Squamous cell subgroups respond differently to treatment

Source: www.medscape.com Author: Nancy A. Melville A long-term follow-up of patients with head and neck squamous cell carcinoma suggests that only certain high-risk subgroups benefit from radiation plus chemotherapy. This information will spare patients who will not benefit from undergoing the additional treatment. According to the study, presented here at the 2012 Multidisciplinary Head and Neck Cancer Symposium, patients with microscopically involved resection margins and/or extracapsular spread of disease had a lower risk for cancer recurrence with radiation plus chemotherapy 10 years later, whereas those with tumors in multiple lymph nodes did not benefit from combination treatment; they fared better with radiation alone. "The clinical implication of these findings is that the high-risk group of patients is not as homogenous a group as we believed it was before the study started," lead author Jay S. Cooper, MD, director of the Maimonides Cancer Center, in Brooklyn, New York, told Medscape Medical News. Dr. Cooper and his colleagues analyzed 10 years of follow-up data from the Radiation Therapy Oncology Group (RTOG) 9501/Intergroup phase 3 trial, which examined 410 patients with high-risk resected head and neck cancers. The patients were considered high risk for cancer recurrence because they had microscopically involved resection margins, extracapsular spread of disease, or multiple lymph node involvement. "The allocation was equally divided [according to treatment regimen] at the beginning of the study; the groups were not intended to be balanced for the different [risk] factors," Dr. Cooper said. "We thought they were all equally important." The treatment regimen [...]

Erlotinib dose doubled for smokers with head/neck cancer

Source: www.oncologyreport.com Author: Miriam E. Tucker Giving smokers a higher, short-course dose of erlotinib before definitive surgery for squamous cell carcinoma of the head and neck resulted in favorable responses for the first patients evaluated in a small pilot study. Investigators gave 300 mg of erlotinib (Tarceva) to smokers daily and 150 mg daily to nonsmokers who had a waiting period of more than 14 days before scheduled surgery for head and neck cancer. Seven of the 10 patients evaluated so far had partial responses and 3 had stable disease, according to a poster presented at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. The study was based on recent data in non–small cell lung cancer (NSCLC) patients showing that smokers metabolize erlotinib, an epidermal growth factor receptor (EGFR) inhibitor, twice as quickly as do nonsmokers (J. Clin. Oncol. 2009;27:1220-6), said lead author Dr. Mercedes Porosnicu of Wake Forest Baptist Medical Center in Winston Salem, N.C. That study established the maximum tolerated dose of erlotinib at 300 mg daily in NSCLC patients who smoke. Dr. Poroniscu’s presentation included the case study of a smoker with a very large oral cavity tumor protruding through his lips. He was described as being in significant pain and unable to eat or chew. The first CT scan showed a tumor of at least 8 cm and there was "significant metabolic activity" on PET scan. "At 6 days of erlotinib treatment, his tumor was obviously smaller and he could [...]

Head and neck cancer in transplant patients: For better or worse?

Source: medicalxpress.com Author: Henry Ford Health System staff Transplant patients who develop head and neck cancer are more likely to be non-smokers and non-drinkers, and less likely than their non-transplant counterparts to survive past one year of diagnosis, according to a new study from Henry Ford Hospital in Detroit. As part of a 20-year review, Henry Ford researchers found cancers of the throat, tonsils and mouth may be more aggressive in transplant recipients as the result of long-term immunosuppressive therapy required to prevent solid organ rejection. Transplant patients in the study who developed skin cancer in the head and neck region were more likely to have multiple lesions, compared to the general public. In all, 2.6% of transplant patients in the study developed some form of head and neck cancer. While the risk for developing head and neck cancer is small, the study serves as an important reminder to all transplant recipients to be vigilant about any changes to their skin, as well as persistent sore throat, ear pain or swallowing issues – all signs of head and neck cancer. "The benefits of organ transplantation and immunosuppressive therapy still outweigh the risk of transplant patients developing head and neck cancer," says study author Robert Deeb, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford. "Still, our study highlights that head and neck cancer arising in transplant patients warrants the need for regular screenings and aggressive treatment." The study will be presented Jan. 28 in Miami Beach at [...]

Newer radiation technology improves head and neck cancer patients’ long-term quality of life

Source: Eurekalert.org Patients treated with IMRT for head and neck cancer report an increasingly better quality of life post-treatment when compared to patients receiving other forms of radiation therapy, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM. Intensity modulated radiation therapy, or IMRT, is a highly specialized form of external beam radiation therapy that allows the radiation beam to better target and conform to a tumor. It is a newer treatment that has become widely adopted for treating head and neck cancer. Prior studies have shown that IMRT decreases the probability of radiation therapy related side effects, including dry mouth and chewing and swallowing problems, but no study has been conducted to measure long-term quality of life in head and neck cancer patients treated with various forms of radiation therapy. Investigators from the University of California, Davis, School of Medicine, prospectively administered the University of Washington Quality of Life instrument, a standardized, previously validated questionnaire that patients complete after radiation therapy, to 155 patients undergoing treatment for cancers of the head and neck and analyzed the scores over time. Fifty-four percent of patients were initially treated with IMRT and 46 percent were treated with non-IMRT techniques. The researchers showed that the early quality of life gains associated with IMRT not only are maintained but become more magnified over time. At one-year post-treatment, 51 percent of IMRT patients rated their quality of life as very good or outstanding compared [...]

2012-01-27T11:29:03-07:00January, 2012|Oral Cancer News|

Grape seed extract kills head and neck cancer cells, leaves healthy cells unharmed

Source: Colorado Cancer Blog Nearly 12,000 people will die of head and neck cancer in the United States this year and worldwide cases will exceed half a million. A study published this week in the journal Carcinogenesis shows that in both cell lines and mouse models, grape seed extract (GSE) kills head and neck squamous cell carcinoma cells, while leaving healthy cells unharmed. “It’s a rather dramatic effect,” says Rajesh Agarwal, PhD, investigator at the University of Colorado Cancer Center and professor at the Skaggs School of Pharmaceutical Sciences. It depends in large part, says Agarwal, on a healthy cell’s ability to wait out damage. “Cancer cells are fast-growing cells,” Agarwal says. “Not only that, but they are necessarily fast growing. When conditions exist in which they can’t grow, they die.” Grape seed extract creates these conditions that are unfavorable to growth. Specifically, the paper shows that grape seed extract both damages cancer cells’ DNA (via increased reactive oxygen species) and stops the pathways that allow repair (as seen by decreased levels of the DNA repair molecules Brca1 and Rad51 and DNA repair foci). “Yet we saw absolutely no toxicity to the mice, themselves,” Agarwal says. Grape seed extract kills head and neck squamous cell carcinoma cells while leaving healthy cells unharmed (image courtesy of Flickr user Anders Ljungberg) Again, the grape seed extract killed the cancer cells but not the healthy cells. “I think the whole point is that cancer cells have a lot of defective pathways and they [...]

2012-01-27T11:17:39-07:00January, 2012|Oral Cancer News|

Prevalence of Oral HPV Infection Higher Among Men Than Women

CHICAGO -- The overall prevalence of oral human papillomavirus (HPV) infection is approximately 7 percent among men and women ages 14 to 69 years in the United States, while the prevalence among men is higher than among women, according to a study appearing in JAMA. The study is being released early online to coincide with its presentation at the Multidisciplinary Head and Neck Cancer Symposium. Oral HPV infection is the cause of a subset of oropharyngeal [relating to the mouth and pharynx] squamous cell carcinomas (OSCC).  Human papillomavirus positive OSCC are associated with sexual behavior in contrast to HPV-negative OSCC that are associated with chronic tobacco and alcohol use. At least 90 percent of HPV-positive OSCC are caused by high-risk (or oncogenic) HPV type 16 (HPV-16), and oral infection confers an approximate 50-fold increase in risk for HPV-positive OSCC. The incidence of OSCC has significantly increased over the last 3 decades in several countries, and HPV has been directly implicated as the underlying cause, according to background information in the article. Although oral HPV infection is the cause of a cancer that is increasing in incidence in the United States, little is known regarding the epidemiology of infection. Maura L. Gillison, M.D., Ph.D., of the Ohio State University Comprehensive Cancer Center, Columbus, and colleagues examined the  prevalence of oral HPV infection in the United States. The researchers used data from a cross-sectional study as part of the National Health and Nutrition Examination Survey (NHANES) 2009-2010, a statistically representative sample of the U.S. population. Men and women ages 14 [...]

2012-01-26T17:50:44-07:00January, 2012|Oral Cancer News|

Oral temperature changes in head and neck cancer patients predicts side effect severity

Source: American Society for Radiation Oncology The abstract, "Pilot study of functional infrared imaging for early  detection of mucositis in locally advanced head and neck cancer  reated with chemoradiotherapy," will be presented at the Head and  neck Society Meeting in Arizona today. This is a synopsis of that  presentation. Slight temperature increases of the oral mucus membranes early in a head and neck cancer patient's chemotherapy and radiation therapy (chemoradiotherapy) treatment is a predictor of severe mucositis later in treatment, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM. Mucositis, or mouth sores, is a common side effect of chemoradiotherapy for head and neck cancer that is painful and can be very severe. Physicians cannot predict which patients will have mild mucositis or severe mucositis that would require narcotic pain  medication, nutritional support and/or feeding tubes. Researchers in this study hypothesized that using sensitive thermal imaging technology to measure temperature changes of less than  one-tenth of a degree early in treatment could predict the severity of mucositis later in treatment. This knowledge could allow for early  intervention and potential changes in therapy using a technology that is simple, harmless and non-invasive. Patients receiving chemoradiotherapy underwent baseline and weekly thermal imaging of their oral mucus membranes. All patients displayed an increase in temperature and severe mucositis was found in 53 percent of patients. "If we could predict which patients were going to suffer the greatest toxicity, we could proactively make changes to [...]

2012-01-26T15:32:36-07:00January, 2012|Oral Cancer News|

Oral Sex Cancer Virus More Common in Men Than Women, Study Finds

Source: Bloomberg.com About 10 percent of men and 3.6 percent of women are orally infected with human papillomavirus, which is acquired through oral sex and can cause cancer. There are two peaks in the age people are infected -- 30 to 34 and 60 to 64, according to the study published today in the Journal of the American Medical Association. The virus is linked to throat cancer, and is becoming a more common cause of the disease as Americans quit smoking. The virus, called HPV, is the most-common sexually transmitted virus in the U.S., where half the population will be infected at some time in their lives, according to the Centers for Disease Control and Prevention. It is known to cause cervical, vulvar, vaginal, penile and anal cancer. The higher HPV infection rate in men explains why their head and neck cancer rates are greater, said Maura Gillison, a professor at the Ohio State University College of Medicine in Columbus. “This provides pretty strong evidence that the higher infection rate is the reason why,” said Gillison, the study’s lead author, in a telephone interview. “This is a jumping board for additional research.” Besides sex, other demographics associated with oral HPV infection include age, lifetime number of sex partners, and the number of cigarettes smoked each day. The research is the first population-based study to examine how many men and women were infected, Gillison said. Existing Vaccines Though Merck & Co.’s Gardasil and GlaxoSmithKline Plc (GSK)’s Cervarix target genital HPV, it’s [...]

2012-01-26T10:10:18-07:00January, 2012|Oral Cancer News|

How online sales and promotion of snus contravenes current European Union legislation

Source: BMJ Journal   Abstract Context The European Union (EU) Tobacco Products Directive that bans sales of snus (a form of oral tobacco) in EU countries other than Sweden is currently under review. Major tobacco companies favour the ban being overturned. This study aims to explore compliance with the current ban on snus sales and examines the conduct of online snus vendors, including their compliance with two other EU Directives on excise and tobacco advertising and Swedish legislation banning sales of snus outside Sweden. Methods To determine who is currently distributing snus via the internet in the EU, searches were carried out in Google, followed by searches in the WHOIS and Amadeus databases. Five online test purchases of snus were made in each of 10 EU Member States using a standardised protocol. Feedback from the test purchases and further analysis of the websites accessed for test purchases were used to critically examine snus retailers' conduct. Results The majority of online vendors operate from Sweden and target non-Swedish EU citizens. Test purchases were successfully made in all 10 EU Member States; of 43 orders placed, only two failed. Age verification relied only on self-report. The majority of sales applied Swedish taxes, contrary to EU requirements. Copious sales promotion activities, many price based, are incorporated in these websites contravening the EU regulation, and three test purchases were delivered with gifts. Conclusions Snus is currently being sold on the single market via the internet in contravention of Swedish legislation and three EU Directives. [...]

2012-01-25T16:52:56-07:00January, 2012|Oral Cancer News|

Emerging indications: antioxidants for periodontal disease

Source: http://www.dentistryiq.com Author: Edward P. Allen, DDS, PhD Since approximately 10 to 15 percent of adults worldwide suffer from periodontitis at one time or another(1), oral health professionals are constantly challenged with treating patients for existing conditions and helping them prevent future occurrences. Root planing, scaling, and in severe cases, surgical intervention are part of the standard treatment for periodontitis, and antibiotics are used for infection control. However, in recent years, dental health professionals have honed in on the inflammation that accompanies periodontitis. Research shows that inflammation in the oral tissues—especially that associated with periodontitis—can be a factor in chronic illness such as heart and vascular disease, diabetes, arthritis, Alzheimer’s, pregnancy complications, and a growing list of other conditions. The real culprit with inflammation is oxidative stress, a disturbance in the balance of oxidants and antioxidants. Oxidative stress is the result of overproduction of free radicals, unstable molecules that attack tissue cells by “stealing” electrons from other molecules. Although infection is a major trigger for inflammation and oxidative stress, there are numerous other causes, such as poor diet, alcohol consumption and nicotine use or chemical pollutants. In oral tissues oxidative stress can result from dental procedures and from materials used for bleaching, composite fillings, implants, crowns, veneers, and so on. Antibiotics control the micro-organisms that contribute to periodontitis and other infection, but they do not necessarily address the free radicals and oxidative stress that accompany inflammation. Innate defense through natural salivary antibiotics and antioxidants The human body has an innate [...]

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