early detection

Ireland: mouth cancer awareness day yields results

Source: http://www.dentistryiq.com/
Author: staff

Dentists are emphasizing the importance of early detection with mouth cancer, after 12 cases of the potentially deadly cancer were discovered on Mouth Cancer Awareness Day and one of these was discovered in Waterford.

The Irish Dental Association estimates that 10,000 people availed of free mouth cancer examinations carried out by participating dentists countrywide on September 21 of last year. As well as the confirmed cases, 286 people were advised to attend their GP for other related problems. Mouth Cancer Awareness Day was set up by a group of mouth, head and neck cancer survivors in September 2010. It is now a joint initiative by the Irish Dental Association, Irish Cancer Society, Dublin Dental University Hospital, Cork Dental University Hospital, the Dental Health Foundation and Mouth, Head and Neck Cancer Awareness Ireland.

The President of the IDA, Conor McAlister said the fact twelve cancers were discovered in one day showed the importance of early detection and the need for everyone to have a regular examination.

He said, “Three hundred cases of mouth cancer are detected here each year with 100 deaths and this type of cancer actually kills more Irish people than cervical cancer or skin melanoma.

“According to the National Cancer Register in Ireland, roughly 50% of all mouth cancers are diagnosed at an advanced stage. Hopefully the fact these 12 cases have been caught at an earlier stage means the impact on quality of life will be reduced.”

He added, “This year we saw up to 10,000 and I hope we can push on from that figure next year and keep the spotlight on this lethal form of the disease.”

Research shows that smoking and drinking alcohol are the main risk factors for mouth cancer and the risk is even greater if a person smokes and drinks. The most common symptoms are mouth ulcers that will not go away, swallowing difficulties and pain on the tongue and if people experience any of these, they are advised to visit their GP or dentist.

Oral temperature changes in head and neck cancer patients predicts side effect severity

Source: American Society for Radiation Oncology

The abstract, “Pilot study of functional infrared imaging for early  detection of mucositis in locally advanced head and neck cancer  reated with chemoradiotherapy,” will be presented at the Head and  neck Society Meeting in Arizona today. This is a synopsis of that  presentation.

Slight temperature increases of the oral mucus membranes early in a head and neck cancer patient’s chemotherapy and radiation therapy (chemoradiotherapy) treatment is a predictor of severe mucositis later in treatment, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM.

Mucositis, or mouth sores, is a common side effect of chemoradiotherapy for head and neck cancer that is painful and can be very severe. Physicians cannot predict which patients will have mild mucositis or severe mucositis that would require narcotic pain  medication, nutritional support and/or feeding tubes.

Researchers in this study hypothesized that using sensitive thermal imaging technology to measure temperature changes of less than  one-tenth of a degree early in treatment could predict the severity of mucositis later in treatment. This knowledge could allow for early  intervention and potential changes in therapy using a technology that is simple, harmless and non-invasive.

Patients receiving chemoradiotherapy underwent baseline and weekly thermal imaging of their oral mucus membranes. All patients displayed an increase in temperature and severe mucositis was found in 53 percent of patients.

“If we could predict which patients were going to suffer the greatest toxicity, we could proactively make changes to their care that could  ameliorate or prevent side effects,” Ezra Cohen, MD, lead author of the study and co-director of the head and neck cancer program at The  University of Chicago in Chicago, said. “Ultimately, we could identify the patients at higher risk of severe complications from treatment.”

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

January, 2012|Oral Cancer News|

Johnson & Johnson Sued for $70 Million Over Oral Cancer Test Detection

Source: Dr.Bicuspid.com

July 8, 2011 — Oral Cancer Prevention International (OCPI), makers of the Oral CDx brush test for oral cancer detection, is suing Johnson & Johnson (J&J) over a terminated distribution contract with OraPharma.

OraPharma was previously a subsidiary of J&J until it was acquired last December by Water Street Healthcare Partners, a private equity firm in Chicago.

J&J, which among other things sells Listerine mouthwash, was worried that a 2008 study linking alcohol-containing mouthwashes with oral cancer would negatively affect sales of Listerine and allegedly induced OraPharma to breach the sales agreement, according to OCPI.

The lawsuit, filed July 6 in U.S. District Court, District of New Jersey, claims that J&J “maliciously and fraudulently” interfered with a contract between OCPI and OraPharma that gave OraPharma exclusive rights to sell the test to U.S. dentists.

J&J’s interference caused OraPharma “to suppress sales of and withhold from the public a proven lifesaving oral cancer prevention product in order to protect sales of its mouthwash, Listerine, which has been linked to oral cancer,” according to the complaint.

After OCPI signed the contract in February 2010, J&J did not want to “lend credence to the link between Listerine and oral cancer” by selling both its mouthwash and OralCDx, the complaint states.

As of press time, J&J did not return calls for comment by DrBicuspid.com.

Sales of Listerine bring in more than $1 billion per year, the suit claims.

OralCDx is a “quick, painless, and inexpensive test that can prevent oral cancer by identifying dysplastic cells in the mouth long before they turn cancerous,” the complaint states, adding that it has “already has been demonstrated to save lives.”

The test, which has been recommended by the ADA, “is the only clinically proven test for the painless early detection of precancerous oral tissue at a stage when lives can be saved,” the complaint states.

Before OCPI signed the distribution contract in 2010, its sales teams sold more than 2,000 tests per month in 2008 and 2009, according to the company.

OraPharma President Russ Sector lobbied OCPI to get the exclusive distribution contract, noting that his sales teams were experienced selling Arestin, a locally administered antibiotic used by dentists to treat periodontitis, Listerine, and OralCDx, which all deal with oral soft tissue, the complaint states.

OraPharma’s sales projections indicated that selling OralCDx would double OraPharma’s revenues.

Just when the contract was to be signed, OCPI “was suddenly informed that the Listerine division of J&J, which had just learned of the imminent signing of the agreement with OCPI, had prevailed upon J&J management to direct OraPharma to not execute it,” according to the complaint.

Australian study

A study published in the Australian Dental Journal in 2008 linked mouthwashes containing high levels of alcohol to an increased risk of oral cancer, and recommended that such mouthwashes be restricted to short-term medical use or replaced with alcohol-free versions. Listerine has the highest alcohol content of any over-the-counter mouthwash, the complaint states.

Sales of Listerine in Australia dropped by approximately 50% following the release of the study, according to the complaint.

J&J Vice President James Murphy then told OCPI CEO Mark Rutenberg that J&J was extremely concerned about the implications of the study, according to the suit.

Murphy told Rutenberg that J&J was “leery of highlighting the risk of oral cancer and was worried that if OraPharma were to sell both Listerine and OralCDx, it would lend credence to the link between Listerine and oral cancer, and could be construed as a tacit acknowledgment by Johnson & Johnson of the validity of the conclusions of the Australian oral cancer study,” the complaint states.

J&J did not tell OCPI that, as a result of the study, J&J “secretly had been planning during 2009 to launch a new alcohol-free mouthwash called Listerine Zero, and was concerned that a nearly simultaneous sales launch by OraPharma of Listerine Zero and the OralCDx brush test could lead to professional and public awareness of the true oral cancer motivation behind Listerine Zero and thus depress sales of the other versions of Listerine,” the complaint reads.

Listerine Zero was developed as an alternative Listerine product that would “preserve the Listerine brand and its revenues in the event ordinary Listerine were to suffer from a public perception linking mouthwashes containing alcohol to oral cancer,” according to the complaint. “Listerine Zero was carefully branded to conceal the fact that it was developed primarily in response to the Australian mouthwash oral cancer study and the subsequent sales drop in Listerine’s Australian sales.”

Breach of contract

In February 2010, Murphy contacted Rutenberg to inform him that J&J had decided to allow the sales agreement with OraPharma because J&J’s management realized that in light of the widespread anticipation of the contract by the dental industry, if J&J blocked the agreement, it would generate exactly the kind of publicity regarding the oral cancer risk of Listerine that J&J sought to avoid, according to the suit.

J&J then agreed that OraPharma could sell OralCDx through all of its dental salespeople to all of its dentist customers following a short sales training period, the complaint states. OCPI claims that representation was false.

On March 11, 2010, Murphy informed Rutenberg that the OraPharma sales training period had been completed and that OraPharma would launch its OralCDx sales efforts on March 15, 2010, according to the suit. OCPI claims that statement was also false.

J&J “never had any intention of allowing OraPharma to sell OralCDx” to dentists most likely to adopt its use in their practices, but only allowed OraPharma to enter into the agreement “as a means to control and suppress sales of OralCDx to those dentists who J&J considered most likely to recommend the use of Listerine mouthwash to their patients, thereby depriving the public of a known cancer prevention product and destroying OCPI’s dental business,” the complaint states.

OCPI raised more than $5 million in debt and equity, and spent more than $2 million to purchase laboratory equipment and to hire and train new doctors and employees to handle the minimum of 20,000 tests a month it was told to anticipate, according to the suit.

After signing the sales agreement, OraPharma insisted that OCPI not only terminate its own sales force but also terminate all of its existing distributor relationships for the OralCDx test kit, according to OCPI.

After the contract was signed, OraPharma informed OCPI that “J&J had instructed it to market OralCDx to only a minute percentage of its dentist customers and, more importantly, only to those dentists who were the least likely to purchase and use OralCDx: dentists whose practices were oriented toward providing the most basic dental services, with little or no attention to broader soft tissue care,” the complaint states.

In addition, the suit claims that J&J “prohibited OraPharma’s sales people from attempting to sell OralCDx to any dentists not on the preselected list, and required OraPharma to inform them that that they would receive no commission for selling OralCDx to dentists other than those preselected dentists and, in fact, would be disciplined or fired for selling OralCDx to any dentists not on the list.”

J&J’s “scheme to take control of OralCDx and prevent it from becoming part of routine screening throughout the U.S. succeeded,” the complaint states. By June 2010, OraPharma’s 100-plus member sales team, with access to more than 50,000 dentists, had made fewer than 50% of the sales that OCPI’ s four-person sales team had made in the six months preceding the contract.

In December 2010, OraPharma informed OCPI in December 2010 that it was selling OraPharma to Water Street Healthcare. A month later, OraPharma terminated the contract with OCPI. OCPI claims that it lost $60 million as a result and is seeking an additional $10 million in punitive damages.

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

Oral, Head and Neck Cancers Continue to Increase While Most U.S. Cancer Death Rates are on the Decline

Source: SHOTS (NPR’s Health Blog)

The rate at which Americans die from cancer continues to fall, according to the latest estimates from the American Cancer Society.

As a result, nearly 900,000 cancer deaths were avoided between 1990 and 2007, the group figures. Survival gains have come as mortality rates have declined for some of the most common malignancies, including colorectal cancer, breast cancer in women and prostate cancer.

Still, the ACS estimates there will nearly 1.6 million new cancers diagnosed this year, and about 572,000 deaths from the disease. The incidence of cancers hasn’t budged much for men in recent years, after falling quite a bit during the first half of the last decade. Cancer incidence for women has been falling since 1998.

The report was just published online by CA: A Cancer Journal for Clinicians.

Lung cancer remains the biggest killer for both men and women. All told, about 160,000 people in the U.S. are expected to die from it this year. Starting in 1987, more women have died from lung cancer each year than breast cancer.

One section of the report focuses on a persistent and, in some cases, widening gap in cancer death rates between people with the least education and those with the most. Educational attainment is often used in research as a proxy for socioeconomic status.

American Cancer Society epidemiologist Elizabeth Ward, one of the report’s authors, tells Shots, “People of a lower socioeconomic status are more likely to smoke and less likely to get access to care where they can get screened for early detection.”

Then there’s issue of health coverage, which can make a big difference in treatment. “People with higher income jobs usually work for employers who offer better insurance,” Ward says.

OCF Note. Oral and head and neck cancers are NOT one of the cancers that has declined. They are one of the few that is actually increasing in incidence in the US.

Oral Cancer Foundation breaks records in April’s Awareness and Screening Month

Source: MSNBC News
Author: staff

Oral cancer is an insidious disease that too often is not discovered until very late in its development, as it might not produce symptoms the average person may notice. By then treatments are less effective, and because of late discovery in far too many patients, it has a five year survival rate of only about 57%, much lower than cancers we commonly hear about. Oral cancer has existed outside the awareness of much of the public, yet it will take one life, every hour of every day in the U.S. This year the combination of unprecedented efforts by the relatively small, non-profit Oral Cancer Foundation, a coalition of strategic partners they formed, and a dose of celebrity power, created what might be called a perfect storm; and one that potentially will change public awareness of one of the few cancers that is actually increasing in incidence in the U.S.

For thirteen years in a row, April has been oral cancer awareness month nationally. More than 85% of all head and neck cancers are oral and oropharyngeal disease. Historically, a loose coalition of stakeholders in the disease has mustered about 200 screening events in April in facilities ranging from large institutions to individual dental offices around the country. Those participants opened their doors for at least a half-day to opportunistically screen members of the public in their communities for free, to find early stage disease, and to raise public awareness.

This year the Oral Cancer Foundation, which assumed responsibility for the logistics and promotion of the April effort, was able to create nearly 2,000 sites/events, a ten-fold increase over any previous year. In combination with 4 major walk/run awareness events the Foundation coordinated in April, tens of thousands of individual screenings for this deadly disease were conducted.

When speaking of this unprecedented success, Brian Hill, the Executive Director of the Oral Cancer Foundation, who is also a survivor of a late stage 4 oral cancer, stated, “I think that several things impacted our success. As a small organization that routinely deals with limited funding and human resources, we historically build strategic alliances to accomplish our goals. As a result, we had established relationships with large and powerful organizations to tap for help. We have a significant membership base of private practice doctors and clinical institutions that were already in place to actually accomplish the screenings, and the foundation put some of its other agendas on hold during March and April, to apply ourselves fully to the task. Combine those assets with an “A-list” celebrity who has recently come out of treatment for the disease, award-wining actor Michael Douglas, altruistically choosing to use his significant celebrity and visibility to advocate for early detection. His prime time appearances on Oprah, The Today Show and The View, discussing the need for early discovery and asking the American public to get screened for the disease, and you have an optimum environment to be successful.”

Dr. Michael Alfano, Vice Chancellor of NYU, and one of the Oral Cancer Foundation’s advisors, was particularly impressed with the metrics at the end of the month. Dr. Alfano has been an oral cancer advocate for decades, and his insightful development of the Oral Cancer Consortium, a confederacy of allied universities, and medical institutions in NY, NJ, and PA began the April screening efforts in 1998. That group continues to be involved today. “I am very pleased that OCF continues to build on their many positive credits in the world of oral cancer. To see what this idea has now become is highly gratifying. Screening has enormous potential to save lives when applied in an opportunistic manner. When the dental community, which is routinely and daily involved in the oral environment, embraces this issue, they become an important first line of defense against these cancers through early discovery of suspect tissues. OCF’s ability to organize these dental practices, and move them to active participation clearly has made a difference.”

The screenings this April were primarily visual and tactile, though many offices used some adjunctive devices in their efforts. None of these devices like the VELscope which uses a wavelength-specific beam of blue light to identify tissues with abnormalities in the oral cavity, are in any way invasive to the patients. Jamie O’Day, the Treatment Facilities Coordinator for OCF observed, “This particular cancer lends itself well to a screening methodology which is quick, painless, and even outside the realm of April’s free events, very inexpensive to accomplish. It is primarily visual and tactile, with the medical and dental professionals looking for things that a layperson may not notice, since they are often painless. Something as simple as a tissue discoloration, a hard painless lymph node in the neck, or in a patient’s verbal history taking, the statement that when swallowing they feel like something is painlessly stuck in their throat, or swallowing has become more difficult, are just a few of the signs and symptoms that professionals know are red flags. While there are more potential symptoms, I state these to illustrate how someone might easily ignore them, allowing a potentially deadly situation to prosper to a more advanced stage.”

“This is the very reason that an annual exam by a trained professional is so important,” Brian Hill added. “There is no question that annual screening and testing for potentially life threatening diseases has become the norm in the U.S. today. There are legitimate concerns about the financial impacts of some of these screenings, whether private or third party paid, and the invasiveness of them as well. Oral cancer screening is likely the least expensive or invasive cancer screening a person can have. I often joke that it is so simple that in the five-minute procedure you don’t even have to take your clothes off. As to expense, many dental offices conduct this cancer exam just as part of their normal intra and extra oral exam with no additional charges.”

Several of OCF’s partners, which the foundation credits with much of the successful turnout this year, are heavy hitters in the world of dentistry, and included both professional organizations and private sector firms.

Dr. Ross Kerr, chair of the Oral Cancer Task Force of the American Academy of Oral Medicine, said of his organizations involvement, “Oral cancer is on the rise in the U.S.. A new viral etiology, Human Papilloma Virus #16 (HPV16) is bringing a new demographic of individuals to the disease. This is the same virus which is a cause of cervical cancers in women. A decade ago, we were confident that we knew who was at high risk for oral cancers, but today that is significantly less so with this viral component as a cause. Historically those who smoked for decades, or were heavy alcohol consumers, developed these cancers after their fifth decade of life. Today we are seeing young, non-smoking individuals as the fastest growing segment of the oral cancer population. While that historic group still is a concern, this new demographic makes differentiation of those at high risk much more problematic. I think that the foundation’s approach to this through opportunistic screening is particularly important today. We may in the future have biological markers that we could test through salivary diagnostics to isolate those most at risk, but today the conventional screening protocol is the tool that we can immediately apply to the problem with tangible results. We (AAOM) were very pleased to be a partner with the Oral Cancer Foundation this year, and will continue to be involved in their future efforts. They clearly understand and can apply the mechanisms to get results.”

Two other dental professional groups also joined OCF’s efforts: The American Dental Association, and the Academy of General Dentistry. Mr. Hill commented that this commitment from these two powerful dental organizations represented a partnership that he has been working towards for some time. “The April awareness initiative was the tipping point opportunity to formalize a joint effort with these two organizations,” said Hill, “and both provided the outreach we needed to bring on private dental practices as screening sites. AGD provided the foundation with a full-page ad in the March issue of their journal Impact, which reaches the vast majority of all general dentists in the U.S. This contribution helped greatly. The ADA also through their publications, encouraged the dental community to partner with us through targeted stories. I think the partnership was made possible this year by changes inside the ADA, particularly the naming of Dr. Kathleen O’Loughlin to the Executive Director position. She is an individual who brings a significant public health background, combined with her own social consciousness to the organization, and I am optimistic that this is just the beginning of things that we can accomplish together. We could not have reached the significant level of dental participations without them.”

In the private sector, the Foundation sought to expand an existing relationship with the world’s largest dental products distribution company and a Fortune 500 member, Henry Schein Inc. Chairman of the Board and CEO Stanley Bergman created a call to action letter directed at their tens of thousands of US customers, asking them to join the effort with OCF. When combined with the messages that were already on the dental community’s radar, this direct request for their involvement was pivotal. LED Dental Inc. also reached out to thousands of customers who use their oral cancer screening tool, the VELscope, and contributed to the dental outreach as well. Outside the world of dentistry, pharmaceutical giant Bristol Meyers Squibb partially supported the costs of the effort through a dedicated grant given to OCF. “This was our first year working with BMS,” observed Megan Cannon, OCF’s Director of Operations, “and I hope that this huge leap OCF was able to facilitate in public awareness, screening sites, and numbers of individuals screened, will fuel their desire to work with OCF in a bigger way in the future. For all the donated time by screeners and volunteers, there is a significant financial component to doing this annual event well. We could not have grown this awareness month program without that generous financial support.” The balance of the funding that the Foundation needed to accomplish this year’s success came from an unrestricted grant in 2010 from The Entertainment Industry Foundation, a longtime supporter of the Oral Cancer Foundation, through the affiliated Bruce Paltrow Fund. OCF Founder Hill stated, “Many of our most important accomplishments in the last couple of years have only been possible through EIF’s generosity. They have been the strongest of all OCF’s supporters, and valuable allies in the war against cancer. They are the powerhouse behind the highly visible and effective Stand Up 2 Cancer effort, that is a catalyst for breakthrough ideas and collaborations in medicine that have not previously existed. We are proud to be official partners with them in their Stand Up 2 Cancer program, and now with their financial support of our efforts, we have developed a more complex and productive synergy.”

According to Mr. Hill, “This year’s screening and awareness events were a huge success by past standards, and I am very proud of what The Oral Cancer Foundation has accomplished. In fact, the efforts were so successful, that we have extended the events into May, and some offices are even signing up to do events in June. My only regret is that we were asked to take on the April effort so late in the game, with only about 4 weeks to pull things together. I believe that next year, with plenty of time to fine tune what we have learned, drum up additional financial support for the national screening and awareness month, and add new components to the program, that we and our partners will be able to accomplish truly amazing things.”

Oral Cancer is not a rare disease. It kills one person every hour of every day in the U.S., and 100 new individuals will be diagnosed each day with oral cancer. These staggering statistics make these free events crucial, as awareness of the disease and its risk factors in the U.S. population is so low. Oral cancer is the largest group of those cancers which fall into the head and neck cancer category. Common names for it include anatomical sites where it occurs such as mouth cancer, tongue cancer, tonsil cancer, head and neck cancer, and throat cancer. While treatments for it can be effective, survivors are often left with significant quality of life issues, including impaired speech, swallowing dysfunctions, and facial disfigurements from surgeries.

Contact for further information: Brian Hill, Executive Director OCF, bhill@oralcancerfoundation.org  (949)278-4362

Additional information can be found on the Foundation’s web site http://www.oralcancer.org

The Oral Cancer Foundation is an IRS registered 501c3 non-profit public charity.

American Dental Association encourages public to get screened for oral cancer

Source: www.prnewswire.com
Author: press release

The American Dental Association (ADA) and the Oral Cancer Foundation (OCF) encourage people  to take part in Oral Cancer Awareness Month in April by visiting a dentist for a free oral cancer screening.  So far, more than 1,250 sites across the nation have registered their screening events with the OCF.

“Although many dentists perform oral cancer screenings as a routine part of dental examinations, the ADA encourages dentists to go out into their communities during the week of April 11-15 to provide free oral cancer screenings to people who might not regularly visit a dentist,” said ADA Spokesperson Sol Silverman, D.D.S., a professor of oral medicine at the University of California, San Francisco.

“Early detection is critical in increasing survival rates for patients who have developed an oral cancer; and recognizing and managing precancerous lesions is extremely important in prevention,” he said.

Mr. Brian Hill, OCF executive director and an oral cancer survivor, also stressed the importance of early detection and the important role that dentists play.  “Early detection is important because it reduces treatment-related morbidity and improves survival rates,” he said.

In 2010, the National Cancer Institute estimated that approximately 36,540 people were diagnosed with oral cancer and approximately 7,880 people died of oral cancer. The National Institute of Dental and Craniofacial Research (NIDCR) estimates that the five-year survival rate for people diagnosed early, when the disease has not spread beyond the original location, is approximately 83 percent compared to a 20 percent survival rate for those who were diagnosed when the cancer has spread to other organs.

In 2010, The Journal of the American Dental Association published “Evidence-based Clinical Recommendations Regarding Screening for Oral Squamous Cell Carcinomas” which was developed by an expert panel convened by the ADA Council on Scientific Affairs. The panel’s report concluded that clinicians should remain alert for signs of potentially cancerous lesions while performing routine visual and tactile examinations in all patients during dental appointments.

Risk factors for mouth and throat cancers include tobacco use, heavy consumption of alcohol, particularly when they are used together, as well as infection with the human papillomavirus, which is better known as HPV.

To locate free oral cancer screening programs in your area, please visit the OCF Web site here: http://www.oralcancer-screening.org/events/index.php?d=2011-4-01. To learn more about oral cancer, please visit the ADA’s Web site here: http://www.ada.org/2607.aspx.

Source: American Dental Association

Dental professionals join The Oral Cancer Foundation to raise awareness as HPV is now the primary cause of Oral Cancers in America

NEWPORT BEACH, Calif., April 4, 2011 /PRNewswire/ — A serious change in the cause of oral cancer is taking place nationally, and its implications are impacting the American public in a manner that a decade ago no one would have predicted.

For decades, oral cancer (also known as mouth cancer, tongue cancer, tonsil cancer, and throat cancer) has been a disease which most often occurred in older individuals, who during their lifetimes had been tobacco users.  Most cases were ultimately the result of lifestyle choices. Today that paradigm has changed. A common, sexually transferred virus has replaced tobacco as the number one cause of oral cancers, Human Papilloma Virus number 16 (HPV16). This is one of the same viruses that are responsible for the majority of cervical cancers in women.

This year alone, approximately 37,000 Americans will be newly diagnosed with oral cancer, and one person will die every hour of every day from this disease. HPV16, one of about 130 versions of the virus, is now the leading cause of oral cancer, and is found in about 60% of newly diagnosed patients. Dr. Maura Gillison from the James Cancer Center, a long time researcher of the relationship between HPV and oral cancers, recently reported these new findings at the American Academy for the Advancement of Science meeting.

This change in etiology, which has accelerated its influence over the last two decades as tobacco use in the US simultaneously was declining, has also changed the demographics of who is getting the disease. It is no longer the domain of those over 50 who have smoked a decade or more of their lives. The fastest growing segment of the oral cancer population, are people in the 25-50 age range, who are never smokers, and that group predominantly comes to the disease from HPV16.  Their oral cancers occur in locations anatomically unique, mostly localized to the posterior of the mouth; in the oropharynx, tonsils, and at the base of the tongue.  This viral etiology makes identifying the “high risk” individual much more difficult.

Tobacco use in any form by itself continues to be an important risk factor for the disease. However, in the developed world, oral cancers are becoming more common because of persistent HPV16 viral infections. Evidence indicates that the virus can be sexually transmitted between partners, and accounts for the increase in young victims of oral cancer who do not fall into the historic, tobacco risk factor group. Additional risk factors include high alcohol consumption, the use of conventional smokeless (chewing/spit) tobacco, as well as prolonged exposure to the sun (for lip cancers).

In a National effort to raise awareness, The Oral Cancer Foundation has joined forces with dental offices throughout the US to screen individuals for the disease. Together, OCF and the dental community are urging the American public to take advantage of free oral cancer screenings during Oral Cancer Awareness Month in April.  Over 1250 free screening events are taking place in dental offices across America in this one month alone.  These simple visual and tactile screenings hold the hope for an early discovery, sometimes even as a pre cancer, when current treatments are the most effective and survival is the highest.  A list of the offices participating in this event can be located on the foundation’s web site at: http://www.oralcancer-screening.org/events/

Dr. Ross Kerr, an oral medicine specialist at NYU comments, “In a painless, three to five minute oral cancer screening, most of the signs and symptoms of oral cancer can be seen with the naked eye, felt with the fingers, or elucidated during the patient’s oral history interview. Suspect tissues can be easily biopsied for a definitive diagnosis. Unlike most other cancer detection exams, the screening for oral cancer does not require any special equipment, is not uncomfortable or expensive, nor require invasive procedures. Any dentist or primary care physician and many nurses and dental hygienists, who have been trained to do oral cancer examinations, are in a position to find the early signs and symptoms of this disease. The dental community, through this partnership with The Oral Cancer Foundation, is positioning itself as the first line of defense against oral cancer through the process of early discovery of suspect tissues.”

Oral cancer kills almost three times as many people as cervical cancer every year, and is responsible for more deaths than from other cancers we hear about more routinely. Yet it continues to remain off the radar to most of the American public. Only recently when actor Michael Douglas was diagnosed with a base of tongue oral cancer, did the disease gain significant visibility.

It is an insidious disease, as in its early development it does not always produce physical symptoms that a person may be aware of, and this makes routine, professional screening highly important. If oral cancer is detected early (in stages 1 or 2), the survival rate can be as high as 80%-90%; but when found as a late stage disease (stages 3 or 4), the chances of survival drop to 20%-30%. Unfortunately, in more than half the cases, oral cancer is found in its later stages, and late discovery and diagnosis are major factors in the high death rate.

The good news is that it does not have to be this way. Like other cancer screenings you engage in such as cervical, skin, prostate, colon and breast examinations, opportunistic oral cancer screenings are an effective means of finding cancer at its early, highly curable stages.

Brian Hill, an HPV+ stage four oral cancer survivor and OCF Founder said, “Reducing the high death rate associated with oral cancer is a tangible opportunity today. We have seen early detection positively impact the death rates of many other cancers. The most notable is our sister disease, cervical cancer. Like oral cancer, it is predominantly squamous cell carcinoma, and is caused almost exclusively by the same HPV virus group. In the 1950’s when American women began getting an opportunistic annual cervical screening, we saw the death rate associated with it drop dramatically. A reduction in oral cancer deaths is not waiting on a new scientific discovery, diagnostic device, intervention, or treatment to make it occur. We do need increased public awareness, coupled with an engaged professional dental and medical community doing opportunistic screenings, to make death reduction a reality. The American public needs to avoid known risk factors and make sure that they receive an oral cancer exam at least annually.”

The Oral Cancer Foundation is encouraging the public to take advantage of these free screenings during April’s Oral Cancer Awareness Month. There are hundreds of free screening events taking place throughout the country. To learn more about oral cancer, or to find a screening location near you, go to the foundation’s website, www.oralcancer.org.  Early detection saves lives.

The Oral Cancer Foundation is an IRS registered 501c3 non-profit public service charity, that provides information, patient support, sponsorship of research and advocacy related to this disease.

SOURCE The Oral Cancer Foundation

US cancer survivors grows to nearly 12 million

Source: www.cancer.gov
Author: staff

The number of cancer survivors in the United States increased to 11.7 million in 2007, according to a report released by the Centers for Disease Control and Prevention and the National Cancer Institute (NCI), part of the National Institutes of Health. There were 3 million cancer survivors in 1971 and 9.8 million in 2001. The study, “Cancer Survivors in the United States, 2007,” is published today in the CDC’s Morbidity and Mortality Weekly Report.

A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the balance of his or her life.

“It’s good news that so many are surviving cancer and leading long, productive, and healthy lives,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “Preventing cancer and detecting it early remain critically important as some cancers can be prevented or detected early enough to be effectively treated. Not smoking, getting regular physical activity, eating healthy foods, and limiting alcohol use can reduce the risk of many cancers.”

To determine the number of survivors, the authors analyzed the number of new cases and follow-up data from NCI’s Surveillance, Epidemiology and End Results Program between 1971 and 2007. Population data from the 2006 and 2007 United States Census were also included. The researchers estimated the number of persons ever diagnosed with cancer who were alive on Jan. 1, 2007 (except non-melanoma skin cancers, which are fairly common and rarely fatal).

Study findings indicate:

  • Of the 11.7 million people living with cancer in 2007, 7 million were ages 65 years or older.
  • Women make up a large proportion of cancer survivors (54 percent).
  • Breast cancer survivors are the largest group of cancer survivors (22 percent), followed by prostate cancer survivors (19 percent) and colorectal cancer survivors (10 percent).
  • Among all survivors, 4.7 million received their diagnosis 10 or more years earlier.

“As the number of cancer survivors continues to increase, it is important for medical and public health professionals to be knowledgeable of issues survivors may face, especially the long-term effects of treatment on their physical and psychosocial well-being,” said Arica White, Ph.D., M.P.H., an epidemic intelligence service officer in CDC’s Division of Cancer Prevention and Control. “This understanding is critical in promoting good health and coordinating comprehensive care for cancer survivors.”

The authors note that the increase in number of cancer survivors is due to many factors, including a growing aging population, early detection, improved diagnostic methods, more effective treatment, and improved clinical follow-up after treatment.

“There is now a growing number of people who have faced a cancer diagnosis and what that means for them and their loved ones – from the time of diagnosis through the rest of their lives,” said Julia H. Rowland, Ph.D., director of NCI’s Office of Cancer Survivorship. “Unfortunately for many cancer survivors and those around them, the effect of cancer does not end with the last treatment. Research has allowed us to scratch the surface of understanding the unique risks, issues, and concerns of this population. This report underscores the need for continued research, as well as for the development and implementation of best practices to provide optimal care and support for all cancer survivors.”

For the full report, visit http://www.cdc.gov/mmwr/.

March, 2011|Oral Cancer News|

Global cancer statistics

Corresponding author: Ahmedin Jemal, DVM, PhD, Surveillance Research, American Cancer Society

The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally.

March, 2011|Oral Cancer News|

Expand the search for oral cancer

Dentistry’s responsibilities remain vital in stopping cancer deaths

By: Donna Grzegorek, RDH

Source: RDH magazine

As dental professionals, we have a remarkable opportunity to affect the health and well-being of each patient we treat. This responsibility manifests itself in patients’ expectations, which is to inform them of disease at the earliest possible moment. This is the fifth consecutive year in which there has been an increase in the rate of occurrence of oral cancers; yet, for several decades the mortality rates for this insidious disease remained virtually unchanged. OCF As dental professionals and health-care providers, we have an obligation to be vigilant in our commitment to early detection, raising awareness, and the management of the cancer for which we as a profession are held accountable.

Approximately 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year. This menacing disease will cause 8,000 deaths, killing approximately one person per hour, 24 hours a day. Of these 37,000 newly-diagnosed individuals, only slightly more than half will survive five years. The mortality rate for oral cancer is higher than that of other cancers we hear about routinely such as cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, and endocrine system cancers such as thyroid or skin cancer (malignant melanoma). If you expand the definition of oral cancers to include cancer of the larynx, for which the risk factors are indistinguishable, the number of diagnosed cases grows to approximately 50,000 individuals and 13,500 deaths per year in the United States alone. Worldwide, the problem is much greater, with 640,000 new cases being diagnosed each year.

The brutal reality

The death rate associated with oral cancer is particularly high, not because it is hard to discover or diagnose, but because the cancer is routinely discovered late in its development. Often, it is only discovered when the cancer has metastasized to another location, most likely the lymph nodes of the neck. Prognosis at this stage of discovery is appreciably worse than when it is caught early in a localized intraoral area. In addition to the metastasis at these later stages, the primary tumor has had time to invade deep into local structures.

Oral cancer is particularly perilous because in its early stages it may not be noticed by the patient, as it can frequently prosper without producing pain or symptoms they might readily recognize, and because it has a high risk of producing secondary tumors. Patients who survive a first encounter with the disease have up to a 20 times higher risk of developing a second cancer. This heightened risk factor can last for five to 10 years after the first occurrence. There are several types of oral cancers, but approximately 90% are squamous cell carcinomas. According to the Oral Cancer Foundation, it is estimated that approximately $3.2 billion is spent in the United States each year on treatment of head and neck cancers.

Human papilloma virus connection

One of the most common virus groups in the world today affecting the skin and mucosal areas of the body is the human papilloma virus. Over 120 different types/versions of HPV have been identified. Most HPVs of this type are very common, harmless, noncancerous, and easily treatable. There are other forms of HPV, which are sexually transmitted, and some of these are a serious problem. The most common of these are HPV-16, HPV-18, HPV-31, and HPV- 45.

Two types of genital tract HPV in particular, HPV-16 and HPV-18 are known to cause the vast majority of cervical cancers, and recent studies show one of them, HPV-16, to be linked to oral cancer as well. In the oral cavity, HPV-16 manifests itself primarily in the posterior regions such as the base of the tongue, the oropharynx, the tonsils and the tonsillar pillars. These oncogenic versions of HPV are also responsible for other squamous cell carcinomas, particularly the anus and penis.

It has now been established that the pathway that brings people to oral cancer contains at least two distinct etiologies: one through tobacco and alcohol and the other via the HPV virus, particularly HPV-16. In the broadest terms, they can be differentiated into HPV-related cancers and non-HPV positive tumors.

Researchers now feel that HPV positive tumors occur most frequently in a younger group of individuals than tobacco-related malignancies. Tobacco oral cancers occur most frequently in the fifth through seventh decade of life. The HPV positive group is the fastest growing segment of the oral cancer population.

Oral Cancer Foundation takes a strong stand

The Oral Cancer Foundation has taken the following position regarding the HPV connection: “We strongly believe that in a younger population of nonsmoking oral cancer patients, HPV is presenting itself as the dominant causative factor. Since the historic definition of those who need to be screened is now changed by this newly defined HPV etiology, and is no longer valid, it is not possible to definitively know who is at risk for the development of the disease, and who is not.

“Simply stated, today anyone old enough to have engaged in sexual behaviors which are capable of transferring this very ubiquitous virus needs to be screened annually for oral cancer. For this reason we are strong promoters of opportunistic annual screenings to catch this disease at its earliest possible stages, when it is most vulnerable to existing treatment modalities and survival rates are the highest.

“We believe that this will bring the oral cancer death rate down as early detection and diagnosis takes place, and will reduce the treatment associated morbidity to patients who do present with oral cancers.”

Dentistry’s responsibility

Published studies show that currently less than 15% of those who visit a dentist regularly report having had an oral cancer screening. This is unfortunate when you consider that, historically, the greatest strides in combating most cancers have come from increased awareness and aggressive campaigns directed at early detection.

It is commonplace to annually seek a PAP smear for cervical cancer, a mammogram to check for breast cancer, or PSA and digital rectal exams for prostate cancer. These screening efforts have been successful as a result of increased public awareness of the value of catching cancers in their earliest forms, combined with effective technologies for conducting the examinations.

Oral cancer is no different. It may be potentially easier to obtain public compliance for oral cancer screenings, since unlike many other cancer screening procedures, there is no invasive technique necessary to look for it, no discomfort or pain involved, and it is very inexpensive to have one’s mouth examined for the early signs of disease. Creating awareness, discovery, diagnosis, and referral are the primary responsibilities of the dental community.

It is important for both patients and dental professionals to recognize that a visit to the dental office is no longer about a filling, a crown, or a cleaning but is actually a matter of life and death.

Dental examinations that include a comprehensive screening for oral cancer save lives! The most important step in reducing the death rate from oral cancer is early discovery. No other professional is better positioned for early detection or will be held more accountable than members of the dental community.

Foundation supported by dental hygienists

For the past three years, dental hygienists have supported the Oral Cancer Foundation through fund-raising efforts at the RDH Under One Roof conference. The Oral Cancer Foundation is a national public service, nonprofit entity designed to reduce suffering and save lives through prevention, education, research, advocacy, and patient support activities.

Founded by a Stage IV oral cancer survivor, Brian Hill, the foundation’s goals are supported by a scientific advisory board composed of leading cancer authorities from varied medical and dental specialties, drawn from premier cancer treatment, research, and educational institutions in the United States.

The foundation is primarily supported by, and dependent on, donations that are received from private individuals who mostly come from the ranks of survivors, as well as family and friends of those who have had this cancer. The foundation is an IRS registered nonprofit 501(c)3, public service charity designed for advocacy and service, created to promote change through proactive means in both the public and medical/dental professional sectors.

At the forefront of its agenda is the firm establishment in the minds of the American public for the need to undergo an annual oral cancer screening, combined with an outreach to the dental and medical communities to provide this service as a matter of routine practice.

The Oral Cancer Foundation site provides hundreds of pages of information discussing the rates of occurrence, risk factors that lead to oral cancer, signs and symptoms, treatments, current research, complications of treatment, nutrition, related clinical trials, and current oral cancer related news. There is an additional resource page dedicated to links to other sources of vetted information about oral cancer and treatment institutions. The site (www.oralcancerfoundation.org) is updated weekly and provides a plethora of valuable information for the dental professional.

Hill, the founder and executive director, is an excellent resource and is accessible to dental professionals who seek further information regarding his experiences and/or wish to discuss the topic of oral cancer in greater detail (bhill@oralcancerfoundation.org). Hill encourages dental professionals to become members of the foundation and partners with the foundation in their effort to increase the number of annual screenings that are being performed.

Hill states, “Please check the ‘members only’ segment of our Web site, which discusses oral cancer from a practice management perspective, and where you can obtain resources to assist you with the incorporation of a comprehensive cancer screening program to your practice. The dental community is the first line of defense against oral cancer, through the process of early discovery.”

“By regularly screening for oral cancer,” Hill added, “these practices engrain into the public’s mind that a visit to the dentist is about not just cleanings, cosmetics, and crowns, but potentially saving a life. These truly heroic efforts reflect the highest standards of dentistry and a commitment to providing the optimum in not only dental care, but overall health care to patients. Reducing the death rate from oral cancer is tangible, and doable in the immediate future.”

Donna Grzegorek, RDH, has been practicing full-time clinical dental hygiene for 31 years. She is the recipient of several industry recognitions including Discus Dental’s “Hygienist of the Year,” Sunstar America’s “Award of Distinction,” and ADHA’s “Hygienist Hero.” Donna is a published author, speaker, and key opinion leader. She sits on the advisory committee for a salivary diagnostics company, a board member of the American Academy of Dental Hygiene, a member of the International Federation of Dental Hygienists, and a 31-year member of ADHA. She may be contacted at: dgrzegorek@comcast.net.