smoking

Study reveals high environmental cost of tobacco

Source: www.cnn.com
Date: May 31st, 2017
Author: Jacopo Prisco

Details of the environmental cost of tobacco are revealed in a study released Wednesday by the World Health Organization, adding to the well-known costs to global health, which translate to a yearly loss of $1.4 trillion in health-care expenses and lost productivity.

From crop to pack, tobacco commands an intensive use of resources and forces the release of harmful chemicals in the soil and waterways, as well as significant amounts of greenhouse gases. Its leftovers linger, as tobacco litter is the biggest component of litter worldwide.

“Tobacco not only produces lung cancer in people, but it is a cancer to the lungs of the Earth,” said Dr. Armando Peruga, who previously coordinated the WHO Tobacco Free Initiative and now works as a consultant. He reviewed the new report for the WHO.

Commercial tobacco farming is a worldwide industry that involves 124 countries and occupies 4.3 million hectares of agricultural land. About 90% of it takes place in low-income countries, with China, Brazil and India as the largest producers.

Because tobacco is often a monocrop — grown without being rotated with other crops — the plants and the soil are weak in natural defenses and require larger amounts of chemicals for growth and protection from pests.

“Tobacco also takes away a lot of nutrients from the soil and requires massive amounts of fertilizer, a process that leads to degradation of the land and desertification, with negative consequences for biodiversity and wildlife,” Peruga said.

The use of chemicals directly impacts the health of farmers, 60% to 70% of whom are women. This is especially prominent in low- and middle-income countries, where some compounds that are banned in high-income countries are still used.

300 cigarettes = one tree

Farming also uses a surprisingly large amount of wood, rendering tobacco a driver of deforestation, one of the leading causes of climate change.

About 11.4 million metric tonnes of wood are utilized annually for curing: the drying of the tobacco leaf, which is achieved through various methods, including wood fires. That’s the equivalent of one tree for every 300 cigarettes, or 1.5 cartons.

This adds to the impact of plantations on forest land, which the study describes as a significant cause for concern, citing “evidence of substantial, and largely irreversible, losses of trees and other plant species cause by tobacco farming.”

Deadly gases

In 2012, 967 million daily smokers consumed approximately 6.25 trillion cigarettes worldwide, the WHO estimates.”That means about 6,000 metric tones of formaldehyde and 47,000 metric tonnes of nicotine are released into the environment,” Peruga said.

Tobacco smoke contains about 4,000 chemicals, at least 250 of which are known to be harmful. It also contains climate-warming carbon dioxide, methane and nitrous oxides. “The combination of greenhouse gases from combustion is equivalent to about 1.5 million vehicles driven annually,” Peruga said.

Secondhand smoke is particularly deadly: It contains twice as much nicotine and 147 times more ammonia than so-called mainstream smoke, leading to close to 1 million deaths annually, 28% of them children.

Some of these pollutants remain in the environment (and our homes) as “third-hand smoke,” accumulating in dust and surfaces indoors, and in landfills. Some, like nicotine, even resist treatment, polluting waterways and potentially contaminating water used for consumption, the study notes.

Non-biodegradable litter

Tobacco litter is the most common type of litter by count worldwide.

“We calculate that two-thirds of every cigarette ends up as litter,” Peruga said.

The litter is laced with chemicals including arsenic and heavy metals, which can end up in the water supply. Cigarette butts are not biodegradable, and tossing one on the ground is still considered a socially acceptable form of littering in many countries.

The WHO estimates that between 340 million and 680 million kilograms of tobacco waste are thrown away every year, and cigarette butts account for 30% to 40% of all items collected in coastal and urban clean-ups.

“In addition to that, there are 2 million tons of paper, foil, ink and glue used for the packaging,” Peruga said.

A way forward?

Even though smoking is declining globally, it is increasing in some regions, such as the eastern Mediterranean and Africa. China is a world leader both in production (44%) and consumption, with 10 times more cigarettes smoked than in any other nation.

Every stage of the production of a cigarette has negative effects on the environment and the people who are involved in manufacturing tobacco products, even before the health of smokers and non-smokers is affected.

Although governments worldwide already collect $270 billion in tobacco taxes a year, the WHO suggests that increasing tax and prices is an effective way of reducing consumption and help development priorities in each country, adding that by collecting 80 cents more per pack, the global tax revenue could be doubled.

“Tobacco threatens us all,” WHO Director-General Margaret Chan said in a note. “It exacerbates poverty, reduces economic productivity, contributes to poor household food choices, and pollutes indoor air.”

May, 2017|Oral Cancer News|

More patients presenting with HPV-associated oral cancers in Lubbock, TX

Source: lubbockonline.com
Author: Ellysa Harris

Detecting oral cancers in patients in their 50s and 60s has never been uncommon. But local dentists and doctors say finding it in younger patient populations has become a new norm.

Oral cancers driven by Human Papillomavirus are now the fastest growing oral and oropharyngeal cancers, according to the Oral Cancer Foundation website. And local health officials say they’ve seen a few more cases than usual.

Dr. Joehassin Cordero, FACS, professor, chairman and program director ofTexas Tech’s Health Sciences Center Department of Otolaryngology-Head & Neck Surgery, said less people are smoking and that has contributed to the decrease in the number of cases of oral cancers in the past two decades.

“In that same period, we have seen an increase in the HPV oropharyngeal cancer,” he said. “And oropharyngeal cancer — what it means it’s affecting the base of your tongue and tonsils.”

Dr. Brian Herring, a Lubbock dentist, chalks the increase up to increased awareness.

“I’m assuming probably for years and years and years it has affected the mouth but we didn’t know that,” he said. “As we get better at cellular diagnostics and molecular diagnostics, things like that, we’re finding that there is a large portion of cancers that do have an HPV component.”

What’s more alarming, said Dr. Ryan Higley, oral surgeon with West Texas Oral Facial Surgery, is it’s being diagnosed in younger people.

Higley said oral cancers are generally diagnosed between the ages of 55 and 65, mostly in women.

“With HPV-associated cancers, we see those four to 10 years before that,” he said. “It’s a younger patient population.”

Cordero said the oral cancers are often caused by exposure to HPV from years before.It starts with exposure to the HPV infection. One in four people in the United States are currently infected, according to the Centers for Disease Control and Prevention website.

“It’s truly considered a sexually transmitted disease,” Cordero said. “It has to do with not so much kissing, but oral sex.”

It’s passed on when somebody with an active lesion engages in sexual activities with another person, he said.

Nine out of 10 infections will disappear on their own, according to the CDC, but infections that linger for longer than about two years can lead to cancer.

“That doesn’t mean they’ll have cancer next week,” Cordero said.

Researchers are still trying to figure out why and how long after HPV exposure it takes for cancer to develop, he said.

“We don’t know the true mechanism because most of these people were not exposed a year ago,” he said. “They were not exposed six months ago. They were exposed a long time before that.”

When it does present, he said, there generally aren’t any noticeable symptoms.Because of that, it’s often diagnosed in later stages, Herring said.

“What we’re finding is because the demographic is changing, they’re not getting diagnosed as early because they’re not expecting to have this problem,” he said.

Screenings for oral HPV exist.

“The gold standard examination is your typical dental exam,” Herring said. If your dentist detects something unusual that might need further examination, he or she will make a referral to an oral surgeon.

Higley said oral HPV cancer presents as a lesion that looks like a kanker that won’t heal.

“However, cancerous lesions can have multiple presentations so that’s not exclusive,” he said. “So oftentimes, we’ll have a patient present with a hard nodule underneath their jaw line or in their neck. Sometimes they’ll just have red or white lesions within the mouth, hoarseness in their voice or difficulty swallowing. All those are things that need to be checked.”

The cancer seems to be more treatable, he said, but it’s hard to pinpoint why.

“We really don’t know if they’re more responsive to treatment because we’re treating a little bit younger patient population who is overall more healthy or if it’s inherant in the tumor itself,” Higley said.

Cordero said he hopes the HPV vaccine, which is recommended for both girls and boys 11 or 12 years old and people up to 26 years old, provides a measure of protection against the infection.

“We’re hoping in the next 10 to 20 years that head and neck cancer caused by HPV will be completely gone,” he said.

Symptoms of throat cancer depend on which throat structures are affected

Source: tribunecontentagency.com
Author: Eric Moore, M.D.

Dear Mayo Clinic: Are there early signs of throat cancer, or is it typically not found until its late stages? How is it treated?

Answer: The throat includes several important structures that are relied on every minute of the day and night to breathe, swallow and speak. Unfortunately, cancer can involve any, and sometimes all, of these structures. The symptoms of cancer, how early these symptoms are recognized and how the cancer is treated depend on which structures are involved.

All of the passageway between your tongue and your esophagus can be considered the throat. It includes three main areas. The first is the base of your tongue and tonsils. These, along with the soft palate and upper side walls of the pharynx, are called the oropharynx. Second is the voice box, or larynx. It consists of the epiglottis — a cartilage flap that helps to close your windpipe, or trachea, when you swallow — and the vocal cords. Third is the hypopharynx. That includes the bottom sidewalls and the back of the throat before the opening of the esophagus.

Tumors that occur in these three areas have different symptoms, behave differently and often are treated differently. That’s why the areas of the throat are subdivided into separate sections by the head and neck surgeons who diagnose and treat them.

For example, in the oropharynx, most tumors are squamous cell carcinoma. Most are caused by HPV, although smoking and alcohol can play a role in causing some of these tumors. Cancer that occurs in this area, particularly when caused by HPV, grows slowly usually over a number of months. It often does not cause pain, interfere with swallowing or speaking, or have many other symptoms.

Most people discover cancer in the oropharynx when they notice a mass in their neck that’s a result of the cancer spreading to a lymph node. Eighty percent of people with cancer that affects the tonsils and base of tongue are not diagnosed until the cancer moves into the lymph nodes.

This type of cancer responds well to therapy, however, and is highly treatable even in an advanced stage. At Mayo Clinic, most tonsil and base of tongue cancers are treated by removing the cancer and affected lymph nodes with robotic surgery, followed by radiation therapy. This treatment attains excellent outcomes without sacrificing a person’s ability to swallow.

When cancer affects the voice box, it often affects speech. People usually notice hoarseness in their voice soon after the cancer starts. Because of that, many cases of this cancer are detected at an early stage. People with hoarseness that lasts for six weeks should get an exam by an otolaryngologist who specializes in head and neck cancer treatment, as early treatment of voice box cancer is much more effective than treatment in the later stages.

Early voice box cancer is treated with surgery — often laser surgery — or radiation therapy. Both are highly effective. If left untreated, voice box cancer can grow and destroy more of the larynx. At that point, treatment usually includes major surgery, along with radiation and chemotherapy — often at great cost to speech and swallowing function.

Finally, cancer of the hypopharynx usually involves symptoms such as pain when swallowing and difficulty swallowing solid food. It is most common in people with a long history of tobacco smoking and daily alcohol consumption. This cancer almost always presents in an advanced stage. Treatment is usually a combination of surgery, chemotherapy and radiation therapy.

If you are concerned about the possibility of any of these cancers, or if you notice symptoms that affect your speech or swallowing, make an appointment for an evaluation. The earlier cancer is diagnosed, the better the chances for successful treatment. — Eric Moore, M.D., Otorhinolaryngology, Mayo Clinic, Rochester, Minn.

Note: For information, visit www.mayoclinic.org

The scary reason doctors say kids need HPV vaccinations

Source: www.washingtonpost.com
Author: Sarah Vander Schaaff

When actor Michael Douglas told a reporter that his throat cancer was caused by HPV contracted through oral sex, two themes emerged that had nothing to do with celebrity gossip. The first was incredulity — since when was oral sex related to throat cancer? Even the reporter thought he had misheard. The second was embarrassment. This was too much information, not only about sexual behavior but also about one’s partners.

Douglas apologized, and maybe the world was not ready to hear the greater truth behind what he was suggesting.

That was four years ago.

Today, there is no doubt in the medical community that the increase in HPV-related cancers such as the one Douglas described — which he later explained was found at the base of his tongue — is caused by sexual practices, in his case cunnilingus. And there is an urgency to better treat and prevent what is becoming the one type of oral cancer whose numbers are climbing, especially among men in the prime of their lives who have decades to live with the consequences of their cancer treatment.

The number of people diagnosed with HPV-related oropharyngeal cancer, tumors found in the middle of the pharynx or throat including the back of the tongue, soft palate, sides of throat and tonsils — is relatively small — about 12,638 men and 3,100 women in the United States each year, according to the Centers for Disease Control and Prevention. But these numbers are expected to continue to rise, overtaking incidence of cervical cancer by 2020. One study revealed the presence of HPV in 20.9 percent of oropharyngeal tumors before 1990, compared with 65.4 percent in those sampled after 2000.

Alarming trend
It’s an alarming trend considering HPV, or human papilloma­virus, is the most common sexually transmitted infection in the country. The CDC estimates that nearly all sexually active men and women will get a form of the virus at some point. Although most HPV infections go away on their own, they are causing 30,700 cancers in men and women every year, including cervical, vaginal and penile cancers along with oral cancers.

Health agencies are pushing hard for HPV vaccinations, which they say could prevent most of those cancers. The CDC says all 11- and 12-year-olds should be ­vaccinated. And last year, the Food and Drug Administration approved a new two-dose series for children ages 9 to 14. And the American Academy of Pediatrics recently updated its vaccine recommendations to reflect that two-dose schedule, a reduction from the three shots previously required. (Children over 14 still need three shots.) The hope is to increase rates of completed vaccinations, which have lagged in the decade since the vaccines were released, averaging 42 percent for girls and 28 percent for boys, far below the Healthy People 2020 goal of 80­ percent.

The patients showing up in Ben Roman’s office at Memorial Sloan Kettering Cancer Center in New York, where he works as a head and neck surgeon and ­health-services researcher, came of age not only before these vaccines hit the market, but also before HPV and its link to cancers was fully understood. These cases, experts say, probably reflect several separate but interconnected factors: the sexual revolutions of the 1920s and 1960s that introduced more HPV into the general population, the changing sexual practices of young people who report more histories of oral sex, and that it can take 10 to 30 years for tumors to develop after an infection.

Roman has seen an increase in a new type of head and neck cancer patient. They are typically white, middle-aged men, ­otherwise healthy, who have no history of smoking or drinking. They may have first noticed a mass in their necks or lymph nodes while buttoning a shirt or shaving. An ear, nose and throat doctor has determined the primary source of the cancer: the tonsils or base of the tongue.

“Most people are familiar with tonsils in the back of the throat,” Maura Gillison, a leading expert in HPV-related cancers at the ­University of Texas MD Anderson Cancer Center, said. “But we also have them in the base of the tongue.”

The palatine tonsils are on the sides of the throat, and there are also lingual tonsils on the back of the tongue. Both areas are made of the same lymphoid tissue at particular risk for HPV infection, and are part of what specialists call Waldeyer’s Ring.

Experts are not sure why an HPV infection in the tonsils is more likely to lead to cancer. It could be because of their anatomy, which has crypts and crevices, making it harder to clear an infection. Gillison said it could also be because of where the tonsils are in the body, an area that serves as a transition from the outside to the inside, much like the genital tract and cervix.

German researcher Harald zur Hausen identified the types of HPV that cause cervical cancer 34 years ago, work that earned him the Nobel Prize in 2008 and contributed to the development of the HPV vaccine. One of those types, HPV-16, is identified in more than half of cancers in the oropharynx, according to the National Cancer Institute.

But there are important distinctions between men and women when it comes to HPV-related cancers. Cervical cancer deaths, for example, have been greatly reduced through early detection with the use of Pap smears. The same screening for precursor lesions or pre-cancer is not yet possible for the oropharyngeal cancers, commonly referred to as OPC or OSCC, for oropharyngeal squamous cell carcinomas.

The male risk
Another difference is how men and women respond to infection. The majority of women develop antibodies to clear HPV when exposed vaginally. These antibodies remain in the body so that a woman is protected from a subsequent oral infection. Men, in contrast, are much less likely to develop antibodies after genital exposure to the virus. When tested, their titers — a measurement of antibodies — are lower, leaving them five times more likely than women to have an oral infection.

HPV is considered an unusual virus because it does not travel through the bloodstream. Infection is localized, meaning it stays at the place where contact occurs. In tonsil cancer, then, oral sex becomes a relevant risk factor, so significant that in an article in the Journal of Clinical Oncology, Gillison and her colleagues stated that the number of these oral sex partners in a lifetime is the behavior measure that is, “. . . most strongly, consistently, and specifically associated with OPC (tonsil and base of tongue).”

Treating a cancer related to a sexually transmitted infection brings up sensitive questions. Roman said a patient’s spouse will often pull him aside to ask: “When did he get this? Was he cheating?” He suggests the patient was probably exposed years ago. But from the viewpoint of prognosis, the HPV-related cancers respond better to treatment.

That fact has prompted rapid changes in treatment protocols that were as recently as five years ago based on heavy smoking and drinking. These new strategies back down from the aggressive radiation, chemotherapy and surgery that exposed patients to high toxicity and could damage the ability to speak and swallow.

When Gillison started her research in 2000, there was little awareness that sexual behavior contributed to cancer of the throat, and fellow researchers were skeptical.

“People were laughing. They thought it was absurd,” she said. Now, Gillison is credited with formally putting together the behavioral data and biomarkers to quell any skepticism, Carole Fakhry, an associate professor of otolaryngology and surgeon at Johns ­Hopkins, said.

Others had noted HPV in oral cavity cancer, but no one was sure whether it was a fluke or more significant. So Gillison reviewed tumor specimens collected by a colleague and then set out to study all of the available ­literature, presenting an analysis in 2009 that compared the ­survival rates of those with HPV-positive and -negative oropharynx cancers. Gillison describes her work — a confluence of observations in the lab and clinic — as an act of serendipity.

“I have always been interested in the association between ­infectious diseases and tumors because there are so many ­opportunities to intervene. If an infection causes a cancer, you can try to prevent infection in the first place, or screen, or if it’s developed you can use the fact that it’s associated with a virus — you can treat cancer by treating infection.”

As far as vaccination’s effect on preventing OPC in men, data is still under review. Officially, the vaccine is recommended for boys and young men to prevent genital warts and anal pre-cancers. But those focused on pediatrics, such as Margaret Stager, director of adolescent medicine at MetroHealth medical center in Ohio and an official spokeswoman for the American Academy of Pediatrics, say that HPV vaccination clearly decreases spreading of HPV through the community, offering immediate, midrange and long-term benefits. And the current vaccines do protect against HPV-16, one of the high-risk types of the virus found in both cervical cancer and a majority of OPC.

New, easier vaccine
The new two-dose vaccination is designed to reach children when their antibody response is highest and make completion less cumbersome, as are electronic medical records that cue physicians when a vaccine is due. The District of Columbia is one of the few areas that has made the vaccine a required immunization for students in grades six through 12, although families may opt out.

There is still a gap in knowledge among some general ­practitioners and dentists, according to Gillison.

It is not uncommon for her to hear a story from a patient who comes to her after six months or so after going to his doctor.

“He told me not to worry ­because I was fighting off an infection. He gave me antibiotics. They were not working. Then ­another lump occurred next to that one . . . ”

The patient is young, healthy and doesn’t smoke. He has a sore throat and a neck mass that doesn’t respond to antibiotics.

Those in the front lines of ­medical practice, she said, should have in mind the question: Could this patient have head and neck cancer?

April, 2017|Oral Cancer News|

Mouth cancer rates soar over 20 years

Source: www.sciencedaily.com
Author: staff

A new Cancer Research UK analysis reveals that rates of mouth (oral) cancer have jumped by 68 per cent1 in the UK over the last 20 years. The figures — released during Mouth Cancer Action Month — reveal the cancer is on the rise for men and women, young and old, climbing from eight to 13 cases per 100,000 people over the last two decades.

For men under 50, the rate has jumped by 67 per cent in the last 20 years2 — going up from around 340 cases to around 640 cases each year. For men aged 50 and over, rates have increased by 59 per cent climbing from around 2,100 cases to around 4,400 cases annually.

Oral cancer is more common in men, but there have been similar increases women3.

In women under 50, oral cancer rates have risen by 71 per cent in the last 20 years, with annual cases climbing from around 160 to around 300. Rates for women over 50 have also gone up by 71 per cent, with cases increasing from around 1,100 to around 2,200.

Around nine in 10 cases are linked to lifestyle and other risk factors. Smoking is the biggest avoidable risk factor, linked to an estimated 65 per cent of cases. Other risk factors include alcohol, diets low in fruit and vegetables, and infections with the Human Papilloma Virus (HPV).

Oral cancers include cancer of the lips, tongue, mouth (gums and palate), tonsils and the middle part of the throat (oropharynx)4.

Cancer Research UK — working with the British Dental Association — has developed an oral cancer toolkit5 to help GPs, dentists, nurses and hygienists spot the disease and refer suspected cases sooner.

Jessica Kirby, Cancer Research UK’s senior health information manager, said: “It’s worrying that oral cancer has become more common. It’s important to get to know your body and what’s normal for you, to help spot the disease as early as possible. An ulcer or sore in your mouth or tongue that won’t go away, a lump on your lip or in your mouth, a red or red and white patch in your mouth or an unexplained lump in your neck are all things to look out for. Speak to your GP or dentist about any changes that are unusual or don’t go away.

“Healthy lifestyles can help reduce the risk of developing the disease in the first place. Not smoking, drinking less alcohol and eating plenty of fruit and vegetables can all help to cut our risk of mouth cancer. HPV vaccination could help protect against oral HPV infections, and it can prevent a range of cancers associated with the HPV virus, so it’s a good idea to get the vaccine if you are offered it.”

With smoking being the biggest preventable cause of oral cancer, Cancer Research UK is also calling on the public and local councillors to help protect vital Stop Smoking Services. These specialist services are the most successful way for people to quit smoking.

Andrea Fearon, 47 from Newbury, was diagnosed in 2013 with mouth cancer after a routine checkup by her dentist.

Andrea said: “I had thought that most people with mouth cancer are heavy smokers over the age of 50, so I completely shocked when I was diagnosed with the disease. I’m proof that this type of cancer isn’t limited to a particular age or sex. I thought seeing the dentist was about looking after your teeth — but it can save your life. It’s thanks to my dentist that the mouth cancer was caught early — that’s why I feel so lucky to be alive.”

Notes:
1. Based on oral cancer incidence rates for all ages, persons, from 8 cases per 100,000 people between 1993-1995 to 13 cases per 100,000 people between 2012-2014.

2. Based on oral cancer incidence rates, for males aged 0-49, the rise is from two cases per 100,000 males between 1993-1995 to three cases per 100,000 males between 2012-2014. For men aged 50 and over, this rise is from 26 cases per 100,000 between 1993-1995 to 41 cases per 100,000 men between 2012-2014.

3. Based on oral cancer incidence rates, for females aged 0-49 years, the rise is from one case per 100,000 females between 1993-1995 to two cases per 100,000 females between 2012-2014.

For women aged 50 and over, the rise is from 11 cases per 100,000 women between 1993-1995 to 18 cases per 100,000 women between 2012-2014.

Cases are based on the number of new diagnoses between 1993-1995 and between 2012-2014.

4. Oral cancer includes ICD-10 C00-C06, C09-C10 and C12-C14 (which include the lip, tongue, mouth, oropharynx, piriform sinus, hypopharynx and other and ill-defined sites of the lip, oral cavity and pharynx).

For the latest oral cancer statistics visit the Cancer Research UK statistics webpage http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/oral-cancer

5. The toolkit covers the signs to look out for, how to respond, as well as possible risk factors for oral cancer. The toolkit also features a detailed image library, a referral guide, case studies, examination videos and a CPD accredited quiz.

Story Source:
Materials provided by Cancer Research UK. Note: Content may be edited for style and length.

November, 2016|Oral Cancer News|

Curbing oral cancer

Source:.businessmirror.com.ph
Author: Henrylito D. Tacio

“Cancer is the third leading cause of death in the country today. Most of it can be prevented since its risk factors are lifestyle and environmentally related. Early detection of cancer is a crucial key to the survival and recovery of its victims. The earlier you detect the malignancy the higher the survival rate of the patient.”
—Dr. Vic Fileto Chua of Movement for Early Detection of Cancer

What’s the leading cause of oral cancer? Is it smoking or heavy drinking? Although smoking and drinking may cause oral cancer, the leading cause is oral sex, a sexual act that involves the stimulation of the genitalia using the mouth.

Studies have shown that 64 percent of cancers of the oral cavity, head, and neck in the United States are caused by human papillomavirus (HPV), which is commonly spread via oral sex. The more oral sex you have – and the more oral sex partners you have – the greater the risk of developing these potentially deadly cancers.

oral_cancer

“An individual who has six or more lifetime partners—on whom they’ve performed oral sex—has an eightfold increase in risk compared to someone who has never performed oral sex,” explained Dr. Maura Gillison, an oncologist at Ohio State University. Gillison headed a team of researchers who examined 271 throat-tumor samples collected over 20 years ending in 2004. They found that the percentage of oral cancer linked to HPV surged to 72 percent from about 16 percent.

The study, which was published in the Journal of Clinical Oncology, said that by 2020, the virus-linked throat tumors—which mostly affected men—will more common than HPV-caused cervical cancer.

“The burden of cancer caused by HPV is going to shift from women to men in this decade,” observed Gillison. “What we believe is happening is that the number of sexual partners and exposure to HPV has risen over that same time period.”

In his weekly column in Philippine Daily Inquirer, Dr. Rafael D. Castillo noted: “Previously, it was well established that smoking (three-fold increase) and drinking alcohol (2.5 times) increased the risk for oral cancer, but even if you combine them, the risk is no match compared to that seen in those who frequently engage in oral sex.”

The government doesn’t have any data on the prevalence of oral cancer in the country but what alarms Castillo is that oral cancer might be rampant among young people. A study done by the University of the Philippines Population Institute showed that more than four million teenagers and young Filipinos are already engaged in sexual practices.

The findings of the third Young Adult Fertility Survey revealed that a total of 4.32 million Filipinos aged 15 to 24 are already sexually active. Another finding is that oral sex has become a common practice “among most sexually adventurous teens.”

“Doing simple math, if the expected prevalence of oral cancer in the general population is 1.5 percent, and with a nine-fold increase in risk, that means that we have approximately 583,000 young Filipinos aged 15 to 24 who are likely candidates to develop oral cancer,” Dr. Castillo surmised.

“Today’s teens consider oral sex to be casual, socially acceptable, inconsequential, and significantly less risky to their health than ‘real’ sex,” said Gillison. Teens simply think oral sex is “not that a big a deal,” added Dr. Bonnie Halpern-Felsher, professor of pediatrics at the University of California, San Francisco. “Parents and health educators are not talking to teens about oral sex. Period.”

Members of the Philippine Medical Association (PMA) and the Philippine Dental Association (PDA) also noted that the practice of oral sex can lead to infections of the oral cavity, which may result to cancer of the tonsils, tongue or throat.

“Any lesion in the mouth should be seriously considered,” said Dr. Anne Camus, PDA’s Manila dental chapter president. “Not all can develop to cancer but malignancy must always be taken as an imminent possibility.”

A regular check-up with a dentist would help detect malignancies in the mouth. “The dentists are usually the first to see lesions in the mouth of our patients,” Camus said. “At this early point, if the lesion turns out to be malignant, then chances are it is still curable.”

Oral cancer, or cancer of the mouth, most commonly involves the lips or the tongue. It may also occur on the: cheek lining, floor of the mouth, gums, and roof of the mouth (palate). Most oral cancers are a type called squamous cell carcinomas, which tend to spread quickly.

Aside from oral sex, smoking, and drinking, other factors that add to the risk of oral cancer include repeated irritation from the sharp edges of broken teeth, fillings, or dental prostheses (dentures). “The research regarding their involvement is uncertain. It is likely that there is a complex interaction of many external and internal factors that play a role in the development of oral cancer,” points out the Oral Cancer Foundation in the United States.

“Oral cancers are usually painless for a considerable length of time but eventually do cause pain,” notes “The Merck Manual of Medical Information.” “Pain usually starts when the cancer erodes into nearby nerves. When pain from cancer of the tongue or roof of the mouth begins, it usually occurs with swallowing as with a sore throat.”

The early growth of salivary gland tumors may or may not be painful. “When these tumors do become painful, the pain may be worsened by food, which stimulates the secretion of saliva,” the Merck manual informs. “Cancer of the jawbone often causes pain and a numb or pins-and-needles sensation, somewhat like the feeling of a dental anesthetic wearing off. Cancer of the lip or check may first become painful when the enlarged tissue is inadvertently bitten.”

Discolored areas on the gums, tongue, or lining of the mouth may be signs of cancer. “An area in the mouth that has recently become brown or darkly discolored may be a melanoma (malignant tumor),” the Merck manual states. “Sometimes, a brown, flat, freckle-like area (smoker’s patch) develops at the site where a cigarette or pipe is habitually held in the lips.”

“Keep in mind that your mouth is one of your body’s most important early warning systems,” reminds the Oral Cancer Foundation. “Don’t ignore any suspicious lumps or sores. Should you discover something, make an appointment for a prompt examination. Early treatment may well be the key to complete recovery.”

According to the US National Cancer Institute, oral cancer treatments may include surgery, radiation therapy or chemotherapy. Some patients have a combination of these treatments.

November, 2016|Oral Cancer News|

HPV and mouth cancer

Source: www.hippocraticpost.com
Author: Thea Jourdan

hpv

Mouth cancer kills nearly 2000 people in the UK each year. The Human Papilloma Virus (HPV) of which there are over 100 different types, is more commonly associated with cervical cancer and genital warts, but it can also cause oral cancer, particularly of the back of the tongue and tonsils. The virus incorporates itself into the cell’s DNA and causes the cell to multiply out of control, leading to cancer.

In Britain, the number of mouth and throat cancers have increased by 40 per cent in just a decade, to 6,200 cases a year. According to Cancer Research UK, the HPV virus, which is transmitted to the mouth region from the genitals during oral sex, may be key to the ‘rapid rise’. Statistics also show that the more sexual partners you have the greater your chance of acquiring mouth cancer.

“There is now scientific evidence that a proportion of mouth and throat cancers are linked to HPV infection,” says Hazel Nunn, head of health information at Cancer Research UK. “We know that HPV is found in the mouth but we do not yet know how it gets there – whether through oral sex or otherwise. HPV virus has been found on the fingers and elsewhere on the body. It is possible that oral sex is having an impact but more research needs to be done into the kinds of behaviour that leads to this infection.”

“HPV has been causing mouth cancer for decades but the link is only now becoming clear. HPV is a hardy virus that likes sitting in lymphoid tissue wherever it is in the body,” explains Professor Mark McGurk, a senior consultant ENT surgeon based at London Bridge Hospital in London. That means it thrives in the lymphoid tissue in the mouth, including that of the tonsils and at the base of the tongue. For the same reason, it settles in the cervix, the vulva and around the anus.

For many people, HPV won’t cause any problems at all. “In fact, we know that 80 per cent of women and men will have the HPV infection at some time in their lives and clear it themselves without any symptoms,” explains Mr Mike Bowen, a consultant obstetrician and gynacologist based at St John and St Elizabeth Hospital in London. “But for a few it can cause cellular changes that lead to cancer.”

Professor McGurk says that over the last 30 years, he has seen a rise in oropharyngeal cancer, which typically affects sexually active men in their 50s and 60s. “They may have been infected with the virus for some time and ,” he explains. The cancer reveals itself as growths on the tonsils and back of the tongue.

Many patients are only diagnosed at the late stage of their disease. Michael Douglas, the actor, already had stage 4 cancer when his cancer was recognized. Fortunately, oral cancer caused by HPV is very treatable, even when it is very advanced, using radiotherapy. “We used to do surgery on these cases, but we don’t need to anymore. In many cases, the cancer simply melts away with radiotherapy,” explains Professor McGurk. Patients with stage 1 and 2 Oral cancer caused by HPV have an 85 per cent chance of surviving for 5 years after treatment, and patients with stage 4 disease have a 60 per cent chance of surviving five years – impressive compared to the survival rates for other types of oral cancer where overall survival is 50 per cent over 5 years. [Cancer Research UK]

Cancer research UK is pushing for all mouth tumors to be tested to see if they are HPV positive, to assist with effective treatment of patients. “At the moment, it varies massively depending on what hospital you are in. We think it should be standard,” says Hazel Nunn.

Professor McGurk believes there is a simple explanation why men are more likely to have HPV in their mouths than women. “Women harbor the virus in their genitalia which provides a hospitable environment while the male penile area is a relatively hostile area for the virus to settle.”

One way to try and turn the tide would be to introduce a HPV vaccination for boys and girls before they become sexually active. Girls from the age of 12 in the UK have been offered vaccinations since 2008 against the two most common strains of HPV -16 and 18- which are linked to cervical cancer.

Boys are not offered the vaccine, but this should change, according to Professor Margaret Stanley, a virologist based at Cambridge University who believes that boys must be given the vaccine for HPV too from the age of 12 or 13.

‘Obviously cervical cancer is the big one but the other cancers – cancers of the anus and increasingly the tonsil and tongue – there is no screening for them and no way of detecting them until they are proper cancers and they are more common in men than in women.’

Hazel Nunn of Cancer Research UK points out that there is no evidence that vaccinating boys will help protect them from oral cancer. “It is theoretically possible but there have been no trials that had this as an end point. There is a danger that we get too far ahead of ourselves without evidence-based medicine.”

She insists that although HPV is a worrying factor, by far the most significant risks associated with mouth and throat cancers of all types are smoking and alcohol. “

November, 2016|Oral Cancer News|

We Now Know Exactly How Many DNA Mutations Smoking Causes

Every 50 cigarettes you smoke gives you one extra DNA mutation per lung cell.

large

Source: The Verge
Author: James Vincent

A common tactic for people trying to give up smoking is to quantify exactly how much damage — financial or physical — each cigarette or pack of cigarette does. How much does smoking cost you per month, for example, or how much shorter is your life going to be for each drag you take? Well, a new study into the dangers of smoking now lets us measure this damage right down to the number of mutations in your DNA.

A research team led by scientists from Los Alamos National Laboratory compared tissue samples from 1,063 non-smokers and 2,490 smokers, examining each individual’s DNA to look for mutations. They found that for every 50 cigarettes smoked, there is one extra DNA mutation for each cell in the lungs. Over the course of a year, this means that someone who smokes a pack a day (20 cigarettes) has 150 extra mutations per cell in the lung, 97 per larynx cell, 23 per mouth cell, 18 per bladder cell, and six per liver cell.

These changes to the cells aren’t dangerous in themselves, but each one has the potential to turn into a cancerous growth. “Smoking is like playing Russian roulette: the more you play, the higher the chance the mutations will hit the right genes and you will develop cancer,” Ludmil Alexandrov, the co-lead author of the study, told the New Scientist. “However, there will always be people who smoke a lot but the mutations do not hit the right genes.”

The reason for all these extra mutations is found in tobacco smoke — a substance that contains some 7,000 different chemicals, over 70 of which are known to cause cancer. How exactly different types of cell mutations lead to cancer is less clear, and the team from Los Alamos are hoping next to drill down further into this line of research and find out the probabilities that any individual DNA mutation will turn into cancer.

The good news for smokers, though, is that it’s never too late to quit. Although smoking causes regular DNA mutations, as soon as people give up cigarettes, the mutations stop too. One UK study from 2004 found that those who quit smoking at age 30 nearly eliminate the risk of dying prematurely, while those who quit at 50 halve it. For people trying to give up, those are certainly some more comforting odds.

 

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

November, 2016|Oral Cancer News|

The startling rise in oral cancer in men, and what it says about our changing sexual habits

Source: www.washingtonpost.com
Author: Ariana Eunjung Cha

Oral cancer is on the rise in American men, with health insurance claims for the condition jumping 61 percent from 2011 to 2015, according to a new analysis.

oc2

The most dramatic increases were in throat cancer and tongue cancer, and the data show that claims were nearly three times as common in men as in women during that same period with a split of 74 percent to 26 percent.

The startling numbers — published in a report on Tuesday by FAIR Health an independent nonprofit — are based on a database of more than 21 billion privately billed medical and dental claims. They illustrate both the cascading effect of human papillomavirus (HPV) in the United States and our changing sexual practices.

The American Cancer Society estimates that nearly 50,000 Americans will be infected this year, with 9,500 dying from the disease. In past generations, oral cancer was mostly linked to smoking, alcohol use or a combination of the two. But even as smoking rates have fallen, oral cancer rates have remained about the same, and researchers have documented in recent studies that this may be caused by HPV.

HPV infects cells of the skin and the membranes that lines areas such as the mouth, throat, tongue, tonsils, rectum and sexual organs. Transmission can occur when these areas come into contact with the virus. HPV is a leading cause of cervical, vaginal and penile cancers.

Surveys have shown that younger men are more likely to perform oral sex than their older counterparts and have a tendency to engage with more partners.

“These differences in sexual behavior across age cohorts explain the differences that we see in oral HPV prevalence and in HPV-related oropharyngeal cancer across the generations and why the rate of this cancer is increasing,” Gypsyamber D’Souza, an associate professor in the Viral Oncology and Cancer Prevention and Control Program at the Johns Hopkins Bloomberg School of Public Health, said at the time. The work was published in the Journal of Infectious Diseases.

In February, researchers at the American Association for the Advancement of Science meeting reported that men are not only more likely to be infected with oral HPV than women but are less likely to clear the infection. It’s not known why oral HPV is more aggressive in men.

oc1

HPV is an extremely common virus that has infected nearly 80 million, or one in four, people in the United States. Fortunately, the risk of contracting HPV can be greatly reduced by a vaccine. HPV has become a public health priority in recent years with dozens of countries recommending universal vaccination. The Centers for Disease Control and Prevention recommends that children get it at the age of 11 or 12, although they may get vaccinated as early as 9 years old. The CDC said earlier this month that young people who get it before the age of 15 need two doses rather than the typical three.

A CDC study has found that although fewer teenagers and young adults are having sex than in previous years, more are engaging in oral sex than vaginal intercourse under the assumption that it’s safer.

“However, young people, particularly those who have oral sex before their first vaginal intercourse, may still be placing themselves at risk of STIs or HIV before they are ever at risk of pregnancy,” the researchers wrote in the 2012 report.

October, 2016|Oral Cancer News|

Oral cancer in the crosshairs at San Antonio Dental School

Source: tpr.org
Author: Wendy Rigby

San Antonio researchers are working on a new therapy for a stealthy killer: oral cancer. Visits to the dentist are your number one protection against the disease. In a lab at the University of Texas Health Science Center at San Antonio, dental researcher Cara Gonzales, DDS, Ph.D., shared promising news on a new approach to healing.

“It was very exciting,” Gonzales said. “These patients have not had any new therapeutic options in 40 years.”

The discovery of a new gene that’s turned on in oral cancers gave Gonzales and her colleagues a new target at which to aim. It’s a gene that’s also found in lung cancers.

So-called nude mice are used in the oral cancer experiments. Webdt Rigby / Texas Public Radio

So-called nude mice are used in the oral cancer experiments.
Wendy Rigby / Texas Public Radio

Gonzales works in a sprawling space filled with lab equipment and cell lines used in many molecular biology projects. One of her research assistants brought in a cage of lab animals with some strange lumps on their backs.

“These are called nude mice because they don’t have a complete immune system,” Gonzales explained.

These mice are at the center of a successful experiment. First, scientists used human oral cancer cells to grow large tumors on the animals. They tried one oral cancer drug already on the market. Not much action. Then, they tried a lung cancer drug, also already approved by the Food and Drug Administration. Not that effective on its own. Finally, they used a combination of two drugs. What happened made the medical profession take notice.

“When we combined the two, then we saw a 50 percent reduction in the tumor volumes after 14 days,” Gonzales described.

That kind of success could help thousands of patients whose cancers aren’t caught until the later stage, patients like Paige Lewis of San Antonio who was only 35 when she got the results of a biopsy from her doctor.

“I walked in and she said the words I’ll never forget,” Lewis recalled. “‘Sweetie, it’s cancer.’”

Lewis had tried for a year to get various doctors and her dentist to examine and biopsy the strange spot under her tongue. But no one really thought she was at risk for the disease.

“I was told it’s most likely nothing because I’m young. I was only 35 years old. I was a female non-smoker, non-drinker,” Lewis said.

While smoking, drinking and age are big risk factors for oral cancer, so is the presence of the human papillomavirus in the body. Some cases, like Lewis’, are simply unexplained.

Since her cancer was so advanced, Lewis, a single mother of three children, faced a massive surgery and weeks of radiation. Paige still bears scars on her arm from a major surgery where doctors removed her tumor and rebuilt her tongue.

“They removed half of my tongue,” she described. “They harvested part of my arm in order to place a flap in my mouth. And then a part of my leg to cover part of my arm.”

Lewis spent 20 days in the intensive care unit. If her cancer had been detected earlier, or if doctors had the ability to shrink her tumor, her ordeal would have been less painful and less risky. Only slightly more than half of all oral cancer patients are alive five years after their treatment. Lewis is four years out.

U.T. Health Science Center researchers are trying to secure funding for human trials which may take place in San Antonio. The pills used in this new combination target tumors specifically, so patients would not suffer as many side effects as they do with conventional chemotherapy, side effects like hair loss and gastrointestinal issues.

Dr. Cara Gonzales’ oral cancer paper was published in the journal Oral Oncology.
“If we can find something that would treat these advanced tumors, we could potentially increase the survival rate of approximately 25 percent of all oral cancer patients,” Gonzales stated.

Lewis is coping well with the side effects of surgery and radiation, but it hasn’t been easy. “Cancer takes over your life during that period of time. And it affects every single person you know,” Lewis said. “All of this could have been avoided with an early diagnosis.”

An oral cancer screening at the dentist only takes two minutes, and checking for oral cancer should be part of a regular dental screening. Like Lewis and thousands of others, though, you may have to insist the hygienist or dentist examine your mouth, tongue and gums in detail. Having a medical professional look for signs and symptoms of the disease is still the best defense against oral cancer which claims an average of one American life every hour.

October, 2016|Oral Cancer News|