More parents balking at giving kids cancer-fighting HPV vaccine

Source: www.usnews.com
Author: Steven Reinberg

From 2012 to 2018, more doctors recommended their patients get vaccinated with the HPV vaccine — from 27% to 49%. But at the same time, the number of parents who were reluctant to have their kids vaccinated increased from 50% to 64%, researchers found.

“Overall, more U.S. teens are getting the HPV vaccine, and the nation is making progress towards reaching the HPV vaccination goals; however, if parental reluctance continues to grow, the current rate of our progress might plateau or possibly decline,” said lead study author Kalyani Sonawane. She’s an assistant professor in the department of management, policy and community health at the University of Texas Health Science Center in Houston.

“In the long term, the lost opportunity to protect our teens from HPV might contribute to cases of HPV-associated cervical, oropharyngeal, penile, anal, vaginal and vulvar cancers in the future,” Sonawane said.

Parents’ reluctance to have their kids vaccinated rose more for girls, from 54% to 68%, compared with 44% to 59% for boys, the researchers noted. The report was published online Feb. 9 in the journal Pediatrics.

To increase the number of boys and girls who get vaccinated, doctors need to strongly recommend it, Sonawane said.

“Further improvements in provider recommendations can be made, given that it is the most important factor for improving HPV vaccine uptake,” she said. “Providers should be prepared to tackle hesitancy by conveying the importance of HPV vaccination to parents and debunking vaccine misinformation. Increasing vaccine confidence in parents will be key to attaining HPV vaccination goals in the U.S.”

The reluctance is largely due to safety concerns, Sonawane said. In a study, she and her colleagues found that the most common reason parents cite for their reluctant to HPV vaccine is concerns regarding adverse effects.

“The public message about the HPV vaccine should highlight that the vaccine protects against cancers. It is important to emphasize to parents that the vaccine offers protection for up to six cancers, because data indicates that many people are not aware of this fact,” Sonawane said.

In another study, Sonawane found that less than one-third of Americans know that HPV causes anal, penile and oral cancers.

Sonawane added that the anti-vaxxer movement is likely contributing to the growing reluctance of parents to have their children vaccinated, and she is concerned that the “negative coverage of the COVID vaccine will trickle down to HPV vaccine and affect perceptions regarding vaccines.”

HPV is a sexually transmitted infection that is the cause of most cervical, vagina and vulva cancers, penis cancer and cancer in the back of the throat. It can take years for these cancers to develop, but children can be protected by getting the HPV vaccine at ages 11 to 12, according to the U.S. Centers for Disease Control and Prevention.

One pediatrician unconnected to the study noted the importance of the marketing for the vaccine.

“When this vaccine first hit the market, they didn’t focus the messaging around it being a cancer preventer vaccine. They focused on the sexually transmitted infections,” said Dr. David Fagan, vice chairman of pediatric administration-ambulatory at Cohen Children’s Medical Center in New Hyde Park, N.Y.

Fagan believes, however, the message should be that the vaccine prevents cancer. “Wouldn’t you, as a parent, want to do everything you could for your child to prevent the possibility of your child getting a cancer — this vaccine does that,” he said.

He also thinks that the quality of the recommendation is key to convincing parents to vaccinate their children.

The American Academy of Pediatrics is doing a lot to educate pediatricians in motivational interviewing techniques, Fagan said.

The tetanus booster, the meningitis vaccine and the HPV vaccine are those recommended for adolescence.

Evidence shows, if you offer the HPV in first or second place as opposed to third place, parents are more likely to opt for it, Fagan said.

“If you do tetanus, meningitis, HPV, they are less likely to accept HPV, but if you put HPV first or even second, there’s evidence that there’s better uptake. So messaging is really, really important,” he said.

The vaccine is safe, Fagan said. A study has shown that no serious side effects have been seen since the vaccine was released.

“You know these things on social media about the safety of the vaccine, obviously that’s crazy stuff,” he said.

“I tell parents if this vaccine was unsafe, it would have been pulled from the market,” Fagan said. “Additionally, you would be reading about multimillion dollar legal settlements in the press, and that has not happened. So the take-home message is this vaccine is safe and effective in preventing cancers caused by HPV.”

More information
For more on the HPV vaccine, go to the U.S. Centers for Disease Control and Prevention.

Sources:
Kalyani Sonawane, Ph.D., assistant professor, department of management, policy and community health, University of Texas Health Science Center at Houston; David Fagan, MD, vice chairman, Pediatric Administration-Ambulatory, Cohen Children’s Medical Center, New Hyde Park, N.Y.; Pediatrics, Feb. 9, 2021, online

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2021-02-10T10:56:54-07:00February, 2021|Oral Cancer News|

How enlisting dentists can speed up Covid-19 vaccinations

Source: Knowable Magazine
Date: February 3rd, 2021
Author: Mary E. Northridge

OPINION: Dental care providers have the skills, the facilities and the trust of patients who might otherwise miss out

 

Even as the Biden administration has upped its Covid-19 vaccine goal to 1.5 million per day, early reports say vaccination rates are lagging in hard-hit Black and Latino communities. On both fronts, America’s dentists can help.

Dental professionals — dentists, dental hygienists and dental assistants — have been responding to the pandemic from the outset, even as many practices were shut down by the emergency. At the health center where I work in Brooklyn, dental providers first donated their personal protective equipment (PPE) to the affiliated hospital. Then many of them were redeployed to perform arterial blood gas measurements and even transport deceased patients to makeshift morgues.

Today, the urgent need is to get millions of shots in arms. States should immediately authorize dental providers to administer Covid-19 vaccines. That would not only expand the trained immunization workforce, it would open up additional sites to dispense the vaccine and bolster vaccine acceptance among patients who do not routinely go to the doctor.

This is not without precedent. In 2019, Oregon became the first state to allow dentists to offer any vaccine to patients. Other states, including Illinois and Minnesota, allow dentists to administer influenza vaccines. Since late 2020, Arkansas, Massachusetts and California have permitted dentists to administer Covid-19 vaccines.

During this devastating public health emergency, this idea needs to be extended to all states.

There are more than 110,000 dentists – excluding specialists — and over 200,000 hygienists in the United States, and they already have the skills needed. Dentists routinely administer intra- and extra-oral injections to provide anesthesia, so any additional training would be minimal. In California, for instance, dentists will do four hours of online training before joining the vaccination effort.

California currently plans to utilize dentists just as extra manpower at vaccine clinics. But dental offices, too, will be valuable in vaccinating hard-to-reach populations.

Dental offices and clinics are a safe location. Despite early concerns that they might be particularly vulnerable to aerosol-borne transmission of the novel coronavirus, evidence is mounting that transmission at dental sites is rare. As in medical settings, precautions such as using PPE and increasing ventilation are effective. Nearly all dental practices and clinics have reopened to provide care. And that has been essential during the pandemic: Treating damaged teeth, tooth decay, gum disease and oral sores before they become acute prevents patients from going to emergency departments because of dental pain.

Interrupting community spread, however, is the chief imperative to prevent Covid-19 cases from overwhelming hospitals today. And that means adding vaccines to dental services.

Inoculating patients who are already in chairs for dental visits could improve vaccine acceptance. At the health center where I work, a simple workflow change for preventive tooth sealant placement nearly doubled the number of eligible children treated, from 37 percent to nearly 78 percent. Rather than schedule a separate appointment, sealants were applied during the kids’ initial or recall visits. Fewer visits meant greater acceptance of the treatment and higher rates of completion. The same could be true for vaccines.

Community dental clinics also serve hard-to-reach patients — minorities, immigrants, impoverished people — those who may be hesitant to seek out the vaccine because of historical injustices, fear of deportation or lack of health insurance. But dental providers have often earned trust through longstanding service in these communities. Ongoing quality improvement studies at our health center, for instance, document no racial/ethnic bias in treatment by dental providers. When patients are treated with respect regardless of their ability to pay for services, they may be more willing to accept a vaccine that will protect them, their families and their communities.

Many states have suspended regulations and expanded the scope of dental practices to combat the pandemic. To help ensure health equity and successfully immunize the whole US population, all states ought to enlist dental providers to administer Covid-19 vaccines as well.

This article is part of “Reset: The Science of Crisis & Recovery,” an ongoing Knowable Magazine series exploring how the world is navigating the coronavirus pandemic, its consequences and the way forward. “Reset” is supported by a grant from the Alfred P. Sloan Foundation. 

 

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2021-02-08T12:25:34-07:00February, 2021|Oral Cancer News|

Using proteogenomics to improve the treatment of squamous cell carcinoma

Source: blogs.bcm.edu, Baylor College of Medicine
Author: Molly Chiu

Patients with head and neck squamous cell carcinoma (HNSCC), the sixth most common epithelial cancer worldwide, are treated with surgery, chemotherapy and radiotherapy. In addition, targeted agents, including an EGFR monoclonal antibody (mAb) inhibitor and two programmed cell death protein 1 (PD-1) inhibitors, have been approved by the U.S. Food and Drug Administration for HNSCC treatment, but response rates are moderate.

In this study, researchers led by Baylor College of Medicine, Johns Hopkins University and the National Cancer Institute’s Clinical Proteomic Tumor Analysis Consortium (CPTAC) investigated what new insight proteogenomic analysis might offer into understanding why certain patients respond to certain treatments while other patients do not. They propose that their findings may help better match patients to an appropriate course of treatment in the future.

Building a proteogenomic profile
The team profiled proteins, phosphosites (a site on a protein associated with phosphorylation) and signaling pathways in 108 human papillomavirus-negative HNSCC tumors in order to understand how genetic aberrations drive tumor behavior and response to therapies.

“We found three subtypes of head and neck squamous cell carcinoma, and each subtype may be a good candidate for a different type of therapy – EGFR inhibitors, CDK inhibitors or immunotherapy,” said Dr. Bing Zhang, lead contact of the study and professor in the Lester and Sue Smith Breast Center and the Department of Molecular and Human Genetics at Baylor. “We also identified candidate biomarkers that could be used to match patients to effective therapies or clinical trials.”

Finding effective biomarkers
One important finding involved matching HNSCC patients to EGFR mAb inhibitors. Cetuximab, an EGFR mAb medication, was approved by the FDA in 2006 as the first targeted therapy for HNSCC, however the success rate for this treatment is low. Moreover, EGFR amplification or overexpression cannot predict response to EGFR mAbs. In this study, researchers found that EGFR ligands, instead of EGFR itself, act as the limiting factor for EGFR pathway activation. When ligand is low, the downstream pathway will not be triggered, even if EGFR protein is highly overexpressed.

“Tumors with high EGFR amplification do not necessarily have high levels of EGFR ligands, which may underlie their lack of response to EGFR mAb therapy.” The team confirmed this hypothesis by analyzing previously published data from patient-derived xenograft models and a clinical trial.

Additionally, tracking a key tumor suppressor known as Rb (retinoblastoma), the research team identified a striking finding that suggests that Rb phosphorylation status could potentially be a better indicator of a patient’s response to CDK4/6 inhibitor therapy. The study showed that the many mutations in the genes regulating CDK4/6 activity were neither necessary nor sufficient for activation of CDK4/6.

Immunotherapy insights
The research team also found important insights into the effectiveness of immunotherapy. PD-1 inhibitors target the interaction between immune checkpoints PD-1 and PD-L1, but success rates of immunotherapy are low, even when PD-L1 expression is used for patient selection. The researchers examined tumors with high expression of PD-L1 and found that when a tumor overexpresses PD-L1, it also upregulates other immune checkpoints, thus allowing the tumor growth despite the use of PD-1 inhibitors.

‘Immune-cold tumors’ are tumors that contain few if any infiltrating immune T cells. Examination of how a tumor becomes immune-cold showed that the problem stems from a flaw in its antigen presentation pathway, a first step toward triggering an immune response against tumor antigens. In immune-cold tumors multiple key gene components of the antigen presentation pathway were deleted. As a result, although tumor antigens are being expressed, the immune system is not able to recognize them on the surface of cancer cells and therefore fails to activate the body’s defense system against the tumor. These deletions have the potential to be effective targets for future therapies.

“This study extends our biological understanding of HPV-negative HNSCCs and generates therapeutic hypotheses that may serve as the basis for future studies and clinical trials toward molecularly-guided precision medicine treatment of this aggressive cancer type,” said Dr. Daniel W. Chan, co-corresponding author of the study, professor of pathology and oncology, and director of the Center for Biomarker Discovery and Translation at the Johns Hopkins University School of Medicine.

Find all the details of this study and a full list of contributing authors in the journal Cancer Cell.

This work was supported by grants U24 CA210954, U24 CA210985, U24 CA210972, U24 CA210979, U24 CA210986, U24 CA214125, U24 CA210967, and U24 CA210993 from the National Cancer Institute (NCI) Clinical Proteomic Tumor Analysis Consortium (CPTAC), by a Cancer Prevention Institute of Texas (CPRIT) award RR160027, by grant T32 CA203690 from the Translational Breast Cancer Research Training Program, and by funding from the McNair Medical Institute at the Robert and Janice McNair Foundation.

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2021-02-04T21:09:30-07:00February, 2021|Oral Cancer News|

Patients with oral cancer may get relief from dry mouth through MU research

Source: www.columbiamissourian.com
Author: Tia Alphonse

Gary Rackers bit his tongue one night, and it began to bleed. Thinking it wasn’t serious, he waited a couple of weeks, but something still didn’t feel right.

So, he asked his wife to take a look. She was shocked, Rackers said. His tongue was black.

After seeing his family physician and a local ear, nose and throat doctor in Jefferson City, Rackers was referred to Ellis Fischel Cancer Center. There, he connected with a physician who specialized in surgical treatment for patients with head and neck cancers. He was diagnosed with squamous cell carcinoma — a common oral cancer. The doctor ended up surgically removing half of Rackers’s tongue and nearly all of his teeth, and he began radiation and chemotherapy treatments.

Since then, Rackers said he‘s had 33 radiation treatments and three rounds of chemotherapy. He is pleased and proud of the work his physician did, he said. Because of her, he’s in the recovery phase: “I’m doing good…and I’m feeling good.”

Many head and neck cancer patients like Rackers lose their ability to produce saliva after radiation treatment. He said it doesn’t affect him much during the day, but his mouth gets quite dry at night. Dry mouth frequently disturbs his sleep, he said, causing him to often fetch water or juice for relief.

“If I could get through the night,” he said, the days are easy.

MU researcher and former dentist Olga Baker hopes to help patients like Rackers by dedicating her efforts to something most of us take for granted — saliva. Through her research, she hopes to find better solutions to combat dry mouth, particularly among cancer patients whose glands have been destroyed by radiation therapy.

When she practiced dentistry, Baker said she encountered many patients who struggled with dry mouth. Although the condition is often viewed as insignificant, those who underproduce saliva often develop mouth sores, cavities and a host of other issues. Baker said she has even worked with patients who have trouble talking because their inner cheeks stick to their teeth without natural lubrication from saliva. She has also treated patients who feel as if they are choking at night without the fluid to keep their airways moist.

Multiple groups of people suffer from chronic dry mouth. Patients who undergo radiation treatment for neck and head cancer are among a common group that often loses the function of salivary glands. After treatment, many of these glands stop working and can no longer naturally produce saliva, Baker said. She has seen patients who suffer from Sjögren’s syndrome, an autoimmune disease that causes inflammation that destroys the salivary glands. Other patients are born without functioning salivary glands at all.

“For these patients, there is no cure,” Baker said. “So, we’re working on different options.”

In the past, she worked to produce artificial saliva from plant-based resources and researched resolvins, lipids derived from the Omega-3 fatty acids commonly found in fish oil. This can be a potential treatment for dry mouth in Sjögren’s syndrome patients. These kind of solutions provide temporary relief, working as a spray that can be applied throughout the day to mimic the effects of saliva lubrication.

Baker’s current research into saliva production is dedicated to finding a more long-term solution to dry mouth, specifically for patients whose glands have been destroyed by radiation therapy. The therapy Baker is researching uses a specialized hydrogel that targets the affected glands. She has zeroed in on a protein called laminin-111, which is important to the embryonic process and has long been associated with regenerative properties. Baker said her previous research found that the protein helped restore salivary gland function when only single molecules were used.

She looked at recent studies on the way trimers, a combination of three molecules of a given protein, could give greater results than single molecules. She became interested in testing trimers of laminin-111 on salivary glands to see whether the protein could further restore salivary function in mice.

The experiment tested mice that had undergone radiation treatment and lost salivary function. Proteins from the treatment are put into hydrogels to make a more efficient delivery system. The gel was applied to the mice, and their saliva secretion was monitored. The treatment has proved effective in mice that lose salivary gland function due to radiation. Baker said the next step is to expand her research into larger animals and ultimately do clinical trials on human patients.

Meanwhile, Rackers is adjusting to his recovery. He said he no longer eats spicy foods, and he can’t stand the tanginess of condiments like barbecue and mustard. He can, however, still enjoy most foods.

“Tonight, I’m making smoked sausage, fried potatoes and steamed vegetables,” he said. “And I can eat that.”

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2021-02-04T20:59:31-07:00February, 2021|Oral Cancer News|

Distinct subtypes and potential treatment options found in analysis of head and neck cancers

Source: www.cancernetwork.com
Author: Matthew Fowler

Data published in the journal Cancer Cell presented possible new treatment options and elaborated on the contributions of key cancer-associated genes, phosphosites, and signaling pathways in human papillomavirus (HPV)­–negative head and neck squamous cell carcinomas (HNSCC).1

The data systematically recorded information regarding the disease, with multi-omic analysis determining 3 distinct subtypes with high potential for treatment with respective available therapeutics.

“This study extends our biological understanding of HPV[-negative] HNSCC and generates therapeutic hypotheses that may serve as the basis for future preclinical studies and clinical trials toward molecularly guided precision treatment of this aggressive cancer type,” wrote the investigators.2

The first subtype, called CIN for “chromosome instability”, was determined to have the worst prognosis. It was associated with the larynx, a history of smoking, and increased instability of chromosomes. The research team suggested that this cancer type would respond best to CDK4/6 inhibitor treatment given its relation to aberrations of the CCND1 and CDKN2A genes as well as a high activity of the CDK4 and CDK6 enzymes.

The investigators analyzed a number of protein elevations of basal factors in the second subtype discovered, which was in turn called Basal. These represent the most basic proteins necessary for gene transcription activation. The subtype had both high activity in the EGFR signaling pathway and high expression of the AREG and TNFA molecules. This led the investigators to suggest that treatment with monoclonal antibodies targeting EGFR would best treat this subtype.

Immune, the final subtype, was discovered among patients who did not smoke and had high expression of multiple immune checkpoint proteins. The data suggest patients with this subtype would respond best to immune checkpoint inhibitors.

The overall data found high potential for treatment response in 32% of patients with the CIN subtype, 62% of those with the basal subtype, and 83% with the immune subtype.

“This study extends our biological understanding of HPV-negative HNSCCs and generates therapeutic hypotheses that may serve as the basis for future studies and clinical trials toward molecularly guided precision medicine treatment of this aggressive cancer type,” Daniel Chan, PhD, principal investigator on the trial and director of the Center for Biomarker Discovery and Translation at the Johns Hopkins University School of Medicine, said in a press release.

The team also determined that there were 2 modes of activation of EGFR. This determination suggests a potentially new way to stratify this cancer type based on the number of molecules bound to EGFR. Moreover, the investigators concluded that the loss of the ability to produce immune responses is credited to the widespread deletion of immune modulatory genes.

Investigators from both the United States and Poland analyzed 110 treatment-naïve primary HNSCC tumors and matched blood samples. A total of 66 tumors matched normal adjacent tissues.

“We have made the primary and processed datasets available in publicly accessible data repositories and portals, which will allow full investigation of this extensively characterized cohort by both the HNSCC and broader scientific communities. We also expect wide application of the demonstrated proteogenomics framework to future studies of HNSCC and other cancer types,” the investigators concluded

References:
1. Huang C, Chen L, Savage SR, et al. Proteogenomic insights into the biology and treatment of HPV-negative head and neck squamous cell carcinoma. Cancer Cell. January 5, 2021. doi: 10.1016/j.ccell.2020.12.007

2. Researchers create comprehensive database of head and neck cancers. News release. Hopkins Medicine. January 7, 2021. Accessed January 25, 2021. https://www.hopkinsmedicine.org/news/newsroom/news-releases/researchers-create-comprehensive-database-of-head-and-neck-cancers

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2021-02-03T10:49:17-07:00February, 2021|Oral Cancer News|

How much does drinking alcohol contribute to US cancer burden?

Source: www.medscape.com
Author: Kristin Jenkins

The first study to estimate the alcohol-related cancer burden on a state-by-state basis provides more evidence that the drinking habits of Americans account for a “considerable” proportion of cancer diagnoses and deaths, researchers say.

“In the United States, on average, alcohol consumption accounts for 4.8% of cancer cases and 3.2% of cancer deaths,” concludes Farhad Islami, MD, PhD, of the American Cancer Society (ACS) and colleagues.

However, the proportion was higher for specific cancer types, with alcohol consumption accounting for an estimated 12.1% of female breast cancers, 11.1% of colorectal, 10.5% of liver, and 7.7% of esophageal cancers, the study showed.

In addition, in 46 states, alcohol accounted for ≥ 45% of oral cavity/pharyngeal and ≥ 25% of laryngeal cancer diagnoses.

The study was published online January 19 in Cancer Epidemiology.

“Implementing state-level policies and cancer control efforts to reduce alcohol consumption could reduce this cancer burden,” the researchers comment.

They noted that restrictive policies on alcohol sales are associated with a reduction in cancer mortality rates and that a recent study showed increasing alcohol controls by 10% was associated with an 8.3% relative decrease in the oropharyngeal cancer mortality rate.

Separating Drinking From Smoking
The study is also one of a growing number to evaluate alcohol consumption and cancer risk in nonsmokers, said Mary Beth Terry, PhD, professor of epidemiology at Mailman School of Public Health, Columbia University, New York City, when approached for comment.

“This is important because the much larger effects of smoking and cancer risk have made it challenging in the past to evaluate the full impact of alcohol consumption,” she told Medscape Medical News. “In the past it was hard to calculate population-attributable fractions for alcohol because a large part of the population smoked and drank.”

“This was a very comprehensive analysis,” added Terry, who was not involved with the study. She pointed out that the authors used sales data in combination with self-reported alcohol consumption “to adjust for the fact that most alcohol consumption is severely underreported.”

For the study, researchers analyzed age-, sex-, and state-specific cancer incidence and mortality data (2013-2016) from the US Cancer Statistics database in adults 30 years of age and older. They also estimated state-level, self-reported age- and sex-stratified alcohol consumption using Behavioral Risk Factor Surveillance System surveys for 2003-2006 .

Large Variation Between States
The study also showed that state-specific estimates for incident cancer cases and cancer deaths varied widely, ranging from 2.1% to 5.0% in men, and from 1.4% to 4.4% in women.

The proportions of alcohol-attributable cancer tended to be higher in New England and the western states and lower in the midwestern and southern states, with two notable exceptions. Delaware had the highest number of alcohol-related cancer cases (6.7%) and deaths (4.5%) among men and women combined, and Utah had the lowest (2.9% and 1.9%, respectively).

The magnitude of the state-to-state variation in cancer burden left the researchers “a bit surprised,” Islami told Medscape Medical News.

“The proportion of cancer cases and deaths attributable to alcohol consumption among women was about three times higher in Delaware than in West Virginia,” he said.

He noted that in the last decade, alcohol consumption among women has increased. “This may make our results even more relevant,” Islami said.

Many adults have limited awareness of the cancer-related risks of alcohol consumption, Islami commented. Others may not take the association seriously but “many pay attention to their doctor’s health recommendations,” Islami said. “Clinicians could have an important role in increasing awareness of the cancer-related risks of alcohol consumption, which could result in a reduction in alcohol-related cancer burden.”

Overall, the proportion of alcohol-attributable cancer cases and deaths was not substantially different from that reported in their 2017 study of national-level estimates, the investigators said. That study was based on sales-adjusted 2013-2014 contemporary exposure data from the National Health Interview Survey. It showed that alcohol consumption accounted for an estimated 5.6% of incident cancer cases and 4.0% of cancer deaths.

“More research is needed to monitor alcohol consumption and the alcohol-related cancer burden to evaluate state-based policies and cancer control efforts,” said Islami. “Further research is also needed to fine-tune proven interventions to increase their efficacy and to identify other effective interventions.”

‘Best Not to Drink Alcohol’
In the meantime, a new, stronger directive on alcohol consumption was issued by the ACS last year (June 2020) in an update of its Guideline for Diet and Physical Activity for Cancer Prevention, the first since 2012.

That guideline recommends “it is best not to drink alcohol,” as previously reported by Medscape Medical News, although it also included the previous recommendation, that men should limit their daily intake to two drinks and women to one drink.

“Guidelines are based on the best available data, but risk does depend on many things, including underlying susceptibility,” Columbia’s Terry told Medscape Medical News. Emerging epidemiological data indicates that independent of daily alcohol consumption, binge drinking may be associated with increased risk of some common cancers, such as breast cancer.

“Alcohol metabolites are known carcinogens. It may be easier to convey a public health message focused on the harmful effects of binge drinking than in a specific daily amount,” Terry said.

Until then, evidence is growing for another disturbing trend: increased alcohol consumption to cope with the SARS-CoV-2 pandemic. Last spring, with many parts of the country in lockdown, 14% of Americans who participated in a national survey said they were drinking significantly more alcohol compared with the same time in 2019. As previously reported by Medscape Medical News, the results showed these increases were most evident in adults aged 30-59, women, and non-Hispanic Whites.

“Alcohol consumption can have significant negative health consequences, so this information suggests another way that the pandemic may be affecting the physical and mental health of Americans,” lead investigator Michael Pollard, PhD, sociologist at the RAND Corporation, said at the time.

More recently, a commentary for Medscape Medical News by F. Perry Wilson, MD, Yale School of Medicine in New Haven, Connecticut, also highlighted increased drinking. Published in the American Journal of Drug and Alcohol Abuse, a survey of 1928 affluent Americans who sheltered in place for an average of 4 weeks showed 60% who self-identified as binge drinkers reported significantly increasing their alcohol intake, as did about 30% of nonbinge drinkers. Depression was the only common factor statistically linked to increased drinking among binge drinkers.

“I think we need to consider that increased alcohol abuse is a potential harm of the social isolation that COVID-19 has forced upon us,” Wilson commented.

And what about physicians? Are they drinking more during the pandemic?

Apparently not. Nearly half of the 12,000 physicians surveyed for Medscape’s Physician Lifestyle & Happiness Report 2021 said they consume less than one drink of alcohol per week and 24% who said they never touch the stuff.

The study was funded by the ACS. Islami and colleagues were all employed by the ACS at the time of the study. The study authors and Terry have also reported no relevant financial relationships.

Cancer Epidemiol. Published online January 19, 2021. Abstract

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University of Cincinnati research unveils possible new combo therapy for head and neck cancer

Source: www.eurekalert.org
Author: Research News, University of Cincinnati

Head and neck cancer is the sixth most common cancer worldwide, and while effective treatments exist, sadly, the cancer often returns.

Researchers at the University of Cincinnati have tested a new combination therapy in animal models to see if they could find a way to make an already effective treatment even better.

Since they’re using a Food and Drug Administration-approved drug to do it, this could help humans sooner than later.

These findings are published in the journal Cancer Letters.

Christina Wicker, PhD, a postdoctoral fellow in the lab of Vinita Takiar, MD, PhD, led this research which she says will hopefully extend the lives of patients one day.

“Head and neck cancer, like any cancer, is truly life-altering,” she says. “Head and neck cancer could impact your throat, tongue or nose, and patients often can’t swallow, talk or eat; it truly takes away some of the most social, enjoyable parts of life.”

Researchers in this study combined radiation therapy with a drug (telaglenastat) that stops a key enzyme in a cell pathway that becomes altered in cancer cells, causing those cells to grow rapidly and resist treatment. Wicker says this drug has already been studied in multiple clinical trials to see if it could improve treatment of various cancers.

“Until now, no one has examined if this drug has the potential to improve radiation treatment in head and neck cancer. Most importantly, this drug compound has been well tolerated by patients and causes minimal side effects,” she says.

Using animal models, researchers found that the drug alone reduced the growth of head and neck cancer cells up to 90%, and it also increased the efficacy of radiation in animals with head and neck tumors by 40%.

“With these results, and especially with previous clinical trials showing that the drug is well tolerated by patients, there is the potential to move more rapidly into head and neck cancer clinical trials,” Wicker says. “In the future, we hope this drug will be used to make radiation treatments for head and neck cancer even more effective.”

Currently, the most common treatment for that cancer is radiation therapy, but the cancer eventually returns in up to half of patients, Wicker says, and often it doesn’t respond as positively to treatment the second time around.

“When [traditional] drugs are less effective, cancer growth becomes difficult to control, which can lead to the cancer quickly spreading to other organs,” she says. “It is very important that scientists and clinicians develop new cancer treatments to improve treatment of this type of cancer, and hopefully our findings will provide one more option to help patients.”

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Research applies Raman spectroscopy to oral cancer diagnostics

Source: www.photonics.com
Author: staff

According to research from the University Medical Center Hamburg-Eppendorf, Raman spectroscopy may provide early detection of oral squamous cell carcinoma. One of the most common cancers, oral squamous cell carcinoma is often undetected until a late stage.

Currently, clinically apparent, conspicuous mucosal lesions of the oral cavity require initial conservative treatment and monitoring. If they persist, surgical biopsy is used to make a diagnosis.

“Our study shows the potential of Raman spectroscopy for revealing whether a lesion is cancerous in real time,” said research team leader Levi Matthies. “Although it won’t replace biopsies any time soon, the technique could help reduce the lapse of valuable time as well as the number of invasive procedures.”

The researchers used a variation of Raman spectroscopy known as SERDS (shifted excitation Raman difference spectroscopy), which is capable of analyzing tissues that exhibit strong background fluorescence. To test the method, they designed a compact and portable Raman sensor consisting of a tunable diode laser, a fiber-coupled spectrometer, and a Raman probe. The scientists used the device to analyze unlabeled biopsy samples from 37 patients at 180 measurement locations.

To classify the raw data, the team trained and tested computer models, ultimately distinguishing oral squamous cell carcinoma from nonmalignant lesions with an accuracy of over 88%, and from healthy tissue with an accuracy of over 89%. The majority of spectral features used to distinguish malignant and nonmalignant lesions came from protein and nucleic acid molecules.

“Our results show that this approach is a promising candidate for objective, chair-side diagnosis of oral cavity lesions in real time without the addition of labeling agents,” Matthies said. “It could help reduce the diagnostic gap between clinical exam and invasive biopsy.”

With further development, the researchers say the approach could be expanded to aid in the classification of precancerous conditions, grading the severity of dysplastic tissue aberration and distinguishing various oral lesion subtypes. Currently, the researchers are working to increase the speed of the method to support real-time diagnosis.

The research was published in Biomedical Optics Express (www.doi.org/10.1364/BOE.409456).

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Top cancer surgeon urges public to get mouth ulcers checked

Source: www.dentistry.co.uk
Author: staff

A top cancer surgeon is calling on people with mouth ulcers and neck lumps to get their symptoms checked. This follows fears from dentists that mouth cancer cases may have gone undetected as a result of the COVID-19 pandemic. Despite the fact that a new international study suggests patients undergoing surgery for head and neck cancers are at no extra risk when it comes to COVID-19 transmission.

Professor Richard Shaw is a consultant and head and neck cancer surgeon at Liverpool University Hospitals NHS Foundation Trust.

He is calling on the public to act fast if they notice any symptoms. These include neck lumps, mouth ulcers, mouth or throat lumps, difficulty swallowing and a hoarse voice.

Don’t delay
‘We know that it can be scary to come to a hospital or any healthcare setting at the moment. People are putting off that trip to the GP and waiting that bit longer to see if their symptoms go away,’ he said.

‘The findings of this study are really important because we can now assure people who need head and neck cancer surgery that it is safe, even during the pandemic.’

He added: ‘Time is of the essence with head and neck cancer. The sooner it is diagnosed the sooner we can treat it – and if we catch it early then the curative surgery required is much less invasive.

‘My message to anyone concerned about symptoms is to get them looked at by a health professional without delay. It could make all the difference.’

Drop in mouth cancer referrals
Last year, data from the Oral Health Foundation revealed oral cancer referrals have dropped 33% since the pandemic hit.

The number of patients referred for possible mouth cancer fell dramatically from the 2,257 in the six months before March 2020. In the six months after, the figure dropped to just 1,506.

Six out of the seven NHS trusts analysed witnessed a drop in referrals during this same period.

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Timing and intensity of oral sex may affect risk of oropharyngeal cancer

Source: www.eurekalert.org
Author: Research News

Human papillomavirus (HPV) can infect the mouth and throat to cause cancers of the oropharynx. A new study published early online in CANCER, a peer-reviewed journal of the American Cancer Society, has found that having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer. The study also shows that having oral sex at a younger age and more partners in a shorter time period (oral sex intensity) were associated with higher likelihoods of having HPV-related cancer of the mouth and throat.

Previous studies have shown that performing oral sex is a strong risk factor for HPV-related oropharyngeal cancer. To examine how behavior related to oral sex may affect risk, Virginia Drake, MD, of Johns Hopkins University, and her colleagues asked 163 individuals with and 345 without HPV-related oropharyngeal cancer to complete a behavioral survey.

In addition to timing and intensity of oral sex, individuals who had older sexual partners when they were young, and those with partners who had extramarital sex were more likely to have HPV-related oropharyngeal cancer.

“Our study builds on previous research to demonstrate that it is not only the number of oral sexual partners, but also other factors not previously appreciated that contribute to the risk of exposure to HPV orally and subsequent HPV-related oropharyngeal cancer,” said Dr. Drake. “As the incidence of HPV-related oropharyngeal cancer continues to rise in the United States, our study offers a contemporary evaluation of risk factors for this disease. We have uncovered additional nuances of how and why some people may develop this cancer, which may help identify those at greater risk.”

Full Citation:
“Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer.” Virginia E. Drake, Carole Fakhry, Melina J. Windon, C. Matthew Stewart, Lee Akst, Alexander Hillel, Wade Chien, Patrick Ha, Brett Miles, Christine G. Gourin, Rajarsi Mandal, Wojciech K. Mydlarz, Lisa Rooper, Tanya Troy, Siddhartha Yavvari, Tim Waterboer Nicole Brenner, David W. Eisele, and Gypsyamber D’Souza. CANCER; Published Online: January 11, 2021 (DOI: 10.1002/cncr.33346).

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