Evaluation of Carotid Angioplasty and Stenting for Radiation-Induced Carotid Stenosis

Authors: Simon C.H. Yu, MD; Winnie X.Y. Zou, PhD; Yannie O.Y. Soo, MD;Lily Wang, MD; Joyce Wai Yi Hui, FRCR; Anne Y.Y. Chan, MD; Kwok Tung Lee, MSc; Vincent H.L. Ip, MD; Florence S.Y. Fan, MD; Annie L.C. Chan, MSc; Lawrence K.S. Wong, MD; Thomas W. Leung, MDSource: http://stroke.ahajournals.org  Abstract Background and Purpose—We aimed to evaluate the procedural safety, clinical, and angiographic outcome of carotid angioplasty and stenting for high-grade (≥70%) radiation-induced carotid stenosis (RIS) using atherosclerotic stenosis (AS) as a control. Methods—In this 6-year prospective nonrandomized study, we compared the carotid angioplasty and stenting outcome of 65 consecutive patients (84 vessels) with RIS with that of a control group of 129 consecutive patients (150 vessels) with AS. Study end points were 30-day periprocedural stroke or death, ipsilateral ischemic stroke, technical success, procedural characteristics, instent restenosis (ISR; ≥50%) and symptomatic ISR. Results—The median follow-up was 47.3 months (95% confidence interval, 26.9–61.6). Imaging assessment was available in 74 vessels (RIS) and 120 vessels (AS) in 2 years. Comparing RIS group with AS group, the rates of periprocedural stroke or death were 1.5% (1/65) versus 1.6% (2/129; P=1); ipsilateral ischemic stroke rates were 4.6% (3/65) versus 4.7% (6/129; P=1); the annual risks of ipsilateral ischemic stroke were 1.2% (3 patient/254.7 patient year) versus 1.2% (6 patient/494.2 patient year; P=0.89); technical success rates were both 100%. Stenting of common carotid artery and the use of multiple stents was more common in the RIS group (P=0 in both cases); ISR rates were 25.7% (19/74) versus 4.2% (5/120; P<0.001); symptomatic ISR rates were 6.8% (5/74) versus 0.8% (1/120; P=0.031). [...]

2014-04-30T11:02:35-07:00April, 2014|Oral Cancer News|

FDA proposes rules to disclose e-cigarette ingredient information and ban sales to children

Source: usatoday.comAuthor: Wendy Koch  As electronic cigarettes soar in popularity, the U.S. government Thursday is proposing historic rules to ban their sale to minors and require warning labels as well as federal approval. Three years after saying it would regulate e-cigarettes, the Food and Drug Administration is moving to control not only these battery-powered devices but also cigars, pipe tobacco, hookahs (water pipes) and dissolvable tobacco products. Currently, the FDA regulates cigarettes, roll-your-own tobacco and smokeless products such as snuff. The proposed rules won't ban advertising unless the products make health-related claims nor will they ban the use of flavors such as chocolate or bubble gum, which public health officials say might attract children. "This is an important moment for consumer protection," said FDA Commissioner Margaret Hamburg, noting tobacco remains "the leading cause of death and disease in this country." The rules will require manufacturers to report their ingredients to the FDA and obtain its approval. They also ban free tobacco samples and most vending-machine sales. "Some of these regulations will be very restrictive," said Ray Story, founder of industry group TVECA (Tobacco Vapor Electronic Cigarette Association), who added he obtained his own pre-release copy of the rules. He said they could be costly for smaller businesses and slow the growth of a product that advocates say has helped many smokers kick the habit. Still, Story said, consumers might benefit, because "it provides them a product that will be consistent." E-cigarettes contain varying ingredients and levels of nicotine that are [...]

2014-04-24T15:19:30-07:00April, 2014|Oral Cancer News|

Current tobacco reports show 50 years of progress

Source: the-scientist.comAuthor: Jef Akst  In 1964, the U.S. Surgeon General released the first report on the effect that cigarettes and other forms of tobacco have on human health, presenting strong evidence of the link between smoking and lung cancer, among other adverse consequences. During the last 50 years, significant progress has been made in terms of understanding how smoking causes various diseases and how to treat them, and educational campaigns have contributed to a drop in smoking rates from 42 percent to 18 percent of US adults. Nevertheless, more than 480,000 Americans still die from tobacco-related diseases each year, and additional health consequences continue to be linked to smoking. “Between now and mid-century, nearly 18 million Americans will die preventable avoidable deaths if we don’t do something to alter that trajectory,” Mitchell Zeller, the director of the Center for Tobacco Products of the Food and Drug Administration (FDA), said during a press conference held today here at the American Association for Cancer Research (AACR) meeting in San Diego, California. To this end, the AACR released a compilation of peer-reviewed research and review articles, published across seven of its journals, covering basic scientific research on the molecular mechanisms of tobacco carcinogenesis, tools for the diagnosis of lung cancer and other tobacco-related diseases, and the impact of the original Surgeon General’s report on tobacco control. Ellen Gritz from the University of Texas MD Anderson Cancer Center helped put the new report together. “Together, these reports add to the broad reach of important tobacco-related [...]

2014-04-17T11:21:58-07:00April, 2014|Oral Cancer News|

Could the everyday use of mouthwash be linked to oral cancer?

Source: nursingtimes.netAuthor: Staff  “Experts warn using mouthwash more than twice a day can give you cancer,” the Daily Mirror reports. The news comes from a European study that examined the oral health and dental hygiene of people diagnosed with cancers of the mouth, throat, vocal chords or oesophagus (collectively called “upper aerodigestive cancers”). The researchers found that people with the poorest oral health (including wearing dentures and bleeding gums) had a more than doubled risk of these cancers compared with those with the best oral health. Similarly, they found that those with the poorest dental care (including frequency of tooth brushing and visiting the dentist) had a more than double risk compared with those with the best dental care. Importantly, these associations remained after adjustment for smoking and alcohol consumption – established risk factors for these cancers – and for other factors that may influence risk, such as socioeconomic status. But despite the Mirror’s headline, the link between oral cancer and mouthwash is less clear. The association was only significant when looking at very frequent use (three times a day). Very few people used mouthwash this frequently, which decreases the reliability of this risk estimate. There is certainly no credible evidence that mouthwash “can give you cancer”. Even if there is a true link, it is unclear whether it is mouthwash itself (the alcohol content) or the reasons it is being used, such as poor oral hygiene, that are responsible for the association. The results do suggest a link between poor dental hygiene and [...]

2014-04-15T16:43:59-07:00April, 2014|Oral Cancer News|

Study finds the prognosis of HPV positive tumors in head and neck cancer patients to vary depending on site

Source: sciencecodex.comAuthor: Staff  Vienna, Austria: Patients with cancer of the throat and who are positive for the Human Papilloma virus (HPV+) have a good prognosis, but until now the effect of being HPV+ on the prognosis of tumours located elsewhere in the head and neck was unknown. Danish researchers have now shown that HPV status appears to have no prognostic effect on the outcome of primary radiotherapy in head and neck cancer outside the oropharynx (the part of the throat located behind the mouth, and which contains the soft palate and the base of the tongue), the ESTRO 33 congress will hear today (Sunday). Presenting her results to the congress, Dr Pernille Lassen, MD, PhD, from the Aarhus University Hospital, Aarhus, Denmark, will say that head and neck cancers located outside the oropharynx should probably not be treated with the less intensive treatment strategies that are currently being investigated in clinical trials for HPV+ oropharyngeal tumours. "HPV status has a very potent prognostic impact in radiotherapy for oropharyngeal cancer, and DNA from HPV has been found in all types of head and neck cancer, although it is far more common in oropharyngeal tumours. We decided to investigate the impact of HPV status in non-oropharyngeal cancers in the DAHANCA database, which includes all Danish head and neck cancer patients," Dr Lassen will say. The researchers searched the database to identify patients with locally advanced cancers who had been treated primarily with radiotherapy, and identified 1606 patients with larynx and pharynx carcinomas. Overall, [...]

2014-04-07T12:38:17-07:00April, 2014|Oral Cancer News|

Liquid nicotine for E-cigarettes found to be extremely toxic

Source: nytimes.comAuthor: Matt Richtel  A dangerous new form of a powerful stimulant is hitting markets nationwide, for sale by the vial, the gallon and even the barrel. The drug is nicotine, in its potent, liquid form — extracted from tobacco and tinctured with a cocktail of flavorings, colorings and assorted chemicals to feed the fast-growing electronic cigarette industry. These “e-liquids,” the key ingredients in e-cigarettes, are powerful neurotoxins. Tiny amounts, whether ingested or absorbed through the skin, can cause vomiting and seizures and even be lethal. A teaspoon of even highly diluted e-liquid can kill a small child. But, like e-cigarettes, e-liquids are not regulated by federal authorities. They are mixed on factory floors and in the back rooms of shops, and sold legally in stores and online in small bottles that are kept casually around the house for regular refilling of e-cigarettes. Evidence of the potential dangers is already emerging. Toxicologists warn that e-liquids pose a significant risk to public health, particularly to children, who may be drawn to their bright colors and fragrant flavorings like cherry, chocolate and bubble gum. “It’s not a matter of if a child will be seriously poisoned or killed,” said Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. “It’s a matter of when.” Reports of accidental poisonings, notably among children, are soaring. Since 2011, there appears to have been one death in the United States, a [...]

2014-04-07T12:06:53-07:00April, 2014|Oral Cancer News|

Recurrent head and neck tumors have gene mutations that could be vulnerable to cancer drug

Source: medicalxpress.com Author: staff An examination of the genetic landscape of head and neck cancers indicates that while metastatic and primary tumor cells share similar mutations, recurrent disease is associated with gene alterations that could be exquisitely sensitive to an existing cancer drug. Researchers from the University of Pittsburgh Cancer Institute (UPCI) and Yale University School of Medicine will share their findings during a mini-symposium Sunday at the American Association for Cancer Research Annual Meeting 2014. About 50 percent of patients diagnosed with head and neck squamous cell cancers already have disease that has spread, or metastasized, to the lymph nodes, explained Jennifer Grandis, M.D., distinguished professor and vice chair of research, Department of Otolaryngology, Pitt School of Medicine, and director of the Head and Neck Program at UPCI, partner with UPMC CancerCenter. About 20 to 30 percent of patients thought to be cured of the disease go on to develop recurrent cancer, which typically doesn't respond to standard treatments. "We decided to compare the genetic signatures of tumor cells from primary tumors with those from disease that had spread and cancers that were thought cured but then came back in the hopes of getting some clues about how best to guide therapy in these different settings," Dr. Grandis said. "We found that recurrent cancers might have an Achilles' heel we can exploit to kill them." The team conducted the first whole-exome genetic sequencing study on what Dr. Grandis called its "treasure trove" of frozen patient samples and found similar [...]

Prognosis of tumors positive for human papilloma virus in head and neck cancers varies according to the site

Source: www.sciencecodex.com Author: staff Patients with cancer of the throat and who are positive for the Human Papilloma virus (HPV+) have a good prognosis, but until now the effect of being HPV+ on the prognosis of tumours located elsewhere in the head and neck was unknown. Danish researchers have now shown that HPV status appears to have no prognostic effect on the outcome of primary radiotherapy in head and neck cancer outside the oropharynx (the part of the throat located behind the mouth, and which contains the soft palate and the base of the tongue), the ESTRO 33 congress will hear today (Sunday). Presenting her results to the congress, Dr Pernille Lassen, MD, PhD, from the Aarhus University Hospital, Aarhus, Denmark, will say that head and neck cancers located outside the oropharynx should probably not be treated with the less intensive treatment strategies that are currently being investigated in clinical trials for HPV+ oropharyngeal tumours. "HPV status has a very potent prognostic impact in radiotherapy for oropharyngeal cancer, and DNA from HPV has been found in all types of head and neck cancer, although it is far more common in oropharyngeal tumours. We decided to investigate the impact of HPV status in non-oropharyngeal cancers in the DAHANCA database, which includes all Danish head and neck cancer patients," Dr Lassen will say. The researchers searched the database to identify patients with locally advanced cancers who had been treated primarily with radiotherapy, and identified 1606 patients with larynx and pharynx carcinomas. Overall, [...]

After-effects of oral cancer surgery forces patients into unemployment and depression

Source: economicvoice.comAuthor: Economic Voice Staff Cancer Patients are being forced into unemployment due to the after-effects of surgery and higher levels of depression. Research into head and neck cancer patients discovered the rate of those employed fell by more than 40 per cent five years after diagnosis, where only one in three managed to secure work. They also reported unemployed cancer survivors had lower social well-being and higher depression scores For those cancer sufferers out of work prior to diagnosis, their reasons for not returning to work also included the knock-on effect of surgery as well as dangerous levels of alcohol consumption. Figures from Cancer Research UK reveal more than 331,000 people were diagnosed with cancer in 2011 – around 910 every day. According to mouth cancer campaigners, the problems are exacerbated for mouth cancer patients. Previous research identified mouth cancer survivors face a diminished quality of life. Survivors reported poor oral function, resulting in persistent eating problems and long term depression. More than half of respondents (51.6 per cent) reported problems with eating, while on average one in four survivors who lived for five or more years still experienced speech problems. It was a similar story when it came to a patient’s physical and mental health, with more than a third (36.7 per cent and 39.3 per cent respectively) recording low functionality after the five year analysis. According to Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, the study highlights the problems mouth cancer sufferers face on a daily basis. Dr [...]

2014-03-31T15:05:13-07:00March, 2014|Oral Cancer News|

Jim Kelly’s toughest game: Fighting oral cancer

Source: www.foxnews.com Author: Dr. Manny Alvarez Jim Kelly, the Hall of Fame quarterback who played for the Buffalo Bills until 1996, is one of the greatest football players that I have ever seen. During his football career, I followed him closely and was always in awe of his athletic abilities, his leadership qualities and his love of family. Unfortunately, Jim Kelly is currently battling a second recurrence of oral cancer and has been scheduled to undergo surgery in an attempt to control the disease. His wife, Jill, told the Associated Press that her 54-year-old husband’s cancer is aggressive and beginning to spread. I’ve been following Jim Kelly’s health struggles and have been thinking about him, praying that he gets better. It is easy to think of some humans as immortal – especially when you’re looking at an individual as physically fit as Jim Kelly. But we tend to forget that sometimes nature has a unique plan for all of us. However, Jim Kelly’s struggles can serve as a reminder for us all to be vigilant about our health. Jim Kelly is suffering from oral cancer, which doesn’t get the attention that it deserves, despite the fact that 42,000 new cases will be diagnosed in 2014, according to the National Cancer Institute. Oral cancers are any cancers occurring in the oral cavity, which starts in your throat and extends all the way to your lips. The sad part about this disease is that oral cancers are typically not identified early, which [...]

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