oral cancer foundation

Oral Cancer Survivor Eva Grayzel Talks About Her Efforts to Make A Difference

Source: www.lehighvalleylive.com
Author: Andrew James Sheldon

 

As an oral cancer survivor, Eva Grayzel knows how lucky she is.

She organizes an annual awareness walk for what she says is an often overlooked disease.

“I was diagnosed sixteen years ago and I am so lucky to be articulate,” she said. “I can’t ethically live my life as I do without doing whatever I can to make sure what happened to me doesn’t happen to other people.”

Grayzel survived stage four oral cancer, which is the most serious of the four stages. She has served as the chair of the oral cancer awareness walk in Bethlehem Township, Pennsylvania, for six years. This year’s walk is Sept. 27.

Grayzel says that raising awareness is the key step to catching the disease early before it can do the most damage. Other survivors will join her in the walk.

“There are going to be 20 survivors who have all been diagnosed late and most of them have facial disfigurements. They can’t speak normally, some of them can’t speak,” she said. “It’s devastating. Oral cancer steals things we take for granted such basic human needs, everything social.”

Grayzel’s group helped organize a continuing education class for dentists to learn about oral cancer and its connection with the human papillomavirus. Symptoms of oral cancer are sometimes unrecognized by sufferers and doctors.

Eileen Ciszak lost her daughter as a result of a misdiagnosis.

“The doctor gave her an antibiotic and told her to see her dentist, that she probably had a cracked tooth,” she said. “By the time she got there, the dentist knew immediately she needed to pursue this and the next day she was having a biopsy done.”

Thanks to the support of people like Ciszak, the walk has been growing. They had attended the walk once several years ago, but stopped after their daughter died.

“The first year we attended the walk, at that time my daughter had just had her oral cancer surgery, and we wanted to show our support,” Ciszak said. “Ten months after we attended the walk, she had passed away and it was just very difficult for us to really get involved at that point.”

After some healing, Ciszak decided to return.

“We just wanted to try to help organize, to create awareness with our story, be there to support others who have lost loved ones and support the survivors,” she said.

Eva GrayzelEva Grayzel, walk chairwoman, attended the 2013 Oral Cancer Foundation Walk for Awareness with her husband, Ken Cohen.

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

HPV Can Damage Genes and Chromosomes Directly, Whole-Genome Sequencing Study Shows

Press release from the James Cancer Center 

 

COLUMBUS, Ohio – The virus that causes cervical, head and neck, anal and other cancers can damage chromosomes and genes where it inserts its DNA into human DNA, according to a new study led by researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).

It’s long been known that cancer-causing types of human papillomavirus (HPV)  produce two viral proteins, called E6 and E7, which are essential for the development of cancer. However, they are not sufficient to cause cancer. Additional alterations in host-cell genes are necessary for cancer to develop. Here, scientists identified a new mechanism by which HPV may damage host DNA directly and contribute to cancer development.

Published in the journal Genome Research, this laboratory study used whole-genome sequencing to investigate the relationship between the HPV and host genomes in human cancers.

“Our sequencing data showed in vivid detail that  HPV can damage host-cell genes and chromosomes at sites of viral insertion,” says co-senior author David Symer, MD, PhD, assistant professor of molecular virology, immunology and medical genetics at the OSUCCC – James.

“HPV can act like a tornado hitting the genome, disrupting and rearranging nearby host-cell genes,” Symer explains. “This can lead to overexpression of cancer-causing genes in some cases, or it can disrupt protective tumor-suppressor genes in others. Both kinds of damage likely promote the development of cancer.”

“We observed fragments of the host-cell genome to be removed, rearranged or increased in number at sites of HPV insertion into the genome,” says co-senior author Maura Gillison, MD, PhD, professor of medicine, epidemiology and otolaryngology and the Jeg Coughlin Chair of Cancer Research at the OSUCCC – James. “These remarkable changes in host genes were accompanied by increases in the number of HPV copies in the host cell, thereby also increasing the expression of viral E6 and E7, the cancer-promoting genes.”

HPV causes about 610,000 cancers annually worldwide, including virtually all cervical cancers, and many anogenital and head and neck cancers. How it causes cancer isn’t completely understood.

The two cancer-causing proteins, E6 and E7, silence two key tumor-suppressor genes in host cells, contributing to cancer development. “E6 and E7 are critically important for the virus to cause cancer. Our findings shed light on how HPV, and perhaps other viruses, can disrupt the structure of host chromosomes and genes and thereby contribute to cancer development,” Gillison explains.

For this study, Symer, Gillison and their colleagues examined 10 cancer-cell lines and two head and neck tumor samples from patients. Along with whole-genome sequencing, the scientists used several molecular assays, including RNA sequencing, spectral karyotyping (SKY) and fluorescence in situ hybridization (FISH).

Key technical findings included:

• The genome-wide analysis, at single nucleotide resolution, identified a striking and recurrent association between HPV integrants and adjacent genomic amplifications, deletions and translocations;

• The HPV integrants mapped broadly across the human genome, with no evidence of recurrent integration into particular chromosomal hotspots;

• The researchers proposed a “looping” model by which abnormal viral replication results in the extraordinary damage that occurs to host chromosomes at the sites of viral DNA insertion.

“Our study reveals new and interesting information about what happens to HPV in the ‘end game’ in cancers,” Symer says. “Overall, our results shed new light on the potentially critical, catastrophic steps in the progression from initial viral infection to development of an HPV-associated cancer.”

Funding from the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), the Ohio Supercomputer Center, an Ohio Cancer Research Associate grant, the Oral Cancer Foundation and the Intramural Research Program of the National Institutes of Health, National Cancer Institute Center for Cancer Research, supported this research.

 

A great company teams up with great employees to raise money for Oral Cancer

As a result of a great company and their employees, at a second annual 5K run and two mile walk for Team Berry at a local event this year in South Carolina, their efforts have raised more than $2,900 which was donated to the Oral Cancer Foundation to be used for oral cancer research.

Shelly BlevinsSixty-four employees, spouses and children of Berry Home Centers and Berry Iron and Metal Company participated in the 5K and walk this year, more than double the participants last year, because the companies were running for a cause. Both were running for Jeremy Blevins, 42, who passed away Aug. 3 after a courageous battle with oral cancer, and his family. Jeremy is the nephew of Tom and Kyra Bishop who own Berry Home Centers and Berry Iron and Metal Company and also the nephew of Steve Kegley, Kyra’s brother and manager of the Abingdon Berry Home Centers’ store.

Berry’s offered to donate $20 for every mile walked or run by employees in this year’s race to the Oral Cancer Foundation in Jeremy’s honor. Employees completed a 145.1 miles during the 5K and 2 mile walk, so Berry’s donated $2,902 to the Oral Cancer Foundation as a result.

Jeremey Blevins wife, Shelley Blevins, pictured above with their son, Bise, and friend, is also coordinating the inaugural Oral Cancer Foundation Run For Awareness in Memory of Jeremy Blevins on Saturday, February 1, 2014. The event will take place at Springmaid Park located at Baxter Village. Please visit the event page at: http://donate.oralcancer.org/index.cfmfuseaction=donorDrive.event&eventID=583

In difficult times like these, when great individuals team up with great companies, great things can happen.

 

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.

 

The New Face of Oral Cancer

Source: nursing.advanceweb.com
By Jonathan Bassett
Posted on: April 22, 2013
 
 

For decades tobacco was the primary cause of oral cancer but a more insidious culprit has emerged. 

Jerry Wilck had no reason to suspect anything. Why would he? He only smoked for a couple of years and gave it up more than 40 years ago. He didn’t drink excessively, didn’t have a family history of cancer, and took good care of himself.

In fact, maybe the only reason the 59-year-old consulted an oral surgeon about the small sore on his tongue – the result of a habit of running this particular spot along his teeth – was that there happened to be such a specialist right there in his office.
Wilck was a general practice dentist in Langhorne, Pa., and particularly attuned to anomalies of the soft tissues of the mouth. His oral surgeon took no chances and ordered a biopsy.

Wilck was “floored” the night in March 2005 when the lab report arrived by fax from the oral pathology department at Temple University in Philadelphia – squamous cell carcinoma.

Wilck immediately consulted with John Ridge, MD, PhD, FACS, chief of head and neck surgery at Temple’s Fox Chase Cancer Center. After surgical removal of part of his tongue and lymph nodes from his neck, along with a round of physical and speech therapy, Wilck is now cancer free and has full use of his jaw, throat and voice.

“I was lucky,” confessed Wilck, who retired from practice in 2009 and now spends a large part of his time speaking to dental students, advocacy groups and the media about the dangers of oral cancers. “The surgery was successful and I didn’t need radiation or chemotherapy. A lot of people in other lines of work might have ignored the symptoms. My story could have ended very differently.”

 

Under the Radar

Wilck was one of the fortunate cases caught early and treated effectively.

Oral cancer, along with cancers of the head and neck, respond well to treatment when detected early in their development, explained Dong Moon Shin, MD, FACP, Frances Kelly Blomeyer Chair in Cancer Research and professor of hematology, medical oncology and otolaryngology at Emory University School of Medicine in Atlanta.

A leading researcher in the field of oral cancer, Shin has authored more than 220 peer-reviewed articles and is principal investigator of Emory’s National Cancer Institute-funded Head and Neck Cancer Specialized Program of Research Excellence (SPORE), an interdisciplinary research collaborative on the forefront of discovering treatments and preventive measures for these cancers, along with other NCI-funded research programs.

Shin’s current research directions center on prevention with natural compounds (including green tea and cancer-fighting agents found naturally in vegetables), along with anti-cancer drug delivery with nanotechnology – using nanometer-sized particles with novel properties engineered for the targeted delivery of anticancer drugs into cancer cells, while sparing healthy cells. Such “smartly” formulated nanoparticles carrying anti-cancer drugs can be specifically delivered to the cancer cells, thus minimizing side effects and maximizing the anti-cancer activity of the drugs, explained Shin. “Nanotechnology has the potential to revolutionize cancer care.”

Despite these encouraging research avenues, oral cancer is a specialty area deserving of more physicians and scientists such as Shin devoted to it, said Terry Day, MD, FACS, director of the division of head and neck oncologic surgery and the Head and Neck Tumor Center at Hollings Cancer Center at the Medical University of South Carolina in Charleston.

 

What You Need to Know about Oral Cancer: 

Christine Brader an oral cancer activist who has survived three bouts with the disease.

Archive ImageA

While oral cancer kills almost three times as many people as cervical cancer – one person dies every hour of every day from the disease, according to the Oral Cancer Foundation – it often receives less attention than more recognizable forms such as cancer of the skin or lungs.

“During my medical school training I began to see that these patients often had nowhere to turn,” said Day of the dearth of qualified specialists. He decided to make it his career’s mission to treat this complex, disabling, and potentially deadly subgroup of oncology.

“To look in the mirror and not recognize the person looking back at you – it’s shocking,” said Christine Brader, 49, an oral cancer activist who has survived three bouts with the disease. “I couldn’t believe it was me. Children would be scared of me out in public. I looked like a monster.”

 

Complex Complications

After “too many surgeries to count,” including the removal of her teeth and half of her jaw, implantation of a titanium plate (which her body rejected), and radiation and chemotherapy, Brader is now cancer free and maintains the use of her voice.

But it wasn’t an easy road. Oral cancer affects everything, said Brader – the way you look, the way you speak, your ability to eat and swallow. She spent two weeks in a medically induced coma, months in the hospital, and a grueling year-long recovery to get where she is today. She had to give up her job, her dogs, and her beloved home in Lehighton, Pa. The single mother of two had no caregiver to depend on, making the treatments even harder to get through.

“This is different than breast cancer and [cancer of] the internal organs,” said Brader, who is now independent but lives with many aftereffects and tires easily. “There’s no hiding it with clothing.”

She spends much of her time volunteering for the Oral Cancer Foundation’s public forum, helping new members and speaking at awareness events. She speaks to young people and the media regarding the dangers of smoking and chewing tobacco. She shares her story freely with the media, attends oral cancer screening events and volunteers for anti-smoking groups. She appeared in a TV commercial for Truth, a national anti-smoking prevention campaign, and the CDC’s Tips From Former Smokers Campaign.

“I try to make a difference,” Brader said. “I tell young people, ‘if someone you know starts smoking, be a friend and try to help them quit.’ It could save their life. By never starting to smoke, you never have to quit.”

 

Emergence of HPV

Brader began smoking as a teenager as a result of peer pressure, and continued the habit throughout her life. Her journey with oral cancer represents the traditional path – for decades, oral cancer was a disease of lifelong tobacco users that showed up later in life.

Fortunately, patient education regarding the riskiness of smoking, chewing tobacco and alcohol abuse has lowered the incidence of oral cancers from those origins, said Day.

However, a new contributing factor has moved into its place – human papilloma virus number 16 (HPV16). HPV16 is a common sexually transferred virus that is also responsible for the majority of cervical cancers in women. It’s now responsible for about 52% of newly diagnosed patients with oral and oropharyngeal cancer, according to the Oral Cancer Foundation.

The emergence of HPV16 as a risk factor has changed the demographic of oral cancers in the U.S. The disease is trending younger; the fastest growing segment of the oropharyngeal cancer population is those between the ages of 25 and 50, said Day. This is primarily due to HPV16, and cancers from this origin typically occur in the area of the throat behind the mouth, in the oropharynx, tonsils, and at the base of the tongue.

It also means oral and oropharyngeal cancers can strike in subtle silence; when in years past, a history of smoking or using chewing tobacco might prompt primary care physicians and their patients to be more diligent in screenings, HPV is a silent invader that can display little or no symptoms until it’s too late.

“HPV is definitely the coming epidemic in oral cancer,” said Brian Hill, a stage four oral cancer survivor and founder of the Oral Cancer Foundation. Hill had never used tobacco and his cancer – of an HPV16 etiology – was detected after bilaterally metastasizing and progressing into his cervical lymph nodes.

“My own journey included radiation and surgery, back in the days before IMRT [intensity modulated radiation therapy], and a very difficult and protracted recovery with significant quality of life issues, now a decade out,” Hill said.

 

Partners in Prevention

For Day, the ideal strategy to get a handle on the disconcerting mortality rates associated with oral cancer arises from a partnership between primary care physicians and dental professionals providing routine screenings for early-stage symptoms and swiftly referring to specialists.

Survival rates after early detection (stages 1 and 2) can be 80%-90%, while survival rates of late-stage detections (after the disease has advanced to stage 3 and 4) fall to 40%-50%, said Shin.

Head and neck screenings for cancer are relatively simple, painless, two- to three-minute visual and tactile exams performed in the dentist’s office, said Seung-Hee Rhee, DDS, FAGD, a general practice and cosmetic dentist in New York City, and spokesperson for the Academy of General Dentistry.

“You’re looking for any asymmetries, sores that don’t heal, abnormal lesions that seem suspect,” said Rhee, who makes these screenings part of her regular dental exams along with obtaining a thorough patient history to uncover potential signs and risk factors before they become major problems.

And new technology is making these screenings even easier for dentists, explained Rhee. Handheld blue-spectrum light emitters such as the Velscope shined inside the mouth will illuminate soft tissue abnormalities in different patterns than healthy tissue. This can aid dentists in detecting cancers even before they can be picked up by the unassisted eye.

“Early detection is where we’ll make a difference,” said Rhee. “[Dentists] are often the first line of defense.” She adds that HPV vaccinations for cervical cancer administered in the pre-teen years are another potential course of action being studied to help prevent these diseases. The Oral Cancer Foundation supports the use of the HPV vaccine for its potential in reducing the incidence of oral cancer, though the FDA currently prohibits drug manufacturers from making this specific claim.

“We highly encourage people who have precancerous lesions in the oral cavity or voice box [to] participate in clinical trials of chemoprevention to block the progression to invasive cancer,” said Shin.

 

Spreading the Word

While dental professionals work on the front lines to detect cases early, and researchers work tirelessly to unearth promising new treatments,

Wilck, Brader and a small army of former patients and activists travel the country speaking to schools, community groups and media outlets to underscore the importance of avoiding risk factors and receiving periodic screenings.

To mark Oral Cancer Awareness Month, the Oral Cancer Foundation is teaming with dental offices nationwide to offer free oral cancer screenings throughout April. Over 1200 free screening events are taking place in dental offices across America. A list is viewable at www.oralcancer-screening.org/events/.

The Head and Neck Cancer Alliance this year sponsored the 16th annual Oral Head and Neck Cancer Awareness Week April 14-20, said Day, who serves as president of the HNCA. This weeklong series of events promotes awareness and offers free screenings. Details are at http://www.ohancaw.com/.

“Reducing the high death rate associated with oral cancer is a tangible opportunity today,” said Hill. “We do need increased public awareness, coupled with an engaged professional dental and medical community doing opportunistic screenings.”

“My role these days is to keep people from taking the same path I did,” said Wilck. “If I reach just one person, it’s been worth it.”

 

 

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

 

Health Experts Praise Michael Douglas For His Oral Cancer Revelation

June 3rd, 2013 7:20pm EDT
Source: starpulse.com

 

Michael Douglas

 

Health experts have commended Michael Douglas for speaking out about link between throat cancer and oral sex.

The 68 year-old actor, who endured a six-month battle with the illness, hit headlines over the weekend when he voiced his belief that his cancer was caused by HPV, the human papillomavirus, which can be contracted through oral sex.

The Behind The Candelabra star told Britain’s The Guardian newspaper, “Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus… I mean, I did worry if the stress caused by my son’s incarceration didn’t help trigger it. But yeah, it’s a sexually transmitted disease that causes cancer. And if you have it, cunnilingus is also the best cure for it.”

Douglas’ frank admission has now won him praise from Brian Hill, executive director of Oral Cancer Foundation, who tells the New York Post, “I’m really quite proud of Michael saying this. This (oral sex) is not an aberrant sexual behavior. But the willingness to talk about this openly can be difficult.”

The actor recorded a public service announcement for the Oral Cancer Foundation last year.

 

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

 
June, 2013|OCF In The News|

The Man’s Guide to HPV

Source: Men’s Health
By: Melaina Juntti

What men can do about HPV

 

What men can do about HPV

Michael Douglas caught major flak for saying oral sex gave him throat cancer. But if you’re laughing, it’s time to grow up. Oral cancers caused by the sexually transmitted human papillomavirus (HPV) have skyrocketed 225 percent in the past 15 years, with men accounting for 75 percent of all cases. The number-one culprit: HPV passed via oral sex.

It used to be that cigarettes caused most of these cancers. But since smoking rates have plummeted over the past few decades, and we’re having way more oral sex today than even our fathers’ generation, HPV has become the most common STD in the U.S. – inevitably leading to more oral cancer cases. It only takes one time going down on someone to contract HPV, and experts estimate that 80 percent of us will be exposed to the virus at some point in our lives. This STD sometimes causes genital warts, but according to the Centers for Disease Control and Prevention, that’s not very common. In most cases, HPV has no symptoms. And since no test exists to detect HPV in guys, you won’t know you have the virus until years later – if it turns into cancer.

“It’s very hard to determine when you acquired HPV,” says Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University. “It doesn’t usually come from just one sexual episode. That said, every once in a while, cancer develops within two years of when you think you acquired HPV. But most often it comes 10, 12, even 20 years later.”

Still, not all HPV cases lead to oral cancer. Far from it. So even though the rapidly rising prevalence of these cancers is scary – and nothing we should take lightly – we need to keep the actual risk in perspective. “It’s true that within the world of oral cancer, HPV-caused cases have become an epidemic,” says Brian Hill, executive director of the Oral Cancer Foundation. “They are rapidly increasing at a rate never seen before, and it’s going to get much worse by 2020. However, in the grand scope of the U.S. population, the term ‘epidemic’ is overstating the reality. Only a small percentage of sexually active people wind up with an HPV-related oral cancer. For 99 percent of those who get HPV, their immune system clears it within 12 to 24 months, and that’s that. So we have to look at the relative risk. Don’t stop having sex. That’s not an appropriate response.”

So what is the right response? To protect yourself without killing your sex life, there are HPV vaccines like Gardisil. These are proven to protect against HPV-caused anal and cervical cancers, and doctors overwhelmingly believe they also prevent oral cancers. However, the CDC recommends vaccination only for men under age 26, and most insurance plans won’t cover it for older guys. Still, that doesn’t necessarily mean you should rule out the vaccine if you’re past 26.

“The CDC’s recommendations are based on a generality,” Schaffner says. “Statistics show that most guys, by age 26, have had multiple sexual partners and have probably been exposed to HPV. But every individual is different. A guy may have been in a long-term monogamous relationship that’s ended, and now he’s reentering the social scene and going to have sex. It won’t do him any harm to get immunized. Insurance probably won’t cover the vaccine, but he can certainly pay the $300 to $400 out of pocket.”

But if you’ve had a handful of partners – and, if the stats are correct, have probably already come in contact with HPV – the decision boils down to whether you want that extra piece of mind, says Schaffner. After all, you could be one of the lucky few who’s had lots of sex but never been exposed. “It’s kind of like wearing a belt and suspenders,” he explains. “Wearing both may be unnecessary, but at least can be sure your pants won’t fall down. By getting the vaccine, you know you’ve done everything you can to protect yourself from HPV.”

Besides being immunized, which only spares you from HPV if you haven’t been exposed, you should limit your sexual partners and always use protection. But even then, condoms and dental dams aren’t surefire HPV blockers, Schaffner says, because you can get the virus from skin-to-skin contact. “HPV can be present on the penis shaft and vaginal lips, not just on mucus membranes, semen, or vaginal fluid,” he says. “Therefore, condoms – both male and female types – are very helpful, but they don’t offer complete protection, even if they’re used as directed and don’t break.”

Schaffner says gay men aren’t necessarily at less risk of oral cancer just because they’re not performing oral sex on women. It has more to do with how often a guy has sex and how many different men he’s slept with. However, the CDC says gay and bisexual men are 17 times more likely to develop anal cancer – also caused by HPV – than men who only sleep with women.

Even if you already have HPV – and don’t know it – you can take steps to decrease your chances of oral cancer. Schaffner says to stop smoking immediately and cut back on booze. “We’re not sure why, but smoking and drinking too much both increase HPV’s likelihood of developing into cancer,” he explains.

To be safe, you should also be on the lookout for early signs of oral cancer, which tend to be subtle, so guys often ignore them, says Hill. Unlike tobacco-caused oral cancers, which present in visible symptoms like white lesions or red spots on the tongue, HPV-related cancer cells love lymph tissue and the way back of your tongue. “HPV-caused oral cancers have very stealthy signs, so you really have to pay attention if you feel changes,” he says.

Here’s what to look for: “If you notice it’s become more difficult to swallow, or you’re suddenly always hoarse or have a sore throat, those are definite cancer red flags, and you need to get examined,” Hill says. “Also, if a lymph node in your neck becomes enlarged – and it’s painless – that’s a warning sign of cancer starting inside the mouth and spreading to your neck. When lymph nodes swell up from ear infections or abscessed teeth, they hurt. But these ones don’t. And if you can’t push it around, that’s a definite sign.”

Thankfully, all you dads and future fathers can help spare your sons from these health issues. Get them vaccinated long before they wind up going down on a girl in the back seat of your car. “Don’t put it off until they’re 17,” Schaffner says. “Have them immunized when they’re 11.”

 

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

 
June, 2013|OCF In The News|

Michael Douglas: Oral sex gave me cancer

By DAVID K. LI
Source: NewYork Post
Last Updated: 11:31 AM, June 3, 2013
Posted: 8:49 PM, June 2, 2013
 

Michael Douglas has made a jaw-dropping revelation about his throat cancer: He didn’t contract it from smoking or drinking — but from oral sex.

The Oscar-winning Hollywood star set tongues wagging after he told The Guardian newspaper that he contracted HPV, or human papillomavirus, through a sex act and it developed into cancer.

“Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus,” he told the British newspaper in an interview published yesterday.

After Douglas was diagnosed with the life-threatening illness in 2010, he said on “Late Show with David Letterman” that the kind of cancer he had was caused by smoking and drinking.

 Ghetty Images

 

Actor Michael Douglas said a virus from oral sex, not booze and cigarettes, gave him throat cancer.

In yesterday’s interview, the 68-year-old actor speculated that his son Cameron’s legal woes may have borne some responsibility, too.

“I did worry if the stress caused by my son’s incarceration didn’t help trigger it,” the “Wall Street” actor said of Cameron Douglas, who is serving 10 years in a federal prison for heroin possession and distribution.

“But, yeah, it’s a sexually transmitted disease that causes [the] cancer.”

A cancer-awareness advocate hailed Douglas for his blunt talk.

“I’m really quite proud of Michael saying this,” Brian Hill, executive director of the Oral Cancer Foundation, told The Post yesterday.

“This [oral sex] is not an aberrant sexual behavior. But the willingness to talk about this openly can be difficult.”

Douglas cut a public-service announcement for the Oral Cancer Foundation last year.

The actor didn’t disclose the cause of this throat cancer to foundation officials.

The group’s director said Douglas’ oral-sex admission doesn’t surprise him — because that’s how Hill contracted his own cancer.

“My wife cringes every time I talk about it, because I’m talking about our sex life,” Hill said.

Reps for Douglas and his actress wife, Catherine Zeta-Jones, could not be reached for comment.

Yesterday’s Guardian report didn’t address whether Douglas contracted the virus through contact with his 43-year-old spouse.

Douglas has been in the spotlight following the release last month of the HBO movie “Behind the Candelabra,” in which he stars as Liberace alongside Matt Damon.

The actor-producer has said he’s had success battling the ailment and has been cancer-free for more than two years.

Douglas has said several specialists missed his cancer and gave him antibiotics to treat ongoing oral discomfort.

Finally, a friend’s doctor in Montreal whipped out a tongue depressor, took one look inside the actor’s mouth and saw trouble.

“I will always remember the look on his face,” Douglas has said.

“He said, ‘We need a biopsy.’ There was a walnut-size tumor at the base of my tongue that no other doctor had seen.”

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

 

 

Dental groups dispute Consumer Reports cancer screening story

Source: http://www.drbicuspid.com
By:  Donna Domino, Features Editor
Date: April 5, 2013

 

The dental community is up in arms over a recent Consumer Reports article that claims oral cancer screening is one of several medical tests that are overrecommended and unnecessary for all but high-risk patients.

The article, which appears in the March 2013 issue, concluded that “most people shouldn’t waste their time” on most diagnostic tests, including chairside visual screenings for oral cancer.

“Most people don’t need the test unless they are at high risk, because the cancer is relatively uncommon,” Consumer Reports wrote.

But the ADA and the Oral Cancer Foundation vehemently disagree with the magazine’s conclusions, asserting that visual screening can result in earlier diagnosis of oral cancer and other oral diseases.

The Consumer Reports article recommends only three cancer tests — cervical, colon, and breast — as worthwhile, and includes oral cancer screening among “eight to avoid” tests: ovarian, pancreatic, testicular, prostate, bladder, lung, oral cavity, and skin cancer.

The magazine said its ratings were based mainly on reviews from the U.S. Preventive Services Task Force.

Early diagnosis critical

According to Consumer Reports, the medical community has “systematically exaggerated” the benefits of screening while downplaying the harms, such as unnecessary radiation and biopsies.

The ADA quickly registered its disappointment with the recommendations and sent a letter — co-signed by the American Academy of Oral & Maxillofacial Pathology — to the editors of Consumer Reports, noting that noninvasive visual and tactile oral cancer screenings are typically included in oral exams and can result in earlier diagnosis of oral cancer and other oral diseases.

Brian Hill, executive director of the Oral Cancer Foundation who had stage IV bilateral cervical lymph node metastases when his oropharyngeal cancer was discovered, also took issue with the magazine’s recommendations.

“I disagree categorically,” he told DrBicuspid.com. “It isn’t an invasive exam, there’s no radiation (no long-term exposure issue), it is painless, it’s usually free, and you’re already sitting in the dentist chair. Why would you not get it?”

The problem is there’s no good screening mechanism to identify the high-risk group, he added.

“Obviously, tobacco users and those who consume high levels of alcohol have been the historic high-risk group. But with HPV [human papillomavirus] 16 becoming the fastest-growing segment of the oral cancer population, we have a new problem: we cannot sort the group of people with persistent viral infections from the general population today,” Hill said, noting that many people with HPV infections don’t know they have it as there are no outward, obvious signs or symptoms.

Some 99% of those with HPV infections clear the virus through normal immune response (within two years if you use the cervical cancer model), and only 1% will develop oral cancer, he added.

“To use the logic that oral cancer does not occur frequently enough to warrant getting the screening is myopic,” he stated. “One American dies every hour of every day of the year from oral cancer. That is not something to ignore. We can no longer realize who is high- or low-risk.

The American Cancer Society also endorses oral screenings and recommends that “doctors examine the mouth and throat as part of a routine cancer-related checkup” in its policy guidelines.

False positives and biopsies

John Santa, MD, MPH, director of the Consumer Reports Ratings Center, acknowledged that the magazine struggled with including oral cancer screening among the tests that were not recommended.

“I think this is more of an issue with doctors than dentists,” he told DrBicuspid.com. “While it’s laudable that all these organizations recommend oral cancer screening, I would ask them to produce evidence that shows it saves lives.”

In addition, Dr. Santa noted, cancer screenings can produce false positives, resulting in unnecessary biopsies, and data from the U.S. Preventive Services Task Force and Cochrane Review research did not support routine oral cancer screening.

In fact, a recent study in the Journal of the American Dental Association found that clinical oral exams have a poor overall performance as diagnostic methods for predicting dysplasia and oral squamous cell carcinoma. But a 2010 report by a panel convened by the ADA Council on Scientific Affairs endorsed routine visual and tactile examinations in all patients during dental appointments (JADA, May 2010, Vol. 141:5, pp. 509-520).

Also, oral oncologists are reporting seeing more young people who don’t have the usual risk factors such as smoking or drinking but are developing oral cancer.

Close to 42,000 Americans will be diagnosed with oral or pharyngeal cancer, and it kills more than 8,000 patients annually, according to the Oral Cancer Foundation, which notes the mortality rate for oral cancer is higher than that of cancers such as cervical cancer or Hodgkin’s lymphoma.

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

Reply to this article that was posted on the Dr. Bicuspid website article by OCF Founder Brian Hill

I put no weight on what the U.S. Preventive Services Task Force and Cochrane Review have to say about this since their determination was based on the evidence that no peer review studies have been done to show that oral cancer screening has any impact on long-term outcomes.  They are actually right, but there is a caveat here.

The fact that there have been no peer-reviewed studies is only partly true. There was a landmark study, published in Lancet which is a strictly peer reviewed, respected journal, done in India by several researchers from different countries which did find significant benefit to early discovery through screening, but Cochrane disagreed with the protocol for the study which looked at tens of thousands of people offer a protracted period of time, (about a decade). The study found a huge reduction in deaths as a result of opportunistic screening. What they really did not like about the study was that the screeners were NOT DOCTORS in many of the cases. So just think of that – you have a study which shows about a 25% reduction in deaths or better, and EVEN WITH NON DOCTORS DOING MANY OF THE SCREENINGS, you have this great outcome. So they subjectively omitted it from the materials they reviewed to come to their conclusion. More so, something much more obvious.  Even with the absence of a study, their conclusion is not proof of a negative, that screenings have no value, it is actually proof that THERE ARE NO STUDIES. Nothing more. Having addressed this on several occasions with groups that do these “meta analysis ” types of reviews and then draw conclusions from them, I have never gotten a satisfactory answer to this question, “Where is the study that shows that parachutes save lives?”  The government (FAA) mandates that I wear one when flying aerobatics, so they obviously think it is a good thing and would save my life in a mishap, and our military pilots fly with one on every mission, so they obviously buy into the value of a parachute to save your life as well. But where is the study that proves it?  One does not exist. There is plenty of anecdotal evidence, and lots of published stories of them saving lives, but no peer reviewed study or paper anywhere. If you exclude common sense, or what is self evident from your conclusion, you would have to have a statement that there is no evidence that parachutes save lives.

So if this is the case, it begs the question as to why are there no studies? The most obvious answer to this question is that no one is going to spend millions of dollars to do a study on something which is self evident.  I asked this question of a H&N surgeon who is routinely up to his elbows in someone’s blood, who stated that his job would be drastically reduced if we were finding more cancers at earlier stages.

So this makes the next question pretty obvious. We know from the best database of disease rates and outcomes in the US, the SEER database (Surveillance, Epidemiology, and End Results) which is how we track incidence, causes, and outcomes in the US, that stage one oral cancer patients have better outcomes, and stage four patients have poorer outcomes. This should not surprise anyone. Stage one people have besides longer lives, far fewer treatment related morbidity issues to get to a point of no disease (NED).

The real question is HOW DO YOU GET TO BE A STAGE ONE FIND AT TIME OF DISCOVERY? There are two possible pathways to this. The first would be what OCF and many others including the ADA have always advocated for, and that is OPPORTUNISTIC screening. This is screening of an entire population or group of people, not just those with complaints or with known high risk factors like tobacco use, but everyone that your practice sees. This concept is even more important today since we no longer can, with the fast rise of HPV16 as a prime driver of oral / oropharyngeal cancers, identify easily the high risk group (outside of tobacco users) in the American population.

The second means to becoming a stage one find at time of diagnosis would be SELF DISCOVERY. This would mean that a population of people were knowledgeable enough to recognize that something is not right in their mouth, neck, etc. and take themselves to the doctor to have it explored in detail, before it got too far out of control. OCF is working on a public outreach and creating a dialog with the American public directly to raise awareness not just of the disease that too few have even heard of, but of the early warning signs and symptoms that should concern them enough that they self refer to a doctor for evaluation.  These are the only two reasonable pathways to becoming a stage one find, which today happens too infrequently in our country.

So I state once again, that Consumer Reports missed this by a mile and is backpedaling to trying and justify a position that is categorically without merit. They have done a significant disservice to their readers by suggesting that just because in their opinion, 42,000 people is too small a group to be concerned with, that skipping the screening is the proper answer.  Dr. Santa should meet some oral cancer patients; see their pain, their inability to speak ever again, to never eat normally, to no longer have the ability to kiss their loved ones and be facially disfigured, just some of the huge drop in quality of life issues that they live with -IF they are one of the lucky ones to be in the 57% that even survives to five years.  Perhaps his attitude about screening and self defense of his finding would be less cavalier.

Painting for the Oral Cancer Foundation

With a desire to help in spreading awareness for oral cancer, Anita McGinn-Natali, a Fine Art Painter from Pennsylvania, donates her original framed and ready to hang oil paintings to Oral Cancer Awareness Walks. Funds collected will benefit the Oral Cancer Foundation.

image 2In October of 2007, Anita’s husband, Clark, was diagnosed with oral cancer. Anita was her husband’s caregiver during his treatments and recovery. Two years later,she found the Oral Cancer Foundation online and began to participate in the Forums, whose contributors include patients, caregivers, as well as family and friends of patients.image

“Discovering the Oral Cancer Foundation website during a challenging time in my husband’s recovery, was gratifying. The information available and the support I received were life savers for me. “I spent hours on the website educating myself about this disease. As a participant in the Forums, I had started out asking questions with others helping me,” Anita says. No long after she was offering support to other patients and caregivers. “It is a unique community of people from all over the world who have the unfortunate common denominator of oral cancer.”

Since September 2011, Anita has donated her original oil paintings to three OCF Walks for Awareness: David Nasto in New Jersey (Susan Nasto Lauria); San Antonio (ElizabethSikon); and Colorado (Susan Cotten)

image 3Currently, there are 18 Walks for Awareness held throughout the United States. Participants can receive a free oral cancer screening, meet others whoselives have been touched by oral cancer, and be inspired by the work the Oral Cancer Foundation is doing to bring awareness to this debilitating and life changing disease.

“I wanted to find a way to give back to this organization that has been such an important part of my life. Many of the people I have met on the website have become my friends.” Anita is thrilled that her paintings have been so well received at each of the events and is hoping to donate more of her work to other OCF Walks for Awareness.

image 4The Oral Cancer Foundation is a national public service, nonprofit entity designed to reduce suffering and save lives through prevention, education, research, advocacy, and patient support activities. Oral cancer is the largest group of those cancers which fall into the head and neck cancer category.

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