March 2011 – Page 3 – Oral Cancer News

Tongue cancer – experts warn against increasing incidence of tongue disease

Source: starglobaltribune.com Author: Matthew Bennett A UNC study released this week in the Journal of Clinical Oncology finds an increasing incidence of squamous cell carcinoma of the oral tongue in young white females in the United States over the last three decades. A team of researchers from UNC Lineberger Comprehensive Cancer Center analyzed data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database and found that, between 1975 and 2007, the overall incidence for all ages, genders, and races of the disease was decreasing. However, the incidence of oral tongue squamous cell carcinoma rose 28 percent among individuals ages 18 to 44. Specifically, among white individuals ages 18 to 44 the incidence increased 67 percent. The increasing incidence was most dramatic for white females ages 18 to 44. They had a percentage change of 111 percent. Interestingly, the incidence decreased for African American and other racial groups. Historically, oral tongue cancer has been strongly associated with heavy tobacco and alcohol use. Other epidemiological studies have related the decreasing incidence of oral tongue cancer in the United States to the decreased use of tobacco products. Though the UNC research team verified the known decreasing incidence of oral tongue cancer, they were surprised to observe an increasing incidence in young white individuals, specifically young white females. “Lately we have been seeing more oral tongue cancer in young white women in our clinic. So we looked at the literature, which reported an increase in oral tongue squamous cell carcinoma in [...]

Oral Cancer Foundation News Team - A2011-03-12T11:35:27-07:00March, 2011|Oral Cancer News|

Tonsillar squamous cell carcinoma- are we making a difference?

Source: SAGE Journals Online Objective. To analyze outcomes in patients with squamous cell carcinoma (SCCA) of the tonsil from the years 1998 to 2006. To assess factors that may affect disease-specific survival, such as patient characteristics and/or treatment modality. Study Design and Setting. National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program. Subjects and Methods. The SEER database was used to perform a population-based cohort analysis for patients diagnosed with SCCA of the tonsil from 1998 to 2006. Disease-specific survival was correlated with sex, age, ethnicity, year of diagnosis, and treatment modality in a univariate Cox proportional hazards analysis and a multiple Cox-regression model with and without interaction effect. Results. Applied inclusion criteria resulted in 8378 patients. Of this patient cohort, 80% were male and 85% were white. The mean patient age at diagnosis was 58.1 years. On univariate and multivariate analyses, ethnicities other than white carried a significantly higher rate of disease-specific death (hazard ratio = 1.71, P < .001). Each additional year of age at the time of diagnosis carried approximately a 4% increase in likelihood of disease-specific death. With each passing year of time at diagnosis, patients carried a decreased risk of disease-specific death (P < .001); this value was significant in all 3 statistical models. Patients who underwent external-beam radiation had a higher likelihood of disease-specific survival with each passing year at time of diagnosis. Conclusion. Population analysis based on the SEER database reveals increased disease-specific survival from tonsillar SCCA in more recent years. This [...]

Oral Cancer Foundation News Team - A2011-03-12T11:29:08-07:00March, 2011|Oral Cancer News|

Reirradiation for head-and-neck cancer: delicate balance between effectiveness and toxicity

Source: HighWire- Stanford University PURPOSE: To analyze the effectiveness and toxicity of reirradiation (re-RT) for head-and-neck cancer. METHODS AND MATERIALS: A retrospective data analysis was performed of 58 patients who underwent re-RT with curative intent. Re-RT was given as definitive treatment in 53% of patients, whereas salvage surgery preceded reirradiation in 47%. The median cumulative RT dose was 119 Gy (range, 76-140). Concurrent chemotherapy was administered with re-RT (CRT) in 57% of patients. Event-free survival was defined as survival without recurrence and without serious toxicity (?Grade 3). RESULTS: Median follow-up was 57 months (range, 9-140). Locoregional (LR) control was 50% at 2 and 5 years. The 2-year and 5-year overall survival (OS) was 42% and 34%. The following factors were associated with improved OS: postoperative re-RT (vs. primary re-RT), treatment with RT only (vs. CRT) and interval >3 years between previous RT and re-RT. For patients treated with postoperative re-RT and definitive re-RT, the 5-year OS was 49% and 20%, respectively. Patients treated with CRT had a 5-year OS of 13%. Serious (late) toxicity ?Grade 3 was observed in 20 of 47 evaluable patients (43%). Three cases of treatment-related death were recorded. The 2- and 5-year serious toxicity-free interval was 59% and 55%, respectively. Associated with increased risk of serious toxicity were CRT and higher re-RT dose. The event-free survival rates at 2 and 5 years were 34% and 31%, respectively. CONCLUSIONS: Re-RT in head-and-neck cancer is associated with poor survival rates of 13-20% in patients with inoperable disease treated [...]

Oral Cancer Foundation News Team - A2011-03-12T11:28:37-07:00March, 2011|Oral Cancer News|

Global cancer statistics

Corresponding author: Ahmedin Jemal, DVM, PhD, Surveillance Research, American Cancer Society The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a [...]

Oral Cancer Foundation News Team - A2011-03-10T10:27:12-07:00March, 2011|Oral Cancer News|

New-generation radiation treatment, a first-line therapy for patients with large head and neck tumours

Source: Medical News Today Biologically targeted BNCT treatment is based on producing radiation inside a tumour using boron-10 and thermal neutrons. Boron-10 is introduced into cancer cells with the help of a special carrier substance (phenylalanine), after which the tumour is irradiated with lowenergy neutrons. The latter react with the boron to generate high-LET radiation, which may destroy the cancer cells. One to two BNCT treatment sessions may be sufficient to destroy a tumour, while keeping the impact of radiation on surrounding healthy tissue to a minimum. A research reactor is currently used as the neutron source, but dedicated neutron accelerators being designed for BNCT. Clinical trials to assess the efficacy and safety of BNCT in the treatment of locally recurrent head and neck cancer have been carried out at the Department of Oncology at Helsinki University Central Hospital (HUCH). OCF Apart from palliative chemotherapy, conventional treatment was no longer considered possible for the patients treated in the BNCT trials. A total of 30 patients referred to HUCH's Department of Oncology from hospitals around Finland took part in the trial. 76% of patients responded well to the treatment and 30% were still alive two years after treatment; although only one patient has survived 55 months. The results of the study, conducted by Professor Heikki Joensuu, have recently been published in the International Journal of Radiation Oncology, Biology, Physics. BNCT treatment is provided by Boneca Corporation, which is based at the main campus of Helsinki University Central Hospital and is the [...]

Oral Cancer Foundation News Team - A2011-03-12T11:27:48-07:00March, 2011|Oral Cancer News|

Cetuximab therapy for head and neck squamous cell carcinoma: a systematic review of the data

Source: http://oto.sagepub.com/ Authors: Travis D. Reeves, MD et al. Objective: To review the current state of the data on the use of cetuximab in head and neck squamous cell carcinoma (HNSCC). Data Sources: The National Center for Biotechnology Information’s PubMed and the Cochrane collection. Review Methods. Search terms included cetuximab and head and neck cancer. These results were reviewed, and a second search was performed using limits: meta-analysis, randomized controlled trial, and clinical trial. Results: The literature search yielded 412 articles. Fifteen were identified for analysis. For patients with recurrent/metastatic disease who received combination chemotherapy in phase I/II trials, the overall response (OR) was 18.7% (95% confidence interval [CI], 10.4%-27.0%). Phase III trial data for combination chemotherapy in recurrent/metastatic disease showed OR to be 17.0% (95% CI, 12.6%-21.4%) for platinum-based regimens and 34.2% (28.6%-39.7%) for platinum-based regimens with cetuximab. For this same group, the estimated aggregate hazard ratio comparing platinum-based therapy plus cetuximab to platinum therapy alone was 1.10 (95% CI, 0.78-1.54), indicating no significant improvement in overall survival in the aggregate analysis. Combination chemoradiation with cetuximab in both phase I/II trials and the single phase III trial shows enhanced responsiveness, but the data are difficult to interpret because it is not used with standard-of-care regimens for advanced-stage disease. Conclusion: Early evidence has shown cetuximab to be effective in the treatment of HNSCC, and it should be used to enhance, but not replace, current treatment paradigms until further phase III data are available. Note: This article was presented at the [...]

Oral Cancer Foundation News Team - A2011-03-05T12:32:58-07:00March, 2011|Oral Cancer News|

Fish oil helps prevent weight and muscle loss in cancer patients

Source: www.medscape.com Author: Roxanne Nelson Supplementation with fish oil might help prevent muscle wasting and weight loss in cancer patients undergoing chemotherapy. In a small study of 40 patients newly diagnosed with nonsmall-cell lung cancer (NSCLC), those who received fish oil supplements maintained weight, muscle mass, and muscle quality. The study, published online February 28 in Cancer, found that about 69% of the patients who took fish oil gained or maintained muscle mass. In comparison, only 29% of patients in the control group maintained muscle mass; as a group, they lost an average of 1 kg of muscle. "Fish oil may prevent loss of weight and muscle by interfering with some of the pathways that are altered in advanced cancer," said senior author Vera C. Mazurak, PhD, assistant professor in the Department of Agricultural, Food & Nutritional Science at the University of Alberta in Edmonton, Canada. "This holds great promise because currently there is no effective treatment for cancer-related malnutrition," she said in a statement. Dr. Mazurak pointed out that fish oil is safe and nontoxic with virtually no adverse effects, and might benefit patients with other types of cancer or chronic diseases that are associated with malnutrition. It might also be beneficial to elderly individuals who are at risk for muscle loss. However, in their paper, the authors point out that previous results with fish oils in cancer patients have been mixed. Three large phase 3 trials failed to demonstrate a clear benefit of eicosapentaenoic acid (EPA) on either [...]

Oral Cancer Foundation News Team - A2011-03-04T19:11:49-07:00March, 2011|Oral Cancer News|

HIM study looks at HPV infection and clearance in men

Medscape Oncology News By Nick Mulcahy March 1, 2011 — Half of all the men participating in a natural history study of human papillomavirus (HPV) were infected with some strain of HPV at some point during study period, according to the results of a new study published online March 1 in the Lancet. The HPV in Men (HIM) study, led by Anna Giuliano, PhD, from the H. Lee Moffitt Cancer Center in Tampa, Florida, followed 1159 adult males for a median follow-up of 27.5 months. However, the prevalence of viral types for which there is a prophylactic vaccine is low — 6% for HPV16 and 2% for HPV18 (the 2 oncogenic types), and 7% for HPV6 and 1% for HPV11 (the 2 nononcogenic types). Data on HPV incidence and clearance from the HIM study have immediate uses, suggests the author of an editorial accompanying the study. "The HIM data on HPV incidence and clearance should be exploited to elaborate prevention guidance, and to minimize transmission and to aid management and associated concerns for couples," says editorialist Joseph Monsonego, MD, from the Institute of the Cervix in Paris, France. Men transmitting HPV to women is especially concerning, writes Dr. Monsonego, because "extrapolation from the HIM data strongly suggests that the natural history of HPV is different in men and women, with high infection and low disease rates in men and low infection and high disease rates in women." However, he points out that "the cost–benefit ratio of vaccinating men to protect women from [...]

Oral Cancer Foundation News Team - A2011-03-04T17:37:35-07:00March, 2011|Oral Cancer News|

Prevention of radiation-induced salivary hypofunction following hKGF gene delivery to murine submandibular glands

Source: clincancerres.aacrjournals.org Authors: Changyu Zheng et al. Purpose: Salivary glands are significantly affected when head and neck cancer patients are treated by radiation. We evaluated the effect of human keratinocyte growth factor (hKGF) gene transfer to murine salivary glands on the prevention of radiation-induced salivary hypofunction. Experimental Design: A hybrid serotype 5 adenoviral vector encoding hKGF (AdLTR2EF1alpha-hKGF) was constructed. Female C3H mice, 8 weeks old, were irradiated by single (15 Gy) or fractionated (6 Gy for 5 days) doses to induce salivary hypofunction. AdLTR2EF1alpha-hKGF or Adcontrol was administered (108 - 1010 particles/gland) to both submandibular glands (SGs) by retrograde ductal instillation before irradiation. Salivary flow was measured following pilocarpine stimulation. Human KGF levels were measured by ELISA. SG cell proliferation was measured with bromodeoxyuridine labeling. Endothelial and progenitor or stem cells in SGs were measured by flow cytometry. The effect on SG hKGF production on SCC VII tumor growth was assessed. Results: In 3 separate single dose irradiation experiments salivary flow rates of mice administered the AdLTR2EF1alpha-hKGF vector were not significantly different from non-irradiated control mice (P greater than 0.05). Similarly, in 3 separate fractionated irradiation experiments the hKGF-expressing vector prevented salivary hypofunction dramatically. Transgenic hKGF protein was found at high levels in serum and SG extracts. AdLTR2EF1alpha-hKGF-treated mice showed increased cell proliferation, and numbers of endothelial cells, compared to mice treated with AdControl. hKGF gene transfer had no effect on SCC VII tumor growth plus/minus radiation. Conclusions: hKGF gene transfer prevents salivary hypofunction caused by either single or fractionated [...]

Oral Cancer Foundation News Team - A2011-03-03T22:53:20-07:00March, 2011|Oral Cancer News|

General medical practitioners not likely to be part of the oral cancer solution

Source: HighWire- Stanford University Summary of a study by: LA Shanks, TW Walker, PJ McCann, and MJ Kerin There has been little improvement in the survival of patients with oral cancer despite advances in treatment. One observation is that late presentation of the disease is this reason for this continuing poor outcome. However research and experience tell us that tuition in medical schools about examination of the oral cavity is poor. This study aimed to ascertain the opinions and experience of medical students regarding this at Stanford by dissemination of a web-based anonymous questionnaire that focused on education about examination of the oral cavity, and experience in carrying it out. From a cohort of 600 students 458 (76%) responded. A total of 334 (73%) had not been taught how to examine the oral cavity, 372 (81%) had had no experience of doing so in patients, and only 15% felt confident to diagnose a carcinoma of the lip or oral cavity. Eighty-nine percent felt that the tuition given had not been adequate. OCF From this survey it is clear that examination of the oral cavity cannot be considered part of the core clinical curriculum, and medical schools and departments of oral and maxillofacial surgery urgently need to embrace the introduction of the necessary skills.

Charlotte Parker2011-03-03T22:46:25-07:00March, 2011|Oral Cancer News|