5 major risk factors for head and neck cancers are within your control

Source: news.llu.edu Author: Lisa Aubry, Loma Linda University Health While head and neck cancers represent a broad category for numerous cancers, a set of five controllable risk factors contribute to most head and neck cancers, says Jared Inman, MD, a head and neck surgical oncologist at Loma Linda University Health. For April’s Head and Neck Cancer Awareness Month, Inman outlines how reducing these five risks in your life can help prevent head and neck cancers. Head and neck cancers, those cancers occurring above the shoulder bones not including brain cancers, occur in the voice box, throat, tongue, mouth, sinus, nose, ear, eyes, as well as other places. Squamous cell cancers are by far the most common types of head and neck cancers, says Inman, and can happen in any location of the head and neck. Therefore, the risk factors and Inman's prevention tips pertain especially to squamous cell cancers. TOBACCO AND ALCOHOL Tobacco, which includes secondhand smoke and smokeless tobacco, is the number one stand-alone risk factor for head and neck cancers, Inman says, with alcohol consumption a close runner-up. Additionally, he says combined tobacco and alcohol use places people at a greater risk of developing these cancers than those who use tobacco or alcohol alone. Most head and neck squamous cell carcinomas of the mouth and voice box are caused by tobacco and alcohol use, according to the National Cancer Institute. “Head and neck cancers are almost always tied to smoking and drinking alcohol,” says Inman. Quitting smoking and [...]

I blamed my ulcers on college stress — until my tongue was removed

Source: nypost.com Author: Brooke Steinberg A college student with ulcers blamed it on stress from exams — but ended up needing to have the majority of her tongue removed and then reconstructed when it turned out to be cancer. Rachel Morton from Edinburgh, Scotland, started noticing ulcers on her tongue in 2019, and initially thought they were a result of stress. “When I’m a bit tired, run down or stressed with exams I seem to be a bit prone to ulcers anyway, so I kind of just put it down to that and starting university,” Morton explained. “I went to the doctor and I’d been given some pain relief tablets, Bonjela and stuff like that.” But after a year, her condition worsened. “I still had them a year later but I wasn’t too worried about it. I had so much other stuff going on in my life and it wasn’t really at the forefront of my mind,” she told Kennedy News and Media. “At the start it was a couple of ulcers, but over the course of a year they got bigger and spread, and covered the whole side of my tongue. They were really red, raw and painful.” Rachel Morton ended up needing to have her tongue removed and reconstructed when her ulcers turned out to be cancer. Kennedy News and Media Morton, now 21, was also experiencing strange symptoms such as extreme tiredness; dry, red and swollen lips; tonsil aches; and abnormal feeling in the left [...]

FDA grants fast track designation to RRx-001 for severe oral mucositis in head and neck cancer

Source: www.onclive.com Author: Chris Ryan The FDA has granted a fast track designation to RRx-001 for the prevention and attenuation of severe oral mucositis associated with chemotherapy and radiation in patients with head and neck cancer, according to a news release from EpicentRx.1 RRx-001, a direct NLRP3 inhibitor and Nrf2 upregulator with anti-inflammatory and antioxidant properties, is also under investigation for the treatment of small cell lung cancer. “The fast track designation is great news for EpicentRx, and it puts us one step closer to a potential treatment for this critical unmet need of oral mucositis with RRx-001,” Tony Reid, MD, PhD, chief executive officer of EpicentRx, stated in a news release. Investigators previously evaluated RRx-001 in the phase 2a PREVLAR trial (NCT03515538). The study evaluated the agent’s efficacy and feasibility in mitigating severe oral mucositis in patients with head and neck cancers who were receiving chemoradiation.2 Findings showed that in patients who experienced severe oral mucositis in the 3 RRx-001 treatment arm, the median duration of severe oral mucositis was 8.5 days, 17 days, and 10 days, in arms 1, 2, and 3 respectively, compared with 24 days in the control arm. When accounting for patients who did not experience severe oral mucositis, the median duration of severe oral mucositis was 5 days for patients in arm 1, 13.5 days for arm 2, 8 days in arm 3, and 18 days in the control arm. The trial enrolled patients at least 18 years of age with pathologically diagnosed stage [...]

HPV testing, p16 IHC may be needed for oropharyngeal cancer trials

Source: www.cancernetwork.com Author: Russ Conroy Human papillomavirus and p16 discordance may correlate with a worse prognosis for oropharyngeal cancer, according to data from an individual patient data analysis. Patients with discordant p16-negative, human papillomavirus (HPV)–positive or p16-positive, HPV-negative oropharyngeal cancer had a significantly worse prognosis compared with patients who had p16-positive and HPV-positive disease and a better prognosis compared with those who have p16-negative and HPV-negative disease. The data suggest the need for routine p16 immunohistochemistry and mandated HPV testing in clinical trials for oropharyngeal cancer, according to findings from the HNCIG-EPIC-OPC individual patient data analysis. The 5-year overall survival (OS) rate was 81.1% (95% CI, 79.5%-82.7%) for patients with p16-positive, HPV-positive disease; 40.4% (95% CI, 38.6%-42.4%) for those with p16-negative, HPV-negative disease; 53.2% (95% CI, 46.6%-60.8%) for those with p16-negative, HPV-positive disease; and 54.7% (95% CI, 49.2%-60.9%) for those with p16-positive, HPV-negative disease. Additionally, 5-year disease-free survival (DFS) was 84.3% (95% CI, 82.9%-85.7%), 60.8% (95% CI, 58.8%-62.9%), 71.1% (95% CI, 64.7%-78.2%), and 67.9% (95% CI, 62.5%-73.7%) for each respective patient group. Investigators of this multi-center, international individual patient data analysis included retrospective and prospective cohorts with a minimum size of at least 100 patients with primary squamous cell carcinoma of the oropharynx. Patients underwent cross-sectional imaging; histological confirmation by biopsy; and treatment with surgery, radiotherapy, chemotherapy, or combination therapy for oropharyngeal cancer. The primary end points of the analysis included OS, DFS, and the proportion of patients in the overall cohort who showed different p16 and HPV result combinations. [...]

New immunotherapy strategies in targeting complexity in the tumor microenvironment

Source: medicalxpress.com Author: International Association for Dental Research A symposium aiming to provide a better understanding of the tumor microenvironment, immune tolerogenic niches at cancer initiation, and novel immunotherapeutic strategies in head and neck cancer patients was featured at the 52nd Annual Meeting & Exhibition of the AADOCR, held in conjunction with the 47th Annual Meeting of the CADR. The AADOCR/CADR Annual Meeting & Exhibition took place at the Oregon Convention Center in Portland on March 15-18, 2023. Cancer immunotherapy has arisen as a promising new treatment modality for head and neck cancer (HNC), built on an increased understanding of tumor immunology over the last two decades. However, it has become clear that not all tumors are created equal when it comes to their immune profiles, and many are resistant to immunotherapy. Thus, there is a need to better understand the complex tumor microenvironment to more accurately determine prognosis and design therapeutic strategies capable of rendering tumors susceptible to immunotherapy and the immunologic effects of conventional therapies. Organized by Simon Young of the University of Texas Health Science Center at Houston, this symposium provided a high-level overview of exciting developments in understanding the tumor microenvironment, both in terms of the complex immunosuppressive mechanics of the extracellular matrix, the creation of an immune tolerogenic niche at cancer initiation, and how novel immunotherapeutic strategies can target the adverse the tumor immune microenvironment in head and neck cancer. A broad spectrum of expertise was represented by featured clinician-scientist speakers: topics included current challenges [...]

Can lymph nodes boost the success of cancer immunotherapy?

Source: medicalxpress.com Author: from University of California, San Francisco Cancer treatment routinely involves taking out lymph nodes near the tumor in case they contain metastatic cancer cells. But new findings from a clinical trial by researchers at UC San Francisco and Gladstone Institutes shows that immunotherapy can activate tumor-fighting T cells in nearby lymph nodes. The study, published in Cell, suggests that leaving lymph nodes intact until after immunotherapy could boost efficacy against solid tumors, only a small fraction of which currently respond to these newer types of treatments. Most immunotherapies are aimed only at reinvigorating T cells in the tumor, where they often become exhausted battling the tumor's cancer cells. But the new research shows that allowing the treatment to activate the immune response of the lymph nodes as well can play an important role in driving positive response to immunotherapy. "This work really changes our thinking about the importance of keeping lymph nodes in the body during treatment," said Matt Spitzer, Ph.D., an investigator for the Parker Institute for Cancer Immunotherapy and Gladstone-UCSF Institute of Genomic Immunology and senior author of the study. Lymph nodes are often removed because they are typically the first place metastatic cancer cells appear, and without surgery, it can be difficult to determine whether the nodes contain metastases. "Immunotherapy is designed to jump start the immune response, but when we take out nearby lymph nodes before treatment, we're essentially removing the key locations where T cells live and can be activated," Spitzer said, [...]

Novel PET radiotracer successfully detects multiple cancers, offers potential for new targeted radionuclide therapy

Source: www.eurekalert.org Author: news release, Society of Nuclear Medicine and Molecular Imaging A new radiotracer, 68Ga-FAP-2286, has been found to be more effective than the most commonly used nuclear medicine cancer imaging radiotracer, 18F-FDG. In a study published in the March issue of The Journal of Nuclear Medicine, 68Ga-FAP-2286 detected 100 percent of primary tumors across multiple cancer types as compared to 18F-FDG, which identified only 80 percent. 68Ga-FAP-2286 was also more effective in detecting lymph node metastases and distant metastases. Currently, 18F-FDG, which measures glucose metabolism, is used extensively in nuclear medicine cancer imaging. Recent advances have shown that fibroblast activation protein (FAP), which is overexpressed in cancer cells, may be a better target for the imaging of solid tumors. “In this study we aimed to investigate the diagnostic accuracy of 68Ga-FAP-2286—a radionuclide developed to target FAP—for detecting the primary and metastatic lesions in patients with various types of cancer,” said Haojun Chen, MD, PhD, nuclear medicine physician at the First Affiliated Hospital of Xiamen University in Xiamen, China. Sixty-four patients with 14 types of cancer were included in the study. Sixty-three of the patients underwent paired 68Ga-FAP-2286 and 18F-FDG PET/CT, and 19 patients underwent paired 68Ga-FAP-2286 and 68Ga-FAP-46 (another 68Ga-radiolabeled variant). Results were evaluated and compared. 68Ga-FAP-2286 PET yielded a higher radiotracer uptake, tumor-to-background ratio and tumor detectability than 18F-FDG. In addition, 68Ga-FAP-2286 and 68Ga-FAPI-46 yielded comparable clinical results. “The novel radionuclide 68Ga-FAP-2286 is shown to be a promising FAP-inhibitor derivative for safe cancer diagnosis, staging and restaging,” [...]

Saliva: The next frontier in cancer detection

Source: knowablemagazine.org Author: Matías A. Loewy In the late 1950s, dentist and US Navy Capt. Kirk C. Hoerman, then a young man in his 30s, attempted to answer a bold question: Might the saliva of prostate cancer patients have different characteristics from that of healthy people? Could it contain traces of a disease that’s so far away from the mouth? Without wasting more of their own saliva on elaborate discussion, Hoerman and his colleagues from the department of dental research at the Naval Training Center in Great Lakes, Illinois, got down to work. They analyzed samples from more than 200 patients and healthy controls, and found that the saliva of patients with untreated prostate cancer showed a significant increase in the levels of enzymes called acid phosphatases. Writing in 1959 in the journal Cancer, the researchers then made a prescient reflection: that it may be valuable to observe discrete biochemical changes in tissues distant from the site of tumor origin. More than 60 years later, the idea that saliva analysis can be used to detect different types of cancer is gaining traction in the scientific community. In the specialized literature, papers containing the keywords “diagnosis,” “cancer” and “saliva” grew more than tenfold over the past two decades, from 26 in 2001 to 117 in 2011, 183 in 2016 and 319 in 2021, according to the PubMed database, a search engine for biomedical research articles. The appeal of this approach is obvious. Although cancer can be diagnosed through tissue biopsy, that [...]

The invisible side effect of visible cancer survivorship

Source: www.curetoday.com Author: Miranda Lankas How do survivors of head and neck cancer cope with drastic changes to one of the most visibly identifiable body parts — the head? Many cancer survivors display outward signs of their disease history; people lose hair, gain scars and ostomy bags, or even experience the full or partial loss of a body part. Some survivors embrace the physical changes in their lives wholeheartedly, with tattoos or photo shoots commemorating their new normal. However, coping with external changes can be a unique challenge for head and neck cancer survivors, whose facial changes include not only disfigurement but challenges with eating, talking and socializing in general. Head and neck cancer refers to a group of diagnoses where cancer forms in the face, mouth (including the lips, tongue and jawbone), throat, voice box and salivary glands: highly sensitive and critical areas. Survivors often face challenges speaking, chewing, swallowing and smiling, as well as changes to the skin and control over facial muscles, making this a diagnosis nearly impossible to disguise. Changes to a person’s face and their ability to eat and speak will significantly affect their ability to socialize, which poses a clear risk to mental health as well as the ability to return to previous activities. Stacey Maurer, an assistant professor and clinical psychologist in behavioral medicine in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina in Charleston, has been working with head and neck cancer survivors on the psychological [...]

Tech innovation offers hope for head/neck cancer treatment

Source: www.miragenews.com Author: University of Colorado Anschutz Medical Campus Over the past decade, human papillomavirus (HPV) has increasingly been identified as a significant cause of certain head and neck cancers – for example, evidence suggests it causes 70% of oropharyngeal cancers in the United States. Further, over the past three decades, incidence of HPV-driven cancers has increased substantially worldwide and in the U.S. While there are well-established screening tools, as well as vaccines, for HPV-driven cancers such as cervical cancer, there are fewer resources for HPV-driven head and neck cancers. As a result, researchers are working with a sense of urgency to develop innovative therapeutics to treat them. One groundbreaking therapeutic has shown significant promise in a phase 1 clinical trial led by Antonio Jimeno, MD, PhD, co-leader of the University of Colorado Cancer Center Developmental Therapeutics Program and the CU Cancer Center head and neck cancer SPORE grant. Research results published today show that a microfluidic squeezing technology used on peripheral blood mononuclear cells (PBMCs), a type of immune cell, helps stimulate anti-tumor activity in a subtype of HPV16-positive cancers, including head and neck, cervical, and anal cancers. “This technology is quite novel,” Jimeno explains. “As opposed to other cell therapies that require a patient’s cells to be genetically modified, this involves a different way of manipulating cells that does not lead to genetic modifications. It makes the process faster and perhaps more agile as to what you can direct the cells against.” “Sending them to boot camp” This [...]

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