Metabolic activity of head and neck cancer may help guide treatment

Source: www.oncologystat.com Author: Staff The metabolic activity of head and neck squamous cell carcinoma on pretreatment imaging independently predicts outcomes in patients who undergo intensity-modulated radiation therapy, new data show. This imaging information can be used to tailor treatment, especially to reduce the risk of distant metastases, lead investigator Dr. Min Yao said at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. Higher standardized uptake value (SUV) of the primary tumor and of the lymph nodes predicted worse outcomes in multivariate analyses presented by Dr. Yao, a radiation oncologist at the Case Western Reserve University, Cleveland. "Several papers have shown that the standardized uptake value (SUV) is a prognostic factor in head and neck cancer," Dr. Yao told attendees. Most of these studies were small series, involved patients receiving conventional radiation therapy, and did not evaluate SUV of the primary tumor and lymph nodes separately. Dr. Yao and his colleagues analyzed outcomes in 177 patients treated for head and neck squamous cell carcinoma with intensity-modulated radiation therapy (IMRT) between 1999 and 2006. The patients had a pretreatment positron emission tomography scan using fluorodeoxyglucose as the tracer (FDG-PET), and the maximal SUV was determined for both the primary tumor and the involved lymph nodes. The patients then underwent IMRT with curative intent. Seventy-seven percent of the patients were male. Twenty-nine percent were receiving IMRT postoperatively, whereas the rest were receiving it as definitive therapy. The cancer was most commonly located in the oropharynx (49%) and [...]

HPV vaccine reduced further disease in women treated for cancer precursors

Source: www.hemonctoday.com Author: staff HPV vaccine quadrivalent (types 6, 11, 16 and 18) decreased HPV-related disease in women previously treated for cancer precursors, according to the post-hoc analysis of findings from two trials. Warner Huh, MD, associate professor in the department of obstetrics and gynecology at the University of Alabama at Birmingham, presented these findings at The Society for Gynecologic Oncologists’ 2010 Annual Meeting on Women’s Cancer in San Francisco. Although the HPV4 (Merck, Gardisil) has been shown to prevent cervical intraepithelial neoplasia (CIN), vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia, genital warts and adenocarcinoma, it is unclear if the vaccine may benefit patients who have already been exposed to the virus and had subsequent surgery. Researchers analyzed data from 17,622 women who were randomly assigned to the HPV4 or placebo. Overall, 587 women assigned to the vaccine and 763 assigned to placebo underwent cervical definitive therapy. Patients in the placebo group were at higher risk for incidence of CIN, vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia, genital warts and adenocarcinoma at a rate of 11.1 per 100 person-years, with an average of 1.4 years after surgery, compared with patients assigned to HPV4. Regardless of causal HPV type, patients who were vaccinated had a reduced risk for developing further disease, with a rate of 45% (95% CI, 21-62). Women treated for vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia and genital warts assigned to placebo had the highest risk for further disease, with a rate of 33.7 per 100 person-years. The risk for further [...]

Lymphedema common in head and neck cancer

Source: www.medpagetoday.com Author: Charles Bankhead, Staff Writer, MedPage Today Treatment of head and neck cancer causes potentially severe lymphedema, which responds to complete decongestive therapy in most cases, a retrospective chart review showed. The most severe lymphedema occurred in patients treated with surgery and radiation therapy, followed by definitive surgery alone. Complete decongestive therapy led to clinical improvement in a majority of the patients, including 83% of those treated with surgery alone. "Lymphedema is vastly under-recognized and under-reported in patients with head and neck cancer," Jan S. Lewin, PhD, of M.D. Anderson Cancer Center in Houston, said in an interview at the Multidisciplinary Head and Neck Cancer Symposium (MHNCS). "The lymphedema can be just as severe as what's seen after treatment of breast and other types of cancer. Lymphedema in patients with head and neck cancer can be terribly disfiguring and cause severe functional problems." "Complete decongestive therapy leads to clinically significant improvement in most patients, whether it's performed in a clinic or at home," she added. Available evidence suggests that fewer than half of patients with head and neck cancer develop lymphedema after treatment. However, cosmetic and functional sequelae can be severe, including problems with speaking, eating, airway obstruction, and drooling, as well as self-image. As compared with lymphedema in other cancers, a paucity of information exists about the presentation and treatment of the condition in patients with head and neck cancer, said Lewin. In an effort to add to the information base, she and her colleagues retrospectively reviewed [...]

Coalition to Stop Contraband Tobacco applauds Senate for passage of the Prevent All Cigarette Trafficking Act of 2009

Source: prnewswire.com Author: press release The Coalition to Stop Contraband Tobacco today praised the U.S. Senate for passing S. 1147, the Prevent All Cigarette Trafficking (PACT) Act of 2009. Sponsored by Sen. Herb Kohl (D-WI) and co-sponsored by a bipartisan group of 20 senators, this legislation will help combat online cigarette sales that have robbed hundreds of millions of dollars in tax revenues from the states and that undermine state laws that prevent youth access to tobacco products. "Passage of the PACT Act is a huge victory for American taxpayers, American small business owners and America's youth," said Scott Ramminger, AWMA president and CEO and coalition spokesperson. "We applaud the Senate for its action today and thank Sen. Kohl for his leadership in ensuring that contraband tobacco sales are eliminated." Numerous stakeholders have worked with Sen. Kohl through the years to pass the PACT Act, which was passed in the House of Representatives last May. The PACT Act closes gaps in current federal laws regulating "remote" or "delivery" sales of cigarettes and smokeless tobacco products. "In a recent study we found that illegal cigarette sales cost states $5 billion per year, and that with online sales there is almost no age verification at the time of purchase," continued Ramminger. "We hope the House will pass this bill quickly and that President Obama will act swiftly to sign this common sense legislation into law so that we can put an end to the illegal sale of tobacco products," conclude Ramminger. The [...]

Smokeless tobacco launches an attack on U.S. market

Source: www.tobacco-facts.net Author: staff General Snus, a smoke-free moist tobacco product originated in Scandinavian countries in the 19th century, is currently holding a massive promotional campaign across the United States. Swedish Match, the manufacturer of General Snus brand has introduced a multi-million-dollar marketing drive intended for bringing the steam-cured tobacco pouches to wealthy tobacco-lovers in major markets across the nation. The General Snus are also promoted at high-end events, such as New York Fashion Week and several notable Film Festivals. Snus are made and sold in cooled pouches packed in cans. The consumers put these tobacco items between cheek and lip and sip it getting their portion of nicotine. Snus is extremely famous among upscale professionals in Sweden, where the product saw the world for the first time almost two centuries ago. Whereas these products are still relatively unknown to the majority of American smokers, they are going through an outstanding growth of popularity since the initial nationwide launch in 2000, according to Swedish Match. The latest General Snus promotional campaign – under slogan “Satisfaction: the Original Pursuit”— was launched at the Sundance Film Festival held in Salt Lake City in January, where Swedish Match has acquired sponsorship deal. Other venues for the marketing campaign include art shows in New York, Boston and Los Angeles, and New York’s Fashion Week. Lars Hansson, the communication director for Swedish Match told the press that in Scandinavian countries snus has been generally used by the upscale audience, and that has been the major [...]

Oral sex can add to risk of HPV positive cancers

Source: www.time.com Author: Coco Masters Oral sex can get most men's attention. The topic becomes considerably more relevant, however, when coupled with a new study linking the human papillomavirus (HPV) to an increased risk of a kind of oral cancer more often seen in men. The study, which appears in this week's New England Journal of Medicine (NEJM), shows that men and women who reported having six or more oral-sex partners during their lifetime had a nearly ninefold increased risk of developing cancer of the tonsils or at the base of the tongue. Of the 300 study participants, those infected with HPV were also 32 times more likely to develop this type of oral cancer than those who did not have the virus. These findings dwarf the increased risk of developing this so-called oropharyngeal cancer associated with the two major risk factors: smoking (3 times greater) or drinking (2.5 times greater). HPV infection drives cancerous growth, as it is widely understood to do in the cervix. But unlike cervical cancer, this type of oral cancer is more prevalent in men. HPV is ubiquitous. Of the 120 strains isolated from humans — about 40 of which are in the mouth and genital tracts — Merck's recently FDA-approved vaccine, Gardasil, protects against four: HPV-6 and HPV-11, which cause warts; and HPV-16 and HPV-18, which cause about 70% of cervical cancers. Similarly, according to the study, HPV-16 was present in 72 of the 100 cancer patients enrolled in the study. Between 12,000 and [...]

Isn’t it about time? Overcoming the real barriers to complete oral cancer screening

Source: www.dentistryiq.com Author: Jonathan A. Bregman, DDS, FAGD In the previous articles of this series, I discussed four barriers I see as stopping those in the dental profession from doing a complete oral cancer screening examination. In Part 1, the barrier I discussed is the overall lack of confidence in doing a complete extra-/intraoral cancer screening exam. The rationale: “not doing the exam at all puts me at less risk than doing it and missing something.” In Part 2, the barrier I discussed is being unclear about who to examine: the changing target population, especially the influence of the human papillomavirus (HPV 16/18). In Part 3, the uncertainties of how the complete cancer screening examination should be done, plus communicating the reasons for doing it for patients. In Part 4: Uncertainty about how to properly record the cancer screening examination Barrier 5: Uncertainty about how to best and most effectively deliver the message of a positive finding The more we look, the more we find. The more we look, the closer we look, the more abnormalities we will detect with our cancer screening exam. This makes sense, of course. The same goes for the complete periodontal examination, the complete occlusal analysis, the complete updated radiographic evaluation, etc. In each area — tissue abnormalities, periodontal abnormalities, occlusal abnormalities — we must address the needs of the patient in a way that sets the stage for understanding of the problem(s) and presenting possible options/solutions to correct the problems. Build on what you [...]

HPV-related cancer not confined to cervix

Source: www.businesswire.com Author: press release The Human Papillomavirus (HPV) is the causative agent responsible for most cases of cervical cancer, but is also associated with several other types of cancer. Expert physicians from the National Comprehensive Cancer Network (NCCN) Member Institutions presented an update on HPV and its link to various cancers including cervical cancer, anal carcinoma, and head and neck cancers discussing prevention strategies and the latest recommended treatment options according to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™). “It is important to counsel against any tobacco use as well as excessive alcohol consumption, and also to inform patients about the role of HPV and its mechanism of spread” Robert J. Morgan, MD, FACP of City of Hope Comprehensive Cancer Center and a member of the NCCN Guidelines Panel for Cervical Cancer began the session speaking about the link between HPV and cervical cancer as well as methods of prevention. “Cervical cancer screening with the pap smear is one of the greatest success stories in medicine,” said Dr. Morgan pointing to data that shows a steadily decreasing death rate from cervical cancer since the 1980s. The link between HPV and cervical cancer first started to emerge in the 1970’s when researchers found evidence linking cervical cancer to a wart virus coupled with the fact that cervical cancer was associated with sexual activity. In 1983, HPV DNA was identified in cervical cancer tissue. There are 120 known HPV serotypes with 19 being considered high risk, although as Dr. [...]

Office-based ultrasound-guided FNA found to be superior in diagnosing head and neck lesions

Source: American Academy of Otolaryngology Author: Jessica Mikulski Office-based, surgeon-performed, ultrasound-guided, fine needle aspiration (FNA) of head and neck lesions yields a statistically significant higher diagnostic rate compared to the standard palpation technique, indicates new research in the March 2010 issue of Otolaryngology - Head and Neck Surgery. FNA is a diagnostic procedure used to investigate superficial lumps or masses. In this technique, a thin, hollow needle is inserted into a mass to extract cells for examination. FNA biopsies are a safe minor surgical procedure. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead. FNA biopsies in the head and neck have also proven to be an invaluable tool in establishing the diagnosis of lesions and masses from a broad range of sites, including the thyroid, salivary glands, and lymph nodes. The efficacy of ultrasound-guided FNA has been well documented in many areas of the body, leading to its acceptance as the standard of care among radiologists and many cytopathologists. However, while the utility of ultrasound in the head and neck is widely appreciated and employed by the radiology community, clinicians in the United States have not embraced office-based ultrasound. The study authors sought to provide additional evidence and support for this procedure in order to ensure appropriate use by the clinical community. In this randomized, controlled trial of 81 adults, researchers divided participants into two groups, using either ultrasound-guided or traditional palpation-guided FNA to evaluate an identified head and neck mass. [...]

2010-03-11T18:54:05-07:00March, 2010|Oral Cancer News|

Why men’s health is a feminist issue

Source: www.msmagazine.com Author: Adina Nack Jorge (not his real name) feared his girlfriend would dump him. He’d been diagnosed with genital warts before meeting her, and hadn’t yet told her about his infection. Jorge was being careful—no skin-to-skin sexual contact—but the disclosure was looming. So he’d done some research and learned what caused genital warts. Armed with that knowledge, he hoped that his girlfriend wouldn’t reject him, especially since he knew she could be protected from contracting warts “because of the Gardasil vaccine.” It never occurred to Jorge that Gardasil, made by the pharmaceutical company Merck, could also have protected him. But that’s probably because it was only last October that the Food and Drug Administration approved a “male” Gardasil for preventing genital warts. And the FDA has yet to put its stamp on another promising usage of the vaccine for men: preventing cancer, especially highly prevalent oral cancers. Since Gardasil was FDA-approved in 2006, it has received a huge marketing push for preventing cervical cancer in women. It has come into frequent—if sometimes controversial—use for females 9 to 26 years old because it’s designed to guard them, before they ever have sex, against contracting a virus that has been linked to cervical cancer. That virus is HPV, human papillomavirus, which causes one-third of all sexually transmitted infections (STIs) in the U.S. Gardasil offers protection against four of the 30 to 40 types of sexually transmissible HPV. While it’s fear of cervical cancer that have motivated young women to get [...]

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