Vaccines plus screening could end cervical cancer

Source: Author: Fram Lowry Out with the old and in with the new is a commonly followed maxim in medicine given the rapid pace of developments in diagnosis and treatment. Human papillomavirus vaccines are relative newcomers to the cervical cancer armamentarium, but they cannot be relied on to do the job on their own; screening is still a must. Richard B. Roden, PhD, from Johns Hopkins University in Baltimore, and Carlos L. Santos, MD, from the Instituto Nacional de Enfermedades Neoplasicas in Lima, Peru, discussed the merits and drawbacks of HPV vaccines and standard screening during a session on female malignancies at ASCO 2009 in Orlando Long-term protection The widespread vaccination of adolescents against HPV will be critical to the eradication of cervical cancer, said Dr. Roden, an associate professor in the department of pathology. “HPV virus-like particle [VLP] vaccines are very effective in preventing genital HPV infection and neoplastic disease,” he explained. “Solid protection has been observed for more than six years after vaccination, suggesting vaccine protection is likely to be long-term, although the need for a booster is not out of the question.” To date, two HPV vaccines are FDA-approved: Gardasil from Merck, produced in yeast, and Cervarix from GlaxoSmithKline, produced in insect cells. In October 2009, Gardasil was approved by the FDA for use in boys and men (aged 9-26) for the prevention of genital warts caused by HPV-6 and HPV-11. Both vaccines target HPV-16 and HPV-18, the two most common oncogenic HPV types. Gardasil also [...]

2009-12-30T13:16:35-07:00December, 2009|Oral Cancer News|

Oropharyngeal cancer, human papilloma virus, and clinical trials

Source: Journal of Clinical Oncology, Vol 28, No 1 (January 1), 2010: pp. 1-3 Author: Danny Rischin As advances in our understanding of the molecular biology of cancer have evolved in recent years, cancers that were once considered to be relatively homogeneous diseases are now being recognized as comprising distinct subtypes. These subtypes may differ in etiology, molecular profile, sensitivity to treatment, and prognosis. Examples include luminal (mainly estrogen receptor–positive), human epidermal growth factor receptor 2–positive, and basal breast cancer subtypes1; non–small-cell lung cancer associated with EGFR2 or EML4-ALK3 mutations; and melanoma associated with BRAF (V600E)4 or c-KIT mutations.5 In head and neck cancer, we have traditionally combined squamous cell carcinomas of the oral cavity, oropharynx, larynx, and hypopharynx in clinical trials. This has been justified on the basis of similar etiology (tobacco and alcohol) and similar sensitivity to radiotherapy and systemic therapy. However, it has also been recognized that there are differences in clinical behavior, treatment outcome, and prognosis with regard to primary site. Although surgery has remained the primary treatment for oral cavity cancers, organ preservation with primary chemoradiotherapy has been widely used over the last two decades for cancers of the oropharynx, larynx, and hypopharynx. It has become apparent over this same time period that a new subtype of oropharyngeal cancer resulting from human papilloma virus (HPV) has emerged.6 The proportion of HPV-associated oropharyngeal cancer has steadily increased, and in many countries, this subtype now represents the majority of new oropharyngeal cancers.7,8 HPV-associated oropharyngeal cancer differs from [...]

2009-12-30T13:03:03-07:00December, 2009|Oral Cancer News|

microRNA evaluation of unknown primary lesions in the head and neck

Source: Authors: Emma BarkerNilva et al. Unknown primary malignancy in the head and neck is not an infrequent diagnosis for patients with metastatic cervical lymph nodes. Although linked with a relatively good prognosis following radiation treatment, widespread radiation is coupled with significant morbidity. Altered microRNA (miRNA) expression has been associated with both cancer progression and metastasis. We sought to determine whether miRNA expression analysis could be used as a diagnostic tool to discover the primary site of malignancy, within the head and neck. We used quantitative real-time PCR to identify miRNA expression profiles of squamous cell carcinoma of the tonsil, base of tongue and post-nasal space, as well as their corresponding metastatic lymph nodes, from 6 patients. Our results revealed that each cancer maintained its expression profile between the primary site and the nodal metastasis (r= 0.82, p<0.0001). In addition, each anatomical sub-site maintained a distinct miRNA profile between individual patients (r=0.79, p<0.0001). Finally, between sub-sites, the miRNA profiles were distinct (p<0.0001). As proof of principle, our study provides an indication that miRNA expression analysis may be useful to compare the primary lesion and local metastatic disease. This may be clinically relevant to predict the primary site of origin of metastatic disease, when the primary site remains obscure. Authors: Emma Barker, Nilva Cervigne, Patricia Reis, Rashmi Goswami, Wei XuIlan Weinreb, Jonathan Irish, Suzanne Kamel-Reid Source: Molecular Cancer 2009, 8:127

2009-12-25T11:14:13-07:00December, 2009|Oral Cancer News|

Doctors using mouthwash to detect head, neck cancer

Source: Author: Jean Enersen For a patient with head and neck cancer, the cure rate is only 30 percent. That's because the disease is often detected in the late stages. Now catching the cancer earlier may be as simple as gargling with mouthwash. Edie Acosta's niece and nephew gave her the courage to fight neck cancer. "They cut from here, all the way down here," she said. On her neck, the scar marks where a stage four tumor was removed. "It seemed bigger and bigger 'til it got to the size of a fist, a man's fist," she said. "And I couldn't even move my neck. You feel like a little bird whose wings got cut and you can't fly anymore. I just, I thought I was really gonna die." For patients like Edie, late stage diagnosis makes treating neck cancer more difficult. Now, researchers have developed a quick, inexpensive mouthwash to detect these cancers earlier. The patient rinses with the saline mouthwash. After they spit it out, doctors add antibodies. In about 48 hours, if there's cancer detected in the saliva, the molecules show up in color. "We've found that these molecules show up differently in the oral rinses from patients that have cancer compared to patients that don't have cancer," said Dr. Elizabeth Franzmann, otolaryngologist, Sylvester Cancer Center at the University of Miami. In a study that included 102 head and neck cancer patients and 69 patients with benign disease, the oral rinse detected the cancer nearly [...]

2009-12-25T11:07:06-07:00December, 2009|Oral Cancer News|

Emory couples cancer drug with green tea extract to help fight cancers of the head and neck

Source: Author: Kristina Bjoran Clinical researchers at the Emory University Winship Cancer Institute have discovered that pairing a popular cancer-fighting drug with green tea extract may help reduce the risks for neck and head cancers. The lead investigator in the trial is Dr. Dong Moon Shin, and he and his team have been working to combine the drug Erlotinib with an extract of green tea to observe the effects. Elrotinib is a drug that has been long used as an effective way to treat certain types of lung and pancreatic cancers. Neck and head cancers are more common than many know. The American Cancer Society touts that almost 50,000 Americans will be diagnosed with one of the two cancers this year alone, so this new trial at Emory may provide hope for those with pre-cancerous lesions related to the cancers. The chemical of interest in the green tea extract is called polyphenon E (PPE), and the lab experiments show that combing PPE with Elrontinib can potentially prevent the development of the cancers by targeting specific cellular activity in the pre-cancerous areas. Shin and his team are focusing on the lesions of the head and neck. Cancers of the head and neck have relatively low survival rates, and have not seen much of an increase over the past few decades. As the sixth most common type of cancer, this new study provides hope to those in need of a new, effective treatment.

2009-12-25T11:02:51-07:00December, 2009|Oral Cancer News|

Best face forward

Source: Author: Lacey Meyer When 16th-century astronomer Tycho Brahe lost part of his nose in a duel, his options for a prosthesis were limited — he donned a folded metal plate in the shape of a nose to cover his missing anatomy. Today, patients with head and neck cancer, who may lose bone, skin, teeth or cartilage as a result of cancer surgery, find that the focus is not only on cancer control, but also on facial restoration with specialists who see the process as not only functional but also aesthetic. For past patients, the evolved approach to treatment with a multidisciplinary team of specialists, each concentrating on a certain area within the full scope of maxillofacial prosthetic rehabilitation, can be life-changing. Joseph Huryn, DDS, says he has patients who were recluses for years, unaware of facial prostheses as a possibility. “It changes their life incredibly,” says Huryn, chief of dental service at Memorial Sloan-Kettering Cancer Center in New York City. Depending on head and neck cancer location, size and treatment, maxillofacial prostheses can be intra-oral (within the mouth) or extra-oral (outside of the mouth). Maxillofacial prosthodontists can fabricate prostheses ranging from a resection appliance — used to replace part of the lower jaw — to an auricular (ear) prosthesis or an orbital prosthesis replacing the eye and surrounding tissues including the eyelid, socket and sometimes part of the cheek and nose. Professionals in anaplastology — the art and science of creating artificial anatomy — specialize in the fabrication [...]

2009-12-24T09:12:26-07:00December, 2009|Oral Cancer News|

Adverse events associated with concurrent chemoradiation therapy in patients with head and neck cancer

Source: Arch Otolaryngol Head Neck Surg. 2009;135(12):1209-1217 Authors: Daniel J. Givens, BS et al. Objective: To assess toxicities, functional outcomes, and health-related quality of life associated with concurrent chemoradiation therapy (CRT) in patients with head and neck cancer. Design: Prospective and retrospective outcomes study. Setting: Tertiary care institution. Patients: Participants in the longitudinal Outcomes Assessment Project whose head and neck cancer was treated with CRT between February 1, 2000, and March 1, 2007 (n = 104). Interventions: Patients prospectively provided functional and health-related quality of life information, including data from the 1-year and most current follow-up visits. Medical records were reviewed to determine toxicity and survival rates. Main Outcome Measures: Well-defined acute and late toxicities; functional outcomes (diet, dentition, tracheostomies); head and neck cancer–specific, general health, and depression outcomes; and survival rates. Results: Most patients had oropharyngeal or laryngeal tumors (87.5%) and advanced-stage disease (75.0%). Approximately one-half had hematologic toxicities and toxicity-related treatment delays. Approximately one-quarter had neurotoxicities and/or ototoxicites, moist desquamation, pneumonia, nausea and vomiting requiring hospitalization or intravenous fluids, dehydration or malnutrition requiring hospitalization, and mild or moderate fever. Although patients receiving the current intensity-modulated radiation therapy (IMRT) protocol using the Pinnacle3 planning system had more toxicity-related treatment delays, they had fewer toxicities and better functional and health-related quality of life outcomes compared with those receiving conventional lateral opposing-field radiation or the initial IMRT protocol using the Best nomos PEACOCK planning system. Conclusions: Patients receiving CRT experience a substantial number of treatment-related adverse events, primarily affecting oropharyngeal and [...]

2009-12-23T14:52:45-07:00December, 2009|Oral Cancer News|

New artificial larynx helps people sound more human

Source: Author: Aaron Saenz You may have a family member or friend who had throat cancer. Maybe you’ve seen a TV show where a heavy smoker needs an artificial larynx pressed to their neck to speak. Either way, you know the voice that they have to use: robotic, monotone, raspy. It works, but it can leave users unable to express themselves well. Researchers at the University of Witwatersrand in South Africa have developed a new system that measures mouth movement to produce a more “human-like” voice. Their work was on display at the recent International Conference on Biomedical and Pharmaceutical Engineering. By placing a device called a palatometer under the tongue, users can try to speak as normal and have their words synthesized on a speaker. The South African artificial larynx can provide inflection, ending the dreaded monotone and providing the means to indicate you are asking a question. With proper calibration, researchers claim greater than 94% accuracy. That’s good news to those who want to regain a normal speaking voice. The palatometer, which measures tongue/mouth movements with 118+ pressure sensors, is an older device developed at BYU and produced by Complete Speech. It is most often used by speech therapists in instructing their patients and retails for around $200-$300. You can see a brief presentation of the palatometer after the break. University of Witwatersrand’s innovation comes in developing a selective way of using the mouth movement data to generate toned speech. After cataloging tongue motions, and using predictive-analysis, [...]

2009-12-23T08:57:24-07:00December, 2009|Oral Cancer News|

Tongue reconstruction

Source: Author: staff Tongue cancer accounts for about 25 percent of all oral cancers. According to the National Cancer Institute, about 10,530 cases of tongue cancer will be diagnosed in the U.S. this year. Although the cancer can occur at any age, it’s most commonly diagnosed in older people, with a median age at diagnosis of 61. Men are affected about twice as often as women. Two important risk factors for tongue cancer are smoking and drinking. For people who smoke and drink, the risk may be up to 100 times that of those who neither smoke nor drink. Another risk factor for tongue cancer is HPV (human papillomavirus) infection. Douglas Chepeha, M.D., Microvascular Reconstructive Surgeon with the University of Michigan, says doctors are also seeing cases of tongue cancer in young and older women who neither smoke nor drink. The reasons for these cases are not clear. Overall five-year survival rates for tongue cancer are about 59.5 percent. However, the cancer has the potential to spread fairly quickly. If the cancer is detected when the condition is still localized, 5-year survival rates are over 77 percent. Once the cancer spreads regionally, survival rates drop to about 55 percent. Thus, early diagnosis is important. Patients who develop a sore on the tongue that doesn’t heal or bleeds easily should see a physician for evaluation. Treating Tongue Cancer: Reconstruction After Surgery Tongue cancer typically occurs on one side of the tongue. The main treatment is surgery, which can require removal [...]

2009-12-19T23:14:42-07:00December, 2009|Oral Cancer News|

FDA clears transoral robotic surgery – developed at Penn –for tumors of mouth, throat and voice box

Source: Author: staff A minimally invasive surgical approach developed by head and neck surgeons at the University of Pennsylvania School of Medicine has been cleared by the U.S. Food and Drug Administration (FDA). The da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, California) has been cleared for TransOral Otolaryngology surgical procedures to treat benign tumors and selected malignant tumors in adults. Drs. Gregory S. Weinstein and Bert W. O’Malley, Jr. of the University of Pennsylvania School of Medicine’s Department of Otorhinolaryngology: Head and Neck Surgery founded the world’s first TransOral Robotic Surgery (TORS) programat Penn Medicine in 2004, where they developed and researched the TORS approach for a variety of robotic surgical neck approaches for both malignant and benign tumors of the mouth, voice box, tonsil, tongue and other parts of the throat. Since 2005, approximately 350 Penn patients have participated in the world’s first prospective clinical trials of TORS. These research trials compromise the largest and most comprehensive studies of the technology on record. “TORS has dramatically improved the way we treat head and neck cancer patients, completely removing tumors while preserving speech, swallowing, and other key quality of life issues,” said Bert O’Malley, Jr., MD, professor and chairman of Penn Medicine’s Department of Otorhinolaryngology:Head and Neck Surgery. “It is very exciting that a concept conceived at PENN, evaluated in pre-clinical experimental models at Penn, tested in clinical trials at Penn, and then taught to key surgeons and institutions both within the U.S. and internationally has been officially [...]

2009-12-19T23:10:00-07:00December, 2009|Oral Cancer News|
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