Youth vaping has soared in 2018, new data show

Source: www.wsj.com
Authors: Betsy McKay and Jennifer Maloney

Number of high schoolers who used e-cigarettes in the past 30 days has risen some 75% in 2018

Teen use of e-cigarettes has soared this year, according to new research conducted in 2018 that suggest fast-changing youth habits will pose a challenge for public-health officials, schools and parents.

The number of high-school students who used e-cigarettes in the past 30 days has risen roughly 75% since last year, according to a person who has seen new preliminary federal data.

That would equate to about three million, or about 20% of high-school students, up from 1.73 million, or 11.7% of high-school students in the most recently published federal numbers from 2017.

Nearly a third of 13-to-18-year-olds who responded to a separate survey conducted by The Wall Street Journal with research firm Mercury Analytics said they currently vape.

The new numbers offer a rare look at evolving teen vaping habits. Sales of e-cigarettes are expected nearly to double this year over 2017, and researchers have wondered how much of that increase is because of teen use. But there can be a long lag time between the collection of data and public reports.

Most of the teens who vape said they are doing it for reasons other than to quit smoking, according to the Journal’s survey conducted in 49 states in May. More than half said they do it because they like the flavors that e-cigarette liquids come in and they think vaping is fun. More than two-thirds said they believe vaping can be part of a “healthy life.”

U.S. Food and Drug Commissioner Scott Gottlieb said last week that teen use “has reached an epidemic proportion.” He announced new measures to curb teen vaping and warned he is considering banning flavored products.

The preliminary federal numbers from 2018 are from the government’s latest National Youth Tobacco Survey, according to the person familiar with the data. The survey was conducted in the spring.

The number of high-school users of combustible, or traditional, cigarettes increased slightly from the 2017 survey, this person said.

Monitoring the Future, a long-running youth survey conducted by the University of Michigan, found in 2017 that 16.6% of 12th-graders and 13.1% of 10th-graders had vaped nicotine, marijuana or flavoring in the previous 30 days. Richard Miech, the survey’s principal investigator, said he believes there has been a “considerable jump” in adolescent vaping this year.

This year’s sales growth has been driven largely by the Juul, a slim device that resembles a flash drive and has become a status symbol among teens, who often vape sweet-flavored liquids like mango. Juul has a 72.8% dollar share of the estimated $2.5 billion market in channels measured by market-research firm Nielsen, according to a Wells Fargo analysis.

Health officials are concerned that the high levels of nicotine in some liquids can alter the chemistry of developing brains, making them more sensitive to addiction.

Juul Labs Inc. says its device is intended to help adult smokers quit. “We cannot be more emphatic on this point: No minor or non-nicotine user should ever try JUUL,” a spokeswoman said. “Our packaging includes a prominent nicotine label and clearly states for adult smokers.”

Parents and educators say they are trying to do more to combat vaping with children back to school. “There is a lot more that needs to be done because at this point there are so many thousands of kids who are addicted to nicotine,” said Meredith Berkman, a founder of Parents Against Vaping E-Cigarettes, which advocates for action to restrict e-cigarette access.

Trinity School in New York City, for example, plans this year to incorporate more material on e-cigarettes into its health-education program for students, said John Allman, head of school. “Parents are letting us know about this,” he said of teen use.

The Journal survey was conducted online with 1,722 participants initially, and most of the survey questions focused on 1,007 participants who said they either vape, used to vape, or know someone who vapes. Nearly three-quarters of the 1,007 participants were 17 or 18 years old; 62% were white, 21% were African-American and 18% were Hispanic. Rates of e-cigarette use are higher in older than younger teens.

A total of 501 participants said they vape: 153 regularly, and 348 occasionally. Their most common reasons for vaping were for the flavors, and because they think it’s cool. “I just enjoy the flavor and blowing really big clouds,” one participant wrote.

“It made me feel good the first time I tried it, and I got hooked,” wrote another.

When asked what they were inhaling, 71% said flavors, and 61% said nicotine.

More than two-thirds of the current vapers said they believe vaping can be part of a healthy life, though they believe there are some risks. More than half said their views of vaping had been influenced by posts on social media, an issue that has public-health experts concerned.

The percentage of respondents who said they vape is unusually high, and should be interpreted with caution, said David Abrams, a professor in the College of Global Public Health at New York University. “We can’t make too much of it,” he said, because the survey was conducted online, and the questions weren’t all asked the way they are asked on large academic or government surveys.

Measures taken by the FDA, Juul, schools and parents to limit underage access to vaping devices since this spring may also be having an effect, some experts say. “It’s possible that prevalence and use may decline over time,” said Jidong Huang, an associate professor of health management and policy at Georgia State University who studies e-cigarette use.

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September, 2018|Oral Cancer News|

RJR Slapped with $6.5M verdict over musician’s mouth cancer

Source: blog.cvn.com
Author: Arlin Crisco

R.J. Reynolds was hit with a $6.5 million verdict Tuesday for the part jurors found the company played in the mouth cancer a Florida musician developed after years of smoking. Harewood v. R.J. Reynolds, 2007-CA-46331.

The award followed the Florida 11th Circuit Court jury’s conclusion that nicotine addiction and cigarettes caused the oral cancer doctors diagnosed Glenn Simmons with in 1995. Simmons, a bassist in bands throughout much of his life, began smoking as a teenager and smoked about a pack a day for decades. He died in 2003, at age 48, from complications related to cancer-related radiation therapy. Monday’s verdict found Reynolds liable on fraud and conspiracy claims related to a sweeping scheme to hide the dangers of cigarettes. However, while jurors awarded Simmons’ daughter, Hanifah Harewood $6.5 million in compensatory damages, they rejected a claim for punitives in the case.

The case is one of thousands of Florida’s Engle progeny lawsuits against the nation’s tobacco companies. They stem from a 2006 Florida Supreme Court decision decertifying Engle v. Liggett Group Inc., a class-action tobacco suit originally filed in 1994. Although the state’s supreme court ruled that Engle progeny cases must be tried individually, it found plaintiffs could rely on certain jury findings in the original case, including the determination that tobacco companies had placed a dangerous, addictive product on the market and had conspired to hide the dangers of smoking through much of the 20th century.

In order to be entitled to those findings, however, each Engle progeny plaintiff must prove the smoker at the heart of their case suffered from nicotine addiction that legally caused a specific smoking-related disease.

Key to the seven-day Simmons trial was the link between his smoking and his mouth cancer. During Monday’s closings, Reynolds’ attorney, King & Spalding’s Randall Bassett, argued the cancer’s location and Simmons’ relatively young age at diagnosis were inconsistent with smoking-related oral cancer. Bassett noted that defense expert Dr. Samir El-Mofty, an oral pathologist from Washington University, concluded Simmons’ cancer stemmed from an infection related to a tooth extraction. “Not a cancer caused by smoking, but a cancer caused by a virus that sometime along the way Mr. Simmons had been exposed to,” Bassett said.

But Harewood’s attorney, Koch, Parafinczuk, Wolf & Susen’s Austin Carr reminded jurors that Simmons’ treating physician, Dr. Francisco Civantos, a South Florida otolaryngologist, believed cigarettes caused Simmons’ cancer. “Dr. Civantos is the more credible, experienced, the more competent physician and surgeon,” Carr said during Monday’s closings. “He is the doctor that you should believe over [the defense] witness.”

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September, 2018|Oral Cancer News|

HPV-related cancer rates outpace vaccinations

Source: www.ctpost.com
Author: Cara Rosner, Conn. Health

Cancers linked to the human papillomavirus, commonly called HPV, rose dramatically in a 15-year period, even as the rates of young people being vaccinated climbed, the Centers for Disease Control and Prevention reported.

The 43,371 new cases of HPV-associated cancers reported nationwide in 2015 marked a 44 percent jump from the 30,115 cases reported in 1999, according to a CDC analysis. HPV vaccination rates have improved over the years, but not fast enough to stem the rise in cancers, the CDC said.

Oropharyngeal, or throat, cancer was the most common HPV-associated cancer in 2015, accounting for 15,479 cases among males and 3,438 among females. HPV infects about 14 million people each year. Between 1999 and 2015 rates of throat and vulvar cancer increased, vaginal and cervical cancer rates declined, and penile cancer rates were stable, according to the CDC.

“The (overall rise) seems to be mostly driven by oropharyngeal cancers,” said Dr. Sangini Sheth, assistant professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine.

“Vaccination is key to preventing those cancers,” said Sheth, who also is an associate medical director and director of colposcopy and cervical dysplasia at Yale New Haven Hospital’s Women’s Center. “Oropharyngeal cancer is most common in men, and HPV vaccination rates, while they are rising in the U.S. and Connecticut, became routine for boys later (than girls). And the rate of vaccinations among boys has definitely lagged that of girls. Hopefully, we will see vaccinating our boys have an impact on oropharyngeal cancer, but that’s going to take time.”

The push to vaccinate adolescents against HPV is a relatively recent development. The vaccination was included in the routine immunization program for females in 2006 and for males in 2011, according to the CDC.

At one time, the HPV-vaccine was viewed largely to prevent sexually transmitted diseases, and some parents “resented” it and thought it was unnecessary for their children, according to Dr. Richard Brauer, section head of otolaryngology at Greenwich Hospital. Now it’s marketed as a cancer vaccine and parents have become more receptive, said Brauer, who also has a private practice, Associates of Otolaryngology, in Greenwich.

In 2017, 65.5 percent of adolescents aged 13 to 17 nationwide had at least one dose of the HPV vaccine, up 5.1 percentage points from 2016, according to CDC data released in August.

In Connecticut, 75.4 percent of girls aged 13 to 17 had one dose of the vaccine, 67.1 percent had two doses and 58.4 received three doses. Among males, 67.3 percent received one dose, 58.8 percent got two and 37.8 percent got three, the 2017 data show. But even amid overall gains, hurdles remain. Gender disparity persists, and many teens received the first vaccine dose but failed to get necessary subsequent doses.

Children who are 11 or 12 years old should get two shots of HPV vaccine six to 12 months apart, according to the CDC. Adolescents who get their shots less than five months apart need a third dose of the vaccine, as do all children older than 14. Three doses also are recommended for people ages nine to 26 who have certain immunocompromised conditions.

“It falls on the parent” whether children get vaccinated, said Dr. Bradford Whitcomb, chief of gynecologic oncology at UConn Health. “People associate HPV with female stuff. It needs to be pushed that we’re not just preventing female cancers.”

While it’s encouraging that vaccination rates are climbing, “we just may not see the benefit of that for years to come,” Whitcomb said. “It’s going to take a longer time, especially with the development of cancer, to see the effect. After the HPV infection, it can take years for a cancer to develop.”

Many people exposed to HPV will never get cancer, doctors said. The most common HPV-associated cancer among women is cervical cancer. Data show rates of that cancer are falling, but there are racial disparities.

Between 2011 and 2015, Hispanic women had the highest incidence rates of cervical cancer at 8.9 percent, according to an analysis by the Kaiser Family Foundation. That compares with 8.4 percent among black women, 7.4 percent among white women and 6.1 percent among Asian and Pacific Islander women.

Cervical cancer mortality rates also showed racial disparities during that time. Black women had the highest mortality rate at 3.7 percent, compared with 2.6 percent among Hispanics, 2.2 percent among whites and 1.8 percent among Asians and Pacific Islanders, data show.

It is crucial for doctors to talk to young patients and their parents about the HPV vaccine, even if it spurs conversations parents may feel awkward having, Sheth said.

“Clinicians need to feel comfortable normalizing the HPV vaccine and really present the HPV vaccine as a cancer prevention tool,” she said.

Note:
This story was reported under a partnership with the Connecticut Health I-Team, a nonprofit news organization dedicated to health reporting. (c-hit.org)

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September, 2018|Oral Cancer News|

Men with more than two oral sex partners are more likely to contract HPV

Source: www.nzherald.co.nz
Author: Rebecca Sullivan

Men who have had more than two oral sex partners are “significantly” more likely to contract HPV, a viral infection that can develop into oesophageal cancer, a new study has found.

HPV, or the human papillomavirus, causes about 20-25 per cent of oesophageal cancer cases, said Professor Shan Rajendra from UNSW’s Ingham Institute.

Men are three times more likely than women to contract HPV through oral sex. Smoking and drinking are also big risk factors causing oesophageal cancer, reports news.com.au.

Actor Michael Douglas, who smoked and drank excessively, famously went public about the cause of his own oesophageal cancer after being diagnosed in August 2010.

“This particular cancer is caused by HPV [human papillomavirus], which actually comes about from cunnilingus.” Douglas, the husband of Catherine Zeta Jones, told The Guardian in 2013. “It’s a sexually transmitted disease that causes cancer.”

The study was presented at the Gastroenterological Society’s annual Australian Gastroenterology Week last weekend and was also published in the academic journal Diseases of the Oesophagus.

“What we found was that if you had more than two oral sex partners in your lifetime, then you increase your risk of HPV-associated esophageal cancer significantly,” Professor Rajendra said.

“It’s sexually transmitted. You swallow the virus and it gets absorbed by the body and gets into the lining of the oesophagus. In some people it doesn’t get cleared by the immune system. In most people it gets cleared but if it doesn’t get cleared it can cause cancers of the head and neck,” he said.

Straight men who perform cunnilingus are three times more likely than women to contract the virus, because vaginal fluid has a higher viral load and men’s bodies are less able to clear the virus, Prof Rajendra said.

Australia was the first country in the world to offer a vaccine for HPV. Introduced in 2008, it was a compulsory vaccine for teenage girls in years 11 and 12.

But the good news is the treatment success rates of oesophageal cancer are actually higher among those who contracted the disease via HPV. The prognosis is not as good for people whose throat cancer is caused by poor lifestyle choices such as smoking and drinking.

Professor Shan Rajendra’s study of 142 patients with esophageal cancer found those who were “virus positive” — meaning they developed the disease through having HPV — had the earliest stage cancers and responded best to treatment.

“They were responding to surgery or endoscopic treatments so much better than those who were virus negative. They also responded better to chemotherapy and radiotherapy,” he said.

“People with the virus live longer because their cancer proteins knock off the normal conventional pathway to cancer. That gives a favourable prognosis.”

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September, 2018|Oral Cancer News|

FDA to review application to modify health warning on Altria subsidiary’s smokeless tobacco product

Source: www.richmond.com
Author: staff

The U.S. Food and Drug Administration will review a request from an Altria Group Inc. subsidiary that wants to make the claim that a smokeless tobacco product is less dangerous than cigarettes. U.S. Smokeless Tobacco Co. said Friday that the FDA has agreed to do a substantive review of its “modified risk” application for Copenhagen Snuff Fine Cut. The company submitted the request for review earlier this year.

The snuff company wants to be able to use the claim “If you smoke consider this: Switching completely to this product from cigarettes reduces risk of lung cancer.”

The FDA requires smokeless tobacco products to carry statements that warn about the risk of mouth cancer, gum disease, tooth loss and addiction and that the product is not a safe alternative to cigarettes. The warnings are to be randomly rotated on packaging.

“We filed this application because we think adult smokers looking for potential reduced risk alternatives to cigarettes should have accurate information about the relative risks of Copenhagen Snuff,” Joe Murillo, Altria Client Services senior vice president for regulatory affairs, said in a statement.

The FDA defines modified risk tobacco products as tobacco products that are sold or distributed for use to reduce harm or the risk of tobacco-related disease associated with commercially marketed tobacco products.
In the review process, the FDA’s Tobacco Products Scientific Advisory Committee vets the scientific claims and makes a recommendation.

The FDA has reviewed more than 30 modified risk applications from tobacco companies since 2011, but none has been approved. Some remain under review, while others were denied by the agency or withdrawn by the companies that submitted them.

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September, 2018|Oral Cancer News|

Scientists map interactions between head and neck cancer and HPV virus

Source: medicalxpress.com
Author: staff, Gladstone Institutes

Human papillomavirus (HPV) is widely known to cause nearly all cases of cervical cancer. However, you might not know that HPV also causes 70 percent of oropharyngeal cancer, a subset of head and neck cancers that affect the mouth, tongue, and tonsils. Although vaccines that protect against HPV infection are now available, they are not yet widespread, especially in men, nor do they address the large number of currently infected cancer patients.

Patients with head and neck cancer caused by HPV respond very differently to treatments than those whose cancer is associated with the consumption of tobacco products. The first group generally has better outcomes, with almost 80 percent of patients surviving longer than 5 years after diagnosis, compared to only 45-50 percent for patients with tobacco-related cancers.

To better understand what might cause these differences, a team of scientists led by Nevan J. Krogan, Ph.D., senior investigator at the Gladstone Institutes, is taking a unique approach by focusing on the cancer-causing virus. They recently mapped the interactions between all HPV proteins and human proteins for the first time. Their findings are published today in the journal Cancer Discovery.

“With our study, we identified several new protein interactions that were previously not known to cause cancer, expanding our knowledge of the oncogenic roles of the HPV virus” said Krogan, who is also a professor of cellular and molecular pharmacology at UC San Francisco (UCSF) and the director of the Quantitative Biosciences Institute (QBI) at UCSF. “The human proteins we found interacting with HPV are involved in both virus- and tobacco-related cancers, which means they could be potential targets for the development of new drugs or therapies.”

A Complete Picture of Virus-Cancer Connections
Krogan and Manon Eckhardt, Ph.D., a postdoctoral scholar in his laboratory at Gladstone, developed an integrated strategy to identify all the interactions between HPV proteins and human proteins. First, using a method called mass spectrometry, they discovered a total of 137 interactions between HPV and human proteins.

Then, in collaboration with computational biologist Wei Zhang, Ph.D., in the laboratory of Trey Ideker, Ph.D., at UC San Diego School of Medicine, they looked at entire networks of each protein—rather than only individual proteins—to detect the most important players. They also compared their list of proteins with data from HPV-associated cancer samples published by The Cancer Genome Atlas project. This large consortium catalogued genetic mutations in tumors of various cancers.

“We integrated together these two sets of data to get a comprehensive look at potential cancer-causing interactions between HPV and head and neck cancers,” said Krogan, who is co-director of the Cancer Cell Map Initiative. “This combined proteomic and genetic approach provided us with a systematic way to study the cellular mechanisms hijacked by virally induced cancers.”

Common Pathways in HPV-Induced and Smoking-Related Cancers
By overlaying the protein interaction and genomics data, the scientists discovered that the HPV virus targets the same human proteins that are frequently mutated in smoking-related cancers. Interestingly, those proteins are not mutated in HPV-positive cancers.

For example, their findings reconfirmed a well-established interaction between the human protein p53 and an HPV protein called E6. In HPV-negative cancers (those related to smoking), p53 is mutated in nearly all cases. However, the same protein is rarely ever mutated in HPV-positive cancer patients.

“In both cases, when p53 is inactivated, it leads to cancer,” explained Eckhardt, one of the first authors of the paper. “The difference is that the HPV virus finds a different way of attacking the same protein.”

In smoking-related cancers, p53 is mutated, which causes the cancer. Instead, in HPV-positive cancers, the viral protein E6 interacts with p53 and inactivates it, resulting in the same cancer, but without the mutation. This suggests the establishment of the viral infection and the development of tumors share common pathways.

“We thought there must be more proteins that can cause cancer either by being mutated or hijacked by HPV, so we developed a new method to detect them,” added Eckhardt. “Our study highlighted two interesting instances where the interaction of HPV and human proteins play a role in the development or invasiveness of the cancer.”

Eckhardt showed that the HPV protein E1 interacts with the human protein KEAP1, which is often mutated in smoking-related cancers. In HPV-positive cancers, KEAP1 is not mutated. But, through its interaction with the protein E1, KEAP1 is inactivated, which helps cancer cells survive.

The researchers also found that the HPV protein L2, which is part of the virus’s packaging, interacts with two human proteins called RNF20 and RNF40. They demonstrated that in HPV-positive cancers, this protein interaction increases the tumor’s ability to spread and invade new parts of the body.

These results confirm that the HPV virus causes head and neck cancer by targeting the same proteins that go awry in response to smoking-induced mutations.

Connecting Cancer and Infectious Diseases
Krogan and his collaborators have shown that integrating HPV-human interaction with tumor genome data, and focusing on genes that are mutated in HPV-negative but not HPV-positive tumors, constitutes a powerful approach to identify proteins that serve as both viral targets and genetic drivers of cancer.

The scientists’ work should lay the groundwork to find better therapeutic options for both HPV-negative and HPV-positive head and neck cancers. In addition, Krogan’s long-term goal is to define a pipeline that will enable the study of many other virally induced cancers, including those linked to Hepatitis B and C, Epstein-Barr virus, and adenoviruses.

“Science can be siloed, and through these unbiased, holistic approaches we can start to find common pathways between different systems,” said Krogan, who also leads the Host Pathogen Map Initiative, which aims to compare protein and genetic interactions across many pathogens and identify similarities. “Our work is helping connect the dots between cancer and infectious diseases in ways that have never been considered.”

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September, 2018|Oral Cancer News|

Why I tell Everyone I have HPV

Source: bustle.com
Author: Emma McGowen

I have HPV. Or, to be more accurate, I was diagnosed with HPV when I was 19 and found a little bump on my vulva in an area where there was no chance it could be an ingrown hair. The nurse at the health clinic at my college put acid on it, watched while it turned white, and told me it was definitely a wart. That was the one and only “outbreak” I’ve ever had, but it was enough for me to say, sure, I have HPV. And I’m not shy about telling people that.

But I wasn’t always this chill about it. When I was diagnosed, I basically lost it. I fell right down the slut-shaming hole. I told myself that was “what I get” for sleeping around, and cycled through the usual you can never have sex again/HPV doesn’t go away/your vagina is going to be covered in hideous warts/YOU’RE A TERRIBLE PERSON thoughts that so many of us go through when we get an STI diagnosis. Mid-freak out, I called a close friend. “Oh yeah, I have it, too,” she said. I got the same response from a female family member. And that’s when I calmed down and realized — HPV isn’t a big deal.

Or, at least, the type of HPV I have isn’t a big deal. What I didn’t know at the time of diagnosis — but learned with a little Googling and had reinforced since, in my training as a sex educator — is that the strains of HPV that cause warts don’t have any other negative health effects. Specifically, if you have a strain of HPV that causes warts, it won’t cause cancer. And the strains that cause cancer don’t cause warts. So while the kind that I was diagnosed with has a visible component, it’s really no more annoying than the occasional pimple. And I’ve had way more pimples since I was 19 than I’ve had warts.

The other thing I’ve realized about HPV is that it’s ridiculously common. Because HPV is a skin-to-skin STI, there’s no way to protect 100 percent against it, other than never touching another human being again. Also, most people with penises carry the virus, but don’t show any symptoms — and can still spread it. So there’s no way for them to know if they have it and no way for the people who are sleeping with them to know, either. As a result of all of these factors, the CDC estimates that anyone not vaccinated against HPV will have it at some point in their lives.

Did you catch that? I’m going to repeat it, really loudly, just in case: the CDC says that anyone who is not vaccinated against HPV will have it at some points in their lives.

And here’s another fun fact: Contrary to the popular belief that HPV “never goes away,” many people actually clear the virus. That’s especially true for young people — which is the group in which the virus shows up most frequently — who get it. It’s also why the CDC doesn’t say “everyone has HPV” but that everyone who isn’t vaccinated “will get HPV at some time in their life.” So even though I was diagnosedwith HPV when I was 19, I don’t necessarily have it now, at 31. Does that mean I for sure don’t? Nope. Does that mean I for sure don’t carry other strains of the virus, including the cancer-causing ones? Nope. And that’s why I go regularly for Pap tests, which are a great method of early detection of irregular cells caused by HPV that can morph into cervical cancer. And also another reason why I honestly DGAF about my HPV status.

So if everyone will get it at some point or another, why do we still freak out about it? The answer is simultaneously really simple and really complicated: STI stigma. STI stigma is the overblown fear and shame so many of us carry about STIs. It’s the idea that getting an STI somehow means a person is “dirty” or “immoral” or a “slut.” It’s the idea that an STI is somehow worse than any other illness that one human picks up from another human. And you know why so many of us believe that? Because our culture teaches us that sex — especially for pleasure or outside of heterosexual marriage — is wrong.

With that in mind, my challenge to you is this. Ask yourself: Do I think sex outside of heterosexual marriage is wrong? Do I think sex for pleasure is wrong? Do I think people who have that kind of sex are bad? If the answer is yes, then you will probably continue thinking that people with STIs are dirty or immoral. And while I disagree with you, that’s your choice.

But if the answer is no, then I ask you: What makes an STI so much more morally wrong than any other illness? Nothing. And when you think about it that way, STI stigma and freaking out about an STI diagnosis — the way I did when I was 19 — just doesn’t make any logical sense. I don’t beat myself up when I get a cold, so why would I beat myself up for getting HPV? In both cases, there are things I could have done to be “safer” and protect myself against the virus but, hey, life happens.

So, yeah, I tell everyone I have HPV. Because, ultimately, it’s not a big deal, and because talking about it can help to eliminate some of that stigma. I also carry many forms of the common cold virus. Want to talk about that, too?

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September, 2018|Oral Cancer News|

Italy Is Living Through What Happens When Politicians Embrace Anti-Vaxxers

Source: Huffingtonpost.com
Author: Nick Robins-Early

Italy’s Five Star movement, which was founded by a man who once called HIV a hoax, campaigned against mandatory vaccinations ahead of the country’s elections in March — and won. Last month, party leaders pushed through a law that ended compulsory immunizations for children attending public school.

The new law has made Italy the darling of the global anti-vaxxer movement. But now the country is struggling to stop a measles outbreak that has already infected thousands of people, and Europe is recording its highest number of cases in a decade — an inevitable and foreseeable result of anti-vaccine policies and rhetoric, experts say.

“Europe now is a good example of what happens when coverage of vaccinations is in decline,” said Vytenis Andriukaitis, the European Commissioner for Health and Food Safety.

The efforts of Five Star and its far-right coalition partner, the League, have particularly complicated the global campaign to combat measles, an extremely contagious virus that often spreads among children and can result in severe complications, including pneumonia and encephalitis. The World Health Organization in 2012 set the goal for Europe to eliminate the disease by 2015. Instead, an estimated 41,000 people across the continent have been infected in the first six months of this year.

Even a slight dip in a population’s vaccination rate can have disastrous effects: Countries need at least a 95 percent coverage rate to be measles-free. So when fewer people get vaccinated, kids get sick.

“We’ve got this terrible self-inflicted wound where you’re reversing public health gains in Europe and the U.S.,” said Peter Hotez, dean for the National School of Tropical Medicine at Baylor College of Medicine.

Five Star and the League have sometimes framed their efforts to do away with compulsory immunizations as a way for parents to make their own health decisions, rather than limiting vaccinations in the country. And Luigi Di Maio, Five Star’s current party leader, has recently tried to tamp down on outright anti-vaccine conspiracies.

But the rhetoric and proposals of other prominent party figures and their allies are much more radical. One top Five Star official, Paola Taverna, last month backed hazardous “measles parties” where children gather to infect each other and build up immunity. League party leader Matteo Salvini described mandatory vaccinations as “useless and in many cases dangerous” in June. Some party candidates and top officials went further, falsely claiming vaccines cause autism and referring to state-funded vaccination as “free genocide.”

These politicians’ rhetoric is in line with anti-vaccine groups that couch conspiracies and opposition to vaccinations in appeals to personal choice and pseudoscience. “They use these phony terms that really have no meaning … like medical freedom and vaccine choice,” Hotez said. “What these [anti-vaccine] groups are really doing is depriving children of fundamental rights.”

In a little over three months in office, Five Star and the League have furthered the goals of a small but vocal anti-vaccine community.

Just a year ago, Italy looked like it was on a path to solving its measles outbreak. The country’s previous government passed a law that required children to receive 10 vaccinations in order to attend state-run schools.

The law received the backing from infectious disease experts from the World Health Organization and Italian doctors, but was fiercely opposed by Europe’s well-organized anti-vaccine movement.

“It’s quantitatively a very small group, but qualitatively they are noisy and very, very aggressive,” said Walter Ricciardi, president of the Italian National Institute of Health.

Anti-vaccine protesters attacked government deputies outside of the Italian parliament. They held rallies in the streets of Rome. A group of 130 families wrote to Italy’s president claiming they would seek asylum in Austria to avoid the vaccinations. At one of Health Minister Beatrice Lorenzin’s events promoting her book, activists screamed accusations that she was killing children.

Prominent international anti-vaxxer organizations, a network made up of activists and even some disgraced doctors, latched on to Italy as a symbol of resistance, and posts on anti-vaxx forums lauded the demonstrations. The League and Five Star parties capitalized on the unrest and criticized the law as government overreach.

“The law was good and it was working, then the major leaders of the two parties made unscientific comments on vaccines,” Ricciardi said.

Stopping the outbreak became less important to Five Star and the League than appealing to the anti-establishment sentiment that ushered the parties into power, critics allege.

“They wanted the votes of anti-vaxxers and people that consider the law of compulsory vaccination a violation of personal freedom,” said Stefano Zona, a doctor of infectious diseases and member of IoVaccino, an Italian nonprofit that seeks to correct misinformation around vaccines.

“They are feeding the anti-vaxxer movement,” he said.

The U.S. has also had several major measles outbreaks in recent years, in part driven by anti-vaccine activists and linked to lower vaccination rates in some communities. And American politicians aren’t much more restrained than their Italian counterparts in fueling vaccine skepticism. President Donald Trump questioned the safety of vaccines during a 2015 Republican presidential debate and spent years promoting anti-vaxxer conspiracies.

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September, 2018|Oral Cancer News|

Study: HPV cancer survivors at risk for second HPV cancer

Source: www.bcm.edu
Author: Dipali Pathak

A retrospective study led by researchers at Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth) School of Public Health found that survivors of HPV-associated cancers have a high incidence of developing second HPV-related cancers. Their findings, which were reported today in JAMA Network Open, suggest the need for increased screening for HPV-associated precancerous and early cancerous lesions among people who are survivors of the disease.

Human papillomavirus, or HPV, is a sexually transmitted infection that can lead to gynecological (cervical, vaginal and vulvar), anogenital (anal and penile) and oropharyngeal (throat and mouth) cancers. Cervical cancer is the most common HPV-associated cancer in women, and oropharyngeal cancers are the most common in men.

“HPV is a virally mediated cancer, so it makes sense if somebody is infected in one site with the virus that they would be infected in other sites as well. It is important for people who have had one HPV-related cancer to know that they are at increased risk for HPV-related cancers in another site, and they are encouraged to have screening for these other cancers, if screening is available. Currently, screening is available for cervical and anal precancers,” said Dr. Elizabeth Chiao, professor of medicine in the section of infectious diseases at Baylor and with the Houston VA Center for Innovations in Quality, Effectiveness and Safety.

Chiao also is a member of the NCI-designated Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine.

For the study, researchers used data from the Surveillance, Epidemiology, and End Results (SEER) Program database, which collects cancer incidence data from registries across the United States. They identified survivors of HPV-associated cancers diagnosed from January 1973 to December 2014 and looked at patients who developed a second primary HPV-associated cancer at the same site or a different site at least two months after the diagnosis.

They found that individuals who had primary HPV-related cancer had an increased risk of HPV-related cancer in other sites later in life.

According to the study, the risk for most types of second primary HPV-associated cancers is high after 1) initial vaginal and vulvar cancers in women, 2) after initial penile cancer in men and 3) after anal cancer in both women and men. The researchers found no association with secondary non-HPV associated cancers.

“Future research needs to be prioritized to determine effective as well as cost-effective ways to screen for HPV-associated second cancers in this high-risk group,” said Dr. Ashish Deshmukh, assistant professor in the department of management, policy and community health at UTHealth School of Public Health in Houston.

The researchers recommend investigating the efficacy of screening and prevention measures for survivors of HPV-associated cancers. They also recommend being vaccinated against HPV. The vaccination series can begin at 9 years of age in males and females and can go through age 26 for females and age 21 in males.

Others who took part in the study include Ryan Suk and Dr. Kalyani Sonawane with UTHealth School of Public Health; Dr. Parag Mahale with the National Cancer Institute; Dr. Andrew G. Sikora with Baylor College of Medicine; Dr. Jagpreet Chhatwal with Harvard Medical School; Dr. Kathleen Schmeler and Dr. Scott B. Cantor with The University of Texas MD Anderson Cancer Center and Dr. Keith Sigel with the Icahn School of Medicine at Mount Sinai.

Note: This work was supported by grants K07180782 and R01 CA163103 from the National Cancer Institute, part of the National Institutes of Health.

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September, 2018|Oral Cancer News|

Head and neck Cancer: Overcoming Challenges in Treatment

Source: www.curetoday.com
Author: staff

Itzhak Brook, M.D., M.Sc., shares the story of his initial diagnosis and treatment for cancer of the head and neck, outlining the challenges that came along with treatment, with fellow board member of the Head and Neck Cancer Alliance Meryl Kaufman, M.Ed., CCC-SLP, BRS-S.

Transcript:
Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: Dr. Brook, can you please share your story about your cancer diagnosis in 2006 and the treatment that followed and also the subsequent surgery that you went through?

Itzhak Brook, M.D., M.Sc.: Once I learned I had cancer and my doctors removed it when they had to biopsy, I needed to receive radiation therapy. I did not get any chemotherapy, and the radiation therapy lasted six weeks, five days a week. It was very difficult to experience the radiation, and the side effects start to accumulate within a few days. And I had to deal with inflammation of the mouth, mucositis, difficulty in swallowing and pain in my throat, and I experienced a burning of the skin around the area of radiation, weakness and then difficulty maintaining intake of food. After a while, I could lose weight, and I tried to persevere because I knew that I had to receive the treatment to get better and soldier through it until it was over.

Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: Exactly. And some people have such severe side effects from the radiation that they actually require a feeding tube to support them during their treatment. In that case, often patients are encouraged to eat and drink and use that feeding tube to supplement what they’re able to eat and drink. Did you find that there were certain foods that were difficult for you to swallow and you needed to avoid during that time?

Itzhak Brook, M.D., M.Sc.: I was fortunate that I was able to maintain my hydration and nutrition without the feeding tube. And in my trial and error, I found solid food, cold food, such as watermelon, ice cream and sour cream. I tried to consume high-calorie food so that even though I don’t eat as much, I would still take calories in and not lose a lot of weight. I was lucky I lost only 5 pounds, but some people lose more. The most important thing is to stay hydrated, get enough food and get enough water, which at that time was a real challenge, as the nausea increased over time. But fortunately, I had a very good support system in the place where I got it. I had a radiation oncologist who had advised me and told me and helped me cope with the side effects.

Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: Exactly. And how important was your support system at home? Who supported you and helped get you through that treatment?

Itzhak Brook, M.D., M.Sc.: Obviously, that’s very, very important. My wife and children were very supportive of me, and they knew that I was going through a rough time and tried to help me in all the other ways possible. Also, at work, I got a lot of understanding and support from my team of co-workers. I was then in the military. I was in the U.S. Navy and got my treatment at Walter Reed, and they were very, very helpful in trying to ease it.

Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: And then when the cancer came back, you faced a laryngectomy. Can you talk to us about what that meant to you and what sort of associated fear and stigma you experienced?

Itzhak Brook, M.D., M.Sc.: Well, the most important thing was that they caught the cancer, and that was because I saw an otolaryngologist every month, and this is done for the first year and second year because that’s the time when more recurrences happen, in those two years. And when the cancer was diagnosed, they tried to remove it through an endoscopy and direct biopsy, but it was already too difficult, as it had gotten into the areas where simple procedures couldn’t work. And then they realized that I needed an experienced physician to do it, and I went for a second opinion to another otolaryngologist in a different city. And he referred me to another one because he felt that person would be the best to do it.

And fortunately, we have fewer laryngectomies today, partly because of the experience in doing it is less prevalent and you need to find what I found: the person who knew it best. And they finally removed it, but the understanding that I needed laryngectomy was very difficult. I suddenly realized that my voice would be lost, and I like to speak. Like anyone, I like to lecture, and accepting that I would have to lose my voice was very difficult. I remember that as a medical student some 50 years ago, when I saw laryngectomies, I said to myself, “If I ever have to make a choice, I would never give up my choice even if it cost me my life.” But once I had a choice and I also understood that I could still speak—differently, but I could speak—I made the decision very quickly. There was no doubt in my mind that in order to stay alive, I was going to do it, and I don’t regret it.

Meryl Kaufman, M.Ed., CCC-SLP, BRS-S: That’s so important for people to understand that there is life after laryngectomy or glossectomy, in the case of having your tongue removed or part of your jaw. There is life, there is rehabilitation and there are ways to go about learning how to speak and swallow again in the face of these challenges. What is something that you wish you had known prior to the diagnosis or during that time period that you can give to other people facing the same situation?

Itzhak Brook, M.D., M.Sc.: I wish I had known that I needed to go to the best physicians who are experienced in the field to do the procedure, and I should not have avoided to make the decision right away but take the time to search for the best person who could help me. I also wish that I had known that even though I was prepared for the procedure, my physicians, nurses and speech pathologists did prepare me, helped me, and they explained to me that experiencing this is completely different from all the words and explanations. And it’s still a very difficult period to undergo this major surgery and be in the hospital completely helpless. But it was worth it because even though it was difficult, I got my life back, and I still believe that life is a very, very precious thing. And if you need to lose something to gain life, it’s worth it.

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September, 2018|Oral Cancer News|