Source: 7thspace.com Author: Stefano Fedele The World Health Organization has clearly indentified prevention and early detection as major objectives in the control of the oral cancer burden worldwide. At the present time, screening of oral cancer and its pre-invasive intra-epithelial stages, as well as its early detection, is still largely based on visual examination of the mouth. There is strong available evidence to suggest that visual inspection of the oral mucosa is effective in reducing mortality from oral cancer in individuals exposed to risk factors. Simple visual examination, however, is well known to be limited by subjective interpretation and by the potential, albeit rare, occurrence of dysplasia and early OSCC within areas of normal-looking oral mucosa. As a consequence, adjunctive techniques have been suggested to increase our ability to differentiate between benign abnormalities and dysplastic/malignant changes as well as to identify areas of dysplasia/early OSCC that are not visible to naked eye. These include the use of toluidine blue, brush biopsy, chemiluminescence and tissue autofluorescence. The present paper reviews the evidence supporting the efficacy of the aforementioned techniques in improving the identification of dysplastic/malignant changes of the oral mucosa. We conclude that available studies have shown promising results, but strong evidence to support the use of oral cancer diagnostic aids is still lacking. Further research with clear objectives, well-defined population cohorts, and sound methodology is strongly required. Source: Head &Neck Oncology 2009, 1:5
Source: www.enfieldindependent.co.uk Author: Sarah Cosgrove A new state-of the art laser will improve surgery for cancer patients, after being donated to Chase Farm Hospital by charities. The carbon dioxide laser allows surgeons to burn out cancers with the minimum of blood loss, sometimes allowing them to avoid cutting into patients completely. Representatives from the Patricia Madden Cancer Trust and Barnet and District CancerLink joined patients, doctors and hospital chiefs to launch the C02 machine at the hospital on Tuesday. Head and neck consultant, Wayne Halfpenny, explained that as well as lessening blood loss, cancers of the voicebox can be removed via the mouth by the machine, avoiding the need for radiotherapy or surgery through the neck. He added: "The carbon dioxide laser is a fantastic piece of equipment in the surgical treatment of head and neck cancer. "It cuts and seals tissue at the same time minimizing blood loss and allows some cancers to be treated without open neck surgery. It can also vaporize early cancers avoiding the need for surgical excision." Mr Halfpenny and Barnet and Chase Farm Hospitals NHS Trust chief executive Averil Dongworth thanked the charities for their "generous" support.
Source: in.reuters.com Author: staff Chewing tobacco and snuff are less dangerous than cigarettes but the smokeless products still raise the risk of oral cancer by 80 percent, the World Health Organisation's cancer agency said on Tuesday. The review of 11 studies worldwide showed people who chewed tobacco and used snuff also had a 60 percent higher risk of oesophagus and pancreatic cancer. The researchers sought to quantify the risk of smokeless tobacco after a number of studies differed on just how dangerous the products were, said Paolo Boffetta, an epidemiologist at the WHO's International Agency for Research on Cancer. "What we did was try to quantify the burden of smokeless cancer," he said in a telephone interview. "This has never been attempted in such a systematic way before." The researchers, who published their findings in Lancet Oncology, did this by looking at population-wide studies and trials of both humans and animals. They found frequency of use varies greatly both across and within countries, depending on sex, age, ethnic origin and economic background, and were highest in the United States, Sweden and India. They also found that while snuff and chew were less dangerous than smoking because they were not linked to lung cancer, getting cigarette users to switch was not good public policy. "If all smokers did this there would be a net benefit," Boffetta said. "The point is we don't know whether this would happen and there is no data to suggest these smokers would stop or switch."
Source: Stomatologiia (Mosk), January 1, 2008; 87(6): 21-23 Author: M St Bratoicheva and V K Kondeva Many authors consider oral hygiene an important factor in the etiology and pathogenesis of oral cavity cancer. The aim of the present study was to establish the role of poor oral hygiene in the development of malignant lesions in the oral cavity. One hundred and three patients were interviewed. Questions, regarding oral hygiene were included in the interview. Results showed that 53,80% of urban residents brush their teeth twice daily whereas 65,52% of rural residents brush their teeth irregularly - p<0,001 (chi(2)=23,67). 46,88% of women clean their teeth twice daily. 46,94% of men do not maintain adequate oral hygiene - p<0,05 (chi(2)= 9,21). Regarding the brush, it was found out that 56,00% of females use a hard bristle toothbrush, the same refers to 28,04% of men - p<0,05 (chi(2)= 4,15). Hard bristle toothbrush was used by 48,88% of urban residents and 9,09% of rural residents - p<0,05 (chi(2)= 5,78). People up to 30 years of age use hard bristle toothbrush most often -39,13% - p<0,01 (chi(2)=12,26). The accumulated evidence provides further explanation why oral cavity cancer is more frequent in men, rural residents and in the elderly. Oral hygiene is a factor in the development of oral cavity cancer. Authors' affilation: stomatologii Meditsinskogo universiteta, Plovdiv, Bolgariia
Source: Cancer Prevention Research, 10.1158/1940-6207 Authors: Jantine F. Bremmer et al. Oral squamous cell carcinomas develop in precancerous fields consisting of genetically altered mucosal epithelial cells. These precancerous fields may appear as clinically visible lesions, in particular, oral leukoplakia, but the large majority remains clinically undetectable. The aim of this study was to assess the potential value of a noninvasive screening approach to detect precancerous fields. As a first step, we developed a suitable assay and investigated 25 leukoplakia patients and 20 noncancer control subjects. Exfoliated cells were removed by a brush from multiple small areas of the oral mucosa, including the leukoplakia. Brushed samples were investigated for allelic imbalance (AI) at chromosomes 3p, 9p, 11q, and 17p using microsatellite markers known to show frequent alterations in oral precancer. AI was absent in all (137) of the samples of the 20 control subjects, yielding a specificity of 100%. AI was detected in exfoliated cell samples of 40% (10 of 25) of the leukoplakia lesions studied. Genetic changes were also found outside the leukoplakia lesions. Most frequent was AI at 9p (9 of 10). The noninvasive assay was validated against the biopsy results of the leukoplakia lesions yielding an estimate of sensitivity of 78% (7 of 9) and a positive predictive value of 100% (7 of 7). Altogether, these results show the feasibility of a noninvasive genetic screening approach for the detection and monitoring of oral precancer. This assay could therefore contribute to the secondary prevention of oral squamous cell carcinoma. [...]
Source: online.wsj.com Author: Kevin Helliker About 18 months ago, Russell Stevens gave up cigarettes and took up a new habit -- placing between his lip and gum a tiny pouch of smokeless tobacco called Camel Snus. The 26-year-old Kentuckian says it satisfies his craving for nicotine while exposing him to far fewer risks than did smoking. Like Mr. Stevens, more Americans are continuing to give up smoking, helping to push cigarette consumption down about 3% each year. To help kick the habit, many smokers turn to safer sources of nicotine -- the addictive but non-carcinogenic ingredient in cigarettes -- such as nicotine gum, patches or lozenges. But one method that has been gaining ground as a safer alternative to cigarettes -- smokeless tobacco -- remains controversial. A decades-old federal law requires smokeless tobacco to carry a label warning that it is not a safe alternative to cigarettes. The perils include possibly increased risk for certain cancers and cardiovascular disease. And U.S. public-health officials note that no clinical trials have been conducted showing that smokeless tobacco is an effective quitting aid. Adding to the controversy: Some of the biggest cigarette makers are jumping into the non-combustible market. "There is no evidence that smokers will switch to smokeless tobacco products and give up smoking," Michael Thun, vice president of epidemiology for the American Cancer Society, said in a recent article in the journal CA. Still, popular brands of smokeless tobacco generally contain far fewer carcinogens than do cigarettes, although some studies indicate [...]
Source: Head &Neck Oncology 2009, 1:4 Authors: Hisham M Mehanna, Paul C Nankivell, Jamil Moledina and Jane Travis Refeeding syndrome is an important, yet commonly overlooked condition affecting patients. It occurs when feeding is commenced after a period of starvation. Head and neck cancer patients are at particular risk owing to prolonged periods of poor nutritional intake. This may be from general effects such as cancer anorexia or from more specific problems of dysphagia associated with this group of patients. Awareness of the condition is crucial in identifying patients at risk and taking measures to prevent its occurrence. Objectives: The aims of this review are to: 1) Highlight the condition and stress the importance of its consideration when admitting head and neck cancer patients. 2) Discuss the pathophysiology behind refeeding syndrome. 3) Review the literature for the best available evidence and guidelines. 4) Highlight the need for further high quality research. Conclusion: Refeeding syndrome is potentially fatal, yet is preventable. Awareness and identification of at-risk patients is crucial to improving management. Refeeding syndrome is caused by rapid refeeding after a period of under-nutrition, characterised by hypophosphataemia, electrolyte shifts and has metabolic and clinical complications. High risk patients include the chronically under-nourished and those with little intake for greater than 10 days. Patients with dysphagia are at particular risk. Refeeding should commence at 10kcal/kg per day in patients at risk, and increased slowly. Thiamine, vitamin B complex and multi-vitamin supplements should be started with refeeding. New NICE guidelines state that pre-feeding [...]
Source: www.earthtimes.org Author: press release Perceptronix is proud to be a silver sponsor for the 2009 UBC Dentistry Research Day on January 27 with its focus on early detection of oral cancer. This event closely parallels the company's agenda in promoting early cancer diagnosis for better patient outcomes. Perceptronix will be showcasing and demonstrating the use of OralAdvance(TM), a new quantitative cytology test for the early detection of oral cancer. With recent advances in visualization techniques for the oral cavity, dentists are encountering more suspicious lesions. OralAdvance(TM), with its soft cyto-brush sample collection kit, provides dentists with an informative new option for assessing these lesions when biopsy is not warranted or possible. It provides an objective measure of gross DNA abnormality that can give important information about the pre-malignant or malignant nature of a lesion. About Perceptronix Medical Inc. Perceptronix Medical Inc. (Vancouver, Canada) is a private laboratory and cancer diagnostics company specializing in the provision of innovative early cancer detection tests based on quantitative cytology. The Company's DNA image cytometry technology was developed in partnership with the British Columbia Cancer Agency (Vancouver, Canada). Quantitative cytology provides physicians with an innovative cytopathology assessment based on an objective measure of large-scale DNA abnormality that can indicate precancerous or cancerous changes. The company has developed proprietary tests for the early detection of lung cancer and oral cancer using its DNA cytometry technology and offers quantitative cytology analysis of various tissues.
Source: Nursing Times Nicorette has launched a new nicotine replacement therapy programme that includes a 25mg nicotine patch to help people trying to stop smoking Nicorette recommends that smokers begin a stop smoking attempt using a 25mg nicotine patch for eight weeks, then step down to a 15mg patch for two weeks, followed by 10mg patch for a further two weeks. They cite evidence from a European multi-centre trialinvolving 3,575 smokers to support the introduction of a higher strength 25mg patch. This study found that one in two smokers who used the 25mg patch and abstained from smoking during the first week of a quit attempt remained smoke free at 12 weeks. Read full study here
Developing smokeless tobacco products for smokers: an examination of tobacco industry documents : February 2009 (Volume 18, Number 1)
Source: Clove Cigarettes News Blog Objective: To investigate whether development of smokeless tobacco products (SLT) is intended to target current smokers. . . . Conclusions: Heavy marketing of new SLT products may encourage dual use and result in unknown public health effects. SLT products have been designed to augment cigarette use and offset regulatory strategies such as clean indoor air laws. In the United States, the SLT strategy may provide cigarette companies with a diversified range of products under the prospect of federal regulation. These products may pose significant challenges to efforts by federal agencies to reduce harm caused by tobacco use. Internal documents show that tobacco manufacturers, including cigarette and SLT companies, have developed and targeted new SLT products to exploit cigarette smokers. Cigarette manufacturers recognised the importance of entering the SLT market especially in light of health, social and legislative changes influencing the cigarette market and shifting demographics of traditional SLT users. Cigarette manufacturers were initially focused on developing alternative smokeless products for smokers who would otherwise quit because of the changes in the cigarette market. Over time, the cigarette companies appear to have focused their efforts on products designed to augment cigarette use when smoking is not possible, thus offsetting regulatory strategies such as clean indoor air laws. Major cigarette companies’ marketing of new SLT products under established brand names may be aimed at increasing the appeal of SLT to smokers, who are not necessarily interested in quitting smoking. At the same time, SLT companies have aimed [...]