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Biofilms in tonsil crypts may explain HPV-related head and neck cancers

Source: www.genengnews.com
Author: staff

Human papilloma virus (HPV) encased in biofilms inside tonsil crypts (pictured) may explain why the roughly 5% of HPV-infected people who develop cancer of the mouth or throat are not protected by their immune systems. Tonsil crypts with HPV are shown in green; epithelial and biofilm layers are shown in red. [Katherine Rieth. M.D.]

How can human papilloma virus (HPV) be prevalent in otherwise healthy people not known to carry it? A just-published study concludes that the virus may be lurking in small pockets on the surface of their tonsils.

Researchers from University of Rochester Medical Center (URMC) found HPV encased in biofilms inside tonsil crypts, where HPV-related head and neck cancers often originate. HPV is shed from the tonsil during an active infection and gets trapped in the biofilm, where it may be protected from immune attack.

In the crypts, the virus likely lays in wait for an opportunity to reinstate infection or invade the tonsil tissue to develop cancer.

“The virus gains access to the basal layer of stratified squamous epithelium through structural breaks in the stratified epithelial superstructure,” the investigators reported in the study. “Tonsillar crypt reticulated epithelium itself has been shown to contain numerous small blood vessels and has a discontinuous basement membrane, which may facilitate this infection and reinfection process.”

The URMC researchers said their finding could help prevent oropharyngeal cancers that form on the tonsils and tongue—and may explain why the roughly 5% of HPV-infected people who develop cancer of the mouth or throat are not protected by their immune systems.

HPV 16 and 18, high-risk strains that are known to cause cervical cancer, also cause head and neck cancers. While verified tests can detect HPV in people before they develop cervical cancer, that’s not the case with head and neck cancers, which according to a 2016 study are expected to outnumber cervical cancer cases by 2020.

“Far-Reaching Implications”
“Given the lack of universal HPV immunization and the potential for the virus to evade the immune system, even in individuals with detectable HPV in their blood, our findings could have far-reaching implications for identifying people at risk of developing HPV-related head and neck cancers and ultimately preventing them,” Matthew Miller, M.D., associate professor of otolaryngology and neurosurgery at URMC, said in a statement.

Dr. Miller and six colleagues detailed their findings in “Prevalence of High-Risk Human Papillomavirus in Tonsil Tissue in Healthy Adults and Colocalization in Biofilm of Tonsillar Crypts,” published online January 25 in JAMA Otolaryngology-Head & Neck Surgery, and announced by URMC today. The study’s corresponding author is Katherine Reith, M.D., an otolaryngology resident at URMC.

The researchers carried out a retrospective, cross-sectional study using samples obtained from tonsils archived at a university hospital following elective nononcologic tonsillectomy from 2012 to 2015. The samples consisted of formalin-fixed, paraffin-embedded samples of tumor-free tonsil tissue from 102 adults who had elective tonsillectomies and were between ages 20 and 39. More than half the patients (55, or 53.9%) were female.

Five of the samples contained HPV and four contained HPV 16 and 18. In every case, HPV was found in tonsil crypts biofilms.

HPV status was assessed by polymerase chain reaction (PCR), and high-risk subtypes 16 and 18 were assessed with quantitative PCR assay. Samples that demonstrated presence of HPV were then analyzed by in situ hybridization to localize the viral capsid protein.

These samples were then stained with concanavalin A to establish biofilm presence and morphology and with 4′,6-diamidino-2-phenylindole (DAPI) to visualize location of the virus in relation to cell nuclei. Data was assembled for aggregate analysis to colocalize HPV in the biofilm of the tonsillar crypts, the URMC researchers reported.

The research team plans to develop topical antimicrobials designed to disrupt the biofilm and allow the immune system to clear the virus—part of their investigation of potential screening tools, such as an oral rinse, to detect HPV in the mouth and throat.

February, 2018|Oral Cancer News|

NHS immunises girls but not boys against potentially deadly HPV virus because its ‘not cost-effective’

Source: www.thesun.co.uk
Author: Jacob Dirnhuber

Girls aged 12 to 13 are already vaccinated for free against the HPV virus, which can cause deadly tumours in the throat and mouth, but boys have to do without.

Experts believe it would take £22 million a year to vaccinate every boy in Britain against the deadly disease – a fraction of the vast £148 billion NHS budget. But low overall infection rates mean that bean-counters refuse to sign off on any additional funding – condemning thousands to months of expensive, agonising cancer treatment.

Cambridge University Professor Margaret Stanley blasted: “You cannot protect against these cancers by only vaccinating half the population.”

She told the Mail on Sunday: “Not to immunise boys is classic Treasury short-termism. You may not spend so much now, but it will cost far more years later.

“We are in the midst of an HPV pandemic.”

HPV is generally spread through genital and oral sex, and can also be transmitted by kissing – meaning that some people who contract it are virgins. Only a tiny minority of those infected go on to develop cancer, often decades after they contract the virus. An estimated 80 per cent of all adults in the UK have been infected at some point.

Throat and cancer specialist Professor Christopher Nutting said: “My patients are being struck down by a preventable cancer that will affect them for the rest of their lives.

“It’s unfair that women are protected but men are not. The vaccine will work. It is starting to make cervical cancer incredibly rare. Why wouldn’t we do the same for cancer of the throat?’

Figures show that in 2011 alone the HPV virus triggered cancers in 1,850 people – and a staggering 1,400 of those were men.

Businessman Chris Curtis, 59, who contracted oropharyngeal cancer after becoming infected, said: “There is something out there that can stop this happening. We’ve got to use it.”

Opening up about his harrowing time with the disease, he said: “My family would eat in the dining room and I would be stuck being fed through my tube by machine.

“I planned suicide twice. All that stopped me was the thought of my kids.

“You’ve seen the cream-cracker challenge? ” live with that every minute of every day. I look at a burger and chips and I see cardboard. If I eat a tomato, it feels like it’s exploding in my mouth – it’s intolerable.

“For months the cancer takes over your life, and there is no respite. It tests you to breaking point.”

Prof Pollard, of the NHS Joint Committee on Vaccination and Immunisation, said the committee could only recommend vaccinating boys if it found this conformed with the “health technology assessment methodology’, which is derived from the Treasury’s ‘Green book’.

“Under the rules we are only looking at cost-effectiveness from the health providers’ perspective.”

“Each possible vaccine had to be considered in the context of the NHS as a whole”

January, 2018|Oral Cancer News|

New “soft” laser treatment to improve quality of life for cancer patients

Source: www.world-first.co.uk
Author: staff

A new “soft” laser therapy is to be used nationwide to help prevent patients undergoing treatment for neck and head cancer from suffering severe side effects.

The low-level laser therapy (LLLT), or photomedicine, will help prevent patients suffering from soreness in the mouth and throat, dry mouth and swallowing problems.

More than 90% of the 4,000 people a year in England and Wales who receive chemoradiotherapy for head and neck cancer experience side effects which can lead to hospital admissions and, in some cases, interrupt the course of radiotherapy.

The new treatment, developed by the NHS foundation trusts of University Hospital Southampton and Newcastle Upon Tyne Hospitals, is being trialled nationwide as part of a £1.2 million study funded by the National Institute for Health Research (NIHR).

One of the main complications of current treatments is oral mucositis (OM), which affects taste and speech. It causes excessive secretions of saliva, which result in nausea, vomiting and weight loss. Currently, patients are treated with a combination of painkillers and anti-sickness drugs and many require frequent hospital appointments to control their symptoms. Some also need nutritional support through nasal or stomach feeding tubes.

LLLT is a drug-free treatment that stimulates damaged cells using a low energy laser beam to reduce pain and inflammation. It’s more commonly used to treat musculoskeletal problems such as tendon, bone and nerve damage.

Consultant clinical oncologist at Southampton General Hospital Dr Shanmugasundaram Ramkumar said the LLLT would improve quality of life for patients.

“If shown to be effective in this large multi-centre study, it could radically change the management of this group of patients in the UK and worldwide,” he said.

January, 2018|Oral Cancer News|

Dr. Califano discusses the role of surgery in head and neck cancer

Source: www.onclive.com
Author: Joseph A. Califano, MD

Joseph A. Califano, MD, professor of surgery, University of California, San Diego, discusses the role of surgery in head and neck cancer.

The surgeon has evolved to have a more integrative role in patient care for those with head and neck cancer. Current surgical techniques used in the treatment of head and neck cancers have greatly evolved in the last two decades. Surgery is more precise, and leaves patients with excellent function and cosmetic results by incision through natural orifices, Califano says.

Robotic surgery is the cornerstone of head and neck cancer surgery, says Califano. It is effective in terms of resecting tumors of the throat, tonsils, back of the tongue, and the nasopharynx—which are hard to reach without robotic instrumentation. Califano says that the benefits of robotic surgery in this setting are that it leaves patients with excellent function, swallowing, voice, and allows for a rapid recovery.

January, 2018|Oral Cancer News|

Study provides new guidelines for assessing severity of head and neck cancers

Source: eurekalert.org
Author: press release Cedars-Sinai Medical Center

Cedars-Sinai investigators have developed a new, more accurate set of guidelines for assessing the severity of head and neck cancers and predicting patient survival.

The new guidelines, outlined in a study recently published in the Journal of Clinical Oncology, center around counting the number of malignant lymph nodes found in each patient.

“The greater the number of malignant lymph nodes, the less favorable the patients’ chances of survival,” said Allen S. Ho, MD. Ho is director of the Head and Neck Program at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai and lead author of the study. “This new approach could dramatically simplify staging systems.”

For decades, doctors have determined the stage and predicted the progression of head and neck cancers based primarily on nodal size, location and how far the cancer has spread beyond the lymph nodes, but they have given less importance to the number of cancerous nodes. As a result, staging and treatment recommendations, based on current national guidelines, “are the same whether a patient has two or 20 positive lymph nodes,” said Zachary S. Zumsteg, MD, assistant professor of Radiation Oncology at Cedars-Sinai and the study’s senior author.

With the new system, based on the number of cancerous lymph nodes, patients are separated into similarly sized groups with distinct outcomes, Zumsteg said. “Our study demonstrated a better way to assess cancer severity, which will improve our ability to predict outcomes and give patients more personalized treatment.”

The Cedars-Sinai study involved reviewing data of 14,554 U.S. patients identified in the National Cancer Database who were treated for squamous cell carcinoma of the oral cavity (mouth, gum and tongue) between 2004 and 2013.

The data showed that an increased risk of death was associated with each additional cancerous lymph node found. The investigators concluded that the number of cancerous lymph nodes is a predominant, independent factor associated with death in those patients. The study also identified an ultra-high-risk group of patients with five or more cancerous lymph nodes.

Head and neck cancers occur in the lips, tongue, gums, bottom of the mouth, throat, larynx, nasal cavity and salivary glands. About 63,000 people developed head and neck cancers in the U.S. in 2017. More than 13,000 deaths from those cancers occurred during that period, according to the American Society of Clinical Oncology.

“Although considering the number of cancerous lymph nodes in staging is a simple concept that many head and neck cancer specialists have assumed to be true for years, data has been limited until now,” Zumsteg said. The study authors said they hope that, based on the new data, the number of positive nodes in staging will now be incorporated into clinical practice.

Notes:
1. Research reported in this publication was supported in part by the National Institutes of Health under award number R01 CA188480-01A1, National Center for Advancing Translational Sciences under award numbers UL1TR000124 and UL1TR001881-01, the Donna and Jesse Garber Award for Cancer Research and the Health Network Foundation Service Excellence Award.

Disclosure: Dr. Zumsteg serves on the external advisory board of the Scripps Proton Therapy Center and has been a paid consultant for EMD Serono.

January, 2018|Oral Cancer News|

Cancer survivors are transforming their radiation masks into art

Source: www.artsy.net
Author: Ryan Leahey

Photos by Ulf Wallin Photography

In a Baltimore basement, behind foot-thick walls, there is a room, and in that room there is a table. Every morning, Monday through Friday for seven weeks, my dad entered the room at 7:40 a.m. sharp. I accompanied him there on a few occasions, sitting outside in the waiting room as the door closed behind him. A minute or two would pass, followed by a barely audible buzz, then the door would slide open again and he’d walk out, another radiation treatment X’d off the calendar.

My dad’s experience in that room, one of many in the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, will be familiar to other throat cancer patients. A radiation technician bolted him down to the table with the help of a white mesh mask perfectly molded to the contours of his face. Wrapped tightly around his head and neck, the bizarre-looking armature ensured that powerful radiation beams targeted his cancer in the exact same position each session, even as his skin deteriorated and his body mass dropped.

Before his first treatment, he had been measured and fitted for his own custom mask. Plastic mesh was draped over his face until it hardened, forming a new face—what some patients call their second skin. For my dad, the object came to symbolize something, just as it symbolizes something for me, our family, and for the countless other people who have survived or helped someone survive head and neck cancer, or HNC.

My dad isn’t exactly the sentimental type, but on his last day of radiation, he rang the bell—a rite of passage for patients who make it through treatment—put the mask in his car trunk, and took it home.

 

Photo by Ulf Wallin Photography

The mask worn by Ryan Leahey’s father during radiation treatment. Courtesy of the author.

Just as cancers and treatments are unique, however, the meaning of the mask is unique to every patient and to every person who comes into contact with it. Among those searching for that meaning are hundreds of artists, some of them survivors themselves, who have transformed radiation masks into works of art that seek to capture, or at least confront, the struggle and, for the lucky ones, the survival of HNC.

Groups across the U.S. and other parts of the world have come together to create new lives for these masks. One such group, Courage Unmasked, has, through a series of auctions and books, shown off an incredible array of masks, all while raising awareness of HNC and funds for patients in need.

Courage Unmasked is the brainchild of Cookie Kerxton, an artist and HNC survivor. In 2009, Kerxton felt lucky. She was fortunate to have had the finances and good health to survive her radiation treatment for cancer of the vocal cords. As Kerxton convalesced, she realized that not everyone is quite so lucky. Some HNC patients face a permanent loss of saliva, destroyed taste buds, digestive issues, and an inability to talk, eat, swallow, or breathe. And when it comes to the cost of covering incidentals like specialty foods, commuting, and the many small but crucial steps toward recovery, health insurance is often insufficient.

Kerxton had an idea. She inquired at the treatment center about the leftover radiation masks, the ghostly white shells of former patients. With permission from the center’s radiation therapists, she took home the discarded masks and called upon her artist friends to help transform them into works of art. She then auctioned off the finished objects, using the proceeds to support HNC patients by sending applicants a $500 check through a Maryland-based nonprofit called 9114HNC (Help for Head and Neck Cancer).

Since the first Courage Unmasked event in 2009, held at American University’s Katzen Arts Center in Washington, D.C.—which featured 108 masks, decorated by more than 100 artists—other such events have followed, each raising more money for 9114HNC.

Photo by Ulf Wallin Photography.

Carol Kanga, an artist and HNC survivor, co-chaired the inaugural Courage Unmasked event and created a mask for the auction. “My attitude toward my mask was gratitude for the safety it represented,” she told me. “It meant precise treatment, the best available. When I walked into the radiation room and looked up at the shelves, scores of masks looked back at me. They signaled that I was not alone, that hundreds of people get through this, that each of us is a distinct individual receiving excellent treatment tailored exactly to each contour of our bodies.”

Her mask, she has said, “is designed to entice viewers to rejoice with me that life is and that we all are part of it.” And the range of other artist-adorned masks testifies to that life-affirming attitude. Some of the works are celebratory, like totemic symbols of victory over incalculable odds, while others are somber and severe, like fragile reminders of death. Flowers in bloom are a recurring theme, as are birds and their delicate, multicolored feathers.

Barbara Kerne created a mask inspired by Athena, the Greek goddess of arts and crafts who is said to have taken the form of an owl. Athena also happens to be the goddess of wisdom and strength, and thus, Kerne says, a symbol of “heroic endeavor and patron of those who need help.”

For artist Jeanne Heifetz, the mask, as an artifact of radiation, carried twin burdens of fear and hope. “I wanted to transform the emotional connotations of the mask, using alternative meanings of ‘radiation’ and ‘radiance,’” she says. Lacework and reflective copper turn the mask into what she calls a “protective armor for the wearer.”

Several artists sought to maintain the thread from mask wearer to mask reimagined. “This radiation mask came to me from a woman’s daughter in Colorado, who had tenderly sent it off in a box with pictures of mountains on it,” writes artist Anita Hinders in a catalogue that accompanied one Courage Unmasked event. “I think of this mask, Shades of Colorado, as a love letter continued.”

Photos by Ulf Wallin Photography

Allen Hirsch, a throat cancer survivor who recently became a board member for Courage Unmasked, hasn’t decided what to do with his mask just yet. “I have it in my living room,” he told me. “Each day I walk past the mask and it reminds me of the treatment experience and the other patients and family members I met at the radiation clinic and the infusion center. The mask is a reminder that life has changed.”

My dad hasn’t decided what to do with his mask, either. When I was home for the holidays, the mask was sitting on the dining room floor, our last name scrawled across the top. In unadorned white, it was bright like a halogen light. Later, I asked if he had any plans for it. He wasn’t sure. I showed him images of the artist-decorated masks in the Courage Unmasked catalogue, which he’d seen in the waiting room at Hopkins.

He liked some of the artwork, he told me, though he wasn’t too impressed by all the birds. He liked the stories, the book’s personal narratives from survivors and from artists trying to comprehend what he and others had been through, the most.

Dad was only a few days into radiation treatment when he first thumbed through the book at Hopkins, before he lost weight, his sense of taste, his hair, his voice. As those things come back to him, however slowly, he has come to appreciate those stories more. His trophy, as he calls his mask, is a symbol of his own story and how he was lucky, too.

January, 2018|Oral Cancer News|

Bacteria linked to periodontitis may play role in onset of cancer

Source: en.brinkwire.com
Author: press release

The bacteria that cause periodontitis, a disease affecting the tissues surrounding the teeth, seems to play a part also in the onset of pancreatic cancer, say the researchers at the University of Helsinki and the Helsinki University Hospital, Finland, and the Karolinska Institutet, Sweden.

The researchers have investigated the role of bacteria causing periodontitis, an inflammation of the tissues surrounding the teeth, in the development of oral cancers and certain other cancers, as well as the link between periodontitis and cancer mortality on the population level.

The study, published in the British Journal of Cancer, has for the first time proven the existence of a mechanism on the molecular level through which the bacteria associated with periodontitis, Treponema denticola (Td), may also have an effect on the onset of cancer. Researchers found that the primary virulence factor of the Td bacteria, the Td-CTLP proteinase (an enzyme), occurs also in malignant tumors of the gastrointestinal tract, for example, in pancreatic cancer.

According to another study finding, the CTLP enzyme has the ability to activate the enzymes that cancer cells use to invade healthy tissue (pro-MMP-8 and -9). At the same time, CTLP also diminished the effectiveness of the immune system by, for example, inactivating molecules known as enzyme inhibitors.

In another study, published in the International Journal of Cancer, it was proven that on the population level, periodontitis is clearly linked with cancer mortality. An especially strong link to mortality caused by pancreatic cancer was found. Some 70,000 Finns took part in this 10-year follow-up study.

“These studies have demonstrated for the first time that the virulence factors of the central pathogenic bacteria underlying gum disease are able to spread from the mouth to other parts of the body, most likely in conjunction with the bacteria, and take part in central mechanisms of tissue destruction related to cancer,” says Timo Sorsa, a professor at the University of Helsinki.

Researchers have come to the conclusion that a low-grade systemic inflammation related to periodontitis facilitates the spreading of oral bacteria and their virulence factors to other parts of the body. They point out that the prevention and early diagnosis of periodontitis are very important not only for patients’ oral health, but their overall wellbeing.

“In the long run, this is extremely cost-effective for society,” notes Sorsa.

January, 2018|Oral Cancer News|

HPV leads to increase In head and neck cancer In men

Source: www.nbcdfw.com
Author: Bianca Castro

The number of men diagnosed with head and neck cancer caused by human papillomavirus has skyrocketed. This report found that 11 million men and 3.2 million women in the United States are infected with some type of oral HPV and oncologists say it’s leading to more head and neck cancer in men.

“From the 1970’s to today, the prevalence of this HPV-related head and neck cancer has increased by three to five percent per year from then until now, and it is continuing that same rate,” said Oncologist Jerry Barker, Jr., M.D. at Texas Oncology.

“This is a silent epidemic. Most patients who are exposed to this virus, they don’t know it. They’ll never have symptoms from it, but some of those patients will move on to develop a cancer,” said Dr. Barker.

Jeff Busby, of Weatherford, is one of those patients. The aerospace engineer and owner of Busby Quarter Horses says he was diagnosed with throat cancer in February of 2016. His wife Andrea, who documented their journey here, says they were both shocked.

“We were just busy living life. You don’t ever think that shoe is going to drop,” said Andrea.

Jeff says the symptoms began as pain in his ear which lead to pain in his throat. Nine months later, he had a biopsy done on what was a mass in his neck.

“I had just been toughing it out and my partner said, ‘hey, you can’t just tough these kinds of things out. You’ve got to go get this checked out,'” said Jeff.

“It was the cancer putting pressure on and radiating nerve pain to the ear. There was nothing wrong with the ear whatsoever,” said Jeff.

A biopsy revealed Jeff had throat cancer caused by the human papillomavirus, the most common sexually transmitted infection.

Jeff was likely exposed in his teens or 20s, but now decades later, created a cancer with one of the most gruesome treatment protocols. He needed surgery to remove his bottom teeth and part of his jaw, 35 radiation treatments and six rounds of chemotherapy.

“I couldn’t let any of my energy go towards feeling sorry for myself because I had to have every amount of energy I had to beat this thing,” said Jeff.

Jeff had never heard of HPV before, while Andrea says she thought it was linked to only cervical cancer.

While pap smears screen for cervical cancer, there is no screening for hpv-related head and neck cancer and that may be part of the reason rates of hpv-related head and neck cancer has surpassed the rate of hpv-related cervical cancer.

There is way to stop the epidemic. The HPV vaccine is recommended for children as early as 11-years-old and young adults as old as 26 years of age. However, according to this study, in Texas, only 35 percent of children get the vaccine.

“Somewhere along the way, these vaccines developed the idea that they had to do with human sexuality and preventing a sexually transmitted disease, but in reality, they are designed to prevent cancer. These are cancer vaccines,” said Dr. Barker.

“If you could just see what some of our patients have to go through to cure one of these cancers, you would run to get the needle in the arm to prevent that from happening to one of your children.”

At 55, Jeff never had the chance to benefit from the vaccine, approved for use in 2006. He’s now cancer free and in some ways, he says, life is better than before cancer.

“I thank God for this challenge and I still wouldn’t change it today. I wouldn’t take it all away because I didn’t think I could be closer to the Lord or to my wife and I certainly have a much better relationship with both,” said Jeff.

He and Andrea are focused on raising vaccination rates and preventing the kind of cancer battle they fought from from happening to someone else.

“There are so many parents that even hear about but still choose not to do it. It’s beyond me. I can’t understand that,” said Jeff.

“Whether it gets a kid vaccinated or somebody sitting on their couch goes, ‘I have ear pain when I swallow. I should go to the doctor.’ That’s why we are doing this,” said Andrea.

The Centers for Disease Control estimates that most Americans have some type of HPV strain but not all strains lead to cancer. Some of the symptoms are head and neck cancer include ear pain, difficulty swallowing and a painless lump on the side of the neck.

January, 2018|Oral Cancer News|

Dentists may soon start asking about your sex life in a bid to control staggering HPV rates

Source: www.dailymail.co.uk
Author: Jaleesa Baulkman for DailyMail.com

Your dentist may be interested in more than just your flossing habits, but for a good reason. Dentists and dental hygienists are being encouraged to assess patients’ risk of developing oral cancers from HPV, the most common sexually-transmitted disease.

According to experts, they will likely skirt around the topic of their patients’ sex life and ask about potential symptoms of cancer like jaw pain and swelling.

But a new report published in the Journal of the American Dental Association insists it is imperative that dentists to play a more active role in detecting the disease, which is linked to seven types of cancer.

‘What we’re going to find over time is that HPV is going to be a more common cause of cancer over time,’ Ellen Daley, a public health professor at the University of South Florida, told Daily Mail Online. ‘We need to worry about how to prevent it.’

HPV is responsible for about 70 percent of oropharyngeal cancers in the US, according to the Centers for Disease Control and Prevention. The most common sexually transmitted infection in the US, it affects more than half of American adults. In fact, Dr Daley says it’s as common as the common cold.

However, asking about a patient’s sex life isn’t necessary to preventing HPV-related oral cancers.

‘If [dentists] want to [ask patient’s about their sex life], they can, Dr Daley explained. ‘But that’s not relevant since HPV is so common. We need to get pass how it’s transmitted and worry about preventing cancers.’

There have been nearly 16,000 annual cases of oropharyngeal cancers — cancer of the tongue, tonsils and pharyngeal wall — between 2008 and 2012, with HPV being the cause of approximately 72 percent of those diagnoses, according to data.

For the study, Dr Daley and her team conducted four focus groups with a total of 33 dentists.

Research showed that most dentists knew HPV was a risk factor for oropharyngeal cancer, but several were not sure about what causes HPV-related oral cancer.

The study found that many dentists don’t know how to approach the subject of HPV and lack the communication skills needed to educate patients effectively.

Most dentists said they were concerned their patients would think they were judging their personal behaviors. In other words, asking patient’s about their sex lives is out of the question. However, dentists and dental hygienists are trained to screen for oral cancers.

Examining the area under the tongue and looking in the back of a patients’ mouth are ways dentists screen for oral cancer. However, HPV-related oral cancers are difficult to detect because they develop in the throat at the back of the tongue, or in the folds of the tonsils, according to the American Dental Association.

HPV oral and oropharyngeal cancers are harder to discover than tobacco related cancers because the symptoms are not always obvious to the individual who is developing the disease, or to professionals that are looking for it. They can be very subtle and painless

HPV, which is transmitted through vaginal, anal and oral sex, is the most commonly sexually transmitted infection in the US, according to the CDC, affecting more than 79 million Americans. There are more than 40 types of HPV that can affect the mouth and genitals, but HPV 16 and 18 are the two most common cancer-causing types. According to the CDC, HPV type 16 is responsible for 60 percent of all oropharyngeal cancers. Non-cancer types of HPV can cause warts in the mouth or throat.

Some symptoms to look out for include, a persistent sore throat, earaches, enlarged lymph nodes, unexplained weight loss and painful swallowing. However, some people have no signs or symptoms, according to the CDC.

The HPV vaccine, which is administered to children aged nine and 12 years old in the US and the UK, is a preventive measure against HPV and HPV-related cancers. The vaccine is offered as a three doses in the US, and two doses in the UK. Condoms and dental dams also serve as protective barriers against the disease.

January, 2018|Oral Cancer News|

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|