Oral Cancer News

Mayo Clinic Q and A: Throat cancer symptoms

Source: newsnetwork.mayoclinic.org
Author: Dr. Eric Moore, Otorhinolaryngology, Mayo Clinic

DEAR MAYO CLINIC: Are there early signs of throat cancer, or is it typically not found until its late stages? How is it treated?

ANSWER: The throat includes several important structures that are relied on every minute of the day and night to breathe, swallow and speak. Unfortunately, cancer can involve any, and sometimes all, of these structures. The symptoms of cancer, how early these symptoms are recognized and how the cancer is treated depend on which structures are involved.

All of the passageway between your tongue and your esophagus can be considered the throat. It includes three main areas. The first is the base of your tongue and tonsils. These, along with the soft palate and upper side walls of the pharynx, are called the oropharynx. Second is the voice box, or larynx. It consists of the epiglottis — a cartilage flap that helps to close your windpipe, or trachea, when you swallow — and the vocal cords. Third is the hypopharynx. That includes the bottom sidewalls and the back of the throat before the opening of the esophagus.

Tumors that occur in these three areas have different symptoms, behave differently and often are treated differently. That’s why the areas of the throat are subdivided into separate sections by the head and neck surgeons who diagnose and treat them.

For example, in the oropharynx, most tumors are squamous cell carcinoma. Most are caused by HPV, although smoking and alcohol can play a role in causing some of these tumors. Cancer that occurs in this area, particularly when caused by HPV, grows slowly ─ usually over a number of months. It often does not cause pain, interfere with swallowing or speaking, or have many other symptoms.

Most people discover cancer in the oropharynx when they notice a mass in their neck that’s a result of the cancer spreading to a lymph node. Eighty percent of people with cancer that affects the tonsils and base of tongue are not diagnosed until the cancer moves into the lymph nodes.

This type of cancer responds well to therapy, however, and is highly treatable even in an advanced stage. At Mayo Clinic, most tonsil and base of tongue cancers are treated by removing the cancer and affected lymph nodes with robotic surgery, followed by radiation therapy. This treatment attains excellent outcomes without sacrificing a person’s ability to swallow.

When cancer affects the voice box, it often affects speech. People usually notice hoarseness in their voice soon after the cancer starts. Because of that, many cases of this cancer are detected at an early stage. People with hoarseness that lasts for six weeks should get an exam by an otolaryngologist who specializes in head and neck cancer treatment, as early treatment of voice box cancer is much more effective than treatment in the later stages.

Early voice box cancer is treated with surgery — often laser surgery — or radiation therapy. Both are highly effective. If left untreated, voice box cancer can grow and destroy more of the larynx. At that point, treatment usually includes major surgery, along with radiation and chemotherapy ─ often at great cost to speech and swallowing function.

Finally, cancer of the hypopharynx usually involves symptoms such as pain when swallowing and difficulty swallowing solid food. It is most common in people with a long history of tobacco smoking and daily alcohol consumption. This cancer almost always presents in an advanced stage. Treatment is usually a combination of surgery, chemotherapy and radiation therapy.

If you are concerned about the possibility of any of these cancers, or if you notice symptoms that affect your speech or swallowing, make an appointment for an evaluation. The earlier cancer is diagnosed, the better the chances for successful treatment. — Dr. Eric Moore, Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota

Print Friendly

Why drinking wine causes very dry mouth, and how eating cheese helps prevent it

Source: www.medicaldaily.com
Author: Lizette Borreli

The real reason why wine and cheese are often paired together has to do with creating a more balanced mouth feel to prevent dry mouth.

Photo courtesy of Pexels, Public Domain

At a happy hour, a dinner event, or a winery, we’re likely to see wine and cheese together on the menu. This classic food pairing makes it less likely for us to get dry mouth when we drink wine, and science has found out why. The food combination pair of astringent wine with fatty cheese, opposing foods of sensory perception, help create a more balanced mouth feel.

In the video, “Why Does Wine Make Your Mouth Feel Dry?” MinuteEarth explains the temporarily leather-like feel in our mouth is linked to the tannins in wine. The over consumption of tannins, like having a few glasses of wine, causes the slippery proteins in our saliva, tongues and cheeks to stick together, which produces a rough feeling on the tongue. Luckily, the bonds between the tannins and proteins are temporary, meaning once the mouth creates new saliva, it will dilute the tannins and carry them away.

Instead of waiting for new saliva to develop, there are proteins in fatty foods that will bond with the tannins, rather than our mouth. In a 2012 study, published in the journal Cell, researchers suggest drinking wine and eating cheese together work as the mild astringent cuts fat. Astringents tend to have a strong effect each time the mouth is exposed to them, implying they react more strongly with the lubricating proteins in the mouth upon each exposure.

A separate study published in the Journal of Food Science found when four different types of cheeses were paired with four different wines, the cheese influenced the dominant taste of each wine. For example, when participants paired a dry white Sancerre with Epoisses cheese, they were more likely to detect citrus notes. Meanwhile, when a spicy red Bourgogne was paired with Roquefort, the astringency decreased because the the fat in the cheese coated the mouth, therefore, reducing the tannin-induced drying.

These findings simply suggest why wine and cheese pairings have come to exist. An excess of tannins leads to dry mouth, but pairing astringent foods with fatty foods, like cheese, can help offset this feeling. Our mouth will feel smooth and leather-free.

Moreover, this sensory method can help us better understand why our perception of food changes when it is paired with something else. Perhaps this is why sandwiches are paired with pickles; why green tea goes with sushi; and why oil goes with vinegar. These famous food pairings could be a direct result of cultures finding the most balanced pairings based on what the foods are made of.

Until then, we will gladly pair our wine and cheese together, in the name of food science.

Print Friendly

Don’t start, be smart: Local, Reno Rodeo competitor advocates being tobacco-free

Source: mynews4.com
Author: Kenzie Bales
Date: June 13th, 2017

RENO, Nev. (News 4 & Fox 11) — As a country phenomenon, Garth Brooks once said, “It’s bulls and blood, it’s dust and mud, it’s the roar of a Sunday crowd. It’s the white in his knuckles, the gold in the buckle, he’ll win the next go ’round. It’s boots and chaps, it’s cowboy hats, it’s spurs and latigo, it’s the ropes and the reins, and the joy and the pain and they call the thing rodeo.”

2017 Reno Rodeo competitor Cody Z Kiser has been riding and roping for as long as he can remember.

Born and raised to Carrie and P.D. Kiser in Carson City, Nevada, Cody started riding bulls as a Dayton High School student.

A horrific injury would set Kiser back, but by no means did it keep him from chasing his dreams.

Kiser says a bull stepped on his face and crushed all the bones in the left side of his face. After recovering, Kiser transitioned from bull riding to bareback bucking horses and hasn’t looked back since.

If traveling to rodeos all the time wasn’t enough to keep someone completely preoccupied, Cody competed while pursuing a Bachelor’s Degree in Civil Engineering at the University of Nevada, Reno.

After testing the waters in the engineering field for awhile, Kiser decided it was time to chase his lifelong dream and give rodeo his full attention.

During his endeavors as a cowboy, Cody was fortunate enough to establish a partnership with the Oral Cancer Foundation.

Everyone knows it is terrible for you, yet they still do it.

He says that being tobacco-free is something he advocates for because he understands the huge health risks that come along with it.

I have seen the impact it can have on a human’s health and it is something that I want no part of, and if I can help others from starting it, then I am happy.

Kiser says he is always willing to answer questions pre-existing tobacco users may have, but by no means is he trying to tell people how to live their life.

A big goal of his: to show people that you don’t have to smoke or chew to be a real cowboy or to be successful in the sport you love. Primarily focusing on kids, Kiser hopes to spread the movement to younger generations who haven’t picked up the bad habit yet.

The sport is hard enough on your body, no sense in making in harder on yourself.

Kiser says he strays away from just throwing facts and statistics at people, but rather making a positive, memorable impact and associating with people without the use of tobacco.

After partnering with the OCF three years ago, the cowboy says that he has had nothing but positive feedback and calls himself the “luckiest guy in the world.”

If you are interested in watching Cody Kiser compete in the 2017 Reno Rodeo, you can catch him on Father’s Day, Sunday, June 18 (making his dad, a former bucking horse rider proud) or Monday, June 19.

Print Friendly
June, 2017|Oral Cancer News|

HPV Vaccination Linked to Decreased Oral HPV Infections

Author: NCI Staff
Date: June 5th, 2017
Source: www.cancer.org

New study results suggest that vaccination against the human papillomavirus (HPV) may sharply reduce oral HPV infections that are a major risk factor for oropharyngeal cancer, a type of head and neck cancer.

The study of more than 2,600 young adults in the United States found that the prevalence of oral infection with four HPV types, including two high-risk, or cancer-causing, types, was 88% lower in those who reported receiving at least one dose of an HPV vaccine than in those who said they were not vaccinated.

About 70% of oropharyngeal cancers are caused by high-risk HPV infection, and the incidence of HPV-positive oropharyngeal cancer has been increasing in the United States in recent decades. In the United States, more than half of oropharyngeal cancers are linked to a single high-risk HPV type, HPV 16, which is one of the types covered by Food and Drug Administration (FDA)-approved HPV vaccines.

“In an unvaccinated population, we would estimate that about a million young adults would have an oral HPV infection by one of these vaccine HPV types. If they had all been vaccinated, we could have prevented almost 900,000 of those infections,” said senior study author Maura Gillison, M.D., Ph.D., of the University of Texas MD Anderson Cancer Center.

Dr. Gillison presented the new findings at a May 17 press briefing ahead of the 2017 annual American Society of Clinical Oncology (ASCO) meeting, held June 2–6 in Chicago.

A Rapidly Rising Cancer

Oropharyngeal cancer “is the fastest-rising cancer among young white men in the United States,” said Dr. Gillison, who was at Ohio State University when she conducted the study.

“The HPV types that cause oropharyngeal cancers are primarily transmitted through sexual contact,” explained lead study author Anil Chaturvedi, Ph.D., of NCI’s Division of Cancer Epidemiology and Genetics. The increased incidence of oropharyngeal cancers in white men has been linked to changes in sexual behaviors from the 1950s through the 1970s, he said. The exact reasons for the greater increase in oropharynx cancer incidence in men versus women are still unclear, Dr. Chaturvedi added.

Clinical trials have shown that FDA-approved HPV vaccines can prevent anogenital HPV infections and precancerous lesions that lead to HPV-associated cancers, including cervical and anal cancer. However, Dr. Gillison said, the potential impact of current HPV vaccines on oral HPV infections that lead to cancer has not yet been rigorously tested in clinical trials, and thus the vaccines are not specifically approved for preventing cancers of the oropharynx.

From 2006 through 2014, most HPV-vaccinated individuals in the United States received Gardasil®, an HPV vaccine that protects against infection with HPV types 6, 11, 16, and 18. In January 2015, FDA approved an updated HPV vaccine, Gardasil 9®, that protects against five additional HPV types.

Looking for a Link

To investigate the relationship between HPV vaccination and oral HPV infection, the researchers analyzed data for 2,627 young adults who participated in NHANES, a national survey that assesses the health of a representative slice of the US population.

Drs. Gillison, Chaturvedi, and their colleagues restricted their analysis to NHANES data from 2011 to 2014, focusing on 18- to 33-year-old men and women “because they were the first group [in the United States] to receive the vaccine,” Dr. Gillison said.

In the United States, routine vaccination against HPV, which causes nearly all cervical cancers, has been recommended since mid-2006 for 11- to 12-year-old girls and for females up to age 26 who have not previously been vaccinated. HPV vaccination has been recommended for males ages 9–26 since 2009.

The researchers analyzed mouth rinse samples (containing oral cells) from all study participants for the presence of 37 HPV types, including types 6, 11, 16, and 18, which are covered by Gardasil, Dr. Gillison said.

The prevalence of oral infections with these four HPV types was 1.61% in unvaccinated young adults versus 0.11% in vaccinated young adults—an 88% reduction in HPV prevalence with vaccination. Among men, the prevalence of oral infection with the four HPV types was 2.1% in unvaccinated individuals and 0.0% in vaccinated individuals.

By contrast, the prevalence of oral infection with 33 HPV types not covered by the vaccine was 4.0% in vaccinated groups and 4.7% in non-vaccinated groups, the researchers found, a difference that was not considered to be statistically meaningful.

Vaccination rates were low overall, with only 29.2% of women and 6.9% of men in the study population reporting having received at least one dose of an HPV vaccine before age 26.

Prevention Potential

Although the self-reported vaccination rates in this study were low, Dr. Gillison said, “there is considerable optimism because more recent data indicate that [roughly] 60% of girls and 50% of boys under age 18 have received more than one HPV vaccine dose.”

“HPV vaccines are already strongly recommended for cancer prevention,” Dr. Gillison continued. “Parents who choose to have their children vaccinated against HPV should realize that the vaccine may provide additional benefits, such as preventing oral HPV infections linked to oral cancers.”

However, she and Dr. Chaturvedi noted, only a randomized clinical trial that follows people over time could definitively show a cause and effect relationship between HPV vaccination and a lasting reduction of high-risk oral HPV infections, which experts agree is a more meaningful indicator of vaccine effectiveness.

In July 2013, NCI researchers and their collaborators reported findings from the NCI-sponsored HPV Vaccine Trial in Costa Rica that suggested that HPV vaccination can reduce oral HPV infections in women.

“Our study builds on those results by showing a reduction in oral HPV prevalence in vaccinated men, the group that bears the greatest burden of HPV-associated oropharynx cancers,” Dr. Chaturvedi said.

Print Friendly
June, 2017|Oral Cancer News|

Novel vaccine therapy can generate immune responses in patients with HPV-related head and neck cancer

Source: www.news-medical.net
Author: staff

A novel vaccine therapy can generate immune responses in patients with head and neck squamous cell carcinoma (HNSCCa), according to researchers at the Abramson Cancer Center of the University of Pennsylvania. The treatment specifically targets human papillomavirus (HPV), which is frequently associated with HNSCCa, to trigger the immune response. Researchers will present the results of their pilot study during the 2017 American Society of Clinical Oncology Annual Meeting in Chicago (Abstract #6073).

HNSCCa is a cancer that develops in the mucous membranes of the mouth, and throat. While smoking and tobacco use are known causes, the number of cases related to HPV infection – a sexually transmitted infection that is so common, the Centers for Disease Control says almost all sexually active adults will contract it at some point in their lifetimes – is on the rise. The CDC now estimates 70 percent of all throat cancers in the United States are HPV-related. Sixty percent are caused by the subtype known as HPV 16/18.

“This is the subtype we target with this new therapy, and we’re the only site in the country to demonstrate immune activation with this DNA based immunotherapeutic vaccine for HPV 16/18 associated head and neck cancer,” said the study’s lead author Charu Aggarwal, MD, MPH, an assistant professor of Hematology Oncology in the Perelman School of Medicine at the University of Pennsylvania.

The vaccine is delivered as an injection of antigens – which leads the immune system to start producing antibodies and activate immune cells. At the time of injection, physicians use a special device to deliver a pulse of electricity to the area, which stimulates the muscles and speeds the intake of the antigens. Aggarwal noted that this study represents a multidisciplinary approach involving the lab and the clinic.

“This is truly bench-to-bedside and shows the value of translational medicine within an academic medical center,” Aggarwal said.

Penn researchers treated 22 patients with the vaccine. All of the patients had already received therapy that was intended to be curative – either surgery or chemotherapy and radiation. When doctors followed up an average of 16 months later, 18 of those patients showed elevated T cell activity that was specific to HPV 16/18. All of the patients in the study are still alive, and none reported any serious side effects.

“The data show the therapy is targeted and specific, but also safe and well-tolerated,” Aggarwal said.

Because of the positive activity, Aggarwal says the next step is to try this therapy in patients with metastatic disease. A multi-site trial will open soon that combines the vaccine with PD-L1 inhibitors, which target a protein that weakens the body’s immune response by suppressing T-cell production.

Print Friendly

Study reveals high environmental cost of tobacco

Source: www.cnn.com
Date: May 31st, 2017
Author: Jacopo Prisco

Details of the environmental cost of tobacco are revealed in a study released Wednesday by the World Health Organization, adding to the well-known costs to global health, which translate to a yearly loss of $1.4 trillion in health-care expenses and lost productivity.

From crop to pack, tobacco commands an intensive use of resources and forces the release of harmful chemicals in the soil and waterways, as well as significant amounts of greenhouse gases. Its leftovers linger, as tobacco litter is the biggest component of litter worldwide.

“Tobacco not only produces lung cancer in people, but it is a cancer to the lungs of the Earth,” said Dr. Armando Peruga, who previously coordinated the WHO Tobacco Free Initiative and now works as a consultant. He reviewed the new report for the WHO.

Commercial tobacco farming is a worldwide industry that involves 124 countries and occupies 4.3 million hectares of agricultural land. About 90% of it takes place in low-income countries, with China, Brazil and India as the largest producers.

Because tobacco is often a monocrop — grown without being rotated with other crops — the plants and the soil are weak in natural defenses and require larger amounts of chemicals for growth and protection from pests.

“Tobacco also takes away a lot of nutrients from the soil and requires massive amounts of fertilizer, a process that leads to degradation of the land and desertification, with negative consequences for biodiversity and wildlife,” Peruga said.

The use of chemicals directly impacts the health of farmers, 60% to 70% of whom are women. This is especially prominent in low- and middle-income countries, where some compounds that are banned in high-income countries are still used.

300 cigarettes = one tree

Farming also uses a surprisingly large amount of wood, rendering tobacco a driver of deforestation, one of the leading causes of climate change.

About 11.4 million metric tonnes of wood are utilized annually for curing: the drying of the tobacco leaf, which is achieved through various methods, including wood fires. That’s the equivalent of one tree for every 300 cigarettes, or 1.5 cartons.

This adds to the impact of plantations on forest land, which the study describes as a significant cause for concern, citing “evidence of substantial, and largely irreversible, losses of trees and other plant species cause by tobacco farming.”

Deadly gases

In 2012, 967 million daily smokers consumed approximately 6.25 trillion cigarettes worldwide, the WHO estimates.”That means about 6,000 metric tones of formaldehyde and 47,000 metric tonnes of nicotine are released into the environment,” Peruga said.

Tobacco smoke contains about 4,000 chemicals, at least 250 of which are known to be harmful. It also contains climate-warming carbon dioxide, methane and nitrous oxides. “The combination of greenhouse gases from combustion is equivalent to about 1.5 million vehicles driven annually,” Peruga said.

Secondhand smoke is particularly deadly: It contains twice as much nicotine and 147 times more ammonia than so-called mainstream smoke, leading to close to 1 million deaths annually, 28% of them children.

Some of these pollutants remain in the environment (and our homes) as “third-hand smoke,” accumulating in dust and surfaces indoors, and in landfills. Some, like nicotine, even resist treatment, polluting waterways and potentially contaminating water used for consumption, the study notes.

Non-biodegradable litter

Tobacco litter is the most common type of litter by count worldwide.

“We calculate that two-thirds of every cigarette ends up as litter,” Peruga said.

The litter is laced with chemicals including arsenic and heavy metals, which can end up in the water supply. Cigarette butts are not biodegradable, and tossing one on the ground is still considered a socially acceptable form of littering in many countries.

The WHO estimates that between 340 million and 680 million kilograms of tobacco waste are thrown away every year, and cigarette butts account for 30% to 40% of all items collected in coastal and urban clean-ups.

“In addition to that, there are 2 million tons of paper, foil, ink and glue used for the packaging,” Peruga said.

A way forward?

Even though smoking is declining globally, it is increasing in some regions, such as the eastern Mediterranean and Africa. China is a world leader both in production (44%) and consumption, with 10 times more cigarettes smoked than in any other nation.

Every stage of the production of a cigarette has negative effects on the environment and the people who are involved in manufacturing tobacco products, even before the health of smokers and non-smokers is affected.

Although governments worldwide already collect $270 billion in tobacco taxes a year, the WHO suggests that increasing tax and prices is an effective way of reducing consumption and help development priorities in each country, adding that by collecting 80 cents more per pack, the global tax revenue could be doubled.

“Tobacco threatens us all,” WHO Director-General Margaret Chan said in a note. “It exacerbates poverty, reduces economic productivity, contributes to poor household food choices, and pollutes indoor air.”

Print Friendly
May, 2017|Oral Cancer News|

More patients presenting with HPV-associated oral cancers in Lubbock, TX

Source: lubbockonline.com
Author: Ellysa Harris

Detecting oral cancers in patients in their 50s and 60s has never been uncommon. But local dentists and doctors say finding it in younger patient populations has become a new norm.

Oral cancers driven by Human Papillomavirus are now the fastest growing oral and oropharyngeal cancers, according to the Oral Cancer Foundation website. And local health officials say they’ve seen a few more cases than usual.

Dr. Joehassin Cordero, FACS, professor, chairman and program director ofTexas Tech’s Health Sciences Center Department of Otolaryngology-Head & Neck Surgery, said less people are smoking and that has contributed to the decrease in the number of cases of oral cancers in the past two decades.

“In that same period, we have seen an increase in the HPV oropharyngeal cancer,” he said. “And oropharyngeal cancer — what it means it’s affecting the base of your tongue and tonsils.”

Dr. Brian Herring, a Lubbock dentist, chalks the increase up to increased awareness.

“I’m assuming probably for years and years and years it has affected the mouth but we didn’t know that,” he said. “As we get better at cellular diagnostics and molecular diagnostics, things like that, we’re finding that there is a large portion of cancers that do have an HPV component.”

What’s more alarming, said Dr. Ryan Higley, oral surgeon with West Texas Oral Facial Surgery, is it’s being diagnosed in younger people.

Higley said oral cancers are generally diagnosed between the ages of 55 and 65, mostly in women.

“With HPV-associated cancers, we see those four to 10 years before that,” he said. “It’s a younger patient population.”

Cordero said the oral cancers are often caused by exposure to HPV from years before.It starts with exposure to the HPV infection. One in four people in the United States are currently infected, according to the Centers for Disease Control and Prevention website.

“It’s truly considered a sexually transmitted disease,” Cordero said. “It has to do with not so much kissing, but oral sex.”

It’s passed on when somebody with an active lesion engages in sexual activities with another person, he said.

Nine out of 10 infections will disappear on their own, according to the CDC, but infections that linger for longer than about two years can lead to cancer.

“That doesn’t mean they’ll have cancer next week,” Cordero said.

Researchers are still trying to figure out why and how long after HPV exposure it takes for cancer to develop, he said.

“We don’t know the true mechanism because most of these people were not exposed a year ago,” he said. “They were not exposed six months ago. They were exposed a long time before that.”

When it does present, he said, there generally aren’t any noticeable symptoms.Because of that, it’s often diagnosed in later stages, Herring said.

“What we’re finding is because the demographic is changing, they’re not getting diagnosed as early because they’re not expecting to have this problem,” he said.

Screenings for oral HPV exist.

“The gold standard examination is your typical dental exam,” Herring said. If your dentist detects something unusual that might need further examination, he or she will make a referral to an oral surgeon.

Higley said oral HPV cancer presents as a lesion that looks like a kanker that won’t heal.

“However, cancerous lesions can have multiple presentations so that’s not exclusive,” he said. “So oftentimes, we’ll have a patient present with a hard nodule underneath their jaw line or in their neck. Sometimes they’ll just have red or white lesions within the mouth, hoarseness in their voice or difficulty swallowing. All those are things that need to be checked.”

The cancer seems to be more treatable, he said, but it’s hard to pinpoint why.

“We really don’t know if they’re more responsive to treatment because we’re treating a little bit younger patient population who is overall more healthy or if it’s inherant in the tumor itself,” Higley said.

Cordero said he hopes the HPV vaccine, which is recommended for both girls and boys 11 or 12 years old and people up to 26 years old, provides a measure of protection against the infection.

“We’re hoping in the next 10 to 20 years that head and neck cancer caused by HPV will be completely gone,” he said.

Print Friendly

Symptoms of throat cancer depend on which throat structures are affected

Source: tribunecontentagency.com
Author: Eric Moore, M.D.

Dear Mayo Clinic: Are there early signs of throat cancer, or is it typically not found until its late stages? How is it treated?

Answer: The throat includes several important structures that are relied on every minute of the day and night to breathe, swallow and speak. Unfortunately, cancer can involve any, and sometimes all, of these structures. The symptoms of cancer, how early these symptoms are recognized and how the cancer is treated depend on which structures are involved.

All of the passageway between your tongue and your esophagus can be considered the throat. It includes three main areas. The first is the base of your tongue and tonsils. These, along with the soft palate and upper side walls of the pharynx, are called the oropharynx. Second is the voice box, or larynx. It consists of the epiglottis — a cartilage flap that helps to close your windpipe, or trachea, when you swallow — and the vocal cords. Third is the hypopharynx. That includes the bottom sidewalls and the back of the throat before the opening of the esophagus.

Tumors that occur in these three areas have different symptoms, behave differently and often are treated differently. That’s why the areas of the throat are subdivided into separate sections by the head and neck surgeons who diagnose and treat them.

For example, in the oropharynx, most tumors are squamous cell carcinoma. Most are caused by HPV, although smoking and alcohol can play a role in causing some of these tumors. Cancer that occurs in this area, particularly when caused by HPV, grows slowly usually over a number of months. It often does not cause pain, interfere with swallowing or speaking, or have many other symptoms.

Most people discover cancer in the oropharynx when they notice a mass in their neck that’s a result of the cancer spreading to a lymph node. Eighty percent of people with cancer that affects the tonsils and base of tongue are not diagnosed until the cancer moves into the lymph nodes.

This type of cancer responds well to therapy, however, and is highly treatable even in an advanced stage. At Mayo Clinic, most tonsil and base of tongue cancers are treated by removing the cancer and affected lymph nodes with robotic surgery, followed by radiation therapy. This treatment attains excellent outcomes without sacrificing a person’s ability to swallow.

When cancer affects the voice box, it often affects speech. People usually notice hoarseness in their voice soon after the cancer starts. Because of that, many cases of this cancer are detected at an early stage. People with hoarseness that lasts for six weeks should get an exam by an otolaryngologist who specializes in head and neck cancer treatment, as early treatment of voice box cancer is much more effective than treatment in the later stages.

Early voice box cancer is treated with surgery — often laser surgery — or radiation therapy. Both are highly effective. If left untreated, voice box cancer can grow and destroy more of the larynx. At that point, treatment usually includes major surgery, along with radiation and chemotherapy — often at great cost to speech and swallowing function.

Finally, cancer of the hypopharynx usually involves symptoms such as pain when swallowing and difficulty swallowing solid food. It is most common in people with a long history of tobacco smoking and daily alcohol consumption. This cancer almost always presents in an advanced stage. Treatment is usually a combination of surgery, chemotherapy and radiation therapy.

If you are concerned about the possibility of any of these cancers, or if you notice symptoms that affect your speech or swallowing, make an appointment for an evaluation. The earlier cancer is diagnosed, the better the chances for successful treatment. — Eric Moore, M.D., Otorhinolaryngology, Mayo Clinic, Rochester, Minn.

Note: For information, visit www.mayoclinic.org

Print Friendly

Jay Fund will forever remain dear to heart of ESPN’s Mortensen

Source: staugustine.com
Author: Gene Frenette

Chris Mortensen remembers the moment last May when his own cancer journey reminded him why he had been coming to Tom Coughlin’s Jay Fund benefit dinner/golf tournament for the previous 15 years.

As Mortensen waited in line to receive his proton radiation treatment at the MD Anderson Cancer Center in Houston, the NFL information insider for ESPN saw a man ahead of him dressed in jeans and work boots strapped to a gurney, holding his 3-year-old son.

“He’s going into the very scary radiation proton room,” said Mortensen. “You have to be in there to understand how intimidating a place it can be, even more so for a child. That’s when I thought of the Jay Fund.

“There’s a dad, who clearly took off from work, with his son who looks sick and scared. It made me think, ‘That’s what the Jay Fund is about, helping families tend to the needs of their children who are suffering from this.’ That was the moment it connected with me.”

Mortensen, diagnosed 17 months ago with Stage IV throat cancer, is now himself an indirect beneficiary of what the Jay Fund does to provide financial/emotional support to pediatric cancer victims and their families. As the man known as Mort learned in his own battle, which metastasized into his lungs in November, he draws inspiration from watching kids fight this terrible disease with an upbeat attitude.

“What I saw at MD Anderson was great humanity, the promise of young people of all nationalities,” said Mortensen. “Not just the patients, but the support of their caregivers. You’re seeing all kinds of pediatric patients and families fight this battle. Now I have a clear image and picture of what they’re feeling.”

Mortensen, 65, remains in the fight of his life to return to the ESPN airwaves for the start of the 2017 football season. He’s been through chemotherapy and the standard 35 radiation treatments. Mortensen thought he was on the cusp of remission last August, until a biopsy in November revealed the cancer had spread into his lungs.

NFL referee Tony Corrente, a throat cancer survivor who had the same oncologist as Mortensen , had forewarned him early on about the challenges he’d be facing.

“[Corrente] said you’re going to go through a period in radiation where you’re going to feel you had the worst strep throat ever in you life times 100,” said Moretensen, whose weight plummeted down to a low of 142 pounds, which he has mostly regained. “And when you’re done with radiation, it’s going to get worse for the next three or four months, which it did.”

Though he can’t play golf due to impending hernia surgery, Mortensen was determined not to miss the Jay Fund event this year. It motivates him to be around people dedicated to a cause, now closer to his heart than he could have imagined a short time ago.

Sunday night at the Jay Fund dinner, Mortensen was touched when he saw 22-year-old cancer survivor Marissa Ierna speak about her battle with rhabdomyosarcoma, which inflicted the lower calf muscles of her legs.

Mortensen, who met Ierna briefly two years ago when they sat at the same table as she received a Jay Fund scholarship, received an email from her right after his cancer diagnosis. Among the hundreds of correspondences of encouragement sent to Mortensen during his battle, it was the words from Ierna on January 19, 2016 that stuck with him the most.

Here is a partial transcript of Ierna’s email to Mortensen: “I want to first say how sorry I am to hear about your recent diagnosis. It took me a while to learn that in order to get through the chemo and all the hard days, I had to keep a smile on my face and always have a positive attitude. I wish I would have known that earlier in treatment, it would have made the first few months a lot easier. As you start treatment, just remember to keep a positive attitude and always stay strong.

“I am very thankful to cancer for all it has provided me. I know this sounds crazy, but it has changed my life for the better. I encourage you to take this terrible disease and turn it into something amazing! The toughest battles are given to the strongest warriors, which means you can do this!”

Now imagine a man in his mid-60s, fresh off a cancer diagnosis, reading that from a young woman he met only briefly at a Jay Fund dinner. It uplifted Mortensen beyond measure, especially when cancer was beating him down.

So when Mortensen heard Ierna’s message to the Jay Fund audience on Sunday, the memory of that email moved him to tears all over again.

“Kids in a cancer unit are just so dang resilient, they actually inspire you,” Mortensen said. “Everybody goes through the fear of cancer on some level, and Marissa’s note was one of the most memorable.

“I read it once or twice all over again when I was in the dark shadows of my cancer journey. I was more emotional listening to her [at the Jay Fund dinner] because it hit me deeper. You couldn’t meet Marissa with that unforgettable smile, hear her story, and ever forget her.”

Ierna recently graduated from Florida State with a marketing degree and just took a job working with the Jay Fund. An avid runner, she’s approaching four years in remission and just ran the Boston Marathon in 3:28.31.

“My oncologist told me I’d never be able to run again any more than five miles because of the radiation in my leg, making me prone to stress fractures,” Ierna said.

A hard tumor was wrapped around her leg muscles, and the cancer in her bone marrow showed it advanced to Stage IV, just like Mortensen.

Ierna, an Atlantic Coast High graduate, credits the Jay Fund for providing her parents and younger brother with the emotional support they needed to cope through her illness. She’s been paying it forward ever since, making it her personal mission to help others like Mortensen in the same predicament.

It’s still unclear what the outcome will be for Mortensen. Acting on a tip from Coughlin, he’s battling the cancer in his lungs with immunotherapy, a treatment option with less intense side effects than chemo or radiation.

The 26-year ESPN employee has most of his voice and hair back, but his saliva glands aren’t yet fully restored to easily get him through 30-second sound bites. He’s hopeful another three months of down time before the season starts will advance the healing process, allowing him to return to full-time duty for Sunday Night and Monday Night Countdown shows.

Mortensen has seen the ravages of cancer up close, how it initially “crushed” his wife Micki and struck fear in so many kids during cancer treatment visits. He has gained an even greater appreciation for Coughlin’s charity, which has delivered over $8 million in grants during its 22-year existence.

But the Jay Fund is about more than just providing families financial assistance. It’s also about cancer survivors emotionally lifting up the next patient.

As Chris Mortensen discovered on his cancer journey, you can never be too old to be inspired by the young.

Print Friendly

Recommendation Against Routine Thyroid Cancer Screening Retained

Author: Shreeya Nanda
Date: 05/23/2017
Source: https://www.medwirenews.com

The decision is based on a systematic review of 67 studies, also reported in JAMA, evaluating various aspects of screening, such as the benefits and harms of screening asymptomatic individuals and of treating screen-detected cancers, as well as the diagnostic accuracy of screening modalities.

Although there were no trials directly comparing the benefits of early versus late or delayed treatment, two separate observational studies compared the outcome of treatment versus no surgery or surveillance. However, as neither study accounted for confounding variables, robust conclusions could not be drawn, say Jennifer Lin, from Kaiser Permanente Center for Health Research in Portland, Oregon, USA, and colleagues.

By contrast, they identified 52 studies, including 335,091 patients, that provided information on the harms of treating screen-detected thyroid cancers. A meta-analysis of the data showed that the incidence of permanent hypoparathyroidism varied between 2% and 6%, while the rate of permanent vocal cord paralysis ranged from around 1% to 2%.

Among patients who received radioactive iodine therapy, the excess absolute risk for secondary cancers ranged from 11.9 to 13.3 per 10,000 person–years. And the incidence of dry mouth ranged widely, from approximately 2% to 35%.

The USPSTF commissioned the systematic review due to the rising incidence of thyroid cancers against a background of stable mortality, which is suggestive of overdiagnosis. And in view of the results, the task force concluded with “moderate certainty” that the harms outweigh the benefits of screening, upholding the “D” recommendation.

The USPSTF emphasizes, however, that this recommendation pertains only to the general asymptomatic adult population, and not to individuals who present with throat symptoms, lumps or swelling, or those at high risk for thyroid cancer.

Editorialists Louise Davies (Department of Veterans Affairs Medical Center, White River Junction, Vermont, USA) and Luc Morris (Memorial Sloan Kettering Cancer Center, New York, USA) welcome the decision, noting that “[e]pidemiologic data from around the world demonstrate that finding more cases of cancer, as has occurred over the past approximately 15 years, has not made death from the disease less likely.”

They write in JAMA Otolaryngology–Head & Neck Surgery: “While suggestions to ‘check your neck’ are well intentioned, the USPSTF recommendation indicates that these practices should not be encouraged or endorsed.”

Other commentators are more circumspect. Julie Ann Sosa (Duke University Medical Center, Durham, North Carolina, USA) and co-authors point out in JAMA Surgery that both the incidence and mortality rates of advanced-stage papillary thyroid cancer have risen over the years, as has the overall thyroid cancer incidence-based mortality.

These findings “[challenge] the prevailing hypothesis that overdiagnosis is the sole culprit for the changing epidemiology,” they write.

Sosa and colleagues continue: “If the explanation for the rise in thyroid cancer is, indeed, not just overdiagnosis, and if mortality from thyroid cancer is also increasing, then enthusiasm for this (non)screening recommendation should be more muted.”

Writing in an accompanying piece in JAMA, Anne Cappola (University of Pennsylvania, Philadelphia, USA) notes that “[t]he rationale for the recommendation against screening is compelling,” but she does not want the conversation about screening to stop.

Like Sosa et al, Cappola does not think that over diagnosis explains all and she believes that “additional research into possible environmental etiologies is needed, particularly to inform prevention efforts.”

Print Friendly
May, 2017|Oral Cancer News|