Oral Cancer News

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 [...]

Oral Cancer Foundation News Team - A2010-04-04T08:58:07-07:00April, 2010|Oral Cancer News|

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 [...]

Oral Cancer Foundation News Team - A2010-04-04T08:52:04-07:00April, 2010|Oral Cancer News|

Learn the risk factors of oral cancer

Source: King5TV Author: Elizabeth Berman Tens of thousands of people will be diagnosed with oral cancer this year. Only half will survive five years. 75% of dentists do not screen for oral cancer which is why it goes undetected and spreads throughout the body before it’s too late. There is now a link between oral cancer being transmitted by oral sex even. Local dentist (of Woodinville, WA), Dr. Michael Koczarski offers life saving screening known as VELscope which uses a bright blue light to illuminate the mouth. The screening can reveal tiny lesions that could be signs of oral cancer. It’s a quick, painless and non-invasive test that can illuminate abnormalities in the mouth before they are visible to the naked eye. • Oral cancer is a disfiguring and life-threatening cancer that affects 34,000 Americans each year and kills roughly one person every hour. • The death rate percentage for those with oral cancer is greater than that of breast cancer. • A disturbing new find is that it’s not all due to tobacco or alcohol use. It has been reported that the increase in oral cancer among younger people is due to a link between oral sex and HPV – the same virus linked to cervical cancer. • Dr. Michael Koczarski is one of the first dentists to adopt VELscope early detection technology for oral cancer screening. In honor of Oral Cancer Awareness Month in April, Dr. Koczarski is offering a free VELscope screening with every exam performed in April. Patients can schedule their [...]

Charlotte Parker2010-04-04T08:41:51-07:00April, 2010|Oral Cancer News|

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 [...]

Oral Cancer Foundation News Team - A2010-04-01T19:59:52-07:00April, 2010|Oral Cancer News|

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 [...]

Oral Cancer Foundation News Team - A2010-04-19T22:26:55-07:00April, 2010|Oral Cancer News|

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 [...]

Oral Cancer Foundation News Team - A2010-04-01T19:51:55-07:00April, 2010|Oral Cancer News|

Research argues HPV vaccine should extend to boys

Source: RadioAustralia.net Author: Staff It is already available free to young girls in countries like Nauru, Vanuatu, Tuvalu and Cook Islands, but researchers are now saying the human papilloma virus, or HPV, vaccine Gardasil should also be offered to males. It follows new Australian research showing that the virus which causes cervical cancer in women is now a leading cause of oral cancer in men. It says 60 per cent of throat and tonsil cancers are caused by the virus. Presenter: Lindy Kerin Speaker: Barbara Rowe, associate professor in research with University of Sydney; Luke Connolly, director of Australian Centre for Economic Research; Dr Jonathan Clark, head and neck surgeon with Royal Prince Alfred and Liverpool Hospitals, New South Wales LINDY KERIN: For the past two years Australia has been rolling out the cervical cancer vaccine Gardasil to young women. It immunises them against the human papilloma virus, or HPV as it's known. Now there's growing evidence that the same virus is responsible for an increasing number of mouth and throat cancers in men. Barbara Rowe is an associate professor in research at the University of Sydney. BARBARA ROWE: 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. And we've tested those for the human papilloma virus type-16 and type-18, which the major cause of cervical cancer in women. And we found a sizeable proportion are associated with those types. In fact probably [...]

Charlotte Parker2010-04-01T17:14:59-07:00April, 2010|Oral Cancer News|

Oral sex and HPV related cancers – a threat for both sexes

Source: Examiner.com Author: Charles Simmins An editorial in the British Medical Journal on March 25 links the increasing incidence of oropharyngeal squamous cell carcinoma to infections by human papillomavirus (HPV) that patients caught through oral sex. HPV infection is known to be related to cancers of the cervix, as well as vulvar, vaginal, and male anal cancers. The United States has seen a 22% increase in this oral cancer from 1999 to 2006 and the United Kingdom a 51% increase from 1989 to 2006. The editorial reports that biopsies of these cancers in the United States are showing a 50% to 100% increase in HPV findings over a decade. The authors point to recent studies that show the risks of developing oropharyngeal carcinoma are increased in those patients with six or more lifetime sexual partners, four or more lifetime oral sex partners and, for men, an earlier age at first sexual intercourse. The implications of these findings suggest reconsideration of some basic healthcare issues. In an e-mail exchange with William Bonnez, M.D., Associate Professor of Medicine at the University of Rochester, he pointed out that no screening tools exist for HPV related cancers other than the Pap smear for cervical cancer. The authors of the editorial report that HPV oropharyngeal squamous cell carcinoma appears to have a more favorable prognosis than the non-HPV variety, and that those affected are usually younger. They point out that this means the patients will be dealing with the illness and its effects for a longer period [...]

Charlotte Parker2010-04-01T19:39:12-07:00April, 2010|Oral Cancer News|

Sharp rise in HPV-related oropharyngeal carcinoma — a legacy of the “sexual revolution”?

Source: MedScape Today Author: Zosia Chustecka March 30, 2010 — The incidence of oropharyngeal carcinoma related to human papillomavirus (HPV) has been increasing in recent years, and there is speculation that this is the result of the "sexual revolution" of the 1960s. This increase in the incidence of HPV-related oropharyngeal cancer has important public health implications, British experts warn in an editorial published online March 25 in the British Medical Journal. HPV-related oropharyngeal carcinoma appears to be a new and distinct disease entity, with better survival than the classic non-HPV-related disease, they point out. "These patients are typically younger and employed, and — because outcomes seem to be more favorable than for patients with non-HPV-related carcinoma — they will live longer with the functional and psychological sequelae of their treatment. Consequently, they need prolonged support from health, social, and other services, and may require help returning to work," write the authors, headed by Hisham Mehanna, BMedSc, MB ChB, FRCS, director of the Institute of Head and Neck Studies and Education at University Hospital in Coventry, United Kingdom. However, currently, there is no good evidence to support managing patients with HPV-related head and neck cancer differently from those whose tumors are not HPV-related, the researchers write. Several studies are being planned to evaluate different treatment options, and Dr. Mehanna and colleagues urge clinicians to offer all patients with oropharyngeal cancer the opportunity to enroll in a clinical trial. However, until data from those trials are available, "we suggest that clinicians should not change their [...]

Charlotte Parker2010-04-01T19:38:46-07:00April, 2010|Oral Cancer News|

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 [...]

Oral Cancer Foundation News Team - A2010-03-29T20:32:34-07:00March, 2010|Oral Cancer News|