Isn’t it about time? Overcoming the real barriers to complete oral cancer screening

Source: www.dentistryiq.com Author: Jonathan A. Bregman, DDS, FAGD In the previous articles of this series, I discussed four barriers I see as stopping those in the dental profession from doing a complete oral cancer screening examination. In Part 1, the barrier I discussed is the overall lack of confidence in doing a complete extra-/intraoral cancer screening exam. The rationale: “not doing the exam at all puts me at less risk than doing it and missing something.” In Part 2, the barrier I discussed is being unclear about who to examine: the changing target population, especially the influence of the human papillomavirus (HPV 16/18). In Part 3, the uncertainties of how the complete cancer screening examination should be done, plus communicating the reasons for doing it for patients. In Part 4: Uncertainty about how to properly record the cancer screening examination Barrier 5: Uncertainty about how to best and most effectively deliver the message of a positive finding The more we look, the more we find. The more we look, the closer we look, the more abnormalities we will detect with our cancer screening exam. This makes sense, of course. The same goes for the complete periodontal examination, the complete occlusal analysis, the complete updated radiographic evaluation, etc. In each area — tissue abnormalities, periodontal abnormalities, occlusal abnormalities — we must address the needs of the patient in a way that sets the stage for understanding of the problem(s) and presenting possible options/solutions to correct the problems. Build on what you [...]

HPV-related cancer not confined to cervix

Source: www.businesswire.com Author: press release The Human Papillomavirus (HPV) is the causative agent responsible for most cases of cervical cancer, but is also associated with several other types of cancer. Expert physicians from the National Comprehensive Cancer Network (NCCN) Member Institutions presented an update on HPV and its link to various cancers including cervical cancer, anal carcinoma, and head and neck cancers discussing prevention strategies and the latest recommended treatment options according to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™). “It is important to counsel against any tobacco use as well as excessive alcohol consumption, and also to inform patients about the role of HPV and its mechanism of spread” Robert J. Morgan, MD, FACP of City of Hope Comprehensive Cancer Center and a member of the NCCN Guidelines Panel for Cervical Cancer began the session speaking about the link between HPV and cervical cancer as well as methods of prevention. “Cervical cancer screening with the pap smear is one of the greatest success stories in medicine,” said Dr. Morgan pointing to data that shows a steadily decreasing death rate from cervical cancer since the 1980s. The link between HPV and cervical cancer first started to emerge in the 1970’s when researchers found evidence linking cervical cancer to a wart virus coupled with the fact that cervical cancer was associated with sexual activity. In 1983, HPV DNA was identified in cervical cancer tissue. There are 120 known HPV serotypes with 19 being considered high risk, although as Dr. [...]

Oral cancer preventive practices of South Carolina dentists and physicians

Source: J Cancer Educ, January 16, 2010 Authors: SG Reed et al. The purpose of this study was to assess the South Carolina (SC) dentists' and physicians' oral cancer knowledge and practices and interest in training in oral cancer screening and tobacco cessation counseling. Method used was a cross-sectional survey of SC dentists and selected physician specialties with responses to mailed questionnaires summarized by descriptive statistics and chi-square tests for comparisons. Overall response rates were 58%for dentists and 44% for physicians. Dentists (81%) and 13% of the physicians reported conduct of oral cancer examinations at least half of the time over the past 12 months. Dentists (41%) and 83% of physicians assisted patients to quit smoking. Few dentists (19%) and 53% of physicians were aware of SC tobacco cessation resources. Dentists (40%) and physicians (37%) were interested in receiving training in oral cancer screening, and 36% and 49%, respectively, in training in tobacco cessation counseling. Results support the development of tailored education for SC dentists and physicians to achieve Healthy People 2010 Oral Health Objectives for Oral Cancer. Authors: SG Reed, KB Cartmell, NG Duffy, AE Wahlquist, D Sinha, A Hollinger, A Bode, AJ Alberg, and TA Day Author's affiliation: Department of Craniofacial Biology, Medical University of South Carolina, 173 Ashley Avenue, MSC 507, Charleston, SC, 29425-5070, USA

2010-02-13T18:51:29-07:00February, 2010|Oral Cancer News|

Cancers can vanish without treatment, but how?

Source: nytimes.com Author: Gina Kolata Call it the arrow of cancer. Like the arrow of time, it was supposed to point in one direction. Cancers grew and worsened. But as a paper in The Journal of the American Medical Association noted last week, data from more than two decades of screening for breast and prostate cancer call that view into question. Besides finding tumors that would be lethal if left untreated, screening appears to be finding many small tumors that would not be a problem if they were left alone, undiscovered by screening. They were destined to stop growing on their own or shrink, or even, at least in the case of some breast cancers, disappear. “The old view is that cancer is a linear process,” said Dr. Barnett Kramer, associate director for disease prevention at the National Institutes of Health. “A cell acquired a mutation, and little by little it acquired more and more mutations. Mutations are not supposed to revert spontaneously.” So, Dr. Kramer said, the image was “an arrow that moved in one direction.” But now, he added, it is becoming increasingly clear that cancers require more than mutations to progress. They need the cooperation of surrounding cells and even, he said, “the whole organism, the person,” whose immune system or hormone levels, for example, can squelch or fuel a tumor. Cancer, Dr. Kramer said, is a dynamic process. It was a view that was hard for some cancer doctors and researchers to accept. But some of [...]

Conducting oral examinations for cancer in general practice: what are the barriers?

Source: Family Practice Advance Access published online on October 15, 2009 Authors: J Wade et al. Background: The incidence of oral (mouth) cancer in the UK is continuing to rise. Individuals who are at greatest risk rarely visit a dentist but do consult general medical practitioners (GMPs). Therefore, GMPs could have an important role in the early detection of oral cancer. Research has shown that GMPs do not opportunistically screen high-risk individuals; however, the barriers to screening are poorly understood. Objectives: To understand the reasons why GMPs may not screen for oral cancer. Methods: A questionnaire was developed, using the Theory of Planned Behaviour (TPB), to measure GMPs attitudes to and screening for oral cancer. The questionnaire was designed using all the key theoretical constructs of the TPB and incorporating the themes identified in a qualitative elicitation study. The questionnaire was posted to 499 GPs in Surrey Primary Care trust. Results: Two hundred and twenty-eight completed questionnaires were returned (46%). Two TPB constructs [subjective norm (e.g. peer pressure) and perceived external control factors (e.g. adequate equipment, time constraints)] were identified as significant predictors of ‘intention’ to perform oral screening. Intention and perceived internal control factors (e.g. self-efficacy) were predictive of actually performing oral screening with patients. Conclusions: The results of the study suggest that there is considerable potential for improving intention to perform oral cancer screening in general practice. Theory-based interventions could include further training to enhance confidence, expertise, knowledge and ease of examination, the provision of adequate equipment in [...]

Study suggests VELscope System helps reduce recurrence of oral cancer

Source: www.prweb.com Author: press release LED Dental Inc. announced today that a recent study suggests that its VELscope screening system can help surgeons reduce the recurrence rate for oral cancer following surgery. The article, "Tracing the 'At-Risk' Oral Mucosa Field with Autofluorescence: Steps Toward Clinical Impact," was just published in the journal Cancer Prevention Research. It was authored by Catherine F. Poh, Calum E. MacAulay and Miriam Rosin of the BC Cancer Agency and Lewei Zhang of the University of British Columbia. The study was prompted by numerous previous studies showing that oral cancer recurs in a significant percentage of patients following oral cancer surgery. The study examined the experience of 60 oral cancer surgery patients between 2004 and 2008. Their cancerous lesions were treated with surgical excision alone, with a minimum follow-up time of 12 months. For 38 of the 60 patients, the surgeon used a surgical margin that was 10 mm beyond the tumor edge defined by the VELscope exam. Because the VELscope system utilizes fluorescence visualization, or FV, technology, these patients are described in the article as having had FV-guided surgery. The remaining 22 patients--the control group--did not have FV-guided surgery; instead, the surgeon used a surgical margin that was 10 mm beyond the tumor edge defined by the standard white-light exam. White light exams rely on visual inspection with the naked eye, whereas the VELscope system allows clinicians to discover cancerous and precancerous tissue that might not be apparent to the naked eye. Four years into [...]

Capturing cell ‘fingerprints’ to advance cancer screening

Source: www.physorg.com Author: staff Researchers at Northeastern University have developed an early-stage, highly accurate cancer screening technology that determines -- in seconds -- whether a cell is cancerous, precancerous or normal. The breakthrough technology, for which there is a patent pending, automatically captures a “fingerprint” of the cell’s biochemical composition, which is subsequently analyzed by a computer for abnormalities. The new method, which currently can screen for oral, cervical and head-and-neck cancers, is faster, more accurate, and enables earlier detection than current screening methods. Those methods rely on the visual detection, under a microscope, of a few abnormally shaped cells among thousands. Referred to as Spectral Cytopathology (SCP), the technology was pioneered by professor of chemistry and chemical biology Max Diem, head of Northeastern’s Laboratory for Spectral Diagnosis; chemistry and chemical biology research scientists Melissa Romeo, Ben Bird and Miloš Miljkovic; and several Northeastern graduate and undergraduate students. “We are looking beyond traditional methods by focusing on detecting cellular changes that happen in the earlier stages of cancer, which will have a tremendous impact on patients,” said Diem. “Cytologists [scientists who study the structure and function of cells] have the most difficulty identifying pre-cancers in the earliest stages,” said Romeo. “Our technology offers the ability to detect abnormal changes in cells even before (structural) changes become apparent.” Earlier detection combined with greater accuracy—SCP has a greater-than 95 percent accuracy rate compared to 65 to 70 percent for current screening methods—would make a significant difference in patient survival rates. The high death [...]

Gene study finds link to cancer of thyroid

Source: nytimes.com Author: Nicholas Wade Scientists have identified two genetic variations that account for 57 percent of cases of thyroid cancer, a finding that could lead to earlier detection among people at high risk for the disease. The report, from the Icelandic company Decode Genetics, may also lead to a resurgence of interest in the quest for the genetic roots of other common maladies like heart disease and schizophrenia. Genetic variants for many such diseases have been identified, but most have turned out to account for a disappointingly small percentage of cases. A scientific team led by Julius Gudmundsson of Decode Genetics reported Friday in the journal Nature Genetics that the two variants each lie at a site on the human genome near genes that control development of the thyroid gland. The variants are changes in a single chemical unit of the genome, which is some three billion units in length. Compared with people who have neither variant, “the risk associated with these variants was almost sixfold, which is quite extraordinary,” said Dr. Erich M. Sturgis, a head and neck surgeon at the M. D. Anderson Cancer Center in Houston who was not connected with the research. Dr. James A. Fagin, chief of endocrinology at the Memorial Sloan-Kettering Cancer Center in New York, said the new study was a significant advance, noting that the Decode Genetics scientists had bolstered their results by replicating the findings among Icelanders in two other populations of European descent, in Columbus, Ohio, and in Spain. [...]

2009-02-08T18:21:44-07:00February, 2009|Oral Cancer News|

New cases of cancer decline in the United States

Source: nytimes.com Author: Roni Cryn Rabin The incidence of new cancer cases has been falling in recent years in the United States, the first time such an extended decline has been documented, researchers reported Tuesday. Cancer diagnosis rates decreased by an average of 0.8 percent each year from 1999 to 2005, the last year for which data are available, according to an annual report by the National Cancer Institute, the American Cancer Society and other scientific organizations. Death rates from cancer continued to decline as well, a trend that began some 15 years ago, the report also noted. It was published online in The Journal of the National Cancer Institute. “Each year that you see these steady declines it gives you more confidence that we’re moving in the right direction,” said Dr. John E. Niederhuber, director of the National Cancer Institute, who is not an author of the report. “This is not just a blip on the screen.” Death rates from cancer fell an average of 1.8 percent each year from 2002 to 2005, according to the new report. Although last year’s report said death rates dropped an average of 2.1 percent each year from 2002 to 2004, a modest 1 percent decline in 2005 lowered the average percentage for the period. The decline is primarily due to a reduction in death rates from certain common cancers, including prostate cancer and lung cancer in men, breast cancer in women and colorectal cancer in both sexes. The report attributes the reductions [...]

2008-11-26T10:36:32-07:00November, 2008|Oral Cancer News|

Queens County dentists to screen for oral cancer at Mets game

Source: ReadMedia Newswire (readme.readmedia.com) Author: press release Dentists from the Queens County Dental Society (QCDS) will be offering free, two-minute oral cancer screenings at Shea Stadium before and during the Mets game on Tuesday, September 9, 2008. Screening stations will be set up on all levels of the stadium and will offer health care information as well as a drawing for free prizes, including a David Wright Mets jersey for those who are screened. "Screenings for oral cancer are quick, painless and can save lives," says Dr. Stuart Kesner, chairman of the event. "Early diagnosis is the key to surviving this disease," adds Dr, Kesner who notes that oral cancer currently kills more than 7,000 Americans each year and, if caught early, can be prevented. He thanks the Mets organization for the opportunity to partner with them in bringing this public health service to the team's fans. In recognition of the event, Dr. Kesner and Dr. Viren Jhaveri, President of QCDS, will be presented with a "Spirit Award" from the New York Mets prior to the game. Dr. Mark Feldman, President of the American Dental Association, Dr. Stephen Gold, President of the New York State Dental Association and the Honorable Jose Peralta, New York State Assemblyman, will be in attendance during the award ceremony. The Queens County Dental Society is a not-for-profit chapter of the American Dental Association, comprised of more than 1,000 members dedicated to promoting good oral health and oral cancer awareness throughout the community. This event is [...]

2008-09-03T18:49:46-07:00September, 2008|Oral Cancer News|
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