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    Riders raise awareness for oral cancer

    Mon, Aug 10, 2015

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    Source: Millard County Chronicle Progress
    Author: Doug Radunich
     
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    Two traveling rodeo riders helped raise awareness for oral cancer at the Days of the Old West rodeo in Delta June 11-13.

    As a non-profit seeking to spread awareness of oral cancer and the dangers of starting terrible tobacco habits, the foundation teamed up with bareback bronco rider Cody Kiser, of Carson City, Nev., and barrel rider Carly Twisselman, of Paso Robles, Calif., in an effort to spread the word among the Rodeo circuit, which is one of the biggest arenas of tobaccos-using patrons. While others are focused on getting users to quit, the Oral Cancer Foundation is encouraging young people to avoid the habit that they may see one of their rodeo heroes engage in. The message of the foundation is simple and not confrontational: “Be Smart. Don’t Start”. This message was displayed at the recent rodeo in Delta.

    Also at the Delta rodeo, Kiser and Twisselman sported Oral Cancer Foundation logos and wording on their clothes and riding gear, while handing out free buttons, wristbands and bandanas. Both riders also gave autographs, talked and had pictures taken with young fans.

    Both riders, who will promote the message at different rodeos across the country, also competed in their respective riding events while in Delta.

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    “It’s an awesome opportunity to use our platform, and it’s for a good cause and to put good message out there,” Twisselman said. “There are family members and friends and peers out there who chew tobacco, and in the rodeo world it’s still a big problem. There are still so many people who do it, and there’s that mentality that ‘if he’s the world champion and he does it’ maybe I should do it. We want to put out a better put message to kids and say they can still be successful and not have to chew.”

    Twisselman said there is a big focus on the positive aspects of not using tobacco.

    “We want to highlight all the good things that come from not using tobacco, and not just talk about the bad things from using it,” she said. “Another great thing about the foundation is we’re not trying to hammer the message into people or be pushy about it. We also want to reach people who haven’t started yet and try to save some lives.”

    Kiser also said he was excited to be part of the campaign.

    “We hand out pins and just try and talk to people as much as we can,” he said. “We want to get the word out there about cancer, and our main focus is on kids and teens. We really want to get to them before the pick up the habit. The slogan is ‘Be Smart Don’t Start.’

    According to the Oral Cancer Foundation, oral cancer is becoming an epidemic in the US. Rodeo has a historic tie to smokeless tobaccos, and if the problem is going to be addressed, the Oral Cancer Foundation has to do it where the problem thrives. Smokeless/spit tobacco is one of the historic causes of deadly oral cancers, and is more addictive than other forms of tobacco use.

    More on oral cancer facts can be found at www.oralcancer.org.

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

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    Baseball and tobacco are a deadly mix

    Thu, Aug 6, 2015

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    Source: www.bostonglobe.com
    Authors: Dr. Howard Koh & Dr. Alan C. Woodward
     
    ortiz copyUnhealthy as it looks: David Ortiz spat out his “chew” after flying out against Tampa Bay in Game 3 of the 2008 ALCS at Fenway Park.

     

    Search the web for the phrase “tobacco and baseball” and you’ll find an association that dates back almost to the beginning of the sport. In the late 1800s, tobacco companies debuted baseball cards in cigarette packs. By the early 1900s, Bull Durham was advertising its chewing tobacco product on outfield fences.

    Today, cigarette smoking is prohibited or restricted in all Major League parks. Still, players, coaches, and others use smokeless tobacco, often referred to as “chew” or “dip,” in virtually every stadium across the country. But tobacco that is “smokeless” is not “harmless.” It contains at least 28 carcinogens and causes oral, pancreatic, and esophageal cancer, along with serious health problems such as heart disease, gum disease, tooth decay, and mouth lesions.

    The longstanding link between tobacco and baseball has led to tragic outcomes, for players and young fans alike. Baseball legend Babe Ruth died at age 53 of throat cancer after decades of dipping and chewing. Last summer, former Red Sox pitching great Curt Schilling announced that he had been treated for oral cancer, which he attributed to three decades of chewing tobacco. Sadly, his news came shortly after the death of Hall of Famer Tony Gwynn, at age 54, after a lengthy fight with salivary gland cancer. Gwynn, too, attributed his cancer to longtime smokeless tobacco use.

    As physicians who have spent decades providing patient care and promoting public health, we believe it is time to make baseball tobacco free. Today, we are proud to join Mayor Marty Walsh as he announces a historic and lifesaving city ordinance to eliminate the use of smokeless and all other tobacco products at baseball venues and athletic fields. This includes Fenway Park.

    Approval of the rule would allow Boston to join San Francisco as the first two US cities to protect the future health of players, coaches, and fans in this way. It could also inspire other jurisdictions to consider similar action.

    Implementing this measure would also add to our city and state’s history of leadership in fighting tobacco. Massachusetts can boast one of the first tobacco prevention and cessation programs in the country (1993), a comprehensive smoke-free law (2004), and a series of tobacco tax increases to protect kids and fund public health. Although adequate funding for state tobacco control remains an ongoing challenge, these and other measures have dropped the Massachusetts youth smoking rate (10.7 percent in 2013) to nearly a third below the national average.

    Despite this progress, the national rate of smokeless tobacco use in high school has stayed disturbingly steady. In the US, nearly 15 percent of high school boys currently use smokeless tobacco. More than half a million youth try smokeless tobacco for the first time. Smokeless tobacco companies annually spend $435 million on marketing. A key message of such advertising is that boys can’t be real men unless they chew. Also, scores of Major League Baseball players who chew or dip in front of fans provide invaluable free advertising for the industry. Impressionable kids stand ready to imitate their every move.

    For too long, the tobacco industry has normalized and glamorized products that cause drug dependence, disability, and death. Leveraging the prestige and appeal of baseball has been an essential part of that strategy. It’s time for baseball to start a new chapter that reclaims tobacco-free parks as the new norm — and for Boston, home to so many sports achievements, to lead the way.

    Dr. Howard K. Koh is the former US Assistant Secretary for Health and former Massachusetts Commissioner of Public Heath. Dr. Alan C. Woodward, a former president of the Massachusetts Medical Society, is chair of Tobacco Free Mass.

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

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    Mayor Walsh Wants Ban On Chewing Tobacco At All City Ballparks

    Wed, Aug 5, 2015

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    Source: www.wbur.org
    Author: Philip Marcelo
    Curt SchillingFormer Boston Red Sox pitcher and mouth cancer survivor Curt Schilling, pictured here at Fenway Park in 2012, was on hand Wednesday as Mayor Marty Walsh proposed banning smokeless tobacco products from all city professional and amateur athletic venues. (Winslow Townson/AP)

     

    From storied Fenway Park to youth baseball diamonds across the city, Boston Mayor Martin J. Walsh is calling for a ban on dip, snuff and chewing tobacco.

    With former Red Sox pitcher and mouth cancer survivor Curt Schilling at his side, the mayor on Wednesday proposed banning smokeless tobacco products from all city professional and amateur athletic venues.

    “Kids shouldn’t have to watch their role models using tobacco, either at a neighborhood park or on TV,” Walsh said, standing at home plate of a South Boston baseball diamond. “Ballfields are places for mentoring and healthy development. They’re no place for cancer-causing substances.”

    Schilling, who revealed earlier this year he was diagnosed with mouth cancer after decades of using chewing tobacco, described his battle with the illness, which he said is in remission.

    “It was more painful than anything you could imagine,” he said, addressing the dozens of school-age kids in attendance. “I couldn’t swallow. I had to eat from a tube. I was sick every single day. And if it came back, I don’t know if I would go through the treatment again. It was that bad.”

    The 48-year-old ESPN analyst acknowledged Walsh’s proposal will likely meet resistance from major league players, but he believes they will eventually come to accept it, just as they had when smoking was banned in ballparks years ago.

    “This is about our kids,” Schilling said. “We have to accept the responsibility that we impact the decisions and the choices that they make.”

    Under their union contract, MLB players aren’t banned from using smokeless tobacco products, though they can’t use them during televised interviews and can’t carry them around when fans are in the ballparks.

    The Red Sox organization applauded Walsh’s proposal, which requires City Council approval.

    “We all know the horrific and tragic stories of ballplayers who have suffered the consequences of using smokeless tobacco,” the team said in a statement. “Our focus on baseball – and on bringing children closer to the game – fortify our resolve to cooperate in this effort.”

    Altria, the makers of popular smokeless tobacco products Skoal and Copenhagen, declined to comment Wednesday. Other smokeless tobacco makers did not immediately weigh in.

    Walsh’s proposal would apply to everyone in a ballpark, including fans, players, ground crews and concession staff.

    The proposed ordinance would cover professional, collegiate, high school or organized amateur sporting events and be effective April 1. His office says those managing sporting event sites would be responsible for assuring compliance. Violators would be subject to a $250 fine.

    If approved, Boston would become the second U.S. city, behind San Francisco, to ban chewing tobacco and related products from ballfields. That city’s ban takes effect Jan. 1. Los Angeles is also considering a ban that’s focused solely on baseball and does not impact other sports.

    Walsh plans to officially file his proposal Monday.

    Specifically, he calls for banning use of smokeless tobacco products, which are defined as any product containing “cut, ground, powdered, or leaf tobacco and is intended to be placed in the oral or nasal cavity.”

    Public health officials Wednesday said major league players represent “powerful marketers” for smokeless tobacco products, whether they realize it or not.

    Cigarette smoking has been on the decline in the U.S., but smokeless tobacco use among youth has remained relatively steady in recent years, noted Dr. Howard Koh, a former U.S. assistant secretary for health who now teaches at Harvard.

    Nearly 15 percent of high-school age boys reported using smokeless products in recent studies, he added.

    The Surgeon General and the National Cancer Institute say smokeless tobacco contains at least 28 cancer-causing chemicals that can lead to oral, pancreatic and esophageal cancer and other health problems like heart disease, gum disease and tooth decay.

    “Smokeless tobacco is not harmless,” Koh said. “All of this is preventable. We can do something about this.”

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

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    Testimony by otolaryngologists in defense of tobacco companies 2009–2014

    Fri, Jul 31, 2015

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    Source: www.onlinelibrary.wiley.com
    Author: Robert K. Jackler, MD
     

    Abstract

    Objectives/Hypothesis

    To examine expert testimony offered by otolaryngologists in defense of the tobacco industry and to assess whether opinions rendered were congruent with evidence in the scientific literature.

    Methods

    Data sources include publically available expert witness depositions and trial testimony of board-certified otolaryngologists employed by the tobacco industry in defense of lawsuits brought by smokers suffering from head and neck cancer. The cases, adjudicated in Florida between 2009 and 2014, focused on whether smoking caused the plaintiff’s cancer.

    Results

    The study includes nine legal cases of upper aerodigestive tract cancer involving six otolaryngologists serving as expert witnesses for the tobacco industry. Cancer sites included larynx (5), esophagus (2), mouth (1), and lung (1). Five of the six otolaryngologists consistently, over multiple cases, offered opinions that smoking did not cause the plaintiff’s cancer. By highlighting an exhaustive list of potential risk factors, such as human papillomavirus (HPV), alcohol, asbestos, diesel fumes, salted fish, mouthwash, and even urban living, they created doubt in the minds of the jurors as to the role of smoking in the plaintiff’s cancer. Evidence shows that this testimony, which was remarkably similar across cases, was part of a defense strategy shaped by tobacco’s law firms.

    Conclusions

    A small group of otolaryngologists regularly serve as experts on behalf of the tobacco industry. Examination of their opinions in relation to the scientific literature reveals a systematic bias in interpreting the data relating to the role played by smoking in head and neck cancer causation.

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

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    Mouth rinse could help predict recurrence of HPV-related oropharyngeal cancers

    Fri, Jul 31, 2015

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    Source: www.eurekalert.com
    Author: Barbara Benham of Johns Hopkins University Bloomberg School of Public Health

    In small study, patients with HPV traces post-treatment were more likely to have cancer recurrence; finding could lead to new monitoring protocols. – Johns Hopkins University Bloomberg School of Public Health

    Oropharyngeal cancer patients who were found to have detectable traces of human papillomavirus type 16 (HPV16) in their saliva following cancer treatment are at an increased risk for recurrence, a study led by researchers at the Johns Hopkins Bloomberg School of Public Health has found.

    The oropharynx is the area of the upper throat that includes the back of the tongue, the soft palate, the tonsils and the walls of the throat. Oropharyngeal cancer accounts for 2.8 percent of new cancers in the United States; it is often treated successfully with surgery.

    In a small study, seven percent (five of 67) of oropharyngeal cancer patients who had HPV16 DNA in their oral rinse at the time of diagnosis were later found to still have traces of HPV16 DNA in their oral rinse following treatment. Of these, all developed a local recurrence of the cancer. The finding, believed to be the first of its kind, could lead to to new follow-up protocols for oropharyngeal cancer patients, the researchers say.

    The study is published July 30 in the journal JAMA Oncology.

    “It’s a very small number so we have to be somewhat cautious,” says Gypsyamber D’Souza, PhD, an associate professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health and a member of the Sidney Kimmel Comprehensive Cancer Center. “The fact that all of the patients with persistent HPV16 DNA in their rinses after treatment later had recurrence meant that this may have the potential to become an effective prognostic tool.”

    For their study, researchers tracked 124 patients who had been diagnosed with oropharyngeal cancer, collecting oral rinses from patients at the time of diagnosis and again following treatment, at nine, 12, 18 and 24 months after diagnosis. Patients were asked to rinse and gargle with Scope mouthwash. Of the 124 patients, slightly over half had oral HPV16 DNA in their oral rinse at the time of their cancer diagnosis. Most patients no longer had HPV DNA detectable in their oral rinse after completing treatment, but some did.

    The researchers do not know if the presence of HPV16 DNA in the post-treatment rinse means that the treatment did not completely eradicate the cancer in the first place or if the cancer returned. Either way, the finding suggests that a simple oral rinse could be a powerful diagnostic tool for the reappearance of this type of oral cancer.

    HPV is associated with several types of cancer, most notably cervical and oral cancers. Incidence of HPV-associated cancers is increasing in the United States and the virus is responsible for the majority of oropharyngeal cancer here. HPV-positive oropharyngeal cancer generally has a better prognosis than HPV-negative cancer, but like other cancers, it can recur, potentially in up to 25 percent of cases.

    HPV-related oropharyngeal cancer responds well to surgical treatment, but the success of surgical treatment decreases if the cancer is caught after it has spread to other parts of the body. The researchers hope that the detection of HPV DNA in oral rinses may enable earlier detection of recurrence and, therefore, better overall prognosis should the cancer recur.

    Moreover, most of the recurrences observed in this study were localized oropharyngeal cancer and not cancers that spread to other regions of the body. “Those that had HPV DNA detected in their mouth after treatment had a much higher risk of local recurrence,” says D’Souza.

    Researchers say that in this study disease recurrence was diagnosed roughly seven months after the detection of HPV16 DNA in the oral rinse. Presence of HPV16 DNA in oral rinses may allow for the detection of cancer recurrence before any other clinical signs or symptoms, which enables earlier treatment options.

    “There was a lead time of several months between when we detected HPV16 DNA in the rinse and when they were diagnosed with recurrence,” says D’Souza. “If we had known at the rinse time, it would have given a lead time for treatment.”

    D’Souza stresses that this type of testing is new. She also notes that this is a rare cancer, and that recurrence is even rarer still.

    “It should be reassuring that most people who have been treated for HPV-related oropharyngeal cancers are cured and there is no HPV16 DNA detected in their mouths, but among those that did recur, this was an important potential predictor,” she says.

    ###

    “Prognostic Implication of Persistent Human Papillomavirus 16 DNA Detection in Oral Rinses for Human Papillomavirus-Related Oropharyngeal Carcinoma” was written by Eleni M Rettig, MD; Alicia Wentz, MA; Marshall R Posner, MD; Neil Gross, MD; Robert I Haddad, MD; Maura L Gillison, MD, PhD; Carole Fakhry, MD; Harry Quon, MD; Andrew G Sikora, MD PhD; William J Stott, CCRP; Jochen H Lorch, MD; Christine G Gourin, MD; Yingshi Guo, MS; Weihong Xiao, MD; Brett A Miles, DDS, MD; Jeremy D Richmon, MD; Peter E Anderson, MD; Krzysztof J Misiukiewicz, MD; Christine H Chung, MD; Jennifer E Gerber, MSc; Shirani D Rajan, MSPH; Gypsyamber D’Souza, PhD.

    The research was supported by grants from the Johns Hopkins Richard Gelb Cancer Prevention Award (GD), the Oral Cancer Foundation (GD), the National Institute of Dental and Craniofacial Research (NIDCR) and the National Institutes of Health (NIH) Research Training in Otolaryngology grant 2T32DC000027-26 (EMR).

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

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    HPV Persistence Predicts Poor Prognosis in Head/Neck Cancer

    Thu, Jul 30, 2015

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

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

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

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

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

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

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

    The study was published online July 30 in JAMA Oncology.

    Biomarker Potential?

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

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

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

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

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

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

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

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

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

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

    Associated With Recurrence

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

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

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

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

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

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

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

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

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

     

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    Kissing overtakes smoking as leading risk for head and neck cancers

    Thu, Jul 30, 2015

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    Source: http://www.dailymail.co.uk
    Author: Lauren Grounsell for Daily Mail Australia

    Contracting Human papilloma virus (HPV) infections through kissing is now a larger risk than smoking for developing head or neck cancer. According to Australian head and neck surgeon, Dr Mahiban Thomas, Oral HPV makes head and neck cancer 250 times more likely with 70% of all US cases being caused by the virus.

    While HPV is normally linked with cervical cancer – it can infect both men and women. This oral variant of the virus can be passed through oral sex and open-mouth (french) kissing.

    Dr Thomas told MailOnline: ‘If you look at the figures coming out of the US, 70 per cent of head and neck cancers are due to HPV.
    ‘There has been a change in high-risk behaviour as far as smoking and drinking goes.

    ‘If you have an (HPV) infection, you have 250 times the chance of developing cancer of somebody who does not have HPV.’
    Health authorities advise that the risk of contracting HPV increases with the number of ‘french kissing and oral sex partners you have.

    While most commonly associated with cervical cancers, HPV can affect both men and women. There are more than 100 types of the virus, but only about eight ‘high risk’ strains of HPV that can cause cancers in the oropharynx.

    The Centers for Disease Control and Prevention said studies suggest Oral HPV could be passed on during oral sex or open-mouthed or ‘French’ kissing, and about 7% of people have oral HPV, but only 1% of people have the type of oral HPV that is found in oropharyngeal cancers.

    Dr Thomas said recent studies suggested even engaging in ‘petting’ without sexual interaction could transfer HPV.

    ‘If you look at the figures coming out of the US, 70 per cent of head and neck cancers are due to HPV,’ Dr Thomas said.
    ‘There has been a change in high-risk behaviour as far as smoking and drinking goes.

    ‘If you have an (HPV) infection, you have 250 times the chance of developing cancer of somebody who does not have HPV.’

    Dr Thomas told NT News HPV was responsible for a ‘tsunami’ of head and neck cancer cases. He said your risk of contracting the HPV virus increased with the number of French kissing partners you had, and people underrated the risks associated with oral sex.

    Yesterday marked World Head and Neck Cancer Day. In 2011, 3121 head and neck cancers were diagnosed in Australia, caused by smoking, frequent alcohol use, sun exposure, radiation, asbestos and HPV.

    The Australian Government funds HPV vaccination for 12 to 13-year-old girls and boys which helps protect against cervical cancer, some vaginal, vulva and anal cancers and genital warts.

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    MD Anderson Team wins NIH grant to uncover novel head, neck cancer drug targets

    Thu, Jul 30, 2015

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    Source: www.genomeweb.com
    Author: staff

    The National Institutes of Health this month awarded MD Anderson Cancer Center researchers a four-year grant to bioinformatically and functionally investigate genomic alterations as novel therapeutic targets for head and neck squamous cell carcinoma (HNSCC).

    In recent years, genomic studies have identified numerous genetic alterations in HNSCC, but such alterations “are dominated by tumor suppressor genes and untargetable oncogenes,” MD Anderson’s Jeffrey Myers, who is leading the research, wrote in the grant’s abstract. “Nevertheless, we hypothesize that novel molecular therapeutic targets are present in HNSCC and that these targets exist in parts of the data that have not been effectively analyzed.”

    With the support of the NIH grant, administered by the National Institute of Dental & Craniofacial Research and worth $971,667 in its first year, Myers and his colleagues plan to examine existing genomic data using a combination of computational and functional approaches to identify candidate drug targets.

    The most promising targets will be tested in a high-throughput in vivo screening system in HNSCC lines with known genotypes, with validated targets further tested for genotype co-dependencies. Known drug targets will be studied in preclinical xenograft models.

    For targets that are currently undruggable, the researchers will computationally and experimentally analyze their pathways for additional targets that can be functionally tested.

    Through the work, the MD Anderson investigators aim to generate a broad list of functionally validated novel targets for HNSCC as candidates for drug development.

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    NYU’s Bluestone Center Receives a $369,250 High Priority, Short Term Project Award from NIDCR to Study Oral Cancer Pain

    Wed, Jul 29, 2015

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    Source: www.nyu.edu/news
    Author: Christopher James
     

    Drs. Yamano and Schmidt have developed a novel non-viral gene delivery method, and the proposed studies are designed to test whether this could be used to treat cancer pain effectively and safely.

    Up to 90% of cancer patients suffer from pain, with oral cancer ranked consistently as one of the most painful cancers. The quality of life for oral cancer patients is the lowest of any patients suffering from cancer because the intense uncontrolled pain interferes with necessary oral functions including eating, talking and swallowing.

    “Oral cancer pain is more severe, and the opioid requirement is higher, than pain from any other cancer,” said Dr. Brian L. Schmidt, DDS, MD, PhD, professor in the Department of Oral and Maxillofacial Surgery, and director of NYU’s Bluestone Center for Clinical Research and the NYU Oral Cancer Center. “And in the end, pharmacological agents used to treat cancer pain often lack anatomical specificity and produce off-target effects that create additional suffering.”

    “Gene therapy is emerging as an exciting prospect and alternative to opioids for the treatment of cancer pain,” said Dr. Seiichi Yamano, DDS, PhD, DMD, MMSc, assistant professor of prosthodontics at NYU College of Dentistry. “We seek to eliminate oral cancer pain by reversing epigenetic changes using gene therapy and set the stage for a new class of medicines that selectively disrupt nociceptive signaling with limited off-target effects.”

    To further their research, the National Institute of Dental and Craniofacial Research (NIDCR), part of the National Institute of Health (NIH) has awarded Drs. Schmidt and Yamano a one-year, $369,250 High Priority, Short-Term Project Award (R56) to study the efficacy of a novel non-viral gene delivery method. The proposed studies are designed to test whether nonviral gene delivery into the oral cancer could be used to treat cancer pain effectively and safely.

    “Viral vector-based treatment of cancer pain has been evaluated in preclinical studies but problems with immune response, limited DNA carrying capacity, recombination and high cost have been encountered,” said Dr. Schmidt. “Synthetic, non-viral vectors are potential alternatives to viral vectors that preclude these obstacles.”

    To improve non-viral gene transfer efficiency, Dr. Yamano recently created two novel nonviral hybrid vectors: a cell-permeable peptide (CPP) combined with either a cationic lipid (CPP/lipid) or a cationic polymer (CPP/polymer). These nonviral vectors have excellent transfection efficiency with little cytotoxicity across a range of cell lines including different types of cancer cells.

    The researchers also found that the transfection efficiency using the nonviral vector in oral cancer cells has a significantly higher expression (~8-fold) than normal cells and has a higher expression (~65%) than an adenoviral vector (~50%). In vivo transfection with either of these nonviral vectors leads to high and long-term transgene expression (~7 months) after intramuscular injection of the vectors.

    “We recently demonstrated that OPRM1 (the gene for the µ-opioid receptor) is methylated and down regulated in oral cancer compared to matched normal tissues in the same patients; these patients reported pain at the site of cancer,” said Dr. Schmidt. “We further demonstrated that OPRM1 re-expression with viral transduction significantly reduced cancer pain in a mouse model.”

    Based on their preliminary work, the researchers hypothesize that re-expression of the OPRM1 gene within oral cancer using our non-viral vectors will attenuate cancer pain and restore orofacial function without excessive toxicity. Their research has three specific aims:

    1. To determine the efficacy of ex vivo OPRM1 gene transfer with non-viral vectors to attenuate cancer-induced pain, with the goal to move their method of non-viral transfection to the clinic, with the goal of clinicians directly inoculating their non-viral vector into an oral cancer;
    2. To determine the feasibility and efficacy of in vivo OPRM1 gene transfer (i.e. directly into the tongue cancer) with non-viral vectors for attenuation of cancer-induced pain; and
    3. To analyze toxicity and immune response in the cancer mice treated with non-viral OPRM1 gene delivery.

    “The proposed research is significant because we will use a local delivery technique directly into the cancer to reduce the potential side effects of systemic drugs,” continues Dr. Yamano. “Our approach is innovative because we will transduce the cancer cells for the treatment of cancer pain and our non-viral vector more efficiently targets oral cancer cells relative to normal cells. Ultimately, these studies might facilitate the development of an effective therapy to treat cancer pain.”

    The researchers note that, tragically, approximately half of all oral cancer patients will not be cured with surgery, chemotherapy or radiation therapy. Oral cancer is the sixth most common cancer in the US; more patients are afflicted with oral cancer than with melanoma, cervical cancer, or ovarian cancer. The intensity of oral cancer pain escalates with disease progression, and terminal patients generally experience debilitating pain during their final months of life.

    NIH NIDCR R56 grant number: R56DE025393 (Schmidt/Yamano)

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

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    ASCO urges expansion of cancer research to include more older adults

    Wed, Jul 22, 2015

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    Source: www.asco.org
    Author: staff

    ASCO  issued landmark recommendations calling for federal agencies and the cancer research community to broaden clinical trials to include older adults. ASCO also called for redefining eligibility for clinical trials. Both calls to action were published in the Journal of Clinical Oncology.

    More than 60 percent of cancers in the United States occur in people age 65 and older, a population that will grow exponentially over the coming years. Yet, the evidence base for treating older adults is sparse because they are underrepresented in clinical trials and trials designed specifically for them are rare.

    “Older people living with cancer often have different experiences and outcomes in their treatment than younger cancer patients,” said ASCO President Julie M. Vose, MD, MBA, FASCO.  “As we age, for example, the risk of adverse reactions from treatment significantly increases. Older adults must be involved in clinical trials so we can learn the best way to treat older cancer patients resulting in improved outcomes and manageable toxicity.”

    Developed by ASCO’s Cancer Research Committee, the ASCO position statement, “Improving the Evidence Base for Treating Older Adults with Cancer,” makes the five following over-arching recommendations:

    •    Use clinical trials to improve the evidence base for treating older adults.
    •    Leverage research designs and infrastructure to improve the evidence base for treating older adults.
    •    Increase Food and Drug Administration (FDA) authority to incentivize and require research on older adults with cancer.
    •    Increase clinicians’ recruitment of older adults with cancer into clinical trials.
    •    Utilize journal policies to incentivize researchers to consistently report on the age distribution and health risk profiles of research participants.

    ASCO also details 16 specific action steps to implement its recommendations, including asking regulatory agencies, research funders, and researchers to carefully consider whether evidence exists to support eligibility criteria based on age, performance status, or comorbid conditions—three primary reasons older adults are excluded from clinical trials.

    Furthermore, ASCO encourages researchers to adopt innovative trial designs that would fill knowledge gaps in the treatment of older adults with cancer.

    “We need to see clinical trials that mirror the age distribution and health risk profile of patients with cancer,” said Arti Hurria, MD, Director of City of Hope’s Cancer and Aging Research Program and co-author of the ASCO position statement. “ASCO has laid out a multi-pronged approach to expand the participation of older adults in clinical trials, ensuring that all patients will receive high-quality, evidence-based cancer care.”

    Redefining Eligibility Criteria for Clinical Trials

    In a related effort, ASCO’s Cancer Research Committee released a paper, “Modernizing Eligibility Criteria for Molecularly Driven Trials,” which examines the need to redefine eligibility criteria around the specific population being researched especially as molecular medicine advances.

    “Understanding the risks and benefits of a treatment in the intended patient population is the fundamental goal of clinical trials,” said Edward Kim, MD, Chair of Solid Tumor Oncology and Investigational Therapeutics at Carolinas HealthCare System’s Levine Cancer Institute and Immediate Past Chair of the ASCO Cancer Research Committee. “Enrollment into clinical trials has not been optimal and needs urgent reassessment. The era of molecularly-targeted therapy is an exciting one and requires us to reevaluate how we meet this primary objective in order to expedite approval of promising drugs into the clinic.”

    Next Steps

    To advance the issues raised in its position statement and paper, ASCO plans to organize a public meeting with input from regulatory bodies and key stakeholders with the ultimate goal of developing an algorithmic approach to determining eligibility criteria for individual study protocols which may help guide future investigators in the era of molecularly-driven therapy. The meeting will be held in the Fall of 2016.

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