July 2013 – Page 2 – Oral Cancer News

IMRT plus chemotherapy offers high locoregional control in advanced nasopharyngeal carcinoma

Source: www.healio.com Treatment with intensity-modulated radiotherapy and concurrent weekly chemotherapy improved xerostomia and dysphagia in patients with advanced nasopharyngeal carcinoma, according to study results presented at the WIN Symposium. Researchers in China recruited 310 patients with stages III to IVb nasopharyngeal carcinoma. All patients received curative IMRT plus weekly chemotherapy with cisplatin (40 mg/m2). Patients received doses of 66 to 70.4 Gy to the gross tumor volume, 60 Gy to the first clinical target, and 54 to 56 Gy to the second clinical target. “The medial group retropharyngeal nodes were never contoured as clinical target volume, aiming to spare the pharyngeal constrictors unless they were involved,” the researchers wrote. “[The] level 1b node was selectively contoured as clinical target volume in order to spare the submandibular glands and oral cavity.” Patient-reported and observer-related scores assessed swallowing and salivary gland function at baseline and periodically up to 3 years after treatment. Median follow-up was 39 months. At 3 years, researchers reported a local RFS rate of 93.6%, a regional RFS rate of 95.8% and a distant metastases-free survival rate of 80%. Researchers reported no marginal or out-of-field relapses. Patients’ dysphagia and xerostomia worsened during late courses of treatment, as well as after treatment, yet scores gradually improved after therapy. Dysphagia was minimal or absent at 9 months post radiotherapy, whereas xerostomia improved from 3 to 15 months post radiotherapy and remained steadily until the conclusion of follow-up. “IMRT concurrent with weekly chemotherapy aiming to reduce xerostomia and dysphagia can be safely [...]

Charlotte Parker2013-07-19T07:42:19-07:00July, 2013|Oral Cancer News|

Celebrity confession linking sex to oral cancer raises local awareness

Source: www.vancouversun.com Author: Pamela Fayerman Michael Douglas is credited for raising awareness about the links between oral sex and oral cancer, but experts worry his disclosure could cause public panic and stigmatize the disease to the point of bringing shame to those afflicted. Or worse, prevent patients with symptoms from getting examined promptly. Miriam Rosin, a BC Cancer Agency scientist, said the actor’s candid revelation that his throat cancer was caused by human papillomavirus (HPV), which he picked up from performing cunnilingus, is raising awareness of a growing problem around the world, and in B.C. “It’s created a lot of noise. I think it’s important to talk about this disease … but not in a headline-grabbing way, which may damage the cause by labelling it as a sexually transmitted disease,” said Rosin, who is also a Simon Fraser University professor. Regardless, the public is finally getting the message that HPV, the most common sexually transmitted virus in the world – and the one that causes virtually all cases of cervical cancer – is accounting for the surge in throat cancers located at the back of the throat. In B.C., if trends continue, HPV-caused throat cancers are expected to overtake cervical cancers in incidence. About 150 cases of cervical cancers are reported annually in this province. Of about 500 head and neck cancers, 115 are HPVcaused throat cancers, according to the BCCA. Douglas’s interview with The Guardian newspaper last month was followed by an avalanche of sensational media reports that apparently [...]

Charlotte Parker2013-07-19T07:43:16-07:00July, 2013|Oral Cancer News|

Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium

Source: Oxford JournalsReceived July 26, 2012.Accepted February 8, 2013 Abstract Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking (Ptrend ≤ 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers. *This news story was resourced by the [...]

Charlotte Parker2013-07-19T07:23:54-07:00July, 2013|Oral Cancer News|

Vaccination Not Found To Increase Risk Of Guillain-Barre Syndrome

Source: Medical News TodayArticle Date: 26 Jun 2013 - 0:00 PDT Patients are not at increased risk of Guillain-Barre syndrome in the six-week period after vaccination with any vaccine, including influenza, according to a Kaiser Permanente study published in Clinical Infectious Diseases. The retrospective study by researchers at the Kaiser Permanente Vaccine Study Center spanned 13 years and was controlled for seasonality. "If there is a risk of Guillain-Barré syndrome following any vaccine, including influenza vaccines, it is extremely low," said Roger Baxter, MD, co-director of the Kaiser Permanente Vaccine Study Center. During the 13-year period (1994-2006), 415 confirmed cases of Guillain-Barré syndrome were observed. Within this group, the researchers found only 25 patients had received any vaccine in the six weeks prior to the onset of the disease. The study also found that 277 patients had a respiratory or gastrointestinal illness in the 90 days preceding the onset. Guillain-Barré syndrome is an acute disease thought to be an autoimmune disorder resulting in destruction of a nerve's myelin sheath and peripheral nerves. In many cases, the syndrome is temporally associated with an infectious disease; most published case series report that approximately two-thirds of all cases are preceded within three months by a gastrointestinal or respiratory infection. Guillain-Barré syndrome had been linked to the influenza vaccine in a 1976 study, but not clearly since. There have been reports of an association with other vaccines, which have not been confirmed. Previous studies of Guillain-Barré syndrome as a possible adverse event related to [...]

Charlotte Parker2013-07-05T10:12:54-07:00July, 2013|Oral Cancer News|

NSAIDs may cut oral cancer risk

Source: www.newsfix.ca Author: Martin March People who smoke are protected from oral cancer by aspirin or ibuprofen, according to a study. It’s already known that smoking is a strong risk factor for oral cancer. A study from the Norwegian Radium Hospital reveals that non-steroidal anti-inflammatory drugs (NSAIDs) may help protect some smokers from the disease. They looked at a group of light to moderate smokers who had taken NSAIDs over a long period. They were about 65 per cent less likely to develop oral cancer compared to smokers who did not take NSAIDs. All types of NSAID were protective, including ibuprofen, aspirin and indomethacin. However, acetaminophen, a common pain reliever which is not an NSAID, was not found to be effective. The benefit of NSAIDs was found to be greatest for those who smoked least. At higher levels of consumption of tobacco, its carcinogenic effect overcomes the benefit of the NSAID.

Oral Cancer Foundation News Team - A2013-07-04T06:20:04-07:00July, 2013|Oral Cancer News|

HPV vaccine still fights for acceptance, despite benefits

Source: www.floydcountytimes.com Author: Tom Collins Last month, actor Michael Douglas caused a stir in the media when he suggested his throat cancer might have been caused by oral sex. He could be right. Although smoking and alcohol use have long been regarded as the key risk factors, new research indicates that HPV, a sexually transmitted virus, is now the leading cause of mouth and throat cancers in the United States. But there’s an important take-away message to this story: Some cancers caused by HPV can be prevented easily, with a simple series of three vaccinations. Since 2000, scientists have known that certain strains of HPV are responsible for nearly all cervical cancer in women. But newer studies indicate HPV can cause other types of cancer as well. Recent findings have also linked HPV to oral, head/neck, anal, vaginal, vulvar and penile cancers, and even some cases of lung cancer. About half of all Americans will become infected with HPV at least once during their lifetime. The most common visible symptom of an HPV infection is genital warts, although the majority of HPV infections do not display symptoms. That’s why the Centers for Disease Control and Prevention recommends that boys and girls alike be vaccinated against HPV. Ideally, they should be vaccinated between the ages of 11 and 12. Vaccination can be initiated as early as age 9, and the U.S. Food and Drug Administration has approved the vaccine to be given up to age 26. Yet HPV vaccination rates remain [...]

Oral Cancer Foundation News Team - A2013-07-04T06:11:34-07:00July, 2013|Oral Cancer News|

Stanford surgeon uses robot to increase precision, reduce complications of head and neck procedures

Source: scopeblog.stanford.edu Author: Margarita Gallardo In today’s San Francisco Chronicle, writer Kristen Brown highlights how surgical robots are simplifying head and neck procedures. Known as transoral robotic surgery, or TORS, Stanford is one of the few places in the country using the da Vinci surgical robot to remove tumors or scar tissue from patients such as 70-year-old John Ayers, who is featured in the story (subscription required). Edward Damrose, MD, chief of the division of laryngeal surgery at Stanford Hospital & Clinics, describes the procedure to Brown: The da Vinci’s most frequent use in transoral procedures is in head and neck cancers. By operating through the mouth, surgeons can remove tumors in places that previously might have required much more complex procedures, such as breaking the jaw to get a good enough look. The robot has four arms – three that can hold typical surgical tools, and a fourth that holds an endoscopic camera, giving a surgeon a full view of the patient’s insides. “You get an almost panoramic view,” said Damrose. “It’s as if you were miniaturized and in someone’s throat looking around.” The da Vinci was first used on a human for a head and neck procedure in 2005 at the University of Pennsylvania. An update to the robot made the experiment possible, when slimmer tools were developed for the robot that might more easily fit inside the mouth. (Even with the smaller tools, working inside someone’s throat can be a tight squeeze, depending on the patient.) “If [...]

Oral Cancer Foundation News Team - A2013-07-04T06:05:53-07:00July, 2013|Oral Cancer News|

Low intracellular zinc induces oxidative DNA damage, disrupts p53, NFκB, and AP1 DNA binding, and affects DNA repair in a rat glioma cell line

Source: Proceedings of the National Academy of Sciences of the United States of AmericaAuthors: Emily Ho and Bruce N. Ames* Abstract Approximately 10% of the U.S. population ingests <50% of the current recommended daily allowance for zinc. We investigate the effect of zinc deficiency on DNA damage, expression of DNA-repair enzymes, and downstream signaling events in a cell-culture model. Low zinc inhibited cell growth of rat glioma C6 cells and increased oxidative stress. Low intracellular zinc increased DNA single-strand breaks (comet assay). Zinc-deficient C6 cells also exhibited an increase in the expression of the zinc-containing DNA-repair proteins p53 and apurinic endonuclease (APE). Repletion with zinc restored cell growth and reversed DNA damage. APE is a multifunctional protein that not only repairs DNA but also controls DNA-binding activity of many transcription factors that may be involved in cancer progression. The ability of the transcription factors p53, nuclear factor κB, and activator protein 1 (AP1) to bind to consensus DNA sequences was decreased markedly with zinc deficiency, as assayed by electrophoretic mobility-shift assays. Thus, low intracellular zinc status causes oxidative DNA damage and induces DNA-repair protein expression, but binding of p53 and important downstream signals leading to proper DNA repair are lost without zinc. The following news story is scientifically tied together with the study above; one explains the other. Please follow this link to read the study titled: Nutritional and Zinc Status of Head and Neck Cancer Patients: An Interpretive Review http://oralcancernews.org/wp/?p=14841 This news story was resourced by the Oral Cancer Foundation, and vetted [...]

Charlotte Parker2013-07-03T17:11:25-07:00July, 2013|Oral Cancer News|

Nutritional and Zinc Status of Head and Neck Cancer Patients: An Interpretive Review

Source: Journal of the American College of NutritionAuthors: Ananda S. Prasad, MD, PhD, MACN, Frances W.J. Beck, PhD, Timothy D. Doerr, MD, Falah H. Shamsa, PhD, Hayward S. Penny, MS, RD, Steven C. Marks, MD, Joseph Kaplan, MD, Omer Kucuk, MD and Robert H. Mathog, MD Abstract In this review, we provide evidence based on our studies, for zinc deficiency and cell mediated immune disorders, and the effects of protein and zinc status on clinical morbidities in patients with head and neck cancer. We investigated subjects with newly diagnosed squamous cell carcinoma of the oral cavity, oropharynx, larynx, and hypopharynx. Patients with metastatic disease and with severe co-morbidity were excluded. Nutritional assessment included dietary history, body composition, and prognostic nutritional index (PNI) determination. Zinc status was determined by zinc assay in plasma, lymphocytes, and granulocytes. Pretreatment zinc status and nutritional status were correlated with clinical outcomes in 47 patients. Assessment of immune functions included production of TH1 and TH2 cytokines, T cell subpopulations and cutaneous delayed hypersensitivity reaction to common antigens. At baseline approximately 50% of our subjects were zinc-deficient based on cellular zinc criteria and had decreased production of TH1 cytokines but not TH2 cytokines, decreased NK cell lytic activity and decreased proportion of CD4+ CD45RA+ cells in the peripheral blood. The tumor size and overall stage of the disease correlated with baseline zinc status but not with PNI, alcohol intake, or smoking. Zinc deficiency was associated with increased unplanned hospitalizations. The disease-free interval was highest for the group which had both zinc sufficient and nutrition sufficient [...]

Charlotte Parker2013-07-03T17:11:10-07:00July, 2013|Oral Cancer News|

Radiation Treatment Breaks and Ulcerative Mucositis in Head and Neck Cancer

Source: The OncologistAuthors: Gregory Russo, Robert Haddad, Marshall Posnerb and Mitchell MachtayaReceived January 31, 2008.Accepted May 14, 2008.First published online in THE ONCOLOGIST Express on August 13, 2008. • Disclosure: The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or staff managers of the article. Abstract Unplanned radiation treatment breaks and prolongation of the radiation treatment time are associated with lower survival and locoregional control rates when radiotherapy or concurrent chemoradiotherapy is used in the curative treatment of head and neck cancer. Treatment of head and neck cancer is intense, involving high-dose, continuous radiotherapy, and often adding chemotherapy to radiotherapy. As the intensity of treatment regimens has escalated in recent years, clinical outcomes generally have improved. However, more intensive therapy also increases the incidence of treatment-related toxicities, particularly those impacting the mucosal lining of the oral cavity, pharynx, and cervical esophagus, and results in varying degrees of ulcerative mucositis. Ulcerative mucositis is a root cause of unscheduled radiation treatment breaks, which prolongs the total radiation treatment time. Alterations in radiotherapy and chemotherapy, including the use of continuous (i.e., 7 days/week) radiotherapy to ensure constant negative proliferative pressure, may improve efficacy outcomes. However, these approaches also increase the incidence of ulcerative mucositis, thereby increasing the incidence of unplanned radiation treatment breaks. Conversely, the reduction of ulcerative [...]

Charlotte Parker2013-07-03T16:36:04-07:00July, 2013|Oral Cancer News|