Which cancers have increased over the past decade?

Source: www.mdlinx.com Author: Naveed Saleh, MD, MS, for MDLinx The incidence of cancers at the level of the oral cavity and pharynx increased between 2007 and 2016, according to a recent report by researchers from the CDC published in Morbidity and Mortality Weekly Report. This rise occurred despite respective decreases in the incidence of cancers at various anatomic sites. Cancers of the oral cavity and pharynx make up 3% of cancers diagnosed in the United States each year, with risk factors including tobacco use, HPV infection, and excessive alcohol intake. “The overall increase appears to be driven by increases in cancers of the tonsil, base of tongue, oropharynx, and other cancers of the oral cavity and pharynx, which are HPV-associated, as well as by those of gum and anterior tongue,” wrote the authors. Breaking down the numbers On average, the incidence rates for cancers of the oral cavity and pharynx combined increased by 0.6% per year between 2007 and 2016, with specific increases as follows: Oral cavity and pharynx (3.4%) Base of tongue (1.8%) Anterior tongue (1.8%) Gum (1.9%) Tonsil (2.4%) Oropharynx (1.9%) For the following cancers, however, incidence rates decreased: Soft palate and uvula (−3.7%) Hard palate (−0.9%) Floor of mouth (−3.1%) Lip (−2.7%) Hypopharynx (−2.4%) Nasopharynx (−1.3%) Of note, the incidence of cheek and other mouth and salivary gland cancers remained unchanged.

HPV is changing the face of head and neck cancers

Source: www.healio.comAuthor: Christine Cona A drastic increase in the number of HPV-associated oropharynx cancers, particularly those of the tonsil and base of tongue, has captured the attention of head and neck oncologists worldwide. In February, at the Multidisciplinary Head and Neck Cancer Symposium in Chandler, Ariz., Maura Gillison, MD, PhD, professor and Jeg Coughlin Chair of Cancer Research at The Ohio State University in Columbus, presented data that showed that the proportion of all head and neck squamous cell cancers that were of the oropharynx — which are most commonly HPV-positive cancers — increased from 18% in 1973 to 32% in 2005. Maura Gillison, MD, PhD, Jeg Coughlin Chair of Cancer Research at The Ohio State University, said screening for HPV in the head and neck is years behind cervical screening for HPV.   In addition, studies from the United States, Europe, Denmark and Australia indicate that HPV-positive patients have a more than twofold increased cancer survival than HPV-negative patients, according to Gillison. With the rising incidence of HPV-related oropharynx cancers, it will soon be the predominant type of cancer in the oral or head and neck region, according to Andy Trotti, MD, director of radiation oncology clinical research, H. Lee Moffitt Cancer Center & Research Institute, in Tampa, Fla. “We should be focusing on HPV-related oropharyngeal cancer because it will dominate the field of head and neck cancers for many years,” he said during an interview with HemOnc Today. “It is certainly an important population for which to continue to [...]

2016-06-03T11:11:05-07:00June, 2016|Oral Cancer News|

Immunotherapy Continues to Advance in Head and Neck Cancer

Source: www.onclive.comAuthor: Megan Garlapow, PhD   Concomitant administration of motolimod with cetuximab (Erbitux) increases the innate and adaptive immune response in the blood and the tumor microenvironment in head and neck squamous cell carcinoma (HNSCC), overcoming negative prognostic biomarkers of cetuximab therapy alone, according to the biomarker data from a recent phase Ib clinical trial that was presented at the 2016 Head and Neck Cancer Symposium. The trial was recently amended to add nivolumab to the combination of cetuximab and motolimod. Dr. Robert Ferris, MD PhD   “We know that PD-1 and PD-L1 are overexpressed in head and neck cancer, and so it was somewhat irresistible to combine our baseline treatment of cetuximab and motolimod with the PD-L1 inhibition pathway. EGFR itself drives PD-L1, so combining cetuximab with anti-PD-1 inhibitor makes sense. So, we’ve amended this trial. We’re now accruing to treatment with cetuximab, motolimod, and the anti–PD-L1 nivolumab in this trial,” said lead author Robert Ferris, MD, PhD, professor, Departments of Otolaryngology, Radiation Oncology, and Immunology, Cancer Immunology Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania. According to the authors of the phase Ib data presented at the symposium, the rationale for combining cetuximab with motolimod (VTX2337) as neoadjuvant therapy was that cetuximab induces cellular immunity that correlates with neoadjuvant clinical response. The phase I dose-escalation and safety of the combination had been established (NCT 01334177). This study of neoadjuvant cetuximab and motolimod had accrued 14 patients with HNSCC that was stage II-IV, resectable, and located in the oropharynx, [...]

2016-02-29T10:49:56-07:00February, 2016|Oral Cancer News|

Nutritional and Zinc Status of Head and Neck Cancer Patients: An Interpretive Review

Source: Journal of the American College of NutritionAuthors: Ananda S. Prasad, MD, PhD, MACN, Frances W.J. Beck, PhD, Timothy D. Doerr, MD, Falah H. Shamsa, PhD, Hayward S. Penny, MS, RD, Steven C. Marks, MD, Joseph Kaplan, MD, Omer Kucuk, MD and Robert H. Mathog, MD  Abstract In this review, we provide evidence based on our studies, for zinc deficiency and cell mediated immune disorders, and the effects of protein and zinc status on clinical morbidities in patients with head and neck cancer. We investigated subjects with newly diagnosed squamous cell carcinoma of the oral cavity, oropharynx, larynx, and hypopharynx. Patients with metastatic disease and with severe co-morbidity were excluded. Nutritional assessment included dietary history, body composition, and prognostic nutritional index (PNI) determination. Zinc status was determined by zinc assay in plasma, lymphocytes, and granulocytes. Pretreatment zinc status and nutritional status were correlated with clinical outcomes in 47 patients. Assessment of immune functions included production of TH1 and TH2 cytokines, T cell subpopulations and cutaneous delayed hypersensitivity reaction to common antigens. At baseline approximately 50% of our subjects were zinc-deficient based on cellular zinc criteria and had decreased production of TH1 cytokines but not TH2 cytokines, decreased NK cell lytic activity and decreased proportion of CD4+ CD45RA+ cells in the peripheral blood. The tumor size and overall stage of the disease correlated with baseline zinc status but not with PNI, alcohol intake, or smoking. Zinc deficiency was associated with increased unplanned hospitalizations. The disease-free interval was highest for the group which had both zinc sufficient and nutrition sufficient [...]

2013-07-03T17:11:10-07:00July, 2013|Oral Cancer News|

Study: Cruciferous vegetables help prevent oral cancer

Soucre: Dr.Biscuspid.com October 1, 2012 -- Eating cruciferous vegetables can significantly reduce the risk of developing several cancers, including oral, esophageal, colorectal, breast, and kidney cancer, according to a study in the Annals of Oncology (August 2012, Vol. 23:8, pp. 2198-2203). Epidemiological studies have shown that eating cruciferous vegetables -- which include broccoli, cauliflower, cabbage, brussels sprouts, kale, and bok choy -- is associated with reduced risk for a number of cancers, the study authors noted. The Italian researchers conducted a meta-analysis of data from multiple case-control studies done in Italy and Switzerland to examine the association between consumption of cruciferous vegetables and risk of multiple cancers. The analysis included 1,468 cancers of the oral cavity/pharynx, 505 of the esophagus, 230 of the stomach, 2,390 of the colorectum, 185 of the liver, 326 of the pancreas, 852 of the larynx, 3,034 of the breast, 367 of the endometrium, 1,031 of the ovary, 1,294 of the prostate, and 767 of the kidney, along with 1,492 control patients. Compared to men and women who ate no cruciferous vegetables, those who ate such vegetables at least once a week cut their risk of cancer of the oral cavity/pharynx by 17%, esophageal cancer by 28%, colorectal cancer by 17%, breast cancer by 17%, and kidney cancer by 32%, the study showed. In addition, eating cruciferous vegetables cut the risk of stomach cancer by 10%, pancreatic cancer by 10%, laryngeal cancer by 16%, endometrial cancer by 7%, ovarian cancer by 9%, and prostate cancer by [...]

2012-10-02T10:14:17-07:00October, 2012|Oral Cancer News|

Suicide Rates Among Oral Cancer Patients on the Rise

Source: Dr.Bicuspid.com May 23, 2012 -- Suicide rates among patients with oral cavity and oropharyngeal (OC/OP) cancer have increased significantly over the past three decades, particularly among male patients during the first year after diagnosis. As many as half of patients with head and neck cancer suffer from depression, among the highest of all oncology patients (Clinical Advances in Hematology & Oncology, June 2009 Vol. 7:6, pp. 397-403). However, despite documented high rates of depression and suicide among patients with head and neck cancer, studies examining suicide and other noncancer-related deaths in patients with OC/OP have not been published. Brian Hill, executive director of the Oral Cancer Foundation, survived stage 4 bilateral cervical lymph node metastases from oropharyngeal cancer. This gap prompted researchers from the New York Eye and Ear Infirmary, New York Medical College, and Peking University to analyze 32,487 patients with OC/OP cancer using the Surveillance, Epidemiology, and End Results cancer registry data for 1980-1984, 1990-1994, 2000-2003, and 2004-2007 (Archives of Otolaryngology-Head & Neck Surgery, January 2012, Vol. 138:1, pp. 25-32). They found that from 1980-1984 to 2004-2007, deaths from suicide increased by 406.2% (p = .01), while cardiovascular disease-related and pneumonia-related deaths decreased by 45.9% (p < .001) and 42.9% (p = .009), respectively. Risk factors for mortality included age (55-64), marital status, advanced tumor stage, and tumor location. The researchers also calculated standardized mortality ratios (SMRs) for suicide, cardiovascular disease, and pneumonia and compared them with patient demographic and clinical characteristics. The risk of death from [...]

2012-05-24T10:21:11-07:00May, 2012|OCF In The News, Oral Cancer News|

Study: Oral cancers take financial toll

Source: Dr.Biscuspid.com April 26, 2012 -- The cost of treating individuals with oral, orapharyngeal, and salivary gland cancers is significant, particularly for patients who undergo all three forms of treatment, according to a new study by Delta Dental of Michigan's Research and Data Institute. And for many that is only the beginning of the financial impact of the disease. The project, which involved Thomson Reuters, Delta Dental of Wisconsin, Vanderbilt University, and the University of Illinois at Chicago College of Dentistry, began in March 2010. It is the first retrospective data analysis of a large number of head and neck cancer patients in the U.S. analyzing direct and indirect costs and comparing those costs to a matched comparison group, according to the authors (Head Neck Onc, April 26, 2012). Using data from the 2004-2008 Thomson Reuters MarketScan Databases: Commercial Claims and Encounters Database, Medicare Supplemental and Coordination of Benefits Database, Medicaid Multi-State Database, and the Health Productivity and Management Database, the researchers retrospectively analyzed claims data of 6,812 OC/OP/SG patients with employer-sponsored health insurance, Medicare, or Medicaid benefits. They found that, on average, total annual healthcare spending during the year following diagnosis was $79,151, compared with $7,419 in a group comprising similar patients without these cancers. They also found that the average cost of care almost doubled when patients received all three types of treatment: surgery, radiation, and chemotherapy. Healthcare costs were higher for oral cancer patients with commercial insurance ($71,732, n = 3,918), Medicare ($35,890, n = 2,303), and [...]

2012-04-27T10:16:48-07:00April, 2012|OCF In The News, Oral Cancer News|

Strong Oral Carcinogen Identified in Smokeless Tobacco

Source: ScienceDaily.com Although smokeless tobacco products have long been linked with certain cancers, including oral cavity cancers and esophageal cancers, this is the first study to identify a specific chemical present in smokeless tobacco products that induces oral cancer in animals, according to Silvia Balbo, Ph.D., research associate at the Masonic Cancer Center of the University of Minnesota in Minneapolis, Minn. "(S)-NNN is the only chemical in smokeless tobacco known to cause oral cancer," Balbo said. "This finding provides mechanistic underpinning for the epidemiologic observations that smokeless tobacco products cause oral cancer." Balbo and colleagues administered two forms of NNN called (S)-NNN and (R)-NNN to four groups of 24 rats. The rats were given either (S)-NNN alone, (R)-NNN alone, a combination of both or tap water. The total dose was approximately equivalent to the amount of (S)-NNN to which a smokeless tobacco user would be exposed from chronic use of these products. All rats assigned to (S)-NNN alone or the combination began losing weight after one year of exposure and died by 17 months. Rats assigned to (R)-NNN or tap water were terminated at 20 months. All rats assigned to (S)-NNN had esophageal tumors and demonstrated 100 percent incidence of oral tumors including tumors of the tongue, buccal mucosa, soft palate and pharynx. In contrast, researchers found oral tumors in only five of 24 rats given (R)-NNN and esophageal tumors in three of 24 rats assigned to (R)-NNN. Twelve rats given the combination of (S)-NNN and (R)-NNN had 153 esophageal [...]

2012-04-02T16:22:05-07:00April, 2012|Oral Cancer News|

Evaluation of a combined triple method to detect causative HPV in oral and oropharyngeal squamous cell carcinomas: p16 Immunohistochemistry, Consensus PCR HPV-DNA, and In Situ Hybridization

Source: 7thspace.com Recent emerging evidences identify Human Papillomavirus (HPV) related Head and Neck squamous cell carcinomas (HN-SCCs) as a separate subgroup among Head and Neck Cancers with different epidemiology, histopathological characteristics, therapeutic response to chemo-radiation treatment and clinical outcome. However, there is not a worldwide consensus on the methods to be used in clinical practice. The endpoint of this study was to demonstrate the reliability of a triple method which combines evaluation of: 1. p16 protein expression by immunohistochemistry (p16-IHC); 2. HPV-DNA genotyping by consensus HPV-DNA PCR methods (Consensus PCR); and 3 viral integration into the host by in situ hybridization method (ISH). This triple method has been applied to HN-SCC originated from oral cavity (OSCC) and oropharynx (OPSCC), the two anatomical sites in which high risk (HR) HPVs have been clearly implicated as etiologic factors. Methylation-Specific PCR (MSP) was performed to study inactivation of p16-CDKN2a locus by epigenetic events. Reliability of multiple methods was measured by Kappa statistics. Results: All the HN-SCCs confirmed HPV positive by PCR and/or ISH were also p16 positive by IHC, with the latter showing a very high level of sensitivity as single test (100% in both OSCC and OPSCC) but lower specificity level (74% in OSCC and 93% in OPSCC).Concordance analysis between ISH and Consensus PCR showed a faint agreement in OPSCC (kappa = 0.38) and a moderate agreement in OSCC (kappa = 0.44). Furthermore, the addition of double positive score (ISHpositive and Consensus PCR positive) increased significantly the specificity of HR-HPV detection on [...]

2012-02-29T17:24:29-07:00February, 2012|Oral Cancer News|

Palliation Trumps PET in Prolonging Head and Neck Cancer Survival

Source: Elsevier Global Medical News. 2012 Feb 23, D McNamara MIAMI BEACH (EGMN) - Using PET scans to diagnose distant metastasis in patients with advanced head and neck squamous cell carcinoma does not significantly prolong life expectancy, compared with other imaging techniques, according to a retrospective study. Palliative chemotherapy did make a difference, however, significantly increasing life expectancy by 215 days in patients who received it, Dr. Matthew E. Spector and colleagues from the University of Michigan, Ann Arbor, reported at a meeting of the Triological Society. "Over 90% of patients at University of Michigan have at least one PET scan at some point in their treatment," Dr. Spector said. Increased sensitivity is one reason for such widespread adoption of the imaging technique. "We were wondering, while it may be more sensitive to identify distant metastatic disease, was it changing what we were doing?" In a retrospective look at 170 patients with such cancers at their institution, researchers found no significant difference in median survival between patients who had a PET scan (168 days) and those who did not (193 days). Determination of any survival difference was a primary aim of the study. "A lot of studies have looked at PET scans, and we know in up to one-third of cases it may change our decisions," Dr. Spector said. For example, a negative PET scan might mean definitive treatment, whereas a positive PET finding might lead to palliative therapy. However, "no one has looked at the impact of the PET findings on the life expectancy after diagnosis." All patients in the study had a distant metastasis diagnosis. "We found PET was more [...]

2012-02-27T11:42:48-07:00February, 2012|Oral Cancer News|
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