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Factors linked with better survival in oral cancer identified

Sat, May 16, 2015

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Source: www.cancertherapyadvisor.com
Author: staff

Factors associated with improved survival in oral cavity squamous cell cancer (OCSCC) include neck dissection and treatment at academic or research institutions, according to a study published in JAMA Otolaryngology-Head & Neck Surgery.

Alexander L. Luryi, from the Yale University School of Medicine in New Haven, Conn., and colleagues analyzed correlations between treatment variables and survival in patients with stages I and II OCSCC. Data were included for 6,830 patients.

The researchers found that five-year survival was 69.7 percent. Treatment factors that correlated with improved survival on univariate analysis included treatment at academic or research institutions, no radiation therapy, no chemotherapy, and negative margins (all P < 0.001).

Improved survival was also seen in association with neck dissection (P = 0.001). Treatment at academic or research institutions correlated with increased likelihood of receiving neck dissection and decreased likelihood of receiving radiation therapy or having positive margins.

Neck dissection and treatment at academic or research institutions correlated with improved survival on multivariate analysis (hazard ratios, 0.85 and 0.88, respectively), while compromised survival was seen for positive margins, insurance through Medicare, and adjuvant radiation therapy or chemotherapy (hazard ratios, 1.27, 1.45, 1.31, and 1.34, respectively).

“Overall survival for early OCSCC varies with demographic and tumor characteristics but also varies with treatment and system factors, which may represent targets for improving outcomes in this disease,” the authors write.

Reference
Luryi, Alexander L., BS, et al. “Treatment Factors Associated With Survival in Early-Stage Oral Cavity Cancer: Analysis of 6830 Cases From the National Cancer Data Base.” JAMA Otolaryngology – Head & Neck Surgery. doi:10.1001/jamaoto.2015.0719. [epub ahead of print]. May 14, 2015.

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The Beginning of the End: Vaccine Prevention of HPV-Driven Cancers

Mon, May 11, 2015

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Source: JNCI – Journal of the National Cancer Institute

Anna R. Giuliano, Aimée R. Kreimer and Silvia de Sanjose
+ Author Affiliations

Affiliations of authors: Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (ARG); Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (ARK); Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Spain (SdS); CIBER Epidemiologia y Salut Pública, Barcelona, Spain (SdS). Correspondence to: Anna R. Giuliano, PhD, Professor and Director, Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, MRC-CAN CONT, 12902 Magnolia Drive, Tampa, FL 33612 (e-mail: anna.giuliano@moffitt.org).
In this issue of the Journal, Saraiya and coauthors present an important analysis of human papillomavirus (HPV) detection in tumors retrieved from select US sites prior to HPV vaccine implementation (2006) (1). Not only are these data necessary to evaluate future vaccine effectiveness in reducing cancers caused by HPV infection, but they will also aid in the growing assessment of the worldwide burden of tumors attributable to HPV infection. These data raise the question: How many cases of cancer can be prevented by HPV vaccination in the United States?

Twenty years ago, in 1995, the World Health Organization recognized for the first time that HPV 16 is the cause of cervical cancer. In 2005, 10 years after this report, there was sufficient accumulated evidence to state that HPV 16 is also the cause of multiple cancers in men and women, and that HPV 16 is only one of 13–15 HPV types deemed “high-risk” types that cause cervical cancer (2,3). Growing evidence that HPV causes cancers, combined with the technology to develop efficacious vaccines against DNA viruses (4), simultaneously led to vaccine development. This was followed by demonstration of vaccine efficacy in women and men (5–8) and, ultimately, licensure of multiple vaccines that protect against HPV infection acquisition and prevention of the lesions these viruses cause (9–11). The recent licensure in the United States of Gardasil 9 presents an opportunity to further expand vaccine protection to prevent 90% of all cervical cancers worldwide (12,13).

While there has been tremendous progress in the prevention of cervical cancer through screening of adult women in high-resource countries and, recently, prevention of cervical precancer with vaccination (14), less progress has been made in the prevention of HPV-related cancers in men, cancers for which screening interventions are not routinely available. Despite clear evidence that HPV causes cancer at the oropharynx, that HPV-related oropharyngeal cancers (OPC) disproportionately affect men, and that OPC incidence is increasing in the United States, there have been no trials conducted to assess the efficacy of HPV vaccines to prevent these cancers. There is preliminary evidence of prophylactic HPV vaccine efficacy against prevalent oral HPV16/18 infections in women (15); however, it remains unknown what proportion of HPV-related OPC can be prevented with broad dissemination of HPV vaccines to males. Moreover, it remains unclear what proportion of OPC that have HPV DNA present are truly attributable to HPV.

Using HPV DNA-based detection to ascribe causality to tumors at different anatomic sites requires caution. There is strong evidence that HPV infection causes all cervical cancers and that DNA detection correlates well with markers of viral activity; thus, the use of DNA detection alone may be well justified at the cervix. However, for noncervical sites, particularly in the head and neck, HPV DNA-based detection methods overestimate the HPV attributable proportion. Identification of viral DNA in the tumor can occur if there is simply a transitory infection (not causal), as well as in cases where HPV is causally involved in the development of the tumor (transcriptionally active). Thus, identification of viral transcripts of the E6/E7 oncogenes by detection of the related mRNA and downstream markers, such as p16INK4a expression, is an approach utilized to ascertain whether HPV is causally involved in the development of the tumor. As an example, a recent meta-analysis of the attributable fraction of HPV in head and neck squamous cell carcinomas showed that HPV DNA was detected in 46% of OPC, 22% of laryngeal cancers, and 24% of oral cavity cancers. When E6/E7 mRNA and p16INK4a status were assessed in these same tumors, the proportion caused by HPV infection was similar for OPC (40%) but overestimated for laryngeal (9%) and oral cavity cancer (16%). Thus, in the current analysis (1), in which 70% of OPC, 21% of laryngeal cancers, and 32% of oral cavity cancers were HPV DNA–positive, it is possible that the HPV attributable fractions for oral cavity and laryngeal cancers were overestimated by two- to three-fold, respectively. Given the documented increases in the proportion of OPC tumors attributable to HPV over the past several decades, the absolute number of cases due to HPV should not be viewed as static; future estimates of the HPV-related OPC burden may be affected by changes in the underlying causes of these cancers, including smoking prevalence and HPV, especially as vaccination dissemination increases. Similar data on the importance of using measures of viral activity to determine HPV causality for noncervical anogenital tumors (penile, vulvar, vaginal, anal) are currently unavailable but will be critical in determining whether HPV DNA detection is sufficient to determine causality (as at the cervix) or whether markers of viral activity should also be utilized (as at the larynx and oral cavity).

Most cancer registries do not have access to molecular data to classify HPV infection status and therefore rely on anatomic site and histology to estimate HPV-related cancer incidence and case counts. In a best-case scenario, such as reported by Saraiya et al., registries have access to discarded samples that enable molecular analysis of tumors. For the purposes of monitoring HPV vaccine impact, these data allow surveillance of HPV-related tumor burden reduction in the post-HPV vaccination era. However, studies aiming to determine the true attributable proportion of HPV in cancers outside the cervix should assess causality with laboratory measures that capture viral activity.

The proportion of HPV-driven cancers that can be prevented with HPV vaccination differs by world region. The United States, like other high-resource countries with organized cervical cancer screening programs, has a low invasive cervical cancer rate but higher rates of noncervical cancers, particularly OPC in men. In contrast, in countries that have not yet benefited from cervical cancer screening programs or tobacco control policies, cervical cancer incidence is higher and HPV-related OPC incidence lower. In the last decade, OPC incidence increased in many economically developed countries as smoking prevalence decreased (16,17). Data reported in this issue indicate that approximately 60% to 70% of OPCs are caused by HPV infection in the United States (1), contrasting with data reported from less economically developed regions where less than 10% of tumors are HPV-positive (18–20). In a comprehensive review of the global burden of infection-associated cancers, de Martel et al. estimated that HPV infection accounts for 38% to 56% of OPC in Australia, Japan, North America, and Northern and Western Europe, compared with only 13% to 17% of OPC in other parts of the world (21). The proportion of OPC attributed to HPV may be even lower in certain African countries (19).

Regardless of how precisely we define the total number of cases due to HPV, vaccination against HPV has the potential to prevent multiple cancers in men and women, cancers for which we have no evidence-based prevention modalities, except in the case of cervical cancer. The data presented by Saraiya and coauthors estimate the number of cancers in the United States we can expect to prevent in the era of HPV vaccination. However, until we reach the national goal of 80% of men and women fully vaccinated against HPV (22), the prevention of multiple cancers with a relatively simple intervention will remain a dream. Providers are the key to implementing the national vaccine recommendations, ensuring this dream becomes a reality. Strong messages from providers to vaccinate age-eligible men and women can move the United States from among the lowest rates of HPV vaccination to the highest, with reductions in the national cancer burden to follow sooner rather than later.

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Second-line afatinib shows promise

Wed, May 6, 2015

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Source: www.nature.com
Author: David Killock

Patients with recurrent and/or metastatic head and neck squamous-cell carcinoma and disease progression after first-line platinum-based chemotherapy have a dismal prognosis. There is no standard second-line therapy; however, afatinib, an irreversible inhibitor of HER family kinases, has shown efficacy in this setting.

The LUX-Head & Neck 1 phase III trial randomly assigned patients to afatinib (n = 322) or methotrexate (n = 161) therapy. Median progression-free survival (PFS) was 2.6 months with afatinib versus 1.7 months (P = 0.03). “The study was also powered to detect a difference in overall survival, which was not significantly improved,” explains lead author Jean-Pascal Machiels, “however, patient-reported outcomes were better with afatinib.” Afatinib was associated with delayed deterioration of global health status, less pain, and improved swallowing, potentially related to the prolonged PFS, compared with methotrexate. Furthermore, afatinib toxicity was manageable and deemed favourable to that of methotrexate.

The patients were unselected for disease subtype, ~60% had received prior anti-EGFR antibody therapy, and 51% received further lines of treatment, possibly diluting the treatment effect of afatinib. Notably, patients with human papilloma virus (p16)-negative non-oropharyngeal cancer and local recurrence (rather than metastasis), who had not previously received an anti-EGFR antibody seemed to derive the most benefit in preplanned subgroup analyses.

Machiels concludes, “Afatinib has some activity in head and neck cancer, but we need to better understand which patients will benefit from this therapy.”

References
Machiels, J.-P. H. et al. Afatinib versus methotrexate as second-line treatment in patients with recurrent or metastatic squamous-cell carcinoma of the head and neck progressing on or after platinum-based therapy (LUX-Head & Neck 1): an open-label, randomised phase 3 trial. Lancet Oncol. doi:10.1016/S1470-2045(15)70124-5

Note: Nature Reviews Clinical Oncology (2015) doi:10.1038/nrclinonc.2015.86
Published online 05 May 2015

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The case for extending the HPV vaccine is clear and urgent

Wed, May 6, 2015

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Source: www.huffingtonpost.co.uk
Author: Dr Shaun Griffin

Last month the world marked Immunization Week, an opportunity to raise awareness about the importance of routine life-saving immunizations and how they have transformed our approach to public health over the course of centuries. Close the Immunization Gap was this year’s theme by the World Health Organisation. Progress towards global vaccination targets for 2015 is far off-track, according to the WHO one in five children still miss out on routine life-saving immunizations that could avert 1.5 million deaths each year from preventable diseases.

The immunization gap also extends to gender, age and sexuality. A vaccination programme against the human papillomavirus (HPV) began in 2008 in the UK for girls aged 12-13 to reduce their risk of developing cervical cancer, which is caused by HPV. However, emerging research over the past eight years has found that cancers of the head, mouth, throat, penis and anus can also be caused by strains of the virus.

The incidence rate of anal cancer in men who have sex with men (MSM) is increasing. Anal cancer incidence rates in MSM are equivalent to the rates that existed for cervical cancer in women before 1988, when the Government introduced the cervical cancer screening programme. Cancer Research UK (CRUK) estimated incidence rate of anal cancer is 78 per 100,000 per year in HIV-positive MSMs who are on HAART (anti-retroviral treatment), compared with 5 per 100,000 per year in HIV-negative MSMs. Around 5,500 men were diagnosed with oral, penile or anal cancer in the UK in 2011.

Heterosexual men gain indirect protection from HPV through “herd protection” if a majority of women in the population are vaccinated. But if men have relationships with women who did not receive the vaccine they are at risk. Additionally, the current programme offers no protection to MSM.

At Terrence Higgins Trust we believe that the HPV vaccine should be extended to all boys irrespective of their sexuality and to MSM as a matter of urgency. This is why we are working with other health organisations as a member of HPV Action to call for the school HPV vaccination programme to include boys as well as girls. Last month Terrence Higgins Trust attended the European Men’s Health Forum (EMHF) HPV Symposium in London. The significant and growing rate of anal and other HPV-related cancers in Europe was described a “time bomb” at the meeting.

We believe that the case for extending the HPV vaccine is a clear and urgent one but progress has not happened at the speed we would like. Since October 2013 the Joint Committee on Vaccination and Immunisation (JCVI) has been considering whether MSM and/or adolescent boys should also be offered the vaccine. The JCVI made an initial recommendation in November 2014 that MSM aged 16-40 should be offered the vaccine in GUM clinics and HIV clinics.

However, the JCVI delayed making its full recommendation until October 2015, following concerns from GUM clinics that the cost for administering the vaccine for MSM would make it not cost-effective. Each delay leaves these groups unprotected against HPV-related cancers and that is why Terrence Higgins Trust is calling for these inequalities to be urgently addressed by the next Government so that the gap for the HPV vaccine is well and truly closed.

Note: Dr Shaun Griffin is Director of External Affairs at Terrence Higgins Trust, the UK’s largest HIV and sexual health charity

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Laser Treatment Halts Oral Mucositis in Its Tracks

Mon, May 4, 2015

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Source: www.medscape.com

Author: Fran Lowry

 

Spa-like treatment with a cool, low-level laser, similar to that use

for wrinkles, vanquishes oral mucositis, one of the most debilitating

toxicities of cancer therapy.

 

“I have been an oncology nurse for over 25 years, and in those 25

years, there has been nothing that helps prevent or is effective

against the treatment for oral mucositis, until now,” said Annette

Quinn, RN, MSN, from the University of Pittsburgh Cancer Institute.

 

“Patients say they rank it higher than nausea and vomiting when it

comes to adverse side effects, especially because we have good

medications to control nausea and vomiting. But the low-level laser

works better than we could have hoped,” Quinn told Medscape Medical

News.

 

She presented results from a pilot project at the Oncology Nursing

Society (ONS) 40th Annual Congress in Orlando, Florida.

 

Oral mucositis affects virtually all head and neck cancer patients

undergoing chemo and radiation therapy, and about 75% to 100% of

patients undergoing stem cell transplantation with whole-body

irradiation experience some degree of oral mucositis.

 

Low-level laser therapy (LLLT) has been used to treat oral mucositis

for a decade in Europe and South America, but it has not made its way

to the United States because there is no mechanism for reimbursement,

Quinn reported.

 

She hopes this study will change that.

 

“Reimbursement is the main obstacle to its use in the United States,

but for this study, I was able to secure the treatment through a

grant. Treating oral mucositis could easily add $20,000 to the cost of

patient care, but with the laser, we can decrease hospital

readmissions and the use of pain medication, IV antibiotics, and

feeding-tube placements. Even though we cannot receive reimbursement,

laser treatment is still cost-effective,” she said.

 

It is thought that LLLT works on the mitochondria to displace the

nitric oxide that is generated as a result of radiation or

chemotherapy, and helps to reoxygenate the cells, Quinn explained.

 

In the pilot project, 52 patients with head and neck cancer, all

deemed to be at high risk for oral mucositis, received LLLT 830 nm

wavelength three times a week, starting the first week of their

radiation treatment and continuing throughout the course of their

radiation therapy.

 

The initial intent was to see if the laser could control the oral

mucositis so patients would not be forced to have a break in their

treatment, Quinn explained.

 

“We know that patients who miss 5 days or more of radiation therapy

have poorer survival, so we wanted to focus on how to get these

patients through with no treatment breaks. We didn’t realize that we

would get them through with no mucositis. But we found that the very

first patient we treated made it all the way through,” she said.

 

None of the 52 patients treated with LLLT developed any oral mucositis.

 

When oncologists treating stem cell transplantation patients

discovered these results, they brought 23 of their stem cell

recipients for LLLT. These patients were treated until their absolute

neutrophil count was above 1000 cell/nm³.

 

Again, results were excellent, although two patients developed grade 3

oral mucositis.

 

“Normally, 100% of stem cell patients develop oral mucositis. It’s

unbelievable what the therapy has done for oral mucositis,” Quinn noted.

 

LLLT Simplicity Itself

 

“The treatment is administered immediately after the radiation

therapy. It takes only about 6 to 8 minutes to administer, and is all

done extraorally; none of the probes actually go into the mouth unless

the patient develops a lesion inside the mouth that we need to target

with the probe,” Quinn explained.

It is simplicity itself, and it works so incredibly well. We just have

to get the word out.

 

“We do five sites along their face, right along the jaw line, and then

we do their tongue. The patients love it. We call it their spa time.

It’s the same laser they use in cosmetics to prevent wrinkles. We have

not had one patient tell us they want to stop their treatment, and we

have had no adverse side effects,” she said.

 

The learning curve is very slight, Quinn added.

 

The training takes about half a day, and learning how to use the

equipment only takes about 30 minutes. “It’s just cold laser therapy,

there’s no heating, there’s no cutting. Nothing. It is simplicity

itself, and it works so incredibly well. We just have to get the word

out,” she said.

 

The poster generated a lot of buzz among the nurses attending the

Congress, noted Ruth C. Gholz, RN, MSN, from the Cincinnati Veterans

Administration Medical Center.

 

“There was a lot of excitement about the laser to treat oral

mucositis. So many people were talking about it,” Gholz told Medscape

Medical News.

 

Oral mucositis is a debilitating side effect that challenges us as we

move forward with patients and providers. Low-level laser therapy has

been a recognized treatment per guidelines, yet many have limited to

no experience in its use,” she said.

 

Gholz explained that these results challenge “all practices to

incorporate low-level laser therapy into their armamentarium.”

 

“The future is bright as we move forward in maximizing this therapy,”

she added.

 

Ms Quinn and Ms Gholz have disclosed no relevant financial relationships.

 

Oncology Nursing Society (ONS) 40th Annual Congress: Abstract 84.

 Presented April 24, 2015.

Medscape Medical News © 2015  WebMD, LLC Send comments and news tips to news@medscape.net.

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

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Three things you might not know about HPV

Wed, Apr 29, 2015

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Source: www.huffingtonpost.ca
Author: Sunnybrook Health Sciences Centre

April 26 to May 2 is National Immunization Awareness week in Canada. One immunization known for raising a lot of questions is the Human Papillomavirus (HPV) vaccination, provided free of charge in Ontario to girls in grades 8-12, and following provincial schedules across the country.

n-HPV-VACCINE-large

While there is lots of information online, at school and at the doctor’s office about HPV, there is still a lot of confusion about what it may mean for your loved ones. Dr. Nancy Durand, gynecologist at Sunnybrook, explains three little-known facts about HPV.

1) HPV causes cancer in men, too
When Michael Douglas candidly revealed his oral cancer was caused by HPV, many people expressed surprise.

Even though HPV has traditionally been thought of as a disease that affects women and mainly causes cervical cancer, men are actually at higher risk of being diagnosed with certain types of HPV-positive cancers than women.

“It’s not well understood why men are at higher risk for HPV-positive oral cancer, but it does point out that vaccination in men is even more important than we may have previously thought,” says Dr. Durand. Physicians are learning more and more that HPV can also cause other cancers in both women and men, such as anal cancers and head & neck cancers (cancers of the base of the tongue, tonsils and soft palate).

2) Not all HPV infections lead to cancer
You’ve probably read some of the (slightly scary) statistics about HPV: Three in four Canadians will get HPV in their lifetime. It can lead to a variety of cancers and cause genital warts, and there is no cure. But should this keep you up at night, worrying about the potentially deadly consequences of HPV?

Hardly, says Dr. Durand. “Most people who are infected with this virus will clear it — probably 80 per cent of people. It’s the other 20 per cent of people with a persistent infection who may be at risk of cancer, and it’s still only a very small percentage of those people who may go on to develop cancer,” she says.

Many people never even realize they’ve had an HPV infection, as there are usually no symptoms, and the infection often goes away on its own.

3) You’re never too old to get the HPV vaccine
What if you didn’t get the HPV vaccine back in middle school, and now you think it’s too late to get it?

“Regardless of your age and your onset of sexual activity, we can vaccinate both men and women, and we can see a reduction in disease,” says Dr. Durand.

It’s actually not too late — the vaccine can still be effective, even in adults who’ve already been sexually active. “Many people think vaccination can only be done before the onset of sexual activity. But regardless of your age and your onset of sexual activity, we can vaccinate both men and women, and we can see a reduction in disease,” says Dr. Durand.

Anyone, male or female, over the age of nine can be vaccinated. So, if you’ve put off getting the vaccine because you thought you were too old, it’s not too late!

Note: Co-authored by Sybil Millar, Communication Advisor at Sunnybrook Health Sciences Centre

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U-M scientists observe deadly dance between nerves and cancer cells

Wed, Apr 29, 2015

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Source: ns.umich.edu
Author: Laura Bailey

In certain types of cancer, nerves and cancer cells enter an often lethal and intricate waltz where cancer cells and nerves move toward one another and eventually engage in such a way that the cancer cells enter the nerves.

The fluorescence image shows the interaction between the nerve (red) and cancer (green). Image credit: Nisha D’Silva

The fluorescence image shows the interaction between the nerve (red) and cancer (green). Image credit: Nisha D’Silva

The findings, appearing in Nature Communications, challenge conventional wisdom about perineural invasion, which holds that cancer cells are marauders that invade nerves through the path of least resistance, said Nisha D’Silva, principal investigator and professor at the University of Michigan School of Dentistry.

D’Silva’s lab discovered that perineural invasion is actually a much more intricately choreographed biochemical give-and-take between the nerves and the cancer cells.

“Once head and neck cancer invades the nerves, it is one of the worst things that can happen,” said D’Silva, who also has a joint appointment at the U-M Medical School Department of Pathology and is a member of the U-M Cancer Center’s Head and Neck Oncology program. “It is highly correlated with poor patient survival, and there is no targeted treatment for it because it is not known why some tumors do this and some don’t.”

Perineural invasion is seen most in head and neck, pancreatic, stomach and colon cancers, and causes severe pain or numbness, tumor spread and recurrence, and loss of function, among other complications.

D’Silva’s lab found that perineural invasion begins when the nerve releases a stimulus that triggers a specific protein receptor in cancer cells. The receptor activates instructions in the cancer and releases the same stimulus back to the nerve.

The photomicrograph shows a nerve (central structure) invaded by cancer cells. Image credit: Nisha D’Silva

The photomicrograph shows a nerve (central structure) invaded by cancer cells. Image credit: Nisha D’Silva

The nerve recognizes the stimulus, which causes the nerve to ‘reach’ toward the cancer—imagine two dancers recognizing each other across a room and slowly moving closer until they become permanent partners. After this initial pairing up, the loop continues.

“Basically it’s like they are waltzing,” D’Silva said. “It is a very elegant dance, if you will.”

It is extremely difficult to study perineural invasion in head and neck cancer, so D’Silva’s lab had to develop a way to observe these interactions in live samples. First, researchers implanted the nerve in chick egg membranes, and after the nerve integrated, they studied the interactions between the nerve and head and neck cancer cells.

D’Silva said the next steps in the research are to find out, “when and how we can interrupt the dance.”

The study is called “Galanin modulates the neural niche to favor perineural invasion in head and neck cancer.”

Note:
Christina Scanlon, a recently graduate of the U-M School of Dentistry, is first author on the paper. Other co-authors include: Rajat Banerjee, Ronald Inglehart, Min Liu, Nickole Russo, Amirtha Hariharan, Elizabeth Van Tubergen, Sara Corson and Charlotte Mistretta of U-M Dentistry; and Irfan Asangani and Arul Chinnaiyan of the U-M Medical School.

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Turmeric spice potential for oral cancer – curcumin quiets HPV

Wed, Apr 29, 2015

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Source: www.science20.com
Author: staff

Turmeric, the familiar yellow spice common in Indian and Asian cooking, may play a therapeutic role in oral cancers associated with human papillomavirus, according to new research published in ecancermedicalscience. One of the herb’s key active ingredients – an antioxidant called curcumin – appears to have a quelling effect on the activity of human papillomavirus (HPV).

HPV is a virus that promotes the development of cervical and oral cancer. There is no cure, but curcumin may offer a means of future control.

“Turmeric has established antiviral and anti-cancer properties,” says corresponding author Dr. Alok Mishra of Emory University. “And according to our new findings, we could say that it’s good for oral health too.”

Mishra’s research group first noted the effect of curcumin on HPV and cervical cancer cells in 2005. The antioxidant slowed the expression of HPV, suggesting that curcumin could control the extent of HPV infection.

“Since HPV-related oral cancer cases are on the rise, we tested the same hypothesis on oral cancer,” Mishra says. “They turned out to be some very interesting findings.”

The new research indicates that curcumin turns down the expression of HPV in infected oral cancer cells by downregulating the levels of cellular transcription factors AP-1 and NF-kB.

These findings could suggest a new therapeutic role for cucurmin in cancer control.

While Mishra cannot comment on the therapeutic benefits of turmeric in cooking, he says that the use of turmeric and other antioxidants may be good for health in general, and HPV-related oral cancers in particular.

Citation: Alok Mishra, Rakesh Kumar, Abhishek Tyagi, Indu Kohaar, Suresh Hedau, Alok C Bharti, Subhodeep Sarker, Dipankar Dey, Daman Saluja, Bhudev Das, ‘Curcumin modulates cellular AP-1, NF-kB, and HPV16 E6 proteins in oral cancer’, ecancermedicalscience 22 Apr 2015 DOI: 10.3332/ecancer.2015.525

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Double the N.I.H. Budget

Wed, Apr 22, 2015

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Source: NYTimes.com
Author: Newt Gingrich

MCLEAN, Va. — NO one who lived through the 1990s would have suspected that one day people would look back on the period as a golden age of bipartisan cooperation. But in some important ways, it was. Amid the policy fights that followed the Republican victories of 1994, President Bill Clinton and the new majorities in Congress reached one particularly good deal: doubling the budget for the National Institutes of Health.

The decision was bipartisan, because health is both a moral and financial issue. Government spends more on health care than any other area. Taxpayers spend more than $1 trillion a year for Medicare and Medicaid alone, and even more when you add in programs like Veterans Affairs, the Children’s Health Insurance Program and the Indian Health Service.

Unfortunately, since the end of the five-year effort that roughly doubled the N.I.H. budget by 2003, funding for the institutes has been flat. The N.I.H. budget (about $30 billion last year) has effectively been reduced by more than 20 percent since then. As 92 percent of the N.I.H. budget goes directly to research, one result is that the institutes awarded 12.5 percent fewer grants last year than in 2003. Grant applications, over the same period, increased by almost 50 percent.

Even as we’ve let financing for basic scientific and medical research stagnate, government spending on health care has grown significantly. That should trouble every fiscal conservative. As a conservative myself, I’m often skeptical of government “investments.” But when it comes to breakthroughs that could cure — not just treat — the most expensive diseases, government is unique. It alone can bring the necessary resources to bear. (The federal government funds roughly a third of all medical research in the United States.) And it is ultimately on the hook for the costs of illness. It’s irresponsible and shortsighted, not prudent, to let financing for basic research dwindle.

For example, the total cost of care for Alzheimer’s and other dementia is expected to exceed $20 trillion over the next four decades — including a 420 percent increase in costs to Medicare and a 330 percent increase in costs to Medicaid. Even without a cure, the premium on breakthrough research is high: Delaying the average onset of the disease by just five years would reduce the number of Americans with Alzheimer’s in 2050 by 42 percent, and cut costs by a third. And that’s not even counting the human toll on both patients and caregivers (often family members), whose own health may deteriorate because of stress and depression.

Yet the N.I.H. is spending just $1.3 billion a year on Alzheimer’s and dementia research — or roughly 0.8 percent of the $154 billion these conditions will cost Medicare and Medicaid this year, more than all federal education spending.

Alzheimer’s isn’t unique: Diabetes, kidney disease, heart disease, cancer, stroke and arthritis all cost enormous sums and cause incredible suffering. But the promise of breakthrough cures and treatments for this disease is amazing. The N.I.H. is funding a clinical study that represents a potential paradigm shift in treatment. Rather than try to eliminate the buildup of plaques in the brain after the onset of dementia, researchers are studying interventions in families with a genetic predisposition to early onset Alzheimer’s to prevent the disease before symptoms even develop.

The N.I.H. is also pioneering the development of immunotherapies, which are already allowing doctors to spur patients’ immune systems to attack cancer and other diseases rather than relying solely on surgery, radiation and chemotherapy. The N.I.H. recently discovered a vaccine that appears to cure an AIDS-like virus in monkeys. The insights from genetics, personalized medicine and regenerative therapies could potentially lead to substantially longer and healthier lives for many. But to achieve that promise will require a greater budget.

Representatives Fred Upton, Republican of Michigan and the chairman of the House Energy and Commerce Committee, and Diana DeGette, Democrat of Colorado, have put forward an initiative, 21st Century Cures, to explore ways to promote the discovery of medical breakthroughs as well as access to new technologies. Ms. DeGette and another committee

member, Michael C. Burgess, Republican of Texas and a physician, have called for requiring the Congressional Budget Office to factor in the savings from preventive health measures when “scoring” the financial impact of proposed legislation, at the request of Congress. In the Senate, Lamar Alexander of Tennessee, Ron Johnson of Wisconsin and Jerry Moran of Kansas, all Republicans, have championed increasing funding for basic research.

House and Senate negotiators are at work on a budget resolution for the fiscal year that starts on Oct. 1, and the N.I.H. should be a priority. Doubling the institutes’ budget once again would be a change on the right scale, although that increase should be accompanied by reforms to make the N.I.H. less bureaucratic, to give the director more flexibility to focus resources on the most common and expensive health problems, and to place a stronger emphasis on truly breakthrough research.

We are in a time of unimaginable scientific and technological progress. By funding basic medical research, Congress can transform our fiscal health, and our personal health, too.

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

Wed, Apr 22, 2015

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Source: www.marketwatch.com
Author: press release

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

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

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

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

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

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

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

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