Monthly Archives: October 2012



Even with our best efforts, oral cancer continues to have a nearly 50% mortality rate at five years. This equals 40,000 deaths annually in the United States with 370,000 worldwide. It is predicted that there will be a world-wide oral cancer epidemic by mid-21st century. Predictions are based on what has been and current situations. The wonderful part of predictions is they can be wrong. Two people, Alison Stahl and Eric Statler, are leading the way to circumvent that future death rate. They challenge all of us across the country not to be reactive — but rather to be proactive in our approach.

Volunteers welcome participants to the oral cancer walk.


Eric Statler is a stage IV oral cancer survivor. As happens far too often, he was initially misdiagnosed and thought to be experiencing pain related to wisdom teeth. An infection that followed his extractions was treated with antibiotics and he was dismissed. With no resolution and increasing pain, he went back to the dentist who immediately referred him to a specialist.

Someone You Should Know: (from left to right:) Mike Stahl, Kim Benkert, Denise Snarski, Bonnie Chisholm-Green, Trish DeDios, Patti DiGangi, Donna Grzegorek, Alison Stahl, Amy Frazin, Lois Roewade, Ewa Posorski, Tracy Fritz, Zuzana Buc, Cynthia Pfeiffer, and Eric Stadler.


At the age of 33, Eric was diagnosed with stage IV HPV related oral cancer. Chemotherapy and radiation treatments followed along with multiple disfiguring surgeries and some facial paralysis. Treatments were initially unsuccessful; cancer was winning the battle. Eric, once the epitome of health, was near death. Due to the extreme pain of his care, his medical team prescribed an addictive medication protocol. This oft told story could have been different.

Alison Stahl, RDH, BS, lives in the Chicago area, the home to the ADA, ADHA, Chicago Dental Soceity, and countless numbers of dentists and specialists. Alison put Illinois on the map when it comes to oral cancer awareness and advocacy. As a passionate dental hygiene professional, Alison says she simply wanted to be more involved and initially to be a volunteer for a cause that supported oral cancer awareness.

When finding no local charitable event for this devastating disease, she decided she would start one herself. It was difficult to know just how large this event would be but the decision to start a charity walk in Illinois could not be delayed any further. People are dying every hour from this disease, yet the public remains very unaware of current risk factors. The Northern Illinois Oral Cancer Awareness (NILOCA) was born. Alison’s vision and thousands of hours of hard work have become a reality giving oral cancer a louder voice.

Alison knew she couldn’t do it alone. She created a committee of people — mostly unknown to each other before this effort — bonded by their passion to bring public awareness to this dreaded disease. Many students, dental, and dental hygiene professionals stepped up as volunteers to make this event possible as well as many generous sponsors.

It took an entire year of planning but the day finally arrived. On June 10, 2012, by 8 a.m., the committee welcomed over 600 registered participants for the event. Families walked in honor of those they had lost. Survivors found comfort and community through this event. Dental professionals were inspired and have vowed to never miss an opportunity to perform that life-saving exam. The walk broke all records for an inaugural event, grossing just over $70,000 as well as breaking all records to date at the Oral Cancer Foundation ( for attendance and fundraising.

Eric was a guest speaker and helped participants understand that he is a thriving survivor — someone who loves life despite the challenges and struggles that remain after cancer. Four years later, Eric spends much of his time supporting others who are living with this disease and tries to help survivors thrive. Eric has become an expert on the latest options, facilities, and protocols for treatment and understands first-hand the emotional toll oral cancer can have on the person, their caregivers, and loved ones. Eric’s words furthered our resolve to do more to carry out his mission and spread the message about the importance of early detection and prevention.

Alison had no prior event planning experience before taking on this endeavor. She learned so much and developed amazing new friendships along the way. Her journey is only just beginning, and NILOCA is already talking about how we can make the 2013 events even bigger and better. Much more can be done. There is room to double or even triple the remarkable numbers. Ways must be found to create awareness in our communities throughout the year. What if we had more dental hygienists, dental offices, oral surgeons, and ENT’s and other health care providers supporting our cause? We have the opportunity to prevent stories like Eric’s.

Alison’s efforts will save lives; she is someone you should know as well as her entire team. Are you talking about current trends and risk factors like the HPV virus and importance of the vaccine? Can you collaborate with other colleagues in your part of the country and create your own awareness and/or screening events? It can be a walk, a golf outing, a dinner gala, or even a block party. The Oral Cancer Foundation has wonderful people who can guide you through the process. We need you and hope you will join us as we continue to “Spread Awareness — Save Lives!” RDH

Patti DiGangi, RDH, BS, is a vision-driven practicing clinician that brings experience and news-you-can-use the next day. Patti is an American Dental Association Evidence Based Champion and Current Dental Terminology Licensee currently writing a series of min-books on insurance coding for hygienists. She is a certified presenter through the Academy of General Dentistry National Speaker’s Bureau for Periodontal Disease and a member of multiple key opinion leader boards. She is a member of the National Speaker’s Association and a Certified Speaking Professional candidate. Patti is a certified Health Information Technology trainer and a member of the American Health Information Management Association taking an active role in our shaping the changes in our electronic world.


Thomason P. Oral Precancer: Diagnosis and Management of Potentially Malignant Disorders. (2012) Hoboken, NJ: Wiley-Blackwell.

Suggestions for volunteering to fight oral cancer (sourced from the OCF volunteer files)

Suggestion #1: Start where you are. You don’t need to know everything, and you certainly don’t need to be perfect. Many are novices regarding oral cancer despite being part of our individual struggles with it. You bring unique insights and contacts to the fray that would be less likely without your involvement. That compensates for shortcomings. We all remain capable of learning.

Suggestion #2: Take things step by step. You set the pace of your engagement. Don’t worry about being swallowed up, because you’ll determine how much you get involved. No single person can keep up with it all. We are on a learning curve and that requires patience. Burnout is always a possibility and that is nonproductive in all respects.

Suggestion #3: Build a supportive community. You can accomplish far more with even a small group of good people than you can alone. Volunteers are formed on that principle and it will become even more powerful as they gain experience, clarity —and more members.

Suggestion #4: Be strategic. Ask what you’re trying to accomplish, where you can find allies, and how to best communicate the urgencies you feel. Our vision and mission are dedicated to being both realistic and expansive in what we can do. Creativity and the “six degrees (or less) of separation” will be called into play often. Our intent to continue finding outreach opportunities (e.g., Relay for Life model) and building awareness on a much larger scale which offers each individual a way of sustaining meaningful involvement. We are not all the same in this regard and we don’t have to be. What we must do is continue to find ways of getting the most bang for our involvement buck.

Suggestion #5: Enlist the uninvolved. They have their own fears and doubts, so they won’t participate automatically; you have to work actively to engage them. If you do, there’s no telling what they’ll go on to achieve. This entails opportunistic searches through all of our contacts and associations. What we are now engaged in can make the world a better place for people who would otherwise suffer greatly; most are currently uninvolved because they are unaware.

Suggestion #6: Seek out unlikely allies. The more you widen the circle, the more you’ll have a chance of breaking through the entrenched barriers to change. This should be invigorating as well as productive. Some of this potential lies in communities of interest that may appear far removed from the world of oral cancer. That is not so because they are all populated with people who are at risk — or worse. No cluster of interests should be immune to your message if we can connect with them.

Suggestion #7: Persevere. Change most often takes time. The longer you continue working, the more you’ll accomplish. We seek to contribute to a reversal in the growth of oral cancer by a specific year but will not stress out if it takes longer — as long as we continue to make progress.

Suggestion #8: Savor the journey. Changing the world shouldn’t be grim work. Take time to enjoy nature, good music, good conversation, and whatever else lifts your soul. Savor the company of good people working with you for a change. We have a lot of other people in our lives to help this happen. Sustained effort without relief will destroy us, not oral cancer. Our particular world is rich in recharging opportunities. No one is in the way of our taking a break when we need it.

Suggestion #9: Think large. Don’t be afraid to tackle the deepest-rooted injustices, and to tackle them on a national or global scale. Remember that many small actions can shift the course of history. This one is pivotal. It means that we can connect with and engage people who wield great influence, bringing their formidable presence to the task. Simply put, there is no one with whom it is automatically beyond our ability to connect. This won’t define all of our activity, but it offers the greatest rewards in terms of return on the time invested.

Suggestion #10: Listen to your heart. It’s why you’re involved to begin with. It’s what will keep you going. This one is simple, but like many simple things, not easy. Remember why we are doing this: to honor the memory and the gift of others Our hearts are already involved; we just need to remind our bodies of it occasionally.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

October, 2012|OCF In The News|

Smokers are 40 times more likely to develop cancers in head and neck

Author: Andrew Creasey, Staff Reporter

The level of concern you should have for contracting cancer of the head and neck can be gauged by the answer to one simple question: Do you smoke?

If the answer is no, chances are your oral cavities and voice box, the places cancers most commonly occur, will be safe from the onerous growth that can cause death if not treated soon enough.

If the answer is yes, then you are 40 times more likely to contract head or neck cancer if you have been smoking for 10 years, and you should probably be aware of what to look for, said Dr. Richard DeVore, an otolaryngologist in Klamath Falls.

Signs of head and neck cancer include a sore or ulcer that doesn’t heal, unexplained bleeding of the throat and, most importantly, throat or tongue pain that persists beyond several weeks, DeVore said. Such pain could be caused by the cancer, which actually eats into the tissue and can cause significant pain when it starts munching on the local nerves.
Swallowing difficulties, hoarseness and lumps in the head and neck that don’t respond to antibiotics should also be examined, DeVore said.

At the onset of such symptoms, it is vital to share them with a physician, DeVore said. Caught early, the cure rate of many neck and head cancers is 100 percent and can be solved with a simple operation.

“The cure rates are slowly improving to some degree, but it’s a bad disease,” DeVore said. “If you wait to a stage four, you’re in trouble.”

For voice box cancer, for example, stage one and two have cure rates close to 100 percent. By stage four, it drops to 60 percent, DeVore said.

Treatment options for advanced stages of head and neck cancer used involve only one option — surgery that often left the patient mutilated and without pieces of their body, such as a voice box or jaw bone. Now, doctors have what’s called the organ preservation protocol, which can treat advanced stages of the disease with a combination of radiation and chemotherapy.

And new knowledge continues to pour in. The AIDS epidemic created a wealth of funding and research into tumor biology. The human genome project allowed doctors to identify the specific genes that caused or contributed to disease. But the translation of this wealth of knowledge to front line treatment options is slow, as doctors sift through the information to make the best treatment decisions, DeVore said.

The best decision a patient can make is still not to smoke or to quit smoking, DeVore said.

“It’s never too late to quit smoking, from a cancer standpoint,” DeVore said, mentioning that while cancer rates increase 40 times after ten years of smoking, they fall almost back to normal 10 years after quitting.

October, 2012|Oral Cancer News|

Top EU official resigns after snus bribe probe


A complaint by Swedish Match about a suspected bribe meant to influence European tobacco policy has resulted in the resignation of EU health commissioner John Dalli, the European Union’s top health official.

“Commissioner John Dalli has today announced his resignation as a member of the Commission, with immediate effect,” the European Commission announced in a statement released on Tuesday.

Dalli’s resignation, the first for a member of the Commission since 1999, came following the release on Monday of report detailing the findings of an investigation carried out by the EU’s anti-fraud office, OLAF, into a complaint filed by Swedish tobacco company Swedish Match in May 2012.

The complaint alleged that a Maltese entrepreneur sought to leverage his connections with Dalli, also of Malta, in order to “gain financial advantages” from Swedish Match in exchange for attempting to influence “a possible future legislative proposal on tobacco products, in particular on the EU export ban on snus”.

Snus – also known as Swedish snuff – is a tobacco product invented in Sweden in the early 1800s which has gained in popularity in Sweden after smoking was banned in restaurants in 2005. The sale of snus is outlawed in the European Union, but due to exemptions, it is still manufactured and consumed primarily in Norway and Sweden.

The European Commission’s Directorate-General for Health and Consumers Protection recently unveiled a proposal that would ban all smoke-free tobacco products outside of Sweden. The Swedish government has for years been trying to sway the EU to allow snuff to be exported in Europe, referring to laws on free movement as well as public health.

“It turns out the snus ban was for sale,” Swedish Match spokesperson Patrik Hildingsson told the Aftonbladet newspaper following the news of Dalli’s resignation.

According to Hildingsson, the Maltese businessman came to a meeting and said that “we can solve this for a sum of money”.

“It’s remarkable; it’s not in our DNA or our culture to accept something like this,” said Hildingsson, refusing to elaborate on exactly how much money was mentioned in the offer.

OLAF found that “no transaction was concluded” between Swedish Match and the Maltese entrepreneur and “no payment was made”.

“The OLAF report did not find any conclusive evidence of the direct participation of Mr. Dalli but did consider that he was aware of these events,” the Commission statement said.

The investigation also found that the Commission’s decision-making process “had not been affected” by the matter, but Dalli nevertheless chose to resign “in order to be able to defend his reputation and that of the Commission”.

“Mr. Dalli categorically rejects these findings,” the Commission said, adding that the OLAF report will be forwarded to the Attorney General of Malta who must determine if and how to pursue the matter.

Swedish MEP Christoffer Fjelllner of the Moderate Party who has long advocated for a lifting of the EU’s snus ban said Dalli’s resignation was “very serious and frightening”.

“I get disappointed when I realize that my facts and arguments have likely been in vain,” he said in a statement.

“Corruption at the top of the EU system undermines not only confidence in EU legislation, but also in the EU as an institution.”

Following Dalli’s resignation, European Commission President Jose Manuel Barroso announced that Commission Vice President Maros Sefcovic will take over the health portfolio pending the appointment of a new Maltese Commissioner.

October, 2012|Oral Cancer News|

Interim results from CEL-SCI’s Multikine Phase III study on head and neck cancer


CEL-SCI Corporation announced today that an interim review of the safety data from its open label, randomized, controlled, pivotal Phase III study of Multikine (Leukocyte Interleukin, Injection) investigational immunotherapy by an Independent Data Monitoring Committee (IDMC) raised no safety concerns. The IDMC also indicated that no safety signals were found that would call into question the benefit/risk of continuing the study. CEL-SCI considers the results of the IDMC review to be important since studies have shown that up to 30% of Phase III trials fail due to safety considerations and the IDMC’s safety findings from this interim review were similar to those reported by investigators during CEL-SCI’s Phase I-II trials. Ultimately, the decision as to whether a drug is safe is made by the FDA based on an assessment of all of the data from a trial.

IDMCs are committees commonly used by sponsors of clinical trials to protect the interests of the patients in ongoing trials especially when the trials involve patients with life threatening diseases, and when, as in cancer clinical trials, they extend over long periods of time (3-5 years). The committee’s membership should include physicians and clinical trial scientists knowledgeable in the appropriate disciplines, including statistics. The CEL-SCI IDMC includes prominent physicians and scientists from major institutions in the USA and abroad who are key opinion leaders in head and neck cancer and who are knowledgeable in all of the disciplines related to CEL-SCI’s study, including statistics.

The Multikine Phase III study is enrolling patients with advanced primary, not yet treated, head and neck cancer on 3 continents around the world. The objective of the study is to demonstrate a statistically significant 10% improvement in overall survival of enrolled patients who are treated with Multikine plus Standard of Care (SOC) vs. subjects who are treated with SOC only. The universally accepted current standard of care for the patient population being enrolled in the CEL-SCI study is surgery plus radiation or surgery plus concurrent radiation and chemotherapy, dependent on the risk factors for recurrence found after surgery. Multikine treated patients receive 15 local injections of Multikine over a 3 week period prior to standard of care treatment. Multikine injections are administered in the area around the tumor and in the area of the adjacent lymphnodes since those two areas are where the tumor is most likely to recur. Multikine is intended to create an anti-tumor immune response to reduce local / regional tumor recurrence and thereby increase the survival of these patients.

Multikine is the first immunotherapeutic agent being developed as a potential first-line treatment for advanced primary head and neck cancer. If it were to be approved for use following completion of our clinical development program, Multikine would become an additional and different kind of therapy in the fight against cancer: one that employs our body’s natural ability to fight tumors.

Source: CEL-SCI Corporation

October, 2012|Oral Cancer News|

On the Job with Laura Schmitz Cook


In seven years as a Registered Dental Hygienist, Laura Schmitz Cook has already seen a lot of change — for example, she said, “Fluoride varnish has progressed. It was yellowish, now it’s clear. You can give it to young kids without fear. It’s a great treatment for kids with high decay risk.”

Digital X-rays are easier to manipulate than film, providing better information about what’s going on, and because they’re instantly viewable, “they’re a great educational tool.”

Of course, some things haven’t changed; Schmitz Cook spends most of her time cleaning teeth. “I take pride in being very gentle, but when people tell me they don’t like the dentist, I say, ‘I don’t take it personally.’ I understand the anxiety about going to the dentist.”

Through her first year in college, Schmitz Cook was torn between being a teacher and being a hygienist. After spending 20 hours shadowing a hygienist, the decision was easy. “I could see myself doing this,” she said. In addition to graduating with a four-year degree from an accredited program, Schmitz Cook had to take clinical and written board examinations.

Schmitz Cook moved to Minnesota as soon as she graduated from the University of South Dakota and “found a job right away through networking,” although she senses that jobs are tighter in the current economy. To be registered in Minnesota, she had to pass a state test on relevant laws and the code of ethics. She also earns 25 continuing education credits every two years to maintain her certification.

Many of the continuing education credits come through the Minnesota Dental Hygiene Association (MNDHA), where Schmitz Cook is an active volunteer. For the past two years, she has organized the Twin Cities Oral Cancer Walk, sponsored by MNDHA and the Minnesota Dental Assistants’ Association. The walk/fun run raises money for the Oral Cancer Foundation and raises awareness of the disease. The first year, nearly 200 people participated , raising $13,000 and providing free oral cancer screenings to anyone who attended the event.

Schmitz Cook hopes that even more people will participate in this year’s event, which will be held on Saturday, Oct. 27 at Lake Nokomis. On-site registration begins at 8 a.m. Free oral cancer screenings will be provided between 8 and 9 a.m., and the walk/fun run around the lake begins at 9:30. To register or donate, go to or email Schmitz Cook at

What do you like best about your job?

I see the before and after. Good dental care is not just the health of the mouth — it’s the rest of the body, too.

What’s the hardest part of the job?

It’s wearing for the body. I work a four-day week, which is not uncommon. A typical work week is 36-38 hours. You have to be careful how you’re sitting, that you’re not twisting your neck, that you’re holding your arms properly. I’ve started using loupes [magnifying lenses] because they enable me to sit up straighter. I tell kids that they’re my microscopes so I can find the sugar bugs.

What should people know about oral cancer?

The human papilloma virus (HPV) now causes more oral cancer than tobacco or alcohol. Younger people can be affected. The earlier oral cancers are found, the more effectively they can be treated. Everyone should come to the Twin Cities Oral Cancer Walk and get a free screening.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

HPV vaccine does not encourage teen sex

Author: CNN staff

There’s been a lot of controversy over the HPV vaccine. Because Gardasil is designed to protect young people against human papillomavirus, a common sexually transmitted disease, some people believe the inoculation gives teens the go-ahead to have sex. Researchers are finding that’s not the case.

HPV is known to be the cause of a number of illnesses, including mouth and throat cancer, genital warts and cervical cancer. Since 2006, the Centers for Disease Control and Prevention has recommended that all girls aged 11 and 12 receive the HPV vaccine to protect themselves. The American Academy of Pediatrics has also advised that girls and boys at that age be given the shot to fight the virus strain.
But according to a new Kaiser Permanete/Emory University study published in this week’s edition of the journal Pediatrics, the vaccine has yet to be embraced by the general public. By 2010, fewer than half of girls eligible for the vaccine had received even one dose.

Investigators believe that may be in part because some people who oppose the vaccine wrongly believe that it also protects against pregnancy and other sexually transmitted diseases, which would open the door for pre-teens to engage in sexual activity at an early age.

The study finds that vaccinating children at ages 11 and 12 does not increase sexual activity in young girls. Researchers looked at the number of pregnancies, sexually transmitted infections and contraceptive use in more than 1,300 pre-teen girls who received the vaccine.

Investigators followed them for three years and found no significant increase in any of these sexual activities.

“Our study found a very similar rate of testing, diagnosis and counseling among girls who received the vaccine and girls who did not,” said Dr. Robert Bednarczyk, an epidemiologist at Emory and the study’s lead author. “We saw no increase in pregnancies, sexually transmitted infections or birth control counseling – all of which suggest the HPV vaccine does not have an impact on increased sexual activity.”

The authors note while it’s known that having sex at an early age with multiple partners is a risk factor for getting the HPV infection, their study is the first to find that getting vaccinated does not modify these young girls’ sexual behavior.

“It’s important we let physicians and parents know that they can put their fears to rest,” says Bednarczyk. “The vaccine does not seem to change a young girl’s attitude towards sex and … receiving the shot is a good way to protect a child or young adult, once they get into their sexual years.”

October, 2012|Oral Cancer News|

Maine guitar savant Nick Curran dies at 35

Source: Portland Press Herald

Curran, who played with Texas rockabilly legend Ronnie Dawson, died Saturday after a three-year battle with oral cancer.

Nick Curran, a nationally known guitarist and singer from Sanford who played with the Texas rockabilly legend Ronnie Dawson, the Fabulous Thunderbirds and numerous other bands, died Saturday after a three-year battle with oral cancer. He was 35.
Curran, who was known for blending punk, blues and rockabilly, was a frequent performer in Portland but spent much of his career in the Austin, Texas, area.

Curran grew up in Sanford and started playing drums when he was 3 years old. By the time he was 9, he was learning to play the guitar.

As a teenager, Curran played with his father’s band, Mike Curran & the Tremors. He entered Portland’s music scene with talent beyond his years.

He made a big impression on Maine musicians such as Matthew Robbins, a guitarist and vocalist for King Memphis.

Robbins remembers the days when Curran would stand outside Gritty McDuff’s in Portland and peer through the window to watch Robbins’ band play.

“He was young and extremely talented,” Robbins said. “Nick was like a sponge. He could see someone play something and play it right back. He was pretty amazing.”

Curran was a regular at The Big Easy in Portland during its popular open mike nights.

Jimmy Junkins, lead singer and guitarist for Jimmy Junkins and the Soulcats, said he would sneak Curran into the bar and get him up on stage to play.

He compared Curran’s talent Monday to that of music icons Jimi Hendrix and Stevie Ray Vaughan.

“He was devastatingly talented,” Junkins said. “There was a level of maturity in his playing at 16 that most guys my age had never accomplished. … The music community is really turned upside down right now. It’s a tremendous loss to the music world and a tremendous loss to Maine.”

Sean Mencher, another musician who moved from Maine to Austin, said Curran played with authority and conviction.

“It’s a tragic loss to the global American roots music community,” he said.

When he was 19, Curran got his first big break and left Sanford for Austin to tour with Ronnie Dawson.

He then toured with the Texas rockabilly singer Kim Lenz. He played with her band, the Jaguars, for two years, including on Lenz’s 1999 CD, “The One And Only.”

He is also featured on Lenz’s 2009 CD, “It’s All True.” He toured with her in the summer of 2009.

Curran played in other bands including Deguello and the Lowlifes. He was also a member of the blues rock band the Fabulous Thunderbirds, from 2004 to 2007.

In 1999, Texas Jamboree Records issued Curran’s debut solo recording, “Fixin’ Your Head.”

He recorded four more albums — all using vintage recording equipment to achieve the sound of old 45 and 78 rpm records.

Curran performed four songs in the 2008 HBO Series “True Blood.”

Later that year, he formed the rock ‘n’ roll band Nick Curran and the Lowlifes, and in 2010 he released his fifth and final album, “Reform School Girl.”

Billy Horton, who played bass with Curran and produced all of his records, described “Reform School Girl” on Monday as “Little Richard meets the Ramones.”

“He wanted the record to sound like your record player blew up,” Horton said. “He loved punk, blues and rockabilly. … He was able to bring in all of those influences he loved and (make) a weird Nick stew. Only he could do that and make it work.”

Curran was a powerhouse in Austin’s music scene and beyond. He lived in Austin, but returned to Maine to visit his mother and play at Portland venues including Empire Dine and Dance and The New Venue.

He was diagnosed with oral cancer in 2010.

Since Saturday, thousands of his fans have turned to Facebook, Twitter and other social media to express their sadness and share memories of him.

He is survived by his mother, Carole-Ann Labbe, and her husband, Mark Labbe, of Shapleigh.

Curran’s father died two years ago.

Curran’s mother said late Monday that she has received an outpouring of love and support from her son’s friends and fans throughout the country.

“Nick made a mark on millions of people’s lives,” Labbe said. “He had fans all over the world and was well respected by musicians. He had a wonderful life in the short time he had on this earth. I’m thankful for that.”

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

October, 2012|Oral Cancer News|

Novel one-step system for restoring voice in throat cancer patients


This picture shows the cannula (A) and the tool (B) for inserting the voice prosthesis which is usually made of silicon (partly shown on the left side of the tool). This tool will then be inserted into the cannula so that it can be injected into the patient’s fistula according to the length required, using the calibration on the cannula. Credit: National University of Singapore.

Patients who have lost their voice box through disease such as throat cancer may be able to speak immediately after a procedure to create a small opening at the throat. A novel system developed through an Engineering-in-Medicine project led by Dr Chui Chee Kiong, NUS Department of Mechanical Engineering, and Dr David Lau, Consultant Ear, Nose & Throat (ENT) Surgeon at Raffles Hospital, cuts down a two-week duration before patients can speak, to about 10 minutes after the initial procedure.

People who undergo laryngectomy and lose their voice box can recover approximately 80 per cent of normal speech by having a voice prosthesis fitted into an opening or fistula between the trachea (windpipe) and esophagus (food pipe). To speak, the patient covers the stoma (breathing opening in the neck) with his or her thumb and forces air through the prosthesis into the esophagus and out through the mouth. Before the prosthesis can be inserted, the doctor needs to make a small puncture (tracheo-esophageal puncture or TEP) in the wall between the trachea and esophagus. During the puncture, a guide-wire is inserted into the fistula to prevent the creation of false passages. Two “dilators” are inserted to widen the fistula, with the second one a little wider in circumference. Previously, a temporary rubber tube is placed into the fistula and the voice prosthesis is not inserted until about two weeks later, when the fistula is “mature”.

However, the new device changes this. Explaining their invention, Dr Chui said, “We have merged all the steps into a single procedure. Most significantly, although doctors still need the nasal endoscope to guide and monitor progress during the procedure, our system ensures an immediate snug fit of the prosthesis in the passageway created between the trachea and the esophagus. Until now, this can take some trial and error to achieve good sizing of the prosthesis.”

Voice prostheses vary in length for different individuals, depending on the thickness between the food pipe and the windpipe. The length of the TEP needs to be accurate. Usually, the length ranges between 6mm to 26mm. It is important that the prosthesis fits well otherwise it may be ineffective, or leak and cause discomfort.

Said Mr Chng Chin Boon, Research Engineer from NUS Department of Mechanical Engineering and member of the research team, “We added markings onto the cannula used for inserting the prosthesis. From the endoscopy, we would know the distance between the anterior esophageal wall (front wall of the food pipe) and the posterior tracheal wall (back wall of the windpipe), allowing us to size the prosthesis appropriately.”

This takes away a lot of discomfort such as coughing and gagging, should the prosthesis need to be removed and fitted again if the measurement is not right.

“Most prostheses need to be changed due to wear and tear, depending on each individual. And each time, the size of the prosthesis to be inserted may differ due to tissue changes in the patient. Our invention will offer patients a more fuss-free system, cutting down time and discomfort. It will also cut down the cost for the patient as the number of procedures is reduced,” added Mr Chng.

The system has been successfully tested on animals, and is now ready for clinical human trial.

Said Dr David Lau, “Patients requiring voice restoration after surgery for laryngeal cancer have to make multiple visits to the clinic, and I had often thought how a simple, one step solution would save them time, discomfort and money. So we decided to go out and design that solution.”

Dr Lau added, “The system we designed has several advantages over existing methods as it not only reduces the number of steps and complexity, but also increases accuracy of placement and safety, and allows for immediate voicing. However patients will still need to put in some effort, and work with the speech therapist to get the best voicing results.”

Source: National University of Singapore

October, 2012|Oral Cancer News|

No ref’s return as special as Corrente’s

Author: Peter King

The voice of Tony Corrente was ebullient, as ebullient as a man who stared down his own mortality within the past few months and lived to tell about it.

“How are you doing?” I asked Corrente an hour after he refereed his first game — Niners-Jets at the Meadowlands Sunday — since his tongue and throat cancer eradication of last winter.

“Wonderful, fantastic, perfect!” he practically shouted into the phone. “Never been better, and I mean that. I am elated. I have a new lease on life.”

Corrente checked into the M.D. Anderson Cancer Center in Houston the day after his final game of the 2011 season — the Detroit-New Orleans Wild Card game — for treatment of a thumb-sized malignant tumor at the base of his tongue, where it connects with the back of his throat. He had 13 chemotherapy treatments and 33 zaps of radiation in a short period, to attack the tumor aggressively. Doctors told him if the tumor had been discovered as little as three weeks later the news would have been very dark for him. But they began treatment in time, and in the spring, they found that the tumor was under control. He’s had two thorough checkups since, and both have given him a clean bill of health.

This is why, as the National Anthem played Sunday in New Jersey, Corrente said a long prayer of thanks for his doctors and for those who supported him during the ordeal.

“I did not ever in my wildest dreams think I’d be back on the field,” Corrente said, his voice catching.

Corrente looks a little slim still. He’s having trouble putting weight on. And he said, “I still carry some of the fatigue with me. But I’m ahead of the curve in physically rebounding from this, so I consider myself lucky in that regard.”

In many regards. It’s good to see Corrente back

October, 2012|Oral Cancer News|

Periodontitis increases risk of oral leukoplakia

Author: Donna Domino, Features Editor

Periodontitis increases the risk of developing oral leukoplakia and mucosal lesions that are predisposed to become oral cancer, according to a study in Oral Oncology (September 2012, Vol. 48:9, pp. 859-863).

The findings provide clues into the complex relationship between systemic and local disease, noted the study authors from the University of Greifswald in Germany.

The development of oral cancer proceeds through discrete molecular changes that are acquired from loss of genomic integrity after continued exposure to environmental risk factors. It is preceded in the majority of cases by clinically evident, potentially malignant oral disorders, the most common of which is leukoplakia, the researchers noted.

Leukoplakia is an asymptomatic lesion in the oral mucosa. Oral cancer — especially oral squamous cell carcinoma — often develops out of these lesions, they added. Studies have shown that as many as 18% of oral premalignant lesions will develop into oral cancer. In addition, periodontal sites are often involved in proliferative types of leukoplakia.

The oral cancer rate attributed to leukoplakia is between six and 29 per 100,000, according to the authors. Smoking and drinking alcohol are the main risk factors for this disease, but acute infections in the oral cavity may contribute to the risk.

Inflammatory markers
The study evaluated 4,310 German residents ages 20 to79 from 1997 to 2001. After five years, 3,300 participants were available for follow-up.

The periodontal assessment included probing depth, clinical attachment loss, plaque, bleeding on probing, and the number of teeth. Among the study population, 123 (2.9%) of the participants had oral leukoplakia, compared with 246 people in the control group who did not have oral lesions.

Patients with oral leukoplakia showed significantly higher measures of periodontal parameters, especially bleeding on probing and gingival attachment loss, the study found. Despite a high variance, the leukoplakia group also exhibited a higher incidence of tooth loss, and there were more diabetics than in the control group (22% versus 13%).

Gingivitis (as characterized by bleeding on probing) is associated with the occurrence of leukoplakia in a dose-dependent manner, the researchers found.

“From the results it may be concluded that there is a continuously increasing risk of leukoplakia with increasing severity of periodontitis or gingivitis,” they wrote. “Increased concentrations of inflammatory markers suggest that tissues irritated by defense processes such as periodontitis are vulnerable to premalignant transformations.”

These study findings echo a 2011 study by researchers in India that showed elevated levels of salivary interleukin-6 — which was used as a marker of malignant progression — among patients with leukoplakia and periodontitis (Clinical Oral Investigations, October 2011, Vol. 15:5, pp. 705-714). Excluding people with periodontitis, the researchers found the leukoplakia cases still had elevated levels of systemic markers of inflammation. Good oral hygiene (brushing at least twice a day) was associated with decreased risk.

One limitation of the German study was that the oral lesions were not biopsied, the researchers noted.

“Our findings give new hints into the complex interrelationship between systemic and local diseases,” they concluded. “Periodontal inflammation may be considered an additional risk acting synergistically with smoking and/or metabolic factors.”

October, 2012|Oral Cancer News|