Oral Cancer News

Teens drink less if they know alcohol causes cancer — but most don’t — study finds

Source: http://www.adelaidenow.com.au/
Author: Tim Williams, Education Reporter

Teens are less likely to drink if they know that alcohol is a major cause of cancer, but most are unaware of the link, a South Australian study has found. More than 2800 school students aged 12-17 were surveyed about their drinking behaviour by Adelaide University and South Australian Health and Medical Research Institute (SAHMRI) researchers.

Those aged 14-17 were deterred from drinking if they knew about the link between alcohol and cancer, but only 28 per cent of students were aware of the connection. Parental disapproval was another deterrent, while smoking and approval from friends resulted in higher rates of drinking. Most students had tried alcohol by age 16 and a third drank at least occasionally. Wealthy students were more likely to drink.

Cancer Council SA chief executive Lincoln Size said there was clear evidence drinking caused cancers of the mouth, pharynx, larynx and oesophagus, as well as bowel cancer in men and breast cancer in women. It likely raised the risk of liver cancer and bowel cancer in women too.

“Any level of alcohol consumption increases the risk of developing an alcohol-related cancer; the level of risk increases in line with the level of consumption,” he said.

“This latest evidence highlights the need to educate young people about the consequences of alcohol consumption and for parents to demonstrate responsible drinking behaviour.

“We need to get the message through that what may be considered harmless fun actually has lifelong consequences.”

Lead author Jacqueline Bowden, a behavioural scientist with both the uni and SAHMRI, said drinking patterns were often set in adolescence.

“With alcohol contributing to four of the top five causes of death in young people, and a leading cause of cancer in our community, it’s important for us to better understand drinking behaviour among young people so we can help to prevent or delay it,” Ms Bowden said.

“One of the major messages from our study is that parents have more influence on their teenagers’ decisions regarding alcohol than they probably realise.

“Parental behaviour and attitudes towards alcohol really do make a difference, and can help prevent children from drinking at an early age.

“Many parents believe providing their children with alcohol in the safe environment of their home teaches them to drink responsibly.

“However, the weight of evidence suggests that this increases consumption, and is not recommended.

“Our results also found that those adolescents who thought they could buy alcohol easily were more likely to drink regularly. The issue of availability — including price — and marketing of alcohol in the community is a major hurdle to be overcome.”

The findings of the study, which was supported by Cancer Council SA and the State Government, have been published in the journal BMC Public Health.

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Plan not to give HPV vaccine to boys causes concern

Source: http://www.bbc.com/news/health-40658791
Date: July 19th, 2017

A decision not to vaccinate boys against a cancer-causing sexually transmitted infection has attracted fierce criticism.

Reported cases of human papilloma virus (HPV) – thought to cause about 80% of cervical cancers – have fallen sharply since girls were given the vaccine.

But the Joint Committee on Vaccination and Immunisation (JCVI) found little evidence to justify treating boys too.

Critics said vaccinating boys could help reduce the risk still further.

Across the UK, all girls aged 12-13 are offered HPV vaccination as part of the NHS childhood vaccination programme.

Mary Ramsay, head of immunisation at Public Health England, said: “Evidence from around the world suggests that the risk of HPV infection in males is dramatically reduced by achieving high uptake of the HPV vaccine among girls.

“While there are some additional benefits to vaccinating both males and females, the current models indicate that extending the programme to boys in the UK, where the uptake in adolescent girls is consistently high (over 85%), would not represent a good use of NHS resources.”

This initial recommendation by JCVI will now be subject to a public consultation and a final decision will be made in October.

The British Dental Association said it would urge the committee to reconsider the evidence.

The chair of the BDA, Mick Armstrong, said: “HPV has emerged as the leading cause of oropharyngeal cancers, so JCVI’s unwillingness to expand the vaccination programme to boys is frankly indefensible.”

Shirley Cramer of the Royal Society for Public Health said: “We are deeply disappointed by the JCVI’s decision today, which suggests that fundamental priorities are focused more on saving money than on saving lives.

“Such a simple vaccination programme has the potential to make such a big impact on the public’s health on a national scale.

“We hope that the government’s advisory committee reconsider this decision as soon as possible and put the public’s health and wellbeing before cost-saving.”

The argument for vaccinating boys HPV

  • About 15% of UK girls eligible for vaccination are currently not receiving both doses, a figure which is much higher in some areas
  • Men may have sex with women too old to have had the HPV vaccination
  • Men may have sex with women from other countries with no vaccination programme
  • Men who have sex with men are not protected by the girls’ programme
  • The cost of treating HPV-related diseases is high – treating anogenital warts alone in the UK is estimated to cost £58m a year, while the additional cost of vaccinating boys has been estimated at about £20m a year

Source: HPV Action

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July, 2017|Oral Cancer News|

Richard Holbrook’s Benefit Concert To Give All Proceeds to The Bruce Paltrow Oral Cancer Fund

NEWPORT BEACH, Calif., July 13, 2017 /PRNewswire-USNewswire/ — Acclaimed cabaret singer Richard Holbrook will be performing two benefit concerts at the Metropolitan Room in New York City on Friday, September 8, 2017 at 7:00pm and Saturday, September 9, 2017 at 4:00pm as a benefit for The Bruce Paltrow Oral Cancer Fund which is connected with The Oral Cancer Foundation.

Holbrook will be singing Richard Rodgers songs from classic Broadway shows and memorable Hollywood film musicals. “I’m so thrilled and excited to be performing my show as a benefit for the Bruce Paltrow Oral Cancer Fund,” he states. Holbrook will be accompanied by the fabulous Tom Nelson Trio.

The stage 4 oral cancer survivor found a canker sore which led to a cancer diagnosis, spreading from gum to jaw. In September 2013 Holbrook stated, “After the surgery, I couldn’t utter a sound. I wrote notes to my family, but they were illegible. I got so frustrated! I now have such empathy for people with conditions that keep them from being able to communicate with the world. One of the most enlightening lessons I learned is how important communication is. As singers, it is all about HOW we communicate through words, sound and storytelling.”

About Richard Holbrook

Born in New York City, Richard taught himself how to sing by listening to the recordings of Fred Astaire, Judy Garland, and Bing Crosby and by watching their films. He found success as an actor on such hit television series as The Sopranos and Spin City, and a passion for performing cabaret which led to his first CD entitled Richard Holbrook Steps Out in 2004. Over the past several years, Richard, a three-time MAC Award nominee for best male vocalist, has appeared at popular Manhattan night spots such as Danny’s Skylight Room, Don’t Tell Mama and of course the Metropolitan Room.

About the Metropolitan Room

This Flatiron “class act” aims to revive the “golden age of cabaret” as “up-and-coming stars” and “renowned performers” alike take the stage in an “intimate” room with “great acoustics”; run with “professionalism” by a “gracious staff”, it’s “worth every penny” for a “sophisticated” night out. – ZAGAT 2014

The Metropolitan Room, 34 West 22nd St.  (Bet. 5th & 6th Aves) New York, NY 10010

For Tickets: Use this website,  www.MetropolitanRoom.com

For Reservations: 212.206.0440

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 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 each 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.

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July, 2017|Oral Cancer News|

Trans oral robotic surgery saves public Australian hospital patients from disfiguring procedure

Source: www.smh.com.au
Author: Kate Aubusson

The cancerous tumour growing at the back of Brian Hodge’s tongue was about as hard-to-reach as cancers get. The 73-year-old was told he’d need radical, invasive surgery to remove the 50¢-sized tumour. His surgeon would make an incision almost from ear-to-ear and split his jaw in two for the 10-12 hour surgery.

After five days in intensive care, another three weeks in hospital and four to six months recovery, re-learning how to eat and talk Mr Hodge would have been left with disfiguring scars, and a voice that he may not recognise as his own.

“My kids didn’t want me to have it,” Mr Hodge said. “But I’m not one to throw in the towel … Then the unbelievable happened,” he said.

Mr Hodge became one of the first public patients to undergo robotic surgery for head, neck and throat cancer at Nepean Hospital, the state’s only hospital offering the service to patients who can’t afford private healthcare.

Mr Hodge’s surgeon, Associate Professor Ronald Chin, performed the trans oral robotic surgery (TORS) by guiding the robot’s arm into his patient’s open mouth to remove the cancerous tumour.

“I went in on Monday morning for the surgery and I was discharged Tuesday night,” Mr Hodge said of his surgery performed on June 19.

“It’s just amazing. Two days compared to six months recovering.

“What’s got me is that before it was only available to people who could pay the big money. I’ve worked all my life, I’ve paid tax and I think, why can’t we people get this surgery as well,” he said.

TORS is available for private health patients in other NSW hospitals, but its use at a major tertiary hospital in Sydney’s west – surrounded by suburbs with some of the highest smoking rates and lowest private health insurance rates in Sydney – was significant.

“It’s an enormous step forward to be able to offer this state-of-the-art treatment with such obvious benefits both cost-wise and [avoiding] disfigurement-wise … to patients who may not have previously had the resources to access it,” Dr Chin said.

The da Vinci robot Dr Chin used was the same one Nepean Hospital’s urological surgeons use to perform prostatectomies on prostate cancers. The TORS procedure takes about 45 minutes.

“Traditionally surgery is incredibly invasive. We had to make very large incisions across the neck, then lift the skin well above the lower lip and cut the jaw open,” said the otolaryngology, head and neck surgeon.

“We’re talking about a massive operation. Then reconstruction is very difficult.

“Not only did people face a horrendously long operation, they had to deal with long post-operative recovery and rehabilitation to regain speech, language, voice and the ability to eat and drink.

“With TORS, patients can go home the next day [with minimal discomfort],” he said.

More than 400,000 cases of oropharyngeal squamous cell carcinomas are diagnosed each year worldwide. The five-year survival rate for head and neck cancer in Australia is 69 per cent, according to government estimates.

Nepean Hospital would see between 10 and 15 patients with head and neck cancers per year who would be suitable for TORS, Dr Chin said. The cancerous tumours, usually linked to smoking and excessive drinking as well as the human papilloma virus, were “extraordinarily difficult to access, almost impossible”, said Dr Chin.

Robotic surgery costs significantly more than traditional surgeries. But Dr Chin said TORS could save the public health system up to $100,000 per procedure, where patients no longer needed to spend days in ICU, costing more than $3000 per night, or weeks in hospital. The robotic surgery is primarily indicated for patients with oropharyngeal carcinomas of up to four centimetres in size. Roughly one-third of TORS patients will not need chemo and radiotherapy.

“The early evidence available on trans oral robotic surgery for oropharyngeal cancer is promising,” said Dr Tina Chen, medical and scientific adviser at the Cancer Institute NSW.

“However, higher-quality research is needed to definitively say whether it means better clinical outcomes for patients, compared to other treatments already available,” she said.

There was currently no high-quality evidence from randomised controlled trials comparing TORS to chemotherapy and radiotherapy for these types of cancers, a 2016 Cochrane review concluded. It noted “data are mounting”.

Mr Hodge will soon be able to swap the pureed food he has eaten since the day after his surgery for his favourite meal, barbecue chicken, and the avid karaoke singer is already planning his first post-surgery crooning set-list. First, Engelbert Humperdinck’s Please Release Me, and the song he has been singing to his wife for decades, Anne Murray’s Could I Have This Dance.

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Smoking Scenes in Movies Have Increased … Why?

Source: www.healthline.com
Author: Shawn Radcliffe

After several years of decline, tobacco use depicted in movies is on the rise again. Does it matter? Where there’s smoke, there’s … probably a PG-13 rated movie.

A new study shows that tobacco incidents depicted in top-grossing movies in the United States are once again on the rise, breaking an earlier decline. This is true despite public health efforts outside theaters to reduce smoking by children and teens.

“If the progress that we had seen between 2005 and 2010 had continued, all of the youth-rated films would have been smoke-free in 2015,” said study author Stanton Glantz, PhD, professor of medicine, and director of the University of California San Francisco (UCSF) Center for Tobacco Control Research and Education.

The July 7 study in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report (MMWR) found that the total number of tobacco incidents in top-grossing movies increased 72 percent between 2010 and 2016. It also increased 43 percent in PG-13 movies. Tobacco incidents are defined as use or implied use, by an actor, of cigarettes, cigars, pipes, hookah, smokeless tobacco products, or electronic cigarettes. This increase comes as the number of movies showing tobacco declined — meaning fewer movies account for a greater number of tobacco scenes.

In 2016, 41 percent of the top-grossing movies had tobacco incidents, down from 45 percent in 2010. In addition, 26 percent of youth-rated movies had tobacco incidents in 2016, a decline from 31 percent in 2010. Tobacco incidents in top-grossing movies peaked in 2005. The lowest number of tobacco incidents on record occurred in 1998. Tobacco depictions are now rare in PG and G movies — only four of these films in 2015 included tobacco use.

The study was a collaboration between UCSF, the Centers for Disease Control and Prevention (CDC), and Breathe California of Sacramento-Emigrant Trails, which provided the data.

The potential harm:
Like on-screen violence, tobacco depicted in youth-rated movies can have a profound effect on children and teens.

“It’s very concerning because five years ago in 2012 the surgeon general concluded that exposure to smoking on-screen in movies causes kids to start smoking,” Glantz told Healthline.

There’s also a dose-response — the more often kids see tobacco use depicted in movies, the more likely they are to pick up the habit. According a National Cancer Institute (NCI) report, youths who are heavily exposed to smoking depicted in movies are two to three times more likely to start, compared with kids who have little exposure.

“An increase in the amount of exposure means that more kids are going to be smoking and dying from tobacco-induced diseases,” said Glantz.

Tobacco use is linked to lung cancer, mouth cancer, emphysema, and other diseases. The NCI report also cited studies showing that cigarette smoking in movies can influence adults’ and teens’ beliefs about smoking. For example, when stars are shown smoking, or when the health consequences of tobacco don’t show up in the film, viewers may develop pro-smoking beliefs and intentions.

What’s causing the increase?
The increase in the number of on-screen tobacco incidents since 2010 runs counter to overall smoking trends in the United States. According to the CDC, overall smoking rates in adults have been falling for decades, and in high school students since the late 1990s. The researchers write that starting in 2001 public health officials became more concerned about tobacco use in movies. This might account for the decline of tobacco incidents in youth-rated movies between 2005 and 2010.

So what has shifted in recent years?
Some public health experts put the blame squarely on the motion picture companies that continue to produce youth movies depicting smoking.

“I think the [public health] messaging is fine,” said Glantz. “It’s been the recalcitrance on the part of the media companies to act responsibly and protect kids.”

The major studios have policies to help reduce the amount of smoking in movies that they release, but all of the polices have what Glantz calls “loopholes.” Paramount Pictures “discourages” depiction of tobacco use in youth-rated films, but also takes into account the “creative vision of the filmmakers.” Universal Pictures “presumes that no smoking incidents should appear” in youth-rated films, but leaves it as an option if there is a “substantial reason for doing so.”

Modernizing movie rating system:
Currently, the Motion Picture Association of America (MPAA), which rates movies in the United States, has a smoking “rating descriptor” that is supposed to alert viewers and parents to tobacco use in a film. However, this descriptor was missing from 89 percent of top-grossing, youth-rated movies that depicted tobacco use, according to a 2015 report by the UCSF Center for Tobacco Control Research and Education.

Public health experts are calling for a more consistent approach.

“The six studios that control the rating system through the MPAA need to modernize the rating system to reflect the science,” said Glantz, “and give an R-rating for smoking, which would get it out of all the youth-rated movies.”

A 2012 study in the journal Pediatrics estimated that this could reduce the number of teen smokers by 18 percent. A related CDC fact sheet estimated that this change would save the lives of a million youth. Advocacy group Smokefree Movies recently ran a two-page statement in The Hollywood Reporter and Variety demanding that MPAA update the rating system by June 1, 2018. The statement was signed by the American Academy of Pediatrics, the American Heart Association, and other health organizations.

So far, the major studios have been unwilling to update the rating system to take into account on-screen tobacco use. Some health experts have proposed running anti-smoking messages before movies to counteract the effect of on-screen tobacco use. These are somewhat effective but would require much more effort than reducing children’s on-screen tobacco exposure.

“It would cost nothing to [update the rating system],” said Glantz. “There’s no public health intervention that would be cheaper and have a bigger effect.”

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Improved quality of life for head and neck cancer patients with Nivolumab

Source: www.oncnursingnews.com
Author: Jason Harris

Patients with head and neck squamous cell carcinoma (HNSCC) saw improved or stable quality of life (QOL) scores following treatment with single-agent nivolumab (Opdivo), according to results published in Lancet Oncology.1

In contrast, patients assigned to investigator’s choice of treatment saw clinical meaningful declines, defined as a decrease in ≥10% from baseline, across 8 of 15 (53%) domains on the EORTC QLQ-C30 questionnaire.

“The results of CheckMate-141 suggest that nivolumab is the first PD-1 inhibitor, to our knowledge, to show a significant improvement in overall survival, with better tolerability and a quality-of-life benefit, compared with standard therapy for platinum-refractory recurrent or metastatic squamous cell carcinoma of the head and neck,” investigators wrote. “In view of the major unmet need in this population and the importance of maintaining or improving quality of life for patients with recurrent or metastatic squamous cell carcinoma of the head and neck, these data support nivolumab as a new standard of care option in this setting.”

Investigators evaluated statistical differences in patient-reported adjusted mean changes from baseline between treatment groups as assessed by the EORTC QLQ-C30, EORTC QLQ-H&N35, and EQ-5D-3L at each time point, and the time to clinically meaningful deterioration per each individual scale’s criteria.

Patient assessments were conducted before treatment initiation, at week 9, and then every 6 weeks during the treatment period using the EORTC QLQ-C30, EORTC QLQ-H&N35, and EQ-5D-3L questionnaires. Posttreatment assessments were made at follow-up visits 1 and 2 (35 days give or take 7 days after the last treatment dose, and 80 days give or take 7 days after follow-up visit 1). The EQ-5D-3L questionnaire was also administered at survival follow-up visits (every 3 months give or take 7 days after follow-up visit 2). Patients completed their assessments at each time point before physician contact, treatment dosing, or any procedures.

Thirty-six patients assigned to investigator’s choice of treatment with platinum-based chemotherapy and 93 patients assigned to nivolumab completed 15 weeks of QoL assessment.

Adjusted mean differences between the treatment groups were significant and clinically meaningful, defined as a difference of 10 points or greater, in favor of nivolumab for role functioning, social functioning, fatigue, dyspnea, and appetite loss at both weeks 9 and 15. Investigators also observed significant and clinically meaningful differences favoring nivolumab for diarrhea week 9, and at week 15 for physical functioning, cognitive functioning, and insomnia.

Nivolumab significantly delayed median time to deterioration compared with investigator’s choice for pain, sensory problems, social contact problems, and mouth opening problems on the EORTC QLQ-H&N35 questionnaire. Patients in the nivolumab group reached median time to clinically meaningful increase in weight, but not in the investigator’s choice group.

The EQ-5D VAS, a measure of the patient’s overall health status, was similar between groups at baseline for the analytical cohort (n = 124) and all-randomized population. However, patients in the nivolumab group had a clinically meaningful improvement, defined as a difference of ≥7 points, in adjusted mean change in VAS score from baseline to week 15 compared with clinically meaningful deterioration in the investigator’s choice group (7.3 vs -7.8). The difference between groups at week 15 favoring nivolumab was both significant and clinically meaningful. Median time to deterioration on the EQ-5D VAS was not significantly different between the treatment groups.

CheckMate-141 was an international, phase III, randomized, open-label study investigating comparing overall survival (OS) with nivolumab versus single-agent therapy of investigator’s choice in patients with platinum-refractory recurrent or metastatic HNSCC. Patients were treated at 66 sites in 15 countries in North America, Asia, Europe, and South America.

Patients with cancer of the oral cavity, pharynx, or larynx were randomly assigned to 3 mg/kg nivolumab every 2 weeks (n = 240) or investigator’s choice of cetuximab (12.4%), methotrexate (44.6%), or docetaxel (43%; N = 121). Cetuximab was administered at 400 mg/m2 for the first dose followed by 250 mg/m2 weekly. Methotrexate was administered at 40 mg/m2weekly. Docetaxel was administered at 30 mg/m2 weekly.

Median age was 60 years, and 31.3% were ≥65 years of age. Most patients were male (83%), Caucasian (83%), and had an ECOG PS of 1 (78.4%). Most patients received ≥2 prior systemic therapies (54.8%), and over 90% had received prior radiation therapy. HPV status was known for 49.3% of patients, using p16 status, and PD-L1 expression was available for 72% of enrolled patients.

In survival data first presented at the 2016 ASCO Annual Meeting, the median OS was 7.5 months with nivolumab compared with 5.1 months with investigator’s choice (HR, 0.70; 95% CI, 0.51-0.96; P = .0101). The objective response rate (ORR) was 13.3% with nivolumab and 5.8% for investigator’s choice.2

The 1-year OS rates were 36% with nivolumab (95% CI, 28.5-43.4) compared with 16.6% for investigator’s choice (95% CI, 8.6-26.8). Similar improvements in survival were seen across demographic subgroups. The median progression-free survival (PFS) was 2.0 months with nivolumab versus 2.3 months with investigator’s choice (HR, 0.89; 95% CI, 0.70-1.10; P = .3236). The 6-year PFS rates were 19.7% for nivolumab and 9.9% for investigator’s choice of therapy.

Writing in an accompanying editorial, Susanne Singer, PhD, chair of the division of Epidemiology and Health Services Research at the Institute of Medical Biostatistics, Epidemiology and Informatics of University Medical Centre of Johannes Gutenberg-University Mainz, listed three caveats about the QoL findings: 1) new drugs have different toxicity profiles than standard chemotherapy and that may affect QoL domains that are not covered by standard instruments; 2) there were no hypotheses and many tests were done without adjustment for multiplicity because the QoL analysis was exploratory, so these results should not be given the same weight as a confirmatory analysis; and 3) Baseline QoL may not be an appropriate metric because patients with advanced disease and poor QoL usually drop out from trials more frequently than do patients with better QoL.3

“Bearing these limitations in mind, Checkmate-141 offers valuable insight into the potential effects of nivolumab on certain QoL domains in patients with advanced head and neck cancer who are reasonably fit (ECOG performance status of 0 or 1),” she wrote. “Domains that are most important to patients with head and neck cancer according to an international EORTC study are worrying, swallowing, talking, eating, sticky saliva, dry mouth, and pain in the mouth. In all of these areas, patients treated with nivolumab reported better QoL both 9 and 15 weeks after than patients treated with investigator’s choice.”

Notes:
1.Harrington KJ, Ferris RL, Blumenschein G, et al. Nivolumab versus standard, single-agent therapy of investigator’s choice in recurrent or metastatic squamous cell carcinoma of the head and neck (CheckMate 141): health-related quality-of-life results from a randomised, phase 3 trial [published online June 23, 2017]. Lancet Oncol. doi: 10.1016/S1470-2045(17)30421-7.

2.Ferris RL, Blumenschein GR, Fayette J, et al. Further evaluations of nivolumab (nivo) versus investigator’s choice (IC) chemotherapy for recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN): CheckMate 141. J Clin Oncol. 2016;34 (suppl; abstr 6009).

3.Singer S. Quality of life after nivolumab treatment for head and neck cancer [published online June 23, 2017]. Lancet Oncol. doi: 10.1016/S1470-2045(17)30463-1.

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An artistic representation of cancer

Source: www.vueweekly.com
Author: Stephan Boissonneault

Obstructed by Jude Griebel // Stephan Boissonneault

One of the most terrifying phrases known to our current human existence is “you have cancer.” Those three words can break a person.

“I would describe it as a terrible cyclone of information,” says head and neck cancer patient Kimberly Flowers. “You’re surrounded by all these medical teams, all these procedures and appointments, and you’re expected as [a] patient to make the best informed decisions while you’re in a state of emotional trauma. It’s just a whirlwind of confusion.”

With their project and exhibition See Me, Hear Me, Heal Me, clinicians, researchers, patients, and artists aim to recreate that initial confusion and the universal experience of head and neck cancer with multiple works of art.

“I thought art was the best way to express this because art presents an effective and visceral understanding to the experience,” head researcher of the project Dr. Minn Yoon says.

Yoon, being an assistant professor with the School of Dentistry at the University of Alberta, initially started the project by interviewing patients with head and neck cancer.

“My research has to do with the oral health of vulnerable populations, and patients with head and neck cancer fall into that category,” Yoon says. “I wanted to get a sense of what these people actually go through and how their lives change after learning they have head and neck cancer.”

After an interview with a patient who had undergone surgery to reconstruct her tongue, Yoon became aware that the project did not have to be confined to the realm of academia.

“Words alone were not sufficient,” Yoon says.

After meeting local artist Sean Caulfield, Yoon realized she had found the perfect medium to convey a new and authentic take on head and neck cancer—art.

Having done past work with biomedical art projects, Caulfield jumped on board. The project touched him not only on an artistic level, but also a very personal one.

“My mother had head and neck cancer so I had that personal experience,” Caulfield says.

His piece, “Veil,” is made up of nine wooden panels, each with its own unique image like a bouquet of flowers, lamps, and a suburban house. The images are clouded with sheets of printed disruption, blown up images of cancer cells that look as if they’re slowly consuming the entire piece.

“I started thinking about the memories of my mother and the classic hospital layout,” Caulfield says. “I thought about the ways this diagnoses creates a veil over the way you see your life.”

Similarly, Jill Ho-You’s piece, “Veils”, features hand cut mylar sheets of cancer MRI scans.

“I wanted to use a material that had the same ghostly presence as the MRI scans did,” Ho-You says. “I wanted to express the fragility of the human body. People don’t really ever think about their bodies when everything is fine, but when you get sick it becomes this weird alien experience.”

Like all of the artists featured in the exhibit, Caulfield and Ho-You’s goals were to create relatable imprints for head and neck cancer patients.

“It perfectly conveys what I experienced when I was told I had tongue cancer,” Flowers says. “Everything just seemed black to me and everything was so closed to me. I was existing at work and at home, but I was so numb to everything around me. You’re constantly grasping for the past.”

All of the pieces created in See Me, Hear Me, Heal Me were created after patients, artists, clinicians, and researchers all worked together to find the ubiquitous and invisible aspects of head and neck cancer.

“We had a workshop where we used something called imagery theatre where everyone involved, including the artists, got together and talked about head and neck cancer,” Yoon says.

“What really surprised me was that these artists were able to create something from someone else’s experience and brought a new accurate perspective,” Flowers adds.

Each piece in the exhibit stands out with its own literal spotlight.

There’s Jude Griebel’s “Obstructed” sculpture which features a patient on a hospital bed depicted as a grotesque anthropomorphic mountain that has just had a landslide. The piece chimes in on a person’s loss of identity when being diagnosed with head and neck cancer.

Another piece portraying that loss of identity is Brad Necyk’s “Waiting Room” which shows Flowers’ face digitally blurred out on a lit up background.

“My arm was used to repair my tongue and my leg skin was used to cover my arm,” Flowers says. “You come out quite fractured and your sense of self really changes.”

The exhibit does a superb job of expressing the hidden qualities of head and neck cancer.

“My experience has been very eye-opening, and through the exhibit I’ve had some enlightened moments with my own recovery with head and neck cancer,” Flowers says.

Yoon and the artists hope to soon unveil the exhibit internationally and use it as a means to promote the understanding of head and neck cancer.

“What has happened behind the scenes with these patients has been really moving to me as a researcher, but also as a human,” Yoon says. “I guess that shows the importance of fostering the humanistic qualities of academia, health, and art.”

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House Committee Looks to Dilute Tobacco Control Act

Source: www.medpagetoday.com
Date: July 12, 2017
Author: Salynn Boyles

The U.S. House Appropriations Committee made a move Wednesday to greatly weaken the FDA’s authority to regulate tobacco products, including flavored cigars and electronic cigarettes, and health advocacy groups were quick to condemn it.

The committee approved a rider to the agriculture funding bill that would exempt certain cigars from FDA’s authority and weaken its regulatory oversight over e-cigarettes, little cigars, and hookah tobacco.

Prior to the vote, the House committee defeated an amendment by Rep. Nita Lowey (D-N.Y.) to remove language from the bill that will effectively eliminate FDA’s authority to review the health hazards of thousands of tobacco products.

A second rider would exempt from FDA authority certain cigars, including many that are cheap, flavored and are most likely to appeal to children, said American Lung Association (ALA) President Harold Wimmer.

“These dangerous riders were added to this bill for the benefit of the tobacco industry and come at a time when e-cigarettes are the most commonly used tobacco product among kids,” Wimmer said in a written press statement.

The riders are similar to those passed by the House Appropriations Committee last year, but the language restricting FDA’s authority under the Tobacco Control Act was dropped from the final FY2017 bill later in the appropriations process. New language in the FY2018 bill does require the FDA to develop standards for the flavors added to e-cigarettes.

ALA spokesperson Erika Sward told MedPage Today that it is not clear if the riders will suffer the same fate this time around.

“Last year there was a President committed to the Tobacco Control Act in the White House,” she said. “This year not only do you have the House attempting to undermine the Tobacco Control Act, but you also have the FDA delaying the deeming rule.”

Nancy Brown, CEO of the American Heart Association, said the cigar rider exempting certain cigars from FDA regulation was particularly troubling.

“Our association strongly believes that the FDA should regulate all products, since tobacco in any form presents health risks. Further, we are particularly concerned that this could create a loophole that would allow tobacco manufacturers to manipulate their products to evade the agency’s oversight,” she said in a written statement.

Brown noted that the tobacco product grandfather rider could allow thousands of tobacco products to skip FDA review.

“While we appreciate that House members included a requirement that the FDA develop a product standard for flavors in e-cigarettes, changing the grandfather date puts e-cigarette users’ health at risk,” she said.

Chris Hansen, president of the American Cancer Society Action Network, charged that the legislation would benefit the cigar and e-cigarette industries at the expense of the nation’s public health.

“Congress made a commitment to protect the health of the American people when it passed the Tobacco Control Act. Today’s committee action is a serious breach of that promise,” he said.

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July, 2017|Oral Cancer News|

Personalized cancer vaccines successful in first-stage human trials

Source: http://newatlas.com/cancer-personalized-vaccine-success-trial/50402/
Author: Rich Haridy
Date: July 9, 2017

A cancer vaccine is one of the holy grails of modern medical research, but finding a way to stimulate the immune system to specifically target and kill cancer cells has proven to be a difficult task. Now two recent clinical trials that have produced encouraging results in patients with skin cancer are are providing hope for the development of personalized cancer vaccines tailored to individual patient’s tumors.

Both studies focus on neoantigens, which are mutated molecules found only on the surface of cancer cells. Neoantigens prove to be ideal targets for immunotherapy as they are not present on healthy cells. A vaccine’s challenge is to train the body’s immune cells, known as T cells, to hunt and kill only those specific tumor cells that hold the target neoantigens.

In the first trial, at Boston’s Dana-Farber Cancer Institute, samples of tumors were taken from six patients with melanoma. The patients were identified as having a high risk for recurrence after first having their tumors removed by surgery. For each individual patient the researchers identified up to 20 neoantigens specific to a subject’s tumor.

Computer algorithms were then utilized to help the researchers select which specific neoantigens would best stimulate the body’s T cells. Those neoantigens were then synthesized, mixed with an adjuvant to stimulate immune response, and injected into the individual patients.

Four out of the six patients in this first trial displayed no recurrence of their cancer 25 months after vaccination. The other two patients did have a recurrence of cancer, although in those cases the cancer had already spread into their lungs. After a secondary treatment with the drug pembrolizumab, they also entered complete remission.

The second trial, by Biopharmaceutical New Technologies (BioNTech) in Germany, used a similar strategy that targeted neoantigens in 13 patients with melanoma. These vaccines targeted up to 10 specific neoantigens in each individual patient, and after 12 to 23 months eight subjects were cancer-free.

The vaccines in both studies successfully stimulated both kinds of cancer-killing T cells: the CD8+ cells and their CD4+ helper cells. The studies also found that the T cells were able to specifically target a patient’s tumor.

It’s still early stages in research terms, but these results are incredibly promising. With more, and broader, clinical trials set for the near future, it is yet to be seen how effective these kinds of personalized vaccines are across a wide range of different cancers. A larger clinical trial that also targets bladder and lung cancers is currently underway.

One of the big challenges to overcome, should this form of personalized treatment prove broadly successful, is the cost and time in developing these customized vaccines. Current estimates claim a single patient’s neoantigen vaccine costs up to $US60,000 to produce. In tandem with other new drug innovations, some patients could be paying several hundred thousand dollars for these treatments should they reach the market.

The time it takes to produce an individual vaccine is also a concern when considering how this treatment could be rolled out on a mass scale. It took several months to produce the vaccines in both studies, but the researchers are confident this time frame could be reduced to six weeks or less. However, this is still a significant amount of time if the process was to be rolled out on a large scale.

Pragmatic challenges aside though, these neoantigen vaccines could pave the way for an exciting new form of personalized cancer treatment. One that allows for specific tumors to be targeted by the immune system through customized vaccines.

The results of the Dana-Farber Cancer Institute trial were published in the journal Nature, as were the results of the second trial by Biopharmaceutical New Technologies (BioNTech).

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July, 2017|Oral Cancer News|

Biotech exec facing death urges: Get the vaccine that prevents his cancer

Source: www.philly.com
Author: Michael D. Becker

Like most people who pen a new book, Michael D. Becker is eager for publicity.

But he has an unusual sense of urgency.

A former oncology biotech CEO, Becker has neck cancer. He expects his 49th birthday in November to be his last, if he makes it.

What also drives him to get his message out, however, is this: Children today can get a vaccine that prevents the kind of oropharyngeal cancer that is killing him.

As he collides with his mortality, Becker wants to share his story and raise awareness about the vaccine, which protects against dangerous strains of human papillomavirus, or HPV, the extremely common, sexually transmitted virus that caused his disease. His book, A Walk With Purpose: Memoir of a Bioentrepreneur (available on Amazon.com), was produced and self-published in a creative sprint between December, when his cancer recurred just a year after initial diagnosis and treatment, and April. He also has a blog, My Cancer Journey, and has been conducting media interviews.

“I had a lot of motivation to write the book quickly,” he said wryly at his home in Yardley.

In the final pages, he urges parents “to talk to their doctor about the HPV vaccine,” which “simply didn’t exist when I was a teenager, or it could have prevented my cancer.”

The leading vaccine brand, Gardasil, was hailed as a breakthrough when it was introduced in 2006. It is approved to prevent cervical cancer and less common genital malignancies, including anal cancer, that are driven by HPV infections. The vaccine was not clinically tested to prevent head and neck cancers, so it is not officially approved for that purpose, but research shows that it works. A study of young men presented last month found that vaccination reduced oral HPV infections by 88 percent.

Still, many adolescents are not getting the shots, for various reasons.

“It just kills me,” Becker says without a trace of irony, “that it’s underutilized. There are parents debating about whether to vaccinate their children. I’ve talked to immunologists about the safety. I had to make the decision to vaccinate my own kids. I was 100 percent convinced.”

From dropout to go-getter:
Becker describes his own youth as a bit misspent. He left home and dropped out of high school in his junior year, soon after his parents divorced.

“During my teens, I had experimented with sex, drugs, and alcohol while teaching myself how to play guitar and dreaming of becoming the next Eddie van Halen,” he writes in his book. “Making it through a number of near-death and reckless experiences during that period now seemed like a minor miracle.”

In his late teens, he wised up, got his equivalency diploma, and went to work for his father’s investment firm, where he discovered a talent for computer programming. Next came a job as a stock broker in Chicago, where he met and soon married Lorie Statland, an elementary school teacher who inspired him to get a college degree. The couple had two children, Rosie, now 19, and Megan, 16.

Becker went on to have a prolific career in biotechnology, complete with the occasional setbacks (lawsuits and soured partnerships) that are part of that high-stakes world. His resume includes Wall Street securities analyst, portfolio manager, founder of his own communications firm, and top executive of three biotech companies, two of which developed oncology products. During his cancer treatment, he used a prescription medicine that he played a major role in developing while at New Jersey-based Cytogen Corp: Caphosol, an electrolyte mouthwash that treats mouth ulcers caused by radiation therapy.

His diagnosis followed his discovery of a lump under his jaw line on the day before Thanksgiving in 2015. Tests revealed cancer that had spread from a tonsil to a lymph node and surrounding tissue.

At Memorial Sloan Kettering Cancer Center in New York, he opted for chemotherapy and radiation instead of surgery. The operation, he explains, can damage speech and swallowing, and if it doesn’t get all the cancer, chemo and radiation are still necessary.

He describes the main side effects of treatment – constant dry mouth and changes in taste – as manageable. And he says he was not unhappy to lose 30 pounds.

Although he sounds almost too stoic, he is frank about “the one major issue I tried to ignore … namely, depression.”

“On more than one occasion I burst into a crying session,” he writes. “I’m not talking about the quiet episode with sniffles and a tear or two. I mean full-fledged bawling your eyes out accompanied by nasal discharge and the near inability to speak normally.”

A sensitive subject:
Conspicuously missing from his book, though, is information about head and neck cancer. Over the last 30 years, the epidemiology has changed dramatically in the United States, with a decline in cases related to smoking and alcohol use, and a steady increase in HPV-related cancers. Men are three times more likely than women to develop these malignancies. Of an estimated 63,000 new head and neck cancer diagnoses this year, 11,600 will likely be caused by HPV, according to the U.S. Centers for Disease Control and Prevention.

This surge reflects changes in sexual practices, especially oral sex, research suggests. That’s a sensitive issue, as actor Michael Douglas discovered when his candor about his throat cancer and cunnilingus turned him into fodder for tweeters and late-night comics. The thing is, genital strains of HPV are so ubiquitous that almost all sexually active people — not just promiscuous ones — will be infected at some point. It is not clear why, for a fraction of these people, the immune system fails to wipe out the infection.

Becker says he did not wade into this subject in his book because of the scientific uncertainties.

In a recent blog post, he quoted the CDC: “Only a few studies have looked at how people get oral HPV, and some show conflicting results. Some studies suggest that oral HPV may be passed on during oral sex or simply open-mouthed (“French”) kissing, others have not. More research is needed to understand exactly how people get and give oral HPV infections.”

After his cancer recurred, Becker explored his options and entered a National Cancer Institute clinical trial of an experimental immunotherapy. It seems to have slowed, but not stopped, his cancer, which has spread to his lungs.

He is philosophical about his plight.

“I get up each morning feeling fine. It’s not a bad quality of life at the moment,” he said. “And I’ve had just a fabulous life. I’ve worked very hard, but the fruits of those labors were phenomenal. Being able to travel. Being able to give my daughters what they wanted. I wanted them to have a better youth than I had. I’ve got the best wife in the world. I’ve had 25 fabulous years with her. It’s hard to look at my situation and have a lot of self-pity.”

But he does have a hope: “That by sharing this experience freely, I can help create greater awareness for the disease and its impact.”

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