squamous cell carcinoma

Cancer survivor Byers driving to help others

Source: Standart.net
Author: Staff

Among the dozens of cars at this weekend’s ARCA race at Pocono Raceway, one will stand out. Not for the color scheme or the lines. For the decals.

When the No. 48 of Ricky Byers Racing rolls out onto the track, it won’t be sporting the usual array of auto parts or alcoholic beverage stickers. Byers’ red-and-black Ford Fusion will decorated for those who have made his dream a reality, the 90 or so people who have given the two-time throat cancer survivor a chance to fight back at the disease that nearly cost him his life.

“It’s the greatest feeling of my life,” Byers said. “Those are the people who support what I’m doing, believe in what I’m doing and they’ve given me a chance to go out there and race for cancer.”

Byers has been around motorsports long as he can remember. His dad was a lifelong racer and little Ricky spent his early days racing motocross and go-carts before moving on to full-sized cars. The Birmingham, Ala., native went on to race for 20 years, winning five different track championships in Pony, Super Pony, Dwarf and Late Model cars.

But when Byers was 33, his career took a back seat to something much bigger: a race for his life.

Byers had lost his voice and wasn’t able to get it back for weeks, but six different doctors told him it just was a sinus infection, that he had nothing to worry about. Then came the real diagnosis: stage one squamous cell carcinoma.

The good news was Byers’ throat cancer was in the early stages and treatable. And, after 35 radiation treatments over seven weeks, Byers was told he was cancer-free.

Not long afterward, however, Byers started feeling weak. Doctors told him the cancer was gone and he was making himself sick by worrying. But Byers kept getting worse, eventually so bad he could barely eat or get out of bed.

Eventually, doctors discovered the problem. The cancer was back, this time in stage four.

“I was physically going downhill when they found it again,” Byers said. “In a couple of months, I was going to be dead.”

Faced with the same disease that had recently killed 49-year-old NASCAR driver Bobby Hamilton Sr., Byers was terrified but not ready to give in.

At first, the doctors said he’d need a laryngectomy, meaning he’d spend the rest of his life with a tube in his throat, speaking through a handheld device. Unwilling to accept the loss of his voice, Byers did some research and found a specialist in Philadelphia who said he could remove the cancer with a less drastic procedure.

Byers lost his left vocal chord, part of the right and had his voice box reconstructed. He was cut from ear to ear, had a tracheostomy tube in his throat for two months, a feeding tube stuck in his side for three. He had to learn how eat, swallow, talk all over again.

A harrowing ordeal, but Byers was alive — and still had a voice.

“I don’t talk the best, but I do talk,” he said.

Now that voice, gravelly and barely above a whisper, has been spreading the message for cancer patients across the country.

Byers returned to work about six months after surgery and later rode in the Lance Armstrong Tour of Hope in Washington, D.C. Not long after that, Byers’ story got attention and people from all over the country started contacting him, looking for help in finding cancer treatments and better doctors, with finances and travel.

Pretty soon, Byers was spending nearly every non-working, non-sleeping hour helping people, often at his own expense.

“I paid it out of my pocket and I couldn’t afford to do that anymore,” said Byers, who’s in the swimming pool business.

That’s when he decided to go back to racing. Not for himself. For all the people he’s trying to help.

Byers created his own racing team last year with a purpose of donating all of its winnings to cancer research. So, despite the limitations of his voice, Byers hit the pavement, the phone and the Web, spreading the word of his cause, convincing sponsors to join in.

Just as when he was fighting for his life, Byers never gave up.

“One of the things that impressed me the most when I met Ricky for the first time was that I knew he was genuine in what he was going to do,” said Charles Robinson, the host of Burning Rubber Radio in southeastern Kentucky who has helped Byers promote his program. “He was going to do it regardless. He was going to use any means to get the word out.”

Still, it hasn’t been easy.

The 40-year-old Byers had a deal lined up to race the entire season, but the sponsor died of a stroke just days before the opener at Daytona in February and the money fell through. He’s spent the five months since working on deals — from donated products to sponsorship money — trying to convince people his cause is worthwhile.

Byers finally pulled enough together, getting just enough money to run at Pocono. So on Saturday, the driver who’s helped so many cancer patients will hit the pavement for the first time in seven years, the support of those 90 decals pushing him along to help so many more.

“We’re about $6,000 short, but we’re going,” he said. “If we can get the word out, get a sponsor to come on full-time, we could raise millions of dollars for cancer research.”

He’s already off to a good start.

July, 2010|Oral Cancer News|

Head and neck cancer among lifelong never-smokers and ever-smokers: matched-pair analysis of outcomes after radiation therapy

Source: HighWire Medline
Author: Am J Clin Oncol

From the Departments of *Radiation Oncology and daggerOtolaryngology-Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, CA.

PURPOSE:: An increasing proportion of patients with head and neck cancer have no history of smoking. The purpose of this analysis was to compare the clinical outcomes between patients without a history of smoking (never-smokers) and those with a previous history of smoking (ever-smokers) treated by radiation therapy. METHODS AND MATERIALS:: Seventy patients with newly diagnosed squamous cell carcinoma of the oropharynx or oral cavity without a previous history of smoking were matched to a control ever-smoker with a positive tobacco history (>10 pack-years) based on age, gender, ethnicity, Karnofsky Performance Status, primary tumor site, disease stage, primary treatment, radiation dose, and start date. Outcome was compared using Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer radiation toxicity criteria. RESULTS:: With a median follow-up of 33 months, lifelong never-smokers had an increased 3-year overall survival (86% vs. 69%), disease-free survival (82% vs. 65%), and local-regional control (85% vs. 70%) compared with the ever-smoker control population (P < 0.05, for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of grade 3+ complications was also significantly lower among never-smokers compared with ever-smokers (10% vs. 29%, P = 0.01). CONCLUSIONS:: Prognosis differed significantly between never-smokers and ever-smokers with head and neck cancer treated by radiation therapy. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.

July, 2010|Oral Cancer News|

New strategies in head and neck cancer: understanding resistance to epidermal growth factor receptor inhibitors

Source: HighWire
Author: Staff

The epidermal growth factor receptor (EGFR) is a validated target in squamous cell carcinoma of the head and neck (HNSCC). However, despite high expression of EGFR in these cancers, EGFR inhibitor monotherapy has only had modest activity. Potential mechanisms of resistance to EGFR-targeted therapies involve EGFR and Ras mutations, epithelial-mesenchymal transition, and activation of alternative and downstream pathways. Strategies to optimize EGFR-targeted therapy in head and neck cancer involve not only the selection for patients most likely to benefit but also the use of combination therapies to target the network of pathways involved in tumor growth, invasion, angiogenesis, and metastasis.

June, 2010|Oral Cancer News|

Human papillomavirus-active head and neck cancer and ethnic health disparities

Source: Medical College of Georgia
Authors: PM Weinberger, MA Merkley, SS Khichi, JR Lee, A Psyrri, LL Jackson, and WS Dynan

OBJECTIVES/HYPOTHESIS:

Mortality for black males with head and neck squamous cell carcinoma (HNSCC) is twice that of white males or females. Human papillomavirus (HPV)-active HNSCC, defined by the concurrent presence of high-risk type HPV DNA and host cell p16(INK4a) expression, is associated with decreased mortality. We hypothesized that prevalence of this HPV-active disease class would be lower in black HNSCC patients compared to white patients. STUDY DESIGN:: Multi-institutional retrospective cohort analysis. METHODS:: Real-time polymerase chain reaction was used to evaluate for high-risk HPV DNA presence. Immunohistochemistry for p16(INK4a) protein was used as a surrogate marker for HPV oncoprotein activity. Patients were classified as HPV-negative (HPV DNA-negative, p16(INK4a) low), HPV-inactive (HPV DNA-positive, p16(INK4a) low), and HPV-active (HPV DNA-positive, p16(INK4a) high). Overall survival and recurrence rates were compared by Fisher exact test and Kaplan-Meier analysis. RESULTS:: There were 140 patients with HNSCC who met inclusion criteria. Self-reported ethnicity was white (115), black (25), and other (0). Amplifiable DNA was recovered from 102/140 patients. The presence of HPV DNA and the level of p16(INK4a) expression were determined, and the results were used to classify these patients as HPV-negative (44), HPV-inactive (33), and HPV-active (25). Patients with HPV-active HNSCC had improved overall 5-year survival (59.7%) compared to HPV-negative and HPV-inactive patients (16.9%) (P = .003). Black patients were less likely to have HPV-active disease (0%) compared to white patients (21%) (P = .017). CONCLUSIONS:: The favorable HPV-active disease class is less common in black than in white patients with HNSCC, which appears to partially explain observed ethnic health disparities. Laryngoscope, 2010.

June, 2010|Oral Cancer News|

Combining surgery for removal of tissue and reconstruction

Source: MedicalNewToday
Author: Staff

Restoring people’s health and returning them to their daily lives as soon as possible is the goal following any surgery. When a person’s ability to eat and speak is affected, as with cancer in the mouth, surgery is particularly disruptive, creating a greater challenge. A one-step surgery can remove cancerous tissue and reconstruct bone and teeth functionality immediately, positively impacting the patient’s quality of life.

A case study in the June issue of the Journal of Oral Implantology describes a one-step surgery performed on a 65-year-old woman with squamous cell carcinoma. A two-year follow-up of this patient showed the one-step procedure to be successful.

Typically, ablative surgery is first performed to remove cancerous bone and tissue. The surgery is followed by radiotherapy, and often tooth loss. Reconstructing the jaw and placing a dental implant at this point are taxing due to the side effects of radiotherapy and poor patient tolerance.

The procedure outlined in this article permitted an impression to be taken immediately after the jaw reconstruction and implant installation during the initial surgery. A rigid prosthesis was fabricated and screw-secured to the implants 48 hours later. Complementary radiotherapy began six weeks following the surgery and implant. The prosthesis was modified as necessary six months after completion of the radiotherapy.

The advantages of single surgery include a reduced risk of osteonecrosis-disease in the jawbone-which can occur with postradiation surgery. A single surgery also can decrease the need for hyperbaric oxygen therapy.

The authors emphasize that this one-step surgery is possible because it respects the concepts of basal implantology. “Absolute primary implant stability and fabrication of a highly rigid prosthesis are essential from the outset,” they conclude.

Full text of the article, “Immediate Functional Loading of an Implant-Supported Fixed Prosthesis at the Time of Ablative Surgery and Mandibular Reconstruction for Squamous Cell Carcinoma,” Journal of Oral Implantology, Volume 36, Issue 1, 2010, is available here.

About Journal of Oral Implantology

The Journal of Oral Implantology is the official publication of the American Academy of Implant Dentistry and of the American Academy of Implant Prosthodontics. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers, and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry.

Source
Allen Press Publishing Services

June, 2010|Oral Cancer News|

Accelerated schedule of radiotherapy for HNSCC is more effective than conventional fractionation

Source: Lancet Oncology 4-2010
Author: Staff

An accelerated schedule of radiotherapy for squamous-cell carcinoma of the head and neck (HNSCC) is more effective than conventional fractionation, and since it does not require additional resources it might be a suitable new global standard baseline treatment for radiotherapy of HNSCC, according to a study published online April 9 in the Lancet Oncology.

The findings of the study called the International Atomic Energy Agency (IAEA) trial showed that accelerated radiotherapy (increasing the number of treatments from five to six a week) prevented local disease recurrence and improved disease-free survival, with no increase in late radiation-induced side-effects, in HNSCC patients in resource-limited settings.

Jens Overgaa
rd, MD, chief of the experimental clinical oncology department at Aarhus University Hospital in Denmark and international colleagues from Asia, Europe, the Middle East, Africa and South America recruited 908 patients with HNSCC of the larynx, pharynx and oral cavity who were eligible for curative radiotherapy from Jan. 6, 1999 to March 31, 2004.

Patients were randomly assigned to an accelerated schedule of six fractions of radiotherapy per week of 2 Gy (458 patients) or to a conventional radiotherapy schedule of five fractions per week of 2 Gy (450 patients), up to a total dose 66-70 Gy in 33-35 fractions, according to Overgaard and colleagues.

The median treatment time was 40 days in the accelerated group and 47 days in the conventional group. Five year locoregional control was 12 percent better in patients given the accelerated regimen (42 percent) compared with those given the conventional regimen (30 percent), according to Overgaard and colleagues.

Additionally, the investigators found that disease-free survival was significantly greater for patients in the accelerated regimen group than in the conventional treatment group (50 vs. 40 percent).

Acute morbidity in the form of confluent mucositis was noted in 45 patients by the investigators in the accelerated group and 22 patients in the conventional group. Also, severe skin reactions were noted in 87 patients in the accelerated group and 50 patients in the conventional group. However, there were no significant differences in late radiation side-effects, wrote Overgaard and colleagues.

The accelerated schedule is therefore more effective than conventional fractionation, and since it does not require additional resources it might be a suitable new international standard of treatment, concluded Overgaard and colleague

April, 2010|Oral Cancer News|

Small atypical cervical nodes detected on sonography in patients with squamous cell carcinoma of the head and neck

Source: Journal of Ultrasound in Medicine
Author: Staff

Probability of Metastasis

Heung Cheol Kim, MD, Dae Young Yoon, MD, Suk Ki Chang, MD, Heon Han, MD, So Jung Oh, MD,Jin Hwan Kim, MD, Young-Soo Rho, MD, Hwoe Young Ahn, MD, Keon Ha Kim, MD andYoon Cheol Shin, MD

Department of Radiology, Kangwon National University College of Medicine, Chuncheon, Korea (H.C.K., H.H.); Department of Radiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea (H.C.K.); Departments of Radiology (D.Y.Y., S.K.C.) and Otorhinolaryngology and Head and Neck Surgery (S.J.O., J.H.K., Y.-S.R., H.Y.A.), Ilsong Memorial Institute of Head and Neck Cancer, and Department of Thoracic Surgery (Y.C.S.), Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea; and Department of Radiology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea (K.H.K.).

Address correspondence to Dae Young Yoon, MD, Department of Radiology, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong, Kangdong-gu, Seoul 134-701, Korea. E-mail: evee0914@chollian.net

Objective. The purpose of this study was to assess the probability of metastasis of small atypical cervical lymph nodes detected on sonography in patients with squamous cell carcinoma (SCC) of the head and neck. Methods. We reviewed, retrospectively and blindly, sonographic findings of 148 patients (118 men and30 women; mean age, 58.2 years) who underwent curative neck dissection. Each lymph node was classified by using a 4-point scale: 1, definitely benign; 2, indeterminate (small [short-axis diameter <10 mm for levels I and II and <7 mm for levels III–VI] atypical node); 3, definitely metastatic; and 4, large (>3-cm) metastatic. Lymph nodes were considered atypical if they met at least 1 of the following criteria: a long- to short-axis diameter ratio of less than 2.0, absence of a normal echogenic hilum, and heterogeneous echogenicity of the cortex. These results were verified, on a level-by-level basis, with histopathologic findings.Results. Small atypical nodes were found on sonography in 63 cervical levels of 48 patients, of which 18 (28.6%) were proved to have metastatic nodes. Theprobability of metastasis was significantly higher with than without a large (>3-cm) ipsilateral metastatic node (0.50 versus 0.20; P = .038) and marginally higher with than without an ipsilateral metastatic node (0.41 versus 0.16; P = .061) but not significantly associated with the T stage of the primary tumor (P = .238) or the presence of an ipsilateral tumor (P = .904). Conclusions. Metastasis was encountered in about 30% of small atypical cervical nodes on sonography in patients with SCC of the head and neck. Our results indicate that small atypical nodes must be interpreted with consideration of metastatic nodes in the ipsilateral neck.

Key Words: head and neck • lymph node • metastasis • sonography • squamous cell carcinoma

Abbreviations: L/S, long- to short-axis diameter • SCC, squamous cell carcinoma

April, 2010|Oral Cancer News|

Cancer survivor tells his experience with smokeless tobacco

Source: Lifestyles
Author: Nicole Printz

Just like the trucks on every corner in Abilene, rings on back jean pockets are a common sight.

Gruen Von Behrens, who visited Abilene High School on Wednesday, knows all about smokeless tobacco. He began with snuff at 13 years old.

He asked the packed high school auditorium if the students knew someone who smoked cigarettes. A sea of hands rose at the question, with almost the same number rising for his next question – did they know someone who used smokeless tobacco?
“I think about half our school smokes or uses smokeless tobacco,” Dynae Whiteley, a junior, said. “I mean, not to get anyone in trouble or anything.”

“I have friends and relatives that use tobacco,” said senior Matt Bowers. “I think smokeless tobacco is safer because the use of cigarettes affects more people through second-hand smoke. Smokeless tobacco only affects that person.”

Collin Sexton, a sophomore, also thought smokeless tobacco would be safer than smoking.

Dynae Whiteley and Paige Piper, both juniors, thought all tobacco was “equally bad.”
According to the Communities That Care 2009 survey, 23.1 percent of Dickinson County students sixth through 12th grade have used smokeless tobacco, and 27.4 percent had smoked a cigarette. Almost half of all seniors in Dickinson County had smoked a cigarette at least once. This statistics are almost double the state average.
Von Behrens, one of the eight members of the National Spit Tobacco Education Program’s speakers bureau, continued his life story. He said “not to toot my own horn, but I was hot,” a popular kid in school who played baseball. His future was bright. Fellow students looked up to him, and he “never had trouble finding a date.”

Blond with sparkling blue eyes, five foot ten inches tall and 190 pounds, the high school junior had it all. He had continued to use smokeless tobacco.

“I grew up in a rural area,” Von Behrens explained. He said his relatives, friends and older people in the community all used smokeless tobacco.

“Tobacco is a highly addictive drug,”
Von?Behrens said. “Nicotine is more addictive than crack and heroin combined.”

He found a white spot on his tongue when he was 16. He had begun drooling, having difficulty speaking and eating. It was cancer. Within six months the squamous cell carcinoma split his tongue.

“I didn’t want to tell my mother I was sick because of a choice I made to put this crap in my mouth,” Von Behrens said. His mother, a surgical nurse, made a dental appointment for him. Von Behrens had told his mother that his wisdom teeth were coming in to avoid more questions about his mouth.

“Right before he [the dentist] slapped that mask on my mouth to remove my wisdom teeth, I grabbed his hand and said ‘Wait,’” Von Behrens said. He told the doctor he had cancer, and one look in his mouth confirmed his self-diagnosis.

“Not only did I hurt myself, but I devastated that woman. I listen to people say that smokeless tobacco only hurts yourself, but I saw the pain on my mom’s face,” Von Behrens said. He had an 80 percent chance of dying within the first five years after the diagnosis.

One week after the dentist appointment, Von Behrens had surgery. During the 13 hour procedure, doctors cut off half his tongue, split the skin of his throat from ear to ear and peeled it back to search for other cancerous areas. He began radiation, which damaged the healthy skin cells while saving his life.

“My skin was so tender that if I scratched it, my skin would peel off. My mouth was blistered. It hurt to drink water,” Von Behrens said. “At the age of 19, I had to have all my teeth pulled because my gums had been damaged during the radiation.”

He had surgery to remove his mandible, and doctors reconstructed a replacement jawbone from his fibula. He pulled up his jeans to show a long scar on his left calf. He explained that doctors also removed a large section of skin from his right thigh to put on his lower face. To help his thigh heal, doctors removed sections of skin from his legs to graft on his thigh.

“Imagine holding your hand above a candle, and the flame makes your skin hot, but you can’t pull your hand away. Now your skin is blistering, but you still can’t pull your hand away. The flame is burning a hole in your hand, but you can’t pull your hand away,” Von Behrens said. “That is what my legs felt like after those surgeries.”

“Doctors are still trying to put my face back together because of what I did – using spit tobacco when I was your age,” Von Behren said. “I don’t like what I’ve been through. I hate the way my face looks and the way my voice sounds. I cringe at the thought of another surgery. I don’t feel sorry for myself – I thank God that I’m alive.”
After 34 surgeries, his face is still distorted. He will be going into surgery once more to try to reconstruct the lower part of his face.

“They’re going to insert skin expanders and put in implants.?They say that when they’re done I’ll look like before,”  Von?Behrens explained. “These surgeries have cost three million dollars – why can’t they make me look hot? Like Brad Pitt or something,” he said jokingly.

“I didn’t come here today to tell you that you’re a bad person if you use, or if your parents do,” Von Behrens said. “I would be a hypocrite if I said that. I just want to give you an opportunity to make a better choice, because I know that if someone who looked like this had come to my school when I was your age, I would have never touched the stuff.”

“I lost my face because I had an addiction,” he said solemnly.

According to the Center for Disease Control and Prevention, nicotine is a psychoactive drug that is as addictive as heroin, cocaine or alcohol.
Smokeless tobacco had been considered safer than cigarette smoking.
“Smokeless tobacco use is 98 percent safer than cigarette smoking,” a 1995 report by Dr. Brad Rodu and Dr. Phillip Cole states.

However, a 2003 testimony by Richard Carmona, M.D., M.P.H., and F.A.C.S., Surgeon General of the U.S. Public Health Service states:
“I cannot conclude that the use of any tobacco product is a safer alternative to smoking. Smokeless tobacco is not a safe alternative to cigarettes. Smokeless tobacco does cause cancer. The National Toxicology Program of the National Institute of Health continues to classify smokeless tobacco as a known human carcinogen.”
According to the National Cancer Institute, chewing tobacco and snuff contain 28 carcinogens.

“All tobacco, including smokeless tobacco, contains nicotine, which is addictive. The amount of nicotine absorbed from smokeless tobacco is three to four times the amount delivered by a cigarette. Nicotine is absorbed more slowly from smokeless tobacco than cigarettes…[but] stays in the bloodstream for a longer time.”

Tobacco also contains formaldehyde, arsenic and nickel, according to the National Cancer Institute.

“In large doses, nicotine is a poison and can kill by stopping a person’s breathing muscles,” the American Cancer Society’s website states.

A brochure with tips for quitting is available at www.nidcr.nih.-gov/oralhealth/topics/spittobacco/spittobaccoaguideforquitting.htm.

The Kansas Quitline  for young adults is available by calling 1-866-526-7867 or visiting www.kstask.org/quitline. Adults can call 1-800-784-8669.

Von Behren used smokeless tobacco for four years. He was  only using one-half to three-fourths a can per day. Doctors say that even if he had gone to the hospital after noticing the white spot, he would probably have had the same surgeries.

“That white spot, that so many smokeless tobacco users have, is 60 percent more likely to turn into cancer,” Von Behrens said.

The high school students were noticeably moved by Von Behrens’ speech.

“Oh yeah, I think he’s changed how everyone thinks about smokeless tobacco,” Collin Sexton said.

“It was a big eye opener,”?Matt Bowers added.

“We didn’t know how bad the surgeries were,” Dynae Whiteley said.

“Just overall how terrible it was,” Paige Piper said in agreement.

“They [tobacco companies] try to make cigarettes and tobacco look cool,” Von Behren said.

“How cool does this look?” he asked, pointing at his face.

March, 2010|Oral Cancer News|

Introducing OraRisk HPV salivary diagnostic test by OralDNA Labs

Source: RDHmag
Author: Staff

NASHVILLE, Tennessee–OralDNA Labs , a leader in advancing wellness in dentistry through salivary diagnostics and a subsidiary of Quest Diagnostics, recently introduced a OraRisk HPV test.

The test is a noninvasive, screening tool to identify the type(s) of oral human papillomavirus (also called HPV). Oral HPV is a mucosal viral infection that is a known risk factor for oral, head, and neck cancers.

High-risk types of HPV that persist present an increased risk for cancers in these regions. This test will provide the dental clinician with the ability to establish risk for HPV-related cancers of the oral, head, and neck regions, and determine appropriate referral and monitoring conditions.

Squamous cell carcinoma of the head and neck, which can be found in the oral cavity, tongue, tonsils, oropharynx, and larynx, affects approximately 40,000 individuals in the United States each year.

The most common symptoms of SCCHN include sore throat, earache, hoarseness–and often–enlarged lymph nodes in the neck. Early detection of oral HPV presents an important opportunity to detect those at risk for these types of cancers before symptoms appear.

According to OralDNA Labs’ Medical Director Ronald C. McGlennen, MD, “The availability of the OraRisksm HPV test marks an important and timely advance in oral diagnostics, because the at-risk profile for oral cancer is rapidly changing.”

The use of tobacco and heavy alcohol consumption has traditionally been considered to be the primary risk factor for SCCHN, but an alarming number of new cases are being diagnosed each year among persons who do not fit the tobacco and alcohol user profile.

“In fact, a new high-risk profile for SCCHN has emerged,” explained Dr. McGlennen. “Recent research studies have identified several high-risk strains of the human papillomavirus, especially the variant known as HPV-16, as potential etiologic agents in the development of SCCHN.”

It is now estimated that 50% of all diagnosed cases of oral cancer in the United States are attributed to the HPV virus. It has been well documented that HPV transmission is associated with sexual contact with the risk of contracting HPV higher among those with multiple sex partners.

“Oral HPV is a silent, serious infection that can now be detected and closely monitored by the dental professional,” stated OralDNA Labs’ Chief Dental Officer, Thomas W. Nabors, DDS.

“Specifically, the laboratory report derived from the OraRisksm HPV salivary diagnostic test helps dental professionals identify the specific types(s) of oral HPV present, as well as the associated risk profile for each type of HPV variant detected in the patient’s oral cavity.”

Strong candidates for the OraRisksm HPV test include patients with the following profile characteristics:

* Sexually active
* Family history of oral cancer
* Signs and symptoms of oral cancer
* Traditional risk factors for oral cancer
* Suspicious oral lesions

Salivary diagnostic tests from OralDNA Labs are fundamental elements of a patient’s wellness plan. OraRisksm HPV is the third molecular salivary DNA test that OralDNA Labs has introduced to the dental profession in less than a year. In 2009, the company launched two tests for periodontal disease named MyPerioPath and MyPerioID PST.

Specifically, MyPerioPath identifies the type and concentration of specific perio-pathogenic bacteria that are known to cause periodontal disease and helps support clinicians with better risk assessment and personalized treatment options for more predictable patient outcomes.

MyPerioID PST identifies an individual’s genetic susceptibility to periodontal disease and enables clinicians to establish which patients are at increased risk for more severe periodontal infections due to an exaggerated immune response.

March, 2010|Oral Cancer News|

Serum prognostic markers in head and neck cancer

Source: Clincancerres

  1. François Meyer1,
  2. Élodie Samson1,2,
  3. Pierre Douville1,
  4. Thierry Duchesne2,
  5. Geoffrey Liu3 and
  6. Isabelle Bairati1

  1. Authors’ Affiliations:1Laval University Cancer Research Center and 2Département de Mathématiques et Statistique, Laval University, Quebec, Quebec and 3Medical Biophysics Department, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Ontario, Canada
  1. Corresponding Author:
    François Meyer, Cancer Research Center, Laval University, CHUQ, HDQ, 11, Cote Du Palais, Quebec, Quebec, G1R 2J6 Canada. Phone: 418-525-4444-15581; Fax: 1-418-691-2970; E-mail: francois.meyer@chuq.qc.ca.

Abstract

Purpose: Recognized prognostic factors do not adequately predict outcomes of head and neck cancer (HNC) patients after their initial treatment. We identified from the literature nine potential serum prognostic markers and assessed whether they improve outcome prediction.

Experimental Design: A pretreatment serum sample was obtained from 527 of the 540 HNC patients who participated in a randomized controlled trial. During follow-up, 115 had a HNC recurrence, 110 had a second primary cancer (SPC), and 216 died. We measured nine potential serum prognostic markers: prolactin, soluble interleukin-2 (IL-2) receptor-α, vascular endothelial growth factor, IL-6, squamous cell carcinoma antigen, free β-human choriogonadotropin, insulin-like growth factor-I, insulin-like growth factor binding protein-3, and soluble epidermal growth factor receptor. Cox regression was used to identify a reference predictive model for (a) HNC recurrence, (b) SPC incidence, and (c) overall mortality. Each serum marker was added in turn to these reference models to determine by the likelihood ratio test whether it significantly improved outcome prediction. We controlled for the false discovery rate that results from multiple testing.

Results: IL-6 was the only serum marker that significantly improved outcome prediction. Higher levels of IL-6 were associated with a higher SPC incidence. The hazard ratio comparing the uppermost quartile to the lowest quartile of IL-6 was 2.68 (95% confidence interval, 1.49-4.08). IL-6 was also associated with SPC-specific mortality but not with mortality due to other causes. No marker improved outcome prediction for cancer recurrence or overall mortality.

Conclusions: IL-6 significantly improves outcome prediction for SPC in HNC patients. Clin Cancer Res; 16(3); 1008–15

January, 2010|Oral Cancer News|