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10 Oral hygiene tips no one ever taught you that you need to know

Source: www.romper.com
Author: Leah Carton

No one loves a dry mouth or bad breath. And although brushing your teeth is something you’ve been doing for years now, there are still oral hygiene tips that no one ever taught you that could still benefit your overall health big time.

You shouldn’t take a relaxed approach when it comes to dental care since many unwanted dental concerns and problems can arise when you do so. According to Colgate, there are simple steps that you can take to decrease the risk of developing tooth decay, gum disease, and other dental problems, in between regular visits to the dentist.

But even if you increase the uptake of cleaning your teeth, it’s still important to regularly visit your dentist, especially if you have preexisting dental problems. To make your life easier, schedule your oral exams as you stay on top of your kid’s dentist appointments.

Incorporating these oral hygiene tips into your daily morning and nighttime routine can help you to see amazing changes when it comes to your teeth, gums, and breath. Hey, maybe your dentist will even finally stop nagging you about flossing once they see all of the other great improvements you’ve made when it comes to oral hygiene.

  1. Brush Your Tongue: Know Your Teeth reports it’s just as important to brush your tongue to remove bacteria and freshen your breath as it is to brush your teeth.
  2. Stop Using Mouthwash Directly After Brushing: According to National Smile Month, you rinse away fluoride from your toothpaste when you use mouthwash right after brushing your teeth. To avoid this, opt to use mouthwash after lunch rather than directly after your morning brush.
  3. Properly Store Your Toothbrush: According to Mayo Clinic, there are simple steps that keep your toothbrush clean. The site noted that you should rinse your toothbrush after brushing, store it in an upright position to air-dry, and keep it away from closed containers to prevent growth of bacteria, mold, and yeast.
  4. Switch To A Soft-Bristled Toothbrush: According to Dr. Chris Nhan, a California dentist, toothbrushes with hard bristles can damage your gums and expose tooth root surfaces if they’re not used properly. When used properly, hard bristles can efficiently remove plague and tartar.
  5. Watch Your Calcium Intake: Dr. Ernest Greenwald, from a Richmond Hill family dentistry practice, says your calcium intake is just as important for your teeth as it is for your bones. Have a glass of milk in the morning or incorporate cheese into your lunch to increase your calcium intake.
  6. Limit The Amount Of Times You Brush: Complete Dental Health suggests you should brush your teeth twice daily — once in the morning and again at night. The site further noted that more is not better, since excessive brushing can weaken your teeth’s enamel.
  7. Visit Your Dentist Annually: The Office of Women’s Health, U.S. Department of Health and Human Services, recommends that you should have an oral exam once or twice a year. If problems or concerns arise, don’t be afraid to contact your dentist to book additional appointments.
  8. Avoid Brushing Your Teeth Too Hard: According to Dr. Cindy Flanagan, a dentist for more than 25 years, you shouldn’t forcefully brush your teeth. She further recommended to use small, circular strokes to cover each tooth on all sides when brushing.
  9. Know When It’s Time To Replace Your Toothbrush: You should replace your toothbrush every two to three months, and even after you get sick. This will help to prevent germs from spreading in your mouth.
  10. Spend The Right Amount Of Time Brushing: The Health Site recommends that you brush each region of your mouth for at least 30 seconds. The site further noted that you should not brush horizontally along the gum line, since doing so can cause damage to it.
February, 2017|Oral Cancer News|

Throat cancer is becoming a national health epidemic say oral fitness experts

Source: californianewswire.com
Author: Raychel Harvey-Jones

As a dentist in practice for over 30 years, Dr. Gary Glassman (“Dr. G”) thought he had seen it all. “I have removed maggots from a child’s gums and a tomato plant that was growing from a seed in another patient. Oral fitness is as important as physical fitness, this week a young man died in California from a tooth infection that spread to his lungs,” says Dr. G.

I will admit I am a little nervous when it comes to visiting the dentist, over the years I have been lucky enough to find very patient dentists who have gradually rid me of my fear. After interviewing Dr. G, I plan on making it a priority to regularly visit the dentist. There is a much bigger problem in the U.S. that’s slowly becoming an epidemic – throat cancer.

Dr. G is concerned about the growing numbers of mouth and throat cancer caused by the Human Papillomavirus (HPV) that is transmitted during oral sex.

Dr. G, a leading global oral fitness expert, says, “The scary part about the growing concern of oral cancer among men is that we think of oral sex as a safer alternative to intercourse.”

According to the Centers For Disease Control and Prevention (CDC), the HPV virus is the most sexually transmitted infection in the United States, and it’s showing up in men aged 40-60 years old. Skeptical? Just ask actor Michael Douglas.

In an interview published in The Guardian newspaper in London, Douglas mentioned that his throat cancer could have been brought on by oral sex, a common way to become infected with HPV. (Douglas later admitted he actually had tongue cancer and “regrets blaming his wife’s vagina.”)

“We are seeing the HPV-positive throat cancer more in older men as they produce less saliva. Saliva acts as a natural coating that protects the mouth from infections. Also, there are a plethora of medications used everyday by older guys that cause dry mouth; medications like Ibuprofen and Amoxicillin,” says Dr. G.

There are about 200 different strains of HPV. Some cause common warts when they invade the skin. Others are the cause of sexually transmitted diseases.

“HPV can cause cervical cancer, as well as cancer in the back of the throat, including the base of the tongue and tonsils, though these are not the same strains of the virus. Cancer often takes years, even decades, to develop after a person gets HPV. More than half of American men who are having sex will get HPV at some point in their lives,” adds Dr. G.

According to the CDC, there is no approved test to check for HPV in the mouth or throat; this is why regular visits to your dentist are critical. A dentist can monitor any changes in your mouth. There are HPV tests that can be used to screen for cervical cancer.

“Your mouth is crucial when it comes to your overall general health. Treat your dentist’s chair as an extension of your trips to the gym; it’s just as vital to your health and fitness,” adds Dr. G.

The HPV vaccine is a must before you are sexually active. However, if you haven’t had the vaccine there are measures you can take, ask your dentist. “It’s not worth the risk,” concludes Glassman.

February, 2017|Oral Cancer News|

Game changer’ HPV vaccine is now just 2 shots – not 3 – in bid to simplify

Source: www.dailymail.co.uk
Author: Mary Kekatos for dailymail.com

  • HPV vaccines will now be administered in two doses instead of three
  • The virus is the most common sexually transmitted infection in the US
  • But only 28% of boys and 42% of girls received the advised three doses in 2015
  • Doctors hope the new guidelines increase the number of kids who get the shot

The HPV vaccine will now be administered in two doses instead of three, new guidelines declare. The new rules, published on Monday, come after years of campaigns from cancer experts insisting an easier schedule would encourage more people to protect themselves from the sexually-transmitted infection.

Human papillomavirus (or, HPV) is the most common STI in the United States, affecting around 79 million people. It has been linked to numerous cancers – including prostate, throat, head and neck, rectum and cervical cancer.

Experts claim more widespread vaccine coverage of middle school children could prevent 28,000 cancer diagnoses a year. Currently, fewer than half the children eligible for the vaccine – given out as three doses over six months – are covered. Experts blame the lengthy, arduous schedule.

The American Cancer Society today endorsed the updated recommendations, which were released by the Advisory Committee on Immunization Practices (ACIP).  Dr Debbie Saslow, Senior Director, HPV Related and Women’s Cancers for the American Cancer Society, said: ‘In the past several years, studies have shown the vaccine is even more effective than expected.

‘This new two-dose regimen is easier to follow, and we now know is very effective in preventing HPV, which is linked to a half dozen types of cancer.’

Each year, about 14 million people become newly infected with HPV. According to the CDC, each year about 19,000 cancers caused by HPV occur in women in the US, with cervical cancer being the most common. And about 8,000 cancers caused by HPV occur each year in men in the US and oropharyngeal (throat) cancers are the most common. Besides cervical cancer, HPV has been linked to vaginal, vulvar, oropharyngeal, anal, and penile cancers.

Despite strong evidence of safety and effectiveness, vaccination rates in the US remains very low compared to other countries. Only 28 percent of boys and 42 percent of girls aged 13 to 17 years receiving the recommended three doses in 2015. The skewed figures between genders are largely attributable to the fact that the jab was only offered to boys as a standard vaccine as of last year.

Previously, it was believed HPV was most strongly linked with cervical cancer in women. Research since has shown links with penile, anal, mouth, throat and other cancers in men. However, the gender divide does not fully account for the staggeringly low levels of coverage overall.

Despite the three vaccines that are widely available, the number who choose to be vaccinated remains low, and the age they wait to do so has increased. Only Rhode Island, Virginia and the District of Columbia require the vaccine for students.

In response to these figures last year, the ACIP, along with the Centers for Disease Control and Prevention (CDC), conducted a thorough review of clinical trial data on HPV vaccines. They found that the vaccine in younger adolescents (aged nine to 14 years) produced an immune response similar or higher than the response in young adults (aged 16 to 26 years) who received three doses.

Generally, preteens receive the HPV vaccine at the same time as whooping cough and meningitis vaccines and it is administered before the likely chance of sexual contact.

The new schedule, approved by the FDA in October 2016, states that two doses of HPV vaccine given at least six months apart at ages 11 and 12 will provide ‘safe, effective, and long-lasting protection against HPV cancers’. Even adolescents between ages 13 and 14 are able to receive the HPV vaccination on the new two-dose schedule.
For patients who did not receive HPV vaccination before age 15, three doses are still required and may be given to females up to age 26 and males up to age 21.

February, 2017|Oral Cancer News|

Silk and stem cells are being used to generate salivary glands

Source: biotechin.asia
Author: Manish Muhuri

Saliva is a watery substance secreted by the salivary glands located in the mouth. Saliva is essential for good health, as it assists in speaking, swallowing, food digestion, preventing oral infections in addition to many other tasks. Without normal salivary function the frequency of dental caries, gum disease (gingivitis), and other oral problems increases significantly.

Location and types of salivary glands in humans. Image Courtesy : Wikimedia Commons

Dysfunction or reduction in activity of salivary glands can be caused by many factors, including diabetes, radiation therapy for head and neck tumors, aging, medication side effects, and Sjögren’s syndrome.

Sjogren’s is an autoimmune disease where the body attacks its own tear ducts and salivary glands. Patients suffering from this disease have severely dry mouth. No treatments are currently available for dry mouth. Salivary glands, unfortunately, have very little regenerative capacity.

The title must have left you wondering about the correlation between silk and saliva – what do they have in common? They are both actually part of a unique experiment going on in San Antonio, a study that could change the lives of millions of people who suffer from dry mouth.

Chih-Ko Yeh , BDS, Ph.D., and Xiao-Dong Chen, MD, MS, Ph.D., of the UT Health San Antonio School of Dentistry decided there had to be a better way to help people than try to develop drugs and figured that stem cells may help solve a common, painful problem.

Yeh said the idea is to use stem cells from the patient’s own body derived from bone marrow to grow new salivary gland cells. In order to coax those stem cells into becoming the right kind of cell, researchers are using silk from worms and spiders as scaffolding.

Silk is a natural protein that mimics the micro-environment of the salivary gland. Silk works well, the scientists say, because it’s biodegradable, flexible and porous, providing easy access to the oxygen and nutrition the cells need to grow. Chen and his partner are using rats to test out ways to place the cells in the body to jump-start tissue repair.

“Then we can deliver those cells to a damaged salivary gland by injection, local injection,” Chen explained.

Yeh and Chen’s early work was published in the journal Tissue Engineering.

Experts said this leap into regenerative medicine is intriguing while patients like Willette are holding out hope. “There’s no reason why they shouldn’t be able to find something to help with this,” Willette said.

In 2016, the researchers received a grant of more than a million dollars from the National Institute of Dental and Craniofacial Research (part of the National Institutes of Health) to continue their promising work.

January, 2017|Oral Cancer News|

Epigenetic modification discovered in adult throat cancers

Source: www.specialtypharmacytimes.com
Author: Lauren Santye, Assistant Editor

An epigenetic modification may be the cause of 15% of adult head and neck cancers that are linked to tobacco and alcohol use, according to a study published in Nature Genetics.

Although the body is made up of a large number of different types of cells––neurons, skins cells, fat cells, immune cells–– they all have the same DNA or genome. It was not until recently that scientists discovered their differences can be explained by epigenetics.

“This discovery was absolutely unexpected since it seemed highly improbable that the kind of alterations of the epigenome that we had previously found in other types of tumors in children and young adults could also target an epithelial tumor like throat cancer that occurs only in adults,” said Dr Nada Jabado.

There are already some promising drug molecules currently on the market for other diseases that could be tested for head and neck cancers, as well as other cancer types, according to the study. Additionally, the investigators hope that the findings could help in developing treatments for pediatric patients.

“Now that we’ve identified this cohort of patients, we can move quite quickly since the case of adults, as opposed to children, there are more patients and lots of clinical trials,” Dr Jabado said. “The medicines could then be tested on children afterward.”

Dr Jabado’s work focuses on epigenetics in pediatric cancers, particularly on the mutations of the histone H3 protein. In particular, the investigators were interested in a 2015 publication by the Tumor Cancer Genome Atlas Consortium on head and neck cancer that included 1 of the genes that regulates H3.

“We made use of the same data but took a completely different approach,” said principal study author Dr Jacek Majewski. “Instead of concentrating on genetic mutations, we looked at the effect of these mutations on histone H3 proteins. That’s when we discovered that the histone H3 protein was abnormal or incorrectly modified in about 15% of patients with head and neck cancer. The data were there, but this fact had gone unnoticed.”

An essential part of the study was collaboration between scientists and access to the vast genomic databases of patients around the globe, according to the investigators.

“It’s crucial to have access to public data, because it allows us to advance faster and go further in our analyses,” Dr Jabado said. “In our case, this discovery revealed a sub group of patients who might benefit from a therapy that targets the epigenome. This could improve the treatment of more than 1 in 5 patients suffering from devastating oropharyngeal cancer. We are currently collaborating with 2 big groups specializing in head and neck cancer with the goal of finding treatments.”

The investigators are hopeful that the results of the study will open a variety of treatment options in the future.

January, 2017|Oral Cancer News|

Artificial larynx implant helps throat cancer patient breathe and speak

Source: www.ctvnews.ca
Author: staff

Sixteen months after receiving an artificial larynx, a 56-year-old French man suffering from throat cancer can now whisper and breathe normally. A report published this week in the New England Journal of Medicine considers this to be a significant first achievement.

Thanks to the implant, a 56-year-old throat cancer patient can now whisper and breathe normally. © ChrisChrisW / Istock.com

Thanks to the implant, a 56-year-old throat cancer patient can now whisper and breathe normally. © ChrisChrisW / Istock.com

This is the first time that doctors have observed a patient with the implant long term recover functions such as breathing and speaking after the complete removal of the larynx. Thanks to an artificial voice box, implanted in 2015 at France’s Strasbourg-Hautepierre university hospital, the 56-year-old Frenchman, who lives in Alsace, can now whisper in a comprehensible manner and breathe normally.

The patient has also recovered his sense of smell, which was damaged by the removal of the larynx. Other than the vocal cords, the larynx features an upper valve, called the epiglottis, which closes when food passes down the throat to prevent it from entering the windpipe.

The prosthetic larynx was developed by a French company called Protip Médical. It consists of a rigid titanium and silicone structure replacing the larynx and a removable titanium part that mimics the function of the epiglottis.

The only problem that remains unresolved in the implant is the function of the epiglottis. As a result, the patient coughs from time to time when eating, as food accidentally enters the windpipe. However, the surgeons still consider the functioning implant a highly satisfactory achievement.

The current procedure used to return voice function to throat cancer patients involves puncturing the throat to insert a valve allowing air to pass from the windpipe to the esophagus.

A few doubts remain about the long-term effectiveness of the implant. For example, blockages caused by dried out mucus and secretions from the lungs and nose could be a risk. Another concern is the risk of rejection, particularly in cancer patients who have undergone radiotherapy or chemotherapy treatments.

As for patient comfort, further testing will establish how the mobility of the patient’s neck is affected by the presence of a rigid tube in the throat.

“This implant is constantly evolving and the next patients will benefit from substantial improvements,” notably to improve the passage of food down the throat, said lead researcher Nihal Engin Vrana.

Each year more than 12,000 new cases of throat cancer are diagnosed in the U.S.. Larynx transplants remain extremely rare worldwide and are generally used in cases unrelated to cancer, which represent a small majority.

Source: The report is published in the New England Journal of Medicine.

January, 2017|Oral Cancer News|

Feds, cancer centers aim to boost HPV vaccinations

Source: www.dispatch.com
Author: JoAnne Viviano

Faced with getting her daughter the HPV vaccine, which helps protect against cervical and other cancers, Anaraquel Sanguinetti paused.

The human papillomavirus is spread through sexual contact, and the Westerville mom didn’t want her now-18-year-old daughter to think she was promoting promiscuity. So Sanguinetti did some research. And she had a long talk with her daughter, and another with her doctor.

In the end, daughter Celine got the vaccine last year.

“We are discovering every day new reasons why people obtain cancer, so it’s just another added layer of protection for my daughter for her future, because you just never know,” Sanguetti said. “ I didn’t want to have a regret.”

Sanguetti is in the minority. Though vaccinating against HPV is recommended by the Centers for Disease Control and Prevention, and countless cancer centers and health-care providers, most children in the United States have not been vaccinated against HPV.

Calling that “a serious public health threat,” dozens of cancer centers released a joint statement on Wednesday urging more parents and pediatricians to get onboard.

The statement endorses the CDC’s recent revisions to its HPV vaccine recommendations. Vaccinating, the statement says, could help prevent the nearly 40,000 cases of HPV-associated cancers diagnosed in the United States each year.

“Get the HPV vaccine for your child so they don’t have to hear those words: ‘You have cancer,’ “ said Electra Paskett, co-leader of cancer control at Ohio State University’s Comprehensive Cancer Center, which is among the institutions participating in the effort.

The CDC estimates that as many as 79 million Americans are infected with HPV, which can cause cervical, genital, anal, rectal and throat cancers as well as genital warts. Fourteen million new infections occur each year.

A 2016 CDC report says that only about 42 percent of girls and 28 percent of boys had completed the recommended vaccination series. In Ohio, 35 percent of girls and 23 percent of boys have completed the vaccination course.

In all, 69 National Cancer Institute-designated cancer centers are participating in the effort.

The recommendations issued last year say that kids who are 11 or 12 should receive two shots of the HPV vaccine, delivered at least six months apart. The previous recommendation was for three shots, which is still advised for people 15 to 26 years old.

Simplifying the process likely will increase participation and move the nation toward the U.S. Department of Health and Human Service’s goal of having 80 percent of young people vaccinated by 2020, said Dr. Li Li, associate director for prevention research at Case Western Reserve’s Comprehensive Cancer Center.

“This is one of the few preventable cancers,” he said. “There’s a very unique opportunity for us nationwide to get together to put this forward.”

Li said he’d like to see the state mandate that children receive the vaccine at age 11 or 12 to enroll in school. That’s the rule in three states, he said.

Paskett said recommendations also call for bundling the HPV vaccine with other vaccines given at that age.

“The public has been clamoring for a cancer vaccine for decades, and we now have one and we need to use it,” she said.

Sanguetti said she wanted to make sure her daughter was vaccinated before going off to college. She said she would recommend that other parents do their own research and have their children vaccinated even if it is uncomfortable thinking about their sons or daughters having sex.

“It’s for their future,” she said. “It’s more toward their well-being. It’s not promoting anything other than a preventative for cancer.”

For more information, go to www.cdc.gov/hpv.

January, 2017|Oral Cancer News|

Head and neck cancer art exhibition unveils hidden experience

Source: edmontonjournal.com
Author: Madeleine Cummings

Few words are as terrifying as these three: “You have cancer.”

“When you’re told you have cancer, everything seems to fall apart,” said Ken Roth, who was diagnosed with squamous cell carcinoma on the base of his tongue four years ago.

art_cancer

“Your head’s spinning, you don’t know what’s going on, you don’t know what the results are going to be,” he said.

Brad Necyk, an artist and PhD student in psychiatry at the University of Alberta, tried to capture some of that disorientation in an installation that features a fragmented video of Roth’s face.

His art is part of a new multimedia exhibition called “FLUX: Responding to Head and Neck Cancer,” which explores how head and neck cancer affects patients’ lives. (Ingrid Bachmann, Sean Caulfield, Jude Griebel, Jill Ho-You and Heather Huston also have works in the exhibit.)

Roth had three-quarters of the base of his tongue removed and his illness led him to leave his job, but others have it a lot worse, he said.

Patients with head and neck cancer often undergo lengthy (sometimes multiple) surgeries and they can have trouble speaking, swallowing and hearing. Some patients have to relearn how to speak, and then do it again after an additional surgery.

These symptoms — many of which are visible — change how patients eat, communicate and behave in public. They can be devastating, and according to the Canadian Cancer Society, depression is common among the thousands of Canadians who have these kinds of cancer.

Minn Yoon, a U of A professor who has been interviewing head and neck cancer patients for her research on oral health and the illness experience, said she felt compelled to share their stories beyond academia.

Typically, researchers publish their findings in academic journals or present them to other experts at conferences, but Yoon said she didn’t think that alone would do them justice. “I wanted to find a way of sharing their stories without losing the person behind them,” she said.

She and Pamela Brett-MacLean, a professor who directs the Arts and Humanities in Health and Medicine Program at the university, led an interdisciplinary project that brought together artists, patients and researchers.

Patients collaborated with artists during multiple workshops and feedback sessions. According to Roth, these sessions could be very emotional and stressful, but also enlightening for patients, who learned about the progression of others’ cancer treatments and exchanged advice.

Lianne McTavish, a professor who curated the exhibit and attended the workshops, said she was struck by many of the stories she heard about surgeries.

“If you have a surgery that changes your appearance significantly, your entire identity is changed and the way you function in public spaces forever is changed,” she said.

One sculpture, “Obstruction,” by Griebel, combines the catastrophe of facing a cancer diagnosis with the deadly 1903 rock slide that occurred in Frank, Alta. There is hope in the piece, however, McTavish noted. The sculpted figure appears to be sitting on a hospital bed and his body is crumbling, but he sits upright and is made of stone. Tiny trees sprout up and down his arms, suggesting recovery and care.

Necyk, the artist whose video installation portrays patients’ faces in a more intimate way, said he was nervous to show the first versions of his art to the patients with whom he worked.

“It was brutal-looking work, almost violent,” he said. “But the patients felt that this is something that’s not represented in a lot of the narrative representations we have of cancer.”

Rather than portray Roth as a hero or a victim, the art reveals how cancer can change a person, for better and for worse.

January, 2017|Oral Cancer News|

Hog jowls and clementines: A bid to awaken cancer patients’ ruined sense of taste

Source: www.statnews.com
Author: Eric Boodman

The medicines were rich and strange, their active ingredients so particular they sounded fictional.

neurogastronomy_illustration_mollyferguson_121616-1600x900

Credit: Molly Ferguson for Stat

One regimen involved jowl bits from Red Wattle hogs; the pigs were bred from sows named Fart Blossom and Hildegard, and had spent the end of their lives gorging on acorns, hickory nuts, apples, and black walnuts. Another experimental drug included the flesh of the Ubatuba pepper, picked when it was red as a Santa suit, dried at precisely 90 degrees for five days, and then pulverized, seeds and all, into a fragrant, pinkish powder.

These concoctions were meant to be therapeutic — but they hadn’t been devised by pharmacologists or biochemists or even lab techs. Their inventors had no scientific training whatsoever: They were celebrity Montreal chef Frédéric Morin and renowned Atlanta pastry-maker Taria Camerino, who would be facing off in an unusual culinary duel. They’d been challenged to help solve a problem that most clinicians and neuroscientists aren’t able to — the impairment of taste in cancer patients who undergo chemotherapy and radiation.

This cook-off in the University of Kentucky’s demo kitchen was the opener for the second annual Neurogastronomy Symposium, which was born over a boozy, late-night chance encounter between neuropsychologist Dan Han and Morin in the chef’s restaurant. Together, they envisioned a conference that would combine neuroscience, agriculture, history, nutrition, medicine, and cooking — to understand the art and science of why we eat what we eat, and how we could change it for the better.

It isn’t your everyday scientific conference. It’s the kind of conference where invited neuroscientists and neurologists experience the flavor wheel of bourbon, sampling Woodford Reserve along with hazelnuts and then orange flesh to see how the liquor migrates into different parts of the palate. The kind of conference where a panel discussion on the science of taste includes a hip New York chef telling a roomful of dietitians that those with binge eating problems should “have sex! It will take your mind away from food.” The kind of conference where attendees suck lollipops designed to evoke the 1812 Overture.

You know, that kind of conference.

But behind the foodie fun is hard science and a real clinical conundrum. Killing cancer cells means killing healthy cells along with them. The poisons of chemo and the waves of radiation are especially good at taking apart the DNA of fast-dividing cells. That can help stop the out-of-control expansion of tumors. But the nerve cells in the nose and mouth replenish themselves quickly, and so they die, too.

The resulting changes in taste and smell might seem like a small price to pay for a lifesaving treatment. Yet one’s desire to get up in the morning can be intimately connected to one’s ability to enjoy food. Lose your ability to taste properly and your mental and physical health — which, for cancer patients, is already fragile — can suffer even more.

“Many people stop eating,” said Gary Beauchamp, a sensory perception researcher at the nonprofit Monell Chemical Senses Center in Philadelphia. “It is a potentially lethal effect.”

The loss of taste and smell is among the most common complaints of cancer patients. But those don’t necessarily bounce back even if you’re lucky enough to transition from patient to survivor.

“The hope is that some of those taste abilities will come back. We’re all different. Some regain it very quickly; others — like myself — might not at all,” said Barry Warner, a 59-year old who was treated for throat cancer seven years ago, and one of the cook-off’s taste-testers. “The bottom line is, if after a period of time, it doesn’t come back, it’s something you’ll have to adapt to. There isn’t going to be anything the same as it was.”

Most doctors hardly ask about this side effect, and when they do, they don’t have much to offer besides apologies and explanations. Their focus is keeping you alive.

“You have no resources to help you deal with the taste aspect,” Morin said in an interview with STAT about a week before he flew to the conference, as he drove to visit a friend with late-stage metastatic cancer. “Who is the next specialist you talk to? It’s the nutritionist: an accountant of nutrition, a bookkeeper of calories. They don’t become nutritionists because they relish the smell and taste of the skin of a roast chicken.”

diamond-break

Camerino does a lot more than “relish” smells and tastes. By her own account, she lives through her sense of taste.

“I taste everything — like, everything,” she told STAT. “I taste colors, people, emotions, music … I can’t remember songs or movies, but I know what everything tastes like.”

That’s not just because she’s a celebrated pastry chef, who has devoted decades of her life to subtle differences in food. It’s also because she’s synesthetic. The unusual wiring of her brain makes her experience the world through her tongue. Sights and sounds conjure up complex flavors, allowing her to become a kind of mystical Willy Wonka, with top hat and plum velvet jacket swapped out in favor of big round glasses and snaking blue tattoos.

Camerino talks about the flavors she perceives the way some saints talk about God — as an experience accessible only through metaphor. And just as monks might interpret their visions through the lens of scripture, she uses her training in French patisserie, Japanese confectionery, and coastal Italian cooking to pinpoint what exactly it is she’s tasting at that moment — and, in some cases, to reproduce it.

When she was tasked with “profiling” the chef and television personality Andrew Zimmern in a cake, she was startled that the first thing to appear on her palate was prawn shell. “I was like, ‘Are you kidding?’” she said.

“How do I take a prawn shell and put it into a cake? You toast it. I toasted it low, for a long time, so it never burned and it didn’t become overly sharp, and then I ground it into a powder and I folded it into the cake batter, so all you got was the essence, nothing overwhelming.” The other flavors she had felt — green Szechuan peppercorns, bay leaves, miso, Asian pear — became accompanying syrups and jellies, until she was confident her cake perfectly embodied Zimmern’s spirit.

Sometimes, she’ll get flavors she’s never had before, and only through extensive research can she identify them. A band she was taste-profiling a few years ago conjured up a tang that turned out to be a Southeast Asian fruit called calamansi. A man she met around 2001 evoked a taste that turned out to be mare’s milk, as used in Tibetan and Mongolian cuisine. She is sure of it, even though she’s never tasted horse milk of any kind.

When Han, the neuropsychologist at the University of Kentucky, emailed to invite Camerino to the conference, she thought it was a joke. Like most people, she had never heard the term “neurogastronomy.” After all, it was only coined in 2011, in the title of a Yale neuroscientist’s book. She wasn’t sure that such a conference existed.

But after a back-and-forth by phone and email, she agreed. The arrangement had a fairy-tale ring to it: The woman for whom taste is everything would concoct a special dish that could rekindle patients’ pleasure in food.

diamond-break

Barry Warner’s first hint of flavor began at least as early as 1957, in the months before he was born. His mother had grown up on a farm southeast of Louisville, where dinner came from the pigpen, the cowshed, and the vegetable patch. That kind of country cooking was what she learned and continued making into her adult years, and during her pregnancy, its fragrant particles filtered down though her digestive system and into her amniotic fluid, shaping what Warner would like once he was born.

He was raised among the rolling corn and tobacco farms of Nelson County, in a small town with a single stoplight. His parents weren’t farmers, but starting at 11 or 12, he helped neighbors to bale hay, loading it into trucks and stacking it in barns for the winter. He loved his mother’s cooking: cornbread sticks made in a cast-iron skillet, cooked cabbage, pork chops soft enough to cut with your fork.

But in 2009, eating became painful. “Every time I tried to extend my mouth wide enough to take a bite out of a sandwich or a hamburger, I had a burning sensation in my tongue,” he said. He went to see a friend, an oral surgeon who’d removed his wisdom teeth years before, and asked him to take a look.

“He thought it was cancer, but he didn’t tell me that and he didn’t tell my wife until he got confirmation,” Warner said. “I didn’t know about it until then.”

Throat cancer was one assault on his body and his ability to eat, but the treatment brought about many more. Five days a week, for seven weeks, he would be immobilized onto a steel table and inserted into a machine for radiation. He also got periodic rounds of chemo.

Those didn’t just dampen his ability to taste; they also left him without saliva and made him taste flavors that weren’t there.

“It really starts out when you’re undergoing chemotherapy, that metal taste you get,” said Warner. “It seems like no matter what you eat, the taste isn’t right.”

He could have been tasting the drugs in his bloodstream — but he could also have been experiencing what some call phantom flavors. Those phantoms, some scientists say, can be the product of a taste system that is no longer in control, like a trained horse gone crazy, bucking off its rider and reverting to a frenzy of kicks and twists.

“Taste has an interesting function beyond what you experience when you eat,” said Linda Bartoshuk, a taste perception expert at the University of Florida. “Nature wants you to eat, so the taste system can be used to turn off sensations that might interfere with your eating. Taste input actually turns down pain. How does taste do that? It does that by sending a lot if inhibitory messages in the brain.”

Take away those inhibitory messages, Bartoshuk said, and those unwanted sensations come roaring in.

Warner no longer tastes those stomach-turning flavors — but he can’t taste anything else either. He might be able to identify mashed potatoes, say, by the texture, and maybe a little by the smell. But beyond that, he wouldn’t be sure what he is eating.

Now, at the lunch before the cook-off, Warner took tiny bites of the squash-and-goat-cheese appetizer that was in front of him. Partially he was saving room for the two different regimens that were on their way to try to rekindle some of those lost gastronomic pleasures for him and a fellow survivor. But that is also just how he’s had to eat since treatment: slowly, mostly without talking, and with little enjoyment, forcing himself to take one small bite after another.

“I don’t really get hungry,” he said. “You might sit down at your meal thinking about how good it tastes. Instead, I’m counting how many bites it will take me to get through it. And you never think about how much eating is part of your social life. That changes dramatically.”

Warner has kept some of his habits anyway. He still drinks bourbon socially — a taste wired into him as a Kentuckian — and he can smell it, and feel the burn of the first sip. And he still drinks a cup of coffee every morning. But he can’t taste either one.

He doesn’t complain about these long-term side effects. “I am so grateful and indebted to the doctors that saved my life, I consider my hearing loss and my loss of taste just … collateral damage,” he said. “Seven years ago, when I was getting my diagnosis, the odds of me having this conversation were less than a flip of a coin.”

Still, part of him wishes that he could experience what he remembers of food and drink. He hopes he’ll wake up one day and be able to taste his coffee.

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Camerino has devoted herself to sweets, studying chocolate-making and practicing the way to twist a pastry bag so a spritz cookie has the perfect swirl. But suffering, loss, illness, pain — those, too, have distinct flavors for her.

She grew up in a poor, abusive household in Gainesville, Fla., with a heroin-addicted father. “Everything tasted like too-salty water, the kind that you gargle when you’re sick and you’re not supposed to drink,” she said.

She remembers a year when they ate little but white rice and packaged brown gravy. She remembers struggling through eating disorders without ever seeing a doctor. She remembers the smell of the Miller High Life her father drank. Yet she also remembers her mother getting a job at the African and Asian languages department at the University of Florida, being invited over and presented with foods she had never imagined. Those visits pushed her into studying linguistics.

It was only a chance encounter with a pastry magazine that made her switch course: “I was like, ‘That’s what I want to do. I want to create something that’s bite-sized that can change your perspective on life.’”

The invitation to the Neurogastronomy Symposium seemed like a perfect opportunity. And as with many of her concoctions, she would be guided by both her synesthesia and her culinary education. This time, though, the food would be a kind of medicine. “I’ve wanted to do something meaningful with this superpower,” she said.

She had been told next to nothing about the patients she would be cooking for. Instead, she both did external research — and turned inward. She began conjuring up the flavors evoked by cancer, by chemotherapy, by terrible pain. They were not so different from what she tasted during the long recovery from a motorcycle accident she had this summer: something acidic, a bit like blood, with an astringent metallic edge. She wasn’t surprised that this was the same taste that many cancer patients got when undergoing treatment.

“The first thing I wanted to do was dim that down. If I can gain control of the taste in their mouth, if I can get rid of it, I can give them some relief,” she said. “Blood or metal, the best way to compete with that would be citrus. I’m not using a really strong citrus: Clementines are sweet, they have a little more of a delicate flavor. The clementine will cut through — it will literally cut through — the blood and metallic taste, so now I have a pathway through into their experience.”

Yet she also knew that some patients didn’t have much sense of taste left at all, so she wanted flavors that, to her, produce vibrations felt beyond the mouth: basil and pistachio. “By using the basil, now I’m opening up from the top of the mouth to the top of the forehead, that’s where basil affects you, now I have their whole attention. And pistachio, it has a floral quality, it’s reminiscent of the Mediterranean, of the ocean.”

She wasn’t completely giving up on the mouth, though. She thought of how fat can fall soothingly on the palate, another sensation beyond taste. Butter was too heavy, too overpowering, she said. Instead she went with olive oil.

The medication she came up with would be delicate, fragrant, and not too sweet: a clementine upside-down cake with a dab of basil and pistachio pesto, crowned with a scoop of olive oil gelato.

She wasn’t sure how well it would work. She had never made it before, and had no plans to try it out before she arrived at the event. She knew nothing about these particular patients. Yet as she was preparing for the symposium, she became so excited about the idea of helping patients with taste loss that she even began to dream up a lozenge with the same goal.

“I’ve made people experience emotions by combining particular flavors,” she said. “If I’ve made them experience disappointment, satisfaction, joy, then it may be possible to activate certain parts of the brain and make them experience all of that even without their sense of taste.”

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The day of the challenge began snowy and gray. Two days before, fatty jowl bacon had been fetched from a long-bearded breeder of Red Wattle hogs, and driven 60 miles back to Lexington, for whatever taste-saving concoction Morin, the Montreal chef, had in mind. Now, the University of Kentucky chef-in-residence Bob Perry was picking up last-minute ingredients from the research farm where the Ubatuba peppers grow.

Morin, it turns out, hadn’t really planned his dish out in advance. He’d asked for some vegetables, wine, bacon, spices. He’d figure something out. Camerino, on the other hand, arrived at the university’s demo kitchen with her own ice cream maker and a duffel bag of tools — infrared thermometers, weird tweezers, Q-tips, an offset spatula, an elaborate assortment of spoons. She was going to bring her own olive oil, too, but thought that might be overkill.

Before they headed into the kitchen, the clinicians and scientists and chefs and sommeliers gathered around Warner and another cancer survivor named Erica Radhakrishnan like overeager medical students crowding around a rare and fascinating case. They peppered the two with questions. What was their most memorable meal? Are there textures you find comforting? Did you eat processed foods before? What about the savory taste, which the Japanese call umami?

Then, with whatever intel they could gather, the chefs began to cook. Morin peeled potatoes and fried bacon. Camerino cracked eggs with a single hit on the side of the bowl, a quick squeeze and a pull.

Camerino adjusted her recipe slightly, making room for local ingredients. She incorporated a sprinkle of Ubatuba paprika into a syrup for the cake; she used molasses boiled down from the green juice of sorghum grass instead of cane sugar.

She had been nervous when she arrived, but now she was in her element. She needs no timer to know exactly when something should come out of the oven, perfectly brown. She tasted a spoonful of the basil-pistachio pesto. “This is a trip to Sicily,” she said. “Your marriage is struggling, it’s winter, you’ve lost the ability to communicate … and you go to Sicily with your partner. That’s what this is.”

On the other side of the kitchen, Morin was breaking up the fractal patterns of Romanesco broccoli into tiny bits of chartreuse, as a topping for his potato soup. “If he does not taste anything, I also have a bottle of bourbon,” he muttered in Québécois French.

The kitchen began to fill with the smells of bacon and basil, a hint of curry, and the sweetness of cake. The dishes were ready. At the last second, Camerino spooned a glistening white ball of gelato onto the two desserts.

The chefs each came forward to introduce their dish. Then they pulled back toward the kitchen. And with everyone watching, Warner and Radhakrishnan took careful bites, rolling around first the soup and then the cake in their mouths. The chefs looked on, tense, as Warner primly wiped his moustache.

Both tasters complimented the moisture of the cake and the aromas of the soup, the way the spices enlivened the purée, the way the ice cream made it easier to swallow the cake. They would not reveal the winner until the next day, at the end of the conference, in an auditorium full of academics and clinicians.

But a few minutes later, when the room’s attention had moved elsewhere, Radhakrishnan, whose sense of taste has largely come back after two battles with breast cancer, turned to Warner.

“Barry, are you able to taste anything?” she asked, gesturing toward the cake.

There was a pause. Warner looked serious, like he was concentrating on a math problem. “No,” he said quietly.

It might have worked for Warner while he was undergoing chemo and tasting its metallic tang. Or it might have worked for someone else. Just as Warner’s pleasure in food had been shaped in complex ways — by his genes, by the country cooking he’d sampled in the womb and as a child, and then by those foods he’d grown to appreciate as an adult — his preferences were equally unique after he’d lost his sense of taste. After all, a loss is only a loss in relation to what came before.

To Camerino, the challenge was at once amazing and humbling. “I could have cried a lot — I cry really easily,” she said. The experiment only heightened her zeal: She is now working with a molecular sommelier to dream up four different lozenges for people with taste loss, and, for those without saliva, two aromatic sprays. She isn’t sure about the exact ingredients, but she is thinking citrus, basil, barley malt as a sweetener, and something reminiscent of anise.

Han hopes that these events for chefs and scientists can move from “fun preclinical challenges” to more rigorous research about what can actually help these patients and survivors. Morin is working on an app for cancer patients to share what helps for which kinds of taste loss, and there are other ideas in the works. “We’re doing very early studies to take stem cells to see if we could regrow the system,” said Beauchamp, the researcher from the Monell Center. “But we’re a long way from that.”

For now, Warner keeps to the regimen he’s turned to for seven years. He uses whomever he’s eating with as a timer for when he can stop making himself take bites. He smells coffee in the morning, sipping it as he heads into his sunroom to listen for birds. He feels that first burn of bourbon, and notices how it falls away with each subsequent sip.

December, 2016|Oral Cancer News|

Genetic variants are associated with susceptibility to mouth and throat cancer

Source: www.eurekalert.org
Author: news release

A number of genetic variants associated with susceptibility to oral cavity and pharyngeal cancer have been described in an international study published in the journal Nature Genetics.

The most noteworthy finding was an association between cancer of the oropharynx and certain polymorphisms (alternative versions of a given DNA sequence) found in the human leukocyte antigen (HLA) genomic region. HLAs, proteins found on the surface of most cells in the body, play an important role in recognizing potential threats and triggering the immune response to foreign substances.

According to Eloiza Helena Tajara, a professor at the São José do Rio Preto Medical School (FAMERP) in São Paulo State, Brazil, and co-author of the article, a specific group of variants in this region, located on chromosome 6, is associated with enhanced protection against oropharyngeal cancer caused by human papilloma virus (HPV).

“Previous research showed that these same variants confer protection against cancer of the uterine cervix, which is known to be associated with HPV,” Tajara said. “Our findings suggest that the genes that control the immune system play a key role in predisposition to HPV-related tumors. This discovery points to the possibility of clarifying the mechanisms whereby such tumors develop and of designing methods for monitoring risk groups.”

The study was coordinated by the International Agency for Research on Cancer (IARC) and involved 40 research groups in Europe, the United States, and South America. The Brazilian participants are members of the Head & Neck Genome Project (GENCAPO), a consortium of scientists affiliated with several institutions.

In a recent study, GENCAPO evaluated more than 7 million genetic variants in samples from 6,034 patients with head and neck cancer. The cases comprised 2,990 oral cavity tumors, 2,641 oropharyngeal tumors, 305 tumors in the hypopharynx (the bottom part of the pharynx near the esophagus), and 168 tumors in other regions or more than one region concurrently. The study population also included samples from 6,585 people without cancer as controls.

The researchers detected eight loci (genomic sites) associated with susceptibility to these types of tumor. Seven had not previously been linked to mouth or throat cancer.

According to Tajara, the IARC set out to focus on analyzing oral cavity and oropharynx tumors because there are no genome-wide association studies of these two tumor types. Although these cancers are predominantly caused by tobacco and alcohol use, the importance of HPV, particularly HPV16, as a cause of oropharyngeal cancer has become more evident in recent years.

“The throat is the most affected area among head and neck cancer subsites, likely because its tissue is more receptive to the virus,” Tajara said.

In the article, the researchers note that the proportion of HPV-related oropharyngeal cancer cases is estimated to be approximately 60% in the US and 30% in Europe but lower in South America.

“One finding that was expected to some extent was the absence of HLA associations with oropharyngeal cancer, which may be due to the fact that the frequency of HPV-positive oropharyngeal cancer is less than 10% in South America,” Tajara said. “The same factor appears to account for the weak association between the variants identified and HPV-positive oral cavity cancer, which is also far less frequent than HPV-negative oral cavity cancer.”

In her view, the strong rise in cases linked to HPV in the US could be partly due to a change in sexual habits, especially regarding the practice of oral sex. “It’s possible that Brazil is still in a transition stage and that the habits that favor infection are only starting to become more common. If so, the effects will appear in a few years’ time,” she said.

Previous studies have already shown that HPV-associated head and neck cancers affect younger people and develop rapidly. By contrast, cases associated with tobacco and alcohol use as well as poor oral hygiene are more prevalent in those over fifty years old and progress more slowly but are harder to treat.

In addition to DNA in tissue samples taken from participants of the study, data were also collected on environmental and clinical factors possibly associated with the development of this type of cancer, such as smoking, alcohol consumption, and age.

According to Tajara, thanks to the joint efforts of 40 research groups it was possible to obtain data on a significant number of patients, thus enhancing the impact and reliability of the results. The GENCAPO team contributed some 1,000 samples from tumors for analysis.

“Based on these results, we can try to understand from the molecular standpoint how the observed polymorphisms interfere with the response to HPV infection,” Tajara said. “This may give us clues as to how to protect people and how to reduce the incidence of this type of tumor.”

December, 2016|Oral Cancer News|