alcohol

With oral cancer on the rise, dentists can play an important role

Source: http://exclusive.multibriefs.com
Author: Tammy Adams

Today’s dental professionals routinely see and deal with many issues and conditions that were not so common just a few short decades ago. For example, there has been a marked increase in the incidence of oral cancer in the United States, sparking the need for regular oral cancer screening as part of a preventive dental checkup. This additional screening is now routinely performed in many dental practices across the nation.

The American Cancer Society estimates that around 50,000 Americans are infected with oral cancer each year. In past generations, oral cancer was mostly linked to smoking, alcohol use or a combination of the two. But even as smoking rates have fallen, oral cancer rates have risen (especially in men), and researchers have concluded that this is likely caused by the human papillomavirus (HPV), a sexually transmitted disease.

Early diagnosis makes a difference
Oral cancer is often only discovered when the cancer has metastasized to another location, most commonly the lymph nodes of the neck. Prognosis at this stage of discovery is significantly worse than when it is caught in a localized intraoral area.

According to the Oral Cancer Foundation, the best way to screen for HPV-related oral and oropharyngeal cancer is through a visual and tactile exam given by a medical or dental professional, who will also perform an oral history taking to ask about signs and symptoms that cover things that are not visible.

Most of the symptoms of a developing HPV-positive infection are discovered by asking questions, using a test, a light or other device.

ADA supports dental industry with this growing challenge
In 2017, a panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs published a clinical practice guideline called the “Evidence-Based Clinical Practice Guideline for the Evaluation of Potentially Malignant Disorders in the Oral Cavity.”

The goal of this guideline is to inform dentists, orthodontists and other dental professionals about triage tools for evaluating lesions, including potentially malignant disorders, in the oral cavity. If you’re a dentist or an orthodontist, the ADA offers the following considerations concerning the diagnosis of oral and oropharyngeal cancers:

  • Clinicians should obtain an updated medical, social and dental history as well as perform an intraoral and extraoral conventional visual and tactile examination in all adult patients.
  • For patients with suspicious lesions, clinicians should immediately perform a biopsy of the lesion or refer the patient to a specialist.
  • Salivary and light-based tools are not recommended for evaluating lesions for malignancy.

If you are a dental professional and want to learn more about the dental industry’s role in addressing the rising occurrence of oral cancer, visit the ADA’s Oral and Oropharyngeal Cancer page.

April, 2018|Oral Cancer News|

Be your own advocate

Source: www.wvnews.com
Author: Mary McKinley

The importance of dental care goes beyond cavities — it’s also about preventing cancer. The week of April 8 is National Oral, Head and Neck Cancer Awareness Week, and your dentist or dental hygienist may be your first line of defense against oral cancer.

More than 50,000 Americans are expected to be diagnosed with oral or oropharyngeal cancer (cancer of the back of the throat, including the base of the tongue and the tonsils) in 2018, and 350 will be diagnosed in West Virginia alone.

Routine dental exams can detect cancer or pre-cancers during the early stages. If you notice a persistent sore or pain, swelling or changes in your mouth, or red or white patches on the gums, tongue, tonsils or lining of the mouth, visit a doctor or dentist so they can examine your mouth more closely.

Some people diagnosed with oral cancer have no risk factors, so it’s important for everyone to keep those dental appointments.

If you use tobacco, drink alcohol in excess, or have the human papillomavirus (HPV), you have an increased risk for oral cancer. Oral cancer is more common in older adults, particularly men, but oropharyngeal cancer is on the rise in middle-aged, nonsmoking white men between the ages of 35 and 55. The majority of these types of cancer cases are caused by HPV.

Take charge of your health and reduce your risk of oral cancer. If you smoke or chew tobacco, quit now (it’s never too late). Moderate your alcohol consumption to no more than one drink a day for women or two for men.

If you have children, make sure they receive the HPV vaccine, which is recommended for all girls and boys ages 11 and 12; a “catch-up” vaccine is also available for young women up to age 26 and most young men up to age 21.

You can be your own best advocate. Check the inside of your mouth in the mirror each month, and speak up to your dentist or dental hygienist if you notice any changes that concern you.

Ask about cancer screenings when making your dental appointments. And to learn more about cancer prevention, be sure to visit www.preventcancer.org.

April, 2018|Oral Cancer News|

Management strategies for oral potentially malignant disorders

Source: www.medscape.com
Author: Joel M. Laudenbach, DMD

Oral potentially malignant disorders (OPMDs) include oral leukoplakia (OL), oral erythroplakia, oral submucous fibrosis, oral lichen planus, proliferative verrucous leukoplakia, and actinic keratosis. Once an OPMD has been clinically diagnosed, execution of management strategy is critical. When formulating the strategy, healthcare providers should consider histopathology, lesion characteristics (ie, surface texture, unifocal, multifocal), lesion location in the mouth (ie, tongue, floor of mouth), patient risk factor assessment, and a detailed medical/cancer history.

In this newly published article, Nadeau and Kerr[1] detail various parameters surrounding evaluation and management of OPMDs. The authors make it clear that OPMDs are challenging, each with their own nuances regarding risk for malignant transformation. For example, when OL is unifocal, nonhomogeneous, nodular, or verrucous, there is a much higher chance of the OL becoming dysplastic (12.63-fold) or demonstrating a focus of carcinoma (8.9-fold) when compared with homogeneous types of OLs.[1]

Provider knowledge of these variables is critical when counseling patients about their diagnosis and management options and when selecting interventions along with follow-up care. Although progression to malignancy is difficult to predict with OPMDs, clinicians can account for multiple risk factors such as smoking/alcohol status, high-risk location in the oral cavity, and size of lesion (>200 mm2) to help formulate a tailored management plan for each patient. Consultation with an oral pathologist to discuss the histologic appearance in the context of specific patient history and lesion characteristics can provide additional perspective and/or recommendations.

Modifiable oral cavity cancer risks related to tobacco and heavy alcohol use should be communicated to patients with OPMDs so that they are able to make changes that may lead to regression/disappearance of certain lesions such as OL. Providers confronted with patients who use tobacco and/or heavy alcohol can integrate recommendations for cessation of tobacco[2] and alcohol[3] because they are both established, independent, causative agents for oral cavity cancer and OPMDs.

Available treatment strategies for OPMDs include surgical removal/ablation, photodynamic therapy, and surveillance. The authors make a clear point with supportive studies that traditional surgical excision of dysplastic OPMDs may decrease malignant transformation (MT) risk, yet it does not fully eliminate that risk and, in some instances, has not changed the MT risk when compared with surveillance alone. Appropriate surgical margin identification for OPMDs is clinically challenging. The authors note that smaller excisional margin sizes (1-2 mm) without marginal histologic assessment are common surgical management goals for OPMDs.[1]

Viewpoint
Nadeau and Kerr carefully outline updated considerations for all OPMDs. Healthcare providers involved in screening, diagnosing, referring, and/or managing patients with OPMDs should be well versed in standards of care, including baseline biopsy goals, tobacco/alcohol cessation, currently available interventions, and surveillance care.

Clinicians should also develop a local team of practitioners who are experts in diagnosis and management of OPMDs to help patients obtain the best opportunity for positive outcomes. I encourage readers with interest to retrieve and review the full article by Nadeau and Kerr as a strategy to update your knowledge base and to continue to improve overall morbidity, mortality, and survival rates related to OPMDs.

References:
1. Nadeau C, Kerr AR. Evaluation and management of oral potentially malignant disorders. Dent Clin North Am. 2018;62:1-27.

2. US Preventive Services Task Force. Final recommendation statement. Tobacco smoking cessation in adults, including pregnant women: behavioral and pharmacotherapy interventions. September 2015. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions1 Accessed March 1, 2018.

3. US Preventive Services Task Force. Final recommendation statement. Alcohol misuse: screening and behavioral counseling interventions in primary care. May 2013. https://www.uspreventiveservicestaskforce.org/Page/Document
/RecommendationStatementFinal/alcohol-misuse-screening-and-behavioral-counseling-interventions-in-primary-care Accessed March 1, 2018.

March, 2018|Oral Cancer News|

HPV is causing an oral cancer epidemic in men by outwitting natural defenses

Source: www.philly.com
Author: Marie McCullough, staff writer

Five years ago, when actor Michael Douglas candidly revealed that his throat cancer was linked to having oral sex, two things happened.

He made headlines that mortified his family. And he helped publicize the fact that a pervasive, sexually transmitted virus called HPV was unleashing an epidemic of oral cancer among men.

Since then, scientists have made headway in figuring out why HPV, the human papillomavirus, has this glaring gender bias. Men are four times more likely than women to be diagnosed with oral cancer, a hard-to-detect, hard-to-treat disease that has overtaken cervical cancer as the most common HPV-related malignancy in the United States.

To be sure, changes in sexual norms over the last few generations have played a role in this alarming trend. But research increasingly shows the real problem is something men have practically no control over: their immune response.

Compared with women, men are more likely to get infected with HPV — including “high-risk” cancer-causing strains. They also are less able to wipe out infection on their own, and more likely to get reinfected. The reasons are unclear.

“There is good evidence that men acquire oral infections more readily than women, even if they have similar sex practices,” said Ashish A. Deshmukh, a University of Florida HPV researcher. “And more than the acquisition, it’s the persistence of the virus. The clearance rate is not that fast in men.”

Michael Becker of Yardley has stepped up as the face of this immunological inequity. The 49-year-old former biotech executive is health-conscious, clean-living, happily married for 26 years – and battling terminal oropharyngeal cancer, the medical term for malignancies in parts of the mouth and throat.

He’s also battling the misconceptions and ignorance that keep too many parents from protecting their pubescent children — especially boys — against HPV-driven cancers. Two shots. That’s all it takes for the leading vaccine, Gardasil, to prevent most cervical cancers, less common genital malignancies, and the disease that is killing Becker.

“I can’t tell you how many emails I got from parents after the CBS segment,” he said, referring to a national television interview last month. “They said, ‘What do you mean this vaccine is for boys?’ and ‘What do you mean oral cancer incidence has eclipsed cervical cancer?’ ”

An inescapable virus
HPV is a family of more than 100 virus types that can live in the flat, thin cells on the surface of the skin, cervix, vagina, anus, vulva, penis, mouth, and throat. The virus is spread through contact with infected skin, mucous membranes, and bodily fluids. Some types can be passed during intercourse or — as Douglas pointed out — oral sex. While virtually all sexually active people will get infected at some point, the virus is usually wiped out by the immune system without so much as a symptom.

But not always.

In the cervix, persistent infection with high-risk HPV types can lead to precancerous changes that, left alone, slowly turn malignant. Fortunately, the Pap smear enables the detection and removal of abnormal cells before cancer develops. What’s more, age-related changes in cervical cells reduce the risk that HPV will take hold there as women get older.

No such screening test exists for oropharyngeal sites – the tongue, soft palate, tonsils, the throat behind the nasal cavity – and symptoms usually don’t appear until cancer is advanced. Becker, for example, had metastatic disease by the time he noticed a lump under his jaw line in late 2015.

Traditionally, smoking and heavy alcohol use are the big risk factors for oral cancer, but the non-HPV tumors linked to these bad habits have been declining in recent years. HPV-related tumors, in contrast, have increased more than 300 percent over the last 20 years. The virus is now found in 70 percent of all new oral cancers.

About 13,200 new HPV oral cancers are diagnosed in U.S. men each year, compared with 3,200 in women, according to federal data. Treatment — surgery, chemotherapy, radiation — can have disfiguring, disabling side effects. About half of late-stage patients die within five years.

Natural defenses go awry
Oral HPV infection rates are skewed by gender, just like the resulting cancers. The latest national estimates of this disparity, published in October, come from Deshmukh and his University of Florida colleagues. They used a federal health survey that collected DNA specimens to estimate that 7.3 percent of men and 1.4 percent of women have oral infections with high-risk HPV types. That translates to 7 million men and 1.4 million women.

The chance of oral infection increases for women as well as men who have simultaneous genital HPV infections or a history of many sex partners, but male infection rates still far surpass female rates.

Patti Gravitt, an HPV researcher at George Washington University, believes these estimates are a bit oversimplified because women counted as uninfected may actually have undetectably low virus levels, or HPV may be hiding in a dormant state in their cells.

Still, Gravitt said the study is in line with others that suggest “men are more susceptible to HPV viral infection than women.”

In women, an HPV infection usually sets off the body’s defense mechanisms. The immune system makes antibodies that kill off the invader, then immune cells remain on guard, ready to attack if the virus reappears.

But in men, something goes awry. The HIM study — for HPV in Men — documented this by collecting genital, anal, and oral samples from 4,100 unvaccinated men in Florida, Mexico and Brazil between 2005 and 2009. The samples were tested for the presence of two high-risk HPV types and two that cause genital warts.

Among 384 men who developed infections during a 24-month period, only 8 percent produced antibodies. But this response rate varied depending on the site of infection; none of the small number of orally infected men produced antibodies.

Rather than putting the immune system on guard and protecting men from the virus, infection sharply increased the chance of getting infected again with the exact same HPV type. And many men who got reinfected were celibate at the time.

How could this be? Anna R. Giuliano, the researcher at the Moffitt Cancer Center in Tampa, Fla., who led the HIM study, said recurring infections may be due to reactivation of dormant virus, or to auto-inoculation – the man spreads infection from one part of his body to another. Or to something else entirely.

While the scientific understanding of this puzzle is evolving, one implication is clear. “HPV vaccination is the only reliable method to ensure immune protection against new HPV infections and subsequent disease in males,” Giuliano and her co-authors declared in a recent paper.

Becker hammers that message – when he is not being hammered by chemotherapy – using his self-published memoir and his blog. This week’s blog gave a shout-out to Sunday’s first-ever International HPV Awareness Day, declared by Giuliano and other members of the International Papillomavirus Society.

Becker realizes that the novelty of the vaccine, the complexity of HPV, and its link to sex are obstacles to immunization. But he focuses on the life-saving aspect.

“Parents are being asked to vaccinate their 11-year-old child and they can’t imagine 30 or 40 years down the line, it will prevent cancer,” Becker said. “If you don’t know it’s connected to six cancers, you’re not going to care. So it really should be cast as an anti-cancer vaccine.”

March, 2018|Oral Cancer News|

Alcohol and cancer – facts and health risks

Source: mesothelioma.net
Author: staff

Alcohol and Cancer – Facts and Health Risks
While there are proven health benefits of drinking alcohol in moderation, and some specific benefits due to the natural compounds found in red wine, drinking is not always good for your health. Drinking regularly and to excess can have some serious and negative impacts on health and may even be linked to an increased risk for mesothelioma or other cancers.

Drinking alcohol in moderation during cancer treatment may be fine for some patients, but generally it should be avoided. It may aggravate side effects and studies are also investigating whether or not alcohol can increase the risk of a cancer recurrence. If you are going through treatment for mesothelioma or another type of cancer, talk to your medical team before indulging in a drink or two.

Alcohol Consumption is a Risk Factor for Cancer
Many studies have found and confirmed, over and over again, that drinking alcohol is a risk factor for developing cancer generally and for specific types of cancers. Specifically, drinking has been linked with throat and mouth cancers, esophageal cancer, liver cancer, colon cancer, breast cancer, stomach cancer, and pancreatic cancer. The more alcohol consumed, the greater the risk. According to research data, approximately 3.5 percent of cancer deaths are related to alcohol consumption. Some of the specific facts about drinking and cancer from research include:

People who drink three to four alcoholic beverages per day have a two to three times increased risk of developing a head and neck cancer.

Drinking is not just a risk factor, but a known cause for liver cancer.
Alcohol consumption is a risk factor for esophageal squamous cell carcinoma, and the risk is greatest for people with a certain genetic mutation that makes it more difficult to metabolize alcohol. Women who consume three alcoholic drinks per day have a 1.5 times greater risk of developing breast cancer.

Alcohol increases the risk of colorectal cancer, especially in men.
Regular alcohol consumption contributes to cancer development in several ways. In cancers of the mouth and throat, the risk may be caused by the fact that alcohol irritates cells in those tissues, causing damage to DNA. In the liver alcohol causes scarring and inflammation, which also damages DNA. In the colon, alcohol is converted to a compound called acetaldehyde, which is a known carcinogen.

Other Negative Health Impacts of Drinking
There are other ways in which alcohol impacts health in negative ways, and some of these may indirectly contribute to causing cancer. For instance, alcohol causes levels of the hormone estrogen to rise in the body. This in turn can lead to breast cancer. Another negative impact of drinking is weight gain and obesity. Being obese is also a risk factor for cancer of all types. Regular drinking prevents the body from absorbing some nutrient, which help keep cells healthy, and this can cause many health problems, including promoting cancer development.

Other health problems that excessive drinking can cause include those that are long-term. One of the biggest health issues is liver damage. Excessive drinking over time causes inflammation and scarring, which ultimately can cause the liver to fail. Alcohol consumption can also damage the brain and pancreas, increase the risk of heart attack and stroke, and raise blood pressure.

Drinking and Mental Health Risks
In addition the many physical health risks of drinking to excess, alcohol can also contribute to or cause mental health problems, including dependence. Alcohol addiction is a very serious disease that is difficult to overcome and that causes physical health effects, mental distress, and major impairment in everyday functioning.

There is also a strong link between drinking and mental illness. The relationship between the two is complicated. In some cases a person may have a mental illness and use alcohol to cope, while in other cases alcohol may trigger mental illness symptoms. Mood disorders, like depression, are most commonly associated with heavy alcohol use. For people with existing mental illnesses, drinking can worsen symptoms.

Drinking During and after Cancer Treatment
Cancer treatments can take a serious toll on the body and mind. Avoiding alcohol, or at least not drinking regularly or heavily, is a good idea. A very specific reason not to drink is that alcohol can interact dangerously with certain chemotherapy drugs. Chemotherapy also causes unpleasant side effects, like nausea, vomiting, mouth sores, and pain that alcohol will only worsen.

If you beat cancer and become a survivor, the fact that you have already had cancer puts you at risk for a recurrence or developing another type of cancer. This is an important reason to limit alcohol intake. The more risk factors, like drinking, that you can eliminate, the less likely you will be to have another battle with cancer in the future.

Drinking alcohol is not always bad, but it should be limited. The American Cancer Society recommends that women have no more than one drink per day and men no more than two. This does not mean that it is safe to have seven drinks just one day per week. Excessive drinking in one sitting is very harmful. If you are going through cancer treatment, make sure your medical team gives you the go ahead to have alcohol before you indulge. And even if they do, it makes sense to limit how much you drink. The healthier you can stay during and after treatment, the better you will be able to tolerate the treatment and to be able to fight your cancer and get well again.

Sources
https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html
http://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/chemotherapy/living-with/alcohol
https://www.medscape.com/viewarticle/853128
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

December, 2017|Oral Cancer News|

Top cancer doctors have some advice about alcohol

Source: www.newser.com
Author: staff

Name things that increase your risk of cancer. Cigarettes and tanning beds might quickly come to mind. But how about alcohol? A recent survey of 4,016 adults by the American Society of Clinical Oncology found that only 30% knew alcohol is a risk factor for cancer, reports the New York Times. ASCO, which includes many leading cancer doctors, had yet to voice its own thoughts on the topic. That changed this month, with the Nov. 7 publication of a statement in the Journal of Clinical Oncology that begins by calling the link between the two “often underappreciated” and noting that “addressing high-risk alcohol use is one strategy to reduce the burden of cancer.”

“Despite the evidence of a strong link between alcohol drinking and certain cancers, ASCO has not previously addressed the topic of alcohol and cancer.”

In the statement they cite outside research they’ve found to be sound, like an estimate that 5.8% of global cancer deaths in 2012 were attributable to alcohol, and evidence that drinking can increase the risk of mouth, throat, voice box, liver, breast, esophageal, and colorectal cancers. So what’s the upshot? It’s not “Don’t drink,” lead statement author Dr. Noelle LoConte tells the Times. “It’s different than tobacco where we say, ‘Never smoke. Don’t start.’ This is a little more subtle”—drink less, essentially. (Though the statement does contain the line, “People who do not currently drink alcohol should not start for any reason.”) So what’s Wine Spectator’s response? It tries to poke a hole or two, noting “the statement … dismisses possible health benefits of alcohol, including lower risks of heart disease, diabetes, and dementia.”

November, 2017|Oral Cancer News|

Is alcohol really good for your health? What the research reveals may surprise you

Source: www.consumerreports.org
Author: Julia Calderone

W e’ve long been told that a little wine with dinner may help prevent heart disease and perhaps offer other health benefits.

But some researchers are now questioning whether the perks of moderate drinking—one drink per day for women, two for men—really outweigh potential downsides.

We know that in older adults, too much alcohol can exacerbate high blood pressure, increase the risk of falls and fractures, and lead to strokes, memory loss, and mood disorders. And in this group, alcohol problems, such as the uncontrollable urge to drink, shot up 107 percent between 2001 and 2013, according to a study published in August in JAMA Psychiatry.

Even small amounts of alcohol can interact with medication (see chart here for a list of which ones), and contribute to cancer risk and potentially cognitive decline.

Here’s the latest research and tips on how to ensure that you’re not going overboard:

Benefits and Risks
More than 100 studies have found that a drink or two per day is linked to a 25 to 40 percent reduced risk of heart attack, stroke, and death from cardiac-related problems, according to the Harvard T.H. Chan School of Public Health.

Another study published in August, one that followed more than 333,000 people for 12 years, found that light to moderate drinkers were 21 to 34 percent less likely to die from cardiovascular disease.

But no studies have yet proved directly that alcohol boosts human health. Most research in this area has looked at whether people’s reported drinking behaviors are “associated” with positive or negative health outcomes.

A growing stack of research also suggests that regular, moderate alcohol consumption may have its hazards.

A 30-year study published in June in the British Medical Journal found that men who consumed eight to 12 drinks per week had three times the odds of having an atrophied hippocampus, which is a possible sign of early Alzheimer’s disease. That’s according to the study’s author, Anya Topiwala, Ph.D., a clinical lecturer in the department of psychiatry at the University of Oxford in the U.K.

And other research has found that moderate drinking may be linked to an elevated risk of breast cancer and—especially in smokers—esophageal, mouth, and throat cancers.

Watch Your Intake
Although moderate drinking isn’t without risks, a daily glass of wine is generally fine, says George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism, even if you’re in your 80s or 90s.

“We don’t want to panic people,” Topiwala adds.

But if you don’t drink, she says, there’s no reason to start for your health’s sake. And if you find yourself exceeding the U.S. Dietary Guidelines, Koob says, there’s no controversy: Consider cutting back.

These strategies can help:
Size up your pour. It can be almost impossible to eyeball a standard drink (5 ounces of wine, 12 ounces of beer, or 1½ ounces of distilled spirits). Some wineglasses can hold up to 22 ounces, more than the amount in four drinks. So use a measuring cup or a shot glass to get it right.

Keep tabs. Tracking how many drinks you have per day or week—perhaps with tick marks on a cocktail napkin—can help you stay within your limit.

Alternate with water. Sipping a glass of water or club soda after each alcoholic drink will help you slow down.

Talk to your doctor. If you’re concerned about your drinking, don’t be afraid to bring up the issue at your next checkup.

Note: This article also appeared in the November 2017 issue of Consumer Reports on Health.

October, 2017|Oral Cancer News|

Penn surgeons become world’s first to test glowing dye for cancerous lymph nodes

Source: www.phillyvoice.com
Author: Michael Tanenbaum, PhillyVoice Staff

Surgeons at the University of Pennsylvania have achieved a global first with the use of a fluorescent dye that identifies cancerous cells in lymph nodes during head and neck cancer procedures.

The study, led by otorhinolaryngologist Jason G. Newman, seeks to test the effectiveness of intraoperative molecular imaging (IMI), a technique that illuminates tumors to provide real-time surgical guidance.

More than 65,000 Americans will be diagnosed with head and neck cancers in 2017, accounting for approximately 4 percent of all cancers in the United States, according to the National Cancer Institute. About 75 percent of these cancers are caused by tobacco and alcohol use, followed by human papillomavirus (HPV) as a growing source for their development.

Common areas affected by these cancers include the mouth, throat, voice box, sinuses and salivary glands, with typical treatments including a combination of surgery, radiation and chemotherapy.

Lymph nodes, which act as filters for the immune system, are often among the first organs affected by head and neck cancers as they spread or resurface. Initial surgeries may leave microscopic cancerous cells undetected in the lymphoid tissue, heightening the risk that a patient’s condition will return after the procedure.

“By using a dye that makes cancerous cells glow, we get real-time information about which lymph nodes are potentially dangerous and which ones we can leave alone,” Newman said. “That not only helps us remove more cancer from our patients during surgery, it also improves our ability to spare healthy tissue.”

With the aid of a fluorescent dye, surgeons are able to key in on suspicious tissue without removing or damaging otherwise healthy areas. Previously adopted for other disease sites in the lungs and brain, the practice now allows Newman’s team to experiment with indocyanine green (ICG), an FDA-approved contrast agent that responds to blood flow.

Newman explained that since tumor cells retain the dye longer than most other tissues, administering the dye prior to surgery singles out the areas where cancer cells are present.

The current trial at Penn will enable researchers to determine whether ICG is the most suitable dye for head and neck cancers and provide oncologists with a deeper understanding of how cancer spreads in the lymph nodes.

October, 2017|Oral Cancer News|

Can even moderate drinking increase the risk of cancer?

Source: www.theguardian.com
Author: Luisa Dillner

Alcohol may be a social lubricant but WHO and Public Health England say it can cause cancer. Last week the alcohol industry was accused of downplaying the link between alcohol and the increased risk of seven cancers: mouth, throat, oesophagus, liver, breast and colon. A research paper in Drug and Alcohol Review found that “responsible drinking” information funded by the alcohol industry tends to push the message that only heavy drinking increases the risk of these cancers. But the paper says the risk starts with low levels of drinking, even though the risk itself is low. So is the recommended number of alcohol units a week – 14 – too high?

The solution
Even less than 1.5 units a day – a small glass of wine – can increase the risk of mouth, throat, oesophagus and breast cancer (in women), according to a UK government committee. While the toll of heavy drinking on the liver and pancreas is well known, the link to cancers, especially breast and colorectal, is less so. There are more than 100 epidemiology studies showing an association between breast cancer and alcohol, the risk increasing with less than one daily glass of wine. Research at Harvard found that while light to moderate drinking was not significantly associated with an increased risk for men (unless they smoked), it did increase the risk of breast cancer for women.

Edward L Giovannucci, professor of nutrition and epidemiology at Harvard School of Public Health and the lead author of the report, says that the increase in risk is modest. And there are some health benefits from occasional drinking that make the true risk to health harder to quantify. He points out other research that shows that one drink per day reduces the risk of diabetes for women. “So the overall effect on health for women might still be positive,” he says. “For colorectal cancer, the risk for men and women is low until you reach more than two drinks per day.”

There are also individual genetic differences in metabolising alcohol that can increase the risk of cancer. Ethanol in alcoholic drinks is broken down into acetaldehyde, which is toxic to cells, damaging DNA and proteins. Some people have genetic variations that are less effective at getting rid of acetaldehyde, and they may have a higher risk of oesophageal cancer.

Giovannucci says that overall he wouldn’t recommend drinking alcohol to improve your health. “But if one enjoys a glass or occasionally two a day as part of a healthy diet, and doesn’t smoke, I think the increased risk of cancer is small,” he says. “For those with a family history of colorectal or breast cancer, I’d suggest not drinking or not exceeding one glass per day.”

October, 2017|Oral Cancer News|

Alcohol industry ‘playing down’ risk of cancer by using tobacco industry tactics

Source: news.sky.com
Author: Paul Kelso, Health Correspondent

The alcohol industry is misleading the public by downplaying the risk of cancer through similar tactics to the tobacco industry, researchers say.

Liquor bottles in grocery store

A study led by the London School of Hygiene and Tropical Medicine (LSHTM) and Sweden’s Karolinska Institutet found the industry is using “denying, distortion and distraction” strategies to minimise evidence.

Researchers analysed information relating to cancer on the websites and documents of 28 alcohol industry organisations between September and December last year, finding that most showed “some sort of distortion or misrepresentation” of evidence.

The industry most commonly presented the relationship between alcohol and cancer as highly complex, implying there was no evidence of a consistent or independent link, according to the study.

Other tactics included denying that any relationship existed or claiming that there was no risk for light or moderate drinking, as well as presenting alcohol as just one risk among many.

Alcohol consumption is an established risk factor for a range of cancers, including oral cavity, liver, breast and colorectal cancers, and accounts for about 4% of new cancer cases annually in the UK.

The latest British government advice on alcohol, issued last year, makes an explicit link between cancer and alcohol.

It states: “The risk of developing a range of health problems (including cancers of the mouth, throat and breast) increases the more you drink on a regular basis.”

During the consultation phase the alcohol industry challenged the link with cancer.

The authors of the report, published in the Drug and Alcohol Review journal, said it was important to highlight that those who drink within the recommended guidelines – not more than 14 units a week for both men and women – “shouldn’t be too concerned when it comes to cancer”.

Mark Petticrew, Professor of Public Health at the LSHTM and the study’s lead author, told Sky News: “The information, on balance, across organisations we looked at seems to be quite extensively inaccurate or misrepresents the evidence.

“The evidence linking alcohol consumption and cancer is reasonably clear and has firmed up over recent years. The information on these websites, given out by alcohol bodies, appears to be not representing that evidence base, which is quite consistent.

“We know the tobacco industry attempted to confuse the relationship between lung cancer and smoking and put out a lot of very distracting information. We see similar types of argument use in these alcohol industry websites.”

Institute of Alcohol Studies chief executive Katherine Brown said: “This report shows that, like the tobacco industry before them, alcohol companies are misleading consumers about the evidence linking their products to cancer.

“We cannot rely on a profit-driven industry to promote public health. Consumers have a right to know the truth about alcohol and cancer, so they can make fully informed decisions about their drinking.”

The alcohol industry denied the report’s findings.

Glasses of light and dark beer on a pub background.

Drinkaware, a charitable trust funded by drinks manufacturers, said: “Its recent review of Drinkaware’s cancer information, which is extensive, has confirmed that the information we are providing accurately reflects the most recent research evidence.”

Henry Ashworth, president of the International Alliance for Responsible Drinking, said: “We do not agree with the conclusions reached in this paper. We believe in sharing the current state of the scientific evidence and stand by the information that we publish on drinking and health.”

Chris Snowdon, head of lifestyle economics at the Institute of Economic Affairs, said: “This is a diatribe disguised as a study that seeks to create a false narrative in which businesses always lie and anti-alcohol campaigners always tell the truth.

“We need to have sensible and evidence-based information about the risks of alcohol. The risks associated with cancer are not the biggest risks when it comes to drinking, the bigger risks are to do with violence, drink-driving and liver cirrhosis.

“It’s not cancer, so I’m not convinced that actually people understood fully what the risks associated with drinking are in terms of cancer when it doesn’t have an effect on people’s consumption of it at all.”

September, 2017|Oral Cancer News|