...]

Oral Cancer Foundation News Team - A2008-11-16T08:03:40-07:00November, 2008|Oral Cancer News|

Sweetest word for a mother to hear

Source: www.journallive.co.uk Author: Neil MacKay It is a memorable moment in any mother’s life when her child utters their first word. But when Daniel Sewell said “Mam” for the first time it was an extra special for his mum Alison. For Daniel was given a “new” tongue during pioneering surgery for mouth cancer at Newcastle’s Royal Victoria Infirmary more than three years ago, and doctors warned Alison that he may never talk properly. Surgeons had to take out three-quarters of his tongue and replace it with muscle from his abdominal lining. Now, after three years in remission, four-year-old Daniel is a happy, talkative primary school pupil. Both he and Alison, 43, of Coronation Street, Crook, County Durham, are backing the British Dental Health Foundation’s Mouth Cancer Action Week, which runs next week. Daniel’s father Richard spotted his badly swollen tongue when he was 13 months old and his quick action saved the tot’s life – early detection of oral cancer means a survival chance of 90%. Alison said: “I was just as ignorant as anyone about mouth cancer. I always presumed it was about the older generation and was linked with smoking and the like. “When we found out Daniel had cancer, we had the shock of our lives. It was so hard for the first few weeks and we didn’t know which way it was going to go. If we hadn’t noticed when we did I really don’t think he would have made it. Mouth cancer is a silent [...]

Oral Cancer Foundation News Team - A2008-11-16T07:46:00-07:00November, 2008|Oral Cancer News|

Adult smoking is at record low

Source: www2.journalnow.com Author: Richard Craver A rate below 20 percent has more symbolic than commercial significance, tobacco analyst says Smoking among U.S. adults hit a record low during 2007, with less than one in five lighting up. Although breaking through the 20 percent threshold was applauded by anti-smoking groups last week, they acknowledged that an ambitious goal of a 12 percent adult-smoking rate by 2010 is not likely to happen. The goal was set in November 2000 as part of the Healthy People 2010 project. "If we want to see far more people quit smoking, we need expanded access to stop-smoking programs, continued progress in eliminating secondhand smoke exposure and ongoing investment in programs that work," said Dr. Matthew McKenna, the director of the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention. The agency reported that 43.4 million U.S. adults smoked in 2007, or 19.8 percent, compared with 45.3 million in 2006, or 20.8 percent. The rate essentially was unchanged from 2004 through 2006. The peak of U.S. adult smokers was 53.5 million in 1983, according to U.S. government figures. The number of adult men who smoke still exceeds women -- 22 percent of men smoke, compared with 17.4 percent of women. The number of white adult smokers was 21.4 percent, compared with 19.8 percent for blacks and 13.3 percent for Hispanics. The report also found that the percentage of everyday smokers who have tried to quit smoking has dropped from 47 percent in [...]

Oral Cancer Foundation News Team - A2008-11-15T12:43:05-07:00November, 2008|Oral Cancer News|

Dietary factors and oral and pharyngeal cancer risk

Source: Oral Oncol, November 4, 2 Authors: Ersilia Lucenteforte et al We reviewed data from six cohort studies and approximately 40 case-control studies on the relation between selected aspects of diet and the risk of oral and pharyngeal cancer. Fruit and vegetables were inversely related to the risk: the pooled relative risk (RR) for high vegetable consumption was 0.65 from three cohort studies on upper aerodigestive tract cancers and 0.52 from 18 case-control studies of oral and pharyngeal cancer; corresponding RRs for high fruit consumption were 0.78 and 0.55. beta-carotene, vitamin C and selected flavonoids have been inversely related to the risk, but it is difficult to disentangle their potential effect from that of fruit and vegetables. Whole grain, but not refined grain, intake was also favorably related to oral cancer risk. The results were not consistent with reference to other foods beverages, and nutrients, but it is now possible to exclude a strong relation between these foods and oral and pharyngeal cancer risk. In western countries, selected aspects of diet may account for 20-25% of oral and pharyngeal cancer, and the population attributable risk increases to 85-95% when tobacco and alcohol consumption are also considered. Authors: Ersilia Lucenteforte, Werner Garavello, Cristina Bosetti, and Carlo La Vecch Authors' affiliation: Dipartimento di Epidemiologia, Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, 20156 Milan, Italy

Oral Cancer Foundation News Team - A2008-11-15T09:58:35-07:00November, 2008|Oral Cancer News|

HPV virus helps cervical and head and neck cancers resist treatment and grow and spread

Source: www.sciencedaily.com Author: staff The human papillomavirus (HPV) allows infected cervical and head and neck cancer cells to maintain internal molecular conditions that make the cancers resistant to therapy and more likely to grow and spread, resulting in a poor prognosis for patients, researchers with UCLA's Jonsson Cancer Center found. Virtually all human cancers experience a state called intratumoral hypoxia, or a low amount of oxygen within the tumor. In the UCLA study, researchers showed that the HPV-positive cancers adapted to and took advantage of the hypoxic environment by expressing a protein that activates a cell signaling pathway that helps the cancers survive, grow and spread. The study is published in the Nov. 4, 2008 issue of the journal Cancer Cell. The research, done on cells in culture and in animal models, may lead to the development of new therapies that target the cell signaling pathway, thereby interrupting ability of the cancer cells to thrive, said Dr. Matthew Rettig, senior author of the study and a researcher at UCLA's Jonsson Comprehensive Cancer Center. "There is potential for therapeutic intervention based on this finding," said Rettig, an associate professor of urology and medicine. The finding is crucial because 90 to 98 percent of cervical cancers are caused by HPV. Cervical cancer is the second most common cancer in women worldwide, with more than 500,000 cases diagnosed annually. In all, 200,000 women die from cervical cancer every year. In oral cavity and pharynx cancers, the HPV virus is linked to about 20 [...]

Oral Cancer Foundation News Team - A2008-11-15T09:51:58-07:00November, 2008|Oral Cancer News|