alcohol

Coupling head and neck cancer screening and lung cancer scans could improve early detection, survival

Source: www.medicalnewstoday.com
Author: staff

Adding head and neck cancer screenings to recommended lung cancer screenings would likely improve early detection and survival, according to a multidisciplinary team led by scientists affiliated with the University of Pittsburgh Cancer Institute (UPCI), a partner with UPMC CancerCenter.

In an analysis published in the journal Cancer and funded by the National Institutes of Health (NIH), the team provides a rationale for a national clinical trial to assess the effectiveness of adding examination of the head and neck to lung cancer screening programs. People most at risk for lung cancer are also those most at risk for head and neck cancer.

“When caught early, the five-year survival rate for head and neck cancer is over 83 percent,” said senior author Brenda Diergaarde, Ph.D., assistant professor of epidemiology at Pitt’s Graduate School of Public Health and member of the UPCI. “However, the majority of cases are diagnosed later when survival rates generally shrink below 50 percent. There is a strong need to develop strategies that will result in identification of the cancer when it can still be successfully treated.”

Screening patients for head and neck cancer and lung cancer could improve early detection and survival.

Screening patients for head and neck cancer and lung cancer could improve early detection and survival.

Head and neck cancer is the world’s sixth-most common type of cancer. Worldwide every year, 600,000 people are diagnosed with it and about 350,000 die. Tobacco use and alcohol consumption are the major risk factors for developing the cancer.

The early symptoms are typically a lump or sore in the mouth or throat, trouble swallowing or a voice change, which are often brushed off as a cold or something that will heal. Treatment, particularly in later stages, can be disfiguring and can change the way a person talks or eats.

Dr. Diergaarde and her team analyzed the records of 3,587 people enrolled in the Pittsburgh Lung Screening Study (PLuSS), which consists of current and ex-smokers aged 50 and older, to see if they had a higher chance of developing head and neck cancer.

In the general U.S. population, fewer than 43 per 100,000 people would be expected to develop head and neck cancer annually among those 50 and older. Among the PLuSS participants, the rate was 71.4 cases annually per 100,000 people.

Recently, the U.S. Preventive Services Task Force*, as well as the American Cancer Society and several other organizations, recommended annual screening for lung cancer with low-dose computed tomography in people 55 to 74 years old with a smoking history averaging at least a pack a day for a total of 30 years. The recommendation came after a national clinical trial showed that such screening reduces lung cancer mortality.

“Head and neck cancer is relatively rare, and screening the general population would be impractical,” said co-author David O. Wilson, M.D., M.P.H., associate director of UPMC’s Lung Cancer Center. “However, the patients at risk for lung cancer whom we would refer for the newly recommended annual screening are the same patients that our study shows also likely would benefit from regular head and neck cancer screenings. If such screening reduces mortality in these at-risk patients, that would be a convenient way to increase early detection and save lives.”

Dr. Diergaarde’s team is collaborating with otolaryngologists to design a national trial that would determine if regular head and neck cancer screenings for people referred for lung cancer screenings would indeed reduce mortality.

January, 2015|Oral Cancer News|

Majority of public unaware of alcohol’s link with cancer

Source: www.cancerresearchuk.org
Author: staff

More than half of the British public are unaware of the link between alcohol consumption and cancer, according to a survey from the Alcohol Health Alliance UK (AHA) (link is external).

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The UK- wide poll found that just 47 per cent of people were aware of any connection between alcohol and the disease. But an overwhelming majority (83 per cent) would back further nutritional and health information on alcohol labelling.

Sarah Williams, Cancer Research UK’s senior health information officer, said: “Alcohol has long been a scientifically established cause of cancer, but there is surprisingly low awareness among the public of this link.

“And it isn’t just a risk for heavy drinkers; regularly drinking alcohol puts you at greater risk of seven different types of cancer, including breast and mouth cancer”

Alcohol is currently exempt from the EU legislation that makes it mandatory for food products and soft drinks to carry nutritional value information, despite alcohol being classed as a group 1 carcinogen by the World Health Organisation (link is external).

The AHA’s chair, Sir Ian Gilmore, says the lack of health information on many alcoholic products is “indefensible”.

“It’s not right that labelling is mandatory for a box of corn flakes but not for alcoholic products which can seriously harm health,” he said.

Gilmore urges the Government to start listening to public opinion on this issue rather than the demands of big businesses.

The results from the survey of 3077 people showed that nine in 10 (91 per cent) think that clarifying the health impacts of alcohol is important. But when challenged over their current knowledge, just under one in three (31 per cent) of people successfully acknowledged the links between alcohol and breast cancer.

This stretched to half of people being aware of the links in relation to mouth or throat cancer.

The AHA is calling for health labelling to be made a legal requirement for alcohol products. Its campaign is pushing for every alcohol product to clearly describe its nutritional, calorie and alcohol content as well as make it clear through labelling that the safest option for pregnant women is to avoid alcohol consumption entirely. Cancer Research UK supports the campaign for clearer labelling so everyone can make better choices about their drinking, said Williams.

“Cutting back on alcohol can help cut the risk, so you could try having more alcohol free days or making every other drink something soft,” she added.

January, 2015|Oral Cancer News|

Oral cancer on rise in young people

Source: www.wwltv.com
Author: Jaclyn Kelley

Alex Dupuy is like most 15-year-old boys, except for one very special talent. Last year he stole the headlines during a bowling tournament for bowling a perfect 300. But that high wouldn’t last long.

“My son came to us one day and said I have an ulcer, and we thought, OK, let’s gargle with some salt water and we kept checking on it and it never went away,” said Nancy Dupuy, Alex’s mother.

When the sore on Alex’s tongue never cleared up, but instead started growing, his mother became concerned and took him to see the doctor.

“It has grown so rapidly that I would really like to have the tumor or whatever it was removed,” she said.

Alex was taken to Children’s Hospital for surgery, and doctors removed the sore and 30 percent of his tongue. Three days later test results came back confirming the Dupuy’s worst fears: It was cancer.

“The word aggressive stuck out to me,” Nancy Dupuy said. “The type of cancer that my son presented with was an adult cancer. It’s not usually diagnosed in young children.”

The doctors said Alex had a rapid form of squamous cell carcinoma of the tongue. Four days later he and his parents were on a plane to MD Anderson Cancer Center in Houston.

Through it all, Alex managed to stay positive.

“I felt nervous, I felt scared and I told myself, I’ll be alright,” Alex said.

In Houston Alex would have yet another surgery before starting six weeks of intense radiation.

“We would wrap his neck because the neck would be burned. The skin, the tissue was burned when it would start to break down,” Nancy Dupuy said.

Dr. Paul Friedlander, the chairman for Tulane’s ear, nose and throat department, said the number of young people with oral cancer is on the rise.

“Most of the cancers we saw were smoking, alcohol related,” Friedlander said. “Right now we’ve seen an increase in a number of people who have not been exposed to cigarettes and alcohol that have these cancers.”

And he said that’s because of the human papaloma virus, or HPV. It’s an orally transmitted virus that he says is easy to get.

“These can be transmitted through oral sexual contact or something as innocuous as an open-mouth kiss,” Friedlander said.

Friedlander said early detection is key.

“If one does have a sore on their mouth, difficulty with swallowing, hoarseness or a neck mass that persists after two or three weeks, it’s a good idea to see your local doctor,” he said.

He recommends parents consider getting their teens the HPV vaccination, which doctors say can help prevent oral cancer.

It’s something Nancy Dupuy did with Alex and his brothers after his diagnosis.

“In our case it wasn’t HPV, but just the thought of oral cancer and that there is maybe something that could have prevented it is just really worth it in the end,” she said.

Several weeks of radiation would take its toll on Alex, but his family says it’s bowling that got him through it.

“On the good days, Alex would bowl and Alex would be in a world that was just perfect, and to me that was the most important thing that helped him get through six weeks of radiation,” Nancy Dupuy said.

Thank to early detection, Alex is now in remission.

“I always thank God I am cancer free.”

December, 2014|Oral Cancer News|

Red wine: Cancer causing or cancer protective? Researchers say both

Source: www.inquisitr.com
Author: staff

People who drink red wine have the lowest incidence of cancer caused by alcohol, and researchers think they know why that is. A new study published in the medical journal Advances in Experimental Medicine and Biology explains that while alcohol has cancer causing effects, red wine offers an anti-cancer quality that most other forms of alcohol do not offer. The study was completed by researchers at the University of Colorado Cancer Center.

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When people first begin to metabolize alcohol, it is converted to acetyl aldehyde, a known carcinogen.

“With enough alcohol, the body can get behind and end up with a backlog of acetyl aldehyde,” Dr. Robert Sclafani, the author of the paper, said. As he looked at epidemiological studies of head and neck cancer, he noted that alcohol is a major factor. He explained that when he separated the data into the type of alcohol, it was clear that people who drank red wine seemed to be more protected from cancer.

“In red wine, there’s something that’s blocking the cancer-causing effect of alcohol,” Sclafani said. Sclafani believed the resveratrol found in the skin of the grapes used to make red wine removes the most damaged cells from wine drinkers’ bodies. The most heavily damaged cells are also the cells most likely to turn cancerous, according to Medical News Today.

“Alcohol bombards your genes,” Sclafani explained. “Your body has ways to repair this damage, but with enough alcohol eventually some damage isn’t fixed. That’s why excessive alcohol use is a factor in head and neck cancer. Now, resveratrol challenges these cells – the ones with unrepaired DNA damage are killed, so they can’t go on to cause cancer. Alcohol damages cells and resveratrol kills damaged cells.”

According to the press release, research into another disease was integral to the research about red wine’s complicated relationship with cancer. Fanconi anemia is a rare genetic disorder which makes it so that these patients are not able to repair DNA as well as the general population. Without being able to make repairs, damaged DNA accumulates in the body, so these patients are very susceptible to head and neck cancer and leukemias, according to the press release about red wine and cancer.

“We learn a lot from genetic disorders because you can put a finger on a gene and say, hey, we know what that does,” Sclafani said, explaining that a genetic cancer-accelerator in Fanconi anemia patients is the same cancer causing mechanism in alcohol-related cancers; partially metabolized alcohol. For red wine drinkers, Sclafani explained, the ability to flush out damaged cells with the help of resveratrol might just be a life saver!

December, 2014|Oral Cancer News|

Study: smoking marijuana found non-carcinogenic

Source: americanlivewire.com
Author: staff

Smoking marijuana does not appear to increase the risk of lung cancer or head-and-neck malignancies, even among heavy users, researchers reported here.

“We expected that we would find that a history of heavy marijuana use, more than 500 to 1,000 uses, would increase the risk of cancer from several years to decades after exposure to marijuana, said Donald Tashkin, M.D., of the University of California in Los Angeles.

But in fact, they reported at the American Thoracic Society meeting here, marijuana use was associated with cancer risk ratios below 1.0, indicating that a history of pot smoking had no effect on the risk for respiratory cancers. Studies have shown that marijuana contains many compounds that when burned, produce about 50% higher concentrations of some carcinogenic chemicals than tobacco cigarettes.

In addition, heavy, habitual marijuana use can produce accelerated malignant change in lung explants, and evidence on bronchial biopsies of pre-malignant histopathologic and molecular changes, Dr. Tashkin said.

The investigators had also previously shown that smoking one marijuana cigarette leads to the deposition in the lungs of four times as much tar as smoking a tobacco cigarette containing the same amount of plant material. Marijuana cigarettes are not filtered and are more loosely packed than tobacco, so there’s less filtration of the tar. In addition, pot smokers hold the smoke in their lungs about four times longer than tobacco smokers do, Dr. Tashkin pointed out.

For the population-based case-control study, they identified cancer cases among people from the ages of 18 to 59, using the Los Angeles County Cancer Surveillance Program registry.

They identified 611 people with lung cancer, 601 with cancers of the head and neck, and 1,040 controls matched by age, gender and neighborhood (as a surrogate for socioeconomic status).

They conducted extensive personal interviews to determine lifetime marijuana use, measured in joint-years, with one joint-year equivalent to 365 marijuana cigarettes. The interviewers also asked participants about tobacco use, alcohol consumption, use of other drugs, socioeconomic status, diet, occupation, and family history of cancer.

The investigators also used logistic regression to estimate the effect of marijuana use on lung cancer risk, adjusting for age, gender, race/ethnicity, education, and cumulative tobacco smoking and alcohol use.

They found that the heaviest users in the study had smoked more than 60 joint years worth of marijuana, or more than 22,000 joints in their lifetime. Moderately heavy users smoked between 11,000 and 22,000 joints.

Despite the heavy use, “in no category was there any increased risk, nor was there any suggestion that smoking more led to a higher odds ratio,” he continued. “There was no dose-responsiveness,not even a suggestion of a dose response”and in all types of cancer except one, oral cancer, the odds ratios were less than one.”

In contrast, tobacco smoking was associated with increased risk for all cancers, and there was a “powerful” dose-response relationship. People who smoked more than two packs of cigarettes per day had a 21-fold risk for cancer, as opposed to a less than one-fold risk for marijuana, Dr. Tashkin said.

“When we restricted the analysis to those who didn’t smoke any tobacco we found the same results, and when we looked for interaction between tobacco and smoking ”would marijuana increase the risk, potentiate the carcinogenic effect of tobacco”we didn’t find that, nor did we find a protective effect against the effect of tobacco, which is very important, because the majority of marijuana smokers also smoke tobacco,” he commented.

It’s possible that tetrahydrocannabinol (THC) in marijuana smoke may encourage apoptosis, or programmed cell death, causing cells to die off before they have a chance to undergo malignant transformation, he said.

Note: Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.

November, 2014|Oral Cancer News|

Alcohol drinking in never-tobacco users and cigarette smoking in never drinkers: pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium

Source: http://cancerres.aacrjournals.org
Authors: Paolo Boffetta, Mia Hasibe & On Behalf Of INHANCE Consortium
 

Abstract: Cigarette smoking and alcohol drinking account for at least 75% of head and neck cancers. A precise understanding of the independent effect of each of these factors in the absence of the other has important implications, in terms of elucidating the mechanisms of head and neck carcinogenesis and assessing the effect of interventions aimed to control either risk factor.We determined the extent to which head and neck cancer is associated with cigarette smoking among never-drinkers and alcohol drinking among never-tobacco users. We pooled individual-level data across 15 individual case-control studies including 10,244 head and neck cancer cases and 15,227 controls.There were 1,072 cases and 5,775 controls who never used tobacco, and 1,598 cases and 4,051 controls who never drank alcohol. Cigarette smoking increased the risk of head and neck cancers [odds ratio (OR)=2.10, 95% confidence interval (CI) 1.49-2.95] among never-drinkers, with clear dose-response relationships for frequency, duration and packyears of cigarette smoking. Approximately 24% of head and neck cancer cases among non-drinkers would have been prevented if these individuals had not smoked cigarettes. Among never-tobacco users, an increasing risk of head and neck cancer was detected for increasing alcohol drinking frequency (p for trend<0.001), but the effect was apparent only at high doses.Our results represent the most precise estimate available of the independent effect of each of the two main risk factors of head and neck cancer and exemplify the strengths of large-scale consortia in cancer epidemiology. 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
October, 2014|Oral Cancer News|

ACS awards $1.7M to study racial disparities in HNC patients

Source: http://www.drbicuspid.com/
Author: DrBicuspid Staff

The American Cancer Society (ACS) has awarded a $1.7 million grant to Philadelphia researchers to investigate factors that may contribute to the racial disparities seen among those diagnosed and treated for head and neck cancers (HNC) — specifically head and neck squamous cell carcinoma (HNSCC).

While head and neck cancers account for only 3% of all cancers in the U.S., a disproportionately high number of African Americans are affected. Recent research has shown that other biological factors, and tobacco and alcohol use, may have a role in the development of these cancers. Other studies suggest that low socioeconomic status and poor healthcare access are the main contributors to this disparity.

“Studies on genes involved in tobacco and drug metabolism and efflux suggest an association of genetic variants with head and neck cancer risk and survival in populations of European and Asian ancestries,” stated Camille Ragin, PhD, an associate professor at the Fox Chase Cancer Center and the study’s principal investigator, in a press release. “Genetic variants associated with the survival disparity of head and neck cancer in African-derived populations, however, is not yet clear.”

An accumulation of cancer-causing compounds occurs when products from tobacco smoke enter the body’s cells, in some cases enabled by alcohol, and are broken down by proteins. Variations in the genetic code that generate these proteins can lead to differences in their function and could affect the way disease may develop or respond to drug therapy. In many cases, the genetic makeup of these proteins differs according to race.

“Our group suggests that genetic factors and the environment work together to contribute to the observed racial disparities in HNSCC incidence and survival,” Ragin said. “With this grant we will be able to use novel techniques to look for variations in the genetic makeup in these genes that are unique to African Americans.”

These findings may help improve early detection and cancer prevention interventions by providing insight into the biology of the disease and factors that contribute to racial disparities.

Researchers find way to diagnose aggressiveness of oral cancer

Source: www.news-medical.net
Author: staff

Studying mouth cancer in mice, researchers have found a way to predict the aggressiveness of similar tumors in people, an early step toward a diagnostic test that could guide treatment, according to researchers at Washington University School of Medicine in St. Louis.

“All patients with advanced head and neck cancer get similar treatments,” said Ravindra Uppaluri, MD, PhD, associate professor of otolaryngology. “We have patients who do well on standard combinations of surgery, radiation and chemotherapy, and patients who don’t do so well. We’re interested in finding out why.”

Reporting in Clinical Cancer ResearchK/em>, the investigators found a consistent pattern of gene expression associated with tumor spreading in mice. Analyzing genetic data from human oral cancer samples, they also found this gene signature in people with aggressive metastatic tumors.

“We didn’t automatically assume this mouse model would be relevant to human oral cancer,” said Uppaluri, who performs head and neck surgeries at Barnes-Jewish Hospital. “But it turns out to be highly reflective of the disease in people.”

Rather than use genetic methods to induce tumors in the mice, the research team repeatedly applied a known carcinogen, in much the same way humans develop cancer of the mouth.

“Patients often have a history of tobacco and alcohol use, which drive the development of these tumors,” Uppaluri said. “We felt that exposing the mice to a carcinogen would be more likely to produce similar kinds of tumors.”

The researchers, including first author Michael D. Onken, PhD, research assistant professor of cell biology and physiology, showed that this exposure sometimes produced tumors in the mice that did not spread, but other times resulted in aggressive metastatic tumors, similar to the variety of tumors seen in people. Uppaluri’s team then collaborated with Elaine Mardis, PhD, co-director of The Genome Institute at Washington University, to find out whether the mouse and human tumors also were genetically similar. They compared their mouse sequences to human data sets from The Cancer Genome Atlas (TCGA).

“When we sequenced these tumors, we found that a lot of the genetic mutations present in the mouse tumors also were found in human head and neck cancers,” Uppaluri said.

Further analysis identified a common signature in the expression of about 120 genes that was associated with the more aggressive tumors, whether in mice or people. The researchers confirmed this signature using data collected from 324 human patients. Subsequently, using oral cancer samples from patients treated at Washington University, they developed a proof of concept test from their signature that identified the aggressive tumors with about 93 percent accuracy.

Working with the Washington University Office of Technology Management, Uppaluri has a patent pending on this technology and recently received funding from the Siteman Cancer Frontier Fund to develop a laboratory test that predicts aggressive disease and would be easily available for any patient diagnosed with head and neck cancer.

“These kinds of tests are available for other types of cancer, most notably breast cancer,” he said. “They are transformative genetic tests that can alter the clinical management of patients, tailoring therapies especially for them. It’s our goal to develop something like that for head and neck cancer.”

Source:
Washington University School of Medicine

Cannabinoids may offer hope for patients with oral cancer pain

Source: www.elements4health.com

Even the strongest available pain medications are largely ineffective for many cancer patients, particularly those with oral cancers. One of the nation’s leading oral cancer treating clinicians, speaking at the American Pain Society’s annual meeting, said he believes that while prospects for major treatment advances remain bleak, a new cannabinoid-based medication may have some promise for providing meaningful pain relief.

Brian Schmidt, DDS, MD, PhD, professor, New York University College of Dentistry and School of Medicine, delivered the Global Year Against Pain Lecture and reported that today, more than 100 years since President Ulysses S. Grant died from oral cancer, there is only modest improvement in patient survival. Grant is the only American president to die from cancer.

“Oral cancer is one of the most painful and debilitating of all malignancies,” said Schmidt, “ and opioids, the strongest pain medications we have, are an imperfect solution. They become dramatically less effective as tolerance to these drugs develops.”

Now considered to be the fastest increasing cancer in the United States, oral and oropharyngeal malignancies usually begin in the tongue. Human papillomavirus transmitted through oral sex, tobacco use and excessive alcohol consumption are the leading causes of this increase in oropharyngeal cancer. In the United States, some 43,000 new cases of oral cancer are diagnosed every year and the disease is more widespread worldwide with 640,000 new cases a year.

Schmidt said oral cancer patients often undergo multiple surgeries as tumors recur and also are treated with radiation and chemotherapy. The disease is difficult to diagnose at early stages and spreads quickly, leaving patients in gruesome pain and unable to speak or swallow. “Our inability to effectively treat oral cancer stems from lack of knowledge. We know that cancer pain is caused by a unique biological mechanism, but more research is needed to develop medications that are effective in treating oral cancer pain,” Schmidt said.

“The only way we can hope to reduce the devastating impact of oral cancer pain is to fund more research to help those who suffer or will suffer from this ruthless disease,” Schmidt told the APS audience. He added that half of oral cancer patients do not survive five years after diagnosis.

Schmidt noted that perhaps some good news is on the horizon, as clinical trials proceed for a drug produced directly from a marijuana plants (Sativex). It is administered as an oral spray and shows promise for treating cancer pain. The drug is available in Canada and Europe for treating spasticity from multiple sclerosis and is in Phase 3 clinical trials in the United States for treatment of cancer pain. Schmidt is a clinical investigator for Sativex trials.

“While it’s too early to conclude the cannabinoid medication will provide effective cancer pain relief, we do know that humans possess numerous cannabinoid receptors in the brain and body which regulate a significant amount of human physiology. So, there is hope that cannabinoid-based medications can become effective pain relievers for cancer patients.”

Jim Kelly’s toughest game: Fighting oral cancer

Source: www.foxnews.com
Author: Dr. Manny Alvarez

Jim Kelly, the Hall of Fame quarterback who played for the Buffalo Bills until 1996, is one of the greatest football players that I have ever seen. During his football career, I followed him closely and was always in awe of his athletic abilities, his leadership qualities and his love of family.

Unfortunately, Jim Kelly is currently battling a second recurrence of oral cancer and has been scheduled to undergo surgery in an attempt to control the disease. His wife, Jill, told the Associated Press that her 54-year-old husband’s cancer is aggressive and beginning to spread.

I’ve been following Jim Kelly’s health struggles and have been thinking about him, praying that he gets better. It is easy to think of some humans as immortal – especially when you’re looking at an individual as physically fit as Jim Kelly. But we tend to forget that sometimes nature has a unique plan for all of us.

However, Jim Kelly’s struggles can serve as a reminder for us all to be vigilant about our health. Jim Kelly is suffering from oral cancer, which doesn’t get the attention that it deserves, despite the fact that 42,000 new cases will be diagnosed in 2014, according to the National Cancer Institute.

Oral cancers are any cancers occurring in the oral cavity, which starts in your throat and extends all the way to your lips. The sad part about this disease is that oral cancers are typically not identified early, which severely reduces survival rates.

The early signs of oral cancer are often missed because lesions are small, painless and often not irritating – especially in tongue cancers or cancers of the gums. But, as the cancer grows, these lesions become ulcerated, causing burning and severe tenderness in the affected areas. Because of the vascular nature of the mouth and throat, many of these cancers tend to metastasize, making matters much worse.

Some risk factors for oral cancer include tobacco use, excessive alcohol consumption and exposure to some strains of the humanpapilloma virus (HPV). HPV has also been linked to cervical cancers in women.

One very important fact to know about oral cancer is that diagnoses of the disease have increased every year for the past five years, according to The Oral Cancer Foundation. That is why it’s so important for people to schedule regular appointments with their dentist – and to make sure they get examined for signs of oral cancer.

If you catch oral cancers early, the survival rate can be over 80 percent. Treatments for oral cancer often include surgery, in addition to radiation and chemotherapy. Yet, once the tumor has metastasized, it can be very challenging for doctors to control or remove it.

Please join me in wishing Jim Kelly all our love and support, and keep his family in our hearts.

March, 2014|Oral Cancer News|