Leaders in Dentistry: Dr. Ezra Cohen

Source: Dr. Bicuspid By: Donna Domino, Features Editor Date: July 17, 2013 May 21, 2013 — DrBicuspid.com is pleased to present the next installment of Leaders in Dentistry, a series of interviews with researchers, practitioners, and opinion leaders who are influencing the practice of dentistry. We spoke with Ezra Cohen, MD, an associate professor of medicine and the co-director of the head and neck cancer program at the University of Chicago, and the associate director for education at the university’s Comprehensive Cancer Center. Dr. Cohen specializes in head and neck, thyroid, and salivary gland cancers, and is an expert in novel cancer therapies who has conducted extensive research in molecularly targeted agents in the treatment of these cancers. His research interests include discovering how cancers become resistant to existing treatments and overcoming these mechanisms and ways to combine radiotherapy with novel agents. Here Dr. Cohen discusses trends in the incidence, detection, and treatment of oral and head and neck cancers. DrBicuspid.com: What’s the significance of your recent finding that there may be five distinct subgroups of the human papillomavirus (HPV)? Dr. Cohen: The purpose of the research was trying to define molecular subgroups of head and neck cancer (HNC) to inform therapy and outcomes a lot more than we do now as defined by stage and anatomic site. We were taking advantage of a cohort of patients that we treated in a similar fashion at the University of Chicago with a chemotherapy regimen that we commonly use here. The patients [...]

2013-07-19T07:48:02-07:00July, 2013|Oral Cancer News|

Living with the long-term consequences of cancer treatment

There are 400,000 people alive up to 20 years after diagnosis. But not all return to full health once treatment is over, and they need support. By: Lesley Smith Source: guardian.co.uk Date: Tuesday 16 July 2013 05.00 EDT ‘GPs must be better equipped to monitor and recognise the potential long-term consequences of cancer treatment.’ Photograph: LWA-Dann Tardif/CORBIS The cancer story is changing. What was once feared as a death sentence is now an illness that many people survive. As survival rates increase, so too will the number of people living with the legacy of cancer and its treatment. Last month Macmillan Cancer Support revealed that by 2020 almost half of the population in the UK will be diagnosed with cancer at some point in their lives. This has risen by more than a third in the past 20 years due to the improvement in overall life expectancy. While the number of people getting cancer is rising, there is also good news. Improvements in when the disease is diagnosed and the kinds of treatment and care available mean more people are surviving cancer than ever before. In England alone, there are currently 400,000 people alive 10 to 20 years after they were diagnosed with cancer, according to research by Macmillan and the National Cancer Intelligence Network. Unfortunately, not all cancer patients return to full health once their treatment is over. Some are left with debilitating health problems as a direct result of their cancer and its treatment, and these people often [...]

2013-07-19T07:36:10-07:00July, 2013|Oral Cancer News|

Researchers find overactive protein among mouth cancer patients

Source: http://www.ibtimes.co.uk/ Author: B.S. Akshaya An overactive protein in mouth cancer encourages tumours to grow fast and scientists claim that the protein will help them to find an effective treatment for the disease. Cancer Research UK scientists have discovered FRMD4A, a protein that is overactive among mouth cancer patients. They claim that just deactivating the protein will help save many lives. A study conducted on mice revealed that when FRMD4A protein is turned on, it helps the cancer cells to group and stick together, but when the protein is deactivated the stickiness of the cell is lost and ultimately it causes cancer cells to die. Scientists have already found some potential drugs that could help them deactivate the protein. “What’s really exciting about this research is that we already have potential drugs that can be used to target this protein or compensate for the effects that it is having,” said Dr Stephen Goldie, researcher at Cancer Research UK, in a statement. “These drugs could offer new options to patients where surgery and chemotherapy have not worked or could be used alongside them. We now need to start trials with these treatments, but we hope this could make a real difference to people with mouth cancer in the future,” he added. Mouth cancer starts anywhere in the oral cavity area like in the cheek lining area, the floor of the mouth, gums or the roof of the mouth (palate). Symptoms of this cancer are chewing problems, mouth sores, speech difficulty, swallowing [...]

2013-07-19T07:41:38-07:00July, 2013|Oral Cancer News|

IMRT plus chemotherapy offers high locoregional control in advanced nasopharyngeal carcinoma

Source: www.healio.com Treatment with intensity-modulated radiotherapy and concurrent weekly chemotherapy improved xerostomia and dysphagia in patients with advanced nasopharyngeal carcinoma, according to study results presented at the WIN Symposium. Researchers in China recruited 310 patients with stages III to IVb nasopharyngeal carcinoma. All patients received curative IMRT plus weekly chemotherapy with cisplatin (40 mg/m2). Patients received doses of 66 to 70.4 Gy to the gross tumor volume, 60 Gy to the first clinical target, and 54 to 56 Gy to the second clinical target. “The medial group retropharyngeal nodes were never contoured as clinical target volume, aiming to spare the pharyngeal constrictors unless they were involved,” the researchers wrote. “[The] level 1b node was selectively contoured as clinical target volume in order to spare the submandibular glands and oral cavity.” Patient-reported and observer-related scores assessed swallowing and salivary gland function at baseline and periodically up to 3 years after treatment. Median follow-up was 39 months. At 3 years, researchers reported a local RFS rate of 93.6%, a regional RFS rate of 95.8% and a distant metastases-free survival rate of 80%. Researchers reported no marginal or out-of-field relapses. Patients’ dysphagia and xerostomia worsened during late courses of treatment, as well as after treatment, yet scores gradually improved after therapy. Dysphagia was minimal or absent at 9 months post radiotherapy, whereas xerostomia improved from 3 to 15 months post radiotherapy and remained steadily until the conclusion of follow-up. “IMRT concurrent with weekly chemotherapy aiming to reduce xerostomia and dysphagia can be safely [...]

2013-07-19T07:42:19-07:00July, 2013|Oral Cancer News|

Celebrity confession linking sex to oral cancer raises local awareness

Source: www.vancouversun.com Author: Pamela Fayerman Michael Douglas is credited for raising awareness about the links between oral sex and oral cancer, but experts worry his disclosure could cause public panic and stigmatize the disease to the point of bringing shame to those afflicted. Or worse, prevent patients with symptoms from getting examined promptly. Miriam Rosin, a BC Cancer Agency scientist, said the actor’s candid revelation that his throat cancer was caused by human papillomavirus (HPV), which he picked up from performing cunnilingus, is raising awareness of a growing problem around the world, and in B.C. “It’s created a lot of noise. I think it’s important to talk about this disease … but not in a headline-grabbing way, which may damage the cause by labelling it as a sexually transmitted disease,” said Rosin, who is also a Simon Fraser University professor. Regardless, the public is finally getting the message that HPV, the most common sexually transmitted virus in the world – and the one that causes virtually all cases of cervical cancer – is accounting for the surge in throat cancers located at the back of the throat. In B.C., if trends continue, HPV-caused throat cancers are expected to overtake cervical cancers in incidence. About 150 cases of cervical cancers are reported annually in this province. Of about 500 head and neck cancers, 115 are HPVcaused throat cancers, according to the BCCA. Douglas’s interview with The Guardian newspaper last month was followed by an avalanche of sensational media reports that apparently [...]

2013-07-19T07:43:16-07:00July, 2013|Oral Cancer News|

Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium

Source: Oxford JournalsReceived July 26, 2012.Accepted February 8, 2013 Abstract Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking (Ptrend ≤ 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers. *This news story was resourced by the [...]

2013-07-19T07:23:54-07:00July, 2013|Oral Cancer News|

Vaccination Not Found To Increase Risk Of Guillain-Barre Syndrome

Source: Medical News TodayArticle Date: 26 Jun 2013 - 0:00 PDT  Patients are not at increased risk of Guillain-Barre syndrome in the six-week period after vaccination with any vaccine, including influenza, according to a Kaiser Permanente study published in Clinical Infectious Diseases. The retrospective study by researchers at the Kaiser Permanente Vaccine Study Center spanned 13 years and was controlled for seasonality. "If there is a risk of Guillain-Barré syndrome following any vaccine, including influenza vaccines, it is extremely low," said Roger Baxter, MD, co-director of the Kaiser Permanente Vaccine Study Center. During the 13-year period (1994-2006), 415 confirmed cases of Guillain-Barré syndrome were observed. Within this group, the researchers found only 25 patients had received any vaccine in the six weeks prior to the onset of the disease. The study also found that 277 patients had a respiratory or gastrointestinal illness in the 90 days preceding the onset. Guillain-Barré syndrome is an acute disease thought to be an autoimmune disorder resulting in destruction of a nerve's myelin sheath and peripheral nerves. In many cases, the syndrome is temporally associated with an infectious disease; most published case series report that approximately two-thirds of all cases are preceded within three months by a gastrointestinal or respiratory infection. Guillain-Barré syndrome had been linked to the influenza vaccine in a 1976 study, but not clearly since. There have been reports of an association with other vaccines, which have not been confirmed. Previous studies of Guillain-Barré syndrome as a possible adverse event related to [...]

2013-07-05T10:12:54-07:00July, 2013|Oral Cancer News|

NSAIDs may cut oral cancer risk

Source: www.newsfix.ca Author: Martin March People who smoke are protected from oral cancer by aspirin or ibuprofen, according to a study. It’s already known that smoking is a strong risk factor for oral cancer. A study from the Norwegian Radium Hospital reveals that non-steroidal anti-inflammatory drugs (NSAIDs) may help protect some smokers from the disease. They looked at a group of light to moderate smokers who had taken NSAIDs over a long period. They were about 65 per cent less likely to develop oral cancer compared to smokers who did not take NSAIDs. All types of NSAID were protective, including ibuprofen, aspirin and indomethacin. However, acetaminophen, a common pain reliever which is not an NSAID, was not found to be effective. The benefit of NSAIDs was found to be greatest for those who smoked least. At higher levels of consumption of tobacco, its carcinogenic effect overcomes the benefit of the NSAID.

HPV vaccine still fights for acceptance, despite benefits

Source: www.floydcountytimes.com Author: Tom Collins Last month, actor Michael Douglas caused a stir in the media when he suggested his throat cancer might have been caused by oral sex. He could be right. Although smoking and alcohol use have long been regarded as the key risk factors, new research indicates that HPV, a sexually transmitted virus, is now the leading cause of mouth and throat cancers in the United States. But there’s an important take-away message to this story: Some cancers caused by HPV can be prevented easily, with a simple series of three vaccinations. Since 2000, scientists have known that certain strains of HPV are responsible for nearly all cervical cancer in women. But newer studies indicate HPV can cause other types of cancer as well. Recent findings have also linked HPV to oral, head/neck, anal, vaginal, vulvar and penile cancers, and even some cases of lung cancer. About half of all Americans will become infected with HPV at least once during their lifetime. The most common visible symptom of an HPV infection is genital warts, although the majority of HPV infections do not display symptoms. That’s why the Centers for Disease Control and Prevention recommends that boys and girls alike be vaccinated against HPV. Ideally, they should be vaccinated between the ages of 11 and 12. Vaccination can be initiated as early as age 9, and the U.S. Food and Drug Administration has approved the vaccine to be given up to age 26. Yet HPV vaccination rates remain [...]

Stanford surgeon uses robot to increase precision, reduce complications of head and neck procedures

Source: scopeblog.stanford.edu Author: Margarita Gallardo In today’s San Francisco Chronicle, writer Kristen Brown highlights how surgical robots are simplifying head and neck procedures. Known as transoral robotic surgery, or TORS, Stanford is one of the few places in the country using the da Vinci surgical robot to remove tumors or scar tissue from patients such as 70-year-old John Ayers, who is featured in the story (subscription required). Edward Damrose, MD, chief of the division of laryngeal surgery at Stanford Hospital & Clinics, describes the procedure to Brown: The da Vinci’s most frequent use in transoral procedures is in head and neck cancers. By operating through the mouth, surgeons can remove tumors in places that previously might have required much more complex procedures, such as breaking the jaw to get a good enough look. The robot has four arms – three that can hold typical surgical tools, and a fourth that holds an endoscopic camera, giving a surgeon a full view of the patient’s insides. “You get an almost panoramic view,” said Damrose. “It’s as if you were miniaturized and in someone’s throat looking around.” The da Vinci was first used on a human for a head and neck procedure in 2005 at the University of Pennsylvania. An update to the robot made the experiment possible, when slimmer tools were developed for the robot that might more easily fit inside the mouth. (Even with the smaller tools, working inside someone’s throat can be a tight squeeze, depending on the patient.) “If [...]

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