Recognizing and treating oral leukoplakia in primary care

Source: www.clinicaladvisor.com Authors: Christina Alvarez, PA-C, Corinne I. Alois, MS, PA-C, Louise Lee, EdD, MHA, PA-C Oral leukoplakia is a common premalignant condition most commonly identified in the smoking patient population. Once oral leukoplakia is diagnosed, the fundamental goal is to minimize progression towards invasive carcinoma through the use of various treatment methods such as traditional scalpel excision, cryotherapy, and carbon dioxide (CO2) laser therapy. Epidemiology and Pathogenesis of Oral Leukoplakia Leukoplakia is defined as a white, painless, plaque most commonly occurring on the buccal mucosa, lateral tongue, or floor of the mouth.1 Leukoplakia is considered one of the most common oral potentially malignant disorders (OPMDs) with an estimated worldwide prevalence of 1.5% to 2.6%.1 This premalignant condition, which can lead to oral cancer, particularly squamous cell carcinoma, presents with various transformation rates ranging from 0.1% to 17.5%.2 Due to variability in transformation to malignancy, identification, treatment, and monitoring is imperative. The etiology of oral leukoplakia is multifactorial and many cases are considered idiopathic; however, several strong risk factors are associated with this condition, the most common being chronic exposure to all forms of tobacco products, which cause mucosal irritation over time.1,2 Prolonged use of tobacco products is attributed to the conversion of normal cells to hyperplasia, dysplasia, and eventually carcinoma in situ or invasive carcinoma. It is reported that leukoplakia is 6 times more common in smokers than nonsmokers.1 Oral leukoplakia is most commonly seen in men aged 40 years and older, particularly after years of chronic tobacco use.1,2 [...]

2021-09-05T08:19:58-07:00September, 2021|Oral Cancer News|

The YAP signal plays a crucial role in head-and-neck cancer onset

Source: www.eurekalert.org Author: press release, Kobe University Joint research between Kobe University and National Hospital Organization Kyushu Cancer Center has revealed that mice with mutations in the YAP signal pathway develop head-and-neck cancer over an extremely short period of time (world's fastest cancer onset mouse model), indicating that this pathway plays a crucial role in the onset of these cancers. This discovery may shed light on the development of new drugs for head-and-neck cancer. This research resulted from a collaboration between a research group led by Professor SUZUKI Akira and Associate Professor MAEHAMA Tomohiko at Kobe University Graduate School of Medicine, and Dr. MASUDA Muneyuki's team at Kyushu Cancer Center. These results were published in the American scientific journal 'Science Advances' on March 18. Main Points: >Deletion of MOB1 (*1, which represses YAP) in mouse tongues causes strong activation of YAP (*2), leading to the early onset of cancer (in about 1 week). >In humans, the expression of YAP increases during the development of dysplasia (pre-cancerous lesions), prior to the onset of head-and-neck cancer. YAP continues to increase with the development and progression of cancer. This high YAP activation is linked to poor patient prognosis. >The onset and progression of head-and-neck cancer in the mice in this study, and the proliferation of stem cells in this cancer in humans, are dependent on YAP. >These results suggest that cancer develops when the YAP activation exceeds a threshold. YAP may play a fundamental role in head-and-neck cancer onset and progression. These conclusions [...]

‘Whitish patch’: increase in oral dysplasia in young adults

Source: www.medscape.com Author: Kristin Jenkins Most 8-year-olds with a wiggly tooth expect the Tooth Fairy to tuck some money under their pillow. In the case of one little Canadian boy, his wiggly tooth got him an incisional biopsy, a diagnosis of oral squamous cell carcinoma (OSCC), a partial maxillectomy, and a defect that was closed with local advancement flaps. "This was the most unusual case we've seen," said Marco A. Magalhaes, DDS, PhD, assistant professor of oral pathology and oral medicine in the Faculty of Dentistry at the University of Toronto in Ontario, Canada. "OSCC predominantly affects patients 40 years of age and older," write Magalhaes and colleagues in a case study report published in November 2016 in Oral Surgery Oral Medicine Oral Pathology Oral Radiology. "It is extremely rare in patients younger than 20 years of age." The clinical, radiographic, and histologic findings in this young patient were distinctive. Although the diagnosis and treatment were challenging, the clinical course was favorable at follow-up, the authors said. This case illustrates the fact that even pediatric patients can be at risk for OSCC. Magalhaes said that he and other dentists are concerned about the rising number of OSCC cases in patients who are in their 20s and 30s. These patients have no known risk factors and are often without symptoms. Many are diagnosed with high-grade oral epithelial dysplasia (OED) that rapidly progresses to cancer, Magalhaes told Medscape Medical News. "When you look at the distribution of cases of oral dysplasia or [...]

Vaccine clears some precancerous cervical lesions in clinical trial

Source: www.sciencedaily.comAuthor: Mark L Bagarazzi, MD et al. Scientists have used a genetically engineered vaccine to successfully eradicate high-grade precancerous cervical lesions in nearly one-half of women who received the vaccine in a clinical trial. The goal, say the scientists, was to find nonsurgical ways to treat precancerous lesions caused by HPV. "Every standard therapeutic option for women with these lesions destroys part of the cervix, which is particularly relevant for women of childbearing age, who may then be at risk for preterm birth due to a weakened cervix," says Cornelia Trimble, M.D., professor of gynecology and obstetrics, oncology, and pathology at the Johns Hopkins University School of Medicine, and first author of the new report, which appears online Sept. 17 in The Lancet. "A vaccine able to cure precancerous lesions could eventually be one way women can avoid surgery that is invasive and can also harm their fertility." High-grade cervical lesions, termed CIN2/3, occur most often in women 40 or younger, according to Trimble, a member of Johns Hopkins' Kelly Gynecologic Oncology Service and Kimmel Cancer Center. Because the lesions can progress to cancer, they are usually removed by surgery, freezing or laser. The procedures are successful in removing the precancerous areas in approximately 80 percent of women, says Trimble. Less troublesome lesions, called low-grade dysplasia, are usually monitored by physicians rather than immediately removed because they pose less of a risk for cancer and usually regress on their own. For the study, the scientists used a vaccine, originally developed [...]

2015-09-21T17:41:30-07:00September, 2015|Oral Cancer News|

LED Medical develops risk assessment test for oral cancer

Source: Dr. BicuspidPublished: January 16, 2014By: Donna Domino    LED Medical Diagnostics has signed an agreement with the BC Cancer Agency to form a collaborative relationship with Genome British Columbia (Genome BC) to create and commercialize a progression risk assessment test for oral cancer. The test, which is the first genetic test for oral cancer, is based on a quantifiable genetic phenomenon known as "loss of heterozygosity" (LOH), the most common molecular genetic alteration observed in human cancers. LOH refers to genetic information that shows if a cell has developed into an abnormal state (dysplasia) and predicts what the outcome of the dysplasia will be, LED Medical Diagnostics' founder and director, Peter Whitehead, explained in an interview with DrBicuspid.com. "The test will show whether or not the dysplasia is going to turn into something you need to remove immediately or something you need to be concerned about and just watch," he said. The test will use the same technology that screened and diagnosed actress Angelina Jolie's breast cancer risk, Whitehead noted. "She had a hereditary high-risk gene, and the lump in her breast had lots of heterozygosity. They removed her breast based on the fact that the LOH in that tumor was high-risk," Whitehead said. "LOH has been around for a while, but no one has translated it from lab bench to a clinical test." When a patient is diagnosed with moderate dysplasia, they usually must see a specialist every six months for five years because there's a chance the dysplasia [...]

2014-01-17T12:57:42-07:00January, 2014|Oral Cancer News|

Oral epithelial dysplasia: What does it really mean?

Source: www.rdhmag.com Author: Nancy W. Burkhart, RDH, EdD Patients are sometimes followed for periods of time for what is called dysplasia, leukoplakia, keratotic lesions, and previous frank carcinoma. With any degree of tissue change, the person should be followed closely and an etiology always needs to be determined. Sometimes, removal of a frictional component is suggested; at other times, the lesion may have a more ominous appearance that will alert the clinician that cancer might be high on the differential list. Obviously, in highly suspicious lesions, a biopsy would occur immediately. Patients will sometimes tell the clinician that they were previously biopsied and the report will note "evidence of dysplasia." Sometimes a diagnosis is made of dysplasia, but the lesion becomes carcinoma over time, even after the initial removal of the lesion. The reverse may be true as well, where the body responds physically and the tissue regains a state of health. Why does one individual develop carcinoma while another person may develop a mild epithelial dysplasia? Perhaps the body is able to stop progression or reverse the state of progression. These are questions that researchers continue to evaluate and study. Frictional keratosis, though, is not in the same category as dysplasia. When the frictional component is removed, the lesion will subside. An example of a common lesion that has a frictional component is cheek chewing or morsicatio buccarum. However, chronic frictional or chemical assault on the tissue over time can also cause dysplastic changes. The body has [...]

Oral cancer: How discovery devices assist screenings

Source: www.dentistryiq.com Author: Nick Efthimiadis, Vice President, Sales & Marketing, LED Dental Inc. As the intense media attention surrounding Michael Douglas’s illness clearly demonstrated, oral cancer is increasingly in the news these days. With the unfortunate growth in the number of relatively young people contracting the disease due to exposure to the sexually-transmitted human papilla virus — specifically, the HPV-16 strain — oral cancer will only become a bigger concern for both patients and dental practices over time. In fact, the Oral Cancer Foundation recently announced that HPV-16 has now replaced tobacco as the leading cause of this disease. Sadly, one North American dies every hour of every day from oral cancer, and many of those who survive the disease are forced to deal with lengthy, painful treatment and permanent disfigurement. The main problem is that oral cancer is typically discovered in late stages, when the five-year survival rate is only around 30%. The good news: when discovered early, the survival rate leaps to 80%-to-90%. The key to early discovery is the dental practice. Ideally, each and every practice should be conducting a two-step oral cancer screening on all adult patients as part of their annual or semi-annual hygiene checkup. The first step consists of a conventional “white light” exam comprising visual inspection and palpation. The second step consists of examination with an adjunctive screening device. Fortunately, the two steps should take no more than five minutes combined. For the past several years, the adjunctive device that has [...]

SIBLING proteins may predict oral cancer

Source: www.sciencedaily.com Author: Medical College of Georgia The presence of certain proteins in premalignant oral lesions may predict oral cancer development, Medical College of Georgia researchers said. SIBLINGs, or Small Integrin-Binding Ligand N-linked Glycoproteins, are a family of five proteins that help mineralize bone but can also spread cancer. SIBLINGs have been found in cancers including breast, lung, colon and prostate. "Several years ago we discovered that three SIBLINGs -- osteopontin, bone sialoprotein and dentin sialophosphoprotein -- were expressed at significantly high levels in oral cancers," said Dr. Kalu Ogbureke, an oral and maxillofacial pathologist in the MCG School of Dentistry. "Following that discovery, we began to research the potential role of SIBLINGs in oral lesions before they become invasive cancers." The study, published online in the journal Cancer, examined 60 archived surgical biopsies of precancerous lesions sent to MCG for diagnosis and the patients' subsequent health information. Eighty-seven percent of the biopsies were positive for at least one SIBLING protein -- which the researchers discovered can be good or bad, depending on the protein. For instance, they found that the protein, dentin sialophosphoprotein, increases oral cancer risk fourfold, while bone sialoprotein significantly decreases the risk. "The proteins could be used as biomarkers to predict [the potential of a lesion to become cancerous]," said Dr. Ogbureke, the study's lead author. "That is very significant, because we would then be in a position to modify treatment for the individual patient's need in the near future." Precancerous oral lesions, which can develop [...]

2010-09-21T12:49:42-07:00September, 2010|Oral Cancer News|

Does green tea prevent cancer?

Source: www.ivanhoe.com Author: staff Evidence continues to brew about the protective effects of green tea against cancer, but scientists are still not sure the tea leaves reveal the answer. Vassiliki Papadimitrakopoulo, M.D., professor of medicine in the Department of Thoracic/Head and Neck Medical Oncology at the University of Texas M. D. Anderson Cancer Center, and colleagues tested 41 patients who took green tea extract orally for three months at three dose levels. Nearly 60 percent of patients with oral pre-malignant lesions, who were at the highest dose levels, displayed clinical response, compared with less than 20 percent among those taking placebo. Researchers also observed a trend toward improved histology, and a trend toward improvement in a handful of biomarkers that may be important in predicting cancer development. Patients were followed for 27.5 months, and at the end of the study period, 15 developed oral cancer. Although there was no difference in oral cancer development overall between those who took green tea extract and those who did not, patients who presented with mild to moderate dysplasia had a longer time to develop oral cancer if they took green tea extract. Although encouraged by the results, Dr. Papadimitrakopoulo cautioned against any recommendations that green tea could definitely prevent cancer. "This is a phase II study with a very limited number of patients who took what would be the equivalent of drinking eight to 10 cups of green tea every single day," Dr. Papadimitrakopoulo was quoted as saying. "We cannot with certainty claim [...]

2009-11-09T14:03:35-07:00November, 2009|Oral Cancer News|

Involvement of potential pathways in malignant transformation from oral leukoplakia to oral squamous cell carcinoma revealed by proteomic analysis

Source: 7thspace.com Author: staff Oral squamous cell carcinoma (OSCC) is one of the most common forms of cancer associated with the presence of precancerous oral leukoplakia. Given the poor prognosis associated with oral leukoplakia, and the difficulties in distinguishing it with cancer lesion, there is an urgent need to elucidate the molecular determinants and key signal pathways underlying the malignant transformation of precancerous to cancerous tissue, and thus to identify novel diagnostic and therapeutic target. Results: We have utilized two dimensional electrophoresis followed by ESI-Q-TOF-LC-MS/MS to identify proteins differentially expressed in six pairs of oral leukoplakia tissues with dysplasia and oral squamous cancer tissues, each pair from the same patient. Approximately 85 differentially and constantly expressed proteins (>two-fold change, P>0.05) were identified, 52 up-regulated and 33 down-regulated. Gene ontological methods were employed to identify the biological processes that were over-represented in this carcinogenic stage. Potential biological networks were also constructed to reveal the link between those protein candidates. Among those proteins, three homologs of proteosome activator PA28 a,b and g were shown to have up-regulated mRNA levels in OSCC cells relative to oral keratinocytes. Conclusions: Amounts of differentially expressed proteins involved in the malignant transformation of oral leukoplakia. Their expression level, bioprocess, interactions networks could be analyzed by bioinformatics approach. All the three homologs of PA28 may be shown to play an important role in the malignant transformation. Our study is an example of a systems biology study, in which functional proteomics was constructed to help to elucidate mechanistic aspects [...]

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