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Comparing the HPV vaccines

Source: www.hemonctoday.com Author: Debbie Blamble, PharmD, BCOP HPVs are double-stranded DNA viruses that affect epithelial cells. More than 100 strains of HPV have been detected. Approximately 40 strains are known to infect genital mucosa, of which about 15 strains are known to cause cancer. HPV types 16 and 18 are the most common cancer-causing strains, leading to about 70% of all cervical cancer cases worldwide. HPV types 6 and 11 are associated with about 90% of all cases of genital warts. Cervical intraepithelial neoplasia is an abnormality of the cervical epithelium associated with HPV infection and is thought to be a precursor to cervical cancer. CIN is classified into three grades: 1, 2, 3. With CIN-1, mild dysplasia is present and affects only the lowest third of the cervical epithelium; 70% to 90% of CIN-1 lesions undergo spontaneous regression. CIN-2 and CIN-3 show moderate to severe dysplasia and affect the lowest two-thirds to full thickness of the cervical epithelium, respectively. More than half of CIN-2 and CIN-3 cases are estimated to persist or progress to squamous cell cancer. Persistent HPV infection may also lead to cervical adenocarcinoma in situ. In the United States, screening with the Pap test identifies these precancerous lesions and has led to a decrease in the rates of cervical cancer. These precancerous lesions may develop less than five years after HPV infection. HPV infection HPV infection is most frequently acquired through sexual contact. It is estimated that more than 80% of men and women in the [...]

2010-04-11T10:57:29-07:00April, 2010|Oral Cancer News|
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Smoking-attributable cancer mortality in California, 1979–2005

Source: Tob Control 2010;19:i62-i67 doi:10.1136 Author: David W Cowling1, Juan Yang2 Background: The adult smoking prevalence has declined more in California than the rest of the US in the past 2 decades. Further, California has faster declines in cancer mortality, lung cancer incidence and heart disease mortality. However, no study has examined smoking-related cancer mortality between California and the rest of the US. Methods: The smoking-attributable cancer mortality rate (SACMR) from 1979 to 2005 in California and the rest of the US are calculated among men and women 35 years of age or older using the Joinpoint regression model to calculate the SACMR annual percentage change. The SACMR is the sum of the smoking-attributable death rates of 10 smoking-attributable cancers. Results: The SACMR has declined more in California (25.7%) than the rest of the US (8.9%) from 1979 to 2005. California men had a lower SACMR than the rest of the US over the entire study period, with the difference tripling from 7.4% in 1979 to 23.9% in 2005. The difference of female SACMR between California and the rest of the US went from 17.9% higher in 1979 to 13.4% lower in 2005. Conclusions: California's SACMR decrease started 7 years earlier than the rest of the US (1984 vs 1991), and California experienced an accelerated decline of SACMR compared to the rest of the US overall and among men and women from 1979 to 2005. Although the SACMR started declining before the creation of the California Department of Public Health, [...]

2010-04-11T05:24:21-07:00April, 2010|Oral Cancer News|
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Sylvester surgeons perform first removal of throat cancer in south Florida using surgical robot

Source: www.healthcanal.com Author: staff Surgeons from the Department of Otolaryngology at UHealth – the University of Miami Health System have performed the first removal of throat cancer in South Florida using a surgical robot. The operation was performed March 22nd at the University of Miami Hospital by Francisco Civantos, M.D., associate professor of otolaryngology and member of the Head and Neck Cancer Site Disease Group at Sylvester Comprehensive Cancer Center, and Giovana Thomas, M.D., associate professor of otolaryngology and member of the Head and Neck Cancer Site Disease Group at Sylvester. They were accompanied by Raymond J. Leveillee, M.D., professor of urology, who is an experienced urologic robotic surgeon. Traditional surgery for various head and neck cancers requires large incisions – extending from the lip, across the chin and to the neck before entering the mouth or throat. Numerous times surgeons need to cut through the lower jaw and move aside vital nerves to gain access to the back of the mouth and throat. By using the da Vinci® Surgical System, surgeons insert the slender instruments into the mouth to reach the base of the tongue, tonsils, and throat. "As a surgeon," says Civantos, "using a surgical robot allows for greater precision and dexterity to remove cancerous tumors from tight spaces in the mouth and throat." The University of Miami Hospital's da Vinci® System consists of robotic arms that replicate a surgeon's motions. Throughout a robot-assisted surgery, patients are positioned as they would be during laparoscopic surgery, with surgical team [...]

2010-04-10T10:28:38-07:00April, 2010|Oral Cancer News|
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Diagnostic delay broadly associated with more advanced stage oral cancer.

Source: Evid Based Dent, January 1, 2010; 11(1): 24 Author: I Al-Dakkak Data sources: Medline, Embase, ISI Proceedings and the reference lists of relevant articles were used to find relevant studies. Study selection: Studies were included if: they presented original data from observational studies; included patients with a confirmed pathological diagnosis of oral or oropharyngeal squamous cell carcinoma; the outcome of interest was clearly defined as disease stage (TNM classification); the exposure of interest was total diagnostic delay, defined as the period between the patient noticing either the first sign or symptom and definitive diagnosis (data were collected from interviews using a standardised questionnaire and medical records); provided relative risks (RR) and 95% confidence intervals (CI) or provided enough data to allow calculation of these figures. Data extraction and synthesis: Quality assessment was undertaken independently by two reviewers and followed the recommendations of the Meta-analysis of Observational Studies in Epidemiology (MOOSE). Meta-analysis was conducted using fixed and random-effects models. Results: Nine studies carried out in nine different countries met the inclusion criteria and were included in the analysis. The fixed-effects pooled relative risk (RR) of advanced stages of oropharyngeal cancer when diagnostic delay is present was 1.32 (95% CI, 1.07-1.62). This association was stronger when the analysis was restricted to oral cancer (pooled RR, 1.47; 95% CI, 1.09-1.99) and when the delay was longer than 1 month (pooled RR, 1.69; 95% CI, 1.26-2.77). Conclusions: The probability for people with delayed diagnosis to present with an advanced-stage tumour at diagnosis was [...]

2010-04-06T11:28:54-07:00April, 2010|Oral Cancer News|
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Docetaxel suppresses invasiveness of head and neck cancer cells in vitro

Source: Cancer Sci, February 22, 2010 Author: Y Kogashiwa et al. The combination of docetaxel, cisplatin, and fluorouracil significantly enhances the survival of head and neck cancer patients compared to cisplatin and fluorouracil. We hypothesized that docetaxel may affect invasiveness of the head and neck cancer cells in addition to its tumor-killing effect. Two different head and neck cancer cell lines (HEp-2 and Ca9-22) were treated with docetaxel at IC(10) and IC(50) concentrations. Cell migration and invasive growth was evaluated by wound healing assay and three-dimensional (3D) culture of multicellular tumor spheroids, respectively. Expression levels of possible downstream effectors for cell migration/invasiveness were measured by immunoblotting in conditions with or without docetaxel. Docetaxel, but not cisplatin, suppressed filopodia formation compared with no treatment (control) condition. Consistent with this, docetaxel suppressed two-dimensional (2D) cell migration and 3D cell invasion compared with control or cisplatin. Only docetaxel treated cells exhibited thick tubulin bundle and had lower activity of Cdc42, a member of the Rho family of small GTPases. In conclusion, Docetaxel treatment suppressed migration and invasiveness of head and neck cancer cells in vitro, which is likely to be mediated by regulating Cdc42 activity. Authors: Y Kogashiwa, H Sakurai, T Kimura, and N Kohno Authors' affiliation: Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan

2010-04-06T11:22:56-07:00April, 2010|Oral Cancer News|
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As cigarette sales dip, new products raise concerns

Source: www.atomiurl.com Author: staff If he were conceived today, there might not be just a cigarette dangling from his mouth. He might also have, tucked into his pocket, a cellphone-size container holding a dozen pouches of snus. It rhymes with “goose,” (cynics might say “noose”), and is a Swedish type of smokeless tobacco that’s not your grandfather’s dip or chew. Snus comes in teabag-like pouches that a user sticks between the upper lip and gum, leaves there for up to 30 minutes and discards without spitting. As no-smoking laws sweep the nation and cigarette sales continue to fall, big Tobacco is alarming the public health community by devising other ways to try to make tobacco appealing. with smokeless products representing the only booming part of the U.S. tobacco market, snus is an effort to boost sales with a product that — unlike most smokeless ones — doesn’t require users to spit out the residue. Snus also represents something more: an attempt to move smokeless tobacco beyond stereotypical users such as baseball players and rodeo cowboys, and into offices or restaurants where people want a nicotine fix but can’t light up. “This is a growth strategy for us,” says Bill Phelps, spokesman for Philip Morris USA, the nation’s biggest tobacco company and maker of Marlboro, the top-selling cigarette. In Dallas this month, Philip Morris is launching its first smokeless product with a cigarette brand name: Marlboro Snus. R.J. Reynolds, second in U.S. tobacco sales, is expanding tests of its Camel Snus [...]

2010-04-05T13:08:02-07:00April, 2010|Oral Cancer News|
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Nano-bio-chip sensor platform for examination of oral exfoliative cytology

Source: Cancer Prevention Research 3(4); 518-28, March 23, 2010 Authors: SE Weigum et al. Oral cancer is a deadly and disfiguring disease that could greatly benefit from new diagnostic approaches enabling early detection. In this pilot study, we describe a nano-bio-chip (NBC) sensor technique for analysis of oral cancer biomarkers in exfoliative cytology specimens, targeting both biochemical and morphologic changes associated with early oral tumorigenesis. Here, oral lesions from 41 dental patients, along with normal epithelium from 11 healthy volunteers, were sampled using a noninvasive brush biopsy technique. Specimens were enriched, immunolabeled, and imaged in the NBC sensor according to previously established assays for the epidermal growth factor receptor (EGFR) biomarker and cytomorphometry. A total of 51 measurement parameters were extracted using custom image analysis macros, including EGFR labeling intensity, cell and nuclear size, and the nuclear-to-cytoplasmic ratio. Four key parameters were significantly elevated in both dysplastic and malignant lesions relative to healthy oral epithelium, including the nuclear area and diameter (P

2010-04-04T09:12:06-07:00April, 2010|Oral Cancer News|
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Socio-economic factors and stage at presentation of head and neck cancer patients in Ottawa, Canada: A logistic regression analysis

Source: Oral Oncol, March 20, 2010 Authors: S Johnson et al. To determine if socio-economic status (SES) affects the stage at presentation of head and neck cancer (HNC) patients in Ottawa, Canada. To determine if the method of diagnosis affects the stage at presentation in these patients. We obtained data on SES, method of diagnosis, and stage at presentation for patients presenting to the head and neck cancer clinic at The Ottawa Hospital Regional Cancer Centre (TORCC). We performed a logistic regression analysis using stage at presentation as the dependent variable. We found no statistically significant association between average family income (by postal code) and stage at presentation. We found that oral cancers presented at a later stage compared with other HNCs but that who made the diagnosis was an important factor. Oral cancers diagnosed by a dentist had 3.44 times the odds of being at a later stage than other HNCs (CI 1.01-11.96), but oral cancers diagnosed by other means had 11.42 times the odds of being at a later stage than other HNCs. We found that male patients presented at a later stage than female patients (OR 2.62, CI 1.03-6.63). Finally, former smokers had about 1/3 the odds of presenting at a later stage than current smokers (OR 0.33, CI 0.13-0.84) although nonsmokers were not significantly less likely than current smokers to present later (OR 0.47, CI 0.17-1.32). We found no evidence that in Ottawa, Canada patients of a lower SES with HNC presented at an different stage [...]

2010-04-04T09:02:33-07:00April, 2010|Oral Cancer News|
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Fluoroscopically guided balloon dilation for pharyngoesophageal stricture after radiation therapy in patients with head and neck cancer

Source: AJR Am J Roentgenol, April 1, 2010; 194(4): 1131-6 Author: HT Hu et al. Objective: The purpose of this article is to assess the safety and long-term efficacy of fluoroscopically guided balloon dilation for pharyngoesophageal strictures after radiation therapy in patients with head and neck cancers. Materials and method: From April 1997 to February 2009, fluoroscopically guided balloon dilation was performed in 17 patients with pharyngoesophageal strictures caused by radiation therapy. Technical success, clinical success (decrease of at least one grade in dysphagia score and good contrast passage on 1-month follow-up esophagogram), recurrence of dysphagia, and complications related to the procedure were retrospectively evaluated. Results: All 17 patients underwent 41 balloon dilation procedures, with each patient undergoing one to seven procedures (mean, 2.4 procedures). The technical success rate was 100%, and clinical success was achieved in 64.7% (11/17) of the patients. Five patients (29.4%) showed no recurrence of dysphagia after one session of balloon dilation. Of 12 patients (70.6%) with recurrence of dysphagia, 10 underwent repeat balloon dilation and two underwent gastrostomy after the first session of balloon dilation. The maximum balloon diameters were 15 mm (n = 22), 20 mm (n = 16), and 25 mm (n = 3). As minor complications, three cases of type 1 esophageal rupture occurred in two patients (11.8%). There were no major complications. Conclusion: Although the recurrence rate was high with repeat balloon dilation, fluoroscopically guided balloon dilation seems to be a simple and safe primary treatment technique for pharyngoesophageal stricture due [...]

2010-04-04T08:58:07-07:00April, 2010|Oral Cancer News|
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Expand+Bcl2 and human papilloma virus 16 as predictors of outcome following concurrent chemoradiation for advanced oropharyngeal cancer

Source: Clin Cancer Res; 16(7); 2138–46 Authors: Anthony C. Nichols et al. Purpose: Oropharyngeal squamous cell carcinoma (OPSCC) associated with human papilloma virus (HPV) is rapidly growing in incidence. Despite better prognosis than OPSCC associated with traditional risk factors, treatment failure still occurs in a significant proportion of patients. We had identified the antiapoptotic protein Bcl2 as a marker for poor outcome in advanced OPSCC treated with concurrent chemoradiation. To determine whether Bcl2 and HPV together might further characterize treatment response, we examined whether the prognostic value of Bcl2 was independent of HPV status. Experimental Design: Pretreatment tumor biopsies from 68 OPSCC patients were tested for HPV by in situ hybridization and were immunostained for Bcl2 to evaluate relations with disease-free (DFS) and overall survival following platin-based concurrent chemoradiation. Median follow-up among surviving patients was 47 months (range, 10-131 months). Results: Bcl2 and HPV independently predicted DFS and overall survival. Hazard ratios (with 95% confidence interval) for positive versus negative status in bivariate Cox proportional hazard analysis of DFS were 6.1 (1.8-21) for Bcl2 and 0.11 (0.035-0.37) for HPV. Only 1 of 32 HPV-positive/Bcl2-negative tumors recurred. Pretreatment Bcl2 expression was specifically associated with distant metastasis; five of six distant metastases occurred in the <40% of patients whose primary tumors were Bcl2 positive. Conclusions: Independent of HPV status, pretreatment Bcl2 expression identifies a subset of OPSCC patients having increased risk of treatment failure, particularly through distant metastasis, after concurrent chemoradiation. Considering HPV and Bcl2 together should help in devising better personalized [...]

2010-04-04T08:52:04-07:00April, 2010|Oral Cancer News|
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