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Disparities in Oral Cancer: The need for early detection and treatment in the black community

Source: www.everydayhealth.com Author: Oladimeji Ewumi, Medically Reviewed by Walter Tsang, MD of American College of Lifestyle Medicine Oral cancer, also called mouth cancer, is a collective term for cancers that affect the mouth or oral cavity. This form of cancer can develop anywhere in the lips, gums, tongue, salivary glands, inner lining of the cheeks, roof of the mouth, or floor of the mouth. It also affects your oropharynx, which is the back part of your tongue, the roof of your mouth, tonsils, and the back of your throat. According to the American Cancer Society, there are about 54,540 new oral cavity and oropharyngeal cancer cases each year, which translates to 3 percent of all cancer diagnoses in the United States, per the National Institute of Dental and Craniofacial Research (NIDCR). Of these, Black Americans are more likely to receive a late diagnosis at an advanced stage of the disease, are less likely to get adequate treatment, and have worse overall survival rates than other racial-ethnic groups, according to a study published in Anticancer Research. The NIDCR reported that the five-year survival rate for oral cancer for Black people is 52 percent, compared with a 70-percent survival rate for white patients — even though there is a higher incidence of oral cancer in white Americans. These reflect a low awareness of oral cancer among Black Americans and hidden biases in the healthcare system. Reasons for Delayed Diagnosis in the Black Community A study published in OTO Open found that Black [...]

Meet the ‘Young Tongues’— including suburban mom, 48, part of shocking tongue cancer diagnosis boom

Source: www.survivornet.com Author: Danielle Cinone Understanding Head & Neck Cancers Tongue cancer is on the rise among young people in the United States, according to a recent Surveillance, Epidemiology, and End Results (SEER) Program analysis, and among those a diagnosed were a 48-year-old mom from Connecticut and a 22-year-old from England, both who are part of the “Young Tongues” group. Dr. Diana Kirke, an otolaryngologist at Mount Sinai Hospital who recently presented an analysis on “geographic trends in oral tongue squamous cell carcinoma among young individuals,” told TODAY.com, “since 2010, there seems to be a national shift to younger patients developing oral tongue squamous cell carcinoma. There is a very clear rise in patients that are non-smokers and non-drinkers.” Tongue cancer can be caused by a sexually-transmitted virus called HPV, and top experts suggest getting young adults vaccinated. “If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told SurvivorNet in an earlier interview, “because finding a doctor who is up to the latest of information is important.” A recent Surveillance, Epidemiology, and End Results (SEER) Program analysis has revealed an oral tongue cancer boom is underway in the United States. Included in this increased incidence is Susan Smith, a 48-year-old mom from Fairfield, Connecticut, who is part of the “Young Tongues” group. Smith didn’t receive her tongue cancer diagnosis until she saw a fourth doctor who [...]

Focus on: Oral Pathology

Source: www.dentistrytoday.com Author: Ashley Clark, DDS Ashley Clark, DDS, discusses the specialized field of oral pathology—from what an oral pathologist does, to how to become one, and when to refer your patients to one. Q: First, what is an oral pathologist? A: An oral pathologist is a job description that is difficult to define, but we all have one thing in common: We are trained in microscopy to diagnose oral, skin, and jaw lesions. That is the most essential part of the profession that binds us all. We are also trained in clinical oral pathology—how to identify and manage oral diseases. Usually, oral pathologists work in academic institutions. This means we must do a combination of teaching, service, and research. After a decade in academia, I have chosen a transition to private practice, which is a bit rare for our profession. I spend my mornings driving around the city picking up biopsy specimens, then sign-in for cases that I receive from across the country. I also serve on a tumor board with my colleagues specializing in otolaryngology, radiology, speech therapy, prosthodontics, etc. Finally, I will provide about 70 continuing education courses/lectures this year (ranging from one to 16 hours long), which is more than normal. However, teaching is my favorite thing to do, so I tend to keep my schedule packed. Q: When should someone refer to an oral pathologist? A: If you are lucky enough to have an oral pathologist (or an oral medicine specialist) in your area, the [...]

HPV-related head and neck cancer may have two distinct subtypes

Source: www.curetoday.com Author: Brielle Benyon There may be two “intrinsically different subtypes” of HPV-positive head and neck cancer — one of which may be more likely to respond to radiation treatment, according to recent research published in the journal Proceedings of the National Academy of Sciences. “We're the first ones to describe these two subtypes,” study author, Dr. Wendell Yarbrough, Thomas J. Dark, distinguished professor of Otolaryngology/Head and Neck Surgery at the University of North Carolina Lineberger Cancer Center, said in a press release. “Using this research, we can firmly identify two groups of patients and are able to associate their tumor subtype with treatment outcomes.” The researchers discovered a difference in outcomes between patients with high and low NF-kB activity. Of note, NF-kB is a biomarker that activates the expression of pro-inflammatory genes and plays a role in inflammasome (response to infection- or stress-related stimuli) regulation, according to the National Institutes of Health. “Tumors with high NF-kB activity were more responsive to radiation therapy potentially contributing to improved patient survival,” Yarbrough said. “We know that there's something about activating the NF-kB pathway that makes the tumors more sensitive to radiation therapy, which could explain how and why those patients are surviving better.” These findings, according to the researchers, may help determine which patients should undergo these aggressive treatments, and which patients might fare better with a different approach. HPV-positive head and neck squamous cell carcinoma is typically treated with a combination of high-dose radiation and chemotherapy, though this regimen [...]

Sheffield team to develop patch that treats oral lichen planus

Source: www.theengineer.co.uk Author: Jason Ford A condition for which there is no cure could be treated more effectively following EPSRC-funded research being carried in the Department of Materials Science and Engineering at Sheffield University. With £471,789 in funding, the three-year project will develop a patch that can stay in the mouth to treat oral lichen planus (OLP), a chronic inflammatory mucocutaneous disease that presents itself as white, red and/or ulcerative lesions of the oral mucosa, which is the moist tissue that lines parts the body including the mouth. Drugs including steroids are available to treat OLP, but there is currently no effective way to administer them. Steroids also come with side effects and the relatively high doses needed to treat OLP can exacerbate them. Now, Professor Ipsita Roy and Dr David Alexander Gregory will develop a solution that delivers the drug locally and in a spatially selective manner. Professor Roy explained that this would facilitate a much lower dosage of therapeutic. A significant challenge, however, is to develop an adhesive that works in the wet environment of the mouth where tissue is highly mobile. To this end, the Sheffield team has obtained proof of concept data for a new highly adhesive polymer system (polyhydroxyalkanoates (PHAs)) that is produced by bacteria and is environmentally sustainable. This has been coupled with the polydopamine chemistry, used by mussels to attach to wet surfaces, to further enhance adhesiveness and be developed into an OLP patch. Work at Sheffield has shown that PHA is approximately [...]

Health effects of using snuffs that should not be ignored

Source: ng.opera.news Author: LoudestSilence86 In recent years, there has been a surge in the use of snuffs as an alternative to smoking cigarettes and chewing tobacco. Snuff is a powdered form of tobacco that is either inhaled through the nose or placed in the mouth. While some people believe that snuffs are a safer alternative to smoking or chewing tobacco, it is crucial to acknowledge that there are significant health effects associated with their use. According to webmd, This article aims to shed light on the health consequences of using snuffs that should not be ignored. Respiratory Health Risks One of the most concerning health effects of using snuffs is the impact on respiratory health. Snuffs are typically inhaled through the nose, causing numerous respiratory issues. The intimate contact of the tobacco powder with the nasal tissues can lead to chronic inflammation and irritation. Over time, this can cause nasal congestion, frequent nosebleeds, a decreased sense of smell, and even sinus infections. Furthermore, snuff contains high levels of nicotine, which is a highly addictive substance. Regular use of snuff can lead to the dependence on nicotine, making it difficult for users to quit. Oral Health Complications Snuffs that are placed in the mouth can have severe consequences on oral health. The tobacco powder in snuffs contains numerous harmful chemicals that can lead to dental problems. Continuous exposure to snuff can cause gum irritation, inflammation, and increased plaque buildup. These factors contribute to an increased risk of gum disease, tooth loss, [...]

Researchers develop noninvasive test to detect oral cancer

Source: www.dentalnewspk.com Author: DN Monitoring Desk Researchers at the University of Surrey have achieved a significant medical breakthrough by creating a non-invasive diagnostic test for oral cancer. Known as PANDORA, this pioneering test has shown exceptional accuracy in identifying patients with oral squamous cell carcinoma (OSCC) and pre-cancerous oral epithelial dysplasia (OED). As per the groundbreaking study detailing the development of PANDORA, published in the esteemed Journal of Oral Pathology and Medicine, with an impressive accuracy rate of over 92 percent, the proof-of-concept test has the potential to revolutionise oral cancer diagnosis. It says PANDORA also exhibits an outstanding accuracy rate of more than 80pc in detecting patients with OED, offering an opportunity for early intervention and preventive measures. The research team conducted their study by collecting cell samples from 40 individuals with OSCC and OED, as well as 79 individuals without cancer, including those with benign lesions. Using the state-of-the-art DEPtech 3DEP analyzer with a unique setup protocol, the researchers meticulously measured and analyzed the cells from the patients. Importantly, these samples can be easily collected at a dentist's office and sent for analysis, making PANDORA a convenient and accessible diagnostic tool for primary care settings. Oral squamous cell carcinoma is a prevalent form of cancer that affects the cells lining the mouth and throat, often associated with lifestyle factors such as smoking, poor oral hygiene, and alcohol use. Symptoms may include persistent mouth sores, difficulty swallowing, and changes in speech. Early detection of OSCC significantly improves treatment outcomes, [...]

Dysphagia-optimized IMRT for head and neck cancer beneficial to swallowing function

Source: www.oncologynurseadvisor.com Author: Vicki Moore, PhD Treatment with dysphagia-optimized (DO) intensity-modulated radiotherapy (IMRT) improved patient-reported swallowing function in patients with pharyngeal cancer compared with standard IMRT. These results of a phase 3 study were published in the journal Lancet Oncology. Dysphagia-optimized IMRT was found to reduce radiation dose to the throat structures, thereby improving dysphagia and aspiration function compared with standard IMRT. Source: Getty Image “Our findings suggest that reducing dose to the pharyngeal constrictor muscle translates into patient benefit through improved swallowing function,” the study investigators wrote in their report. The phase 3 DARS study (ISRCTN Registry Identifier: ISRCTN25458988) was conducted across radiotherapy centers in the UK and Ireland. Enrolled patients had biopsy-confirmed squamous cell carcinoma of the oropharynx or hypopharynx in addition to meeting certain eligibility criteria. Patients were randomly assigned 1:1 to receive either DO-IMRT or standard IMRT over 6 weeks. The radiotherapy target dose was 65 Gy to the primary and nodal tumor, while the remaining tumor subsite and nodal regions considered at risk of occult microscopic disease had a target dose of 54 Gy. With DO-IMRT, there was a 50-Gy mean dose constraint for the superior and middle pharyngeal constrictor muscle or inferior pharyngeal constrictor muscle residing beyond the high-dose target volume. The primary endpoint of the study was the MD Anderson Dysphagia Inventory (MDADI) composite score at 12 months following treatment in the modified intention-to-treat population, which included patients completing this assessment. In this study, 112 patients were assigned to treatment, with [...]

High-risk sexual behavior alone may not increase risk for oropharyngeal cancer

Source: www.healio.com Author: Matthew Shinkle High-risk sexual behavior may not be the primary contributor to the development of oropharyngeal squamous cell carcinoma, according to data published in Cancers. Although patients with oropharyngeal squamous cell carcinoma appear more likely to self-report having their first sexual intercourse before age 18 years, study findings did not show an association between high-risk sexual behavior and the disease, researchers wrote. “The consistent absence of high-risk sexual behavior in the overwhelming majority of HPV-driven oropharyngeal squamous cell carcinomas stands against the argument of a lowered frequency of HPV-driven oropharyngeal squamous cell carcinoma in our cohort ... that would have lowered the chance to detect an impact on high-risk sexual behavior on the development of HPV-driven oropharyngeal squamous cell carcinoma,” Gunnar Wichmann, PhD, head of the ENT ResearchLab at University of Leipzig Medical Center, and colleagues wrote. Background and methodology Certain studies have provided evidence to establish a potential link between high-risk sexual behavior, the persistence of HPV DNA in saliva and the presence of oncogenic high-risk HPV subtypes in oropharyngeal squamous cell carcinoma. Researchers conducted a case-control study of patients with oropharyngeal squamous cell carcinoma and propensity score-matched unaffected controls from a large population-based German cohort study. The investigators interviewed patients and provided them with questionnaires on main risk factors — including age, sex, tobacco smoking and alcohol consumption — as well as logging information regarding sexual behavior categories. The study included 329 patients with head and neck squamous cell carcinoma, of whom 317 patients answered [...]

Introduction to teledentistry and its benefits

Source: dentistry.co.uk Author: Khad Shah The COVID-19 pandemic led to numerous lockdowns across the globe. Countless industries left offices redundant but many workforces still intact working from home, and some even over performing. Healthcare, particularly dentistry, came to a standstill due to the majority of our clinical jobs requiring dental surgery equipment and face to face contact with patients. During the pandemic there was a rise in demand for telemedicine with virtual dental appointments made necessary due to lockdown measures. England and Scotland have continued with remote and hybrid working patterns according to data from the Opinions and Lifestyle Survey (OPN). When asked in February 2022 the survey found that more than eight in 10 workers who had worked from home during the pandemic planned to continue with hybrid working. Alongside this shift in some of our patients’ working patterns, how will dentistry respond? This article aims to explore the benefits and scope of remote working with virtual appointments in dentistry. Advantages Time efficiency Offering virtual appointments in dentistry can offer significant advantages in accessibility and convenience for patients. This shift in our industry can offer patients residing in remote areas or with limited mobility the chance to receive high quality and specialised dental care, without needing to travel. Furthermore, this change can improve time and cost savings for both patients and dental professionals alike. This valuable time patients would have otherwise been spent commuting and waiting in the clinic can be utilised more efficiently. With improved efficiency dental professionals [...]

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