Adjuvant radiotherapy helpful in early, node-positive oral cancer

Source: www.acr.org Author: David Douglas Postoperative radiotherapy significantly improves survival in patients with early T stage oral cavity squamous cell carcinoma and a single positive lymph node, researchers report in the March issue of Archives of Otolaryngology: Head and Neck Surgery. "Even for small primary tumors of the oral cavity, the presence of a single positive lymph node may be an indication to offer radiation despite the relatively early stage of these tumors," lead author Dr. Mark G. Shrime told Reuters Health by email. "This is especially true in T2 tumors of the tongue and the floor of mouth." Dr. Shrime of Boston University Medical Center and colleagues examined data on more than 1500 patients who had surgery between 1983 and 2004. Patients who had postoperative radiotherapy had significantly better 5-year overall survival (54.2% versus 41.4%). The largest advantage was in patients with T2 primary tumors (48.8% versus 32.5%). The difference in patients with T1 tumors (63.4% versus 56.5%) was not statistically significant. Also, the authors report, adjuvant radiotherapy was particularly effective in T2 tumors of the tongue (improving 5-year survival from 37.9% to 52.3%) and floor of the mouth (boosting survival from 17.7% to 39.9%). For all other sites, adjuvant radiotherapy was not associated with improved overall 5-year survival. The 5-year cause-specific survival rate was 64.3% in patients treated with surgery alone, versus 72.1% in patients who also had radiotherapy. While the results appear encouraging, the researchers call for "further analysis with either large multi-institutional series or more detailed [...]

Rise in mouth cancer linked to STI’s, primarily HPV16

Source: www.nhs.uk Author: staff The Daily Telegraph reported that a “rise in mouth cancer may be due to sexually transmitted infection”. The newspaper said that there has been a 50% increase in the number of mouth cancers in the last 20 years, and the increase appears to be in those cases related to the human papilloma virus (HPV). The story is based on an editorial in the British Medical Journal by cancer specialists, which highlighted an increase in the numbers of a specific type of throat cancer in the UK. The specialists also discussed studies from other countries that show an increase in the proportion of HPV-related throat cancers. The editorial reported on a very small number of studies, but it shows that there may be a need to investigate the incidence of HPV-related throat cancers in the UK, to track these cases and to see if HPV-related cancers should be treated differently to non-HPV-related throat cancers. There is insufficient evidence at the moment to suggest that the HPV vaccination, currently available for teenage girls, should also be given to boys. Where did the story come from? This editorial was written by Hisham Mehanna, director of the Institute of Head and Neck Studies and Education at University Hospital, Coventry, and colleagues at the University of Liverpool, Université Catholique de Louvain and the University of Texas. The editorial was commissioned and published by the British Medical Journal and was not externally peer reviewed. What was the editorial about? This editorial was [...]

Study evaluating clinical performance of Cervista(R) HPV HR presented at AOGIN

Source: www.prnewswire.com Author: press release Hologic, Inc. (Hologic or the Company), a leading developer, manufacturer and supplier of premium diagnostics, medical imaging systems and surgical products dedicated to serving the healthcare needs of women, today announced that interim data from the first large-scale independent evaluation of clinical performance of Cervista® HPV HR compared to Hybrid Capture 2 (hc2), were presented at the 4th Biennial Meeting of AOGIN (Asia-Oceanic Research Organization in Genital Infection and Neoplasia) in New Delhi, India on March 26-28, 2010. Cervista HPV HR is a diagnostic test for the detection of 14 high-risk human papillomavirus (HPV) types. The study, SHENCCAST II, is a major cervical cancer screening trial including more than 10,000 women that is being conducted in China to evaluate the performance of HPV assays, among other endpoints. A preliminary analysis of data from 5,043 patients showed the Cervista HPV HR test performed as follows: Overall HPV positivity for this cohort was 12.2 percent for the Cervista HPV HR test and 14.6 percent with the hc2 test. For histologically confirmed CIN 2 or more severe lesions, the Cervista HPV HR test showed a sensitivity of 90.7 percent and a specificity of 90.2 percent. For the hc2 test, sensitivity and specificity were 94.7 percent and 87.9 percent, respectively. While the Cervista HPV HR test demonstrated improved specificity and the hc2 test yielded higher sensitivity, a statistical analysis of overall test accuracy that plots sensitivity and specificity found the two methods were clinically equivalent (area under the ROC [...]

Oropharyngeal carcinoma related to human papillomavirus

Source: BMJ 2010;340:c1439 Author: Staff Incidence is increasing rapidly, with implications for prognosis and policy Head and neck cancer is the sixth most common cancer, with about 640,000 new cases each year worldwide. Despite an overall marginal decline in the incidence of most head and neck cancers in recent years,1 the incidence of oropharyngeal squamous cell carcinoma has increased greatly, especially in the developed world. In the United States, the incidence of oropharyngeal squamous cell carcinoma increased by 22% from 1.53 per 100,000 to 1.87 per 100,000 between 1999 and 2006, after showing no change between 1975 and 1999. 1 The United Kingdom has seen a 51% increase in oral and oropharyngeal squamous cell carcinoma in men from seven per 100,000 to 11 per 100,000 between 1989 and 2006. 2 The increase in incidence of oropharyngeal squamous cell carcinoma seems to be accounted for by a rise in human papillomavirus (HPV) related oropharyngeal carcinoma. A recent retrospective study showed a progressive proportional increase in the detection of HPV in biopsies taken to diagnose oropharyngeal squamous cell carcinoma in the Swedish county of Stockholm over the past three decades (23.3% in 1970s, 29% in 1980s, 57% in 1990s, 68% between 2000 and 2002, 77% between 2003 and 2005, and 93% between 2006 and 2007).3 Similarly, HPV related oropharyngeal carcinoma has been reported in 60-80% of recent oropharyngeal biopsy samples in studies conducted in the US, compared with 40% in the previous decade.4 More research is needed to establish the incidence of HPV related oropharyngeal carcinoma in African, Asian, and South American countries. HPV related oropharyngeal carcinoma seems to be a new and distinct [...]

2010-03-26T16:16:09-07:00March, 2010|Oral Cancer News|

HPV-related cancer leap to have big impact on health services

Source: www.dentistry.co.uk Author: staff The rapid rise in cases of squamous cell carcinoma related to human papillomavirus (HPV) infection has serious implications for health services around the world, warn researchers. They suggest that sexual transmission of HPV might be the reason for the rise. Head and neck cancer is the sixth most common cancer, with about 640,000 new cases each year worldwide. Despite an overall marginal decline in most head and neck cancers in recent years, the level of oropharyngeal squamous cell carcinoma (OSCC) has increased greatly, especially in the developed world. In the US, cases increased by 22% between 1999 and 2006, after showing no change between 1975 and 1999, while the UK has seen a 51% increase in oral and oropharyngeal cancer in men between 1989 and 2006. This increase seems to be accounted for by a rise in HPV-related tumours, say the authors, led by Hisham Mehanna at the Institute of Head and Neck Studies and Education, University Hospital, Coventry. A recent study showed a 70% increase in the detection of HPV in biopsies taken to diagnose oropharyngeal carcinoma in Stockholm since the 1970s. HPV-related oropharyngeal carcinoma has also been reported in 60-80% of recent biopsy samples in studies conducted in the US, compared with 40% in the previous decade. HPV-related oropharyngeal carcinoma seems to be a new and distinct disease entity, explain the authors. It has a better prognosis than non-HPV related oropharyngeal carcinoma, particularly in non-smokers, but the reason for this improved survival is not [...]

Time-released muco-adhesive patch more effective than oral rinse for xerostomia

Source: www.news-medical.net/news Author: press release A newly developed time-released muco-adhesive patch for treating oral health conditions, including the widespread condition of dry mouth (xerostomia), has been shown to be more effective than a leading oral rinse, according to a newly-published study. As increasing segments of the population consume more medications (one of the leading causes of dry mouth), the results of this study could potentially help provide relief for millions of Americans. Chronic dry mouth impacts the quality of life and for some, can be debilitating. Published in the March 2010 issue of Quintessence International, the study found that chronic dry mouth sufferers can now get a statistically significant reduction of mouth dryness from a new time-released muco-adhesive patch (OraMoist Dry Mouth Patch), compared with the leading oral rinse which has been on the market for nearly two decades. Overall, patients with xerostomia treated with the muco-adhesive patch reported a statistically significant reduction in mouth dryness sensation with elevated salivary flow rate (150%) after just 30 minutes, which was considered clinically outstanding by the study authors, since the product does not contain any cholinergic agonist, a drug often used to treat dry mouth. OraMoist, a new time-released, non-drug formula, not only outperformed the mouthwash, one of the most often used delivery formats for treating dry mouth, but unlike dry mouth sprays, rinses or gels, which need to be applied frequently – sometimes every 20 minutes – OraMoist works to increase moisture and help restore a healthy oral environment for hours [...]

Public awareness level of oral cancer in a group of dental patients

Source: J Contemp Dent Pract, January 1, 2010; 11(2): E049-56 Authors: I Peker and MT Alkurt Aim: The aim of this study was to evaluate levels of public awareness and knowledge about early signs and risk factors of oral cancer among a group of dental patients in Turkey. Methods and materials: This study included 1022 participants. Sociodemographic information of patients was obtained. A questionnaire about awareness and knowledge of oral cancer and early signs and risk factors related to the disease was completed by two examiners. Data were statistically analyzed with descriptive analyses, crosstabs and chi-square tests. Results: In total 60.7% of participants had never heard of oral cancer. While 79.2% of the participants were unaware of the early signs related to oral cancer, 29.9% of them were unaware of risk factors of the disease. There were no statistically significant differences between age, gender, and education levels for awareness of risk factors. Statistically significant differences were found between age and gender and no statistically significant difference was found between education levels for awareness of early signs. Conclusion: This study showed that public awareness and knowledge about oral cancer were insufficient in Turkey. Clinical significance: There is an important need to inform the public about oral cancer, its risk factors, and early signs of the disease. Media campaigns can be useful to raise oral cancer awareness.

Fluoroscopically guided balloon dilation for pharyngoesophageal stricture after radiation therapy in patients with head and neck cancer

Source: AJR 2010; 194:1131-1136 Authors: Hong-Tao Hu et al. Objective: The purpose of this article is to assess the safety and long-term efficacy of fluoroscopically guided balloon dilation for pharyngoesophageal strictures after radiation therapy in patients with head and neck cancers. Materials and methods: From April 1997 to February 2009, fluoroscopically guided balloon dilation was performed in 17 patients with pharyngoesophageal strictures caused by radiation therapy. Technical success, clinical success (decrease of at least one grade in dysphagia score and good contrast passage on 1-month follow-up esophagogram), recurrence of dysphagia, and complications related to the procedure were retrospectively evaluated. Results: All 17 patients underwent 41 balloon dilation procedures, with each patient undergoing one to seven procedures (mean, 2.4 procedures). The technical success rate was 100%, and clinical success was achieved in 64.7% (11/17) of the patients. Five patients (29.4%) showed no recurrence of dysphagia after one session of balloon dilation. Of 12 patients (70.6%) with recurrence of dysphagia, 10 underwent repeat balloon dilation and two underwent gastrostomy after the first session of balloon dilation. The maximum balloon diameters were 15 mm (n = 22), 20 mm (n = 16), and 25 mm (n = 3). As minor complications, three cases of type 1 esophageal rupture occurred in two patients (11.8%). There were no major complications. Conclusion: Although the recurrence rate was high with repeat balloon dilation, fluoroscopically guided balloon dilation seems to be a simple and safe primary treatment technique for pharyngoesophageal stricture due to radiation therapy in patients with [...]

Experts warn that new “smokeless” tobacco products are still dangerous

Source: FOX21News Author: Tracee Tolentino DULUTH - The tobacco industry is offering new products and finding new ways to attract and keep customers. However, health advocates say the new products are just as dangerous, and the customers are getting younger and younger. "Most 6-year-olds, if you queried them, they would know who Joe Camel is," said Michele Hughes of the Douglas County Health Department. Now, with the introduction of new smokeless tobacco alternatives, there are new ways that young adults can get hooked to nicotine. “They’re out there as the ‘good guy’ or look, these aren't quite as harmful, but indeed these are deadly products that lead to a lifetime of addiction and this is an industry that is out for our youth,” said Pat McKone of the American Lung Association of Minnesota. Many new tobacco products are more appealing to younger customers, with bright packaging, candy flavors and the illusion of a "safer" nicotine delivery source. McKone warns that these products are tricks. The alternative products include forms of snuff, chewing tobacco, e-cigarettes or snus, which are spit-less tobacco pouches that users place under their upper lip. "These products are to enable people to keep using nicotine and nicotine delivery systems until they can get out to smoke," said McKone. The popularity of these products has increased as more states have adopted smoking bans for workplaces and businesses. Minnesota’s ban is already in place and in July, Wisconsin will follow suit. “80% of current adult smokers started between the [...]

2010-04-19T22:29:13-07:00March, 2010|Oral Cancer News|

Busting the myth of the cervical cancer vaccine

Source: Temple University Press Editorial by: Gkramer Adina Nack, author of Damaged Goods? Women Living with Incurable Sexually Transmitted Diseases, draws on her expertise as a sexual health researcher to discuss the impact of human papillomavirus (HPV) on men and the need for gender-neutral STD vaccines. When I wrote my book, Damaged Goods? I focused on how living with contagious, stigmatizing, medically incurable (though highly treatable) infections transformed women’s lives – medically, socially and psychologically. I had included a discussion of the Gardasil vaccine, which had received FDA-approval and CDC recommendation for ‘routine’ use in girls and women (ages 9 to 26) back in 2006, and I had articulated some of my concerns about the delayed testing and approval process for ‘male’ Gardasil. A family of viruses, HPV is an ‘equal opportunity infector,’ so why have HPV vaccines not been equally accessible for men as well as women? In a recent interview on Huffington Post, several blog posts of my own, and my new feature article, “Why Men’s Health Is a Feminist Issue” (Ms. Magazine,Winter 2010), I investigate the substantial public health costs that result from HPV vaccines, such as Gardasil, not having been originally developed, tested and approved as gender-neutral vaccines. The narrow and inaccurate marketing of Gardasil as a female-only, “cervical cancer” vaccine has distracted us from public discourse about this family of sexually transmitted viruses that are not only a U.S. epidemic but also a global pandemic. In the U.S., HPV is estimated to affect 75% of adults and certain strains are known [...]

2010-03-23T22:33:02-07:00March, 2010|Oral Cancer News|
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