ASCO Urges Aggressive Efforts to Increase HPV Vaccination

Source: www.medscape.comAuthor: Zosia Chustecka Human papillomavirus (HPV) vaccines have now been available for 10 years, but despite many medical professional bodies strongly recommending the vaccine, uptake in the United States remains low. Data from a national survey show that about 36% of girls and 14% of boys have received the full schedule of HPV vaccines needed to provide protection (Vaccine. 2013;31:1673-1679). Now the American Society of Clinical Oncology (ASCO) has become involved, and in a position statement issued today the organization calls for aggressive efforts to increase uptake of the HPV vaccines to "protect young people from life-threatening cancers." "With safe and effective vaccines readily available, no young person today should have to face the devastating diagnosis of a preventable cancer like cervical cancer. But unless we rapidly increase vaccination rates for boys and girls, many of them will," ASCO President Julie M. Vose, MD, said in a statement. "As oncologists, we see the terrible effects of these cancers first hand, and we have to contribute to improving today's alarmingly low vaccination rates," she added. The new policy statement is published online April 11 in the Journal of Clinical Oncology. The statement notes that HPV vaccination has been previously recommended by many US medical societies, including the American Cancer Society, the American College of Obstetrics and Gynecology Committee, the American Dental Association, the American Head and Neck Society, the American Nurses Association, the American Pharmacists Association, the Association of Immunization Managers, the Society for Adolescent Medicine, and the Society of Gynecologic Oncology. [...]

2016-04-18T13:12:04-07:00April, 2016|Oral Cancer News|

The burden of cancer isn’t just cancer

Source: www.news.doximity.comAuthor: Carolyn Y. Johnson Money is low on the list of things most people want to think about after a doctor says the scary word "cancer." And it's not just patients — physicians also want to weigh the best treatment options to rout the cancer, unburdened by financial nitty gritty. But a growing body of evidence suggests that, far from crass, ignoring cost could be harmful to patients' health. In the age of $10,000-a-month cancer drugs and health plans that shift more of the cost of health care onto patients, research suggests we've been underestimating one of cancer's real harms: "financial toxicity." The financial difficulties that stem from dealing with cancer can lead people to avoid or delay care or drugs, studies suggest, and also may cause stress that can lead to mental and physical health problems. "When people are diagnosed, it behooves the provider to assess their financial risk at baseline — to find out if they’re at risk, and if they are, to be very aggressive with getting them to financial planning, to patient assistance programs to reduce their likelihood of having financial devastation," said Scott Ramsey, a health economist and physician at the Fred Hutchinson Cancer Research Center in Seattle who showed in 2013 that people with cancer are 2.65 times more likely to file for bankruptcy than people without cancer. "We think unless you do, it’ll be hard to keep people from ending up in this situation." For years, the evidence has accrued that cancer patients experience greater financial challenges than other groups of sick people. A study in the Journal of Clinical Oncology found [...]

2016-04-11T10:54:10-07:00April, 2016|Oral Cancer News|

Suicide: A Major Threat to Head and Neck Cancer Survivorship

Source: www.jco.ascopubs.comAuthors: Nosayaba Osazuwa-Peters, Eric Adjei Boakye, and Ronald J. Walker
, Mark A. Varvares TO THE EDITOR: The article by Ringash that was recently published in Journal of Clinical Oncology provided a compelling narrative of both the improvements made in head and neck cancer survivorship, as well as the challenges created by longer-term treatment and associated toxicities. There are currently at least 280,000 head and neck cancer survivors in the United States. As the article by Ringash stated, the upturn in head and neck cancer survivorship in the last three decades has coincided with the emergence of human papilloma virus-positive oropharyngeal cancer, as well as a decrease in tobacco use in the general population. These make it a challenge to isolate survival gains as a function of improved therapy from the natural prognostic value of a diagnosis of human papilloma virus-positive oropharyngeal cancer. Whatever the case, the fact that more than one-quarter million Americans are currently alive after a diagnosis of head and neck cancer means there needs to be a more deliberate effort in longer-term management of treatment-related toxicities, some of which are lifelong. We agree with Ringash’s conclusion that new models of care need to be developed in response to the significant quality-of-life issues faced by patients with head and neck cancer. The Institute of Medicine publication From Cancer Patient to Cancer Survivor: Lost in Transition, also cited by Ringash, called for a clear individualized survivorship plan for cancer patients. There is a serious need for this model to [...]

2016-03-24T15:06:02-07:00March, 2016|Oral Cancer News|

New Model Proposed for More Accurate Prediction of Treatment Outcomes for HPV Related Throat Cancer Patients

Source: news-medical.netAuthor: Researchers at Princess Margaret Cancer Centre, University Health Network Researchers at the Princess Margaret Cancer Centre are proposing a new model to enable doctors to predict outcomes more accurately for patients with throat cancers specifically caused by Human Papillomavirus (HPV). The findings are published online today in the Journal of Clinical Oncology. Study investigators, Dr. Brian O'Sullivan, Lead, Head and Neck Cancer Site Group and Shao-Hui Huang, Research and Clinical Radiation Therapist at Princess Margaret Cancer Centre, have determined that a new model for classifying the most frequently seen throat cancers in our geographic location is needed. This classification incorporates individual patient factors including age and their smoking status with the traditional classification of the extent of disease, to offer a more personalized approach to predict outcomes and guide treatment. "Our study shows that the current model derived for smoking and alcohol related cancers is not suited for throat cancer caused by HPV, a burgeoning throat cancer population in the Western World, including Canada," says Huang. "This is the future of tumour staging. We need to consider the patient as a whole. Both individual factors, how extensive the disease is in the patient, and tumour biology should play a role in determining the best course of treatment." The purpose of a tumour staging system is to classify the disease into early, intermediate or advanced stage cancer. This classification helps determine treatment plans and can suggest what is likely to be the outcome. In recent years, it's been discovered that [...]

2015-02-11T11:01:45-07:00February, 2015|Oral Cancer News|

Facing the Facts: HPV-Associated Head and Neck Cancers Get a Second Look

Source: CureToday.com HPV causes surge in oral cancer rates. Kevin Pruyne knew he didn’t fit the stereotype of a hard drinker or heavy smoker who one day develops an oral cancer. The 52-year-old mechanic had been working a three-week stint in a remote section of northern Alaska, repairing trucks on an oil field, when he noticed a hard lump beneath his jaw while shaving. For nearly three months, as Pruyne was prescribed antibiotics for a possible infection and then later shuttled between physician specialists, he kept hearing the same thing: the lump could not be cancer. Pruyne only occasionally consumed alcohol and had never smoked. His wife, Kathy, began researching her husband’s symptoms, which included repetitive throat clearing, a nagging sensation that something was lodged in his throat and ringing in his ears. And the lump, which looked like the top half of an egg, felt solid to the touch. This wasn’t some inflamed lymph node from a lingering head cold, Kathy Pruyne says. “He had every symptom [of cancer], but nobody would listen to me.”   Kevin Pruyne, with his wife, Kathy, is hopeful his HPV-positive oral cancer will be cured. Photo by Rick Bacmanski. Pruyne received a diagnosis of stage 4 oral cancer, which started with a tumor at the base of his tongue. He had already begun chemotherapy when he learned that researchers had discovered an association between the human papillomavirus (HPV) and increasing rates of oropharyngeal cancers. He asked that his tissue be tested; the results came [...]

2012-06-20T12:05:38-07:00June, 2012|Oral Cancer News|

HPV a gender-neutral killer

Source: DailyPress.com Socially conservative lawmakers will likely repeal Virginia's requirement that schoolgirls get vaccinated against a sexually transmitted virus called HPV that can, and now will, kill many of them. They're repealing it in the name of sexual abstinence, family values and apple pie. In the name of keeping government out of private health-care decisions — and, yes, they say that with a straight face. A body count doesn't bother them. Virtually all cervical cancer is caused by the human papillomavirus, which infects about 80 percent of sexually active adults by age 40. Most don't even know they have it. But, in some women, the virus mutates cells lining the cervix, turning them into cancerous lesions. About 12,000 women each year are diagnosed with cervical cancer, and 4,000 of them will die of it, according to the National Cancer Institute. This vaccine would prevent nearly all that cancer. All that death. Yet for moral reasons, not medical, the GOP-controlled House voted last month to eliminate the state's 2007 requirement that girls receive the vaccine before enrolling in sixth grade. (The vaccine is most effective before the onset of sexual activity.) The bill now goes to the GOP-controlled Senate, where it's also expected to pass. Lawmakers in Richmond weren't swayed by appeals to conscience, to logic or to medicine. They didn't care that the law already allows parents to decline the vaccine for their child for any reason whatsoever. They even rejected an amendment by a socially conservative colleague, Del. Chris [...]

2012-02-15T10:16:31-07:00February, 2012|Oral Cancer News|

Fatal Infusion Reactions to Cetuximab: Role of Immunoglobulin E–Mediated Anaphylaxis

Source: Journal of Clinical Oncology To the Editor: In Journal of Clinical Oncology, Tronconi et al1 report a fatal hypersensitivity reaction to cetuximab in a 63-year-old patient with metastatic colon cancer and outlined a 0.1% incidence of death in the literature. We greatly acknowledge the authors' desire to communicate the risk of fatal anaphylactic reaction with cetuximab. Over the past 2 years in our center in Tours, France, four instances of grade 4 anaphylactic reactions occurred in patients treated for head and neck cancer (locally advanced or metastatic), with one immediately fatal; another patient died within 5 days (unpublished data). Seven lethal anaphylactic reactions were registered in a pharmacovigilance survey in France, based on spontaneous declarations (Grandvuillemin et al, manuscript in preparation). Anaphylaxis to cetuximab is a problem that merits serious clinical attention. In the authors' words, “the pathogenic mechanisms underlying the development of this phenomenon remain to be elucidated.”1 They raise the hypothesis of immunoglobulin E (IgE) –independent mechanisms, even in the context of a paradoxic atopic history. Moreover, Tronconi et al suggest that the field “search for reliable risk factors that can facilitate the safe selection of patients as candidates for cetuximab-based treatment.”1 These comments are quite surprising, because they do not integrate major contributions that have been previously published. Indeed, it has been known for 3 years that anaphylaxis to cetuximab is the result of antidrug IgE antibodies present in patient serum before therapy.2 These IgE antibodies are directed against galactose-α-1, 3-galactose (α3Gal) residues, present in the [...]

2012-01-19T10:24:57-07:00January, 2012|Oral Cancer News|

The Oral Cancer Foundation Helps Sponsor HPV/Oral Cancer Study

Source: Jada.org An increase in the incidence and survival of oropharyngeal cancer in the United States since 1984 can be attributed to the human papilloma-virus (HPV) infection, say researchers in an article published online Oct. 3 in Journal of Clinical Oncology. The results of previous studies have shown that oropharyngeal cancers can be divided into two separate diseases with distinct causes: HPV-negative cancers, which are associated with tobacco and alcohol use; and HPV-positive cancers, which are linked to certain types of HPV, a sexually transmitted virus. Patients with HPV-positive oropharyngeal cancer tend to be younger than and to have better survival rates than patients with HPV-negative cancer. To determine HPV infection’s role, researchers led by Anil K. Chaturvedi, PhD, National Cancer Institute, National Institutes of Health, Bethesda, Md., tested for HPV infection 271 archived samples of cancerous oropharyngeal tissue collected between 1984 and 2004 at three population-based cancer registries located in Hawaii, Iowa and Los Angeles in the National Cancer Institute’s Surveillance, Epidemiology and End Results Residual Tissue Repositories Program. By using a variety of molecular assays, researchers found that the proportion of oropharyngeal cancers that were HPV-positive—particularly among men—increased over time, from 16.3 percent for cancers diagnosed from 1984 to 1989 to 72.7 percent for cancers diagnosed from 2000 to 2004. They also found that the incidence of HPV-negative oropharyngeal cancers declined by 50 percent between 1988 and 2004, likely due to declines in smoking and tobacco use. According to senior author Maura Gillison, MD, PhD, a professor of [...]

Oncologists must discuss all options in advanced cancer: ASCO policy

Source: MedScape.com By: Zosia Chustecka January 28, 2011 — A new policy statement from the American Society of Clinical Oncology (ASCO) aims to improve communication with, and decision making for, patients with advanced cancer (defined as incurable disease). It calls for a change in paradigm for advanced cancer care and a new approach in which all available treatment options are discussed from the very beginning. The statement was published online on January 24 in the Journal of Clinical Oncology. "While improving survival is the oncologist's primary goal, helping individuals live their final days in comfort and dignity is one of the most important responsibilities of our profession," ASCO president George Sledge, MD, said in a statement. "Oncologists must lead the way in discussing the full range of curative and palliative therapies to ensure that patients' choices are honored," he said. New Paradigm of Care This new approach "requires stepping back from the paradigm of applying one line of therapy after the other and focusing primarily on disease-directed interventions," say the authors, comprised of a panel of oncologists and specialists in palliative care. "Instead, we need to move toward developing a treatment plan that is consistent with evidence-based options (including disease-directed and palliative care), and the patients' informed preferences for how we pursue and balance these options throughout the course of illness," they add. Conversations about all of the options that are available must be started earlier, and they must be more thorough, the panel insists. "These conversations should be going on [...]

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