Robotic surgery yields better quality of life for OC patients

Source: Author: Donna Domino, Features Editor Patients with oropharyngeal squamous cell carcinoma maintain a high quality of life a year after having transoral robotic surgery, according to a new study in the JAMA Otolaryngology -- Head & Neck Surgery (April 10, 2013). But elderly patients and those treated with adjuvant treatments such as external-beam radiation therapy and chemoradiation therapy do not, according to the study authors. Patients with oropharyngeal squamous cell carcinoma (OPSCC) have historically been treated with primary open surgery. However, cure rates were low, complication rates were high, and patient health-related quality of life (HRQOL) decreased, the researchers noted. Efforts to minimize morbidity and preserve organs have shifted treatments to primary external-beam radiation therapy or chemoradiation therapy, but these treatments are often associated with significant side effects and decreased quality of life, they added. Transoral laser microsurgery was pioneered in the 1990s by Wolfgang Steiner, MD, for laryngeal tumors and eventually adapted to the oropharynx. Since then, primary laser microsurgery has yielded favorable treatment outcomes for OPSCC patients, the researchers noted. Transoral robotic surgery (TORS), a more minimally invasive approach, was introduced in 2005 and has since been recognized as "oncologically sound," while also preserving function in OPSCC patients. Complication rates are low and swallowing function remains high, according to the study authors. Research has shown that speech, eating, social, and overall quality of life tend to decrease but remain high three months after TORS. However, long-term results among a significant number of patients are lacking. Long-term quality [...]

Be a trendsetter for oral cancer screenings

By Trish De Dios April 18, 2013Source:  April is Oral Cancer Awareness Month. We are well-trained in hygiene school to perform a non-invasive visual and tactile oral cancer screening. We perform it on every patient we see and the patients of our school clinic are accustomed to the comprehensive nature of the exam we perform. We then are set free from the chains of dental hygiene school and unleashed into the world of professional private practice. Unfortunately, the transition from school to work can cause us to cut corners and be negligent in our oral cancer screening, due in part to the demands of being in private practice. Employers are often apprehensive of the time constraints of the exam and may be misinformed regarding how screenings would take place in their practice. My advice to the new grad is stay true to your ethical and clinical standards of care. Do not deviate from being thorough in your oral cancer screenings because of your newly acquired degree or work position. The most important part of a patient’s hygiene visit is this potentially life-saving exam, and once your patients and employer realize this, they will never undermine your clinical protocol. In addition to the great service you are providing your patients, it is a good business practice to create value in the dental hygiene appointment. Your patients are not just getting their teeth cleaned – convey to your employer and patients that when you are their hygienist, the hygiene visit will consist [...]

2013-04-24T16:51:37-07:00April, 2013|OCF In The News, Oral Cancer News|

Dose of reality: HPV is epidemic, which is odd since it is largely preventable

Source: Author: Nathan Seppa There are two vaccines that guard against human papilloma­virus, and they are in rare company among medical inventions — the vaccines prevent cancer. Only the hepatitis B vaccine can make the same claim. Cancer-causing HPV can trigger abnormal cell growth on the cervix, and cervical cancer still kills up to 4,000 U.S. women each year. The virus is also implicated in cancers occurring in the anus and the throat. All told, according to a 2011 study, 29 percent of sexually active U.S. girls and women carry a potentially cancer-causing HPV infection. Preteen and adolescent girls and boys are priority groups for vaccines that prevent human papillomavirus infection.© Jessica Rinaldi/Reuters/Corbis Back in 2006 and 2009, when the HPV vaccines Gardasil and Cervarix came onto the market, health officials dreamed of halting the spread of HPV, which is sexually transmitted, in a single generation. Scientists call such blanket coverage herd immunity — in which a pathogen gets vaccinated into oblivion, becoming so rare that even unvaccinated people are protected. With such heady potential, Gardasil, developed by Merck, and Cervarix, created by GlaxoSmithKline, should be an easy sell. They rev up a potent immunity against HPV 16 and 18, the two types of the virus that account for most cases of cervical cancer. Gardasil also prevents most genital warts. The immunity the vaccines provide is many-fold better than the weak protection engendered by a run-in with the virus itself, and since approval, both vaccines have proven [...]

Oral cancer cases higher in developing countries

Source: Author: staff Oral cancer is the sixth most common cancer reported globally with roughly two thirds of these reported in developing countries, according to a report. Regardless of nationality, roughly half of long-term smokers will die from the effects of tobacco smoking, be it oral cancer, lung cancer or cardiovascular disease. In India 20 deaths per 100,000 are caused by oral cancer as compared to 10 deaths per 100,000 in the US and two deaths per 100,000 in the Middle East. Oral cancer, as well as updates in maxillofacial reconstruction, microneurosurgery, oral trauma, and facial cosmetic and orthognathic surgery, will be reviewed at the 2nd Oral and Maxillofacial Surgery Congress to be held in Dubai from May 1-5. Organised by Imedex in association with Arab Health, this year’s meeting will provide a number of new features that explore the rapidly reshaping field of oral and facial surgery. “The main causes of oral cancer have classically been related to smoking tobacco products and the Middle East has a higher rate of tobacco consumption then many other countries and this includes the use of the Shisha or Hookah,” said Dr Eric J Dierks, Clinical Professor of Oral and Maxillofacial Surgery at Oregon Health and Science University, USA and director of the Fellowship in Head and Neck Oncologic Surgery based at Legacy Emanuel Hospital in Portland, Oregon, who will be speaking at the congress. “There is a myth that smoking through a Shisha pipe is safer than smoking cigarettes but this [...]

Lower radiation reduces xerostomia in head/neck cancer patients

Source: Author: DrBicuspid Staff Lowering the radiation dose to the submandibular gland of patients with head and neck cancer decreases xerostomia, according to a study presented on April 20 at the European Society for Radiotherapy and Oncology (ESTRO) meeting in Geneva. Radiation oncologists at University Medical Center Utrecht (UMCU) showed for the first time that it is possible to reduce xerostomia in patients treated with radiotherapy for head and neck cancer if the radiation dose to a salivary gland (the submandibular gland) on the opposite side to the tumor is minimized, stated a university press release. It is the largest study yet to show a correlation between radiation doses to the submandibular glands and their output of saliva. Guidelines for the recommended maximum dose could potentially be issued for use in clinical practice to benefit patients, according to the researchers. Approximately 40% of head and neck cancer patients suffer from xerostomia in the long term, which causes problems with eating, sleeping, speech, tooth loss, and oral hygiene, leading to diminished quality of life, social isolation, and difficulty in the ability to work. Attempts to treat xerostomia and its consequences can be costly and are not very effective, the study noted. Therefore, the UMCU researchers looked at using intensity-modulated radiotherapy (IMRT) to treat the tumors and spare the submandibular gland on the opposite side of the tumor and both parotid glands. They also wanted to determine the maximum radiation dose and how the treatment would affect patients' xerostomia. They analyzed [...]

What the ‘rinse-and-spit’ oral cancer test could mean for dental professionals and their patients

Source: Author: Vicki Cheeseman, Associate Editor A new oral cancer “rinse-and-spit” test for the early detection of tumors could mean great things for dental professionals and their patients when the test becomes available for use in dental practices nationwide possibly as early as late 2014 or into 2015. The test, developed at the University of Miami Miller School of Medicine and exclusively licensed to Vigilant Biosciences, Inc., will be available as a low-cost, point-of-care screening test for the early detection of oral cancer, and is envisioned as a kit with a special oral rinse and test strip. The test strip detects proteins that are markers of oral cancer and are captured by the rinse. The markers may be present before a lesion is easily visible. Early detection tests are critical because the majority of patients present in late stage when cure rates reach only 40%. I asked Dr. Franzmann to explain how the test strip works. “The beauty of the test strip approach is that it is so simple for the patient and health-care professional to use. The technology behind the test strips has been around for many years and is used for many medical applications. The key is to know what to test for. Through our research, we discovered certain proteins, or markers, are present in the saliva in the early stages of squamous cell carcinoma, the most common head and neck cancer.” How early can tumors be detected with the test strip? Dr. Franzmann said, “The tumors [...]

HPV vaccination—reaping the rewards of the appliance of science

Source: bmj.comDate: April 18, 2013By: Simon Barton, clinical director  National programmes could virtually eliminate certain diseases and substantially reduce costs. The optimism generated by scientific breakthroughs often turns to disappointment when applied to the real world of clinical care. It is therefore worth celebrating the extraordinary success of Australia’s national human papillomavirus (HPV) vaccination programme, which was implemented five years ago, as reported in the linked paper by Ali and colleagues (doi:10.1136/bmj.f2032).1 This analysis of data on 85 770 new patients from six Australian sexual health clinics shows a remarkable reduction in the proportion of women under 21 years of age presenting with genital warts—from 11.5% in 2007 to 0.85% in 2011 (P<0.001). Only 13 cases of genital warts were diagnosed in women under the age of 21 across all six health clinics in 2011. Such a reduction in this distressing disease caused by a sexually transmitted virus is a major public health achievement. Furthermore, the near eradication of genital warts in young Australian women will probably have a major impact on the costs of sexual healthcare. In 2007, Australia became one of the first countries to implement a nationally funded HPV vaccination programme for girls and young women with the quadrivalent vaccine. It started with the vaccination of girls aged 12 years in schools and a catch-up programme for girls and women aged 13-26 years. Quadrivalent vaccine protects against HPV types 6 and 11, which cause more than 90% of genital warts, in addition to HPV types 16 and 18, which [...]

2013-04-22T12:13:42-07:00April, 2013|Oral Cancer News|

Robotic surgery vs. radiation, chemo for throat cancer, study to see which is best

By: Sheryl Ubelacker, The Canadian Press, April 17, 2013Source:  TORONTO - It was quite a shock for Rod Sinn when he learned the persistent sore throat he'd had for five months, initially diagnosed as tonsillitis, was actually an increasingly common form of throat cancer caused by the human papilloma virus. Equally unpleasant was the news that the standard treatment for oropharyngeal cancer, which typically affects the back of the tongue, tonsils and nearby tissues, is radiation and chemotherapy. Sinn, a physically fit non-smoker who only drinks alcohol occasionally, had seen what the double-barrelled treatment could do. A friend diagnosed with throat cancer a year earlier and given the standard treatment lost his salivary glands and sense of taste. "I thought, wait a minute, there's got to be another option. I really don't like the side-effects of all that radiation," the 52-year-old businessman, who lives in Oakville, Ont., near Toronto, said Tuesday. After searching the Internet, he discovered doctors at Western University in London, Ont., were the only ones in Canada performing robotic-assisted surgery for throat cancer. Sinn had the robotic surgery in spring 2011, plus a follow-up operation to remove some lymph nodes for testing to make sure his cancer hadn't spread. While the surgery left him unable to swallow for several weeks and he lost some taste buds for a time, he is virtually back to normal except for some numbness in his neck where the lymph nodes were removed. "It was fantastic," said Sinn, who counts himself a believer [...]

2013-04-18T16:40:32-07:00April, 2013|Oral Cancer News|

Researchers design drug to block incidence of head, neck cancer caused by HPV virus

Source: Researchers have discovered a new mechanism by which the human papilloma virus (HPV) causes head and neck cancer, and they have designed a drug to block that mechanism. Though further research is needed, the new agent might offer a safer treatment for these tumors when combined with a tapered dose of standard chemotherapy. HPV-positive head and neck cancer has become three times more common since the 1970s, and it could reach epidemic levels in the future, say researchers at the Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC-James) who led the study. "We believe these findings will help meet the real need for more effective and safer therapy for a growing number of HPV-positive head and neck cancer patients," says principal investigator Dr. Quintin Pan, associate professor of otolaryngology at the OSUCCC - James. The study was published in the journal Oncogene. The research, which mainly used head and neck cancer cells, shows that a protein produced by the virus blocks a protein made by the host cell. The cell protein, called p300, regulates a gene called p53. This gene both controls cell division and protects the body against cancer by causing cells to die before they become malignant.By blocking the cell protein, HPV forces the host cell to live instead of die and to proliferate and form tumors. The prospective new drug, called CH1iB, prevents the viral protein from binding with the cell protein. This restores [...]

HPV linked to certain lung cancers; is oral sex to blame?

Source: Author: Jonathan Weiss By now, it's a given that smoking causes lung cancer. The American Lung Association reports that 80 to 90 percent of all cases of lung cancer are smoking-related. The remaining 10 to 20 percent, though, has been more of a mystery — until now. A new line of research has implicated thye sexually transmitted infection human papillomavirus, or HPV, in lung cancers that were found in non-smokers. HPV is the leading cause of all cervical cancer cases in the world. It's a well-known disease that's gottena lot of press in recent years; an effective vaccine was recently developed that can prevent the viral infection and subsequent cervical cancer development. Whether or not the vaccine should be required for teenage girls has become a hot-button political issue. Adding fuel to the fire, a research team from the Fox Chase Cancer Center recently looked at tissue samples from lung cancer patients who had no history of smoking and saw that close to 6 percent showed evidence that they had been driven by HPV infection. Four out of 36 lung samples had signs of infection from two strains of HPV known to cause cancer. Looking more closely at the two samples infected by one strain of HPV, Dr. Ranee Mehra, MD, attending physician in medical oncology at Fox Chase and her team saw signs the virus had integrated into the tumor's DNA — which is even more suggestive that the infection had caused the tumor in the first [...]

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