drinking

Rating HPV biomarkers in head, neck cancers

Source: www.sciencecodex.com

Not all head and neck cancers are created equal. Those started by infection with the human papillomavirus are less often fatal than those with other causes, such as smoking. Detection of a reliable fingerprint for HPV could help patients avoid unnecessarily harsh treatment. A new study finds that while one popular biomarker for HPV is not a reliable predictor of mortality from the cancers alone, combinations of some biomarkers showed much more promise.

“Everybody who has studied it has shown that people with virally associated disease do better,” said Karl Kelsey, aprofessor of epidemiology and pathology and laboratory medicine at Brown University, and corresponding author of the study in Cancer Research. “There are now clinical trials underway to determine if they should be treated differently. The problem is that you need to appropriately diagnose virally related disease, and our data suggests that people need to take a close look at that.”

In the study, Kelsey and his multi-institutional team of co-authors measured the ability of a variety of biomarkers to predict mortality from head and neck squamous cell carcinoma (HNSCC). Their data came from hundreds of adult head and neck cancer patients in the Boston area that they have been tracking since late 1999. As part of that data set, they were able to look at blood serology and tumor tissue samples, and they interviewed participants about risk behaviors such as smoking and drinking.

DNA alone not reliable
One of the most important findings of the study, Kelsey said, is that extracting and amplifying the DNA of HPV in tumors, a popular notion among doctors given its success in confirming HPV’s role in cervical cancers, is not particularly helpful in predicting eventual mortality from head and neck cancer.

For example, among 94 patients for whom the researchers could assess the predictive value of all the biomarkers in the study, HPV DNA was present in tumors of 59 patients and absent in 35. Among the 59 who had the DNA, 23 of them, or 39 percent, had died. Among the 35 without the DNA, 13 of them, or 37 percent had died.

“You can’t just do PCR [a DNA amplification technique] of the virus in the tumor and assume it means much,” Kelsey said.

More promising combinations
Among several other potential HPV biomarkers in patients, the most reliable predictors of mortality turned out to be certain combinations of them, particularly antibodies to the E6 and E7 proteins that are expressed by the virus and have the effect of turning off cells’ ability to suppress tumors.

Kelsey and his colleagues found that measuring blood serum levels of antibodies that respond to E6 and E7 helped to assign meaning to measures of HPV DNA in tumors. Among people who had both HPV DNA and E6/E7 measurements, those with HPV DNA in tumors who were E6/E7 negative died in 30 of 56 cases, while those with HPV DNA in tumors who were E6/E7 positive died in only eight of 55 cases.

Levels of E6 and E7 antibodies in blood also proved telling in combination with staining tumors to detect the p16 protein, which indicates that tumor-suppression has been inactivated. Among patients in whom both those tests were both run, those with p16 overexpression who were E6/E7 negative had a much higher rate of death (11 in 17 cases) than people who did not overexpress p16 and were E6/E7 positive (3 in 9 cases) or those who overexpressed p16 and who were also E6/E7 positive (6 in 37 cases).

“Our study strongly suggests that the combination of detection of HPV 16 DNA in HNSCC tumors or p16 immunostaining with E6/E7 antibodies represents the most clinically valuable surrogate markers for the identification of patients with HNSCC who have a better prognosis,” Kelsey and his co-authors concluded.

In a companion paper published simultaneously in Cancer Research another team found that measuring viral load and patterns of viral gene expression were also useful markers.

Source: Brown University

September, 2012|Oral Cancer News|

Even one drink can raise cancer risk – research

Source: www.nzherald.co.nz

Just one alcoholic drink a day may increase the risk of cancer, according to a new study, which estimates that light drinking is responsible for 34,000 deaths a year worldwide.

New research based on more than 150,000 men and women shows that light drinking increases the likelihood of cancer of the mouth, pharynx, oesophagus and breast.

One drink a day increased the risk of cancer of the oesophagus by almost a third, according to the study being reported in the Annals of Oncology, which analysed data from more than 200 research projects. Low alcohol intake increased the risk of oral cavity and pharynx cancer by 17 per cent, and breast cancer in women by 5 per cent.

“Alcohol increases the risk of cancer even at low doses,” say the researchers.

“Given the high proportion of light drinkers in the population, and the high prevalence of these tumours, especially of breast cancer, even small increases in cancer risk are of great public health relevance.”

When it comes to enjoying your favourite drink and looking after your health, advice has often been complicated. Evidence suggests that drinking in moderation may decrease the risk of heart disease, type-2 diabetes and dementia, leading many to believe a glass of wine a day is good for you.

But the damaging effects of drinking are well known. An estimated 2.2 million deaths a year worldwide are linked to alcohol, according to the report, and 3.6 per cent of all cancers are attributable to drinking alcohol.

Until now, almost all the evidence has come from studies that focused on people drinking moderate or large amounts of alcohol, or binge drinkers, and not those who drink less.

In the new study, researchers from the University of Milan and other centres in the US, France, Canada, Iran and Sweden, estimated that, in one year alone, 24,000 deaths from oesophageal cancer, 5000 from oral and pharyngeal, and 5000 from breast cancer, were due to light drinking.

The study defined light drinking as up to one drink a day or 12.5g or less of ethanol. Data on 92,000 light drinkers and 60,000 non-drinkers was used to calculate the overall cancer risk. No link was found with other cancers that have been associated with heavier drinking, including colon, liver and larynx.

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “This study adds to the evidence linking alcohol consumption to several types of cancer, and confirms that even light drinkers have a small but definite increase in the risk, particularly for those parts of the body, such as the throat and oesophagus, that come into direct contact with alcohol.

“People who wish to minimise their risk of cancer can help by cutting down on their drinking.”

Just why light intake increases the risk of some cancers and not others, is unclear. The researchers suggest that with cancer of the mouth, pharynx and oesophagus it may be because the alcohol comes into direct contact with the affected tissue. They suggest the rise in risk for breast cancer may be associated with increased levels of oestrogen, or higher levels of insulin-like growth factors that are produced by the liver after drinking alcohol.

August, 2012|Oral Cancer News|

Survey reveals most are unaware of the causes and symptoms of mouth cancer

Source: www.cosmeticdentistryguide.co.uk
Author: staff

A survey has revealed that most people are unaware of the major risk factors and symptoms of oral cancer.

The SimplyHealth Annual Dental Health Survey revealed that of the 11,785 adults surveyed, 70 percent were unaware of the symptoms of mouth cancer while only 3 percent knew that kissing could increase your risk of moth cancer as a result of exposure to the human papilloma virus (HPV).

A spokesperson for SimplyHealth said that most were aware that smoking and drinking increased the risk of oral cancer, but very few people were aware of the link between oral cancer and the HPV, a virus which is also responsible for some cases of cervical cancer. According to Cancer Research UK, some strains of HPV increase the risk of mouth cancer, which could explain why the disease is becoming more common in young people, as the virus is spread through physical contact.

Dentist Michael Thomas said that it was important for people to be aware of the symptoms of mouth cancer, as well as the causes. As with most forms of cancer, the earlier mouth cancer is diagnosed, the higher the chance of survival.

Only 28 percent of adults surveyed had discussed mouth cancer with their dentist and this is worrying, as dentists are in a prime position to spot the early warning signs and arrange further tests and treatment.

The most common symptoms of mouth cancer include lumps or swellings in the mouth or throat, sores or ulcers that take a long time to heal and red or white patches in the mouth.

April, 2012|Oral Cancer News|

More troops on smokeless tobacco after deployment

Source: Reuters.com

The findings, reported in the journal Addiction, follow other studies that have tied deployment and combat to health risks, including higher rates of smoking and drinking.

“This adds to the list of things we’re learning are associated with combat,” said lead researcher Dr. Eric D.A. Hermes, of the Yale University School of Medicine in New Haven, Connecticut.

It’s not fully clear why some troops take up smokeless tobacco after deployment. But Hermes suspects stress is involved.

That’s because deployment with combat exposure was linked to a higher risk than deployment alone. And troops with symptoms of post-traumatic stress disorder (PTSD) also had an increased risk.

The findings come from the Millennium Cohort Study, an ongoing government project looking at the health effects of military service.

Of more than 45,000 personnel followed from 2001 to 2006, 2 percent started using smokeless tobacco during that time. Another 9 percent had already developed the habit, and kept it up.

Overall, troops who were deployed but did not see combat were almost one-third more likely to take up a smokeless tobacco habit than their non-deployed counterparts. Those odds were two-thirds to three-quarters higher for troops who were in combat or who deployed multiple times.

According to Hermes, those different levels of deployment can be seen as stand-ins for different levels of stress.

So it’s possible that stress plays a role, he said.

Another finding gives weight to that idea. “We also saw a relationship with PTSD symptoms,” Hermes said.

Just under 4 percent of all troops had PTSD symptoms, based on a standard questionnaire. And they were 54 percent more likely to start using smokeless tobacco than troops without symptoms, Hermes and his colleagues found.

There are other factors that, along with stress, might push some deployed troops toward tobacco, according to Hermes.

“You’re not at home, you have more exposure to smokeless tobacco, you’re around more people doing it,” Hermes said. “Maybe it’s all these little things coming together.”

MILITARY TOBACCO USE STILL HIGH

Past studies have found that while tobacco use in the military is declining, it’s still higher when compared to the U.S. public as a whole. In 2005, almost 15 percent of military personnel said they’d used smokeless tobacco in the past year — versus just three percent of Americans overall.

“Smoking is the thing that everyone talks about,” Hermes said. “But there’s also smokeless tobacco, and it seems to be related to the stress of combat.”

Whether some troops are “treating” their stress with tobacco, or whether the tobacco somehow feeds the stress is not entirely clear, according to Hermes. “There’s still a chicken-and-egg question,” he said.

But the findings suggest that doctors treating military personnel should ask not only about smoking habits, but any use of the smokeless forms of tobacco, Hermes said.

Tobacco products are widely available at U.S. military bases. A 2009 study commissioned by the Pentagon and the Department of Veterans Affairs recommended a phased-in ban on tobacco on military property. But whether that will ever happen remains up in the air.

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

February, 2012|Oral Cancer News|

Men in doubt still don’t get checked out!

Source: www.easier.com
Author: staff

Men are almost twice as likely to die from mouth cancer and statistics consistently show they are less likely to consult with a doctor than their female counterparts. But with rates of incidence and mortality rising at an incredible rate, men can no longer afford to ignore the increasing threat of a killer disease.

Mouth cancer cases in the UK have almost doubled in the last decade, rising to 6,000 every year with almost 4,000 of those coming from men and although there are some clear early warning signs many postpone seeking professional advice, leaving fatality rates of the disease at 50 per cent.

This is supported by data from the Office of National Statistics, which reveals that women are twice as likely to see their GP as men, visiting the doctors an average of six times a year compared to just three for men. Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, puts this failing down to a lack of general cancer health knowledge in men and warns that ignoring the issue can lead to severe problems in future.

Dr Carter said: “For almost all types of cancer, men will die more often than women. There’s no biological reason that this should be the case so the reason must be purely down to the timing of diagnosis. Unfortunately, when men do go to their GP their condition may be at a far more advanced stage and therefore much more difficult to treat.

“By ignoring or dismissing the early and minor symptoms the disease will become rapidly advanced so that when they do seek help it makes it so much harder for treatment to be successful. The message is simple… ‘If in doubt, get checked out.'”

Throughout November, leading oral health charity the British Dental Health Foundation, is running Mouth Cancer Action Month and hoping to improve rates of ‘early detection’, especially in men. One in two people who contract mouth cancer will die without early diagnosis, which can improve the five year survival rate to 90 per cent.

However, while the treatment of many cancers is resulting in an improvement of survival rates, the same cannot be said for mouth cancer, of which the proportion that dies has remained fairly constant over the last ten years.

Dr Carter added: “Regrettably, most men will only resort to seeing their GP because their partner has ‘told’ them to – this must change, as must the education of health issues to all men. The first stage in this process is being able to identify the risks factors. Smoking, drinking alcohol to excess, poor diet and the Human Papilloma Virus (HPV), transmitted via oral sex, are all risk groups of the disease. The good news is that these are environmental and lifestyle choices, which can be avoided and altered.”

Early detection is critical to the survival of mouth cancer sufferers. Learn and recognise the warning signs, which include ulcers which do not heal within three weeks, red and white patches in the mouth, and unusual lumps or swellings in the mouth.

November, 2011|Oral Cancer News|

Using mouthwash can increase cancer risk for smokers

Source: www.independent.ie
Author: Eilish O’Regan, health correspondent

Smokers have been warned to stay away from mouthwash – as it might increase their risk of developing mouth cancer. The combination of smoking and drinking alcohol has been established as increasing the risk of the disease.

Now researchers have warned that may apply even to the alcohol contained in mouthwash. They pointed out that, while the link between the use of mouthwash containing alcohol and the cancer is not firmly established, it is best avoided or limited in use by smokers. The risk was examined by researchers led by dentist Dr John Reidy and colleagues in the Royal College of Surgeons and St James’s Hospital in Dublin.

Around 400 new cases of oral cancer are diagnosed each year in Ireland with two people a week dying from the disease. Symptoms include red and white patches on the lining of the mouth or tongue, a mouth ulcer that does not heal or a swelling that lasts for more than three weeks.

The most effective way of preventing mouth cancer is to quit smoking and limit consumption of alcohol, say experts. The researchers said they were concerned about the effects the alcohol in the mouthwash had and it was therefore “prudent” to restrict its use by smokers who are considered “high-risk” for mouth cancer. Around three-quarters of mouth cancers arise due to a patient both smoking and drinking, according to the study in the Journal of the Irish Dental Association.

August, 2011|Oral Cancer News|

With HPV-related head and neck cancers rising, focus on treatment and vaccination

Source: blogs.wsj.com/health
Author: Laura Landro

A form of head and neck cancer associated with the sexually transmitted human papillomavirus is on the rise, especially in men, the WSJ reports.

Fast-rising rates of oropharyngeal cancer — tumors in the tonsil and back-of-the-tongue area — have been linked to changes in sexual behavior that include the increased practice of oral sex and a greater number of sexual partners.

But HPV-positive cancer has also been reported in individuals who report few or no sexual partners. It may also be possible for the virus to be transmitted to an infant via an infected mother’s birth canal. An HPV vaccine is routinely recommended for girls because the virus can cause cervical cancer.

The rise in HPV-positive head and neck cancers is leading to a new focus both on treatment of the disease, and whether recommending routine vaccination for boys could prevent oral infections and cancers. (A CDC advisory panel said in 2009 that it was fine for boys to get the vaccine, but recommended against routine administration.)

Eric Genden, chief of head and neck oncology at Mt. Sinai Medical Center, tells the Health Blog that when treated appropriately, patients with HPV-positive cancers have an 85% to 90% disease-free survival rate over five years. By contrast, patients with HPV-negative head and neck cancers, which are often associated with smoking and drinking, typically have more advanced disease when the cancer is detected and face a five-year survival rate of only 25% to 40%, Genden says.

HPV-induced head and neck cancer responds well to almost all forms of cancer therapy including surgery, external beam radiotherapy and chemotherapy. At Mount Sinai, the use of robotic surgery and radiation –with no chemotherapy required — resulted in three-year survival rates of 90% and significantly improved quality of life for patients, its studies show. Robotic surgery is less invasive than non-robotic tumor surgeries, minimizing complications and recover time.

Philip Keane, a 52-year old photographer and father of three , had the surgery last July at Mount Sinai, followed by a six-and-a-half week course of radiation at Memorial Sloan-Kettering Cancer Center. Keane says he’s switched to a healthier diet, and didn’t develop many of the symptoms of radiation he was warned about, such as mouth or neck sores. He says that during his therapy, he was able to continue working and doing everything he did before he got sick, and is now cancer-free.

On the vaccine front, at a meeting next month the CDC plans to review data on the issue of the cost and benefits of routinely recommending HPV vaccination for boys.

Michael Brady, chair of the department of pediatrics at Nationwide Children’s Hospital in Columbus, Ohio and chairman of the infectious disease committee for the American Academy of Pediatrics, says the AAP is awaiting any updates before changing its own policies: routine recommendation for girls at age 11 to 12 (with catch-up for teens and young women who have not received the vaccine, up to age 26 years) and a permissive recommendation for boys — meaning families or teens can get it if they ask for it.

Brady explains that the gender discrepancy for HPV vaccine occurred because initial studies for safety and effectiveness were done in females and the idea was a high coverage rate in females would result in protection of heterosexual males via herd immunity.

But low coverage of females by the vaccine means that there is minimal protection of heterosexual males, and there’s increasing evidence of the impact of HPV-related genital, oral and anal cancers in men. There is also no value in a female vaccine program for homosexual men. “All [this leads] to a realization that males would benefit from the HPV vaccine,” Brady says.

The CDC’s own permissive recommendation for young men allowed for payment through the Vaccines for Children program, and a Merck spokeswoman says more commercial insurers are paying for the vaccine for males. But Brady says vaccines with that level of recommendation tend to not be discussed at physician visits, and administration of HPV vaccine to males has been very low.

Moreover, while clear evidence of a cost benefit in girls was shown prior to the release of the vaccine, cost/benefit data for males are still being determined. “The more that people look; the more that it is clear that males would benefit by receiving the HPV vaccine,” Brady says. “The discussion is [over] whether it merits a routine recommendation.”

Alcohol linked to 10% of cancer cases, study finds

Source: www.irishtimes.com
Author: Dr. Muiris Houston

Reducing alcohol intake would reduce the number of cancer cases in the Republic, the Irish Cancer Society has said.

It was responding to the results of a major European study, published online by the British Medical Journal, which found that up to one in 10 cancers in men and one in 33 in women could be caused by drinking.

Researchers concluded that drinking above recommended alcohol limits was likely to be responsible for the majority of cancer cases linked to alcohol, although for some people even a small consumption may increase the risk.

They analysed data from eight European countries, involving more than 360,000 men and women who were aged between 35 and 70 at the beginning of the study. The research is part of the European Prospective Investigation of Cancer, one of the largest ever studies into the links between diet and cancer.

Some 17 per cent of bowel cancers in men were linked to drinking, as were 4 per cent of cases in women. And 5 per cent of cases of breast cancer in women were also linked to drinking, the study showed. Overall, more than 18 per cent of cancers in men were down to drinking more than 24g of alcohol a day. In women, 4 per cent of cancers were due to drinking more than 12g of alcohol daily.

Naomi Allen, from Oxford University, one of the researchers, said: “This research supports existing evidence that alcohol causes cancer and that the risk increases even with drinking moderate amounts.

“The results from this study reflect the impact of people’s drinking habits about 10 years ago. People are drinking even more now, and this could lead to more people developing cancer because of alcohol in the future.”

Men and women in Germany, Denmark and the UK were most likely to exceed recommended alcohol intake guidelines, which also looked at people in France, Italy, Spain, Greece and the Netherlands.

Dr Sinéad Walsh, research officer with the society, said: “We recommend that to reduce the risk of developing cancer, people should try to avoid or limit their intake of alcohol. We recommend that, in line with the European Cancer Research Fund guidelines, men should have no more than two standard drinks per day and women no more than one standard drink.”

According to the International Agency for Research on Cancer, there is a causal link between alcohol consumption and cancers of the liver, female breast, bowel, and upper digestive tract. Alcohol also plays a role in the development of oral cancers, including cancer of the pharynx and larynx.

However, until now, data had not been available on the number of cancer cases linked to total alcohol consumption or the proportion of cases caused by alcohol consumption beyond the recommended upper limit. When broken down by the body, alcohol produces a chemical that can damage DNA and increase the risk of cancer.

April, 2011|Oral Cancer News|

Oral sex now main cause of oral cancer: Who faces biggest risk?

Source: www.cbsnews.com
Author: David W Freeman

What’s the leading cause of oral cancer? Smoking? Heavy drinking?

Actually, it’s oral sex.

Scientists say that 64 percent of cancers of the oral cavity, head, and neck in the U.S. are caused by human papillomavirus (HPV), which is commonly spread via oral sex, NPR reported. The more oral sex you have – and the more oral sex partners you have – the greater the risk of developing these potentially deadly cancers.

“An individual who has six or more lifetime partners – on whom they’ve performed oral sex – has an eightfold increase in risk compared to someone who has never performed oral sex, Ohio University’s Dr. Maura Gillison, said at a recent scientific meeting, according to NPR.

It’s news that might alarm some parents, who worry about adolescents’ appetite for oral sex.

“Today’s teens consider oral sex to be casual, socially acceptable, inconsequential, and significantly less risky to their health than ‘real’ sex,” Dr. Gillison and colleagues said in a written statement released in conjunction with the meeting.

Teens simply think oral sex is “not that a big a deal,” Dr. Bonnie Halpern-Felsher, professor of pediatrics at the University of California, San Francisco, told NPR. “Parents and health educators are not talking to teens about oral sex. Period.”

But simply needling teens about the risks posed by oral sex and HPV – the same virus that causes cervical cancer – is no substitute for literally giving them the needle.

“When my patients ask whether they should vaccinate their sons, I say ‘certainly,” Gillison said, the Telegraph reported. “The vaccine will protect them against genital warts and anal cancer and also as a potential byproduct of that it may protect them against oral cancer caused by HPV.”

This year, 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year, according to the Oral Cancer Foundation. Eight thousand will die from the cancers.

Practical strategy for oral cancer management in dental practices published in UK

Source: www.medicalnewstoday.com
Author: staff

The British Dental Association (BDA) has published a practical guide to help dental professionals combat the growing problem of oral cancer. It reiterates the importance of the early detection of the condition, stressing the improved chances of patient survival in cases where early diagnosis takes place. The proportion of patients with oral cancer who die is higher than for cervical, breast or prostate cancers, the guide points out. It also warns that some patients are beginning to take legal action against dentists alleging failure to detect the condition.

The BDA guide, Early detection and prevention of oral cancer: a management strategy for dental practice, offers practical advice on preventing, detecting and managing oral cancer. It addresses both the clinical aspects of the condition and the management of relationships with patients. It explains the risk factors for the disease, provides guidance on talking to patients about examinations and offers tips on medical history taking and record keeping. It also explores taboos around the practitioner’s right to explore patients’ lifestyle choices that can cause oral cancer, such as drinking, smoking and chewing tobacco, and offers advice on how to overcome them.

Professor Damien Walmsley, the BDA’s Scientific Adviser, said:

“The magnitude of the problem of oral cancer in the UK is growing. While the treatment of many cancers is leading to an improvement in survival rates, the same cannot be said for oral cancer. Early detection is absolutely vital to addressing this situation.

“General dental practitioners and their teams are ideally placed to lead the fightback, but they face many practical difficulties including patient resistance to practitioners’ advice on lifestyle factors. This publication provides in-depth guidance on overcoming those problems and involving the whole dental team in the effective prevention, detection and treatment of the disease.”

BDA members can access the guide free of charge here.

Notes
1. Early detection and prevention of oral cancer: a management strategy for dental practice was edited by Professors Paul Speight (University of Sheffield), Saman Warnakulasuriya (King’s College London and World Health Organisation Collaborating Centre for Oral Cancer, UK) and Graham Ogden (University of Dundee).
2. It is published during Mouth Cancer Action Month (MCAM) 2010, which takes place in November. The month is organised by the British Dental Health Foundation (BDHF) and is supported by a group of organisations including the BDA. Details of MCAM 2010 are available here.

Source:
British Dental Association (BDA)

November, 2010|Oral Cancer News|