Monthly Archives: April 2015

Three things you might not know about HPV

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

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

n-HPV-VACCINE-large

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

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

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

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

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

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

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

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

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

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

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

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

April, 2015|Oral Cancer News|

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

Source: ns.umich.edu
Author: Laura Bailey

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

April, 2015|Oral Cancer News|

Double the N.I.H. Budget

Source: NYTimes.com
Author: Newt Gingrich

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

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

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

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

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

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

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

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

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

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

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

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

April, 2015|Oral Cancer News|

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

Source: www.marketwatch.com
Author: press release

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

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

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

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

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

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

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

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

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

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

brocoli

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

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

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

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

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

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

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

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

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

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

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

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

April, 2015|Oral Cancer News|

HPV Shots for Boys Might Cut Cancer Costs

Source: MedPageToday.com
Author: Charles Bankhead

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

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

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

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

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

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

Background

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

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

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

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

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

Key Findings

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

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

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

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

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

U.S. Perspective

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

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

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

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

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

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

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

Siu and co-authors disclosed no relevant relationships with industry

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

April, 2015|Oral Cancer News|

Legal loopholes allow big tobacco companies to target young children with new products

Source: http://www.contracostatimes.com
Author: Sen. Mark Leno & Tony Thurmond 
 

With smoking now widely known as the nation’s No. 1 preventable killer, Big Tobacco is targeting our kids with new products that give an illusion of more safety but carry the age-old motive to hook kids on tobacco at a young age.

Preventing children from picking up nicotine addiction is the best way to keep them free of tobacco-related disease for life. That’s why we’ve each introduced bills that seek to curb youth usage of smokeless (chewing) tobacco and e-cigarettes.

Last year, many were shocked when Hall of Famer Tony Gwynn, who played for the San Diego Padres, died from cancer of the salivary glands that was related to decades of smokeless tobacco usage. 

Former World Series hero Curt Schilling, who helped propel the Arizona Diamondbacks and Boston Red Sox to championships, has blamed his bout with mouth cancer on chewing tobacco. 

Use of chewing tobacco by professional athletes sends the wrong message to our kids, but nonetheless a powerful one. Researchers at the Harvard School of Public Health have found that the use of smokeless tobacco by players has a powerful “role model effect” on youths, particularly young males. 

It’s no wonder then that while overall rates of smoking have declined thanks to several decades of intense educational programs, smokeless tobacco rates have remained stubbornly high among youth. One in every 6 high school boys report regular usage.

Assembly Bill 768 bans smokeless tobacco at all ballparks in California with organized baseball, including all five major league stadiums. Not only would this prevent usage at high school and college games, but our youths would not be unduly influenced by seeing their heroes serve as de-facto smokeless tobacco advertisers.

While smokeless tobacco must at least carry a warning label, electronic cigarettes unfortunately are being marketed as both a safe alternative to regular cigarettes and a tool to help smokers quit. 

With mounting evidence demonstrating the health risks of e-cigarettes, we must close the legal loopholes that have enabled kids to be targeted with products that give a false sense of safety.

Tobacco makers are prohibited from marketing cigarettes to youths or producing various flavors, but the same is not true of e-cigarettes. 

Sales of e-cigarette devices to minors are prohibited in California, but gummy bear, cotton candy and bubble gum flavors are widely available to our young people in many communities. 

Meanwhile, the use of e-cigarettes is increasing at alarming rates among our youth. The Centers for Disease Control and Prevention found that more than a quarter of a million youths who had never smoked a traditional cigarette used e-cigarettes in 2013, and youth usage tripled between 2011 and 2013.

The availability of e-cigarettes to kids belies a growing public health concern over the products. The California Department of Public Health reported in January that e-cigarettes contain 10 chemicals that cause cancer, birth defects and other reproductive harm. 

A team of researchers at UCSF also found that e-cigarettes deliver carcinogens that have been linked to asthma, stroke, heart disease and diabetes. 

Senate Bill 140 would ensure that e-cigarettes are subject to the same state rules that prohibit smoking in certain public places as well as prevent the sale of tobacco products to minors with regulations and enforcement.

In 2014, 40,000 Californians died from tobacco-related diseases, which cost California’s health care system more than $13 billion annually, with taxpayers picking up a $3 billion bill for tobacco-regulated disease in the Medi-Cal program alone. 

These two bills are part of a five-bill effort at the California state Capitol that is supported by the Save Lives Coalition of doctors, nurses, health professionals, patients and nonprofit health organizations that seek to curb tobacco usage among Californians, particularly youths. 

Individually, these bills are good policy; together, they take a step toward protecting youths from predatory tobacco companies and the grip of nicotine addiction.

Sen. Mark Leno is a Democrat from San Francisco. Assemblyman Tony Thurmond is a Democrat from Richmond.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
April, 2015|Oral Cancer News|

Breath test for detecting head and neck cancer

Source: http://medicalxpress.com/
Author: provided by Ecole Polytechnique Federale de Lausanne

A portable device can detect the presence of certain types of cancer in people’s breath. Tested on patients, the new device was developed in part by EPFL researchers as part of an international collaboration.

breath_test

Inhale, then exhale. This simple act could now save lives. A technology developed in part at EPFL can quickly identify the presence of a head and neck cancer, such as of the throat or mouth by analysing people’s breath. The new device, equipped with extremely sensitive sensors, has been tested on patients and operates with a computer or even a mobile phone. It’s an innovative tool for the early diagnosis of tumours.

Very few routine exams exist to detect cancer. Yet this disease is the third leading cause of death worldwide. Most tumours are found relatively late, which makes recovery less likely.

Cancer “signals” its presence in human breath
At SAMLAB in Neuchâtel, under the direction of Nico de Rooij, a team of researchers including Frédéric Loizeau, a doctoral student at the time, developed very precise micro-sensors able to distinguish the breath of a healthy patient from that of a sick one. The scientists’ starting point was the observation that human breath contains not only air, but also hundreds of volatile organic compounds (VOCs) whose presence and concentration vary depending on the patients’ state of health. The metabolism of cancerous cells is different from that of healthy cells, and the two types of cells produce different substances in terms of both quantity and typology. As a result, they leave their “signature” in people’s breath.

The researchers managed to detect these nuances with the aid of a network of micro-sensors. The technology called MSS was initially developed jointly by EPFL researcher and the late 1986 co-laureate of the Nobel price of physics, Heinrich Rohrer. Each sensor is composed of a silicon disk 500 micrometres in diameter that is covered by a polymer and suspended by four minuscule “bridges” with integrated piezoresistors. When exposed to a gas, the polymer absorbs certain molecules and the disk changes shape. This deformation is detected by the four piezoresistive bridges, which emit an electrical signal. This phenomenon makes it possible to determine the signature of the gas and its concentration. The trick lies in using different polymers on each sensor, in order to obtain an overview of the gas composition.

“There are already methods for detecting molecules called ‘electronic noses’ on the market. But they have a hard time analysing very complex gases like human breath,” says Nico de Rooij. “Humidity in particular can disrupt the reading, leading to false positives or false negatives.” With the new sensors, the detection process becomes extremely accurate.

Clinical tests on healthy and sick patients
With the collaboration of the Swiss Nanoscience Institute of the University of Basel, the EPFL researchers were able to test their device on actual patients from the University Hospital of Lausanne (Centre hospitalier universitaire vaudois, CHUV) who were either sick or had undergone surgical treatment for head and neck cancer. The results of these tests showed that the sensors were incredibly effective. A Neuchâtel-based company has already expressed interest in marketing this technology, which has been patented.

Breathe into your smartphone
breathtest2

But the story doesn’t end there for the sensors, which have numerous applications. Recently, the NIMS/MANA research centre in Japan, another partner in the project, connected the sensors to mobile phones. This innovation earned them an award at the Nanotech 2015 event.

This technology is also of interest to biologists. At the University of Neuchâtel, tests are currently being run by the Laboratoire pour la recherche fondamentale et appliquée en écologie chimique in order to analyse the gases given off by plants when they are attacked by certain insects or mushrooms. These gases serve to attract other insects that will protect the plant. The ability to detect this phenomenon early on could allow farmers to react more quickly to an attack and, as a result, use less insecticide.

April, 2015|Oral Cancer News|

Nova Scotia to include boys in HPV vaccination schedule

Source: www.theglobeandmail.com
Author: Kelly Grant, Health Reporter

hpv_vaccine
Boys in Nova Scotia will begin receiving free vaccinations against the human papillomavirus next fall, a move that makes the Maritime province only the third in Canada to extend public funding of the cancer-thwarting shot to all children, regardless of gender.

In the budget unveiled on Thursday, Nova Scotia’s Liberal government announced it would make the HPV vaccine available to Grade 7 boys as part of the regular school-based immunization program. The expansion is expected to cost $492,000 a year.

Every province in Canada already covers the HPV vaccine for girls in an effort to prevent genital warts and cervical cancer, both of which can be caused by some strains of the virus, which is transmitted through sex and skin-to-skin contact.

But in recent years, oncologists and major health organizations – including the Canadian Cancer Society and the National Advisory Committee on Immunization – have begun calling for HPV vaccinations for boys, too. Until this week, only Prince Edward Island and Alberta had heeded that call with a publicly funded program.

HPV can lead to cancers of the penis, anus, oral cavity and throat in men, as well as genital and anal warts.

“We have a vaccine. It can prevent cancers in men and women, so we want Canadians to be vaccinated against it, because we can actually prevent cancers from starting in the first place,” said Robert Nuttall, the assistant director of cancer control policy at the Canadian Cancer Society.

Nova Scotia’s decision to fund the vaccine for boys was especially important to one recently retired member of the provincial legislature. Gordie Gosse, who until last week represented the riding of Sydney-Whitney Pier in Cape Breton, was diagnosed nearly a year ago with Stage 4 throat cancer caused by HPV. The 59-year-old former speaker of the legislature had more than 12 hours of surgery to remove the tumour and reconstruct parts of his face, followed by chemotherapy and radiation.

“If I’d had the vaccine, I wouldn’t have had the cancer,” he said in an interview on Friday.

Mr. Gosse, a member of the opposition NDP, made it his final mission as an elected official to extend public funding of the HPV vaccine to boys, which, according to a spokesman for the province’s department of health, the Liberal government was already studying as part of its annual vaccine review.

When his private members’ bill on the male vaccine program passed second reading on April 1, Mr. Gosse figured the measure would be in the budget. He announced his retirement the next day. “I was quite ecstatic,” Mr. Gosse said.

The HPV vaccine is most effective when administered before a child or teen starts having sex.

However, provincial governments are wrestling with whether it is cost-effective to vaccinate boys as well as girls.

“Right now it’s [about] money,” said Eduardo Franco, chair of the department of oncology at McGill University in Montreal.

Dr. Franco pointed to an evaluation done in Quebec two years ago that found vaccinating boys would not be cost-effective, in part because men who sleep with women would benefit from the protection the vaccine provided to their female partners. But that leaves gay men vulnerable, Dr. Franco said.

“The solution is truly universal HPV vaccination,” he said. “No questions asked. We [should] just take it for granted that it’s part of the adolescent vaccine calender.”

Alberta’s Grade 5 HPV immunization program costs $11-million a year – $4-million for boys, $4-million for girls, plus an extra $3-million a year for a limited-time “catch-up” program for Grade 9 boys that ends in 2017.

But the overall HPV immunization program is expected to save an estimated $13.4-million a year down the road by preventing some cases of HPV-caused cancer, according to Alberta Health.

Ontario is reviewing its HPV immunization program, said David Jensen, a spokesman for the Ministry of Health and Long-Term Care.

“Various factors are being considered such as scientific evidence (e.g., burden of disease and vaccine effectiveness), economic and societal factors, as well as cost effectiveness and impact on the health system,” he said by e-mail.

April, 2015|Oral Cancer News|

FDA Advisory Committee hesitates to endorse message of safe smokeless tobacco

Source: www.medpagetoday.com
Author: Shannon Firth

An FDA advisory panel were reluctant to recommend a gentler warning label for one brand of smokeless tobacco products at a committee hearing on Friday.

snus

Swedish Match North America (SMNA), the first company to be considered for a modified risk tobacco designation by the FDA, is asking to replace a current label warning, “This product is not a safe alternative to cigarettes,” with this: “Warning: No tobacco product is safe, but this product presents substantially lower risks to health than cigarettes.”

It also wants to drop warnings required for other smokeless tobacco products about oral cancers, tooth loss, and gum disease.

In a key vote, the eight-member FDA’s Tobacco Products Scientific Advisory Committee split 4-4 on whether the claim that snus offer a “substantially lower risk” claim relative to cigarettes is justified.

Many members said the health risks were lower for certain tobacco-related illnesses, but not for all health concerns. Those who disputed the claim argued that it could not be taken as a “global statement” — as there are known risks to pregnant women and uncertain risks for adolescents.

As for the proposed label change, the whole committee agreed that the sponsor’s statements would not suffice. Gary Giovino, PhD, chair of the department of Community Health and Health Behavior at the State University of New York at Buffalo, felt the statement was “dismissive of the health risks.” The word “but” in any sentence seems to negate the first half, he said.

Snus is a finely ground smokeless tobacco powder in a filter packet that is placed under the upper lip.

In his opening remarks on Thursday, Mitch Zeller, JD, director of the FDA’s Center for Tobacco Products, said that in the past companies alone decided how to advertise their products — a practice which proved damaging to consumers’ health. “Now it’s the FDA who serves as the regulatory gatekeeper, standing between consumers and the companies seeking to make claims about their products.”

To meet the standards of a modified risk tobacco product, Zeller explained, “Applicants must not only demonstrate that the products, as actually used by consumers, will significantly reduce risks to individual users of those products; they must demonstrate that they will benefit the population as a whole – taking into account both users and non-users of tobacco products.”

In its application, Swedish Match has asked to revise the labels for 10 snus products. It would maintain its warning that smokeless tobacco is addictive.

Oral Safety Unproven
The committee was unmoved by the firm’s evidence related to gum disease and tooth loss and voted 8-0 against supporting a conclusion that snus products “do not pose a risk of gum diseases or tooth loss.”

Or as Thomas Novotny, MD, MPH, the graduate school of public health at the University of California San Diego State said, when explaining his vote, “It’s not causal relationships that we’re after, it’s perception of risk and the studies don’t rule that out.”

The committee’s vote was likely influenced by Scott Tomar, DMD, MPH, DrPH, of the department of Community Dentistry and Behavioral Science, at the University of Florida, who said that “advanced gingival recession can result in tooth loss.” One of the studies presented showed a relationship between gingival recession and snus use.

As to whether snus products also “do not pose risks of oral cancer” to consumers, the committee was split 3-3 with two abstentions.
“I think the data are tending towards no increased risk but I’m not quite ready to go there,” said Giovino, one of the abstainers.

Pebbles Fagan, PhD, MPH, associate professor and member of the Cancer Prevention and Control Program at the University of Hawaii, said that based on the absence of women in the larger cohort studies, she was not comfortable claiming that snus products posed no risk of oral cancer.

Can the ‘Swedish Experience’ Cross the Ocean?
Perhaps the most important questions the committee voted on was whether the proposed labeling change would help or harm consumers. Swedish Match threw the weight of its argument behind the “Swedish Experience,” a series of government, academic ,and industry studies showing a dramatic shift from cigarette smoking to snus in the mid-1990s. The firm argued that Swedish men reduced their risk of tobacco-related diseases.

But asked whether American tobacco users would likely follow suit — swapping cigarettes for snus — panel members were unconvinced.

Only one committee member said such a switch was likely, against six voting against and one abstention.

Richard O’Connor, PhD, associate professor of oncology at the Roswell Park Cancer Institute, in Buffalo New York, the lone panelist to agree that the experience in Sweden might translate to the U.S., said the data informed “a potential pattern in the U.S.”

Another subpopulation of obvious concern is adolescents. Timothy McAfee, PhD, MPH, director of the Office on Smoking and Health at the CDC, cited animals studies on tobacco addiction that showed “deleterious effects on adolescent brain development.”

On the plus side for Swedish Match, the majority of the committee felt it unlikely that nonusers of tobacco would pick up the snus habit, although three committee members abstained from this question because they did not believe there was enough data to support such a scenario.

Lars-Erik Rutqvist, the senior vice president of scientific affairs at Swedish Match said the company was pleased with the discussion at the hearing. “On the whole they seemed to accept the fact that there is a considerable risk reduction in our products and of course that’s very important. It’s part of the definition of a modified risk product.” Rutqvist added that he would expect to continue discussions with the FDA while awaiting their decision this summer.

“I look forward to the path forward for us.”

The FDA is not required to follow the advice of its advisory committee but it usually does.

April, 2015|Oral Cancer News|