Cancer ‘vaccine’ shown to be effective in small trial

Source: www.upi.com
Author: Dennis Thompson, HealthDay News

A new method of brewing a cancer vaccine inside a patient’s tumor could harness the power of the immune system to destroy the disease, researchers report.

Immune stimulants are injected directly into a tumor, which teaches the immune system to recognize and destroy all similar cancer cells throughout the body, said senior researcher Dr. Joshua Brody. He is director of the Lymphoma Immunotherapy Program at the Icahn School of Medicine at Mount Sinai in New York City.

“We’re injecting two immune stimulants right into one single tumor,” Brody said. “We inject one tumor and we see all of the other tumors just melt away.”

Eight out of 11 lymphoma patients in a small, early clinical trial experienced partial or complete destruction of the tumor that received the initial injection, according to the report published April 8 in the journal Nature Medicine.

The vaccine also halted overall cancer progression in six patients for three to 18 months, and caused significant regression or actual remission in three patients, the investigators found.

The results were solid enough that the research team is expanding its next clinical trial to include lymphoma, breast, and head and neck cancer patients, Brody said. That trial started in March.

Prior efforts at unleashing the immune system to fight cancer have focused on T-cells, which Brody calls the “soldiers” of the immune army because they directly attack harmful invaders in the body.

Drugs called checkpoint inhibitors help T-cells identify cancer cells as the bad guys and kill them off.

“We call them the ‘Jimmy Carter’ medicines because that’s what Jimmy got when he had very advanced-stage melanoma,” Brody said.

But the checkpoint inhibitors have typically only been able to help about one in five cancer patients significantly, “so there’s lots of room for improvement,” he added.

This new vaccine approach focuses on dendritic cells, which Brody calls the “generals” of the immune system’s army. Dendritic cells guide the response of T-cells to fight off invaders.

“We’re trying to mobilize these immune generals to tell the soldiers what to do,” Brody said.

Patients first received nine daily injections of an immune stimulant intended to “recruit” dendritic cells by teaching them how to recognize cancerous cells, the study authors said.

The patients then received eight injections of a second stimulant that “activates” the dendritic cells, prompting them to instruct T-cells to hunt and destroy the now revealed cancer cells in the body.

Essentially, the method turns the injected tumor into a cancer vaccine factory, the researchers explained.

The approach differs from traditional vaccines for the flu or measles because those are preventive, teaching the body beforehand how to fight off an infectious disease, Brody pointed out.

This vaccine is therapeutic. “We’re trying to teach the immune system to get rid of the thing even after you’ve already got the problem,” he said.

Lab tests involving mice show that this vaccine approach could be at least three times more powerful if combined with checkpoint inhibitors, Brody added.

Because of this, patients in the new trial will receive both the vaccine and checkpoint inhibitors, the researchers said.

Susanna Greer, scientific director of clinical cancer research and immunology for the American Cancer Society, said that “priming” dendritic cells inside a person’s tumor to produce the best anti-tumor immune response “suggests a promising immunotherapy strategy.”

“Additional human studies are warranted to confirm these findings,” Greer said.

Dr. Catherine Diefenbach, director of clinical lymphoma at the NYU Langone Perlmutter Cancer Center in New York City, said the vaccine approach is “novel and extremely interesting,” and could help explain why checkpoint inhibitors usually don’t help patients with non-Hodgkin lymphoma.

However, she noted that really only three of the 11 patients in the initial clinical trial had truly meaningful responses to the vaccine.

“These are indolent lymphoma patients,” said Diefenbach, an expert for the American Society of Clinical Oncology. “The fact there was stable disease doesn’t really mean anything because these cancers don’t grow fast.”

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April, 2019|Oral Cancer News|

How does alcohol compare with tobacco in terms of cancer risk?

Source: rocklandregister.com
Author: Rockland Staff

Everyone knows, these days, about the cancer risks associated with smoking cigarettes. Perhaps not as many understand that drinking alcohol also poses some elevated risk for developing cancer. A new study, however, has compared and quantified these risks in a new report suggesting that drinking a single bottle of wine per week can bear the equivalent cancer risk of at least five cigarettes.

Study author Dr. Theresa Hydes comments, “It is well-established that heavy drinking is linked to cancer of the mouth, throat, voice box, gullet, bowel, liver, and breast. Yet, in contrast to smoking, this is not widely understood by the public.”

According to the National Cancer Institute, data shows there are “clear patterns” related to alcohol consumption and the development of several types of cancer: liver cancer, colorectal cancer, esophageal cancer, breast cancer, and head and neck cancer. Essentially, the more you drink (both acutely and cumulatively), the higher your risk for developing cancer. However, the study also suggest that even very light drinks (one or fewer drinks per day, or up to 7 per week) have about the same moderately elevated risk as binge drinkers (sporadic drinking of at least four servings in one session).

From this data, then, a British team of researchers from University of Southampton, Bangor University, and the University Hospital Southampton NHS Foundation Trust investigated the data, particularly in how alcohol consumption might compare against smoking.

Analyzing data taken from Cancer Research UK—regarding lifetime cancer risk across the general population—and data taken from cancer patients linked specifically to tobacco or alcohol, they calculated the likelihood for developing cancer among men and women. They found that out of 1,000 non-smoking men who drank one bottle of wine for week, at least 10 more would develop cancer in their lifetime. For women, the number was 14. This is the equivalent of smoking 5 to 10 cigarettes per week, respectively; and, keep in mind, it is an estimate.

Dr. Hydes goes on to say, “We hope that by using cigarettes as the comparator we could communicate this message more effectively to help individuals make more informed lifestyle choices. We must be absolutely clear that this study is not saying that drinking alcohol in moderation is any way equivalent to smoking. Our finds relate to lifetime risk across the population.”

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April, 2019|Oral Cancer News|

April is Oral Cancer Awareness Month: Self-exams, early detection can save lives

Source: www.prnewswire.com
Author: press release

Because early detection of oral cancer offers a greater chance of a cure, the American Association of Oral and Maxillofacial Surgeons (AAOMS) is reminding the public during Oral Cancer Awareness Month of the importance of performing monthly self-exams.

AAOMS promotes self-exams and screenings every April with the Oral Cancer Foundation, which predicts about 53,000 new cases of oral cancer will be diagnosed in 2019 in the United States – leading to more than 9,000 deaths.

“A monthly self-exam takes only minutes and could potentially save your life,” said AAOMS President A. Thomas Indresano, DMD, FACS. “If done on a regular basis, you’re increasing the chances of identifying changes or new growths early. The survival rate for oral cancer is between 80 and 90 percent when it’s found at early stages of development.”

Oral and maxillofacial surgeons (OMSs) encourage a six-step oral cancer self-exam that involves looking and feeling inside the mouth for suspicious sores and feeling the jaw and neck for lumps. Using a bright light and a mirror:

  1. First remove any dentures.
  2. Look and feel inside the lips and the front of the gums.
  3. Tilt the head back to inspect and feel the roof of the mouth.
  4. Pull the cheek out to inspect it and the gums in the back.
  5. Pull out the tongue and look at its top and bottom.
  6. Feel for lumps or enlarged lymph nodes in both sides of the neck, including under the lower jaws.

Oral cancer symptoms may include one or more of the following if they are persistent and not resolving:

  • Red, white or black patches in the soft tissue of the mouth.
  • A sore in the mouth that fails to heal within two weeks and bleeds easily.
  • An abnormal lump or hard spot in the mouth.
  • A painless, firm, fixated mass or lump felt on the outside of the neck that has been present for at least two weeks.
  • Difficulty in swallowing, including a feeling food is caught in the throat.
  • Chronic sore throat, hoarseness or coughing.
  • A chronic earache on one side.

The risk factors for oral cancer include smoking and tobacco use, alcohol consumption and the human papillomavirus (HPV).

“About 25 percent of oral cancer patients have no known risk factors,” Dr. Indresano said. “It’s important that everyone perform a monthly self-exam. And if you have any of the symptoms for more than two weeks, promptly contact an oral and maxillofacial surgeon. OMSs are experts in diagnosing and surgically treating oral cancer.”

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April, 2019|Oral Cancer News|

The HPV Vaccine Is Already Dramatically Lowering Rates of Cervical Disease

Source: Gizmodo
Date: 04/03/19
Author: Ed Cara

A new study out Wednesday in the BMJ is the latest to showcase even the short-term benefits of the human papillomavirus (HPV) vaccine. It found that the routine vaccination of preteen girls in Scotland, starting in 2008, led to drastically lower rates of cervical disease by the time the girls turned 20. That included conditions known to raise the risk of cervical cancer later on in life.

There are over 100 different types of HPV that regularly infect humans. Most types cause no symptoms at all, while some can cause annoying but harmless warts on our hands, feet, or genitals, depending on where they like to call home. High-risk HPV types, however, linger in the cells that line the surfaces of our body, triggering changes that can eventually turn them cancerous. These HPV types account for nearly all cases of cervical cancer, as well as a substantial proportion of cancers in the mouth, throat, anus, and penis.

We’ve had a vaccine available for two of the most common high-risk types of HPV since 2006, when it was at first recommended only for teen girls. Over the years, the window of opportunity for getting the vaccine has expanded, as has the number of HPV types it protects against. The newest version protects against seven high-risk types that account for 90 percent of cervical cancers (along with two types that cause genital warts). And young boys and men are now also encouraged to get the vaccine, as are women up to age 45.

Despite this increase in recommended age, getting vaccinated while young provides the most benefit, since it’s incredibly easy to contract HPV once a person becomes sexually active. But rates of childhood HPV vaccination in places like the U.S. are still abysmally low. According to one estimate, only 35 percent of children are fully vaccinated by age 15 (the current guidelines call for kids to begin their vaccination from age 11 to 12, with only two shots needed if they get both by age 15; otherwise three shots are required). That low adherence rate not only hampers the protective effects of the vaccine, it also complicates efforts by researchers to study the real-world impact of the vaccine on a population.

In countries like Scotland, though, routine HPV vaccination was quickly adopted and made commonplace, thanks to a nationally funded vaccination program that targeted 12- to 13-year-old girls starting in 2008, along with a later program that targeted older teens. But there are other factors that make Scotland an ideal country to test the value of widespread HPV vaccination, according to lead author Tim Palmer, a pathologist at the University of Edinburgh.

“Up until June 2016, we started [cervical disease] screening at age 20, so we’re one of the first countries to have immunized women attend for screening,” he told Gizmodo via email. “We are also one of the few countries to be able to link directly the fact that an individual had or had not been vaccinated and her screening outcome many years later.”

Palmer and his team looked at the records of more than 130,000 women in Scotland who received one of these cervical screenings at age 20. They compared women vaccinated for HPV as young girls to slightly older women vaccinated during the catch-up program and to unvaccinated women born in 1988.

Compared to these unvaccinated women, they found, the women vaccinated as young girls were far less likely to have any kind of cervical disease, defined as the growth of abnormal cells in the cervix. Most importantly, the rate of growths classified as a cervical intraepithelial neoplasia (CIN) grade 3 also dropped substantially, by nearly 90 percent. That’s crucial because a CIN3 growth puts women at their greatest risk of someday developing cervical cancer. According to Palmer, the 90 percent reduction they found is the largest drop seen with CIN3 in any population where HPV vaccination is available.

“Thus, we are confident that the reduction in CIN3 will lead to a reduction in cancers,” Palmer said.

The high vaccination rate in Scotland also had indirect effects, they found. The rate of cervical disease in the minority of women who were eligible but did not get vaccinated dropped as well, meaning vaccine coverage was high enough to provide some herd immunity (put simply, the more protected a population is from a disease, the less opportunity the disease has to spread to unprotected people). As expected, women who were older when vaccinated still had a lower rate of cervical disease than unvaccinated women, but not to the same degree as those who got the vaccine when young.

All in all, Palmer said, the study shows that Scotland’s HPV program has been an unmitigated success, one that will continue to pay off for decades. And Scotland’s early success story should provide plenty more motivation for other countries to drive up their own local vaccination rates.

That said, it’ll still take some time before we can really be sure that cervical cancer rates will similarly plummet, since many women develop it in their mid 30s and 40s. But Palmer says his team is already at work studying screening data that might show the vaccine’s effectiveness at preventing earlier cases of cancer.

The growing success of the HPV vaccine might eventually lead to changes in how we screen women for cervical cancer, Palmer said, since there’ll be fewer total cases of cancer to catch—a welcome problem, obviously.

“Ultimately, when routinely immunized women form the majority of the women eligible for screening, the need for cervical screening programs should be reviewed; they may no longer be justified,” he said. “However, this point will not be reached in Scotland for at least 25 or 30 years. Before that stage, the frequency and number of screening tests will need to be reviewed; there are suggestions that just two or three tests in a screening ‘lifetime’ will be adequate.”

Currently, in the U.S., it’s estimated there are 12,000 new cases of cervical cancer annually.

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April, 2019|Oral Cancer News|

Flossing and going to the dentist linked to lower risk of oral cancer

Source: www.livescience.com
Author: Yasemin Saplakoglu, Staff Writer

Regularly flossing and going to the dentist may be tied to a lower risk of oral cancer.

That’s according to findings presented March 31, here at the American Association for Cancer Research (AACR) annual meeting.

In the new study, researchers analyzed the dental health behaviors of patients who were diagnosed with oral cancer between 2011 and 2014 at the ear, nose and throat clinic at The Ohio State University Comprehensive Cancer Center. The patients’ behaviors were compared to those of non-cancer patients who came to the clinic for other reasons, such as dizziness or an earache. [7 Odd Things That Raise Your Risk of Cancer (and 1 That Doesn’t)]

All of the patients in the study had responded to a survey that included questions about how often they flossed, how often they went to the dentist, how sexually active they were and if they smoked or drank alcohol.

Oral cancer can be divided into two categories: those driven by the sexually transmitted human papillomavirus (HPV) and those that aren’t, said lead study author Jitesh Shewale, a postdoctoral fellow at the University of Texas MD Anderson Cancer Center in Houston. (Smoking and drinking are both risk factors for non-HPV oral cancers.)

After adjusting for factors such as age, gender, socioeconomic status and race, the researchers found that oral HPV-negative people who went to the dentist less than once a year had nearly twice the risk of developing oral cancer than those who went once a year or more. Similarly, oral HPV-negative people who flossed less than once a day had over twice the risk than those who flossed more. In other words, poor oral hygiene was linked to increased non-HPV oral cancer risk.

The study didn’t find an association between poor dental hygiene and oral cancer in those who also had oral HPV, however.

The researchers hypothesize that the oral microbiome may play a role in the association between oral hygiene and cancer risk. In previous research, scientists from the same team found evidence that “poor oral hygiene practices causes a shift in your oral microbiome,” Shewale told Live Science. That shift “promotes chronic inflammation and [can lead to] the development of cancers.” HPV-positive oral cancers mostly affect the base of the tongue and the tonsils region, while HPV-negative cancers mostly affect oral cavities, which are more affected by oral hygiene, he added.

Denise Laronde, an associate professor in dentistry at the University of British Columbia who was not a part of the study, said that the new research was “interesting” but added that it was too early to draw conclusions. (The study found an association between oral hygiene and cancer risk, but did not show cause-and-effect.)

Still, “a lot of the times people look at their oral health as almost disconnected from the rest of their body,” Laronde told Live Science. “But so many systemic diseases are reflected in your oral health and vice versa.”

Laronde added that the new research will hopefully raise awareness about the importance of flossing. “We all know people say they floss way more than they do,” she said. But studies like this raise awareness that “you’re not just flossing to keep your teeth, you’re flossing to maintain your health.”

The findings have not yet been published in a peer-reviewed journal.

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April, 2019|Oral Cancer News|

How do speech-language pathologists support cancer patients?

Source: syvnews.com
Author: Aundie Werner

Question: What are speech-language pathologists and how do they support cancer patients?

It is estimated that about 100,000 people will be diagnosed with a head, neck or thyroid cancer this year.

Although this does not grab headlines as often as many other cancers, for those affected the disease and treatment can have a significant impact on their lives. In general, most people survive head and neck cancer; however, side effects of treatment can sometimes be a long-term problem.

The support and guidance of a speech-language pathologist (SLP) can do much to help promote recovery and cope with the difficult symptoms of treatment. Ideally, the SLP becomes involved when the patient has been identified as having head and neck cancer before their surgery or before their chemotherapy/radiation protocol. Counseling and education are provided as to the functions of voice, speech and swallowing. Assessment is made to determine the patient’s baseline and to provide guidance as to the patient’s role in their rehabilitation.

Frequently, the SLP works with patients who have difficulty eating and drinking. Treatment is based on the cause of the problem: anatomical changes from surgery, decreased saliva, changes in taste, difficulty opening the mouth due to trismus, and problems protecting the airway, which can result in coughing and choking during meals.

Maintaining nutrition after surgery and during treatment is necessary to help the body heal. At times, the patient may need to have a feeding tube to help with nutrition when it becomes too difficult to swallow. The SLP assesses the patient’s current needs, instructs the patient in specific swallowing exercises, compensatory swallowing strategies or diet modification recommendations. The goal is for patients to continue to eat and drink during and after treatment.

Following radiation therapy, patients may experience lymphedema and/or fibrosis of the radiated tissue. These effects can persist long after the treatment concludes. Difficulties can include problems opening the mouth to eat from a spoon or fork, or decreased ability of the throat muscles to protect the airway while eating or drinking. In these cases, specific testing and exercises are instructed by the SLP.

Voice changes may also occur after surgery or radiation. The SLP instructs patients how to use their voice efficiently so as not to strain the muscles. Patients who have had their voice box removed are instructed in alternative methods to produce voicing to communicate.

Additionally, articulation and resonance changes can occur from surgery and/or radiation. Patients who have had sinus, palatal, jaw or tongue cancer are instructed how to articulate more clearly through customized treatment or prosthetic devices, if needed.

Each patient’s cancer is unique, as is the plan of care developed by the SLP. The Central Coast has excellent speech-language pathologists who are trained to provide their expertise to facilitate your road to recovery.

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March, 2019|Oral Cancer News|

Robot that can cut out hard-to-reach throat tumours through patients’ mouths: Pioneering operation reduces need for chemo and radiotherapy

Source: www.dailymail.co.uk
Author: Fiona McCrae, Roger Dobson

British surgeons are using a cutting-edge robot to remove difficult-to-reach throat tumours – through the mouths of patients.

The pioneering operation is designed to dramatically reduce the need for gruelling radiotherapy and chemotherapy, which can leave patients unable to swallow and dependent on a feeding tube for life.

With growing numbers of people developing throat cancer, it is more important than ever to have a range of effective treatments that lessen the impact on quality of life, says Asit Arora, consultant head and neck surgeon at Guy’s & St Thomas’ NHS Trust in London.

Once most common in elderly people with a history of drinking and smoking, rates of head and neck cancers have soared by 31 per cent in the past 25 years and are now as common in people in their 50s as in those in their 80s.

The 90 minute operation is designed to dramatically reduce the need for gruelling radiotherapy and chemotherapy, which can leave patients unable to swallow and dependent on a feeding tube for life

Much of the rise is attributed to HPV – a range of viruses that can be passed on during intimate and sexual contact. At least 80 per cent of the adult population carries some kinds of HPV on their skin, although most will never know it. In some cases, HPV can cause skin or genital warts, and other types are a known cause of cervical and anal cancers.

HPV can also infect the mouth and throat and is now to blame for at least half of throat cancers in the UK. Until a tumour occurs, the infection is typically symptomless.

Conventional treatment for early-stage throat cancer involves either powerful radiotherapy and chemotherapy to destroy the tumour, or laser surgery to cut it out.

Courses of radiotherapy and chemotherapy are time-consuming – some patients make up to 30 trips to hospital over a few months. The treatment can also damage the jaw and the swallowing muscles, meaning patients cannot eat without the help of a feeding tube.

Laser treatment is more gentle on the body but it can be difficult to cut out a hard-to-reach cancer completely and most patients need radiotherapy afterwards. Some also need chemotherapy.

Using the robot, the surgeon can zero in on the tumour and cut it away precisely. With the patient under general anaesthetic, the surgeon controls the robot with his hands and feet. One of the robot arms holds a 3D camera, while two others wield tiny instruments that can be passed through the mouth and into the throat, and turned and twisted in ways impossible with the human hand alone.

Surgery in the mouth and throat can be challenging because you are working in very small areas, manipulating surgical instruments in a tight space where there are important nerves and blood vessels to be avoided,’ says Mr Arora, who has pioneered robotic surgery for throat cancer in the UK.

‘With the latest robotic systems, we can be more targeted than ever before in how we treat these throat conditions in order to reduce unwanted side effects, particularly related to swallowing.’

Studies suggest that trans-oral robotic surgery (TORS) is at least as good as conventional surgery, although a definitive comparison has yet to be carried out, says Mr Arora. But importantly, by cutting out the tumour so precisely, it may reduce the amount of chemotherapy and radiotherapy patients need.

A £4.5 million Cancer Research UK trial into the procedure is now being carried out at Guy’s and hospitals around the country.

Mr Arora has used the method to remove about 30 throat tumours in the year since setting up the service with Jean-Pierre Jeannon, Guy’s clinical director for cancer.

The operation takes 90 minutes and patients are usually discharged after two days. They then undertake rehab, including speech therapy.

Retired policeman David Wonfor, 60, chose to take part in the trial after being diagnosed with early-stage throat cancer last summer. After his operation, David, 60, of Petts Wood, Kent, started on five weeks of low-dose radiotherapy. Although he lost weight and his sense of taste at first, he has now largely recovered, and says he is convinced that his recovery would have been very different if he had had chemotherapy.

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March, 2019|Oral Cancer News|

HPV infection may be behind rise in vocal-cord cancers among young nonsmokers

Source: www.eurekalert.org
Author: Public Release Massachusetts General Hospital

A remarkable recent increase in the diagnosis of vocal-cord cancer in young adults appears to be the result of infection with strains of human papilloma virus (HPV) that also cause cervical cancer and other malignancies. Investigators from Massachusetts General Hospital (MGH) describe finding HPV infection in all tested samples of vocal-cord cancer from 10 patients diagnosed at age 30 or under, most of whom were non-smokers. Their report appears in a special supplement on innovations in laryngeal surgery that accompanies the March 2019 issue of Annals of Otology, Rhinology and Laryngology.

“Over the past 150 years, vocal-cord or glottic cancer has been almost exclusively a disease associated with smoking and almost entirely seen in patients over 40 years old,” says Steven Zeitels, MD, director of the MGH Division of Laryngeal Surgery, senior author of the report. “Today nonsmokers are approaching 50 percent of glottic cancer patients, and it is common for them to be diagnosed under the age of 40. This epidemiologic transformation of vocal-cord cancer is a significant public health issue, due to the diagnostic confusion it can create.”

The researchers note that the increase in vocal-cord cancer diagnosis appears to mimic an earlier increase in the diagnosis of throat cancer, which has been associated with infections by high-risk strains of HPV. After initially attributing incidents of vocal-cord cancer in nonsmokers, which they began to see about 15 years ago, to increased travel and exposure to infectious diseases, Zeitels and his colleagues decided to investigate whether HPV infection might explain the diagnosis in younger nonsmokers.

To do so they examined the records of patients treated by Zeitels either from July 1990 to June 2004 at Massachusetts Eye and Ear Infirmary or between July 2004 and June 2018 at MGH. Of 353 patients treated for vocal-cord cancer during the entire period, none of the 112 treated from 1990 to mid-2004 were age 30 or younger. But 11 of the 241 patients treated from 2004 to 2018 were 30 or younger – 3 were age 10 to 19 – and only 3 of the 11 were smokers. Analysis of tissue samples from the tumors of 10 of the 11 younger patients revealed high-risk strains of HPV in all of them.

The authors note that these high-risk-HPV-associated vocal-cord cancers greatly resemble recurrent respiratory papillomatosis (RRP), a benign condition caused by common, low-risk strains of HPV. One of the 11 patients treated by Zeitels had previously been diagnosed at another center with vocal-cord cancer, and when it recurred after being surgically removed, she was misdiagnosed with RRP and treated with a medication that made the cancer worse, leading to the need for a partial laryngectomy.

“Benign RRP of the vocal cords has been a well-known HPV disease for more than a century, and it is very remarkable that there is now an HPV malignancy that looks so similar, creating diagnostic and therapeutic confusion,” says Zeitels, the Eugene B. Casey Professor of Laryngeal Surgery at Harvard Medical School. “It should be noted that these HPV-associated vocal-cord carcinomas are not a malignant degeneration of the benign disease.”

Zeitels adds that HPV vocal-cord cancers are amenable to endoscopic treatment with the angiolytic KTP laser that he developed. “Large-scale studies are now needed to determine the pace of the increase in glottic cancer among nonsmokers, the incidence of high-risk HPV in these cancers and changes in the age and genders of those affected,” he says.

Note:
The lead author of the Annals of Otology, Rhinology and Laryngology paper is Semirra Bayan, MD, previously a fellow in laryngeal surgery at MGH and now at University of Chicago Medicine; William Faquin, MD, PhD, MGH Pathology, is a co-author. The study was supported by the Voice Health Institute, the National Philanthropic Trust, and the Eugene B. Casey Foundation.

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March, 2019|Oral Cancer News|

Suspect laryngeal cancer in patients with sore throat and hoarseness, GPs urged

Source: www.pulsetoday.co.uk
Author: Isobel Sims

GPs should suspect laryngeal cancer and consider urgent referral in patients who present with a persistent sore throat and hoarseness, according to a new study.

A recurrent sore throat in combination with symptoms such as hoarseness, difficulty swallowing or ear pain increases the likelihood that a patient has laryngeal cancer and may warrant urgent referral, the authors said.

The study, published in the British Journal of General Practice, was carried out by researchers at the University of Exeter and looked at primary care data for just over 800 patients diagnosed with laryngeal cancer, as well as just over 3,500 controls.

The researchers found hoarseness carried the greatest individual risk, with those presenting with the symptom having a 2.7% likelihood of having laryngeal cancer – just under the NICE (National Institue for Health & Care Excellene) threshold of 3% for urgent referral.

Patients presenting with a recurrent sore throat in combination with hoarseness had a 12% likelihood of having laryngeal cancer.

The likelihood of cancer was also increased above the NICE threshold when recurrent sore throat presented with dysphagia, recurrent dyspnoea, ear pain and raised inflammatory markers, the researchers said.

They found that, ‘unexpectedly’, neck lumps were not associated with laryngeal cancer.

The authors said the findings back up the NICE recommendation to consider referring patients with persistent unexplained hoarseness, but that GPs should also be vigilant about symptoms not currently listed in the NICE guidance.

The paper said: ‘This evidence supports some of the recommendations in current NICE guidance, particularly relating to hoarseness.It refutes the recommendation for neck lumps, though the clinician must still consider lymphoma.

‘It adds some new symptom combinations: sore throat supplemented by otalgia, dyspnoea, or dysphagia.

‘However, selection of patients for investigation is not simply a matter of totting up symptoms and positive predictive values. Clinical experience — although almost impossible to measure — adds to skilful decision making.’

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March, 2019|Oral Cancer News|

How regular use of painkillers could boost survival rates from cancer

Source: www.mirror.co.uk
Author: Miriam Stoppard

In recent research, aspirin or ibuprofen were found to treble the chance of beating head and neck cancer.
Could regular use of aspirin or ibuprofen boost survival rates from head and neck cancer? It seems it’s possible.

In recent research, the common painkillers were found to treble the chance of survival (from 25% to 78%) for patients with a specific kind of cancer which contains an altered gene, known as PIK3CA. Around a third of head and neck cancers carry this mutation and it’s also found in other types of cancer.

Head and neck cancer is newly ­diagnosed in more than 12,000 people in the UK each year, and in 65,000 in the US. It kills just over 4,000 people here and 14,000 in America. There are more than 30 areas in the head and neck where cancer can develop, such as the mouth and throat.

Researchers at the University of ­California, San Francisco, looked at five-year survival rates for people ­diagnosed with the disease and found the regular use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, significantly improved survival for a third or more of patients with the disease.

All the patients had the mutated gene. NSAIDs, however, had no effect on tumours without PIK3CA mutation. The study included 266 patients from the University of Pittsburgh Medical Center whose tumours were surgically removed. Altogether, 75 tumours (28%) in the study had a change in the PIK3CA gene. Among the patients who regularly used NSAIDs, 93% used aspirin at some point, and 73% only took aspirin.

Dr Jennifer Grandis, a professor of head and neck surgery and senior author of the paper, said: “Our results suggest that the use of NSAIDs could significantly improve outcomes for not only head and neck cancer patients, but also patients with other cancers that contained the PIK3CA mutation.

“The magnitude of the apparent advantage is strong, and could potentially have a positive impact on human health.”

The researchers said the regular use of NSAIDs for at least six months provided “markedly prolonged” improved survival compared to patients whose PIK3CA gene was mutated and didn’t use NSAIDs.

They suggest that NSAIDs possibly block tumour growth by reducing the production of an inflammatory ­molecule called prostaglandin E2.

For something so simple, it seems too good to be true.

It would be very easy and cheap to try in patients but there’s a little way to go yet.

First, we need much larger trials as proof that what is only a theory actually works.

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March, 2019|Oral Cancer News|