October 2011 – Page 2 – Oral Cancer News

Senate takes aim at tobacco in baseball

Source: chicagoist.com Author: Angie Wiatrowsk As the Rangers and Cardinals play in the World Series, the U.S. Senate is pushing for something else. As if they have nothing better to do. Four United States Senators, including Dick Durbin of Illinois, and health officials from St. Louis and Arlington, TX. made pleas in separate letters in hopes of banning chewing tobacco at baseball games and on camera. They want to stress not only the harmful effects on the players, but the image they're sending to children who watch them. St. Louis public health authority Pamela Walker said in her letter, "Younger people believe smokeless tobacco is a safer alternative to cigarettes, and when they see people they idolize do it that reinforces that belief. Not only that, it makes dipping look cool." Baseball players dipping is no news, it's been affecting kids for years whether we tend to ignore it or not. Shoot, the term "bullpen" came to existence when Blackwell Tobacco Company released Bull Durham brand tobacco in 1860. After all, who as a kid growing up playing ball didn't have their share of Big League Chew? That's right, before you hit the field, pull out that stringy wad of "groundball grape" and stick it in your cheek like the guys on TV. It was an alternative to chewing tobacco that was very well marketed to kids. It was created by Portland Mavericks' pitcher Rob Nelson and New York Yankees' Jim Bouton. The two were sitting in the bullpen and [...]

Oral Cancer Foundation News Team - A2011-10-23T09:13:24-07:00October, 2011|Oral Cancer News|

Ethanol Promotes Chemically Induced Oral Cancer in Mice through Activation of the 5-Lipoxygenase Pathway of Arachidonic Acid Metabolism

Source: Cancer Prevention Research Abstract Alcohol drinking is a known risk factor for oral cancer in humans. However, previous animal studies on the promoting effect of ethanol on oral carcinogenesis were inconclusive. It is necessary to develop an animal model with which the molecular mechanism of ethanol-related oral carcinogenesis may be elucidated to develop effective prevention strategies. In this study, mice were first treated with 4-nitroquinoline-1-oxide (4NQO, 100 μg/mL in drinking water) for 8 weeks and then given water or ethanol (8%) as the sole drink for another 16 weeks. During the experiment, 8% ethanol was well tolerated by mice. The incidence of squamous cell carcinoma (SCC) increased from 20% (8/41) to 43% (17/40; P < 0.05). Expression of 5-lipoxygenase (5-Lox) and cyclooxygenase 2 (Cox-2) was increased in dysplasia and SCC of 4NQO-treated tongues and further enhanced by ethanol. Using this mouse model, we further showed that fewer cancers were induced in Alox5−/− mice, as were cell proliferation, inflammation, and angiogenesis in the tongue, as compared with Alox5+/+ mice. Interestingly, Cox-2 expression was induced by ethanol in knockout mice, whereas 5-Lox and leukotriene A4 hydrolase (LTA4H) expression and leukotriene B4 (LTB4) biosynthesis were dramatically reduced. Moreover, ethanol enhanced expression and nuclear localization of 5-Lox and stimulated LTB4 biosynthesis in human tongue SCC cells (SCC-15 and SCC-4) in vitro. In conclusion, this study clearly showed that ethanol promoted 4NQO-induced oral carcinogenesis, at least in part, through further activation of the 5-Lox pathway of arachidonic acid metabolism. This news story was resourced [...]

Oral Cancer Foundation News Team - A2011-10-19T15:36:04-07:00October, 2011|Oral Cancer News|

Thyroid Dysfunction from Antineoplastic Agents

Source: Journal of the National Cancer Institute Abstract Unlike cytotoxic agents that indiscriminately affect rapidly dividing cells, newer antineoplastic agents such as targeted therapies and immunotherapies are associated with thyroid dysfunction. These include tyrosine kinase inhibitors, bexarotene, radioiodine-based cancer therapies, denileukin diftitox, alemtuzumab, interferon-α, interleukin-2, ipilimumab, tremelimumab, thalidomide, and lenalidomide. Primary hypothyroidism is the most common side effect, although thyrotoxicosis and effects on thyroid-stimulating hormone secretion and thyroid hormone metabolism have also been described. Most agents cause thyroid dysfunction in 20%–50% of patients, although some have even higher rates. Despite this, physicians may overlook drug-induced thyroid dysfunction because of the complexity of the clinical picture in the cancer patient. Symptoms of hypothyroidism, such as fatigue, weakness, depression, memory loss, cold intolerance, and cardiovascular effects, may be incorrectly attributed to the primary disease or to the antineoplastic agent. Underdiagnosis of thyroid dysfunction can have important consequences for cancer patient management. At a minimum, the symptoms will adversely affect the patient’s quality of life. Alternatively, such symptoms can lead to dose reductions of potentially life-saving therapies. Hypothyroidism can also alter the kinetics and clearance of medications, which may lead to undesirable side effects. Thyrotoxicosis can be mistaken for sepsis or a nonendocrinologic drug side effect. In some patients, thyroid disease may indicate a higher likelihood of tumor response to the agent. Both hypothyroidism and thyrotoxicosis are easily diagnosed with inexpensive and specific tests. In many patients, particularly those with hypothyroidism, the treatment is straightforward. We therefore recommend routine testing for thyroid abnormalities [...]

Oral Cancer Foundation News Team - A2011-10-19T15:29:24-07:00October, 2011|Oral Cancer News|

New Guidelines for Reirradiation of Head and Neck Cancer

Source: Medscape News Today When head and neck cancer recurs and surgery is not an option, reirradiation provides the only potentially curative option. However, because the tumor often recurs in the same place or very close to tissue that has already been irradiated, this treatment approach represents a "significant challenge." For this reason, it should be handled at a tertiary-care center, according to a new guideline issued by the American College of Radiology. Specifically, it stipulates that the tertiary center should have a head and neck oncology team that is equipped with the resources and the experience to manage the complexities and toxicities of retreatment. In the guideline, published in the International Journal of Radiation Oncology, Biology and Physics, a panel of experts outline appropriateness criteria for various clinical scenarios that arise with such patients. It provides a consensus on how patients should be managed. "This is an important document because it is the first set of guidelines for the potentially curative treatment of patients who have regrowth of head and neck tumors. It provides a consensus on how patients should be managed," coauthor Madhur Kumar Garg, MD, said in a statement. Dr. Garg is from the Department of Radiation Oncology at Montefiore Medical Center, in the Bronx, New York, where about a dozen reirradiation procedures are performed annually. Commitment to Retreatment Retreatment is justified because clinical trial results have shown that local treatment improves overall survival, the panel of experts notes. However, they emphasize that, before a commitment to [...]

Oral Cancer Foundation News Team - A2011-10-18T10:35:08-07:00October, 2011|Oral Cancer News|

New Therapies and Prognostic Techniques Highlighted in Head and Neck Cancer

The Asco Post D. Neil Hayes, MD, MPH, of the University of North Carolina at Chapel Hill, described efforts to position the epidermal growth factor receptor (EGFR) inhibitor cetuximab (Erbitux) in head and neck cancer treatment. Surprisingly negative results came from the phase III Radiation Therapy Oncology Group (RTOG) 0522 trial (N = 940), which showed no benefit to adding cetuximab to the radiation/cisplatin platform for front-line therapy of advanced head and neck squamous cell carcinoma.1 At 2 years, progression-free survival was approximately 64% in both arms; overall survival was 79.7% with chemoradiation (P = .68) and 82.6% with the addition of cetuximab (P = .17). Rates of locoregional relapse and distant metastases were also similar. Cetuximab increased grade 3/4 mucositis (43% vs 33%;P < .004), in-field skin toxicity (25% vs 15%;P < .001), and out-of-field skin reactions (19% vs 1%;P < .001), but toxicity beyond 90 days was similar between the arms. "RTOG 0522 was the study of the year in head and neck cancer. Unfortunately, it was flat-out negative," Dr. Hayes noted. No differential effect emerged by p16 (HPV status). "While 70% of patients had oropharynx tumors (suggesting HPV positivity), tissue collection was lacking in half the patients. Our ability to make inferences with this amount of missing data is very limited," Dr. Hayes said. Even as a negative study, RTOG 0522 is practice-changing. "Many physicians have been treating with this regimen, assuming this study would be positive," he said. "But we now have no data to support this." Cetuximab Equivalent [...]

Oral Cancer Foundation News Team - A2011-10-18T09:58:29-07:00October, 2011|Oral Cancer News|

GP96 is over-expressed in oral cavity cancer and is a poor prognostic indicator for patients receiving radiotherapy

Source: http://7thspace.com Author: Chien-Yu Lin et al. Oral cavity cancers (ORC) are the most common cancers, and standard treatment is radical surgery with postoperative radiotherapy. However, locoregional failure remains a major problem, indicating radioresistance an important issue. Our previous work has shown that GP96 contributed to radioresistance in nasopharyngeal and oral cancer cell lines. In this study, we determined clinical significance of GP96 in ORC by evaluation of GP96 expression and its association with disease prognosis in patients receiving radiotherapy Methods: Total of 79 ORC patients (77 males, median age: 48 years old) receiving radical surgery and postoperative radiotherapy between Oct 1999 and Dec 2004 were enrolled. Patients in pathological stages II, III and IV were 16.5%, 16.5% and 67%, respectively. For each patient, a pair of carcinoma tissue and grossly adjacent normal mucosa was obtained. GP96-expression was examined by western blot analysis, and the association with clinicopathological status was determined. Results: Three-year locoregional control (LRC), distant metastasis-free survival (DMFS), disease-specific survival (DSS) and overall survival (OS) rates were 69%, 79%, 63% and 57%, respectively. We found that 55 patients (70%) displayed GP96-overexpression in the tumor tissue, which correlated with a higher pN stage (p=0.020) and tumor depth (>10 mm) (p=0.045). Nodal extracapsular spreading (ECS) and GP96-overexpression predicted adverse LRC (p=0.049 and p=0.008). When stratified by nodal ECS, the adverse impact of GP96 remained significant in three-year LRC (p=0.004). In multivariate analysis, GP96-overexpression was also an independent predictor of LRC, DSS and OS (p=0.018, p=0.011 and p=0.012). Conclusion: GP96 may [...]

Oral Cancer Foundation News Team - A2011-10-15T06:06:51-07:00October, 2011|Oral Cancer News|

Kids get graphic anti-tobacco message

Source: www.chroniclejournal.com Author: staff Though it’s hard to understand Gruen Von Behrens’ speech, his message could not be clearer. The cancer survivor, who lost much of his neck, chin and tongue to the disease, is on a Northern Ontario high school tour to tell the story of how his chewing tobacco addiction impacted his life. Von Behrens, who started chewing tobacco (also known as dipping) at the age of 13 and was diagnosed with cancer at 17, spoke to hundreds of students in the cafeteria at Thunder Bay’s Superior Collegiate and Vocational Institute on Wednesday morning. He said that many young people start smoking or chewing tobacco to look cool. Addressing the crowd, he asked, “How cool will you look? “I want everyone in here to take a good long look at my face,” he added, pointing to his disfigured features. “I was very naive about what tobacco could do to me.” The Thunder Bay District Health Unit sponsored Von Behrens’ speaking engagements in partnership with the Northwest Tobacco Control Area Network and Regional Cancer Care. Steve Tomé, youth engagement facilitator with the health unit, said that the use of chewing tobacco is 10 per cent higher in Northern Ontario than the rest of the province, so the unit wanted to send a message to students that dipping is no safer than smoking cigarettes. “(Von Behrens) has got a great story that high school students can relate to,” Tomé said. Von Behrens, now 34, has undergone 30 surgeries with at [...]

Oral Cancer Foundation News Team - A2011-10-15T06:01:01-07:00October, 2011|Oral Cancer News|

Locoregional recurrence of an HPV-positive squamous cell carcinoma of the head and neck

Source: www.cancernetwork.com Authors: Daniel W. Bowles, MD et al. Locoregional recurrences are a major source of morbidity and mortality for patients with squamous cell carcinomas of the head and neck (HNSCC). This article examines the multidisciplinary care of a patient with recurrent human papillomavirus (HPV)-positive squamous cell carcinoma of the tonsil. Case Presentation: DR. DANIEL BOWLES: The patient was a 46-year-old man who presented to the University of Colorado Cancer Center (UCCC) for evaluation and treatment of a locoregionally recurrent squamous cell carcinoma (SCC) of the left tonsil. SCC was originally diagnosed one year earlier when a left tonsil mass was biopsied and determined to be a poorly differentiated HPV-positive SCC. The patient was a lifelong nonsmoker and drank alcohol(Drug information on alcohol) rarely. He chose surgery as his primary modality of care and underwent a tonsillectomy and left neck dissection. His primary mass was 3.1 cm x 2.5 cm x 1.3 cm, and 1 of 20 level 2A lymph nodes was positive, with a maximal dimension of 3.5 cm. His cancer was stage IVA (T2 N2a M0) based on the histology and a PET/CT scan that did not show evidence of metastatic disease. Surgical margins were negative, but he had evidence of both angiolymphatic and perineural invasion. Fluorescence in situ hybridization (FISH) was positive for high-risk HPV. He received adjuvant external beam radiation to 60 Gy to the primary tumor site and 54 Gy to the bilateral neck. He did not receive a systemic sensitizing agent. A PET/CT scan [...]

Oral Cancer Foundation News Team - A2011-10-15T05:55:19-07:00October, 2011|Oral Cancer News|

Screen carotids after head and neck radiation

Source: www.oncologyreport.com Author: Neil Osterweil, Oncology Report Digital Network Head and neck cancer patients treated with radiation should be screened routinely for carotid artery stenosis, investigators recommended at the annual meeting of the American Society for Radiation Oncology. Among 225 patients who had received radiation and were screened, an estimated 18% had significant asymptomatic stenosis (50% or greater narrowing) of one or both carotid arteries 3 years after treatment said Dr. Jennifer Dorth, a resident in radiation oncology at Duke University Medical Center in Durham, N.C. "We recommend screening for head and neck cancer patients given that there are high rates of stenosis as well as high rates of progression of stenosis," she said. Factors significantly associated with risk for stenosis included Framingham risk factors (smoking history, hypertension, hyperlipidemia, diabetes mellitus, cardiovascular/peripheral vascular disease, and atrial fibrillation) and radiation dose. The investigators retrospectively reviewed outcomes of asymptomatic, disease-free head and neck cancer patients who had received radiation with curative intent to the neck. The patients were screened with carotid Doppler ultrasound at or after the 1-year follow-up visit, and this was repeated every 2-3 years. Patients with ultrasound evidence of 50% or greater stenosis were referred to vascular surgery. The study identified 225 patients, 139 of whom had received intensity-modulated radiation therapy (IMRT), with the dose calculated separately for each side of the neck. Because of the separate treatment planning, the investigators analyzed the data by creating two separate models: one looking at all patients, and the other looking at [...]

Oral Cancer Foundation News Team - A2011-10-15T05:25:58-07:00October, 2011|Oral Cancer News|

Oral cancers on rise due to HPV

Source: gargoyle.flagler.edu Author: staff Many Flagler College students are reconsidering human papillomavirus (HPV) vaccines due to the growing number of head and neck cancers in the United States caused by the HPV virus. According to a new study in the Journal of Clinical Oncology, the number of cases of oropharyngeal cancer, which are cancers of the tonsils, throat and base of the tongue, have been rising since the mid-1980s. “I got all three shots because I was influenced by my doctor and my mom because it seemed like a good way to protect myself,” said student Courtney Fusilier. “I think people should get it if they don’t want to die from those types of cancer.” The causes of oral cancers function within two categories: cancer caused by tobacco and alcohol and cancer caused by the sexually transmitted virus, HPV, researchers said. Researchers now believe that 70 percent of oropharyngeal cancers are caused by HPV. “The HPV status of a patient’s tumor is the single greatest determinant of whether a person lives or dies after a diagnosis of local-regionally advanced oropharynx cancer,” Gillison said. According to Gillison, about 95 percent of the HPV-positive oropharynx cancers were caused by HPV16. This strain is specifically targeted by Gardasil and Cervarix, which are two vaccines on the market to prevent cervical cancer. Communication major Adair Findley believes the HPV vaccines should be taken for a good piece of mind. “HPV is the most common sexually transmitted infection so I think it is important to [...]

Oral Cancer Foundation News Team - A2011-10-15T05:19:56-07:00October, 2011|Oral Cancer News|