Recognizing and treating oral leukoplakia in primary care

Source: www.clinicaladvisor.com Authors: Christina Alvarez, PA-C, Corinne I. Alois, MS, PA-C, Louise Lee, EdD, MHA, PA-C Oral leukoplakia is a common premalignant condition most commonly identified in the smoking patient population. Once oral leukoplakia is diagnosed, the fundamental goal is to minimize progression towards invasive carcinoma through the use of various treatment methods such as traditional scalpel excision, cryotherapy, and carbon dioxide (CO2) laser therapy. Epidemiology and Pathogenesis of Oral Leukoplakia Leukoplakia is defined as a white, painless, plaque most commonly occurring on the buccal mucosa, lateral tongue, or floor of the mouth.1 Leukoplakia is considered one of the most common oral potentially malignant disorders (OPMDs) with an estimated worldwide prevalence of 1.5% to 2.6%.1 This premalignant condition, which can lead to oral cancer, particularly squamous cell carcinoma, presents with various transformation rates ranging from 0.1% to 17.5%.2 Due to variability in transformation to malignancy, identification, treatment, and monitoring is imperative. The etiology of oral leukoplakia is multifactorial and many cases are considered idiopathic; however, several strong risk factors are associated with this condition, the most common being chronic exposure to all forms of tobacco products, which cause mucosal irritation over time.1,2 Prolonged use of tobacco products is attributed to the conversion of normal cells to hyperplasia, dysplasia, and eventually carcinoma in situ or invasive carcinoma. It is reported that leukoplakia is 6 times more common in smokers than nonsmokers.1 Oral leukoplakia is most commonly seen in men aged 40 years and older, particularly after years of chronic tobacco use.1,2 [...]

2021-09-05T08:19:58-07:00September, 2021|Oral Cancer News|

Decoding the oral leukoplakia/oral cancer link

Source: www.drbicuspid.com Author: DrBicuspid Staff Is there a direct relationship between oral leukoplakia and tobacco and alcohol consumption? Do all oral leukoplakias lead to oral squamous cell carcinoma (OSCC)? Is it possible to detect premalignant oral leukoplakia? These are some of the questions a recent literature review in Oral Diseases attempted to answer (January 11, 2013). A team of researchers from Italy, Spain, the U.K., and the U.S. did a literary search of Medline/PubMed, Embase, and Best Evidence from January 1966 to June 2012. Search terms included leukoplakia, oral leukoplakia, preneoplastic oral, precancerous oral, oral precancerous, oral dysplasia, oral mucosal lesion, proliferative verrucous leukoplakia, multifocal leukoplakias, tobacco, and alcohol. The searches were designed to help the study authors address four key questions: 1.Do tobacco and alcohol cause oral leukoplakias? 2.What percentage of oral leukoplakias evolve into OSCC? 3.Can practitioners distinguish between premalignant and innocent oral leukoplakias? 4.Is proliferative verrucous leukoplakia (PVL) a specific entity or just a form of multifocal leukoplakia? For the purposes of this study, the term oral leukoplakia was used to recognize "predominantly white plaques of questionable risk, having excluded (other) known diseases or disorders that carry no increased risk of cancer." Tobacco, alcohol, and oral leukoplakia Although oral leukoplakia is generally considered one of the primary clinical precursors of OSCC, "the role of alcohol and smoking in this disorder has never been thoroughly assessed," the researchers wrote. "Existing evidence suggests that tobacco and alcohol could be associated with at least a subset of [oral leukoplakia]." It [...]

Periodontitis increases risk of oral leukoplakia

Source: www.drbicuspid.com Author: Donna Domino, Features Editor Periodontitis increases the risk of developing oral leukoplakia and mucosal lesions that are predisposed to become oral cancer, according to a study in Oral Oncology (September 2012, Vol. 48:9, pp. 859-863). The findings provide clues into the complex relationship between systemic and local disease, noted the study authors from the University of Greifswald in Germany. The development of oral cancer proceeds through discrete molecular changes that are acquired from loss of genomic integrity after continued exposure to environmental risk factors. It is preceded in the majority of cases by clinically evident, potentially malignant oral disorders, the most common of which is leukoplakia, the researchers noted. Leukoplakia is an asymptomatic lesion in the oral mucosa. Oral cancer -- especially oral squamous cell carcinoma -- often develops out of these lesions, they added. Studies have shown that as many as 18% of oral premalignant lesions will develop into oral cancer. In addition, periodontal sites are often involved in proliferative types of leukoplakia. The oral cancer rate attributed to leukoplakia is between six and 29 per 100,000, according to the authors. Smoking and drinking alcohol are the main risk factors for this disease, but acute infections in the oral cavity may contribute to the risk. Inflammatory markers The study evaluated 4,310 German residents ages 20 to79 from 1997 to 2001. After five years, 3,300 participants were available for follow-up. The periodontal assessment included probing depth, clinical attachment loss, plaque, bleeding on probing, and the number of [...]

Cancer risk reduction study reports green tea extracts may protect against oral cancer

Source: baileyshealthstore.wordpress.com Author: staff Over 50 per cent of participants in the University of Texas M. D. Anderson Cancer Center study experienced a clinical response to the green tea extracts, according to findings published in Cancer Prevention Research. “While still very early, and not definitive proof that green tea is an effective preventive agent, these results certainly encourage more study for patients at highest risk for oral cancer,” explained the research team. “The extract’s lack of toxicity is very crucial in prevention trials. It’s very important to remember that these are otherwise healthy individuals and we need to ensure that agents studied produce no harm,” they added. Green tea contains between 30 and 40 per cent of water-extractable polyphenols, while black tea (green tea that has been oxidized by fermentation) contains between 3 and 10 per cent. Oolong tea is semi-fermented tea and is somewhere between green and black tea. The four primary polyphenols found in fresh tealeaves are epigallocatechin gallate (EGCG), epigallocatechin (EGC), epicatechin gallate (ECG), and epicatechin (EC). The study followed 41 people with oral leukoplakia, a condition is a sign of oral cancer risk. The participants were assigned to receive either placebo or green tea extract at one of three doses, including 500 milligrams or 1,000 mg three times a day. The researchers collected oral tissue biopsies, which they say was “essential in that it allowed us to learn that not only did the green tea extract appear to have benefit for some patients, but we pointed [...]

Green tea shows promise as chemoprevention agent for oral cancer, M. D. Anderson study finds

Source: www.eurekalert.org Author: press release Green tea extract has shown promise as cancer prevention agent for oral cancer in patients with a pre-malignant condition known as oral leukoplakia, according to researchers at The University of Texas M. D. Anderson Cancer Center. The study, published online in Cancer Prevention Research, is the first to examine green tea as a chemopreventative agent in this high-risk patient population. The researchers found that more than half of the oral leukoplakia patients who took the extract had a clinical response. Long investigated in laboratory, epidemiological and clinical settings for several cancer types, green tea is rich in polyphenols, which have been known to inhibit carcinogenesis in preclinical models. Still, clinical results have been mixed. "While still very early, and not definitive proof that green tea is an effective preventive agent, these results certainly encourage more study for patients at highest risk for oral cancer," said Vassiliki Papadimitrakopoulou, M.D., professor in M. D. Anderson's Department of Thoracic/Head and Neck Medical Oncology, and the study's senior author. "The extract's lack of toxicity is attractive - in prevention trials, it's very important to remember that these are otherwise healthy individuals and we need to ensure that agents studied produce no harm." In the Phase II dose-finding study, 41 M. D. Anderson oral leukoplakia patients were randomized between August 2002 and March 2008 to receive either green tea extract or placebo. Participants took the extract, an oral agent, for three months at one of three doses - 500 per [...]

2009-11-05T13:05:14-07:00November, 2009|Oral Cancer News|
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