July 2009 – Page 5 – Oral Cancer News

Aggressive head and neck cancer

Source: speech-language-pathology-audiology.advanceweb.com Author: staff Scientists at Albert Einstein College of Medicine of Yeshiva University in Bronx, NY, have identified genetic markers that signal poor outcomes for patients with head and neck cancer. These findings could one day lead to a genetic test that could help select or predict successful treatment options for patients with this type of cancer [American Journal of Pathology, 174 (3): 736-745]. Head and neck cancer refers to tumors in the mouth, throat or larynx (voice box). Each year, about 40,000 men and women in the U.S. develop head and neck cancer, making it the sixth most common cancer in the U.S. Surgery, chemotherapy and/or radiation are the main treatment options but cause serious side effects: surgery may involve removing large areas of the tongue, throat, or neck and can affect appearance, and any type of therapy can cause swallowing or speech problems that can significantly affect quality of life. Despite curative treatment attempts, on average only about half of patients survive beyond five years after treatment. This is greatly affected by the size and location of the tumor. The Einstein study focuses on microRNAs, a recently identified class of short RNA molecules that play key roles in regulating gene expression. Abnormal microRNA levels have been associated with all types of cancer yet examined. In previous research, the Einstein scientists and other groups reported that approximately 50 specific microRNAs were expressed at higher or lower levels in head and neck tumor cell lines compared with normal cells. [...]

Oral Cancer Foundation News Team - A2009-07-10T15:39:37-07:00July, 2009|Oral Cancer News|

Drug to treat anemia in cancer is harmful

Source: www.emaxhealth.com Author: ruzik_tuzik A new review of data confirms that erythropoietin — a drug to treat anemia in many cancer patients — might be harmful. The review found that patients with head and neck cancers who received erythropoietin in combination with radiation had poorer outcomes than those who received radiation treatment alone. The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic. Severe anemia in cancer patients can lead to decreased oxygen supply to tumor cells. A lower level of oxygen in tumor cells is associated with more rapid tumor progression and a poorer response to therapy. Many use erythropoietin, or EPO, a hormone that controls red blood cell production, to correct anemia. “It has therefore been thought logical that using erythropoietin to correct anemia before or during chemotherapy, radiotherapy or both would improve prognosis,” the review authors write. Dr. Philippe Lambin and colleagues at the MAASTRO (Maastricht Radiation Oncology) Clinic in the Netherlands conducted the review. The investigators analyzed data from five published clinical trials that looked at whether combined radiation and EPO was better than standard radiation therapy alone in the treatment of head and neck cancers. Nearly 1,400 patients were included in the analysis. The researchers compared overall survival, the length of time during and after treatment in which the [...]

Oral Cancer Foundation News Team - A2009-07-10T12:24:13-07:00July, 2009|Oral Cancer News|

Fighting malnutrition in cancer patients

Source: MSNBC Author: Staff Poor nutrition contributes to 1 in 5 cancer deaths; experts urge counseling WASHINGTON - The statistic is shocking: Severe malnutrition and weight loss play a role in at least one in five cancer deaths. Yet nutrition too often is an afterthought until someone's already in trouble. A move is on to change that, from hospitals that hire fancy gourmet chefs to the American Cancer Society's dietitians-on-call phone service. With cancer, you've got to "bring a lot more nutrients to each spoonful of food," Certified Master Chef Jack Shoop is learning. A former restaurateur, he's newly in charge of the kitchen at the Cancer Treatment Centers of America in Philadelphia. Don't underestimate the added temptation should the result resemble Bon Appetit: "The visual hardiness, and the actual heartiness, of these foods has to be understood for them to embrace it," Shoop insists. Tempting the palate is a huge hurdle: At diagnosis, up to a quarter of patients already have their appetite sapped, and most treatments can bring side effects that worsen the problem. Aside from the well-known nausea, vomiting and diarrhea, some cancers inhibit absorption of the nutrients patients force down. Not to mention strangely altered taste, mouth sores, dry mouth, difficulty swallowing and constipation. Literally wasting away About half of all cancer patients eventually suffer serious weight loss and malnutrition, a wasting syndrome called cachexia where they don't just lose excess fat but vital muscle. A healthy person's body adjusts when it doesn't get enough calories, [...]

Charlotte Parker2009-07-10T11:17:09-07:00July, 2009|Oral Cancer News|

New evidence supports HPV vaccine

MONDAY, July 6 (HealthDay News) -- The human papillomavirus (HPV) vaccine is highly effective at preventing precancerous cervical lesions that can lead to cervical cancer, a new study shows. The researchers also found that the HPV-16/18 AS04-adjuvanted vaccine also appears to protect against other cancer-causing HPV types closely related to HPV-16/18, most notably HPV-31 and HPV-45. The study of women aged 15 to 25, who received three vaccine doses over six months, found that it was as much as 98 percent effective against HPV-16/18, and between 37 percent and 54 percent effective against 12 other cancer-causing HPV types. HPV-16/18 causes about 70 percent of cervical cancer cases, while the remaining 30 percent of cases are caused by other cancer-causing HPV types. The cross-protective effect of the HPV-16/18 vaccine could provide an additional 11 percent to 16 percent protection against cervical cancer. "Although the importance of continued tests for Pap or HPV in vaccinated and unvaccinated women must be emphasized, HPV vaccination has the potential to substantially reduce the incidence of cervical cancer and precancer, and the numbers of colposcopy referrals and cervical excision procedures," concluded Dr. Jorma Paavonen, of the University of Helsinki in Finland, and colleagues. The study, which was funded by GlaxoSmithKline Biologicals, maker of the HPV-16/18 AS04-adjuvanted vaccine Cervarix, appears online July 7 and in an upcoming print issue of The Lancet. In an accompanying editorial, two experts wrote that men must also be included in efforts to halt the spread of HPV. "Currently, the targets for [...]

Charlotte Parker2009-07-10T15:34:24-07:00July, 2009|Oral Cancer News|

Topical EGF may decrease severe mucositis in patients with head and neck cancer receiving radiotherapy

Source: professional.cancerconsultants.com Author: staff Researchers from Korea have reported that recombinant epidermal growth factor (EGF) delivered as a spray twice daily may decrease the severity of severe mucositis in patients undergoing radiotherapy with or without chemotherapy for head and neck cancer. The details of this study appeared in an early online publication on June 9, 2009 in Cancer.[1] Oral mucositis is a frequent clinical problem in patients receiving chemotherapy and/or radiation therapy. Mucositis can be a severe dose-limiting toxicity, especially in patients receiving high-dose chemotherapy. Keritonocyte growth factor (Kepivance®) has been approved for prevention of mucositis in patients undergoing autologous stem cell transplantation. Other methods of treating or preventing oral mucositis include oral antiseptics, cryotherapy, laser therapy, L-glutamine (Saforis® and velafermin). Previous studies of antiseptic, antibiotic, and antifungal mouth washes and lozenges have revealed no dramatic effects, but two recent randomized trials suggested a limited role for topical antibiotic and antifungal treatment of mucositis. This multicenter trial enrolled 113 patients who were receiving definitive chemoradiotherapy or adjuvant radiotherapy. Patients were randomly allocated to a placebo group or to a group receiving three doses of EGF. Responders were defined as patients who had an RTOG grade of 2 or lower at the fourth- and fifth-week examinations. By this criteria 64% of patients receiving a 50-microgram dose of EGF responded compared with 37% in the control group. These authors concluded: “The EGF spray may have potential benefit for oral mucositis in patients undergoing RT for head and neck cancer. Phase 3 studies [...]

Oral Cancer Foundation News Team - A2009-07-08T05:12:37-07:00July, 2009|Oral Cancer News|

New figures reveal ethnic minorities are not aware of their cancer risk

Source: www.medicalnewstoday.com Author: staff Despite growing evidence that cancer is becoming more prevalent amongst ethnic minority groups, news figures out today at the start of Ethnic Minority Cancer Awareness Week show that cancer awareness levels are critically low amongst this cohort. At least 46% of ethnic minorities are unfamiliar or not sure about the signs and symptoms of the various forms of cancer or how to reduce their cancer risk even though 61% have had a family member suffer from cancer1. These figures are alarming because studies examining specific cancers and ethnic groups have shown that African Caribbean men are three times more likely to develop prostate cancer than white men2 and that mouth cancer is more common amongst South Asian and Chinese communities3. Quite a high number of ethnic minority women (78%) are aware of the NHS breast cancer screening programme1, however research has shown that 45% of black ethnic minority women of screening age (50-70) have never attended a screening of which 76% said it was because they had never been invited4. Only 22% of those questioned are aware of the NHS bowel cancer screening programme1 despite this form of cancer being the second most common cause of cancer death in the UK. If diagnosed at the earliest stage, bowel cancer is highly treatable with an estimated 83% survival rate5. Ethnic Minority Cancer Awareness Week (6th - 12th July 2009) was launched last year by Cancer Equality in partnership with an alliance of leading cancer charities who have [...]

Oral Cancer Foundation News Team - A2009-07-08T05:06:37-07:00July, 2009|Oral Cancer News|

Intensity-modulated radiotherapy reduces xerostomia in head and neck cancer

Source: www.oncologystat.com Author: staff Intensity-modulated radiotherapy significantly reduces the risk of subjective xerostomia by about 50% in patients with pharyngeal tumors, according to the first results of the multicenter, phase III PARSPORT trial. Cancer Research UK's PARSPORT (Parotid-Sparing Intensity-Modulated Radiation Therapy Compared With Conventional Radiation Therapy in Treating Patients With Oropharyngeal or Hypopharyngeal Cancer Who Are at High Risk of Radiation-Induced Xerostomia) trial evenly randomized 94 patients with pharyngeal tumors to conventional radiotherapy (conventional radiotherapy ) or intensity-modulated radiotherapy (IMRT). A three-dimensional technique, IMRT produces highly conformal dose distributions that can reduce the radiation dose to the salivary glands and normal tissue. At 12 months, the incidence of grade 2 or higher xerostomia was 74% in CRT patients vs. 39% in IMRT patients, based on the subjective portion of the LENT/SOM (Late Effects on Normal Tissue-Subjective/Objective Management) questionnaire (P = .004). The benefit of IMRT appeared to continue over time, with an 18-month xerostomia incidence of 71% with conventional therapy vs. 29% with IMRT (P = .003), principal investigator Dr. Christopher Nutting reported in a late-breaking abstract presentation at the annual meeting of the American Society of Clinical Oncology. A similar pattern was observed using the RTOG (Radiotherapy Oncology Group) scale. The incidence of at least grade 2 xerostomia was 64% with CRT vs. 41% with IMRT at 12 months (P = .05), and 81% vs. 20% at 18 months (P less than .001). This is the first randomized IMRT trial in head and neck squamous cell carcinoma, although phase [...]

Oral Cancer Foundation News Team - A2009-07-07T19:02:00-07:00July, 2009|Oral Cancer News|

Follow doctor’s advice, have lesion removed

Source: www.cantonrep.com Author: Peter Gott, M.D. Patients' question: In 1999, my dentist saw a discoloration on the floor of my mouth. He told me to see a doctor about it. The doctor talked me into having the spot surgically removed. A while back, I remember reading in your column that, 95 percent of the time, discolorations in the mouth are nothing to worry about. Recently, I had a procedure done to see if I had oral cancer. That procedure revealed another abnormal area. I assume it is the same thing as what I had removed before but the doctors now want me to have the spot surgically removed with a laser. I am hesitant and would like your advice. I have enclosed copies of both pathology reports, the first from 1999 and the second from a biopsy taken during the screening. Dr. Gott's response: In your first pathology report, the lesion was examined under a microscope. Abnormal changes were noted. These changes were labeled as mild to moderate squamous epithelial dysplasia. Primarily, this means that the flat, platelike cells in the interior covering of your mouth were altered in size, shape and organization. It was not stated that this was cancerous, but in my opinion, these changes were probably precancerous. Thus, having the lesion removed was a smart choice. Now, to the pathology report of your new lesion. According to the report, it very clearly showed that you have oral squamous cell carcinoma in-situ. This means that you have a [...]

Oral Cancer Foundation News Team - A2009-07-03T18:00:37-07:00July, 2009|Oral Cancer News|

Invasion characteristics of oral tongue cancer: frequency of reporting and effect on survival in a population-based study

Source: Cancer, June 23, 2009 Author: Michael Goodman et al. Background: The 2000 College of American Pathologists (CAP) guidelines recommend that a characterization of carcinomas of the upper aerodigestive tract, including tongue cancer, should include depth of invasion (DI) and the presence of lymphovascular invasion (LVI) or perineural invasion (PNI). Methods: This study included patients who were diagnosed with cancer of the oral tongue, who underwent tumor resection, and who were reported to either the Metropolitan Atlanta and Rural Georgia Surveillance, Epidemiology, and End Results (SEER) registry or the Los Angeles SEER registry. The authors assessed the completeness of pathology reporting with respect to the documentation of PNI or LVI and DI. Generalized estimating equations were used to examine factors that influenced reporting while taking into consideration clustering of observations within the hospitals. Univariate and multivariate survival analyses were conducted to examine the impact of tumor invasion characteristics on mortality while controlling for other prognostic factors. Results: DI reporting increased from 13% between 1997 and 1999 to 23% between 2000 and 2004 after the CAP issued its recommendations; whereas mode of invasion (the presence of LVI and/or PNI) reporting for the same period increased from 13% to 38%. The observed increase in reporting was most pronounced in the first 2 years (2000 and 2001) and appeared to decline again afterward. Tumor invasion >3 mm in depth and the presence of PNI were among the strongest predictors of survival in multivariate analyses. Conclusions: The current results indicated the importance of reporting [...]

Oral Cancer Foundation News Team - A2009-07-03T17:46:33-07:00July, 2009|Oral Cancer News|

The prognostic significance of histological features in oral squamous cell carcinoma

Source: J Oral Pathol Med, June 25, 2009 Authors: S R Larsen et al. Background: Different factors predict nodal metastasis, recurrence and survival in oral cancer. The aim was to assess the prognostic value of histological features related to the primary tumour. Methods: A total of 144 patients surgically treated at Odense University Hospital for oral cancer between 1999 and 2004 were included in the study. Postoperative radiation therapy was given in case of close and involved margins or high TNM stages (UICC 1997). Median follow-up time was 38 months. All surgical resections were reviewed and 22 histological characteristics were assessed. Results: The predominant sites were floor of mouth (FOM, 39%) and lateral tongue (35%). Fifty-nine per cent had UICC97 stage I-II disease. Five-year cause-specific survival was observed in 65%. Nodal involvement at diagnosis was observed in 36% which was significantly related to grade, neural and vascular invasion; surgical margins and increasing tumour depth. A cut-off value of 2 mm (4 mm for FOM) separated patients without and with nodal metastasis at the time of diagnosis. However, on multivariate analysis, neck disease was only associated with tumour depth and grade. Cox analysis of local recurrence in the oral cavity over time showed that tumour diameter and surgical margins were significant predictors while cause-specific survival was related to diameter, depth of invasion, surgical margins and extracapsular spread (ECS). Conclusions: Tumour depth and grade were strong prognostic factors for nodal metastasis, independently of other histological features. Tumour diameter and margins independently predict [...]

Oral Cancer Foundation News Team - A2009-07-03T17:40:45-07:00July, 2009|Oral Cancer News|