Monthly Archives: February 2013

Painting for the Oral Cancer Foundation

With a desire to help in spreading awareness for oral cancer, Anita McGinn-Natali, a Fine Art Painter from Pennsylvania, donates her original framed and ready to hang oil paintings to Oral Cancer Awareness Walks. Funds collected will benefit the Oral Cancer Foundation.

image 2In October of 2007, Anita’s husband, Clark, was diagnosed with oral cancer. Anita was her husband’s caregiver during his treatments and recovery. Two years later,she found the Oral Cancer Foundation online and began to participate in the Forums, whose contributors include patients, caregivers, as well as family and friends of patients.image

“Discovering the Oral Cancer Foundation website during a challenging time in my husband’s recovery, was gratifying. The information available and the support I received were life savers for me. “I spent hours on the website educating myself about this disease. As a participant in the Forums, I had started out asking questions with others helping me,” Anita says. No long after she was offering support to other patients and caregivers. “It is a unique community of people from all over the world who have the unfortunate common denominator of oral cancer.”

Since September 2011, Anita has donated her original oil paintings to three OCF Walks for Awareness: David Nasto in New Jersey (Susan Nasto Lauria); San Antonio (ElizabethSikon); and Colorado (Susan Cotten)

image 3Currently, there are 18 Walks for Awareness held throughout the United States. Participants can receive a free oral cancer screening, meet others whoselives have been touched by oral cancer, and be inspired by the work the Oral Cancer Foundation is doing to bring awareness to this debilitating and life changing disease.

“I wanted to find a way to give back to this organization that has been such an important part of my life. Many of the people I have met on the website have become my friends.” Anita is thrilled that her paintings have been so well received at each of the events and is hoping to donate more of her work to other OCF Walks for Awareness.

image 4The Oral Cancer Foundation is a national public service, nonprofit entity designed to reduce suffering and save lives through prevention, education, research, advocacy, and patient support activities. Oral cancer is the largest group of those cancers which fall into the head and neck cancer category.

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

HPV and oral cancer

Source: myfoxny.com
Date: Feb 21, 2013 4:02 PM PST  Updated: Feb 25, 2013 2:07 PM PST

NEW YORK (MYFOXNY) – 

Oral cancer is being diagnosed at near epidemic proportions, and in many cases it strikes those people who would least suspect it.

At 28, Jessica Tar appeared young and healthy. That is why she was floored to find out she had oral cancer; a small tumor was growing on her tongue.

“It was just this raised area, and pain from time to time,” Tar says.

They are symptoms many of may have ignored, but thankfully Jessica did not. Her cancer was caught early and had not spread.

She went to Memorial Sloan Kettering’s Dr. Jatin Shah for treatment. He recommended a surgery to remove part of her tongue, an aggressive treatment that threatened her career as an actress and singer.

“They tell you your mouth is going to be rearranged. The tip of your tongue, where you thought it once was, it won’t be there anymore,” Tar says.

Jessica Tar was anxious to get back to work, so she underwent extensive speech therapy. The hardest thing for her to pronounce was the letter S.

Jessica knew she want to work hard at it and she had the ultimate motivation, a specific name in mind for her daughter on the way.

“I said to my speech therapist if I can’t improve on these S’s I don’t think I’m going to name her Kalista, but I got better and the day she was born, we named her Kalista.”

Today Jessica is cancer-free, but doctors have never been able to pinpoint the cause of her cancer. “When you think of oral cancer the picture that comes to into your head is someone who smokes and drinks heavily. I’m neither of those things,” Tar says.

Even Dr. Shah was surprised by Jessica’s cancer diagnosis. Smoking and drinking are the most common risk factors, but that is changing.

The biggest risk factor now is the sexually transmitted virus called HPV, the same virus that can cause cervical cancer. Jessica did not have HPV, either.

But many being diagnosed now do. The Oral Cancer Foundation says 40,000 people will be diagnosed with oral cancer this year alone, the majority of those cases will be tied to HPV.

“Of the 100 patients coming in today with oral pharynx cancer I would say 80 percent will be HPV-positive,” says Dr. Shah.

And experts say that number is climbing in almost epidemic proportions.

Celebrities Michael Douglas, Gwyneth Paltrow, and Blythe Danner are helping spread the work about the potentially deadly disease.

Michael Douglas has battled oral cancer for several years.

Bruce Paltrow, Gwenth’s father and Blythe Danner’s husband, died from it download illustrator cs6.

“There is an epidemic of oral cancer among young people, unfortunately due to oral sex,” says Blythe Danner.

It’s not just young people, you can live with HPV for years and never know you have it, there is no way to screen for the virus and in most cases it doesn’t have any symptoms.

That is why at 52, Kevin Pruyne’s oral cancer diagnosis was a shock.

“I went to see my general doctor and she felt like it was just an infection or something like that and did the antibiotics,” says Kevin Pruyne.

After several months and rounds of antibiotics, Kevin’s ‘infection’ seemed to be getting worse.

Finally a CT scan and biopsy determined Kevin had stage 4 cancer, the cause?

The sexually transmitted virus HPV, Kevin didn’t know he had it or that it could cause cancer.

“You don’t talk about it but we have been monogamous for 30 years,” Kevin says.

Kevin and his wife, Kathy, were worried the cancer had taken too long to diagnose.

“If it’s gone past your collar bone and into your lungs its game over,” Kevin says.

Thankfully the cancer hadn’t reached his lungs. Kevin underwent an aggressive treatment of radiation and chemotherapy.

“He was sick, he was really sick and it was hard to see and watch him vomiting becoming less of the strong man that he was,” Kathy says.

Doctors say HPV-positive cancers are typically curable. A couple of months ago Kevin got the good news he is cancer free, but he still worries.

“You say what is my prognosis, you make up 5 years we will call you cured unless it pops up somewhere else,” Kevin says.

Kevin wishes he knew the dangers of HPV. Now he is warning everyone he knows.

“I’ve got some guys that I work with that are younger and have a tendency to be a bit more promiscuous than they should so I sent a letter saying listen this is what caused my cancer and you all need to be careful,” Kevin says.

The early symptoms of oral cancer, like a sore throat can easily go undetected, so early screening is important.

Dentists are now starting to do comprehensive oral cancer screenings.

Upper East Side Doctor Robert Friedman uses a florescent light to look for irregularities in the mouth.

“Your dentist is your mouth specialist,” Dr. Friedman says. “Dentists really should be the first line of detection of these types of known entities.”

Fluorescent light cancer screenings aren’t covered by most dental insurance policies, but it typically costs only $25.

There is a vaccine against HPV, Gardasil, which can be administered to pre-pubescent girls and boys.

A screening will be held in April:
 
Thursday, April 25, 2013
9:00 am – 12:00 Noon
Memorial Sloan-Kettering Cancer Center
Enid A. Haupt Pavilion
425 East 67th Street
Fourth Floor, Suite 5
Between York and First Avenues

No appointment necessary. For further information, call 646-497-9161.

For More Information:

http://oralcancerfoundation.org/

 

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

 

 

‘Risk’ Varies in HPV-Positive Oropharyngeal Cancer: Study

Source: Medscape Medical News > Oncology
Author: Kate Johnson
Date: February 21, 2013
 

Deintensification of chemotherapy might not be the best option for all patients with oropharyngeal cancer whose disease is associated with human papillomavirus (HPV).

However, such an approach might be reasonable for patients with a low risk for distant recurrence; namely, those with less advanced disease and limited exposure to smoking, according to a large retrospective institutional study conducted by Brian O’Sullivan, MD, from the Princess Margaret Hospital in Toronto, Ontario, Canada, and colleagues.

The study was published in the February 10 issue of the Journal of Clinical Oncology.

The findings “provocatively suggest there is a limit to the favorable biology of HPV-associated OPSCC [oropharyngeal squamous cell carcinoma],” write Harry Quon, MD, and Arlene Forastiere, MD, from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, Maryland, in an accompanying editorial.

“It could be that today’s treatment paradigms result in the overtreatment of many patients (and the consequent late effects on swallowing function) and undertreatment of a smaller subset,” they add.

There is growing concern among OPSCC experts about patients’ risks for radiation-related morbidity, particularly severe late swallowing complications, Dr. Forastiere told Medscape Medical News.

“The potential for this damage is increased when chemotherapy is added to the radiation,” she explained. “One simple strategy is to drop the chemotherapy from the treatment of those with a low risk for recurrence of tumor in the oropharynx or the regional lymph nodes in the neck.”

However, she pointed out that Dr. O’Sullivan and colleagues “have refined this ‘risk definition’ by focusing not just on local failure, but also on predictors of distant failure…. As we consider strategies to deintensify treatment, we do not want to alter chemotherapy in those at increased risk for metastatic disease.”

The researchers examined 505 patients with OPSCC (382 HPV-positive and 123 HPV-negative) who were treated from 2001 to 2009 with either radiotherapy (RT) alone or chemoradiotherapy (CRT). Median follow-up was 3.9 years.

In the 2 HPV groups, they compared overall survival; recurrence-free survival; local, regional, and distant control; and late toxicity.

HPV status, age, sex, tumor and node categories, smoking and alcohol consumption, and treatment modality were used in the univariate and multivariate analyses to identify predictors of outcomes.

More Favorable Outcomes, But Only for Some

As expected, HPV-positive patients had more favorable 3-year outcomes than HPV-negative patients. This included better overall survival (83% vs 49%), better recurrence-free survival (84% vs 64%), and significantly higher rates of local control (94% vs 80%; P < .01) and regional control (95% vs 82%; P < .01).

Distant control rates were similar in the HPV-positive and HPV-negative groups (90% vs 86%; P = .53), but the temporal pattern of distant relapse was different. “The HPV-positive curve continued to decline for up to 5 years, in contrast to the relatively stable HPV-negative curve beyond 2 years,” the researchers report.

Because distant metastasis “remains the predominant pattern of failure,” deintensification “might best be deployed in subgroups least likely to develop [distant metastasis],” they note.

Using recursive partitioning analysis to identify such subgroups, the researchers found that advanced-stage disease significantly increased the risk for distant metastasis in all patients.

In HPV-positive patients, those with stages T1–3 and N0–2c disease were classified as low risk (a 3-year distant control rate of 93%), and those with stages T4 and N3 disease were classified as high risk (a 3-year distant control rate of 76%).

However, even in the low-risk HPV-positive group, there was a subgroup of patients for whom deintensified treatment (RT alone) produced worse outcomes than chemoradiotherapy (CRT).

Two subgroups of patients had worse distant control when treated with RT alone (n = 150) than when treated with CRT (n = 136): those with stage N2b disease (89% vs 98%; P = .03); and those with N2c disease (73% vs 92%; P = .02).

In the RT-treated N2b subgroup, the risk increased with heavy smoking (at least 10 pack-years); distant control rate was 84%.

“It seems prudent to exclude N2c disease from deintensification strategies that do not include conventional chemotherapy,” the researchers suggest. They add that reducing the intensity of or omitting chemotherapy might also be unsuitable for N2b heavy smokers.

However, HPV-positive patients with T1–3 and N0–2a disease and patients with N2b disease who are heavy smokers have minimal risk for distant metastasis, irrespective of treatment approaches. In such subgroups, deintensification might be optimal, they conclude.

“Overall survival can be misleading because it includes deaths from causes unrelated to the cancer,” Dr. Forastiere told Medscape Medical News. “Individuals with non-HPV-associated cancers have comorbid conditions as a result of tobacco and alcohol use,” she said. On that basis alone, we would expect them to have worse survival. Using disease-specific survival allows for a comparison of “apples to apples,” she explained.

The editorialists emphasize that, given current knowledge, treatment of HPV-associated locoregionally advanced cancers with anything less than the standard full doses of radiotherapy and concurrent cisplatin should only occur in the context of a clinical trial.”

 

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

 

February, 2013|Oral Cancer News|

Professor of dentistry told woman suffering from tumour in her jaw to chew sugar-free gum and misdiagnosed 32 others, tribunal hears

Source: mailonline.com
Author: Steve Robson
Date: February 19, 2013
 
Blunders: Professor Philip Lamey is accused of misdiagnosing 33 patients at Royal Victoria Hospital in Belfast
 

A professor of dentistry misdiagnosed patients who had cancer – prescribing one with sugar-free chewing gum when she had a tumour in her jaw and another with iron supplements for skin cancer – a tribunal has heard.

Philip Lamey allegedly misdiagnosed seven people with mouth cancer – four of whom later died – at the School of Dentistry in Royal Victoria Hospital, Belfast.

In total 135 patients were recalled after doubts were raised about their biopsy results, a hearing of the General Dental Council (GDC) in London was told today.

Professor Lamey, who is being represented by lawyers at the hearing, faces 46 charges after concerns were raised about his diagnosis of 33 patients.

David Bradly, counsel for the GDC, said on one occasion the dentist’s blunders caused a patient to be rushed to hospital after a wrong diagnosis.

The patient was told she had temporomandibular joint dysfunction (TMD) – chronic jaw pain – when she in fact had a tumour in her jawbone.

Mr Bradly said: ‘Professor Lamey gave a diagnosis of TMD and prescribed sugar-free chewing gum for treatment and said he would see her in three months.

‘She actually had a tumour in the mandible and was admitted to hospital. She had a squamous cell carcinoma – a type of skin cancer – and had radiotherapy following an operation.’

On another occasion he diagnosed an elderly patient as having a traumatic ulceration of the tongue.

He repeatedly prescribed iron supplements to the 78-year-old, but eventually again made a late diagnosis of squamous cell carcinoma.

Mr Brady added: ‘Professor Lamey failed to review the diagnosis of trauma.’

He also wrote in his notes that the patient declined a biopsy, when no biopsy was even offered to the pensioner.

In total 135 patients at the Royal Victoria Hospital in Belfast had to be recalled after doubts were raised about their diagnosis by Professor Philip Lamey

While treating another patient, Professor Lamey diagnosed a traumatic mucocele in the upper lip, which can be a sign of a tumour on the salivary gland, but got a dental trainee to carry out the biopsy.

And the professor caused ‘unnecessary delay’ removing a patient’s mercury fillings and prescribing antibiotics when a patient actually had lesions spreading through her mouth.

Mr Bradly said: ‘Medications were not going to work because this lesion was a tumour.

‘This patient should have been referred for a biopsy. It was all an unnecessary delay.’

The hearing, expected to take 19 days, will focus on seven mouth cancer patients who were wrongly treated by Professor Lamey, among others.

The hearing in central London continues.

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
February, 2013|Oral Cancer News|

Even moderate drinking may substantially raise risk of dying from cancer

Source: www.nydailynews.com
Author: Tracy Miller, New York Daily News

Alcohol causes about 19,500 cancer deaths each year — and even as little as 1.5 drinks per day can make you part of that statistic, according to a sobering new study.

The research, published in the American Journal of Public Health, is the first in several decades to examine deaths from a variety of cancers that can be attributed to alcohol consumption, said lead study author David E. Nelson of the National Cancer Institute.

“One of the reasons we did the study was to update data that hadn’t been looked at for 30 years,” Nelson told the Daily News. “In that time, other diseases, and other cancers, have been linked to alcohol.”

The researchers looked at mortality data from two national surveys conducted in 2009, and using a mathematical formula, determined which of the cancer deaths were alcohol related.

About 3.2 to 3.7% of all cancer deaths in 2009 were attributed to alcohol, with oral cancers, pharynx, larynx and esophageal cancers the top killers in men, and breast cancer the most deadly in women.

About 15% of all breast cancer deaths were attributable to alcohol consumption, the study found.

Furthermore, while the risk of death was greatest among people who had three or more drinks per day, about 30% of deaths occurred among people who consumed 20 ounces, the equivalent of 1.5 drinks, per day.

“There’s no question that people who drink more frequently are at greater risk,” Nelson said. “What we do know is that alcohol is a cancer-causing agent. There is no acceptable or safe level.”

Heavier drinkers are more likely to engage in other unhealthy behaviors such as smoking, which also ups their risk, Nelson said, but the vast majority of drinkers don’t fall into this category.

“We’re missing one of the things we can do to help lower our cancer risk that’s hiding in plain sight,” he said. “This is something that doctors and people are just not paying attention to.”

That might be upsetting news to moderate drinkers who’ve been told their habit is harmless and may actually be good for them. Red wine in particular has been touted for heart health, cancer prevention and possibly even counteracting Alzheimer’s disease. Among older adults, one drink a day for women or two for men has been shown to guard against heart attack and stroke.

Most public health experts temper that advice with plenty of caution, however, saying the research isn’t conclusive.

“If you currently don’t drink, don’t start drinking for the possible health benefits,” the Mayo Clinic advises on its website.

This new study may help drive home the message that for many of us, even moderate drinking carries significant risks. People with a family history of cancer, especially, should think before choosing to imbibe.

“If you choose to drink, the lowest level possible is best,” Nelson said.

February, 2013|Oral Cancer News|

New drug combination could prevent head and neck cancer in high-risk patients

Source: www.sciencedaily.com
Author: staff

A new drug combination shows promise in reducing the risk for patients with advanced oral precancerous lesions to develop squamous cell carcinoma of the head and neck. The results of the study, which included preclinical and clinical analyses, were published in Clinical Cancer Research, a journal of the American Association for Cancer Research.

“Squamous cell carcinoma of the head and neck (SCCHN) is the most common type of head and neck cancer,” said Dong Moon Shin, M.D., professor of hematology, medical oncology and otolaryngology at Emory University School of Medicine, and director of the Cancer Chemoprevention Program at Winship Cancer Institute at Emory University in Atlanta, Ga. “The survival rate for patients with SCCHN is very poor. An effective prevention approach is desperately needed, especially since we can identify patients who are at extremely high risk: those with advanced oral precancerous lesions.”

Based on prior research suggesting a role for epidermal growth factor receptor (EGFR) and cyclooxygenase-2 (COX-2) in promoting SCCHN, Shin and colleagues believed combining an EGFR inhibitor and a COX-2 inhibitor could provide an effective chemopreventive approach.

They found that the combination of the EGFR inhibitor erlotinib and the COX-2 inhibitor celecoxib was more effective for inhibiting the growth of human SCCHN cell lines compared with either drug alone. In addition, treating mice with the drug combination prior to transplanting them with human SCCHN cells more effectively suppressed cancer cell growth than did pretreating the mice with either drug alone.

Based on these preclinical analyses, Shin and colleagues initiated a phase I chemoprevention trial. Eleven patients with advanced oral precancerous lesions were assigned to treatment with erlotinib and celecoxib. Tissue samples from the patients were obtained and evaluated pathologically at three, six and 12 months after therapy initiation. Biopsies at baseline and follow-up were available for seven patients.

Pathologic examination of the biopsies indicated that three of the seven patients had a complete pathologic response; that is, there was no longer evidence of the precancerous lesions in the follow-up biopsy sample. Among the other patients, two had a partial pathologic response and two had progressive disease.

“Finding that this drug combination caused some advanced premalignant lesions to completely disappear was great news,” said Shin. “Advanced premalignant lesions rarely regress, so our data are proof-of-principle that a combination chemopreventive strategy with molecularly targeted agents is possible.”

Several patients dropped out of the trial because of severe adverse side effects, according to Shin. “Prevention is not achieved through short-term treatment,” he said. “So, we need to investigate the safety and toxicity of this combination further before planning a large-scale trial. We are also looking to combination therapies using less toxic or nontoxic agents, such as natural compounds.”

February, 2013|Oral Cancer News|

Kentucky cancer center emphasizes patients’ quality of life

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

The James Graham Brown Cancer Center at the University of Louisville is among a growing number of facilities working to improve care for head and neck cancer (HNC) patients through collaborative care programs that bring together a spectrum of oncology specialists.

The center provides multidisciplinary treatment for HNC patients using novel techniques that decrease the debilitating side effects of radiation and chemotherapy. The clinic also conducts research and clinical trials with targeted therapies that aim to restore patients’ oral functions.

Kentucky has a higher rate of HNC than the U.S. average, which provides a large patient pool for the many clinical trials that the center conducts, according to Zafrulla Khan, DDS, MS, professor and director of maxillofacial/oncologic dentistry in the center’s HNC clinic.

“That’s what happens when you mix tobacco and bourbon,” Dr. Khan noted.

Intraoral radiation shields
Some of the center’s novel treatment techniques involve using intraoral radiation shields during brachytherapy radiotherapy procedures to prevent the tongue and nearby oral areas from getting irradiated while minimizing mucositis and xerostomia, Dr. Khan explained.

rad_shield1

Intraoral radiation shields prevent the tongue and nearby oral areas from getting irradiated while minimizing mucositis and xerostomia

“We put catheters right into tumors so they can deliver the radiotherapy in the mouth with high-density therapy machines rather than doing an external beam,” he said.

The clinic also uses a surgical obturator, a prosthetic device that enables patients to speak and swallow following surgery for maxillary sinus cancer. The maxillectomy procedure removes bones and tissue in the hard palate of the mouth, so when patients try to eat, the food can come through the nose, sinuses, and even into the lungs.

The device is similar to a denture or partial and includes a bulb that fills the opening in the roof of the mouth and part of the soft palate if it’s missing.

“It’s like a denture with a hump,” Dr. Khan explained. “It might be crude and simplistic but it gives patients the ability to eat orally and speak. That’s two major functions that are restored.”

The novel approaches are among the advantages of having a multidisciplinary team that includes maxillofacial oncologists, he noted.

rad_shield2

The surgical obturator is a prosthetic device that enables patients to speak and swallow following surgery for maxillary sinus cancer.

Previously, surgeons consulted with specialists individually, Dr. Khan said. Weekly meetings with the center’s specialists include an HNC pathologist, radiation oncologist, medical oncologist, otolaryngology surgeon, ear nose and throat specialist and Dr. Khan, who is a dental oncologist/maxillofacial prosthodontist.

Multidisciplinary approach
The center also has a palliative care physician for pain management, nurse study coordinator for the clinical trials, speech pathologist, and social worker for indigent patient needs such as transportation.

“We meet Friday mornings and everybody gets their two cents in,” Dr. Khan said. “What if we do this or that? So the overall plan is much better simply because everyone has input before you present treatment options to the patient. You’re not second guessing what the radiologist, medical oncologist or surgeon is thinking because they’re all at the table. I think it’s the only real way to treat cancer nowadays.”

One of his most interesting and unusual cases involved maxillary prosthodontics for a bodyguard whose face had to be largely replaced after he developed a fungal infection in his maxillary sinus. “He was a diabetic on steroids, and he ignored the infection too long,” Dr. Khan told DrBicuspid.com.

A specialty team including plastic, microvascular and maxillofacial oral surgeons performed a bilateral orbital exenteration (removing the contents of the eye socket), a maxillectomy (removal of the bones along the palatal fissure that forms the upper jaw) and also removed his upper lip.

“His face was pretty much carved off,” Dr. Khan said. “Everything was removed up to the base of his skull. We redid his face completely.”

The man’s eyes were replaced with prosthetic eyes and his upper palate was reconstructed with free flaps grafts from his fibula.

Afterward, his face was “reasonably acceptable,” Dr. Khan said. But sadly, he became sedentary after he lost his vision and died about seven years later when he was only in his 40s.

Improving quality of life
The first line of therapy for HNC patients is now shifting more toward radiation and chemotherapy, Dr. Khan observed.

“When I first started it was surgery followed by radiation because it was close to a positive margin and there might be nodal involvement,” he recalled. In fact, the center’s surgical rate for HNC dropped from 43% in 2004 to 23% in 2006.

“It makes a lot of sense because you can always do surgery later,” he noted.

All HNC patients must get a dental clearance and any needed extractions before radiation therapy to avoid complications later. “It’s essential and minimizes the side effects that you used to see,” Dr. Khan explained. “But there’s no escaping xerostomia and mucositis because that’s the nature of the therapy.”

HNC cases are hugely expensive, he noted. An average seven-day treatment course costs between $40,000 to $60,000 just for radiation therapy.

Some 40% of the patients are indigent, but their costs are covered because the center is a university-based hospital, he noted. “We never turn down patients because of their inability to pay.”

For Dr. Khan, the main priority is improving the lives of his patients.

“Quality of life is so critical,” he said. “I don’t care who the patient is, when they have a cancer diagnosis they’re devastated. Even if it’s a late diagnosis, we as dentists can make their quality of life a lot better.”

February, 2013|Oral Cancer News|

Detecting cancer’s biochemical ‘fingerprint’ for early diagnosis

Source: www.siliconrepublic.com
Author: Claire O’Connell

Detecting cancer in its early stages could help to make treatment more effective. Claire O’Connell found out from Dr Fiona Lyng about Cervassist, an emerging technology that uses spectroscopy to analyse tissue samples and spot when cells are showing signs of abnormality.

So far the technology has been focusing on assessing cervical smear samples, which are routinely collected as part of screening programmes for cervical cancer in many countries.

Cervical cancer is the one of the most common female cancers in Europe, and women are encouraged to be screened every few years. Cells are removed from the neck of the womb, and they are examined by eye under a microscope. If there are abnormal or potentially cancerous cells in the sample, the person can be monitored or treated as appropriate.

Cervassist, which is being developed at Dublin Institute of Technology (DIT), could offer another view of those cells on the microscope slide. By shining laser light on the samples and collecting some of the scattered radiation, the technology can automatically analyse the biochemical content of the cells, explains Lyng, who is manager of the DIT Centre for Radiation and Environmental Science.

“We use Raman spectroscopy to analyse the cervical samples – it’s a vibrational spectroscopic technique that gives a biochemical fingerprint of a sample,” she says. “If you shine laser light on a sample, light is scattered back and we collect the inelastic scatter, which contains information about the biochemical components in the sample, the proteins, nucleic acids, lipids and carbohydrates.”

Validating the technology
The team at DIT, funded by Enterprise Ireland, has been working with Prof John O’Leary and Dr Cara Martin at the Coombe Women and Infants University Hospital in Dublin, building up a database of Raman fingerprints from normal, abnormal and cancerous cells in order to develop and validate the technology.

Preliminary results suggest the Raman approach offers around 98pc accuracy, according to Lyng, and the hope is that the technology could eventually support screening programmes.

“It could be used as an initial screening step, to screen out all the normal samples – which are the bulk of the samples – and highlight the ones that are abnormal and have cytologists assess them,” she explains.

Lyng, who won the Enterprise Ireland ‘One to Watch’ award in 2011, has been working closely with DIT Hothouse, and Cervassist technology has been licensed to business partner Raman Diagnostics. At the moment, the drive is on to validate the technology with larger numbers of samples before moving to a clinical setting.

“We are now building up the numbers of the different classes of cervical cytology samples, and ultimately we want to move the Raman microscope into the current cytology setting and compare it directly, side by side with the normal screening programme,” says Lyng.

The research team has also been investigating whether Raman spectroscopy could help to identify the presence of specific human papilloma viruses (HPV) in cervical samples, which are linked with increased cancer risk.

SFI grant
Meanwhile, Lyng has just been awarded a grant from Science Foundation Ireland to develop the Raman technology to analyse oral cancer.

“For Raman spectroscopy, the ultimate goal would be to have an in vivo probe, so we wanted to concentrate on sites that are accessible to a fibre optic probe, and that’s one of the reasons we decided to have a look at analysing samples from the mouth,” she explains.

Lyng will work with Prof Stephen Flint from the Dublin Dental University Hospital on the four-year grant: “We are looking to understand what the Raman spectra look like for normal, pre-cancer and cancer cells in the mouth and then take what we know from our work with cervical cancer and apply it to oral cancer.”

February, 2013|Oral Cancer News|

One Less Cancer to Worry About (If Only)

Posted: 02/07/2013

By: Joaquin M. Espinosa

Source: Huffington Post

 

Thankfully, there is one cancer that I no longer have to worry about. I just need to figure out when exactly my seven-year-old twin daughters will have sex for the first time.

In 2013, around 12,000 American women will be diagnosed with invasive cervical cancer and more than 4,000 will die from it. Globally, cervical cancer is the third most common cancer in women worldwide, killing >275,000 every year. But these numbers will go down, must go down, because cervical cancer is now a fully preventable disease. Or isn’t it?

For us cancer researchers, good news is often not good enough and too spread apart. In this long war, we became weary of unfounded celebrations. When asked when exactly our discoveries will make a difference in the clinic, we balk and hesitate, as we have been scarred by the many times that our discoveries did not translate into a cure. Yet this time is different, this victory is unequivocal, scientific research has led to the development of vaccines that can make cervical cancer history. Now all there is left to do is to get people vaccinated. Startlingly, this seemingly simple objective is proving to be a monumental task.

Cervical cancer originates in the lower portion of the uterus, and if not detected and treated early it will eventually metastasize and kill. Virtually all cervical cancers are caused by the Human Papilloma Virus (HPV), which is present in about half of sexually active people. With the advent of easy diagnosis via Pap smears and effective surgical procedures, the rate of cervical cancer deaths dropped steadily in the U.S. during the 20th century, but the numbers have now stabilized. The disease remains a leading cause of death for women in developing countries, where access to screening and treatment is scarce.

The vaccines effectively create immunity against the cancer-causing HPV strains, and if deployed at a large scale they would eradicate cervical cancer as well as other HPV-caused cancers, such as penile cancer and head and neck carcinomas in both males and females. Shockingly, a number of economic, political, and ideological issues now blunt this phenomenal scientific achievement.

For developing countries that need these vaccines the most, the price tag is simply too high. The retail price in the U.S. is about 130 dollars per dose, with three shots required over six months. Encouragingly, the GAVI Alliance recently selected HPV vaccines for support, raising 4.3 billion dollars from donors and negotiating a price of 5 dollars per dose. In sub-Saharan Africa, the HPV vaccination campaign has gathered strong support from leaders and the population, and more than 30 million girls are expected to be vaccinated by 2020, yet another 300 million could benefit in low income countries.

Paradoxically, in the U.S. and other countries where the vaccines are free or affordable to many, unnecessary controversies are delaying their widespread use. Currently, only 30 percent of eligible girls and virtually no boys are receiving the vaccine. Why not? Some prominent politicians have promoted the unfounded claim that the vaccines are not safe. Science proves them wrong, as more than 46 million HPV vaccines had been given in the U.S. with an outstanding safety record. Shockingly, last year five Catholic bishops in Canada banned HPV vaccines from the Calgary Catholic School board, postulating that HPV vaccination would increase sexual activity in their youth. Again, science proves them wrong, as a recent study found no increase in sexual activity among those vaccinated. By the way, the international Catholic Medical Association has no ethical or scientific issue with HPV vaccination.

Perhaps the most insidious obstacle toward HPV vaccination resides in a nasty little parenting decision. When exactly should we vaccinate our boys and girls? The answer is key, because vaccines should be applied at least six months before the first exposure to the virus.

Which brings me back to the key question: when will my daughters have sex for the first time?

Well, in the very specific case of my twin seven-year-old daughters, I don’t think vaccination will be necessary until they are in their early twenties, right? I think is fair to assume at this point that these precious little girls who love their daddy so much will wait until they graduate from college to have sex with their husbands during their honeymoons, right?

Wrong. Wake up, Joaquin.

The average American has their first sexual experience at 16.9 years of age.

Wow, really? Hold on a minute, that can’t be right, I am sure they polled the wrong population. They must have surveyed some very liberal place, like Los Angeles or New York. I am sure that it was much later for women in my circle of friends. I am going to send a few emails to all these women that I respect and admire asking when exactly they had intercourse for the first time.

The answers are in: 17, 15, 14, 16, 14, 15, 14, 15, 16, 23 (the outlier). Average: 15.9. Darn it.

Okay, given the overwhelming evidence, I think I should vaccinate my girls when they turn 13.

Ouch. The thought of taking two 13-year-old teenagers to the doctor for an HPV vaccination is freaking me out. What if they start asking questions about the vaccine? What am I going to say, that it’s just another flu shot? I could not possibly tell them the truth about the vaccine, because if I did it would surely lead to a conversation about sex. Now, that’s scary. Furthermore, by telling the truth I would be implying that they are ready for sex, which of course they would not be. I wish I could vaccinate them right now, before this whole thing gets any more awkward.

HPV vaccines can be administered as early as nine.

OK, I will vaccinate them at nine. Better yet, maybe I don’t have to be there; they could go with their mom. Yes, that’s right, they will go with Mom.

 

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

 

February, 2013|Oral Cancer News|

Where Do the Millions of Cancer Research Dollars Go Every Year?

Posted: Thursday, Feb. 7, 2013, at 5:18 PM ET

By: Quora Contributor

Source: Slate.com

 

This question originally appeared on Quora.

Answer by David Chan, MD, Oncologist :

I’ll be the first to admit that despite all the billions put into cancer research, the end results of preventing cancer and treating advanced cancer have been disappointing.

Unlike reducing deaths from heart attacks and stroke, progress in reducing deaths from cancer has been disappointingly slow. Sure, we’ve had our breakthrough drugs like Gleevec, the targeted drug for chronic myelogenous leukemia, and Herceptin for a certain type of breast cancer. But for a lot of other cancers, the treatments aren’t giving us bang for the buck. Spending $100,000 to $200,000 a year to extend life for an additional three to six months may be very important to those individuals with cancer, but are a very poor return on investment for society. It’s not sustainable, and that’s why a lot of national health care programs won’t pay for drugs like Avastin, Sutent, Yervoy, and Provenge.

Dr. Margaret Cuomo (sister of New York Gov. Andrew Cuomo) recently wrote about her perspective about this.

On the amount spent on cancer research:

“More than 40 years after the war on cancer was declared, we have spent billions fighting the good fight. The National Cancer Institute has spent some $90 billion on research and treatment during that time. Some 260 nonprofit organizations in the United States have dedicated themselves to cancer — more than the number established for heart disease, AIDS, Alzheimer’s disease, and stroke combined. Together, these 260 organizations have budgets that top $2.2 billion.”

On how ineffective the research has been for end results:

“It’s true there have been small declines in some common cancers since the early 1990s, including male lung cancer and colon and rectal cancer in both men and women. And the fall in the cancer death rate — by approximately 1 percent a year since 1990 — has been slightly more impressive. Still, that’s hardly cause for celebration. Cancer’s role in one out of every four deaths in this country remains a haunting statistic.”

What does she suggest?

“Simply put, we have not adequately channeled our scientific know-how, funding, and energy into a full exploration of the one path certain to save lives: prevention. That it should become the ultimate goal of cancer research has been recognized since the war on cancer began. When I look at NCI’s budget request for fiscal year 2012, I’m deeply disappointed, though past experience tells me I shouldn’t be surprised. It is business as usual at the nation’s foremost cancer research establishment. More than $2 billion is requested for basic research into the mechanism and causes of cancer. Another $1.3 billion is requested for treatment. And cancer prevention and control? It gets $232 million altogether. (Remarkably, in the very same budget report, the NCI states, “Much of the progress against cancer in recent decades has stemmed from successes in the areas of prevention and control.”)”

Are We Wasting Billions Seeking a Cure for Cancer?

As a result of the billions put into cancer research, we do know a lot about what causes cancer, how cancers grow, and how cancers spread. We have ideas about how to stop cancer. But the process of translating laboratory advances into the clinic has been agonizingly slow. This because cancer isn’t one disease, but a general term for many diseases that have some things in common and many things that vary from one type of cancer to another.

Even within a cancer, like breast cancer, we are finding that there are different subtypes that have different molecular signatures that should be attacked in different ways. And we’re making progress.

But we should also understand that for the most part, cancer is a disease of aging, and we aren’t close to solving that problem. We’re finding that cancer survivors are developing second and third cancers. So there are going to be significant limits on what cancer treatment can accomplish. I don’t think that we’ll ever defeat aging.

Let’s also accept some personal responsibility. The leading cause of cancer death is lung cancer. We know what causes it, and we know how to prevent it. But people continue to smoke. So in America …

“Lung cancer causes more deaths than the next three most common cancers combined (colon, breast, and prostate). An estimated 160,340 Americans were expected to die from lung cancer in 2012, accounting for approximately 28 percent of all cancer deaths.”

Cancer researchers can’t be blamed for that statistic. Stop smoking and that death rate will drop by 85 percent.

What about obesity. It’s pretty clear that about one-third of all cancers are related to being overweight. We’ve publicized the data, and yet we’re getting fatter by the year.

“Results from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) show that 68 percent of U.S. adults age 20 years and older are overweight or obese.”

One study, using NCI Surveillance, Epidemiology, and End Results (SEER) data, estimated that in 2007 in the United States, about 34,000 new cases of cancer in men (4 percent) and 50,500 in women (7 percent) were due to obesity.

Why don’t we like cancer prevention? Isn’t prevention better than cure? Cancer researchers know that hepatitis B is the leading cause of liver cancer and HPV is the leading cause of cancers of the cervix, anal canal, and contributes to many head and neck cancers.

But 50 percent of Americans have not been vaccinated for hepatitis B. The HPV vaccine rate is even lower.

“The 2010 version of the CDC’s National Immunization Survey-Teen was published in a recent Morbidity and Mortality Weekly Report. The survey found that the proportion of adolescents ages 13-17 who had received at least one dose of HPV vaccine increased from 44.3 percent in 2009 to 48.7 last year. The proportion of teens who had completed the series increased from 26.7 percent to 32.0 percent.”

If we’re not curing cancer effectively, we know how to reduce the risk preventatively, but as a society, we’re not doing that.

 

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

 

February, 2013|Oral Cancer News|