OCF In The News

HPV Persistence Predicts Poor Prognosis in Head/Neck Cancer

Source: www.medscape.com
Author: Roxanne Nelson, RN, BSN

Among patients with human papillomavirus–positive oropharyngeal cancer (HPV-OPC), persistence of HPV following treatment is associated with a poorer prognosis.

Results of a new study show that the persistence of HPV16 DNA, detected in oral rinses after treatment has ended, may be predictive of disease recurrence.

In a cohort of 124 patients with HPV-OPC, HPV16 DNA was detected in oral rinses from 54% (n = 67) of patients at the time of their diagnosis. Following treatment, it was detected in only six patients after treatment, including five patients with persistent oral HPV16 DNA that was also detected at diagnosis.

All five patients with persistent HPV16 experienced disease recurrence, with three eventually dying of their cancer. Conversely, only nine of 119 patients without persistent oral HPV16 DNA developed recurrent disease.

“Our findings indicate that persistent HPV16 DNA in oral rinses may be a useful early marker of disease that has either recurred or never fully responded to treatment,” said first author Eleni Rettig, MD, of the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

“In the clinical setting, this could one day be a part of routine surveillance after treatment for HPV-positive oropharyngeal cancers, in addition to clinical examination and imaging,” she told Medscape Medical News.

The study was published online July 30 in JAMA Oncology.

Biomarker Potential?

In an accompanying editorial, Julie E. Bauman, MD, MPH, and Robert L. Ferris, MD, PhD, both of the University of Pittsburgh, in Pennsylvania, point out that HPV-specific biomarkers in oropharyngeal squamous cell carcinoma (OSCC) may be used to improve clinical outcomes, and “this pioneering study demonstrates an association between persistent oral HPV16 DNA detection and recurrence.”

But an ideal biomarker for recurrence, they say, should have a number of characteristics, including high sensitivity to identify the population with salvageable locoregional recurrence, a high positive predictive value (PPV) so as to avoid the economic, physical, and emotional costs of false-positive evaluations, and accuracy for detecting subclinical locoregional recurrence.

The prevalence of a positive oral rinse at diagnosis, however, was only 54%, and so the “low sensitivity of the assay, even with gross disease present, raises legitimate questions regarding its utility for diagnosing subclinical disease,” they say.

Of the six cases in which posttreatment HPV16 DNA was detected, five patients developed recurrent disease, representing a PPV of 83%, the editorialists write. When restricted to the five cases with persistent HPV16 DNA, the PPV then becomes 100%.

Although this looks impressive, they point out that “persistence can only occur in those who initially test positive — making this recurrence biomarker irrelevant for half of patients with HPV-positive” disease.

In addition, they add, the PPV can apply to any recurrence, including presentation with distant metastases, and “unfortunately, early diagnosis of disseminated OPSCC [oropharyneal squamous cell carcinoma] has not been associated with improved survival.”

“Operating characteristics, including low sensitivity, low confidence in the PPV, and high NNT [number needed to treat], preclude immediate clinical adoption,” say Dr Bauman and Dr Ferris. They add that incorporating an HPV-specific biomarker in future surveillance guidelines will require some refinement, including improved sensitivity and perhaps combining it with other serologic markers, such as HPV16 DNA or E6 antibodies.

“Meanwhile, the high negative predictive value of oral rinse HPV16 DNA detection raises the promise of deintensifying surveillance visits and/or costly imaging, particularly if on a prospective trial,” they conclude.

Dr Rettig agrees that more studies are needed before this test can be recommended. “For example, we need to understand when and how frequently to administer the test, what exactly we should do with a positive result, and what the cost-effectiveness would be, given the small number of individuals who actually have persistent oral HPV16 ― only five of 124 people in our study,” she said.

“We also can’t say for sure that all of the HPV16 DNA comes from tumor cells, and in some cases, it might just come from an oral HPV16 infection,” Dr Rettig explained. “For all of these reasons, right now, this test should only be used in the research setting until we have more information from additional studies.”

Associated With Recurrence

In this study, Dr D’Souza and colleagues examined HPV DNA detection in oral rinses after treatment for HPV-OPC and how it related to disease recurrence and survival.

This prospective cohort study included HPV-OPC patients diagnosed from 2009 to 2013 at four centers. Oral rinse samples were collected at diagnosis and after treatment (9, 12, 18, and 24 months after diagnosis) and were evaluated for HPV DNA. One or more posttreatment oral rinses were available for the 124 patients included in the study.

The median follow-up time was 33 (24-41) months, during which there were 14 recurrences and six deaths — all due to recurrent disease.

Two years after diagnosis, disease-free survival (DFS) was 92% (95% confidence interval [CI], 94% – 100%), and overall survival was 98% (95% CI, 93% – 99%).

The presence of HPV16 DNA in oral rinses at the time of diagnosis was not associated with either DFS (P = .15) or overall survival (P = .14), but on univariate analysis, persistent HPV16 DNA detection in oral rinses (eg, both at diagnosis and any time after treatment) was associated with a greater than 20-fold increased risk for recurrence (hazard ratio [HR], 29.7; 95% CI, 9.0 – 98.2) and death (HR, 23.5; 95% CI, 4.7 – 116.9).

It still remained associated with both DFS (adjusted HR [aHR], 35.8; 95% CI, 8.6 – 149.1) and overall survival (aHR, 16.1; 95% CI, 2.8 – 92.7) after adjusting for pack-years of smoking and tumor stage.

This research was supported financially by the Johns Hopkins Richard Gelb Cancer Prevention Award (Dr D’Souza), the Oral Cancer Foundation (Dr D’Souza), the National Institute of Dental and Craniofacial Research, and the National Institutes of Health Training in Otolaryngology grant (Dr Rettig). Several of the authors report relationships with industry, as noted in the article. The editorialists report no relevant financial relationships.

JAMA Oncol. Published online July 30, 2015. Abstract, Editorial

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


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Professional Rodeo Competitors Join Fight Against Oral Cancer

Source: www.upr.org
Author: Melissa Allison


The number of oral cancer deaths related to tobacco use is on the rise nationwide according to the Oral Cancer Foundation. Brian Hill is the founder of the OCF and a survivor of the disease.

Kiser-OCFCody Kiser encourages the youth to not start using tobacco to help secure good health. Oral Cancer Foundation


“Up until about (the year) 2000 this was primarily a disease of older men who had smoked a lot or chewed tobacco during their lifetime,” Hill said. “About that point in time we started to see a shift in the cause of the disease.”

Hill said tobacco is still a primary cause of oral cancers and adds that the oral human papillomavirus type 16 (HPV16) is new etiology that has forced the number of cases to accelerate.

According to an October 2014 study by Johns Hopkins researchers the HPV16 causes cancers of the mouth and throat and that any form of tobacco use increases the risk of the virus. The research suggests as few as three cigarettes a day can increase the risk of infection by almost one-third.

Hill created the foundation in 1999 to promote change by educating the public about risk factors that contribute to the disease. Among those risks is the use of spit tobacco.

“The world of rodeo has been the realm of sponsorship by the tobacco industry for decades,” Hill said. “With the nicotine content in a can of dip equaling approximately that of 80 cigarettes, this addiction can be one of the hardest to break. We hope to educate parents and youth about the dangers before they even get started.”

The OCF is turning to professional rodeo competitors to serve as positive role models during a national campaign.

Cody Kiser is a professional bareback bronc rider from Reno, Nevada.  He was in Delta, Utah recently where he competed at the Millard County Fairgrounds. Kiser told parents at the rodeo that nearly 15 percent of high school boys in the United States use smokeless tobacco.

“My dad was a cowboy, so I know what it’s like looking up to cowboys as heroes for my whole life. Health and fitness have always been incredibly important to my family. My dad was a positive role model in my life growing up in that regard, and the idea of using spit tobacco never appealed to me,” Kiser said. “Right now, I’m pursuing rodeo as a passion of mine, and if at the same time I can do some good in the world and set the right example for young kids who might look up to me, then I’m honored and eager to do so.”

Kiser said cowboys have a reputation that is second only to baseball players for being users of tobacco in the world of sports.  He wants to change that reputation throughout the country and in Utah, where rodeo is popular.

“From my point of view, Utah seems to be on the front lines of health and fitness,” he said.  “I’ve been very impressed with Utah as far as a healthy lifestyle, people who don’t smoke and chew so it’s good to see in Utah that they don’t do that as much.”

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

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Guest View: Stampede riders take stand against tobacco habits

Source: Prospect Magazine
Author: Natalie Riggs

Smokeless/spit tobacco is one of the historic causes of deadly oral cancers, and is more addictive than other forms of tobacco use.

As a national nonprofit seeking to spread awareness of oral cancer and the dangers of starting terrible tobacco habits, the Oral Cancer Foundation has teamed up with professional barrel racer, Carly Twisselman, and bareback bronc rider, Cody Kiser, in an effort to spread the word in one of the biggest arenas of tobacco using patrons — the rodeo circuit.

While others are focused on getting users to quit, the Oral Cancer Foundation is taking a proactive stance against tobacco by reaching out and educating youth about the dangers and risks of the habit. The message is simple and non confrontational: “Be Smart. Don’t Start.” With the strong addictive powers of smokeless tobacco, we have to engage them early.

The Oral Cancer Foundation is a big believer that in order to solve problems, you have to become involved where the problem lies. The western/rodeo environment in the U.S. has had a long-term relationship with tobacco, and until 2009, the Professional Rodeo Cowboys Association and the rodeos that they sanctioned had a lengthy history of tobacco sponsorship money funding the sport.

While that has ended at PRCA events, tobacco use, and smokeless/spit tobaccos still thrive in the sport.

As a national nonprofit, OCF is taking a stance against tobacco with the help of both a cowboy and cowgirl who value their choice of not associating or partaking in this act; making them alternative positive role-models for the adolescent age group whose minds are so easily molded.

Carly Twisselman comes from a seventh-generation ranching family in California. Rodeo has always been a family sport for her and she feels it is important to protect that family lifestyle.

Besides her work with the foundation, Carly can be found as a TV host on the new Ride TV cable channel, in Hollywood as a stuntwoman for popular television shows such as: “Glee,” “Vegas” and the motion picture film “Crank.” OCF is very proud to have her as a spokesperson in our “Be Smart — Don’t Start” program.

Cody Kiser is your All-American cowboy. He graduated with a degree in engineering from University of Nevada, Reno. Cody has worked in Hollywood as a professional stuntman and can be seen in the recent blockbuster film “American Sniper,” starring Bradley Cooper. Cody’s desire to put forth effort to try to make a change in the world with his stance for non-tobacco use, while encouraging youth to make the decision against tobacco, is admirable. It is important for our youth to have positive role models who practice healthy habits, and OCF feels that Cody is the perfect candidate.

Both Cody and Carly will be riding this weekend at the Marysville Stampede.

Natalie Riggs is director of special projects for the Oral Cancer Foundation. For more information, visit the website: http://www.oralcancer.org.

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

Source: www.marketwatch.com
Author: press release

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

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

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

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

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

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

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

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The Oral Cancer Foundation Launches April Oral Cancer Awareness Month

Source: Yahoo News
Author: The Oral Cancer Foundation

NEWPORT BEACH, Calif., April 9, 2015 /PRNewswire-USNewswire/ — April is Oral Cancer Awareness Month. 2015 marks the 16th year that The Oral Cancer Foundation has lead the effort to raise awareness of this disease and the need for an annual screening.

OCF has learned that although we accomplish a great deal as an organization, we can do so much more through the formation of strategic relationships with those who share our values and goals. OCF is grateful to the thousands of private dental offices that make time on multiple days during the month of April to offer free screenings to members of the public in their local communities across the nation. Besides the screening itself, these offices provide valuable information to the public related to risk factors and early signs and symptoms. An informed public can engage in self-discovery, which has generated early stage finds in so many other cancers.

In addition to the 1,000’s of private dental offices who will join with OCF this April, a coalition of professional organizations, private sectors companies, and educational institutions have chosen to partner with us. The professional organizations include; The American Academy of Oral Medicine (AAOM), The American Academy of Periodontology (AAP), The American Dental Hygienists Association (ADHA), The American Association of Oral and Maxillofacial Surgeons (AAOMS), The Academy of General Dentistry (AGD), The American Dental Association (ADA), The American Academy of Oral & Maxillofacial Pathology (AAOMP), and The Canadian Dental Hygiene Association (CDHA).  Our private sector corporate partners include Bristol-Myers Squibb, Henry Schein Dental, LED/VELscope, OralID and Identafi. The university partners this year are NYU, Penn Dental Medicine, and Columbia University College of Dental Medicine.

Jamie O’Day, OCF Director of Operations, expressed, “We are very proud that we have been able to assemble a powerful coalition of organizations, all with a vested interest in the oral cancer cause. OCF is thrilled to be in the company of such prestigious organizations and institutions. Coupled with thousands of private dental practitioners, this creates a formidable force to alter the late discovery paradigm that has plagued this disease for too many years.”

OCF Co-Founder Ingrid Hill, states that “There are steps as a nation that WE MUST take if we are to bring this disease down from its high ranking as a killer.

  • Since the HPV16 virus has become the fastest growing cause of oropharyngeal (back of the mouth) cancers, we must engage in a more robust effort to vaccinate our youth against this virus and allow our children and grandchildren to live in a country that has reached herd immunity against HPV related cancers, all of which are killers.
  • Create a national effort, ideally lead by dental professionals who see more than 60% of Americans at least once a year, to screen everyone opportunistically that currently visit their practices, as the vaccine only works in pre-sexual youth. Catching cancers in the current adult generation of Americans at early stages decreases treatment related morbidity, and improves long-term outcomes.
  • Create enough public awareness and knowledge that some SELF DISCOVERY of early signs and symptoms can occur, and self-referral for evaluation to medical or dental professionals takes place. Combined with professional screening, this will also yield more early stage discovery of both pre-cancers and early stage disease.”

Primary risk factors for developing an oral or oropharyngeal cancer

  • Tobacco use in all its forms
  • Excessive alcohol consumption
  • A persistent HPV16 (human papilloma virus #16) oral infection

Oral cancer signs and symptoms identifiable in a conventional visual and tactile screening

  • An ulcer or sore that does not heal within 2-3 weeks
  • A discoloration on the soft tissues of the mouth that persists. It may be white, red, or even blackish in color
  • A swelling or lump in the mouth that persists. This also applies to a tonsil that is swollen but painless
  • Any abnormality that bleeds easily when touched. (friable)
  • A lump, or hard spot in the tissue. (induration)
  • Tissue raised above that surrounding it, a growth. (exophytic)
  • A sore under a denture, which even after adjustment of the denture, still does not heal.
  • A numb feeling in the mouth or lips
  • Persistent sore throat, hoarse voice, or cough
  • A painless fixated lump felt on the outside of the neck, which has been there for at least two weeks
  • Difficult or painful swallowing, or a painless sensation that when swallowing things are becoming stuck in your throat
  • An ear ache on one side (unilateral) which persists for a protracted period of time

OCF releases its 2015 projections for oral and oropharyngeal cancers derived from the government SEER database.

45,750 Americans will be newly diagnosed with an oral or oropharyngeal cancer, and there will be approximately 8,650 associated deaths. That is a one-year jump of about 5%. Brian Hill, Executive Director and Co-Founder of OCF stated, “Big numbers are hard to digest, even abstract to individuals, and people are not sure how important this data is. In simpler terms, it means 125 Americans will be newly diagnosed every day, and one American will die from this disease every hour of the day 24/7/365.  Since the two drivers of these numbers are a preventable lifestyle choice, (tobacco use), and a virus (HPV16) for which we have a readily available vaccine, the use of which would protect our next generation, is disheartening. Worse, with the virus being the more aggressive driver of these statistics, this number is without doubt, going to increase every year during our generation, since there is no vaccine for adults already exposed. When compared to other first world countries, the U.S. is far behind in vaccination and reaching herd immunity in our young people. Speaking as someone who almost lost his life to this disease from an HPV etiology, and who talks with patients and families in crisis with routine, my personal opinion is that we as Americans are doing a poor job of controlling tobacco use, contrary to scientific evidence of its harm. Given the huge financial component to the tobacco paradigm in the U.S. and the lack of any political will to change it, I do not see this undergoing any significant change in the future. That we have no national vaccine policy to protect our youth/the next generation with something in our power to change, policies accomplished with huge success in other countries around the world, I find unconscionable.”

It’s not too late to join with the other thousands of dental offices to get involved in bringing down these numbers. Click the following link to learn more about oral cancer awareness month, and how to create your own Free Oral Cancer Screening Event if you are a professional. http://www.oralcancer.org/events/oral-cancer-awareness-month.php

Members of the public can view our online calendar of events to find a screening event near them at – http://www.oralcancer-screening.org/events/?d=2015-04-01&b=1.

Be aware. Get Screened. BE PART OF THE CHANGE.

About the Oral Cancer Foundation
The Oral Cancer Foundation, founded by oral cancer survivor Brian R. Hill, is an IRS registered non-profit 501(c)(3) public service charity that provides information, patient support, sponsorship of research, and advocacy related to this disease. Oral cancer is the largest group of those cancers that fall into the head and neck cancer category. Common names for it include such things as mouth cancer, tongue cancer, head and neck cancer, and throat cancer. OCF maintains a web site at http://www.oralcancer.org, which receives millions of hits per month. Supporting the foundation’s goals is a scientific advisory board composed of leading cancer authorities from varied medical and dental specialties, and from prominent educational, treatment, and research institutions in the United States.

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

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Young supports Oral Cancer Awareness with launch of new Burgundy Disposable Prophy Angle

Source: http://www.dentistryiq.com
Author: DentistryIQ Editors

Screening is the beginning of the end of oral cancer, and Young is joining the Oral Cancer Foundation in empowering hygienists to “Be Part of the Change.”

Hygienists are on the front lines of oral cancer detection, and their involvement in early screening is paramount in the fight against oral cancer. Young is helping to support hygienists and keep oral cancer awareness in the forefront by launching the new Classic Burgundy Petite Web disposable prophy angle just in time for Oral Cancer Awareness Month in April.

In addition to being the signature burgundy color of oral cancer awareness, the Classic Burgundy Petite Web disposable prophy angle packaging acts as a billboard to promote awareness through early detection.

According to the Oral Cancer Foundation, more than 43,000 people are diagnosed with oral cancer in the U.S. each year, and only 57% will survive past five years due to late diagnosis. When found at early stages of development, oral cancer victims have an 80 to 90% survival rate.

Thanks to engagement from the RDH community, we are on the cusp of a major change in this paradigm. With a commitment to screening for oral cancer warning signs during routine prophylaxis procedures, hygienists are helping to save lives through early detection.

“Just doing ‘opportunistic’ cancer screenings during routine dental hygiene procedures would yield tens of thousands of opportunities to catch oral cancer in its early stages. One of our goals is to initiate an effort within the dental community to aggressively screen all patients,” said Brian Hill, executive director of the Oral Cancer Foundation. “Screening for oral cancer during dental examinations will save lives. We are thrilled to partner with Young in launching the Classic Burgundy Petite Web disposable prophy angle to help raise awareness about the early detection of oral cancer.”

To learn more about the Oral Cancer Foundation, visit www.oralcancer.org. To learn more about the new Classic Burgundy Petite Web disposable prophy angle, visit www.youngdental.com.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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Giving chew the boot: Rodeo riders lead oral cancer awareness campaign

Source: mohavedailynews.com
Author: DK McDonald

LAUGHLIN — Rodeo professionals Carly Twisselman and Cody Kiser are bringing something extra to their competition at the Avi Stampede PRCA Rodeo this weekend.

They are bringing a message to kids.

The public faces of the “Be Smart, Don’t Start” tobacco use awareness campaign, Twisselman and Kiser are sponsored by The Oral Cancer Foundation.

“We’re the first charity to ever be the exclusive sponsors of any rodeo competitors,” said Brian Hill, founder and executive director of The Oral Cancer Foundation. “We go to the rodeos with Carly and Cody to get the word out to kids. 

“As in most things, if we can catch kids early and can show them good role models like Carly and Cody, who are fierce competitors and great people, they can see that tobacco doesn’t have to be a part of being a great cowboy or cowgirl.”

The Professional Rodeo Cowboys Association and tobacco have a history; until 2009 the PRCA accepted tobacco sponsorship money to fund the sport. 

“Now, the PRCA disassociated itself with spit tobacco companies back in 2009 and they’re no longer financial sponsors of rodeo,” said Hill. “It was really a great thing for PRCA to do. That being said, the people who attend and the competitors themselves still tend to be heavy users of tobacco, spit tobacco and cigarettes.”

Spit tobacco, which can refer to smokeless tobacco, dip, snuff, chew, and chewing tobacco, according to the OCF, can cause gum disease, tooth decay, and white patches and oral lesion that can lead to oral cancer.

“I grew up rodeoing in a huge ranching family in California,” Twisselman said. “I have family members who have had problems with tobacco and I thought being a spokesperson for OCF would be a great way to get the youth out there that look up to rodeo athletes and show them that you don’t have to be smoking or doing drugs to be successful.”

“We’re non-confrontational,” Hill said. “I don’t believe that you convert people to your way of thinking by being anti-everything and getting in their face about it. Our message is directed at kids and usually kids that are too young to have even thought about picking up tobacco. If we can keep them from even starting, we’ve won the battle.”

“When the opportunity came up to do this, I wanted to get into it right away,” Kiser said. “I got involved because I want to make a difference, not only in rodeo but also in young people’s lives. 

“It’s a lot more to it than trying to get people information about oral cancer. It’s trying to change the sport of rodeo. One day, we might be able to have an oral cancer night at a rodeo and everyone will wear maroon. Trying to move rodeo in a positive direction — it would be tremendous to be a part of that.”

“We’re both put in front of thousands of people all the time,” said Twisselman. “What better way to use that exposure than to do good and to show our future generations that this sport isn’t about drugs and alcohol or smoking.”

“After doing this for a while now, I look at other people that are trying to do good in the community,” said Kiser. “It’s changed my outlook on wanting to do more for the community and for other people. It’s opened my eyes to getting involved more.” 

Kiser competes in the men’s bareback bronc riding competition at the Avi Stampede PRCA Rodeo today; Twisselman competes in the women’s barrel racing on Sunday.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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New research shows possibility of cure for HPV positive throat cancer patients

Source: Eurek Alert! The Global Source for Science News

Nice, France: Patients with cancer of the throat caused by the Human Papilloma virus (HPV+) have a better prognosis than those who are negative for the virus (HPV-). Now, for the first time, researchers have shown with convincing evidence that a group of patients with HPV+ cancer of the oropharynx (the part of the throat located behind the mouth, that makes up the region of the tonsils and the back part of the tongue where it connects to the swallowing part of the throat), can be cured in some cases even after disease has spread to distant organs in the body, like the lungs.

Dr Sophie Huang, Assistant Professor in the Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Canada, will tell the 5th International Conference on Innovative Approaches in Head and Neck Oncology (ICHNO) today (Friday) that her research has shown that, following intensive treatment, certain patients with HPV+ oropharyngeal cancer (OPC) and distant metastases (tumours appearing in an organ not directly related to the primary cancer site) can survive for more than two years without further evidence of disease. Such cancers are usually considered to be incurable, and the goal of treatment is usually limited to symptom control. “Our research, the largest study to date to explore survival predictors for metastatic HPV+ and HPV- oropharyngeal cancer patients, has shown that cure is a realistic goal in those patients with oligometastasis – metastases involving five or fewer lesions in one distant organ”, she will say.

Dr Huang and colleagues identified 934 patients with HPV+ OPC out of the 1238 OPC patients who had been treated at the Princess Margaret Cancer Centre between 2000 and 2011. Distant metastases were detected in 15% of these patients; 88 in the HPV+ group and 54 in those with HPV- disease. Oligometastasis was present in 24 HPV+ patients with distant metastases in a single organ.

The researchers found two types of distinct distant metastases in HPV(+) patients: “explosive” and “indolent” metastases. The explosive type metastasis, where more than ten lesions in one organ appear quickly in a short period (within three months of appearance of the first lesion), was present in 55% of the HPV+ group, as opposed to none in those who were HPV-. In both HPV+ and HPV- groups, lung was the most common metastatic site. The indolent type of metastases grow and spread at a much slower pace, most often manifesting as oligometastasis. This occurred in 24% of the HPV+ cases with metastases in a single organ as opposed to 26% of those who had HPV- cancer.

“In the HPV+ group of patients with oligometastases, when they were given definitive local treatment aimed at disease control – for example, a high radiation dose or surgical removal of the metastatic lesion, as opposed to a less aggressive treatment used to control symptoms -there was a long term disease-free period, suggesting that some may be cured,” Dr Huang will say. “In the HPV+ group with oligometases 25% were still alive after three years, whereas the percentage in the HPV- group was 15%.”

The survival advantage in HPV+ OPC patients is due to a number of factors, the researchers say. The cancer is more sensitive to radiotherapy and chemotherapy; the patients tend to be younger (an average age of 55 at diagnosis as opposed to 65) with fewer other health problems, including those caused by smoking-related illness, and this enables them to receive the more aggressive treatment necessary to eradicate metastatic disease.

The percentage of HPV positive to negative OPC cancers varies globally, depending on a number of factors, including the prevalence of smoking and the practice of oral sex. Overall the incidence of HPV+ throat cancers has increased over the past 20 years in developed countries, such as US, Canada, Japan, Australia, and some European countries. [1]

“This research has shown that metastatic HPV+ OPC patients who receive active treatment can survive considerably longer than those who did not receive treatment. One of the reasons patients with metastatic disease do not receive aggressive treatment is due to the physician and patient’s perception that this is an incurable state. We hope that these results will motivate researchers to optimise management strategies for these patients. This will not only help to produce a better quality of life and a return to work for them, but also reduce the cost to healthcare systems,” Dr Huang will say.

“We also hope that our study may trigger research to explore cost-effective methods for the early detection of metastases. Optimising and tailoring surveillance strategies for HPV+ patients are also important. For example, our research has shown that the surveillance period should be longer than the traditional two-year window, due to the possibility of later onset of metastases. Selecting the appropriate imaging method in order to detect asymptomatic oligometastasis (e.g. ultrasound for the early detection of liver metastasis) may allow salvage treatment of some patients before the cancer progresses. Finally, we hope that it will help clinicians identify patients who are best able to benefit from aggressive treatment, such as metastasectomy (surgical removal of the metastases) or stereotactic radiotherapy (highly focused high dose radiotherapy to small regions),” Dr Huang will say.

Whether it is possible to identify which patients at initial presentation are at high risk of developing distant metastasis, and which type of distant metastasis will subsequently develop are other important questions for future studies, say the researchers. “We know there is a degree of correlation between the initial stage and the risk of distant metastasis, but we did not find a strong relationship between this stage and the type of metastasis. The intensity of cigarette smoking in the years prior to the time of diagnosis is a possible factor. Being able to identify such relationships could be a huge help in deciding appropriate treatment at an early stage,” Dr Huang will say.

Although head and neck cancer is the sixth most common type of cancer worldwide, awareness of it is low, and hence the majority of diagnoses are not made until the disease is in an advanced stage, resulting in limited treatment choices and hence a reduction in the chance of survival.

Professor Jean Bourhis, co-chair of the conference scientific committee, said: This important piece of research adds substantially to what we know about the role and the importance of the Human Papilloma Virus (HPV) in oropharyngeal cancers and gives real hope of improvement in both diagnosis and treatment to those who are affected by the condition.”


1Chaturvedi AK, Anderson WF, Lortet-Tieulent J, et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. Journal of Clinical Oncology : official journal of the American Society of Clinical Oncology 2013;31(36):4550-9.

Abstract no OC-044: Proffered paper session, Auditorium Athena, Friday 16.00 hrs

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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

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February, 2015|OCF In The News|

Boy Scout Troop Hiking to Raise Awareness of Oral Cancer in Honor of their Former Scoutmaster

Source: abcnews4.com
Author: Staff

AWENDAW, S.C. (WCIV) — South Carolina is second in the nation for the number of people who die from oral cancer every year. That statistic hits too close to home for one local Boy Scout troop who is now taking on the fight against the cancer.

For five days, Boy Scout Troop 50 will be hiking through the Francis Marion National Forest from Awendaw to Moncks Corner.

“Last summer our former Scoutmaster was diagnosed with tongue and throat cancer and he had to step down,” said Larry Elkin, who is volunteering to help lead the hike.

Elkin says the boys have been preparing the 53 mile voyage for months. Their goal is to raise $5,000 to donate to the Oral Cancer Foundation.

“Mr. Hardy loved his troop and he loved to hike, so what way better way to honor and bring awareness than through something he loved,” said Elkin.

“If it’s one thing Mr. Hardy taught me is that if you are not going to do something right then don’t do it at all,” said Reid Kaplan, a 17-year-old who was under Hardy’s leadership when he was in the sixth grade.

It’s memories and lessons learned from Hardy that Kaplan says will keep him going when he gets tired.

“I remember going camping with him, and no matter how tired or worn out he was he never gave up he never complained, so when I’m drained I’ll be thinking about that,” said Kaplan.

Cole Shuber is another teenager who’s learned lots of life lessons from Hardy, and now he wants to give back to a man who has given so much to him.

“With everything going on, he really isn’t in a position to hike which is something he loved, so I want him to know I’m doing this — we are doing this — for him,” said Shuber.

Troop 50 is doing three 12-mile hikes and finishing off the last two days each with an 8-mile hike.

So far they’ve raised nearly $3,600. To help the Troop 50 reach their goal, click here.


*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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Study suggests that experience counts when it comes to head and neck cancer treatments

Source: medicalxpress.com
Author: staff

When it comes to specialized cancer surgery, it’s generally true that the more experienced the surgeon, the better the outcome. The same might hold true for radiation therapy used to treat head and neck cancer, according to a new study led by researchers Evan Wuthrick, MD, assistant professor of radiation oncology at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), and Maura Gillison, MD, PhD, professor of internal medicine and epidemiology at the OSUCCC – James.

Published in the Journal of Clinical Oncology with an accompanying editorial, the study compared survival and other outcomes in 470 patients treated with radiation therapy at 101 treatment centers through a clinical trial held from 2002 to 2005. The trial was sponsored by the National Cancer Institute and organized by the Radiation Therapy Oncology Group (RTOG).

The findings indicated that patients treated at the less-experienced centers were more likely to have cancer recurrence (62 percent versus 42 percent at five years) and had poorer overall survival compared with those at the highly-experienced centers (51 percent versus 69 percent five-year survival, respectively).

“Our findings suggest that institutional experience strongly influences outcomes in patients treated with radiation therapy for head and neck cancer,” says Wuthrick, the paper’s first author. “They indicate that patients do better when treated at centers where more of these procedures are performed versus centers that do fewer.”

Radiation therapy for head and neck cancer requires complex treatment planning that can vary considerably between institutions and physicians. In addition, significant short-term and long-term side effects can occur that require management by a carefully coordinated multidisciplinary care team. National Comprehensive Cancer Network guidelines recommend that head and neck cancer patients receive treatment at experienced centers, but whether provider experience affects outcomes was previously unknown.

Wuthrick, Gillison and their colleagues used participation in previous RTOG head and neck cancer clinical trials as a surrogate for experience. They identified 88 low-accruing centers that enrolled an average of four patients yearly to the trials, and 13 high-accruing centers that enrolled an average of 65 patients annually. Next, the researchers compared outcomes based on whether patients were treated at the high-accruing (more experienced) or low-accruing (less experienced) centers.

The study’s key findings include:

  • Five-year local recurrence rates were higher among patients treated at less experienced centers versus more experienced centers (36 percent and 21 percent, respectively);
  • The radiation therapy plan was more likely to deviate from protocol at less experienced centers (18 percent versus 6 percent);
  • Treatment at low-accruing centers was associated with a 91-percent increased risk of death and an 89-percent increase in progression or death when compared with high-accruing centers.

Institutional elements not assessed by the study that can also influence outcomes included use of a tumor board, the number of colleagues and their years of practice, and ancillary services such as speech and swallowing therapy, dietetic and nutritional support, and specialized nursing.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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December, 2014|OCF In The News|