Mouth cancer in the UK at record high

Source: www.hippocraticpost.com
Author: staff

New cases of mouth cancer in the UK have risen to a record high, according to the findings of a new report.

  • New figures show there have been 8,722 new cases of mouth cancer in the UK last year.
  • This is an increase of 58% compared to ten years ago and 97% compared to 20 years ago.
  • Data released in a new report to coincide with November’s Mouth Cancer Action Month.

Figures collected by the Oral Health Foundation show that 8,722 people in the UK were diagnosed with the disease last year, increasing by 97% since 2000.

Mouth cancer cases in the UK have soared for the 11th year in a row and have more than doubled within the last generation.

The findings are part of the charity’s new State of Mouth Cancer UK Report 2020/21 and have been released to coincide with November’s Mouth Cancer Action Month.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, believes with mouth cancer cases continuing to rise, more must be done to raise awareness of the disease.

Dr Carter says: “While many cancers are seeing a reduction in the number of people affected, mouth cancer is one of very few that is sadly going the other way. Established risk factors like smoking and excessive alcohol have been joined by emerging causes like the human papillomavirus (HPV). This has changed the profile of the disease quite considerably over recent years and mouth cancer can now affect anybody.

“The disease can have a devastating and lasting effect on a person’s life. It can change how somebody speaks, it makes eating and drinking more difficult, and often leads to changes to a person’s physical appearance. Because of this, it also takes a heavy toll on a person’s mental health too.

“One of the biggest challenges we face regarding mouth cancer is how little educational support it receives from government and public health bodies. As part of Mouth Cancer Action Month, we will be working with thousands of organisations to improve awareness of the disease so that more people are able to recognise the early warning signs.”

Statistics from governing health bodies across the UK show around two-in-three (67%) mouth cancers are recorded in men while three-in-four (78%) are in the over 55’s.

Mouth cancer is most likely to occur in the tongue, contributing to more than one-in-three (34%) cases. Mouth cancer can also appear in the tonsils, the roof and floor of the mouth, lips and gums.

The early warning signs of the disease include mouth ulcers that do not heal within three weeks, red or white patches in the mouth, or unusual lumps and swellings. Persistent hoarseness could also be a symptom.

Dr Catherine Rutland, Clinical Director at Denplan, part of Simplyhealth, speaks about the importance of knowing how to spot mouth cancer early and acting quickly if you notice anything out of the ordinary.

Dr Rutland says: “Self-checks and regular dental visits are extremely important for spotting mouth cancer in its initial stages, yet public awareness of mouth cancer actually remains very poor – around 3 out of 4 people said they did not know what the symptoms of mouth cancer are in the Oral Health Foundation’s latest research. Many mouth cancer cases are caught far too late. For a significant proportion of patients, a delay of three to six months in diagnosis and treatment will affect the likelihood of achieving long-term survival.

“Be ‘mouthaware’ and alert to any unusual changes to the mouth, head or neck. Mouth ulcers lasting more than three weeks, unexplained persistent lumps, red patches and white patches are all signs that should be checked by a dentist. If you notice anything out of the ordinary, don’t wait. Book an appointment with your dentist so that they can examine you.

“For Mouth Cancer Action Month this November, make sure you know the basics. Learn how to perform a quick self-check (visit mouthcancer.org), know what to look for and where mouth cancer occurs. By doing this, you give yourself the best possible chance of overcoming mouth cancer.”

Roy Templeton (59) from Beauly, Inverness, was diagnosed with mouth cancer of the tonsils. Now given the all clear, Roy says his experience of mouth cancer will never leave him.

Roy says: “Although I had heard of mouth cancer, I wasn’t aware how terribly common it was, and I didn’t know anybody personally who had had it. Any conversations I’d heard about people with mouth cancer had given me the impression it happens to much older people and especially those who heavily drank or smoke. I didn’t smoke and I was a moderate drinker, so the diagnosis really came as a shock.

“Going through cancer treatment had a big effect on me mentally. It crystallised in my own mind that life is quite precious. When it comes to opportunities arising in your life, either in work or your personal life, you want to grab every moment more than ever before.

“I was quite fortunate that I went to my GP early when I found something not right. If you have any inkling something is wrong, I would urge you to get it looked at. Getting checked out early could save your life.”

Spotting mouth cancer early is crucial for beating the disease. Early detection boosts the chances of survival from 50% to 90% while also dramatically improving a person’s quality of life.

Sadly, far too many mouth cancers are caught in the late stages of the disease. Latest annual reports show mouth cancer claims 2,702 lives a year, which on average is one person every hour.

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2020-11-04T11:53:47-07:00November, 2020|Oral Cancer News|

Breath analysis for effective detection of cancer

Source: washingtonnewsday.com
Author: Jonathan Edwards

By analyzing a breath sample, it seems possible to successfully identify different types of cancer, according to the results of the new study involving researchers from Flinders University. The study was published in the English language journal British Journal of Cancer.

Researchers have now made significant progress in developing a breath analysis to detect cancer. The new method has made it possible to effectively identify cancer of the head and neck.

Six percent of all cancers worldwide are head and neck cancers, which kill more than 300,000 people every year. Tobacco, alcohol and poor oral hygiene are known major risk factors for this form of cancer. The increase in head and neck cancer is associated with human papilloma virus (HPV) and also affects younger population groups, the research team continued.

Current therapies are effective in treating early-stage disease, but such diseases are often detected in the late stages and are often associated with a poorer prognosis and high morbidity. It is therefore important to identify dangerous diseases such as head and neck cancer as quickly as possible.

Cancers of the neck and head are widespread

The global effort to use a person’s breath analysis for fast, inexpensive and accurate testing for cancer and other early-stage diseases could take a big step forward with the new method.

For the study, breath samples were taken from 181 people suspected of having early head and neck squamous cell carcinoma. By examining exhalation profiles, the newly developed method made it possible to differentiate precisely between people with head and neck cancer and non-cancer patients, the researchers report.

“We were trying to determine the diagnostic accuracy of breath analysis as a non-invasive test for detecting head and neck cancer, which over time may lead to a simple method to improve treatment outcomes and patient morbidity,” the experts explain in a press release from Flinders University.

Detect cancer through a breath test?

In the future, the researchers hope to test the new method in primary care facilities such as family doctor’s offices in order to effectively develop the test for early detection. (as)

The new breath test has an average sensitivity and specificity of 85 percent when it comes to differentiating between people with cancer and people in the control group with a benign disease. The diagnosis was then verified by analyzing tissue biopsies, the team explained.

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Thousands of Britons with deadly mouth cancer will be spared gruelling chemotherapy thanks to immune-boosting drug

Source: www.dailymail.co.uk
Author: Eve Simmons for The Mail on Sunday

Thousands of Britons with deadly mouth cancer will now be spared grueling chemotherapy thanks to an immune-boosting drug. The treatment, given the green light by health chiefs last week, offers fresh hope to patients whose cancer has either spread or deemed inoperable.

Currently, these patients have two options to prolong their life – chemotherapy and weekly infusions of potent cancer drugs, which often leave patients debilitated and confined to bed for the short time they have left. But now immunotherapy drug pembrolizumab can help some patients with the disease live up to 30 per cent longer than they would with chemotherapy, with 50 per cent fewer side effects.

Last week’s ruling by UK health watchdog NICE, which was based on the results of final-stage international trials, permits the treatment not only for advanced mouth cancer but also cancers of the nose, sinuses and salivary glands, known collectively as head and neck cancers.

Doctors must first test patients’ tumours for a protein called PD-L1, which limits the immune system’s ability to find and destroy the cancer.

Immunotherapy drugs such as pembrolizumab blocks PD-L1, helping the body’s fighter cells to attack tumours.The majority of people with advanced head and neck cancer will test positive for PD-L1.

Roughly 12,000 Britons are diagnosed with these cancers every year – mostly men over the age of 70. In the majority of cases, head and neck cancers are spotted at a late stage as they are often mistaken for other less serious conditions. By the time they are diagnosed, the cancer has spread to other nearby tissues and prognosis is poor, with many surviving just six months.

Researchers from the Institute of Cancer Research who trialled the new drug discovered that some patients lived for more than a year following pembrolizumab treatment. Pembrolizumab is already used widely on the NHS to treat skin, bladder and small cell lung cancers.

Professor Kevin Harrington, consultant clinical oncologist at The Royal Marsden Hospital in London, welcomed the decision. He said: ‘Pembrolizumab can improve survival, while avoiding some of the most challenging side effects.’

Prof Harrington said he was ‘disappointed’ that health chiefs did not extend approval for combination therapy – using pembrolizumab alongside chemotherapy, which is shown to have the most significant impact on survival.

He remains ‘hopeful’ that NICE may go further and fund combination therapy in the future, for those whom it is appropriate.

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Oral cancer pain linked to disease spread

Source: www.docwirenews.com
Author: Robert Dillard

Oral cancer is more likely to spread in patients who experience high levels of pain, according to a study published in the journal Scientific Reports.

When oral cancer spreads to lymph nodes in the neck, a patient’s chance of survival is cut by half, the researchers noted. However, it’s often unclear through imaging and physical assessment if oral cancer has spread, leaving surgeons struggling with whether to preemptively perform prophylactic neck dissection to remove the cancer when research shows that up to 70% are unnecessary.

Researchers documented the pain experienced by 72 oral cancer patients before surgery by way of an oral cancer pain questionnaire developed by the investigators. While most patients reported some pain, researchers observed that patients with the most pain were more likely to have cancer that spread to lymph nodes in the neck. This observation suggests that patients with less pain are at low risk of metastasis, and will rarely benefit from a neck dissection.

“I have been investigating the underlying cause of oral cancer pain for two decades. This is the first time that we have demonstrated a correlation between a patient’s pain and the clinical behavior of the cancer,” said Brian L. Schmidt, DDS, MD, PhD, director of the NYU Oral Cancer Center and one of the study’s authors via a press release.

Aditi Bhattacharya, PhD, an assistant professor in the Department of Oral and Maxillofacial Surgery at NYU College of Dentistry added: “While we need to undertake a follow-up study, our current data reveal that a patient’s pain intensity score works as well as the current method–depth of invasion, or how deeply a tumor has invaded nearby tissue–as an index to predict metastasis.”

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With 3 new movies on the horizon, Val Kilmer is an inspiration to anyone facing cancer

Source: www.survivornet.com
Author: staff

Val Kilmer, 60, is stepping back into Hollywood in full force. The actor took a hiatus from the red carpet after his battle with throat cancer, but now it’s clear he doesn’t plan to stop again.

Kilmer has been recently cast in upcoming biopic Canyon Del Muerto, following the real-life story of Ann Axtell Morris — one of America’s first female archeologists and leading discoverers of North America’s primary civilizations in Arizona. So far, it’s unclear what character Kilmer will be portraying, but we have no doubt he’ll rise to the occasion. He took a hiatus from acting due to his battle with throat cancer a few years back, but now he’s back and taking on new roles.

In addition to the biopic, Kilmer is preparing for the long anticipated Top Gun sequel, Top Gun: Maverick. The film is set to premiere in July 2021, and Kilmer will be reprising his role as iconic Admiral Tom “Iceman” Kazansky. Additionally, he’ll be starring alongside his daughter Mercedes in Pay Dirt, set to release in October. It’s so nice to see Kilmer return to the big screen, since before his throat cancer diagnosis, he was known as quite the Hollywood heartthrob.

His hiatus from acting is likely due to the side-effects he suffered as a result of his tracheotomy — a surgical procedure that connects the windpipe to a hole in the front of the neck. This is a common part of treatment for throat cancer patients, but as a result of the procedure, Kilmer’s voice has been significantly impaired. Initially, Kilmer kept his battle with throat cancer private, but after a lot of speculation from fans, he eventually shared his journey in 2017.

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Smell of a person’s breath may help identify early cancers

Source: www.theweek.in
Author: staff

Cancer researchers from Flinders University have reported significant progress in developing a method to test exhaled breath profiles which accurately differentiate head and neck cancer from non-cancer patients.

Previous studies elsewhere have indicated that the exhaled breath condensate can reveal gene mutations or DNA abnormalities in patients with lung cancer.

The global quest to use a person’s breath analysis for rapid, inexpensive and accurate early-stage testing for cancer and other diseases has taken a leap forward.

The Australian researchers collected breath samples from 181 patients suspected of having early-stage head and neck squamous cell carcinoma (HNSCC) before any treatment began.

“We sought to determine the diagnostic accuracy of breath analysis as a non-invasive test for detecting head and neck cancer, which in time may result in a simple method to improve treatment outcomes and patient morbidity,” says lead researchers Dr Roger Yazbek and Associate Professor Eng Ooi.

Worldwide, head and neck cancer accounts for 6 percent of all cancers, killing more than 300,000 people per year globally. Tobacco, alcohol and poor oral hygiene are known major risk factors for this cancer.

A surge in human papilloma virus (HPV)-associated head and neck cancers is seeing these cancers affecting a much younger population, the researchers say.

Current therapies are effective at treating early-stage disease, however late-stage presentations are common, and often associated with poor prognosis and high treatment-related morbidity.

In the Australian study, a selected ion flow-tube mass spectrometer was used to analyse breath for volatile organic compounds. Using statistical modelling, the Flinders researchers were able to develop a breath test that could differentiate cancer and control (benign disease) patients, with an average sensitivity and specificity of 85 percent.

Diagnosis was confirmed by analysis of tissue biopsies.

“With these strong results, we hope to trial the method in primary care settings, such as GP clinics, to further develop its use in early-stage screening for HNSCC in the community,” says co-lead author Dr Nuwan Dharmawardana.

The study has been published in the British Journal of Cancer.

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Cancer drug for photoimmunotherapy approved: Japan approves drug used in new treatment

Source: www3.nhk.or.jp
Author: press release

A drug for a new cancer treatment called photoimmunotherapy has been granted government approval for the first time. Japan’s government approved the drug last week to treat head and neck cancers, which are difficult to treat with other methods.

US National Institutes of Health researcher Kobayashi Hisataka, who created the method, and Rakuten Medical, which developed the drug, held a news conference in Tokyo on Tuesday.

Photoimmunotherapy involves a combination of a drug that uses antibodies to target cancer cells and chemicals that react to light.

The drug is administered intravenously, and is activated when the patient’s body is illuminated with near-infrared laser light, killing cancer cells.

Kobayashi said he’s overjoyed that the method he’s been engaged in for decades was approved in Japan, and hopes it will be another option for cancer treatment.

Rakuten Medical Chairman Mikitani Hiroshi said he believes the method can be combined with chemotherapy, and hopes to use it to treat patients as soon as possible.

Procedures are to be carried out so that use of the drug is covered by insurance. Since the drug was approved quickly, its safety and effectiveness will continue to be assessed after it goes onto the market.

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2020-09-30T05:30:04-07:00September, 2020|Oral Cancer News|

A deep learning algorithm for detection of oral cavity squamous cell carcinoma from photographic images: a retrospective study

Source: www.thelancet.com
Authors: Qiuyun Fu et al.

Abstract

Background:
The overall prognosis of oral cancer remains poor because over half of patients are diagnosed at advanced-stages. Previously reported screening and earlier detection methods for oral cancer still largely rely on health workers’ clinical experience and as yet there is no established method. We aimed to develop a rapid, non-invasive, cost-effective, and easy-to-use deep learning approach for identifying oral cavity squamous cell carcinoma (OCSCC) patients using photographic images.

Methods:
We developed an automated deep learning algorithm using cascaded convolutional neural networks to detect OCSCC from photographic images. We included all biopsy-proven OCSCC photographs and normal controls of 44,409 clinical images collected from 11 hospitals around China between April 12, 2006, and Nov 25, 2019. We trained the algorithm on a randomly selected part of this dataset (development dataset) and used the rest for testing (internal validation dataset). Additionally, we curated an external validation dataset comprising clinical photographs from six representative journals in the field of dentistry and oral surgery. We also compared the performance of the algorithm with that of seven oral cancer specialists on a clinical validation dataset. We used the pathological reports as gold standard for OCSCC identification. We evaluated the algorithm performance on the internal, external, and clinical validation datasets by calculating the area under the receiver operating characteristic curves (AUCs), accuracy, sensitivity, and specificity with two-sided 95% CIs.

Findings:
1469 intraoral photographic images were used to validate our approach. The deep learning algorithm achieved an AUC of 0·983 (95% CI 0·973–0·991), sensitivity of 94·9% (0·915–0·978), and specificity of 88·7% (0·845–0·926) on the internal validation dataset (n = 401), and an AUC of 0·935 (0·910–0·957), sensitivity of 89·6% (0·847–0·942) and specificity of 80·6% (0·757–0·853) on the external validation dataset (n = 402). For a secondary analysis on the internal validation dataset, the algorithm presented an AUC of 0·995 (0·988–0·999), sensitivity of 97·4% (0·932–1·000) and specificity of 93·5% (0·882–0·979) in detecting early-stage OCSCC. On the clinical validation dataset (n = 666), our algorithm achieved comparable performance to that of the average oral cancer expert in terms of accuracy (92·3% [0·902–0·943] vs 92.4% [0·912–0·936]), sensitivity (91·0% [0·879–0·941] vs 91·7% [0·898–0·934]), and specificity (93·5% [0·909–0·960] vs 93·1% [0·914–0·948]). The algorithm also achieved significantly better performance than that of the average medical student (accuracy of 87·0% [0·855–0·885], sensitivity of 83·1% [0·807–0·854], and specificity of 90·7% [0·889–0·924]) and the average non-medical student (accuracy of 77·2% [0·757–0·787], sensitivity of 76·6% [0·743–0·788], and specificity of 77·9% [0·759–0·797]).

Interpretation:
Automated detection of OCSCC by deep-learning-powered algorithm is a rapid, non-invasive, low-cost, and convenient method, which yielded comparable performance to that of human specialists and has the potential to be used as a clinical tool for fast screening, earlier detection, and therapeutic efficacy assessment of the cancer.

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2020-09-24T13:41:39-07:00September, 2020|Oral Cancer News|

Deadly Spread of Some Cancers May Be Driven by a Common Mouth Microbe

Source: Scientific American
Author: Claudia Wallis
Image courtesy of Fatinha Ramos

When people hear that they might have cancer, perhaps the only thing more frightening than the C word is the M word. Metastatic disease—in which the malignancy has traveled beyond its primary site to other spots in the body—is responsible for nine out of every 10 cancer deaths.

Recently an unexpected player in this process has emerged: a common bacterium. Fusobacterium nucleatum, which normally lives harmlessly in the gums, appears to have a role in the spread of some cancers of the colon, esophagus, pancreas and—possibly—breast. Laboratory studies and evidence in patients indicate that the microbe can travel through the blood and infect tumor cells by attaching to a sugar molecule on their surface. There it provokes a range of signals and immune responses known to cause tumor cells to migrate. If further confirmed, the work with F. nucleatum could add to a growing understanding of how the microbiome influences cancer progression and may even point the way to fresh approaches to treatment.
In a healthy human mouth, F. nucleatum is a law-abiding member of the microbial community. With poor dental hygiene, uncontrolled diabetes and other conditions, however, it can go rogue and cause periodontitis, tonsillitis, appendicitis and even preterm labor. A connection to colorectal cancer was first hinted at about nine years ago, when two research groups discovered that the bacterium’s DNA was overrepresented in colon tumor tissue compared with normal tissue. Dozens of studies have since found that the infection in tumor cells is a sign of trouble: it is linked to a poorer prognosis in patients with pancreatic, esophageal or colorectal cancer; resistance to chemotherapy in the latter two groups; and metastasis in colorectal cancer, which is the world’s third most common and second most deadly malignancy.

Still, the question remained: Is this bug merely a warning sign, or is it an active participant in cancer progression? This year at least three studies of colon cancer, by separate teams, pointed to an active role. “We reached the same conclusion through different pathways,” says biochemist Daniel Slade of Virginia Tech. Slade and his colleagues found that when cultured human colon tumor cells were invaded by the bacterium, they produced two inflammatory proteins called cytokines—specifically, interleukin-8 and CXCL1—that have been shown to promote the migration of malignant cells, a step in metastasis. A second paper reported that the bacterium induces changes in gene regulation that boost metastasis to the lungs in mice. A third study determined that the abundance of F. nucleatum in human colon cancer tissue correlates with the amount of metastases and, in mice, identified additional signals by which the microbe may “orchestrate” metastasis. Slade and others have also demonstrated that the bacterium incites a kind of cytokine storm that is aimed at controlling the infection but that ultimately exacerbates the cancer. “It’s like throwing gas on an already lit fire,” Slade says.

Something similar may be going on in some breast tumors. In June a team led by microbiologist Gilad Bachrach of Hebrew University reported finding F. nucleatum DNA in 30 percent of the human breast cancer tissue examined; the bacterium was most common in cancer cells that expressed a lot of the surface sugar molecule Gal/GalNAc. Researchers also showed that the infection promotes growth of both primary tumors and metastases in mouse models of breast cancer. “The data imply that fusobacterium is not a cause of cancer, but it can accelerate progression,” Bachrach says.

How much this is happening in humans is, of course, a critical question. “The findings are intriguing, and it makes sense,” says Joan Massagué of Memorial Sloan Kettering Cancer Center, who is a leading investigator of metastasis. Inflammation is invariably part of the metastatic process, he says, so an infection that incites a dramatic inflammatory reaction in a tumor will have a consequence: “it helps cancer cells engage in mobile, invasive behavior.”

The discoveries about fusobacterium are part of a fast-moving field that is illuminating the way the microbiome both promotes and battles cancer. Many modern immunotherapy drugs, for instance, work best in the presence of beneficent microbes—as do some older chemotherapies. Some scientists envision that fusobacterium eventually could be turned into a cancer fighter. Given the microbe’s attraction to a sugar on tumor cells, they suggest, perhaps it could be deployed as a Trojan horse, bound to cancer drugs and carrying them straight to a malignant target.

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2020-09-24T11:24:02-07:00September, 2020|Oral Cancer News|

FDA clears IND application for cell therapy to treat radiotherapy-induced dry mouth

Source: www.healio.com
Author: staff

The FDA cleared an investigational new drug application for a mesenchymal stromal cell therapy to treat radiotherapy-induced xerostomia, also known as dry mouth.

Researchers at University of Wisconsin Carbone Cancer Center developed the therapy, which uses the patient’s interferon-gamma activated marrow stromal cells.

Xerostomia is a one of the most common adverse effects of radiation therapy for head and neck cancers and may cause difficulties eating, speaking and sleeping, in addition to oral health complications.

“There is a critical need for improved treatments for this condition,” Randy Kimple, MD, PhD, associate professor of human oncology at University of Wisconsin School of Medicine, said in a press release. “For most patients, the best care we can provide currently is to encourage them to eat specially prepared food, suck on hard sugar-free candies and carry a water bottle with them all day.”

Kimple told Healio the therapy process involves the patient undergoing a bone marrow biopsy to harvest mesenchymal stromal cells.

Kimple — who will lead the forthcoming phase 1 trial for the therapy — said the cells will be prepared by the Program for Advanced Cell Therapy’s lab at UW Health’s University Hospital. Patients will receive the therapy via injection into the submandibular gland after completion of radiation therapy.

The phase 1 trial soon will begin enrolling up to 30 patients and will be conducted by University of Wisconsin School of Medicine and Public Health as a single-center study of patients treated at Carbone Cancer Center.

Study participants will be monitored for safety and development of adverse effects after receiving the cell therapy injection.

“Patients will also provide samples of their saliva and complete quality-of-life questionnaires to help determine if the treatment is effective,” Kimple said.

Researchers hope to complete the first phase of the trial within a year, according to Kimple.

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2020-09-12T10:26:52-07:00September, 2020|Oral Cancer News|
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