Oral cancer test’s value unproven

Source: Boston.com Author: Neil Munshi The usual dental checkup goes something like this: lean back, open wide, avoid flinching, rinse, spit. But in addition to looking for cavities, dentists are increasingly checking for oral cancer, too - and not just by peering and probing. A relatively new screening tool allows dentists to better gauge whether a patient is in the early stages of oral cancer by looking at the mouth under a special light. But the test may be overused, and it's not yet clear whether it justifies its price tag. A review of studies of the devices published in this month's Journal of the American Dental Association concluded that for low-risk patients, there is "insufficient evidence to support or refute the use of visually based examination" devices, such as the ViziLite. Still, roughly 10 to 15 percent of the 100,000 practicing dentists in the United States offer ViziLite or a similar scan, which some credit with helping them better identify lesions in the mouth than simply looking with the naked eye. "Frankly, I've seen stuff I would normally just have glossed over and it doesn't hurt to take a second look . . . at something that might not normally be looked at - that might save somebody's life," said Dr. Anjum A. Ansari, a downtown Boston dentist, who charges her patients $80 for the service. Insurance has only covered the scan for one of her patients, Ansari said. That $80 is the test's only actual advantage, said Dr. [...]

Has Cancer Spread? Research Identifies Best Way to Find Answers

Source: Newswise (www.newswise.com) Author: staff For patients with head and neck cancer, accurately determining how advanced the cancer is and detecting secondary cancers usually means undergoing numerous tests – until now. New Saint Louis University research has found that the PET-CT scanner can be used as a stand-alone tool to detect secondary cancers, which occur in 5 to 10 percent of head and neck cancer patients. The study findings, which will be presented on Tuesday, July 22 at the 7th International Conference on Head and Neck Cancer in San Francisco, Calif., will streamline care for head and neck cancer patients allowing them to begin treatment earlier, says Michael Odell, M.D., assistant professor of otolaryngology at Saint Louis University School of Medicine. “There has been a lot of confusion about the best ways to evaluate head and neck cancer patients to see if their cancer has spread,” said Odell, the study’s primary author. “Traditionally, doctors used many different tests, such as chest X-rays, CT scans, ultrasounds, bone scans and blood work. Patients went through too many unnecessary procedures because there was no real consensus on the best way to evaluate them.” According to Odell, when choosing the appropriate treatment plan for head and neck cancer patients, it is critical to accurately stage the primary cancer and detect secondary cancers. Odell’s research shows PET-CT scanning can replace all the other traditional tests. Using the PET-CT scanner is not just a time saver, though; it also can be a life-saver. “We all know [...]

Smile — Benefits Improve

Source: Wall Street Journal (online.wsj.com) Author: M.P. McQueen At a time when workers are shouldering an ever-greater share of health-insurance costs, some insurers surprisingly are increasing benefits in dental plans. A growing number of plans are rewarding patients who get regular preventive care by allowing them a higher maximum yearly allowance. More plans are paying for services that were formerly excluded, including tooth bleaching and dental implants to replace missing teeth. And more plans also are covering additional cleanings or gum treatments for patients who are pregnant or have chronic health conditions. The new features are showing up in employer-provided group plans and some are finding their way even into individual plans. A Way to Fight Disease Experts say the enhanced preventive care is aimed at reducing overall employer health costs by reducing the prevalence of serious disease. A growing number of studies have linked gum disease to such conditions as pre-term births, diabetes and heart disease, although the relationship is not always well understood by science. (All dental plans aren't available in all areas, however, and some of the new features are included only if an employer chooses to offer them.) Delta Dental of California, New York and Pennsylvania and Affiliates, one of the largest dental plans in the U.S., recently introduced a plan that doesn't count diagnostic and preventive care toward the annual maximum. That enables patients to conserve more of their annual benefits allowance, usually capped at $1,500 to $2,500, for such big expenses as bridges and [...]

Quality of life in patients treated for cancer of the oral cavity requiring reconstruction: a prospective study

Source: Acta Otorhinolaryngol Ital, June 1, 2008; 28(3): 120-5 Authors: AB Villaret et al. Surgical treatment for cancer of the oral cavity can result in dramatic aesthetic and functional sequelae partially avoidable by reconstructive techniques. Many studies concerning quality of life have been carried out in order to retrospectively assess outcomes after such major oncological procedures. Aim of this study was to evaluate, in a prospective fashion, the quality of life as a primary endpoint in patients treated for cancers involving the oral cavity and requiring reconstruction. The study design consisted of a prospective evaluation of pre- and post-operative quality of life at 3, 6, and 12 months to assess variations during follow-up using two different questionnaires: the University of Washington Quality of Life and the Head and Neck Performance Status Scale. Between May 1999 and October 2004, 92 patients with oral cancer requiring reconstruction were treated. All were included in the study, but only 35 (38%) concluded the evaluation protocol at one year after surgery without evidence of disease. The mean pre- and post-operative (3, 6, and 12 months) scores of the questionnaires and the scores of specific University of Washington Quality of Life categories (disfigurement, chewing, swallowing, comprehension of speech) were evaluated. The impact on residual quality of life of different factors such as gender, extension of tongue and mandibular defects, type of reconstruction, and radiotherapy was statistically quantified with a Wilcoxon non-parametric test and logistic regression for multivariate analysis. Comparison of mean pre- and post-operative scores between [...]

Cancer nurse takes on a special role

Source: ChronicleLive (www.chroniclelive.co.uk) Author: Helen Rae A head and neck cancer nurse specialist has been appointed to offer expertise to those living with cancer in the region. Macmillan Cancer Support has employed new head and neck cancer nurse specialist, Laura Gradwell-Nelson, based at Newcastle’s Freeman Hospital. Laura, 28, of New York, North Shields, will work alongside existing Macmillan head and neck nurse specialist Amanda Dear and will see patients throughout Tyneside and Northumberland. Laura said: “We have a fantastic team working with head and neck patients in the area and I’m delighted to be part of it. “I work with patients who may have lost the ability to speak, eat, drink or even breathe. Some have to deal with facial disfigurement after surgery. “These are complex cases and my job is to try and make life as easy as I can for the patient and their family in what can be an incredibly stressful and frightening time. I try and build a relationship up with the patient because I feel being on the same level is crucial to helping them deal with their cancer. “Amanda and I coordinate the patient’s medical care, such as pain control and managing side effects. “We also spend time listening to their concerns, talking through their options and generally being a point of contact when they need help, advice or are worried about anything. “I also point them to the Macmillan benefits advisers if they need financial help. Throughout my career I’ve always had an [...]

Tobacco: What Is It and Why Do People Continue to Use It?

Source: RedOrbit.com Author: Paul C. Lewis In this issue of Medsurg Nursing, we are fortunate to have an article written by a nursing expert in the areas of tobacco use, addiction, and abstinence. Dr. Lewis provides an overview of the prevalence of tobacco use and the risks of exposure to tobacco and second-hand smoke for both adults and adolescents. He explains the challenges surrounding smoking cessation and encourages abstinence, starting at the grade school level. He concludes by emphasizing that nurses can provide a vital role in addressing this continued public health crisis. Additionally, Web sites that contain valuable information regarding smoking are included. Cigarette smoking among adults has remained at about 20.8% since 2004 (Centers for Disease Control and Prevention [CDC], 2005b). Those most likely to smoke include men, adults less than age 40, and those living below the poverty line. American Indians/ Alaskan Natives smoke at a much higher rate (32.4%) than non- Hispanic Blacks (23.0%), non-Hispanic Whites (21.9%), or Hispanics (15.2%). Cigarette smoking among adolescents has stopped declining since 2005 at a level of 23% (CDC, 2005c, 2005d). Adolescent males and females are equally likely to smoke (22.9% vs. 23.0%), with White adolescents smoking more often (25.9%) than Hispanic (22.0%) or non- Hispanic Black (12.9%) adolescents. While most people recognize the harmful effects of tobacco use, and particularly smoking, few are able to quit easily. Relapse is common among people trying to quit, with up to a 80% relapse rate (U.S. Department of Health and Human Services [...]

Hopkins Doctor Urges Early Diagnosis To Avoid Cancer’s “Forgotten Killer”

Source: Medical, Health News and Articles (03530.com/2008/08/25) Author: staff On average, two Marylanders each day are diagnosed with potentially fatal oral cancers that are often curable if identified and treated early. The Maryland Department of Health and Mental Hygiene’s Office of Oral Health reports that the state ranks in the country’s top 10 for number of deaths caused by oral cancers. Nationally, statistics show that the death rate from these cancers is higher than those of cervical cancer, Hodgkin’s lymphoma, testicular cancer, and thyroid and malignant melanoma. A sore in the mouth that doesn’t heal could be a warning sign of oral cancer, which kills more than 8,000 people a year. Of the 34,000 Americans newly diagnosed with oral cancer annually, only half will be alive in five years. According to the American Dental Association, early diagnosis and treatment could boost that rate to 75 or 80 percent. John O’Brien, 70, who had not smoked a cigarette in 33 years, was adamant about maintaining proper oral hygiene. But, in 2007, O’Brien, a national sales manager for an advertising agency, father of four and a grandfather of five, found a small lump that turned out to be a cancerous tumor at the base of his tongue. After 45 radiation treatments and six chemotherapy sessions, O’Brien says he is grateful to be alive. “I was just in disbelief. Nobody wants to hear that they have cancer,” says O’Brien. “But, for me I was lucky because the doctors caught it quickly.” “Often, oral [...]

Armstrong’s cancer summit puts spotlight on survivors

Source: Columbus Dispath (www.columbusdispatch.com) Author: Misti Crane Surgical scars have begun to fade. Chemo and radiation are a memory. The cancer appears destroyed. “The scariest moment is when all the treatment is over and they close that door,” Jeanette Ferguson said today as she stood outside Ohio State's Mershon Auditorium during a morning break in the Lance Armstrong Foundation's Livestrong Summit. Ferguson is one of a thousand people here this weekend who wants to give voice to a community of millions and sculpt a polished and sound cancer-care network from its uneven and, at times, weak existence. Her cancer bio: oral cancer, 2002, advanced, no known risk factors, treated at the Arthur G. James Cancer Hospital with a protocol so aggressive that only the strongest of patients can withstand its side effects. She was 26 and had a 50-50 chance of living. She is, to use the term so often employed with this disease, a survivor. That idea is taking a new shape. People are talking about what that really means. This morning, former Surgeon General Richard Carmona told delegates to the summit that survivorship is often forgotten. “It's like dropping a citizen in a wilderness without a map or a compass and saying, ‘Find your way out.' ” He and three other surgeons general earlier this week called for invigorated efforts to combat cancer and its fallout. Among those: Former cancer patients should leave treatment with knowledge and resources, with a “survivorship plan.” The thing about survivorship is it [...]

Louisville Researchers Make Breakthrough With HPV

Source: WLKY.com Author: staff Looking at Petri dishes and transferring chemical solutions may not look exciting, but if you understood what doctors Alfred Jenson and Shin-Je Ghim have discovered in doing just that, it could save your life. Now, the same scientists have made another discovery concerning the virus, and it could potentially save nearly 50,000 lives a year. "The reason it's so exciting is because we developed the vaccine for the cervical cancer because 100 percent of cervical cancer is caused by the human papillomavirus," said Jenson. "Now it looks like during the last year, up to 50 percent of head and neck cancers are caused by the human papillomavirus." So having a vaccine that's 100 percent effective against the human papillomavirus means the same vaccine is going to be able to prevent both cervical cancer and head and neck cancer. HPV is known to be transferred by sexual intercourse and through the birth canal. So how did it manifest in the head and neck? Doctors linked it to oral transmission. "There has been a change in the cause of head and neck cancers since 1972, and it's just been realized in the last couple of years," said Jenson. Cancer specialists realized there was a sharp rise, particularly in cancer of the tongue and tonsils. U of L's research team at the cancer center, led by resident Payal Desai, looked at the last seven years of patients who had cancerous tissue in those areas. Twenty-eight percent of the samples [...]

U.S. Cancer Authority Says Cell Phone Cancer May Be Real

Source: PR-Inside.com (www.pr-inside.com) Author: staff It's been rumored for years: Cell phones cause cancer. European cancer experts have been generating damning research on the subject for months, but now the first U.S. cancer center director has gone on record with a firm warning. 'I am convinced that there are sufficient data' to issue a warning on cell phone use, says Dr. Ronald Herberman, director of the University of Pittsburgh Cancer Institute and UPMC Cancer Centers. Other countries have recommended limits on cell phone exposure, and Toronto public health officials have advised young people to limit their use. A child's developing organs "are the most likely to be sensitive to any possible effects of exposure," Dr. Herberman warns. In clear recognition of the potentially catastrophic disease effects of cell phone use, the British government is launching a massive study. They hope to determine - Does long-term use of cell phones cause brain cancer, Alzheimer's and Parkinson's disease? Worldwide, 3.3 billion cell phones were in use in 2007 - enough for about half the world's people. 90% of the global population should have cellular coverage by 2010. A person's exposure level depends on such things as the number and length of calls, amount of cell traffic at the time of a call, distance to the nearest cell tower, and size of the handset. The phone's internal antenna is the main source of radiation. Hold the phone to your head and you're radiating your ear, brain, mouth and neck. Move the antenna away [...]

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