Monthly Archives: December 2017

Chronic heartburn might increase chance of neck, head cancers

Source: www.upi.com
Author: HealthDay News

Millions of American seniors suffer the discomfort of chronic acid reflux. Now, new research suggests the condition might raise their odds for even more dangerous foes — head and neck cancers.

The research can’t prove cause-and-effect, and the odds of any one person with chronic heartburn developing one of these relatively rare cancers remains low, experts noted.

But the study of nearly 28,000 Americans over the age of 65 did show a heightened risk.

Overall, a history of gastroesophageal reflux disease — the clinical term for chronic heartburn — was linked to nearly triple the odds of developing cancers of the voice box (larynx); about a 2.5 greater odds for cancers of the pharynx (top of the throat); a doubling of risk for cancers of the tonsils; and a 40 percent higher odds for cancers in the sinuses.

Head and neck cancers of the respiratory and upper digestive tracts cause more than 360,000 deaths worldwide each year, the researchers noted.

The new study was led by Dr. Edward McCoul, of the Ochsner Clinic Foundation in New Orleans, and published Thursday in the journal JAMA Otolaryngology Head & Neck Surgery.

One gastroenterologist said the findings aren’t surprising, given what’s known about the effect of acid reflux on sensitive tissues.

“Reflux material from the stomach can rise high in to the esophagus, the food tube between the mouth and the stomach,” explained Dr. Anthony Starpoli. He said the same juices “can invade the throat, sinus passages and the lungs, causing [chronic] inflammation.”

The link between GERD and another tumor type, esophageal cancer, is already well-known, said Starpoli, associate director for esophageal endotherapy at Lenox Hill Hospital in New York City.

In the new study, McCoul’s team tracked data from 13,805 U.S. seniors who’d had cancers of the respiratory and upper digestive tracts between 2003 and 2011. Their medical histories were then compared to the same number of similarly aged people without cancer.

While the study found an association between GERD and head-and-neck cancers, McCoul’s team stressed that the data they sourced did not include information about each patient’s smoking and drinking history. Both of those habits are major risk factors for head and neck cancers, the study authors noted, so more investigation is needed to tease out the findings.

Dr. David Hiltzik directs otolaryngology at Staten Island University Hospital in New York City. Reading over the findings, he agreed that the study wasn’t designed to prove cause-and-effect.

But Hiltzik believes chronic heartburn remains a potential carcinogen and needs to be treated when it occurs.

“We know clinically that acid reflux causes problems throughout life in these areas in the head and neck,” he said. “This study reinforces the fact that we need to address these issues early and perhaps more aggressively. I believe patients should be more aware of how their daily diet and behavioral habits can have serious long-term effects.”

More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on acid reflux.

December, 2017|Oral Cancer News|

Cancer survivors often face another hurdle: faster aging

Source: www.upi.com
Author: staff

Treatments that help people beat cancer also can cause them to age prematurely and die sooner, Mayo Clinic researchers report.

Cancer survivors naturally age faster than others who haven’t had cancer, and are more likely to develop long-term health problems related to aging while they’re still relatively young, the study authors said.

These ailments can include hormone and gland disorders, heart problems, brittle bones, lung scarring and new cancers. Survivors also are more likely to become frail as the years pass.

Childhood cancer survivors’ estimated life expectancy is 30 percent lower than that of the general population, and they are three to six times more likely to develop a second cancer, the researchers noted.

With the number of cancer survivors growing, the medical profession needs to start paying more attention to how to keep these people healthy throughout their now-extended lifetimes, said senior researcher Dr. Shahrukh Hashmi. He is an assistant professor of medicine at the Mayo Clinic in Rochester, Minn.

“We are now beginning to see the gravity of a multitude of complications among cancer survivors,” Hashmi said. “There is an essential and immediate need for formal cancer survivorship programs to prevent complications in millions of cancer survivors.”

Currently there are about 30 million cancer survivors worldwide, but researchers predict that about 19 million new cancer diagnoses will be made every year by 2025. Many of those people will survive their cancer, only to face long-term health consequences.

According to Dr. Charles Shapiro, director of cancer survivorship programs at the Tisch Cancer Institute at Mount Sinai, in New York City, “We’re now struggling with our own success. This only comes up as a product of how well we’re doing in terms of cancer mortality and increasing the population of survivors. Now we have to deal with the consequences. Sure, you’re alive and that’s great, but there are consequences.”

Harsh chemotherapy and radiation therapy kill off cancer cells, but they also damage normal healthy tissues, Hashmi and colleagues explained. This diminishes the body’s natural resilience.

Other drugs used in cancer treatment also appear to contribute to accelerated aging. These drugs can include steroids, hormone therapy and targeted cancer treatments.

The study authors said a wide-ranging review of scientific evidence found that:

  • Chemotherapy, radiation therapy and other cancer treatments cause aging at a genetic and cellular level, prompting DNA to start unraveling and cells to die off sooner than normal.
  • Bone marrow transplant recipients are eight times more likely to become frail than their healthy siblings.
  • Long-term steroid treatment is associated with an increased risk of cataracts, brittle bones, nerve damage, impaired wound healing and diminished immune response.
  • Cancer drugs have been associated with hearing loss, reduced thyroid levels, high blood pressure, heart failure, muscle weakness, arthritis, infertility, constipation, and kidney and liver diseases.
  • Radiation therapy has been linked to dementia, memory loss, hardened arteries and secondary cancers.
  • The hormone drug Tamoxifen, used against breast cancer, has been associated with cataracts.

And, Shapiro added, women who receive chemotherapy are more likely to go into early menopause.

There’s now a movement afoot to reduce the amount of treatment needed to beat cancer, as a means of either avoiding or easing these aging effects, Hashmi and Shapiro said.

Studies and clinical trials are evaluating ways to de-escalate treatments for cancers like lymphoma, Shapiro said.

Cancer survivors also can help themselves by adopting a healthier lifestyle, Hashmi advised — quitting smoking, limiting alcohol consumption, eating right and exercising regularly.

“Taking these steps will help reduce the chances of new cancer development and the development of heart disease,” Hashmi said.

The new study was published online Dec. 18 in the journal ESMO Open.

December, 2017|Oral Cancer News|

Evolving role of surgery in multidisciplinary care for head and neck cancer

Source: www.onclive.com
Author: Danielle Bucco

Even with the advent of systemic therapeutic advancements to the armamentarium of head and neck cancer, surgery and novel techniques continue to rapidly evolve to effectively treat patients and leave less opportunity for adverse events (AEs).

Additionally, the role of the surgeon has changed to be a more integrative role in patient care.

“We are more precise and more integrated with other therapeutic modalities,” said Joseph A. Califano, MD. “Together, we work as a team and that is the best way that patients can receive their optimal outcomes. We do not just want to cure their cancer but to get back to function and wellness.”

In an interview during the 2017 OncLive State of the Science SummitTM on Head and Neck Squamous Cell Carcinoma, Califano, a professor of surgery at the University of California, San Diego, discussed how surgery factors into modern multidisciplinary care for patients with head and neck cancer.

OncLive: Please provide an overview of your presentation on surgery for patients with head and neck cancer.
Califano: I discussed the fact that the surgery that we do now for head and neck cancers is very different from what used to be done 15 to 20 years ago. Our ability to do effective surgery is good, but now we can do it in a way that leaves patients with excellent function and cosmetic results.

When you see someone walking down the street who has had major head and neck surgery, you wouldn’t know it because we are doing new techniques that are going through natural orifices to do major significant surgeries.

Can you discuss robotic surgery in this space?
Robotic surgery is part of what we do as head and neck surgeons. It is effective in terms of taking care of tumors—particularly in the throat, the tonsils, the back of the tongue, and perhaps even in the nasopharynx. Ordinarily, we cannot get to them unless we have robotic instrumentation. The beauty of robotic surgery in this setting is that we can have patients with excellent function, good swallowing, good voice, and rapid recovery from a significant procedure that was not available 10 years ago.

How do you believe surgeons fit into multidisciplinary care in head
and neck cancer?
Multidisciplinary care is one of the most important things that we practice when we take care of patients with head and neck cancer. It is not just medical professionals who do chemotherapy or radiation surgery; it is a whole host of other people, such as speech pathologists, dentists, dieticians, social workers, nurses, occupational therapists, and physical therapists.

The reason this is so important is that the effects of our therapy combined are good in terms of curing cancers. The AEs need to be treated. We need to get people back to not just curative cancer, but functioning and happy, as well.

What is your message to community oncologists who do not understand the importance of surgery when systemic therapies are available?
Together as a team, we can do much more effective therapy and leave people with much better functions than we could in isolation. The second message is that surgery has rapidly evolved in the past 5 to 10 years. If you are a community oncologist or a community radiation oncologist, you do not realize that we can treat diseases that 10 years ago were treated with radiotherapy alone. We can very effectively treat with surgery alone or in combination with radiation therapy to reduce the AEs. Those AEs are what our patients are going to feel 10 or 15 years down the road.

For example, the risk of stroke after radiotherapy long term is as high as 6% at 12 years. If we can treat people effectively with surgery alone, then we can eliminate that risk of stroke and eliminate some of the long-term effects of other therapies.

What are some big concerns in head and neck cancer and what would you like to see addressed in the next 5 to 10 years?
Some of the newer targeted therapy and immunotherapy approaches are going to blend in well with surgery; it will be one way we can tell whether someone responds to a systemic agent. For example, if a patient receives immunotherapy alone and has a complete response, we can do a minimally invasive surgery to not only make sure that we clear the disease but even to document that there is no disease and spare the patient additional therapy.

The second thing I would say is that we are going to have a host of imaging technologies available. They are just starting to become clinically applicable. We are going to know exactly where the tumor is so that when we do surgery, we can make sure that we get all the cancer [out] most of the time and reduce the need for additional therapy, such as debilitating combination therapy. We can choose who is good for surgery, who is not, and who is better treated with other therapeutic approaches, such as radiation, chemotherapy, immunotherapy, and targeted therapy.

How is surgery an integrated part of the team?
Historically, we are unlike a lot of other surgeries. We follow our patients throughout the rest of their lifetimes and we are an integrated part of the care team. There are other things we can do as surgeons, for example. We can move salivary glands out of the way of radiation for patients with good saliva function to swallow better and have a better quality of life.

We do not think of ourselves as an isolated [group] to take out the cancer, but we are also there to reconstruct, rehabilitate, and help people get on their way to being well.

The head and neck is all about who we are, how we interact socially, and how we feel about ourselves. Social things that we do with other people are eating, talking, and communicating. There are many who now have these functions after head and neck cancer.

December, 2017|Oral Cancer News|

Alcohol and cancer – facts and health risks

Source: mesothelioma.net
Author: staff

Alcohol and Cancer – Facts and Health Risks
While there are proven health benefits of drinking alcohol in moderation, and some specific benefits due to the natural compounds found in red wine, drinking is not always good for your health. Drinking regularly and to excess can have some serious and negative impacts on health and may even be linked to an increased risk for mesothelioma or other cancers.

Drinking alcohol in moderation during cancer treatment may be fine for some patients, but generally it should be avoided. It may aggravate side effects and studies are also investigating whether or not alcohol can increase the risk of a cancer recurrence. If you are going through treatment for mesothelioma or another type of cancer, talk to your medical team before indulging in a drink or two.

Alcohol Consumption is a Risk Factor for Cancer
Many studies have found and confirmed, over and over again, that drinking alcohol is a risk factor for developing cancer generally and for specific types of cancers. Specifically, drinking has been linked with throat and mouth cancers, esophageal cancer, liver cancer, colon cancer, breast cancer, stomach cancer, and pancreatic cancer. The more alcohol consumed, the greater the risk. According to research data, approximately 3.5 percent of cancer deaths are related to alcohol consumption. Some of the specific facts about drinking and cancer from research include:

People who drink three to four alcoholic beverages per day have a two to three times increased risk of developing a head and neck cancer.

Drinking is not just a risk factor, but a known cause for liver cancer.
Alcohol consumption is a risk factor for esophageal squamous cell carcinoma, and the risk is greatest for people with a certain genetic mutation that makes it more difficult to metabolize alcohol. Women who consume three alcoholic drinks per day have a 1.5 times greater risk of developing breast cancer.

Alcohol increases the risk of colorectal cancer, especially in men.
Regular alcohol consumption contributes to cancer development in several ways. In cancers of the mouth and throat, the risk may be caused by the fact that alcohol irritates cells in those tissues, causing damage to DNA. In the liver alcohol causes scarring and inflammation, which also damages DNA. In the colon, alcohol is converted to a compound called acetaldehyde, which is a known carcinogen.

Other Negative Health Impacts of Drinking
There are other ways in which alcohol impacts health in negative ways, and some of these may indirectly contribute to causing cancer. For instance, alcohol causes levels of the hormone estrogen to rise in the body. This in turn can lead to breast cancer. Another negative impact of drinking is weight gain and obesity. Being obese is also a risk factor for cancer of all types. Regular drinking prevents the body from absorbing some nutrient, which help keep cells healthy, and this can cause many health problems, including promoting cancer development.

Other health problems that excessive drinking can cause include those that are long-term. One of the biggest health issues is liver damage. Excessive drinking over time causes inflammation and scarring, which ultimately can cause the liver to fail. Alcohol consumption can also damage the brain and pancreas, increase the risk of heart attack and stroke, and raise blood pressure.

Drinking and Mental Health Risks
In addition the many physical health risks of drinking to excess, alcohol can also contribute to or cause mental health problems, including dependence. Alcohol addiction is a very serious disease that is difficult to overcome and that causes physical health effects, mental distress, and major impairment in everyday functioning.

There is also a strong link between drinking and mental illness. The relationship between the two is complicated. In some cases a person may have a mental illness and use alcohol to cope, while in other cases alcohol may trigger mental illness symptoms. Mood disorders, like depression, are most commonly associated with heavy alcohol use. For people with existing mental illnesses, drinking can worsen symptoms.

Drinking During and after Cancer Treatment
Cancer treatments can take a serious toll on the body and mind. Avoiding alcohol, or at least not drinking regularly or heavily, is a good idea. A very specific reason not to drink is that alcohol can interact dangerously with certain chemotherapy drugs. Chemotherapy also causes unpleasant side effects, like nausea, vomiting, mouth sores, and pain that alcohol will only worsen.

If you beat cancer and become a survivor, the fact that you have already had cancer puts you at risk for a recurrence or developing another type of cancer. This is an important reason to limit alcohol intake. The more risk factors, like drinking, that you can eliminate, the less likely you will be to have another battle with cancer in the future.

Drinking alcohol is not always bad, but it should be limited. The American Cancer Society recommends that women have no more than one drink per day and men no more than two. This does not mean that it is safe to have seven drinks just one day per week. Excessive drinking in one sitting is very harmful. If you are going through cancer treatment, make sure your medical team gives you the go ahead to have alcohol before you indulge. And even if they do, it makes sense to limit how much you drink. The healthier you can stay during and after treatment, the better you will be able to tolerate the treatment and to be able to fight your cancer and get well again.

Sources
https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html
http://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/chemotherapy/living-with/alcohol
https://www.medscape.com/viewarticle/853128
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

December, 2017|Oral Cancer News|

HPV vaccine IS safe and effective, confirms longest-ever study into the shot which prevents cancer of the cervix, head, neck throat and penis

Source: www.dailymail.co.uk
Author: Mia De Graaf, Health Editor

The HPV vaccine is safe and effective at preventing human papilloma virus, according to the longest investigation ever conducted on the relatively new shot. While the vaccine has been a success in every study since it came out in the US and the UK in 2006, the medical community has been keenly waiting for some long-term data to show its lingering benefits.

Today, Augusta University’s 10-year study was published in the journal Pediatrics, appearing to confirm the findings in every other short-term report. The data also supported the view that the vaccine should be administered to both boys and girls from the age of nine years old, despite previously only being offered to girls.

Experts say they hope the findings will help drive up rates of children getting the vaccine, which protects against HPV and therefore HPV-linked cancers such as throat, head, neck, penis, and cervical cancer.

‘The vaccine was virtually 100 percent effective in preventing disease in these young individuals,’ says Dr Daron G. Ferris, professor in the Department of Obstetrics and Gynecology at the Medical College of Georgia and at the Georgia Cancer Center at Augusta University.

HPV is the most common sexually transmitted infection in the US and the UK with an estimated 14 million Americans infected every year, and a third of British adults. While about two-thirds of infected individuals can eventually clear the virus, it persists and can cause a wide range of health problems in the remainder, including a whole host of cancers.

The researchers tracked 1,661 people in 34 sites across nine countries, assessing the effectiveness of the three-shot vaccine – which is the format offered in the US, while UK citizens get a two-shot vaccine.

At first, a third of the participants received a placebo. But within 30 months, they also received the vaccine. They started assessing the patients for signs of HPV – genital warts, precancerous or cancerous growths and other infections – from three-and-a-half years into the study.

Those assessments were carried out twice a year for the next seven years. But by the end of the study, all participants were still disease-free. Notably, those who received the vaccine earlier had a more robust resilience to the virus, judging by the amount of infection-fighter cells in their blood.

‘Now we need to push for more young people to get vaccinated,’ he says. ‘We are doing miserably in the United States.’

The virus is typically spread through vaginal and anal sex and can develop into cancers in the vagina, penis, throat and anus. Nearly all men and women will be contracted with one form of HPV, there are an estimated 150 types, in their lifetime, according to the CDC.

Annually an average of 38,000 cases of HPV-related cancers are diagnosed in the US. Of those cases, 59 percent are women and 41 percent are men. But men are more likely to develop a type of head or neck cancer, known as oropharyngeal squamous cell carcinoma, than women.

The CDC recommends for all children in the US to receive the vaccine between the ages of nine and 12. Forty percent of girls and 22 percent of boys aged 13 to 17 years old had completed the three-vaccine series by 2014, the organization found.

In contrast, the National Health Service in the UK recommends for only females to receive the vaccination between the ages of 12 and 13. There are no plans to extend the vaccine to males at this time because it is ‘unlikely to be cost-effective’, according to the The Joint Committee on Vaccination and Immunization.

The vaccination was first introduced for females in a three-part series to help prevent against cervical cancer that forms in the cervix. Cervical cancer occurs from genital HPV, which is skin-to-skin contact during sex.

US men are now encouraged to receive the jab after data revealed they too were at risk from developing HPV and cancers associated with the virus.

Research has also shown that men who give or receive anal sex increase their risk of developing HPV.
Condoms are a protective barrier that health experts recommend for men use in order to prevent the spread of the virus.

December, 2017|Oral Cancer News|

Young men should be required to get the HPV vaccine. It would have saved me from cancer.

Source: www.thedailybeast.com
Author: Michael Becker

In December 2015, at the age of 47, I was diagnosed with Stage IV oral squamous cell carcinoma.

More simply, I have advanced cancer of the head and neck. While initial treatment with grueling chemo-radiation appeared successful, the cancer returned one year later in both of my lungs. My prognosis shifted from potentially curable to terminal disease. The news was shocking and devastating—not just for me, but for my wife, two teenage daughters, and the rest of our family and friends.

Suddenly, my life revolved around regular appointments for chemotherapy, radiation therapy, imaging procedures, and frequent checkups. I made seemingly endless, unscheduled hospital emergency room visits—including one trip to the intensive care unit—to address some of the more severe toxicities from treatment.

All told, I suffered from more than a dozen side effects related to treatment and/or cancer progression. Some are temporary; others permanent. These include anxiety, depression, distorted sense of taste, clots forming in my blood vessels, dry mouth, weight loss, and many more.

My cancer started with a human papillomavirus (HPV) infection, a virus that is preventable with vaccines available for adolescent girls since 2006 and boys starting in 2011. The Food and Drug Administration (FDA) has approved three vaccines to prevent HPV infection: Gardasil®, Gardasil® 9, and Cervarix®. These vaccines provide strong protection against new HPV infections for young women through age 26, and young men through age 21, but they are not effective at treating established HPV infections. It was too late for me in 2011 when the HPV vaccine was made available to young men, and I was 43 years old.

According to the Centers for Disease Control and Prevention (CDC), more than 30,000 new cancers attributable to HPV are diagnosed each year. Unlike human immunodeficiency virus (HIV), which is spread by blood and semen, HPV is spread in the fluids of the mucosal membranes that line the mouth, throat, and genital tracts, and can be passed from one person to another simply via skin-to-skin contact.

While most HPV cases clear up on their own, infection with certain high-risk strains of HPV can cause changes in the body that lead to six different types of cancer, including cancers of the penis, cervix, vulva, vagina, anus, and head and neck (the last of which is what I have). Two of these, HPV strains 16 and 18, are responsible for most HPV-caused cancers.

Researchers believe that it can take between 10 and 30 years from the time of an initial HPV infection until a tumor forms. That’s why preventing HPV in the first place is so important and the HPV vaccine is so essential.

However, only 49.5 percent of girls and 37.5 percent of boys in the United States were up to date with this potentially lifesaving vaccination series, according to a 2017 CDC report. In sharp contrast, around 80 percent of adolescents receive two other recommended vaccines—a vaccine to prevent meningococcus (PDF), which causes bloodstream infections and meningitis, and the Tdap vaccine to prevent tetanus, diphtheria, and pertussis.

Even if you don’t think your child is at risk for HPV now, they almost certainly will be. HPV is extremely common. Nearly everyone gets it at some point; in fact, the CDC estimates that more than 90 percent and 80 percent of sexually active men and women, respectively, will be infected with at least one strain of HPV at some point in their lives. Around one-half of these infections are with a high-risk HPV strain.

As a cancer patient with a terminal prognosis, I find it infuriating that the HPV vaccine is tragically underutilized more than a decade since its introduction. Two simple shots administered in early adolescence can reduce a child’s risk of receiving a cancer diagnosis much later in life.

Parents who oppose the use of vaccines cite popular misconceptions that they are unsafe, ineffective, and that immunity is short-lived. Others argue that receiving the HPV vaccine may increase sexual promiscuity. Films like Vaxxed based on research that has been discredited, and directed by a researcher who fled the United Kingdom due to the misleading uproar he created, are still quoted as science.

Regardless, the fact remains that millions of adolescents aren’t getting a vaccine to prevent a virus known to cause cancer. We must counter untrue, exposed, and discredited research that keeps some parents from having their children vaccinated and put an end to the campaign of misinformation.

Viruses that are preventable, such as HPV, should be eradicated just like previous success with polio and smallpox. Cancers that are preventable through HPV vaccination should be prevented. The safety and efficacy of these vaccines are no longer subject to serious debate (PDF). Research has shown that vaccinations work; they keep children healthy, save lives, and protect future generations of Americans—but only when they are utilized.

The lesson: Don’t wait. Talk to your pediatrician about vaccinating your 11-year-old boys and girls against HPV today to eradicate this cancer-causing virus.

I only wish my parents had that opportunity when I was young, as it could have prevented the cancer that’s killing me.

December, 2017|Oral Cancer News|