human papilloma virus

Inherited factors linked to head and neck cancers in young adults

Source: www.news-medical.net
Author: Oxford University Press

An article published online today in the International Journal of Epidemiology pools data from 25 case-control studies and conducts separate analyses to show that head and neck cancers (HNC) in young adults are more likely to be as a result of inherited factors, rather than lifestyle factors such as smoking or drinking alcohol.

Approximately 550,000 new cases of HNC are diagnosed worldwide annually, with an increased incidence in young adults (YA) also being reported. In particular, reports indicate an increase in tumours affecting the tongue and oropharynx among young adults in Europe, the United States, India, and China.

Dr Tatiana Natasha Toporcov and colleagues pooled data from 25 studies from the International Head and Neck Cancer Epidemiology (INHANCE) consortium to compare the role of major risk factors and family history in HNC for YA (45 years of age or younger) and older adults (over 45 years of age). Participants were surveyed about their history of cigarette smoking, alcohol drinking, and diet, as well as family history of cancer. In total, there were 2,010 cases and 4,042 controls in YA, and 17,700 cases and 22,704 controls in older adults.

The attributable fraction (an estimate of the proportion of cases which could be avoided if the exposures were eliminated) for smoking on the risk of HNC was 20% in young women, 49% in older women, 46% in young men, and 64% in older men. The attributable fraction for drinking alcohol on the risk of HNC was 5% in young women, 20% in older women, 22% in young men, and 50% in older men. Eating a diet rich in fruits and vegetables was shown to be inversely associated with the risk of HNC in both age groups.

Dr Toporcov says: “To our knowledge, this is the largest study to evaluate the role of the major risk factors for HNC in young adults as well as to compare risks in younger and older patients. The large sample size allowed us to elucidate any differences in the role of risk factors in HNC in YA according to age group, sex and cancer sub sites.

“Although they were less likely to be drinkers and/or smokers, alcohol consumption was a risk factor for HNC in YA. However, a stronger association with heavy drinking was observed for the older group. Our results also indicate that the inverse association with fruit and vegetable intake is similar among young and older populations. YA were more likely to have been diagnosed with oral and oropharynx cancer than older adults. Also, early onset cancer in the family was associated with HNC risk only among YA.

“Our results support public health efforts to decrease exposure to major risk factors for HNC in the population regardless of age. However, investigations of the role of other risk factors, such as human papilloma virus and inherited characteristics, on HNC in the younger age group are warranted.”

January, 2015|Oral Cancer News|

In one study, lower dose treatment for HPV oropharyngeal cancers is successful

Author: Anthony Cmelak, M.D.
Source: medicalnewstoday.com
 

A new study suggests that lowering the dose of radiation therapy for some head and neck cancer patients may improve outcomes and cause fewer long-term side effects.

The research was presented by lead author Anthony Cmelak, M.D., professor of Radiation Oncology at Vanderbilt-Ingram Cancer Center (VICC), during the 50th annual meeting of the American Society of Clinical Oncology (ASCO), held recently in Chicago.

The study focused on patients with newly-diagnosed oropharyngeal cancers related to the human papilloma virus (HPV). More than two-thirds of new head and neck cancer patients have HPV-positive tumors and the number of these patients is on the rise. Cmelak’s prior cooperative group study found that patients with HPV-positive oropharyngeal cancer have significantly longer survival rates than patients whose tumors are HPV negative.

For the new study, 80 HPV-positive patients with stage III, or IVa,b squamous cell cancer of the oropharynx received inductionchemotherapy, including paclitaxel, cisplatin and cetuximab.

After chemotherapy, 62 of the patients showed no sign of cancer and were assigned to receive a 25 percent lower dose of intensity-modulated radiation therapy – an advanced technology that targets the radiation beam more accurately to treat the tumor without harming surrounding tissue. The rest of the patients received a standard IMRT dose. The drug cetuximab was also given to both groups of patients along with the IMRT treatment.

Two years after treatment, the survival for the low-dose IMRT patients was 93 percent. Those who did not have complete resolution of cancer following induction and went on to get full-dose radiation had an 87 percent two-year survival. Eighty percent of the low-dose patients and 65 percent of standard IMRT patients also showed no evidence of tumor recurrence. Ninety-six percent of those who had minimal or no smoking history had no evidence of tumor recurrence after two years following treatment, and long-term side effects were minimal.

The investigators concluded that patients with HPV-positive cancer who had excellent responses to induction chemotherapy followed by a reduced dose IMRT and cetuximab experienced high rates of tumor control and very low side effects particularly for those with a minimal smoking history.

Treating tumors in the delicate head and neck region often causes side effects that can be troublesome and long-lasting, including difficulty swallowing, speech impairment, dry mouth, problems with taste and thyroid issues, so any therapy option that reduces these side effects can have an impact on patient quality of life.

“Treatment for head and neck cancer can be quite grueling, so it’s very encouraging to see we can safely dial back treatment for patients with less aggressive disease and an overall good prognosis, particularly for young patients who have many years to deal with long-term side effects,” said Cmelak.

He noted that lower-dose IMRT is not recommended for patients with HPV-negative cancer or larger tumors.

The authors note that further studies of reduced-dose IMRT in HPV-positive patients are warranted.

Other investigators include Jill Gilbert, M.D., VICC; Shuli Li, Ph.D., Dana Farber Cancer Institute, Boston, Massachusetts; Shanthi Marur, M.D., William Westra, M.D., Christine Chung, M.D., The Johns Hopkins University School of Medicine, Baltimore, Maryland; Weiqiang Zhao, M.D., Ph.D., Maura Gillison, M.D., Ph.D., The Ohio State University, Columbus, Ohio; Julie Bauman, M.D., Robert Ferris, M.D., University of Pittsburgh Cancer Institute; Lynne Wagner, Ph.D., Feinberg School of Medicine, Northwestern University, Chicago, Illinois; David Trevarthen, M.D., Colorado Cancer Research Program, Denver; A. Demetrios Colevas, M.D., Stanford University, California; Balkrishna Jahagirdar, M.D., HealthPartners and Regions Cancer Care Center, St. Paul, Minnesota; Barbara Burtness, M.D., Fox Chase Cancer Center, Philadelphia, Pennsylvania.

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

Prognosis of tumors positive for human papilloma virus in head and neck cancers varies according to the site

Source: www.sciencecodex.com
Author: staff

Patients with cancer of the throat and who are positive for the Human Papilloma virus (HPV+) have a good prognosis, but until now the effect of being HPV+ on the prognosis of tumours located elsewhere in the head and neck was unknown. Danish researchers have now shown that HPV status appears to have no prognostic effect on the outcome of primary radiotherapy in head and neck cancer outside the oropharynx (the part of the throat located behind the mouth, and which contains the soft palate and the base of the tongue), the ESTRO 33 congress will hear today (Sunday).

Presenting her results to the congress, Dr Pernille Lassen, MD, PhD, from the Aarhus University Hospital, Aarhus, Denmark, will say that head and neck cancers located outside the oropharynx should probably not be treated with the less intensive treatment strategies that are currently being investigated in clinical trials for HPV+ oropharyngeal tumours.

“HPV status has a very potent prognostic impact in radiotherapy for oropharyngeal cancer, and DNA from HPV has been found in all types of head and neck cancer, although it is far more common in oropharyngeal tumours. We decided to investigate the impact of HPV status in non-oropharyngeal cancers in the DAHANCA database, which includes all Danish head and neck cancer patients,” Dr Lassen will say.

The researchers searched the database to identify patients with locally advanced cancers who had been treated primarily with radiotherapy, and identified 1606 patients with larynx and pharynx carcinomas. Overall, 40% of the tumours were HPV positive, and the frequency was significantly higher in oropharyngeal cancer (57%), than in non-oropharyngeal (13%).

Being positive for HPV significantly improved tumour control (81% as opposed to 55%), as well as survival from the cancer (89% and 55% respectively), and death from any cause (82% and 38% respectively), after five years.

“In non-oropharyngeal cancers we found no prognostic impact of being HPV positive in any of these endpoints,” Dr Lassen will say. “This indicates that HPV status does not help us in predicting response to treatment, and hence the outcome of these cancers.

“We know from laboratory studies that HPV positive tumour cells are much more sensitive to radiation therapy than HPV negative cells, so until now we believed that they would behave similarly irrespective of site,” Dr Lassen will say. “However, these data indicate that this is not the case, and at present we do not understand why this should be, though it probably can be ascribed to other biological/genetic differences between the tumours rather than the HPV status. We would now like to try to elucidate the underlying mechanisms behind these different outcomes.”

There could be, for example, biological and/or genetic differences between the tumours other than the HPV status, the researchers say; for example, genetic changes caused by smoking tobacco, differences due to tumours of mixed make-up (for example, a combination of HPV+ and tobacco), or perhaps simply differences due to the site. “Such tumours with a combination of causes represent a challenge in our clinical daily practice,” Dr Lassen will say.

“We have started following up our work by analysing all the tumour samples using polymerase chain reaction, a way of amplifying DNA in order to be able to analyse changes in genetic information. We hope this will enable us to understand more about why the role of HPV in non-oropharyngeal tumours is so different. There are few data available on this subject at present, so finding out will be an important step towards optimising treatment for these patients.”

President of ESTRO, Professor Vincenzo Valentini, a radiation oncologist at the Policlinico Universitario A. Gemelli, Rome, Italy, commented: “These findings will have an important impact on the treatment of HPV+ head and neck cancers, and are likely to lead to a change in current practice.”

Source: European Society for Radiotherapy and Oncology (ESTRO)

April, 2014|Oral Cancer News|

Anti-seizure medications prevent cancer

Source: guardianlv.com
Author: Lindsey Alexander

A recent report came out from the journal Cancer indicating a new finding that anti-seizure medications might prevent some forms of cancer. Drugs like valporic acid (Depakote), are one form of prescription in this classification. Though also used as a mood-stabilizer, Depakote can prevent seizures from occurring, and has been investigated for cancer prevention.

These particular anti-seizure medications have been found to inhibit genetic changes that lead to cancer of the head and neck. The study included nearly 440,000 veterans, including 27,000 who were taking valporic acid for various disorders including post-traumatic stress disorder, bipolar disorder, seizures, and migraines. The overall findings suggested that veterans who were on the prescription were 34 percent less likely to develop cancers of the head and neck, than those who were not taking the drug.

The risk decreased in those subjects who took higher doses or for longer periods of time.

Dr. Johann Brandes with Atlanta Veterans Affairs Medical Center was the team leader of this study. He claims that this 34 percent statistic means 16,000 new cases, and between 3,000 and 4,000 cancer deaths can be prevented every year. Though there is a strong association, the study did not form a direct cause-and-effect relationship between cancer prevention and anti-seizure medications.

The National Cancer Institute describes cancers of the neck and head as usually squamous cell cancers that line mucosal surfaces inside the head and neck. This can affect the mouth, the throat, and the nose. This is a carcinoma that can begin in the salivary glands, and can contain many different types of cells that can in turn also become cancerous.

Valporic acid was found not to have any impact on lung, bladder, prostate, or colon cancers.

The Mayo Clinic currently says there is no proven way to prevent throat cancer. A person can restrict the amount of alcohol consumed, avoid smoking, chose a healthy diet to stick to (which includes plentiful amounts of fruits and vegetables), and protect against the human papilloma virus (HPV). Even though the HPV vaccine is recommended by the Mayo Clinic, other sources warn against the shot.

Christina England from Vactruth claims 140 people as of 2013 were lost due to the HPV vaccine, commonly referred to as Gardasil. Statistics from the Vaccine Adverse Event Reporting System (VAERS) listed many more side-effects than deaths, however. In 2013, the VAERS recorded nearly 1,000 people physically disabled, 10,000 people made a visit to the ER, and 3,000 were hospitalized among many others severe, and sometimes life-threatening side-effects.

The American Academy of Otolaryngology mentions three people in history who suffered from either oral, head, or neck cancer.

Babe Ruth, born in 1895, played for the National Baseball League and held a record of 60 home runs in one season. He was diagnosed just before retirement with nasopharyngeal carcinoma, which metastasized and later killed him.

Ulysses S. Grant was a Civil War leader and the 18th President of the United States. He came down with a cancer of the right tonsillar pillar, which was at the base of the tongue. This was referred to as a malignant squamous epithelioma. His death was referred to a slow and painful illness.

Today, however, he could have been treated and perhaps saved with inventions such as the aspiration pump, radiotherapy, surgery, and even a tracheotomy.

Sigmund Freud was also a victim of cancer. Freud was an Austrian psychoanalytic psychologist. He suffered from multiple health disorders and smoked heavily. He had cancer in the jaw, and was diagnosed at the age of 67. Treatment continued for 16 years, and he underwent many surgeries–one of which included the merging of the nasal cavity and the mouth. He died in 1939 from heart failure, cancer, and morphine overdose.

Researchers in medicine are discovering new ways of preventing cancer, and treating cancer, ranging many disciplines. Recent findings suggest future studies are necessary to determine a more substantial link between cancer prevention and anti-seizure medications. However, people are now able to consider yet another preventative measure that might prove helpful.

March, 2014|Oral Cancer News|

Global trends suggest HPV positive oral cancer greatly increased in young males

Source: www.zawya.com
Author: staff

While the incidence of smoking-related oral squamous cell carcinoma has decreased in many parts of the world, cases of human papilloma virus (HPV) positive oropharyngeal cancer (OPSCC) have greatly increased. Otolaryngologists are finding that the majority of their patients are male and a lot younger in age than their counterparts. This “new” head and neck cancer patient differs in several ways from the “traditional” head and neck cancer patients who were older, had significant tobacco and alcohol exposure, and potential tumours throughout the upper aerodigestive tract. The significance of this global trend suggests that more attention needs to be paid to the phenomena here in the Middle East.

Dr Marilene Wang, Professor, Chief of Otolaryngology, UCLA Department of Head and Neck Surgery, will be discussing the increasing incidence of young cancer patients who are non-smokers, but happen to be HPV positive and how these cases should be managed in the Middle East at the 11th Middle East Update in Otolaryngology Conference & Exhibition – Head and Neck Surgery (ME-OTO) from the 20-22 April 2014 at the Madinat Jumeirah Arena, Dubai, UAE.

According to Dr Wang, “Currently, the most common head and neck cancer patients are younger, primarily male, and have no or relatively minimal exposures to tobacco and alcohol. Yet, they often have histories of notable increased sexual encounters. Although HPV positive OPSCC demonstrates an alarming increasing incidence, this is balanced by a significant response to treatment regardless of advanced stage.

“Cases of OPSCC associated with HPV have increased 225% in the US from 1988-2004. HPV infection is ubiquitous, as up to 85% of adults may have an HPV infection at some point from any of the over 120 subtypes. Only a small percentage of these subtypes develop malignancy and these are primarily related to the HPV-16 subtype. There is also an increased risk of OPSSC in husbands of women with cervical cancer and in situ cancer.”

The majority of epidemiological studies on HPV positive OPSCC have been done in the Western hemisphere, where there is a documented rise in the incidence of both HPV infection and HPV positive OPSCC. The impact of HPV in other parts of the world is less clear.

“A recent study from Turkey did document an increase in the incidence of HPV positive OPSCC between 1996 and 2011, from 33% to 70% (Dural et al. Asian Pac J Cancer Prev. 2013; 14(10):6065-8). Further studies will need to be done to determine the incidence of HPV-positive OPCC in the Middle East,” says Dr Wang.
“Vaccination against HPV is recommended for adolescents and young adults, boys and girls, ages 9 -25, ideally prior to onset of sexual activity. This commonly utilized vaccine provides protection against the 4 strains of HPV most associated with cervical and OPSCC, including HPV-16. However, there is no evidence to support efficacy of the vaccine to treat HPV-related cancers,” concludes Dr Wang.

March, 2014|Oral Cancer News|

Support HPV Vaccination to protect children in the US

Source: www.usatoday.com

Author: Liz Sbazo

The USA is failing to protect children from preventable cancers that afflict 22,000 Americans a year by not vaccinating enough of them against HPV, a new report says.

Although a safe and effective HPV vaccine has been available for eight years, only one-third of girls have been fully immunized with all three recommended doses, according to a report from the President’s Cancer Panel, which has advised the White House on cancer since 1971. HPV, or human papillomavirus, is a family of viruses that causes cancer throughout the body, including cancers that predominantly affect men, such as a type of throat cancer. Only 7% of boys are fully vaccinated, although the Centers for Disease Control and Prevention has recommended the shots for them since 2011.

Raising vaccination rates to at least 80% of teen girls could prevent 53,000 future cases of cervical cancer in girls alive today, according to the CDC.

“Our children deserve this protection,” says panel chairperson Barbara Rimer, a professor at the University of North Carolina at Chapel Hill.

Administering the HPV shot poses practical difficulties not faced by other adolescent vaccines, because it currently requires three doses, at least two months apart, beginning when kids are 11 or 12, says pediatrician Mary Anne Jackson, director of infectious diseases at Children’s Mercy Hospital & Clinics in Kansas City, Mo., who wasn’t involved in the new report. Although emerging research suggest that two doses could be equally effective, experts have not yet changed their recommendations.

And at a total cost of $400 for three shots, the HPV vaccine is also more expensive than other vaccinations, although it’s often covered by insurance, Jackson says.

The real problem, research shows, is that doctors are treating HPV vaccinations differently than other shots recommended for kids at that age, such as meningitis and whooping cough boosters, Jackson says.

All too often, doctors offer HPV shots, giving parents the option to vaccinate, without strongly recommending them, says Debbie Saslow of the American Cancer Society, who served as an adviser on the report. That could be because doctors are leery of initiating a discussion about sexual activity, which is how HPV spreads, Saslow says. Doctors recommend giving HPV shots to kids at a young age, when they’re most effective.

Yet studies show that most parents are likely to follow their pediatrician’s recommendations, Jackson says. Most families would likely agree to HPV vaccinations if doctors simply included it in their general package of middle-school shots, Jackson says. Studies have found the vaccine to be extremely safe, with no increase in serious side effects, in spite of giving 56 million doses of the shots in the USA alone.

Future HPV vaccines may soon be even more protective than the original shot. While the current vaccines can prevent about 70% of cervical cancers, HPV vaccines under development will protect against 90% of cervical tumors, the report says.

“If we could get physicians to give a strong message about HPV vaccination to every child, we could make a real difference,” says Rimer, whose report notes that 60% of girls in the United Kingdom and 71% in Australia are fully vaccinated against HPV. “The conversation needs to be framed around cancer prevention, not about sex.”

State lawmakers could help boost vaccination rates, Rimer says, by passing laws to allow pharmacists to administer HPV shots to teens just as they do flu shots. Only 6% of pharmacists are in states that allow them to give HPV shots without prior approval from a physician.

The panel also asks President Obama to lend his support to HPV vaccination.

“Your support of widespread HPV vaccination starting today can help save thousands, and perhaps hundreds of thousands, of lives, and could forever alter the landscape for cancers related to HPV,” the report says. “No man or woman should have to suffer or die from cancer or other diseases when the means by which to prevent them is within our grasp.”

 

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

February, 2014|Oral Cancer News|

Michael Douglas: ‘Throat cancer’ was really tongue cancer

Source: cnn.com
Author: Jen Christensen, CNN

Michael Douglas never had throat cancer, as he told the press in 2010.

The actor now says he had tongue cancer. Douglas said he hid the diagnosis at the urging of his doctor to protect his career.

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“The surgeon said, ‘Let’s just say it’s throat cancer,’ ” Douglas told fellow actor Samuel L. Jackson for a segment that ran on British television as a part of Male Cancer Awareness Week.

Douglas says that the doctor told him if they had to do surgery for tongue cancer, “it’s not going to be pretty. You could lose part of your tongue and jaw.”

When Douglas first talked about his cancer diagnosis in the summer of 2010, he was on a worldwide publicity tour for the movie “Wall Street: Money Never Sleeps.”

Douglas and Jackson joked that could have been the end of his acting career. Douglas said if he had surgery he could see the director saying, “What’s your good side? I’ve got no side over here.”

“There really is no such thing as throat cancer per se,” explained Brian Hill, an oral cancer survivor and the founder of the Oral Cancer Foundation. Douglas has taped a public service announcement to raise awareness about oral cancer for Hill’s foundation.

“Throat” cancer and tongue cancer are both colloquial terms that fall under the oral cancer umbrella. Throat cancer usually refers to cancerous tumors that develop in your pharynx, voice box or tonsils. Tongue cancer refers to cancerous cells that develop on your tongue.

“The treatment up until just recently can be very brutal,” Hill said of tongue cancer. “Your career as a leading man could be over. If you have signed a contract to promote a movie, you would have a strong motivation not to say … ‘Maybe in six months I won’t have a tongue or lower jaw.’ ”

Douglas apparently did not need the potentially disfiguring surgery. He told Jackson he was instead treated with an aggressive form of radiation and chemotherapy. The treatment, he said, lasted five months.

In June, Douglas kicked off an animated conversation about the cause of oral cancer when he told The Guardian that he got throat cancer after engaging in oral sex. Oral sex can expose individuals to the human papilloma virus, which can cause cancer.

Later, Douglas’ publicist told CNN that Douglas did not blame HPV solely for his cancer; Douglas said he was also a smoker and a drinker. Smoking and drinking, particularly when combined, are considered the most significant contributing factors to oral cancer, according to the Centers for Disease Control and Prevention. So is Douglas’ gender. Men are twice as likely to develop oral cancer as women.

Oral cancers account for 2% to 4% of all cancer diagnoses in the United States. An oral cancer diagnosis is particularly serious; only half of the people diagnosed with oral cancer are still alive after five years, according to the CDC. In large part, that’s because of the late diagnoses of this disease. Most signs of this cancer are difficult to detect and are often painless.

Douglas told Jackson that initially his doctors treated him with antibiotics. Douglas had been complaining of a soreness at the back of his teeth. Three months later when it still hurt, the doctor gave him another round of antibiotics. Nine months later, after talking to a friend who was a cancer survivor, he went to the oncology department where a doctor did an initial exam and then a biopsy. He was diagnosed with stage four oral cancer in 2010.

Douglas is not the first celebrity to misidentify the kind of cancer they have.

Actress Valerie Harper, who first came to fame on the TV show “Mary Tyler Moore,” announced her cancer on the cover of People magazine in March. The story said she had little time left to live and was suffering from terminal brain cancer. It turns out the “Dancing With the Stars” celebrity actually had lung cancer that had spread to the lining of her brain.

“I see a lot of people with ‘brain cancer’ who actually have… lung cancer or breast cancer or some other cancer (that spread) to the brain,” Dr. Otis Brawley, the American Cancer Society’s chief medical and science officer, told CNN. “We treat cancer according to its origin.”

Harper’s kind of cancer, leptomeningeal carcinomatosis, can be slowed but the cells are adaptable and can develop a resistance to treatment. A complete remission is unlikely.

Douglas, on the other hand, has had regular check-ups since the diagnosis. At his two-year mark, he told Jackson, his doctors said he was clear of the cancer.

“There is a 95% chance it’s not coming back,” he told Jackson.

October, 2013|Oral Cancer News|

Cancer survivor advocating for men’s HPV awareness

Source: The Tampa Tribune (tbo.com)
By Mary Shedden | Tribune Staff
Published: July 28, 2013  
 

LUKE JOHNSON/STAFF

David Hastings, the co-owner of Gulport’s Habana Café, has testified in front of Florida legislators and officials at the Centers for Disease Control and Prevention, since becoming a volunteer patient advocate with the Oral Cancer Foundation.

 

Seven years ago, David Hastings got the worst news of his life. He had oral cancer, and a grueling series of radiation and chemotherapy treatments would be necessary if he wanted to survive.

Undergoing months of the “barbaric” treatment was awful, he said, but so was the knowledge that five different doctors couldn’t explain how a 56-year-old with no history of smoking or heavy drinking ended up with such an aggressive cancer.

“If something is trying to kill you, don’t you want to find out what it is?” the Gulfport accountant and business owner asked over and over.

It took months, but Hastings learned his cancer was linked to HPV, the sexually transmitted virus long known for its connection to deadly cervical cancers. The answer was elusive because few scientists at that time were looking at the virus and male cancers, he said.

Today, doctors know that about 5,600 cases of oral cancer diagnosed each year are tied to the human papillomavirus, a number increasing at a rate faster than that of tobacco- or alcohol-related oral cancers. That’s likely because more hospitals and cancer centers, including Moffitt Cancer Center, are able to test for the male HPV cancer connection on site.

Still, in June, when actor Michael Douglas announced that his stage 4 cancer was linked to oral sex with women, the news spurred nervous giggles, gossipy speculation and a lot of “who knew?” comments across the country.

The public reaction shows how much remains to be learned about the deadly disease, said Hastings, a volunteer patient advocate with the Oral Cancer Foundation.

Since 2006, the co-owner of Gulport’s Habana Café has testified in front of Florida legislators and officials at the Centers for Disease Control and Prevention.

He estimates he now spends about two hours a day educating people about HPV and oral cancer. The self-described “staunch Republican,” who keeps a framed photo of himself posing with President Ronald Reagan in his office, said his advocacy is not political.

“I became so vocal because there was a total lack of education to the public and front-line doctors,” said Hastings, now 65 and cancer-free.

Douglas’ announcement also shows how much significant science around these cancers has emerged in just the past few years, said Anna Giuliano, director of Moffitt’s Center for Infection Research in Cancer.

“The scientific literature keeps growing and growing,” said Giuliano, one of the doctors who was unable seven years ago to definitively tell Hastings how he contracted oral cancer, despite her own experience in HPV research.

Researchers, including Giuliano and others based at Moffitt, today are leading multiple international studies aimed at identifying who is most at risk for HPV cancers, why, and the treatment options for men with HPV-related cancers.

At Moffitt, research looking at the history of men with HPV-related cancers has been underway since 2005, Giuliano said. Her grants initially focused on male genital cancers, but now include oral cancers.

The most recent findings were published this month in the medical journal The Lancet.

HPV is the most common sexually transmitted virus in the United States, the CDC says. Almost every sexually active person – straight, gay or bisexual – will be exposed in his or her lifetime. But many will never develop cancer.

Hastings, a “product of the ’60s” who believes he was infected decades ago, long before he met his wife of 20 years, said men of his generation need to know this.

“My cancer was not caused by tobacco or alcohol. It was caused by a virus,” he said. “Men need to pay attention.”

These infection rates, and the extreme risks of HPV-related cervical cancers, prompted a lot of the initial research two decades ago. Giuliano said initial HPV research focused on women, but evidence is building concerning HPV-related cancers and men.

“In the background has been the question, ‘What about the guys?’ ” she said.

Also, a lot of attention has been paid to HPV vaccination, Giuliano said. The CDC and others see it as the most effective way to prevent future infections, and recommend it for anyone younger than 26 years.

Giuliano said the research now underway at Moffitt looks long-term at adults who missed the opportunity to get the vaccine. For example, researcher Andy Trotti is building on the growing understanding that HPV-related oncology patients have higher survival rates than men with other types of oral cancer.

Trotti, of the Radiation Treatment Oncology Group, wonders if HPV cancer patients can be given a less-aggressive treatment and face a similar chance of long-term survival.

Hastings, who has vivid memories of his treatment, said he welcomes research that could reduce the severity of the treatment. The radiation burns your throat and the ability to taste is gone within a week. Sores develop, as does constant nausea. Taking pain pills or attempting to swallow lukewarm liquids bordered on torture, he said.

“That research is so important for our generation,” he said.

Advancements like this are critical, and results have been swift when compared to other cancer research, Giuliano said. But that’s still not enough.

“Between the two groups, we hopefully can in the next few years make a great difference,” she said.

 

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

 

Fact check: Michael Douglas on HPV and throat cancer

Source: www.huffingtonpost.com
Author: Meredith Melnick

A Michael Douglas interview in The Guardian caused waves when the publication reported that the “Behind the Candelabra” star revealed HPV, the human papilloma virus, to be the cause of his stage-4 throat cancer diagnosis in 2010.

“Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus,” Douglas allegedly told The Guardian.

Douglas, through his publicist, has said that the statement was misinterpreted: He wasn’t saying that his cancer was caused by the sexually transmitted disease — merely that many cancers like his are HPV-positive. As The Daily Beast points out, there is scant research evidence to directly link the act of cunnilingus with HPV infection. But regardless of the details of his own cancer, the actor is right about one thing: A growing majority of oral cancer cases are caused by HPV.

While most strains of HPV clear up on their own, the sexually transmitted disease is responsible for an array of cancers. As Douglas describes, it’s true that oral sex is an avenue through which a person can contract HPV and especially the strains, HPV-18 and HPV-16, the latter of which is responsible for half of oral cancer cases, according to the National Cancer Institute. HPV-16, HPV-18 and some less-common strains can also cause cancers of the cervix, vagina, vulva, anus and penis.

Douglas’ experience follows trends in cancer diagnosis, according to a January report from the American Cancer Society, which found a rise in oral cancer caused by HPV in both women and men. As the report said, as of 2004, 72 percent of oral cancer tumors were HPV-positive — up from 16 percent of tumors in data collected between 1984 and 1989.

Previously, excessive drinking and tobacco use were the most common causes of the throat cancer Douglas developed, but HPV has replaced tobacco as the leading cause of throat cancers. HPV’s rise as the leading cause of oral cancer is not just the result of growing rates of the virus — it is also explained by drops in smoking, thanks to public health campaigns that describe the dangers of cigarette use.

HPV-16 and 18 are targeted by the vaccine Cervarix and are two of the four strains targeted by Gardasil, the other of the two approved vaccines against HPV. Gardasil is currently recommended for boys between the ages of 13 and 21 and both Cervarix and Gardasil are recommended for girls, aged 13 to 26, according to the Centers for Disease Control and Prevention. HPV-6 and HPV-11, both of which the Gardasil vaccine immunizes against, cause about 90 percent of genital warts cases.

Despite the growing rates of oral cancer, cases like Douglas’ are still relatively rare, with about 7,100 new cases each year, reported USA Today. But that doesn’t mean oral HPV infection is rare: According to a 2012 study of Americans, aged 14 to 69, about 10 percent of men and 3.6 percent of women currently have an oral HPV infection.

According to the CDC, there is no screening test to determine overall HPV status. While women are screened for HPV-associated cervical cancer via a Pap-smear test, other HPV-associated cancers don’t have a specific screening test. Despite the fact that there are no uniform screening techniques for oral cancer, the prognosis for the disease is good, with an 80 to 90 percent survival rate, according to The Oral Cancer Foundation.

When a virus causes cancer, surgical robot can help

Source: www.bizjournals.com
Author: James Ritchie

Dr. Keith Wilson finds robotic surgery to be a good approach for removing tumors growing deep in the throat, as I recently reported. As it turns out, such tumors are often part of an alarming trend. They’re often caused by the sexually transmitted human papillomavirus, also known as HPV.

In decades gone by, oral cancer was almost always associated with tobacco and alcohol use. It was typically a disease of old men. No more. Many of Wilson’s patients are nonsmokers and very light drinkers.

“I can’t tell you how surprised people get,” said Wilson, who is chief of staff at University of Cincinnati Medical Center. “We’re seeing younger, more affluent and more highly educated patients.”

High-risk HPVs cause virtually all cervical cancers. They have in recent years been implicated in oropharyngeal cancers. The oropharynx is the middle part of the throat, including the soft palate, the base of the tongue and the tonsils.

About 63 percent of oropharyngeal cancers, or 11,000 cases per year, are associated with HPV infection, according to the American Dental Association. They’re frequently under age 50.

Fortunately for such patients, HPV-associated oropharyngeal cancers have a better prognosis than those with other causes. Wilson said that cure rates can approach 90 percent.

The da Vinci surgical robot is an effective tool for removing them, he said, because its long, joined arms can go where a surgeon’s hands can’t. But the machines, made by Sunnyvale, Calif.-based Intuitive Surgical Inc., are gaining some criticism. The robotic surgery system is facing safety questions from the U.S. Food and Drug Administration after a string of complaints across the country – as many as 500 since January 2012.