human papillomavirus

Thirty-second oral cancer test could save your life

Source: savannahnow.com
Author: Angela C. Canfield, DDS

Every 60 minutes, a person dies from oral cancer. The disease is typically associated with long-term tobacco use, but it is becoming more frequent in young adults who have never smoked.

According to the National Cancer Institute, 40 percent of those diagnosed with oral cancers will die within five years.

Besides tobacco use, the risk factors that could lead to oral cancer include DNA abnormalities or family history. But the main cause of oral cancers, especially in young adults who don’t smoke, is the human papillomavirus (HPV), which may be spread by sexually active people through intimate or even close contact.

HPV is the leading cause of cervical cancer, which used to be the leading cause of cancer deaths for women in the United States. Now that more women routinely get PAP tests that provide early detection of conditions that could lead to cervical cancer, those cancer rates are on the decline. In fact, these days, a person is three times more likely to die from oral cancer than cervical cancer.

According to the National Cancer Institute, 40 percent of those diagnosed with oral cancers will die within five years. While the disease has few, if any, early symptoms, early detection can make a dramatic difference, increasing survival rates to as much as 90 percent. Now, a routine test that takes only 30 seconds is available to provide that early detection and even offer prevention from the disease itself.

The test is basically a minty mouthwash or saline solution administered by a dentist or other oral health care provider. You swish and gargle and spit it back into the test cup. It’s that simple.

Oral cancer signs

While easily administered, this genetic test has a complex function, looking for oral cancer risk on a molecular level in three ways:

• Cell abnormalities. Changes to your cells could mean a precancerous condition or infection exists.

• HPV. This virus can lead to some cases of oral cancer, or clear up on its own. In either case, I monitor and test my patients more frequently, especially if an infection tends to linger.

• DNA damage. People with certain DNA damage seem to be at a higher risk for oral cancer. These abnormalities don’t mean you have oral cancer or that you are destined to get it, but more frequent monitoring is usually necessary, just to be safe.

While not always present, possible signs of oral cancer could include a mouth sore that bleeds easily and does not heal within two weeks, a lump or thickening in the oral soft tissues, soreness or a feeling that something is caught in the throat, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, or numbness of the tongue. Some signs of oral cancer might also easily be mistaken for a toothache or a cold.

I recommend to my patients aged 18 and older that they be tested annually for oral cancer. Results can vary from negative to being high risk or positive. For patients who test positive for precancerous cells, I usually suggest a follow-up visit with an ear, nose and throat specialist, depending on the levels found. I will continue to monitor high-risk patients and administer follow-up tests as needed.

Please talk with your oral health care provider about your risk factors and the advantages of oral cancer screening.

Angela Canfield, DDS, is licensed by the Georgia Board of Dentistry and the National Board of Dentists.

Novel vaccine therapy can generate immune responses in patients with HPV-related head and neck cancer

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

A novel vaccine therapy can generate immune responses in patients with head and neck squamous cell carcinoma (HNSCCa), according to researchers at the Abramson Cancer Center of the University of Pennsylvania. The treatment specifically targets human papillomavirus (HPV), which is frequently associated with HNSCCa, to trigger the immune response. Researchers will present the results of their pilot study during the 2017 American Society of Clinical Oncology Annual Meeting in Chicago (Abstract #6073).

HNSCCa is a cancer that develops in the mucous membranes of the mouth, and throat. While smoking and tobacco use are known causes, the number of cases related to HPV infection – a sexually transmitted infection that is so common, the Centers for Disease Control says almost all sexually active adults will contract it at some point in their lifetimes – is on the rise. The CDC now estimates 70 percent of all throat cancers in the United States are HPV-related. Sixty percent are caused by the subtype known as HPV 16/18.

“This is the subtype we target with this new therapy, and we’re the only site in the country to demonstrate immune activation with this DNA based immunotherapeutic vaccine for HPV 16/18 associated head and neck cancer,” said the study’s lead author Charu Aggarwal, MD, MPH, an assistant professor of Hematology Oncology in the Perelman School of Medicine at the University of Pennsylvania.

The vaccine is delivered as an injection of antigens – which leads the immune system to start producing antibodies and activate immune cells. At the time of injection, physicians use a special device to deliver a pulse of electricity to the area, which stimulates the muscles and speeds the intake of the antigens. Aggarwal noted that this study represents a multidisciplinary approach involving the lab and the clinic.

“This is truly bench-to-bedside and shows the value of translational medicine within an academic medical center,” Aggarwal said.

Penn researchers treated 22 patients with the vaccine. All of the patients had already received therapy that was intended to be curative – either surgery or chemotherapy and radiation. When doctors followed up an average of 16 months later, 18 of those patients showed elevated T cell activity that was specific to HPV 16/18. All of the patients in the study are still alive, and none reported any serious side effects.

“The data show the therapy is targeted and specific, but also safe and well-tolerated,” Aggarwal said.

Because of the positive activity, Aggarwal says the next step is to try this therapy in patients with metastatic disease. A multi-site trial will open soon that combines the vaccine with PD-L1 inhibitors, which target a protein that weakens the body’s immune response by suppressing T-cell production.

More patients presenting with HPV-associated oral cancers in Lubbock, TX

Source: lubbockonline.com
Author: Ellysa Harris

Detecting oral cancers in patients in their 50s and 60s has never been uncommon. But local dentists and doctors say finding it in younger patient populations has become a new norm.

Oral cancers driven by Human Papillomavirus are now the fastest growing oral and oropharyngeal cancers, according to the Oral Cancer Foundation website. And local health officials say they’ve seen a few more cases than usual.

Dr. Joehassin Cordero, FACS, professor, chairman and program director ofTexas Tech’s Health Sciences Center Department of Otolaryngology-Head & Neck Surgery, said less people are smoking and that has contributed to the decrease in the number of cases of oral cancers in the past two decades.

“In that same period, we have seen an increase in the HPV oropharyngeal cancer,” he said. “And oropharyngeal cancer — what it means it’s affecting the base of your tongue and tonsils.”

Dr. Brian Herring, a Lubbock dentist, chalks the increase up to increased awareness.

“I’m assuming probably for years and years and years it has affected the mouth but we didn’t know that,” he said. “As we get better at cellular diagnostics and molecular diagnostics, things like that, we’re finding that there is a large portion of cancers that do have an HPV component.”

What’s more alarming, said Dr. Ryan Higley, oral surgeon with West Texas Oral Facial Surgery, is it’s being diagnosed in younger people.

Higley said oral cancers are generally diagnosed between the ages of 55 and 65, mostly in women.

“With HPV-associated cancers, we see those four to 10 years before that,” he said. “It’s a younger patient population.”

Cordero said the oral cancers are often caused by exposure to HPV from years before.It starts with exposure to the HPV infection. One in four people in the United States are currently infected, according to the Centers for Disease Control and Prevention website.

“It’s truly considered a sexually transmitted disease,” Cordero said. “It has to do with not so much kissing, but oral sex.”

It’s passed on when somebody with an active lesion engages in sexual activities with another person, he said.

Nine out of 10 infections will disappear on their own, according to the CDC, but infections that linger for longer than about two years can lead to cancer.

“That doesn’t mean they’ll have cancer next week,” Cordero said.

Researchers are still trying to figure out why and how long after HPV exposure it takes for cancer to develop, he said.

“We don’t know the true mechanism because most of these people were not exposed a year ago,” he said. “They were not exposed six months ago. They were exposed a long time before that.”

When it does present, he said, there generally aren’t any noticeable symptoms.Because of that, it’s often diagnosed in later stages, Herring said.

“What we’re finding is because the demographic is changing, they’re not getting diagnosed as early because they’re not expecting to have this problem,” he said.

Screenings for oral HPV exist.

“The gold standard examination is your typical dental exam,” Herring said. If your dentist detects something unusual that might need further examination, he or she will make a referral to an oral surgeon.

Higley said oral HPV cancer presents as a lesion that looks like a kanker that won’t heal.

“However, cancerous lesions can have multiple presentations so that’s not exclusive,” he said. “So oftentimes, we’ll have a patient present with a hard nodule underneath their jaw line or in their neck. Sometimes they’ll just have red or white lesions within the mouth, hoarseness in their voice or difficulty swallowing. All those are things that need to be checked.”

The cancer seems to be more treatable, he said, but it’s hard to pinpoint why.

“We really don’t know if they’re more responsive to treatment because we’re treating a little bit younger patient population who is overall more healthy or if it’s inherant in the tumor itself,” Higley said.

Cordero said he hopes the HPV vaccine, which is recommended for both girls and boys 11 or 12 years old and people up to 26 years old, provides a measure of protection against the infection.

“We’re hoping in the next 10 to 20 years that head and neck cancer caused by HPV will be completely gone,” he said.

American Dental Association and The University of Texas MD Anderson Cancer Center announce collaboration

Source: www.prnewswire.com
Author: press release

The American Dental Association (ADA) and The University of Texas MD Anderson Cancer Center today announced a joint effort to improve patient outcomes through programs aimed at dental and medical professionals and the public to increase human papillomavirus (HPV) vaccinations and tobacco cessation for oral cancer prevention.

“ADA member dentists promise to put patients first, and as a profession we look for innovative ways to treat and prevent disease, and promote wellness,” said ADA President Gary Roberts, D.D.S. “Together with MD Anderson, one of the most respected cancer centers in the world, we are excited to pioneer new programs to help our patients live healthy and disease-free lives.”

Both organizations agree that increasing the percentage of children and young adults vaccinated for HPV is critical to improving their health and reducing risk of several related cancers, including those of the oropharynx (the part of the throat just behind the mouth which includes the back third of the tongue; the back part of the roof of the mouth, also known as the soft palate; the tonsils, and the side and back wall of the throat). In addition, programs aimed at preventing children and young adults from starting to smoke while encouraging current smokers to quit are another key component of the collaboration.

“MD Anderson is pleased to partner with the ADA to develop innovative educational programs that will increase awareness about the prevention and early detection of oral cancers,” said Marshall E. Hicks, M.D., president ad interim, MD Anderson. “Tobacco use and HPV infection remain the leading causes of oral cancers. Through this collaboration, we have a significant opportunity to inform care providers and the public about the associated risks, and we can make a difference in the fight to end cancer.”

According to the American Cancer Society, an estimated 50,000 cancers of the oral cavity and pharynx will be diagnosed this year in the U.S., and rates in men are more than twice as high as in women. These cancers are often not diagnosed until late stages, when treatment is less effective.

Tobacco use remains the leading preventable cause of cancers in the U.S., responsible for roughly one-third of all cases. HPV infections are responsible for approximately 70 percent of all oropharyngeal cancers, about 9,000 annually, as well as the majority of cervical, anal and genital cancers. HPV-related oropharyngeal cancers are four times more common in men than women, and the incidence rate of these cancers has risen significantly in recent years.

About the American Dental Association
The not-for-profit ADA is the nation’s largest dental association, representing more than 161,000 dentist members. The premier source of oral health information, the ADA has advocated for the public’s health and promoted the art and science of dentistry since 1859. The ADA’s state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA’s flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit ADA.org. For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA’s consumer website MouthHealthy.org.

About MD Anderson
The University of Texas MD Anderson Cancer Center in Houston ranks as one of the world’s most respected centers focused on cancer patient care, research, education and prevention. The institution’s sole mission is to end cancer for patients and their families around the world. MD Anderson is one of only 47 comprehensive cancer centers designated by the National Cancer Institute (NCI). MD Anderson is ranked No.1 for cancer care in U.S. News & World Report’s “Best Hospitals” survey. It has ranked as one of the nation’s top two hospitals since the survey began in 1990, and has ranked first for nine of the past 10 years. MD Anderson receives a cancer center support grant from the NCI of the National Institutes of Health (P30 CA016672).

HPV vaccine; cancer prevention

Source: www.nujournal.com
Author: staff

Human papillomavirus (HPV) is a sexually transmitted infection, of several strains, most associated with cervical cancers. The virus is so common that nearly all males and females have been infected at some time in their life. One in four is currently infected in the nation.

Signs and symptoms of HPV are variable. Most will recover from the virus within two years without ever knowing they were infected, making HPV easy to spread. Occasionally, the virus lasts much longer in the body which can cause cells to change and lead to cancer. Fortunately, we have a vaccine to prevent cancer caused by HPV.

The Food and Drug Administration (FDA) has approved three vaccines for HPV; Cervarix, Gardasil, and Gardasil 9. These vaccines are tested and proven to be safe and effective.

Prevention is important with HPV. The vaccine should be administered before exposure to the virus for stronger protection against cervical, vaginal, vulvar, penile, and some mouth or throat cancers. (Gardasil and Gardasil 9 also prevent genital warts and anal cancer.) The best age to obtain maximum potential of the vaccine is at 11 or 12 years old. At this age, the body’s immune system is the most receptive to the vaccination’s virus-like particles and the body produces higher amounts of antibodies in defense, protecting the adolescent for his or her future. Both girls and boys should get the HPV vaccine. For ages 9-14, two doses – six to twelve months apart, are recommended. For 15-26 year olds, three doses are recommended. Side effects may include brief soreness, or redness or swelling at the injection site.

The HPV vaccine does prevent cancer, limiting biopsies and invasive procedures thus cutting potential health care costs. Most private insurance companies cover preventive vaccinations, it is best to call your carrier for more information. The HPV vaccine is covered by Minnesota Health Plans. Uninsured individuals may be eligible to get the vaccine at their local public health office.

Schedule your adolescent’s annual health exam today and ask which HPV vaccine is best for the child in your life.

“Every year in the United States, HPV causes 30,700 cancers in men and women. HPV vaccination can prevent most of the cancers (about 28,000) from occurring.” (CDC, December, 2016)

Learn more at www.cdc.gov/hpv or www.cancer.gov

April, 2017|Oral Cancer News|

Beating HPV-positive throat cancer

Source: www.huffingtonpost.com
Author: Pamela Tom, Contributor

National Oral, Head, and Neck Cancer Awareness Week is April 12-18, 2017

For at least two years, 47 year-old Rob Clinton of Rochester, NY, would choke on post nasal drip in the shower. He knew something was wrong in his throat but he didn’t feel any pain.

Did he have cancer? Clinton smoked cigarettes for 30 years and worked in an auto body shop where he was regularly exposed to carcinogens, but he wasn’t experiencing the typical symptoms of throat cancer. These include hoarseness or a change in the voice, difficulty swallowing, a persistent sore throat, ear pain, a lump in the neck, cough, breathing problems, and unexplained weight loss.

In November 2015, Clinton went to the dentist to have his teeth cleaned. His dentist felt Clinton’s swollen neck and recommended that he visit a medical doctor. Clinton heeded the advice and sought the opinion of an ear, nose, and throat specialist at Strong Memorial Hospital in Rochester, NY.

The ENT doctor sent Clinton to have a CAT scan and when he scoped Clinton’s throat, the doctor said, “I see something in there.”

What he saw was a tumor and there were a few other things going on too.

The Diagnosis
The biopsy showed that Clinton had Stage IVa oral squamous cell carcinoma (OSCC) at the base of his tongue—and the cancer was HPV positive. HPV stands for the human papillomavirus and a recent survey found that more than 42% of Americans are infected with HPV. While most people’s bodies naturally clear HPV after two years, some people’s immune systems do not recognize the virus and consequently, HPV can harbor in the body for decades. HPV-related throat cancer has been linked to oral sex.

The Treatment
On December 4, 2015, Clinton underwent neck dissection surgery at Roswell Park Cancer Institute in Buffalo, NY. Dr. Hassan Arshad, a head and neck cancer surgeon, removed 30 lymph nodes; two had cancer and one tumor was the size of a golf ball. One lymph node on the other side of neck and a tongue tumor would be treated with radiation.

The first of 35 radiation treatments began one month later in conjunction with Cisplatin chemotherapy infusions. That’s seven weeks of simultaneous radiation and chemo.

“I drove myself to treatment for the first five weeks. Up until the last week of treatment, it wasn’t too terrible,” Clinton says. “But then I started getting tired and my mother took me to the cancer center.”

Clinton had decided not to get a feeding tube prior to or during treatment and as the radiation and chemo attacked his cancer, he began to lose weight. The treatment reduced Clinton’s appetite because foods began to taste different. For two weeks, he also felt a burning sensation in his mouth and says his saliva tasted like hot sauce.

“It was excruciating and the worst thing I dealt with during treatment.”

Furthermore when radiation makes the throat feel tender and raw, it becomes nearly impossible to eat normally through the mouth.

Clinton was 215 pounds before treatment. After treatment, he weighed in at a mere 165 pounds. A loss of 50 pounds. In hindsight, Clinton wishes he had the feeding tube inserted while he was still strong.

“Don’t be afraid of the treatment. It’s manageable and you can get through it. I recommend a feeding tube because it’s a comfort knowing you have an option,” says Clinton.

The Recovery
While it took a month for Clinton to recover from the initial surgery, doctors say it takes at least a year for HPV+ throat cancer patients to find their “new normal”—regaining strength, adapting to lingering side effects.

Following chemo, Clinton experienced “chemo brain” or “chemo fog,” known as a cognitive impairment that can occur after chemotherapy. The patient may experience memory loss or dysfunction, and have difficulty concentrating or multi-tasking.

The radiation also took its toll on Clinton. He researched and found a salve made of calendula flowers, olive oil, beeswax, and Vitamin E oil to soothe his parched skin. Trying to gain weight was a bigger challenge. First, his taste went “totally upside down” and spicy foods were intolerable.

“A vanilla cookie tasted like black pepper,” Clinton says. “Only frozen peas and parsley tasted normal.”

And dry mouth is a common result of the radiation treatment. While both sides of Clinton’s neck received radiation, he had less saliva production on his left side. At night he would have to wake up every 40 minutes to drink water. Clinton must make certain not to become dehydrated because it causes the dry mouth to worsen. Now he chews gum almost non-stop.

In his search to combat dry mouth, Clinton says he researched solutions online and found ALTENS, or acupuncture-like transcutaneous electrical nerve stimulation. A study led by Dr. Raimond Wong, an associate professor of oncology at McMaster University in Ontario, Canada, found evidence that ALTENS may reduce patient-reported xerostomia, the medical term for dry mouth.

Clinton joined Dr. Wong’s clinical trial to determine whether ALTENS for six weeks/four days a week would be as effective as treatment for 12 weeks/two times a week.

“Four days a week, the researchers put pads on the inside of my ankles, the outside of my knee, back of my hands, between my thumb and forefingers, and between my chin and bottom lip,” says Clinton.

Clinton says ALTENS felt like little shocks and the acupuncture-like stimulation improved his saliva production by 80 percent. “Even after I stopped ALTENS, my saliva kept improving,” says Clinton.

The Survivor
Two years after cancer treatment, regular PET scans show that Rob Clinton has no evidence of cancer. In fact, the prognosis for HPV-related throat cancer is 85 to 90 percent positive if caught early. In contrast, patients who battle advanced throat cancer caused by excessive smoking and alcohol have a five-year survival rate of 25 to 40 percent.

Dr. Arshad, Clinton’s surgeon at the Roswell Park Cancer Institute, explained why.

“The majority of tonsil and tongue base (“throat”) cancers are HPV-positive, but smoking is still a major risk factor. Typically, non-smoking patients with HPV-positive tonsil/tongue base cancers present with a lump in the neck, implying that the cancer has already spread to lymph nodes. This used to mean that the patient would have a reduced chance of long-term survival,” Arshad says. “We now know that for nonsmokers who have HPV-positive cancers, metastasis to lymph nodes doesn’t carry the same poor prognosis. The newest staging system reflects that change, i.e. Some of those patients who were previously classified as stage IV are now at stage II if the cancer is HPV-positive.”

Clinton is not only faring well physically, surviving cancer changed his outlook and lifestyle.

“My life is pretty much back to normal. I get a little nervous each time I get a PET scan but so far, it shows I am free of cancer,” Clinton says. “I have a better appreciation of things. I live healthy in terms of diet and recreation. I don’t smoke or drink heavily.”

The Future of HPV+ Oropharyngeal Cancer
De-stigmatizing HPV is a key component to building public awareness and acceptance of HPV infection, and the ability to recognize the early symptoms of HPV-related throat cancer. As more and more people are diagnosed with HPV-related throat cancer, the social stigma surrounding the virus is a disturbing deterrent because HPV cancer patients are often reticent to disclose the HPV connection.

In a 2015 public service announcement, actor Michael Douglas who was treated HPV+ base of tongue cancer called for oral screenings but never said “HPV” by name. “A very common virus, one responsible for the vast majority of cervical cancers is now identified as the cause of this rapid rise in oral cancers,” said Douglas.

In the early years of the AIDS crisis, people associated infection with illness, fear, and death. It took a decade to generate a movement and begin to change the public sentiment. Now after continual education, AIDS is accepted and the focus centers on hope instead of ostracization.

Clinton hopes more people will accept that HPV infection is common—the most common sexually-transmitted infection in the U.S., according to the CDC. The American Society of Clinical Oncologists also found that by 2020, the annual number of HPV-related oropharyngeal in nonsmoking, middle-aged men will surpass the number of cervical cancer cases.

“HPV is not a shameful thing. It’s very common. It’s just that some people can’t clear the virus from their bodies,” Clinton says. “This type of cancer is the next epidemic. I feel fortunate every day that I came through it as well as I did.”

April, 2017|Oral Cancer News|

More than 1 In 5 Americans have a potentially cancer-causing HPV infection

Source: www.huffingtonpost.com
Author: Erin Schumaker

More than 42 percent of adults in the United States are infected with human papillomavirus ― and nearly 23 percent are infected with a high-risk strand of the virus that can cause cancer, according to a report published by the National Center for Health Statistics on Thursday.

“We tend to overlook the fact that 20 percent of us are carrying the virus that can cause cancer (indluding oral cancer – OCF news editor),” Geraldine McQuillan, lead author of the report and an epidemiologist at the U.S. Centers for Disease Control and Prevention, told The Washington Post.

“People really need to realize that this is a serious concern.”

The report, which examined U.S. adults ages 18 to 59, marks the first time the CDC has recorded HPV rates in men as well as women. There is no FDA-approved HPV test for men, but the CDC developed its own test for the research. “We did penile swabs which we tested for HPV DNA,” McQuillan told The Huffington Post.

HPV is the most common sexually transmitted disease in the country, and nearly every sexually active American will be exposed to it by their early 20s. Although 90 percent of HPV infections clear the body within two years, that’s not always the case. High-risk strains are linked to cervix, vaginal, penile, anus and throat cancers, as well as genital warts.

In fact, two high-risk strains, HPV-16 and -18, cause nearly all cervical cancer cases.

Not all Americans have the same risk of contracting high-risk HPV. Asian-Americans had the lowest HPV rate (12 percent), followed by whites and Hispanics (22 percent). Black Americans had the highest HPV prevalence (34 percent), according to the report. Overall, men were more likely to have high-risk genital HPV than women.

The best defense against HPV is getting the HPV vaccine before being exposed to the virus. The CDC strongly recommends the HPV vaccine as a cancer-prevention method for boys and girls starting at age 11, before they are exposed to the virus through sex.

“I commonly hear parents thinking that it’s better to wait until their children are sexually active before immunizing,” Dr. Dean Blumberg, associate professor and chief of pediatric infectious diseases at UC Davis Children’s Hospital, previously told The Huffington Post.

“Younger children have a more robust immune response to HPV vaccine compared to older children and young adults,” Blumberg said. “Specifically, children 9 to 15 years of age develop higher antibody levels after the vaccine series compared to 16- to 26-year-olds.”

While there’s no treatment for HPV itself (just for some symptoms, such as genital warts), routine Pap smears can catch cancer caused by the virus in its early stages. People with HPV should also use a condom to avoid passing the disease to a partner.

The CDC recommends cervical cancer screening for women ages 21 and older. The FDA approved an HPV test for women in 2003, but only 39 percent of clinicians ordered the test during a study of five Michigan health clinics from January 2008 to April 2011.

April, 2017|Oral Cancer News|

Game changer’ HPV vaccine is now just 2 shots – not 3 – in bid to simplify

Source: www.dailymail.co.uk
Author: Mary Kekatos for dailymail.com

  • HPV vaccines will now be administered in two doses instead of three
  • The virus is the most common sexually transmitted infection in the US
  • But only 28% of boys and 42% of girls received the advised three doses in 2015
  • Doctors hope the new guidelines increase the number of kids who get the shot

The HPV vaccine will now be administered in two doses instead of three, new guidelines declare. The new rules, published on Monday, come after years of campaigns from cancer experts insisting an easier schedule would encourage more people to protect themselves from the sexually-transmitted infection.

Human papillomavirus (or, HPV) is the most common STI in the United States, affecting around 79 million people. It has been linked to numerous cancers – including prostate, throat, head and neck, rectum and cervical cancer.

Experts claim more widespread vaccine coverage of middle school children could prevent 28,000 cancer diagnoses a year. Currently, fewer than half the children eligible for the vaccine – given out as three doses over six months – are covered. Experts blame the lengthy, arduous schedule.

The American Cancer Society today endorsed the updated recommendations, which were released by the Advisory Committee on Immunization Practices (ACIP).  Dr Debbie Saslow, Senior Director, HPV Related and Women’s Cancers for the American Cancer Society, said: ‘In the past several years, studies have shown the vaccine is even more effective than expected.

‘This new two-dose regimen is easier to follow, and we now know is very effective in preventing HPV, which is linked to a half dozen types of cancer.’

Each year, about 14 million people become newly infected with HPV. According to the CDC, each year about 19,000 cancers caused by HPV occur in women in the US, with cervical cancer being the most common. And about 8,000 cancers caused by HPV occur each year in men in the US and oropharyngeal (throat) cancers are the most common. Besides cervical cancer, HPV has been linked to vaginal, vulvar, oropharyngeal, anal, and penile cancers.

Despite strong evidence of safety and effectiveness, vaccination rates in the US remains very low compared to other countries. Only 28 percent of boys and 42 percent of girls aged 13 to 17 years receiving the recommended three doses in 2015. The skewed figures between genders are largely attributable to the fact that the jab was only offered to boys as a standard vaccine as of last year.

Previously, it was believed HPV was most strongly linked with cervical cancer in women. Research since has shown links with penile, anal, mouth, throat and other cancers in men. However, the gender divide does not fully account for the staggeringly low levels of coverage overall.

Despite the three vaccines that are widely available, the number who choose to be vaccinated remains low, and the age they wait to do so has increased. Only Rhode Island, Virginia and the District of Columbia require the vaccine for students.

In response to these figures last year, the ACIP, along with the Centers for Disease Control and Prevention (CDC), conducted a thorough review of clinical trial data on HPV vaccines. They found that the vaccine in younger adolescents (aged nine to 14 years) produced an immune response similar or higher than the response in young adults (aged 16 to 26 years) who received three doses.

Generally, preteens receive the HPV vaccine at the same time as whooping cough and meningitis vaccines and it is administered before the likely chance of sexual contact.

The new schedule, approved by the FDA in October 2016, states that two doses of HPV vaccine given at least six months apart at ages 11 and 12 will provide ‘safe, effective, and long-lasting protection against HPV cancers’. Even adolescents between ages 13 and 14 are able to receive the HPV vaccination on the new two-dose schedule.
For patients who did not receive HPV vaccination before age 15, three doses are still required and may be given to females up to age 26 and males up to age 21.

February, 2017|Oral Cancer News|

Feds, cancer centers aim to boost HPV vaccinations

Source: www.dispatch.com
Author: JoAnne Viviano

Faced with getting her daughter the HPV vaccine, which helps protect against cervical and other cancers, Anaraquel Sanguinetti paused.

The human papillomavirus is spread through sexual contact, and the Westerville mom didn’t want her now-18-year-old daughter to think she was promoting promiscuity. So Sanguinetti did some research. And she had a long talk with her daughter, and another with her doctor.

In the end, daughter Celine got the vaccine last year.

“We are discovering every day new reasons why people obtain cancer, so it’s just another added layer of protection for my daughter for her future, because you just never know,” Sanguetti said. “ I didn’t want to have a regret.”

Sanguetti is in the minority. Though vaccinating against HPV is recommended by the Centers for Disease Control and Prevention, and countless cancer centers and health-care providers, most children in the United States have not been vaccinated against HPV.

Calling that “a serious public health threat,” dozens of cancer centers released a joint statement on Wednesday urging more parents and pediatricians to get onboard.

The statement endorses the CDC’s recent revisions to its HPV vaccine recommendations. Vaccinating, the statement says, could help prevent the nearly 40,000 cases of HPV-associated cancers diagnosed in the United States each year.

“Get the HPV vaccine for your child so they don’t have to hear those words: ‘You have cancer,’ “ said Electra Paskett, co-leader of cancer control at Ohio State University’s Comprehensive Cancer Center, which is among the institutions participating in the effort.

The CDC estimates that as many as 79 million Americans are infected with HPV, which can cause cervical, genital, anal, rectal and throat cancers as well as genital warts. Fourteen million new infections occur each year.

A 2016 CDC report says that only about 42 percent of girls and 28 percent of boys had completed the recommended vaccination series. In Ohio, 35 percent of girls and 23 percent of boys have completed the vaccination course.

In all, 69 National Cancer Institute-designated cancer centers are participating in the effort.

The recommendations issued last year say that kids who are 11 or 12 should receive two shots of the HPV vaccine, delivered at least six months apart. The previous recommendation was for three shots, which is still advised for people 15 to 26 years old.

Simplifying the process likely will increase participation and move the nation toward the U.S. Department of Health and Human Service’s goal of having 80 percent of young people vaccinated by 2020, said Dr. Li Li, associate director for prevention research at Case Western Reserve’s Comprehensive Cancer Center.

“This is one of the few preventable cancers,” he said. “There’s a very unique opportunity for us nationwide to get together to put this forward.”

Li said he’d like to see the state mandate that children receive the vaccine at age 11 or 12 to enroll in school. That’s the rule in three states, he said.

Paskett said recommendations also call for bundling the HPV vaccine with other vaccines given at that age.

“The public has been clamoring for a cancer vaccine for decades, and we now have one and we need to use it,” she said.

Sanguetti said she wanted to make sure her daughter was vaccinated before going off to college. She said she would recommend that other parents do their own research and have their children vaccinated even if it is uncomfortable thinking about their sons or daughters having sex.

“It’s for their future,” she said. “It’s more toward their well-being. It’s not promoting anything other than a preventative for cancer.”

For more information, go to www.cdc.gov/hpv.

January, 2017|Oral Cancer News|

Blood-borne HPV antibodies indicate head, neck cancer prognosis

Source: medicalxpress.com
Author: provided by Brown University

People with head and neck cancers with evidence of human papillomavirus (HPV) infection generally have a better prognosis than people without evidence of infection. A new study in JAMA Oncology suggests that to produce a strong, reliable prognostic signal, all that’s needed is a blood serum test for two specific HPV antibodies, rather than lab work on a biopsy. Further, the researchers said, the study shows that this blood-based biomarker is predictive of outcome for all types of head and neck cancer.

bloodbornehp

The human papillomavirus causes not only cervical cancer but also cancers of the head and neck. Credit: National Cancer Institute

“What this adds is that it helps us know how best to measure clinically the HPV contribution to this disease,” said study senior author Karl Kelsey, a professor of epidemiology and of pathology and laboratory medicine at Brown University. Kelsey collaborated with lead author Heather Nelson of the University of Minnesota Masonic Cancer Center in making the findings.

Moreover, Nelson, Kelsey and their colleagues wrote, referring to the common HPV16 strain of the virus: “These data are among the first to demonstrate a convincing relationship between HPV16 and improved patient survival for tumors of the larynx and oral cavity.”

Appraising antibodies
The study examined blood serum samples and five-year survival rates among more than 1,000 Boston-area head and neck cancer patients diagnosed between 1999 and 2011. Overall, those who tested positive for antibodies to the oncogenic HPV proteins E6 or E7 were less likely to die during the five year follow-up period after diagnosis compared to those who tested negative for the antibodies. Based on the analysis, the researchers estimated that those with evidence of an immune response to HPV were 25% less likely to die during the course of follow-up compared to those with no immune response to HPV.

The study’s purpose was to determine whether the antibodies provide a reliable indication of prognosis. In ongoing trials, doctors are testing whether patients with HPV-associated cancers can be treated less aggressively—and hopefully with fewer negative side effects—than people with non-HPV-associated cancers, Kelsey said. If trials prove successful, then it will be particularly important to determine whether cancers are HPV-associated.

“The assessment of a patient’s HPV status likely will affect treatment,” he said. “That’s why there’s real interest in getting it right; for instance, how do you test?”

Better prognosis across the board
Prior studies have focused primarily on the role of HPV in the oropharynx—the area of the throat right behind the mouth. An important contribution of the current study, Nelson said, is demonstration that an immune response to HPV is important for all forms of head and neck cancer, although the benefit does show some variance based on the exact cancer location. Those patients with an HPV immune response with tumors located in the oropharynx and larynx had a similar risk of dying during the follow-up period, though the reduced risk was slightly attenuated for those patients with tumors located in the oral cavity.

The results didn’t depend significantly on whether people had high or low levels of the antibodies, so long as they had some, the researchers found, though testing positive for both E6 and E7 was better than for just one.

The reduced chance of dying by five years carried through for people who tested positive for the antibodies even if they consumed tobacco and alcohol. But the worst prognoses in the study were among smokers whose cancers could not be traced to HPV.

In all, the findings controlled for the statistical influences not only of tobacco and alcohol exposure, but also of age, race, gender, education and how far advanced the cancer was.

Relates to broader advances
Kelsey said the findings could help bring head and neck cancer treatment closer into line with two emerging practices of fighting the disease: personalized medicine and immunotherapy.

“To me, personalized medicine really reflects using all the information you can glean about an individual tumor to treat it appropriately,” Kelsey said. “Here HPV is an example of a causal factor that delineates the mechanism of the tumor suppressor genes that drive the tumor and that gives you insight into the differences in the tumor.”

Meanwhile, the study might help shed light on why immunotherapy—in which the body’s immune system is marshaled to attack cancer—appears to help for some head and neck cancers, Kelsey said. It may not be coincidence, for instance, that the prognosis is better among people whose cancers are associated with a virus that promotes a robust immune response, in the form of antibodies, than among people without a viral cause for their cancer.

If HPV-related cancers can indeed be treated differently, Kelsey said, then serum-based testing to determine the role of the virus could soon be available, too.

December, 2016|Oral Cancer News|