The dental hygienist’s guide to pathology in patients with oral cancer

Source: www.dentistryiq.com Author: Sandra L. Benavides, RDH Dental hygienists are the unacknowledged heroes in oral health care, diligently working to protect their patients’ oral health. Besides removing plaque and polishing teeth, hygienists can identify early signs of potentially life-threatening conditions, including oral cancer. One of the most common cancers affecting humans across the globe is oral cancer, and early detection can significantly reduce morbidity.1 The key to successful treatment outcomes is early detection and intervention. The dental hygienist's keen eye, skilled hands, and understanding of oral anatomy equip them to identify oral pathology in patients with oral cancer. In 2023, according to the Oral Cancer Foundation, “Close to 54,000 Americans will be diagnosed with oral or oropharyngeal cancer this year. It will cause over 9,750 deaths, killing roughly 1 person per hour, 24 hours per day. Of those 54,000 newly diagnosed individuals, only slightly more than half will be alive in 5 years (approximately 57%). This is a number that has not significantly improved in decades.”2 Following is an overview of what to look for when examining oral cancer patients, how to differentiate typical from atypical findings, and steps to take when pathology is suspected. Understanding oral cancer There has historically been a high death rate associated with oral cancer, not because it is difficult to detect or diagnose, but because it is discovered late in its development. In its early stages, oral cancer can often go undetected by the patient as OC is frequently asymptomatic and likely to cause [...]

2023-09-22T06:39:46-07:00September, 2023|Oral Cancer News|

Oral health woes may lower head, neck cancer survival

Source: www.miragenews.com Author: University of North Carolina Health Care An international study has revealed strong associations between oral health and survival among people diagnosed with head and neck cancer. Specifically, better oral health, as evidenced by the number of natural teeth and dental visits prior to the time of diagnosis, was associated with increased survival. Importantly, those who had more frequent dental visits were more likely to have their cancer diagnosed at an earlier, and less deadly, stage of the disease than those who had few or no dental visits. The study, by researchers at UNC Lineberger Comprehensive Cancer Center and UNC Adams School of Dentistry, Chapel Hill, North Carolina, and Moffitt Cancer Center, Tampa, Florida, in partnership with the International Head and Neck Cancer Epidemiology (INHANCE) consortium, appeared Sept. 19, 2023, in the Journal of the National Cancer Institute. "The INHANCE consortium's patient data allowed us to be as thorough as possible and identify robust associations between oral health and survival," said lead author Jason Tasoulas M.D., DMD, a current Ph.D. candidate. "We assembled a diverse and experienced team to examine records of approximately 2,500 patients from eight countries to carry out our state-of-the-art statistical analyses." Head and neck cancer patients were asked to self-report aspects of their oral health and hygiene, including gum bleeding, tooth brushing frequency and mouthwash use, as well as the number of natural teeth and frequency of dental visits they had during a 10-year period prior to their cancer diagnosis. Those who had frequent [...]

2023-09-19T17:11:02-07:00September, 2023|Oral Cancer News|

Throat cancer is becoming an epidemic, and sex could be why

Source: www.sciencealert.com Author: Hisham Mehanna, Professor, Institute of Cancer and Genomic Sciences, University of Birmingham Over the past two decades, there has been a rapid increase in throat cancer in the west, to the extent that some have called it an epidemic. This has been due to a large rise in a specific type of throat cancer called oropharyngeal cancer (the area of the tonsils and back of the throat). The main cause of this cancer is the human papillomavirus (HPV), which are also the main cause of cancer of the cervix. Oropharyngeal cancer has now become more common than cervical cancer in the US and the UK. HPV is sexually transmitted. For oropharyngeal cancer, the main risk factor is the number of lifetime sexual partners, especially oral sex. Those with six or more lifetime oral-sex partners are 8.5 times more likely to develop oropharyngeal cancer than those who do not practice oral sex. Behavioral trends studies show that oral sex is very prevalent in some countries. In a study that my colleagues and I conducted in almost 1,000 people having tonsillectomy for non-cancer reasons in the UK, 80 percent of adults reported practicing oral sex at some point in their lives. Yet, mercifully, only a small number of those people develop oropharyngeal cancer. Why that is, is not clear. The prevailing theory is that most of us catch HPV infections and are able to clear them completely. However, a small number of people are not able to get rid [...]

2023-09-15T06:24:29-07:00September, 2023|Oral Cancer News|

Deep vein thrombosis as a side effect of cancer: 9 things to know  

Source: www.mdanderson.org Author: Cynthia Demarco The risk of developing blood clots is somewhat higher among cancer patients. This is due both to the inflammatory nature of the disease itself and the therapies used to treat cancer. Deep vein thrombosis (DVT) is one such type of blood clot. It forms in the veins found deep inside muscles and other tissues, and it can be fatal if left untreated. Why are cancer patients more susceptible to DVT? And, can it be prevented? We asked breast medical oncologist Ajit Bisen, M.D., for insight. Why are cancer patients at increased risk for deep vein thrombosis? Our bodies have a natural ability to balance blood clotting with blood flow. But whenever you introduce a variable into the mix, it causes an imbalance that can lead to the development of blood clots, including DVT. Cancer is considered a “hypercoagulable” condition because it’s more likely to lead to blood clots. That’s because both cancer and its treatment often create one or more of the conditions necessary for blood clot formation. Collectively, they’re known as the Virchow triad: a change in blood flow, a blood vessel injury, or a change in the composition of the blood. Cancer causes inflammation, which can make blood more likely to clot. Tumors can cause blockages and issues with blood flow. And surgeries and radiation therapy can cause injuries to tissue, sometimes even at the microscopic level. So, any or all of these could contribute to DVT. Where do cancer patients typically develop [...]

2023-09-15T06:14:35-07:00September, 2023|Oral Cancer News|

“Gates of Heaven” – the protein fueling oral cancer’s pain and progression

Source: scitechdaily.com Author: New York University Protein ORAI1 fuels oral cancers—and may provide a promising therapeutic target. An essential protein that acts as a gatekeeper for calcium entering cells promotes the growth of oral cancer and generates pain, according to a new study published on September 5 in the journal Science Signaling led by researchers at NYU College of Dentistry. Targeting this protein—the ORAI1 calcium channel—could provide a new approach to treating oral cancer, which causes persistent pain that worsens as it progresses. “Our results show that the ORAI1 channel fuels the growth of oral cancer tumors and produces an abundance of molecules that, once secreted, interact with neurons resulting in an increased sensitivity to pain,” said Ga-Yeon Son, a postdoctoral fellow in the Department of Molecular Pathobiology at NYU College of Dentistry and the study’s first author. The Keepers of the Gates of Heaven ORAI calcium channels—named after the three sisters in Greek mythology who guarded the gates of heaven at Mount Olympus—play an important role in controlling how much calcium enters cells. “These calcium channels can be a source of good or bad for cells,” said Rodrigo Lacruz, professor of molecular pathobiology at NYU College of Dentistry and the study’s senior author. “Calcium entering cells is necessary for many good things, but too much calcium for a long time has the opposite effect.” Calcium channels have been linked to various cancers, especially cancer progression, but few studies have looked at the role of ORAI1 in cancer and pain. [...]

2023-09-08T07:19:50-07:00September, 2023|Oral Cancer News|

Early findings suggest clinical and lab-based approach critical to tracking head and neck cancer recurrence

Source: medicalxpress.com Author: Anna Megdell, University of Michigan Early findings of two studies from the University of Michigan Rogel Cancer Center shed light on new ways to anticipate recurrence in HPV-positive head and neck cancer sooner. The papers, published in Cancer and Oral Oncology, offer clinical and technological perspectives on how to measure if recurrence is happening earlier than current blood tests allow, and provide a framework for a new, more sensitive blood test that could help in this monitoring. "When metastatic head and neck cancer returns, it impacts their quality of life and can be disfiguring, interfering with the ability to talk, swallow, and even breathe," said Paul Swiecicki, M.D., associate medical director for the Oncology Clinical Trials Support Unit at Rogel. "As of now, there's no test to monitor for its recurrence except watching for symptoms or potentially using a blood test which may not detect cancer until shortly before it clinically recurs." The paper in Cancer aims to identify different clinical ways that providers can more strategically track for recurrence. To do this, Swiecicki and his team needed to first understand what patient population was at the highest risk to then figure out an appropriate monitoring pattern. The team examined 450 patients with metastatic head and neck cancer, including people with HPV-positive and HPV-negative cancer. HPV-positive cancer is caused by the human papillomavirus and is increasingly more common in head and neck cancer patients. The team identified some predictors of when recurrences would happen, and to what [...]

2023-09-08T05:39:02-07:00September, 2023|Oral Cancer News|

Best practices for immunotherapy for metastatic head and neck cancer

Source: www.medpagetoday.com Author: Mark L. Fuerst , Contributing Writer, MedPage Today This Reading Room is a collaboration between MedPage Today® and: Medpage Today Immunotherapy with anti–programmed cell death protein 1 (PD-1) immune checkpoint inhibitors (ICIs) is now an essential treatment for patients with recurrent and metastatic head and neck squamous cell carcinoma (HNSCC), and ICIs also show promise for patients with nasopharyngeal carcinoma and other rare head and neck cancer types. A recently released ASCO Guideline on immunotherapy and biomarker testing in recurrent and metastatic HNSCCs provided evidence-based recommendations. A new related document by expert panel co-chairs Emrullah Yilmaz, MD, PhD, of the Cleveland Clinic, and Loren K. Mell, MD, of the University of San Diego, and colleagues poses questions and answers about the guideline. The following is a summary: For patients with recurrent and metastatic head and neck cancer, which biomarkers should be used in the selection of anti–PD-1 immune checkpoint inhibitor therapy? We recommend programmed death ligand 1 (PD-L1) combined positive score (CPS) testing for recurrent and metastatic HNSCC. PD-L1 reports come via immunohistochemistry using CPS or tumor proportion score. CPS has emerged as a preferred biomarker in HNSCC and has been used in landmark head and neck clinical trials such as KEYNOTE-048. Tumor mutational burden (TMB), another emerging biomarker for predicting response to anti–PD-1 ICIs, was studied in KEYNOTE-158. TMB is not used routinely in HNSCC, but may help in cases where PD-L1 CPS is unavailable or for rare head and neck cancers. In first-line treatment of [...]

2023-09-04T08:50:20-07:00September, 2023|Oral Cancer News|

Antibiotic prescriptions linked to significant delays in head and neck cancer diagnosis

Source: www.healio.com Author: Drew Amorosi Key takeaways: Researchers reported increased rates of antibiotic prescriptions in the 3 months prior to head/neck cancer diagnosis. Antibiotic prescriptions appeared linked to longer time between symptom onset and diagnosis. Approximately 15% of individuals with head and neck cancer received an antibiotic prescription within 3 months of diagnosis, study results showed. Those who received antibiotic prescriptions had significantly longer time to head and neck cancer diagnosis than those who did not receive antibiotics, findings published in JAMA Otolaryngology–Head & Neck Surgery showed. “These patients have been through the health care system for many months without an accurate diagnosis,” Sean T. Massa, MD, assistant professor in the department of otolaryngology — head and neck surgery at Saint Louis University School of Medicine, told Healio. “Prescribing antibiotics is a common practice and was associated with a delay in diagnosis,” he added. “For adults with a neck mass or swelling lasting more than 2 weeks, the most likely cause is a tumor, so patients should be evaluated through further testing and referral to a specialist.” Background Head and neck specialists have observed a steady stream of patients with neck masses mistakenly prescribed antibiotics because symptoms mirror that of infection, Massa said. This occurs despite 2017 guidelines from American Academy of Otolaryngology — Head and Neck Surgery (AAO-HNS) for evaluation of neck mass among adults. The guidelines recommend against prescribing antibiotics without other infectious symptoms. “We wanted to see if patients who received antibiotics took longer to get from [...]

2023-09-02T07:50:29-07:00September, 2023|Oral Cancer News|

Dr Jennifer Choe discusses head and neck dancer relapse, new treatment trials, promising responses

Source: www.ajmc.com Author: Brooke McCormick Jennifer Choe, MD, PhD, shared her thoughts on why head and neck cancer patients relapse after radiation therapy, new head and neck cancer treatment trials, and promising responses from these trials. Choe is a head and neck oncologist at Vanderbilt University Medical Center and was a presenter at The American Journal of Managed Care®’s Institute for Value-Based Medicine® held in Nashville, Tennessee on August 17, 2023. Transcript Can you explain some of the thought behind why there is disease relapse in head and neck cancers after radiation treatment? There's a lot of theoretical basis as to why we think this is the case. A lot is driven by just aggressive biology; it's really not known. Head and neck cancers are considered immune responsive, technically speaking, but the response rates still are pretty low, in general, and whether or not the immune system and head and neck cancer patients are depressed compared to other cancers. I, in theory, think that a part of it is actually the radiation creating an environment where there could be a reduction in the body's ability to regulate the immune system. There's an immune suppressed state for these patients that could be due to radiation of the lymph nodes that's decreasing the ability for the immune system to respond, but also the local radiation induced immune suppression effects that may be producing a more conducive environment for the cancer to return. What are some of the trials evaluating new treatment regimens [...]

2023-09-02T07:41:01-07:00September, 2023|Oral Cancer News|

Doctors couldn’t operate on my tumour, but this robot did — and it may have saved my life

Source: www.cbc.ca Author: Glenn Deir This is a First Person column by author Glenn Deir, who lives in St. John's, Newfoundland. Glenn Deir has special thanks for the robot who operated on his tonsil cancer. Long before I had cancer, and long before I lived in Japan, the rock band Styx released a synthesizer-drenched song with the hook "Domo arigato, Mr. Roboto." Forty years later I, too, found myself thanking a robot. Its name is da Vinci. Da Vinci resembles a giant spider with four arms, and my journey to lying beneath those arms began with a niggling problem: I was having discomfort swallowing. Even sipping water sometimes stung. A flexible scope up my nose and down my throat revealed an apparent ulcer on my tonsil, the right tonsil, my one remaining tonsil. But given my history, my doctor couldn't ignore it. Ah, my history. Sixteen years ago, I contracted cancer in the left tonsil thanks to the human papillomavirus. That's the same virus that causes cervical cancer. Most folks shed the HPV virus with no harm done, but I had crappy luck. The subsequent radiation had me retching into a toilet for weeks. I turned into an advocate for the HPV vaccine. The da Vinci robot operates on Glenn Deir. (Glenn Deir) "Sex gave me cancer," I used to say. "You don't want your little boy to grow up and go through what I went through." What I wanted to ask Dr. Boyd Lee was, "So, what's [...]

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