Diagnostic delay broadly associated with more advanced stage oral cancer.

Source: Evid Based Dent, January 1, 2010; 11(1): 24 Author: I Al-Dakkak Data sources: Medline, Embase, ISI Proceedings and the reference lists of relevant articles were used to find relevant studies. Study selection: Studies were included if: they presented original data from observational studies; included patients with a confirmed pathological diagnosis of oral or oropharyngeal squamous cell carcinoma; the outcome of interest was clearly defined as disease stage (TNM classification); the exposure of interest was total diagnostic delay, defined as the period between the patient noticing either the first sign or symptom and definitive diagnosis (data were collected from interviews using a standardised questionnaire and medical records); provided relative risks (RR) and 95% confidence intervals (CI) or provided enough data to allow calculation of these figures. Data extraction and synthesis: Quality assessment was undertaken independently by two reviewers and followed the recommendations of the Meta-analysis of Observational Studies in Epidemiology (MOOSE). Meta-analysis was conducted using fixed and random-effects models. Results: Nine studies carried out in nine different countries met the inclusion criteria and were included in the analysis. The fixed-effects pooled relative risk (RR) of advanced stages of oropharyngeal cancer when diagnostic delay is present was 1.32 (95% CI, 1.07-1.62). This association was stronger when the analysis was restricted to oral cancer (pooled RR, 1.47; 95% CI, 1.09-1.99) and when the delay was longer than 1 month (pooled RR, 1.69; 95% CI, 1.26-2.77). Conclusions: The probability for people with delayed diagnosis to present with an advanced-stage tumour at diagnosis was [...]

Docetaxel suppresses invasiveness of head and neck cancer cells in vitro

Source: Cancer Sci, February 22, 2010 Author: Y Kogashiwa et al. The combination of docetaxel, cisplatin, and fluorouracil significantly enhances the survival of head and neck cancer patients compared to cisplatin and fluorouracil. We hypothesized that docetaxel may affect invasiveness of the head and neck cancer cells in addition to its tumor-killing effect. Two different head and neck cancer cell lines (HEp-2 and Ca9-22) were treated with docetaxel at IC(10) and IC(50) concentrations. Cell migration and invasive growth was evaluated by wound healing assay and three-dimensional (3D) culture of multicellular tumor spheroids, respectively. Expression levels of possible downstream effectors for cell migration/invasiveness were measured by immunoblotting in conditions with or without docetaxel. Docetaxel, but not cisplatin, suppressed filopodia formation compared with no treatment (control) condition. Consistent with this, docetaxel suppressed two-dimensional (2D) cell migration and 3D cell invasion compared with control or cisplatin. Only docetaxel treated cells exhibited thick tubulin bundle and had lower activity of Cdc42, a member of the Rho family of small GTPases. In conclusion, Docetaxel treatment suppressed migration and invasiveness of head and neck cancer cells in vitro, which is likely to be mediated by regulating Cdc42 activity. Authors: Y Kogashiwa, H Sakurai, T Kimura, and N Kohno Authors' affiliation: Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan

As cigarette sales dip, new products raise concerns

Source: www.atomiurl.com Author: staff If he were conceived today, there might not be just a cigarette dangling from his mouth. He might also have, tucked into his pocket, a cellphone-size container holding a dozen pouches of snus. It rhymes with “goose,” (cynics might say “noose”), and is a Swedish type of smokeless tobacco that’s not your grandfather’s dip or chew. Snus comes in teabag-like pouches that a user sticks between the upper lip and gum, leaves there for up to 30 minutes and discards without spitting. As no-smoking laws sweep the nation and cigarette sales continue to fall, big Tobacco is alarming the public health community by devising other ways to try to make tobacco appealing. with smokeless products representing the only booming part of the U.S. tobacco market, snus is an effort to boost sales with a product that — unlike most smokeless ones — doesn’t require users to spit out the residue. Snus also represents something more: an attempt to move smokeless tobacco beyond stereotypical users such as baseball players and rodeo cowboys, and into offices or restaurants where people want a nicotine fix but can’t light up. “This is a growth strategy for us,” says Bill Phelps, spokesman for Philip Morris USA, the nation’s biggest tobacco company and maker of Marlboro, the top-selling cigarette. In Dallas this month, Philip Morris is launching its first smokeless product with a cigarette brand name: Marlboro Snus. R.J. Reynolds, second in U.S. tobacco sales, is expanding tests of its Camel Snus [...]

Nano-bio-chip sensor platform for examination of oral exfoliative cytology

Source: Cancer Prevention Research 3(4); 518-28, March 23, 2010 Authors: SE Weigum et al. Oral cancer is a deadly and disfiguring disease that could greatly benefit from new diagnostic approaches enabling early detection. In this pilot study, we describe a nano-bio-chip (NBC) sensor technique for analysis of oral cancer biomarkers in exfoliative cytology specimens, targeting both biochemical and morphologic changes associated with early oral tumorigenesis. Here, oral lesions from 41 dental patients, along with normal epithelium from 11 healthy volunteers, were sampled using a noninvasive brush biopsy technique. Specimens were enriched, immunolabeled, and imaged in the NBC sensor according to previously established assays for the epidermal growth factor receptor (EGFR) biomarker and cytomorphometry. A total of 51 measurement parameters were extracted using custom image analysis macros, including EGFR labeling intensity, cell and nuclear size, and the nuclear-to-cytoplasmic ratio. Four key parameters were significantly elevated in both dysplastic and malignant lesions relative to healthy oral epithelium, including the nuclear area and diameter (P

Socio-economic factors and stage at presentation of head and neck cancer patients in Ottawa, Canada: A logistic regression analysis

Source: Oral Oncol, March 20, 2010 Authors: S Johnson et al. To determine if socio-economic status (SES) affects the stage at presentation of head and neck cancer (HNC) patients in Ottawa, Canada. To determine if the method of diagnosis affects the stage at presentation in these patients. We obtained data on SES, method of diagnosis, and stage at presentation for patients presenting to the head and neck cancer clinic at The Ottawa Hospital Regional Cancer Centre (TORCC). We performed a logistic regression analysis using stage at presentation as the dependent variable. We found no statistically significant association between average family income (by postal code) and stage at presentation. We found that oral cancers presented at a later stage compared with other HNCs but that who made the diagnosis was an important factor. Oral cancers diagnosed by a dentist had 3.44 times the odds of being at a later stage than other HNCs (CI 1.01-11.96), but oral cancers diagnosed by other means had 11.42 times the odds of being at a later stage than other HNCs. We found that male patients presented at a later stage than female patients (OR 2.62, CI 1.03-6.63). Finally, former smokers had about 1/3 the odds of presenting at a later stage than current smokers (OR 0.33, CI 0.13-0.84) although nonsmokers were not significantly less likely than current smokers to present later (OR 0.47, CI 0.17-1.32). We found no evidence that in Ottawa, Canada patients of a lower SES with HNC presented at an different stage [...]

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 [...]

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 [...]

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 [...]

2010-04-04T08:41:51-07:00April, 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 [...]

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 [...]

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