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Journal of Nuclear Medicine: Costs for PET, PET/CT decreasing with increase in oncologic exams

Source: www.healthimaging.com Author: staff An article published in the March issue of the Journal of Nuclear Medicine reports on the methodologies for conducting economic evaluations of PET and PET/CT in oncologic applications, suggesting that PET and PET/CT are cost effective for staging of non–small cell lung cancer, differential diagnosis of solitary pulmonary nodules, restaging of Hodgkin's disease and non-Hodgkin's lymphoma and the restaging of colorectal carcinoma. Healthcare systems globally have recently approved reimbursement for PET and PET/CT for staging of non-small cell lung cancer and differential diagnosis of solitary pulmonary nodules because PET and PET/CT have been found to be cost-effective for those uses, according to Andreas K. Buck, MD from Nuklearmedizinische Klinik und Poliklinik in München, Germany, and colleagues. Additional indications that are covered by healthcare systems in the U.S. and several European countries include staging of gastrointestinal tract cancers, breast cancer, malignant lymphoma, melanoma, and head and neck cancers, added Buck and colleagues. PET and PET/CT are highly sensitive diagnostic tests to screen for metastatic tumor deposits in the entire body that may be missed by standard imaging modalities. On a patient basis, costs for PET and PET/CT are decreasing with the increasing numbers of examinations performed, noted Buck and colleagues. In Germany, “costs per examination range between approximately € 600 ($885 U.S.) and €1,000 ($1,474 U.S.); the amount for production and delivery of radiopharmaceuticals is approximately €180–€ 260 ($265–$383 U.S.) per scan.” In Great Britain, costs range from £635–£1,300 ($1,030– $2,109 U.S.) for PET. In Europe, reimbursement [...]

Another call to extend HPV vaccine to boys. Is anyone listening?

Source: www.abc.net.au Author: Lindy Kerin Australian researchers say the human papillomavirus (HPV), which can cause cervical cancer in women, is now a leading cause of oral cancer in men in the Western world. The news has reignited debate over whether the HPV vaccine, which is free for young women, should also be offered to men. A University of Sydney study shows that 60 per cent of throat and tonsil cancers are caused by the virus. "We've tested just over 300 cancers of the oropharynx, and the oropharynx includes the tonsil and the base of tongue and part of the pharangyl wall," said Barbara Rose, an Associate Professor in research at the University of Sydney. "We've tested those for the human papillomavirus type-16 and type-18, which are the major cause of cervical cancer in women. "And we found a sizeable proportion are associated with those types. In fact, probably in excess of 50 per cent now." Those figures from 2001 to 2005 increased to almost 60 per cent in 2006 and 2007. Associate Professor Rose says head and neck cancers have traditionally been associated with older men and related to alcohol and smoking. She says these findings show that has now changed and most are due to the increasing practise of oral sex. "We now know that there's another subset, which is quite distinct biologically, which tends to affect younger people who don't smoke and don't drink, caused by human papillomavirus probably by sexual transmission," she said. "And the types of [...]

SciClone announces topline results from Phase 2 clinical trial of SCV-07 for prevention of oral mucositis

Source: CNNMoney.com Author: press release SciClone Pharmaceuticals, Inc. today announced topline results from the company's phase 2 clinical trial of SCV-07 for the prevention of severe oral mucositis (OM) (World Health Organization, WHO scale, grades 3 to 4) -- a painful, debilitating, and costly toxicity caused by chemoradiotherapy regimens used to treat head and neck cancer. This proof of concept study was intended to provide an estimate of SCV-07's treatment effect and guide further studies of SCV-07 in addressing this serious unmet medical need. Patients receiving the study's higher dose (0.1 mg/kg) of SCV-07 showed a trend towards delay to onset of severe OM, the study's primary endpoint. Patients in the low dose treatment arm (0.02 mg/kg) appeared to do worse than placebo, suggesting that the treatment effect is sensitive to dose. Additionally, SCV-07 was safe and well tolerated with no drug-related serious adverse events reported, indicating that there is potential to administer higher doses of SCV-07 in future clinical studies. Additional data analysis showed a more pronounced clinical benefit for patients in the high dose treatment arm when evaluating the delay to onset of ulcerative OM (WHO scale, grades 2 to 4), an expanded measure of OM. In this analysis, the low dose treatment arm appeared similar or slightly better than placebo. "We are encouraged that the trial provides an indication of a biological signal, in the high dose arm, for the pre-specified primary endpoint of the study," said Stephen T. Sonis, DMD, DMSc, Senior Physician, Brigham and Women's [...]

Adjuvant radiotherapy helpful in early, node-positive oral cancer

Source: www.acr.org Author: David Douglas Postoperative radiotherapy significantly improves survival in patients with early T stage oral cavity squamous cell carcinoma and a single positive lymph node, researchers report in the March issue of Archives of Otolaryngology: Head and Neck Surgery. "Even for small primary tumors of the oral cavity, the presence of a single positive lymph node may be an indication to offer radiation despite the relatively early stage of these tumors," lead author Dr. Mark G. Shrime told Reuters Health by email. "This is especially true in T2 tumors of the tongue and the floor of mouth." Dr. Shrime of Boston University Medical Center and colleagues examined data on more than 1500 patients who had surgery between 1983 and 2004. Patients who had postoperative radiotherapy had significantly better 5-year overall survival (54.2% versus 41.4%). The largest advantage was in patients with T2 primary tumors (48.8% versus 32.5%). The difference in patients with T1 tumors (63.4% versus 56.5%) was not statistically significant. Also, the authors report, adjuvant radiotherapy was particularly effective in T2 tumors of the tongue (improving 5-year survival from 37.9% to 52.3%) and floor of the mouth (boosting survival from 17.7% to 39.9%). For all other sites, adjuvant radiotherapy was not associated with improved overall 5-year survival. The 5-year cause-specific survival rate was 64.3% in patients treated with surgery alone, versus 72.1% in patients who also had radiotherapy. While the results appear encouraging, the researchers call for "further analysis with either large multi-institutional series or more detailed [...]

Rise in mouth cancer linked to STI’s, primarily HPV16

Source: www.nhs.uk Author: staff The Daily Telegraph reported that a “rise in mouth cancer may be due to sexually transmitted infection”. The newspaper said that there has been a 50% increase in the number of mouth cancers in the last 20 years, and the increase appears to be in those cases related to the human papilloma virus (HPV). The story is based on an editorial in the British Medical Journal by cancer specialists, which highlighted an increase in the numbers of a specific type of throat cancer in the UK. The specialists also discussed studies from other countries that show an increase in the proportion of HPV-related throat cancers. The editorial reported on a very small number of studies, but it shows that there may be a need to investigate the incidence of HPV-related throat cancers in the UK, to track these cases and to see if HPV-related cancers should be treated differently to non-HPV-related throat cancers. There is insufficient evidence at the moment to suggest that the HPV vaccination, currently available for teenage girls, should also be given to boys. Where did the story come from? This editorial was written by Hisham Mehanna, director of the Institute of Head and Neck Studies and Education at University Hospital, Coventry, and colleagues at the University of Liverpool, Université Catholique de Louvain and the University of Texas. The editorial was commissioned and published by the British Medical Journal and was not externally peer reviewed. What was the editorial about? This editorial was [...]

Study evaluating clinical performance of Cervista(R) HPV HR presented at AOGIN

Source: www.prnewswire.com Author: press release Hologic, Inc. (Hologic or the Company), a leading developer, manufacturer and supplier of premium diagnostics, medical imaging systems and surgical products dedicated to serving the healthcare needs of women, today announced that interim data from the first large-scale independent evaluation of clinical performance of Cervista® HPV HR compared to Hybrid Capture 2 (hc2), were presented at the 4th Biennial Meeting of AOGIN (Asia-Oceanic Research Organization in Genital Infection and Neoplasia) in New Delhi, India on March 26-28, 2010. Cervista HPV HR is a diagnostic test for the detection of 14 high-risk human papillomavirus (HPV) types. The study, SHENCCAST II, is a major cervical cancer screening trial including more than 10,000 women that is being conducted in China to evaluate the performance of HPV assays, among other endpoints. A preliminary analysis of data from 5,043 patients showed the Cervista HPV HR test performed as follows: Overall HPV positivity for this cohort was 12.2 percent for the Cervista HPV HR test and 14.6 percent with the hc2 test. For histologically confirmed CIN 2 or more severe lesions, the Cervista HPV HR test showed a sensitivity of 90.7 percent and a specificity of 90.2 percent. For the hc2 test, sensitivity and specificity were 94.7 percent and 87.9 percent, respectively. While the Cervista HPV HR test demonstrated improved specificity and the hc2 test yielded higher sensitivity, a statistical analysis of overall test accuracy that plots sensitivity and specificity found the two methods were clinically equivalent (area under the ROC [...]

HPV-related cancer leap to have big impact on health services

Source: www.dentistry.co.uk Author: staff The rapid rise in cases of squamous cell carcinoma related to human papillomavirus (HPV) infection has serious implications for health services around the world, warn researchers. They suggest that sexual transmission of HPV might be the reason for the rise. Head and neck cancer is the sixth most common cancer, with about 640,000 new cases each year worldwide. Despite an overall marginal decline in most head and neck cancers in recent years, the level of oropharyngeal squamous cell carcinoma (OSCC) has increased greatly, especially in the developed world. In the US, cases increased by 22% between 1999 and 2006, after showing no change between 1975 and 1999, while the UK has seen a 51% increase in oral and oropharyngeal cancer in men between 1989 and 2006. This increase seems to be accounted for by a rise in HPV-related tumours, say the authors, led by Hisham Mehanna at the Institute of Head and Neck Studies and Education, University Hospital, Coventry. A recent study showed a 70% increase in the detection of HPV in biopsies taken to diagnose oropharyngeal carcinoma in Stockholm since the 1970s. HPV-related oropharyngeal carcinoma has also been reported in 60-80% of recent biopsy samples in studies conducted in the US, compared with 40% in the previous decade. HPV-related oropharyngeal carcinoma seems to be a new and distinct disease entity, explain the authors. It has a better prognosis than non-HPV related oropharyngeal carcinoma, particularly in non-smokers, but the reason for this improved survival is not [...]

Time-released muco-adhesive patch more effective than oral rinse for xerostomia

Source: www.news-medical.net/news Author: press release A newly developed time-released muco-adhesive patch for treating oral health conditions, including the widespread condition of dry mouth (xerostomia), has been shown to be more effective than a leading oral rinse, according to a newly-published study. As increasing segments of the population consume more medications (one of the leading causes of dry mouth), the results of this study could potentially help provide relief for millions of Americans. Chronic dry mouth impacts the quality of life and for some, can be debilitating. Published in the March 2010 issue of Quintessence International, the study found that chronic dry mouth sufferers can now get a statistically significant reduction of mouth dryness from a new time-released muco-adhesive patch (OraMoist Dry Mouth Patch), compared with the leading oral rinse which has been on the market for nearly two decades. Overall, patients with xerostomia treated with the muco-adhesive patch reported a statistically significant reduction in mouth dryness sensation with elevated salivary flow rate (150%) after just 30 minutes, which was considered clinically outstanding by the study authors, since the product does not contain any cholinergic agonist, a drug often used to treat dry mouth. OraMoist, a new time-released, non-drug formula, not only outperformed the mouthwash, one of the most often used delivery formats for treating dry mouth, but unlike dry mouth sprays, rinses or gels, which need to be applied frequently – sometimes every 20 minutes – OraMoist works to increase moisture and help restore a healthy oral environment for hours [...]

Public awareness level of oral cancer in a group of dental patients

Source: J Contemp Dent Pract, January 1, 2010; 11(2): E049-56 Authors: I Peker and MT Alkurt Aim: The aim of this study was to evaluate levels of public awareness and knowledge about early signs and risk factors of oral cancer among a group of dental patients in Turkey. Methods and materials: This study included 1022 participants. Sociodemographic information of patients was obtained. A questionnaire about awareness and knowledge of oral cancer and early signs and risk factors related to the disease was completed by two examiners. Data were statistically analyzed with descriptive analyses, crosstabs and chi-square tests. Results: In total 60.7% of participants had never heard of oral cancer. While 79.2% of the participants were unaware of the early signs related to oral cancer, 29.9% of them were unaware of risk factors of the disease. There were no statistically significant differences between age, gender, and education levels for awareness of risk factors. Statistically significant differences were found between age and gender and no statistically significant difference was found between education levels for awareness of early signs. Conclusion: This study showed that public awareness and knowledge about oral cancer were insufficient in Turkey. Clinical significance: There is an important need to inform the public about oral cancer, its risk factors, and early signs of the disease. Media campaigns can be useful to raise oral cancer awareness.

Fluoroscopically guided balloon dilation for pharyngoesophageal stricture after radiation therapy in patients with head and neck cancer

Source: AJR 2010; 194:1131-1136 Authors: Hong-Tao 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 methods: 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 to radiation therapy in patients with [...]

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