Oral Cancer News – Page 44 – The Oral Cancer Foundation News Archive

Deintensification of Treatment in HPV-Associated Cancers Holds Promise, But With Caveats

Source: Targeted Oncology Date: May 17th, 2020 Author: Tony Berberabe De-escalating therapy has the potential to dramatically reshape the treatment of patients with HPV-associated oropharyngeal cancers, but only if a number of key trials come back with positive long-term data with 3 cycles of cisplatin at 100 mg/m2 times 3, given every 3 weeks, Sue Yom, MD, PhD, a professor in the Departments of Radiation Oncology and Otolaryngology-Head and Neck Surgery atthe University of California, San Francisco, said in an interview with Targeted Therapies in Oncology (TTO). Sure, there were some minor variations over the years, small alterations made on a case-by-case basis. “But long story short, that’s fundamentally what was happening: 70 Gy with 3 cycles of high-dose cisplatin,” Yom said. The story began to change a little over a decade ago, with the introduction of a variable that could potentially change the course of therapy for a large percentage of patients with head and neck cancers. Today, the operative word remains potentially. In 2008, Maura L. Gillison, MD, PhD, of Johns Hopkins University, and colleagues found that whether head and neck squamous cell carcinoma tumors were associated with the human papillomavirus (HPV) turned out to be a major prognostic indicator.1 “When that finally came to be reported, there was a very, very striking result,” said Barbara Burtness, MD, a professor of medicine (medical oncology), Disease-Aligned Research Team leader of the Head and Neck Cancers Program, and coleader of Developmental Therapeutics at Yale Cancer Center in New Haven, [...]

Charlotte Parker2020-05-26T12:41:45-07:00May, 2020|Oral Cancer News|

An Occult HPV-Driven Oropharyngeal Squamous Cell Carcinoma Discovered Through a Saliva Test

Source: Frontiers in Oncology Date: March 31st, 2020 Authors: Kai Dun Tang, Sarju Vasani, Touraj Taheri, Laurence J. Walsh, Brett G. M. Hughes, Lizbeth Kenny, and Chamindie Punyadeera Oropharyngeal cancer (OPC) caused by human papillomavirus (HPV) is a rising global concern. Early lesions are small and are often located in difficult to access areas (such as the crypts of the tonsils or base of tongue). Unlike cervical cancer, there is no standard or routine screening program for HPV-driven OPC. HPV DNA from OPC tumors may shed directly into saliva, and this can be used as a biomarker for early diagnosis. In this study, we report the first-ever clinically occult OPC in an asymptomatic patient discovered through a saliva test. This case relied upon serial measurements of HPV-16 DNA in saliva, which fell to undetectable levels following low morbidity, curative treatment. Introduction The incidence of high-risk human papillomavirus (HR-HPV−16,-18,-33) driven oropharyngeal cancer (OPC) is rapidly increasing in developed countries (1–3). HPV-driven OPCs have surpassed cervical cancer as the most common HPV-driven cancer in the USA. The prevalence of HR-HPV has been reported as 3.7% of the USA population, with a bimodal age distribution of incidence (4). It remains unclear why some individuals go on to develop OPC, while others clear the initial HPV infection (5). The strong association between HR-HPV infection and cervical cancer has led to screening programmes in primary healthcare settings, resulting in earlier diagnosis and a reduction in cancer deaths (6). Unlike cervical cancer, no screening test is [...]

Charlotte Parker2020-05-26T11:07:07-07:00May, 2020|Oral Cancer News|

Revealed: How cancer unit kept theatres open and saved lives despite coronavirus lockdown

Source: www.sundaypost.com Author: Janet Boyle Patients with head and neck malignancies have continued to get vital surgery at Queen Elizabeth University Hospital in Glasgow under strict infection vigilance set up by its maxillofacial surgery unit. More than 40 patients have been treated for head and neck cancer during lockdown. Others have undergone procedures for facial skin cancer and facial injuries. The Royal College of Surgeons Edinburgh says 87% of its members in cancer surgery had stopped operating altogether or significantly reduced the number of procedures due to the danger of patients contracting the virus. And experts fear deaths from cancer could rise by a fifth over the next year as a result of scores of treatments and consultations being cancelled. Now it is hoped the protocols followed by the Glasgow team can be adopted to allow more surgery to resume. Critical to the safety of the operations is that the patients are tested for coronavirus twice before the procedure – once 48 hours beforehand, and then again immediately before surgery begins. Patients are also asked to self-isolate for two weeks before surgery, the surgical team works in a separate building to the main hospital and some surgical techniques have been modified to reduce the risk of infection. Operating on head and neck malignancies poses considerable risk to theatre teams because the work is closely associated with patients’ faces and respiratory systems, making the virus easily transmissible. Further risk lies in the head and neck surgeon having to abandon a face [...]

Oral Cancer Foundation News Team - A2020-05-26T09:08:16-07:00May, 2020|Oral Cancer News|

Study: Regular drinkers can curb chance of getting alcohol related diseases with exercise

Source: www.express.co.uk Author: Richard Percival The scientists revealed that heavier drinkers needed to produce greater physical output to offset other deadly diseases associated with drink. Meanwhile, people who recently gave up alcohol could also reduce their chances of getting sick if they exercised more too. Researchers from the University of Sydney used data from participants aged 30 years and over in ten British population-based health surveys. They then compared this with death rates of alcohol-related cancers which included oral cavity, throat, larynx, oesophagus, liver, colorectal, stomach and additionally pancreas and lung Using models, they discovered a strong direct association between alcohol consumption and mortality risk of alcohol-related cancers, with a significantly higher risk among ex-drinkers. They discovered people who drank excessive amounts of alcohol every week (more than 14 units for women and 21 for men) but who did at least seven hours of exercise were less likely to die from these cancers. The study published in the International Study of Cancer last week added: “Engaging in a recommended level of physical activity attenuated the negative effects of alcohol consumption on alcohol-related cancer mortality. “This provides valuable evidence of the potential of promoting physical activity as an adjunct risk minimisation measure for alcohol-related cancer prevention.” It is the first time analysts have looked at the link between exercise and surviving cancers linked with alcohol. Anne McTiernan, a cancer prevention expert at the Fred Hutchinson Cancer Research Centre, said that the evidence between exercise and alcohol “was clear”.

Oral Cancer Foundation News Team - A2020-05-25T17:48:17-07:00May, 2020|Oral Cancer News|

A new tool to predict delays in post-surgical radiotherapy for head and neck cancer

Source: www.eurekalert.org Author: Medical University of South Carolina news release More than 65,000 Americans are diagnosed annually with head and neck cancer, which most often occurs inside the mouth and throat. For patients who undergo surgery to treat this cancer, guidelines recommend that prompt initiation of radiotherapy -- within six weeks -- is critical for best outcomes. Unfortunately, delays in initiating post-operative radiotherapy (PORT) are far too common. Patients do not always understand the importance of prompt initiation of radiotherapy and may have to overcome other barriers, such as lack of social support and insurance. In addition, health care providers do not always communicate with one another or coordinate care. These avoidable delays have a negative impact on outcomes in a disease that claims almost 15,000 lives in the U.S. each year. To ameliorate this crisis, a research team at the Medical University of South Carolina has developed and validated tools known as nomograms to help predict treatment delays in high-risk patients based on individualized risk factors. The team was led by Evan Graboyes, M.D., an assistant professor in the Department of Otolaryngology-Head & Neck Surgery at MUSC and a member of the Cancer Control Program at Hollings Cancer Center. The results of the nomogram study were reported in JAMA Otolaryngology-Head & Neck Surgery. "A nomogram is a graphical representation of a mathematical model that we are using to predict how likely it is that a patient with head and neck cancer may have a treatment delay," explained Graboyes. "We [...]

Oral Cancer Foundation News Team - A2020-05-14T12:55:58-07:00May, 2020|Oral Cancer News|

World-first saliva test detects hidden throat cancer

Source: www.miragenews.com Author: staff A simple saliva test developed by Queensland University of Technology (QUT) biomedical scientists has detected early throat cancer in a person who had no symptoms, and no clinical signs of cancer. QUT researchers Associate Professor Chamindie Punyadeera and Dr Kai Tang. A series of saliva HPV tests detected an asymptomatic throat cancer during a trial of a new saliva diagnostic Further validation studies are needed to confirm this finding It is a world-first discovery, previously there was no screening test for HPV-DNA oropharyngeal cancers The patient had surgery in which a 2mm cancer was removed and has had no recurrence of HPV-DNA in his saliva. In what is believed to be a world-first, the non-invasive test picked up HPV-DNA in a saliva sample from an infected healthy person. Persistent human papillomavirus (HPV) infection is now the leading cause of cancers in the oropharynx (tonsils and tongue base area of the throat). “The series of saliva tests raised the alert and detected an early cancer before the person had any symptoms,” said QUT Faculty of Health’s Associate Professor Chamindie Punyadeera, who, with Dr Kai Tang developed the test. “This enabled removal of the tonsil which had a 2mm cancer in it, by straightforward local surgery alone. “The incidence of high-risk human papillomavirus (HPV)-driven throat cancers is on the rise in developed countries and, unfortunately, it is often discovered only when it more advanced, with patients needing complicated and highly impactful treatment. “In the US, HPV-driven throat cancers [...]

Oral Cancer Foundation News Team - A2020-05-13T08:01:54-07:00May, 2020|Oral Cancer News|

Liquid biopsy accurately detects HPV+ oropharyngeal cancer recurrence

Source: www.medpagetoday.org Author: Zeena Nackerdien PhD, CME Writer, MedPage Today In general, HPV-positive OPSCC has a favorable prognosis as compared with HPV-negative disease, which has supported efforts to de-intensify treatment regimens to reduce exposure to potentially toxic therapies. Positron emission tomography/computed tomography (PET/CT) imaging 3 months after definitive treatment is standard for response assessment in many cases. However, the disease will recur in up to 25% of patients, depending on clinical risk factors and tumor biology. The latency period prior to OPSCC recurrence is 2 years for many patients, but rare case reports have described latency periods exceeding 5 years. Currently, National Comprehensive Cancer Network (NCCN) guidelines recommend surveillance of patients with HPV-associated OPSCC every 1 to 3 months for the first year, every 2 to 6 months for the second year, every 4 to 8 months for years 3 to 5, and then once a year thereafter. Because the oropharynx can be a difficult anatomic location to evaluate -- a process that may be further obscured by treatment-related tissue changes -- radiologic imaging studies have been used in cancer surveillance for this disease. According to study findings published in the Journal of Clinical Oncology, a blood test for tumor-associated HPV-DNA had near-perfect accuracy for identifying OPSCC patients at high risk of recurrence after treatment. The findings have clear and immediate implications for clinical practice, including earlier initiation of salvage therapy for patients with recurrent disease, reported Bhishamjit S. Chera, MD, of the UNC Lineberger Comprehensive Cancer Center in Chapel [...]

Oral Cancer Foundation News Team - A2020-04-30T08:53:02-07:00April, 2020|Oral Cancer News|

Which cancers have increased over the past decade?

Source: www.mdlinx.com Author: Naveed Saleh, MD, MS, for MDLinx The incidence of cancers at the level of the oral cavity and pharynx increased between 2007 and 2016, according to a recent report by researchers from the CDC published in Morbidity and Mortality Weekly Report. This rise occurred despite respective decreases in the incidence of cancers at various anatomic sites. Cancers of the oral cavity and pharynx make up 3% of cancers diagnosed in the United States each year, with risk factors including tobacco use, HPV infection, and excessive alcohol intake. “The overall increase appears to be driven by increases in cancers of the tonsil, base of tongue, oropharynx, and other cancers of the oral cavity and pharynx, which are HPV-associated, as well as by those of gum and anterior tongue,” wrote the authors. Breaking down the numbers On average, the incidence rates for cancers of the oral cavity and pharynx combined increased by 0.6% per year between 2007 and 2016, with specific increases as follows: Oral cavity and pharynx (3.4%) Base of tongue (1.8%) Anterior tongue (1.8%) Gum (1.9%) Tonsil (2.4%) Oropharynx (1.9%) For the following cancers, however, incidence rates decreased: Soft palate and uvula (−3.7%) Hard palate (−0.9%) Floor of mouth (−3.1%) Lip (−2.7%) Hypopharynx (−2.4%) Nasopharynx (−1.3%) Of note, the incidence of cheek and other mouth and salivary gland cancers remained unchanged.

Oral Cancer Foundation News Team - A2020-04-26T12:43:31-07:00April, 2020|Oral Cancer News|

Novel intervention looks to improve timeliness, equity of head and neck cancer care delivery

Source: www.miragenews.com Author: staff report, Medical University of South Carolina Many factors go into surviving cancer. Hollings Cancer Center researcher Evan Graboyes, M.D., specializes in head and neck cancer, a disease with poor survival prospects despite intense therapy with combinations of surgery, radiation and chemotherapy. While head and neck cancer only accounts for 4% of all cancer cases each year in the US, it has a high mortality rate. The American Cancer Society estimates that more than 14,000 patients died from this disease in the U.S. in 2019. Overall, only 50% of head and neck cancer patients are alive at five years. Unfortunately, the mortality rate is even worse for African American head and neck cancer patients. That’s why researchers are looking for new strategies to improve patient survival and decrease racial disparities in outcomes for these patients. Graboyes and MUSC Hollings Cancer Center researchers Chanita Hughes-Halbert, Ph.D., Katherine Sterba, Ph.D., Hong Li, Ph.D., and Graham Warren, M.D., Ph.D., have teamed up to develop and test a novel intervention to improve the timeliness, equity and quality of head and neck cancer care delivery, which they think might one day be the key to improving survival for these patients. Funded by a $1.3 million 5-year grant from the National Cancer Institute, their study - Improving the Timeliness and Equity of Adjuvant Therapy Following Surgery for Head and Neck Cancer-started in September 2019 and built upon important research funded by grants from Hollings Cancer Center. Graboyes explained that for patients with advanced [...]

Oral Cancer Foundation News Team - A2020-04-11T06:04:04-07:00April, 2020|Oral Cancer News|

Home-based chemo skyrockets at one US center

Source: www.medscape.com Author: Nick Mulcahy In the fall of 2019, the University of Pennsylvania in Philadelphia started planning a pilot program of home-based chemotherapy for two treatment regimens (one via infusion and one via injection). Six months later, the Cancer Care at Home program had referred 40 patients. The uptake within the university's large regional health system was acceptable but not rapid, admitted Amy Laughlin, MD, a hematology-oncology fellow involved with the program. Then COVID-19 arrived, along with related travel restrictions. Suddenly, in a 4-week period (March 10 to April 7), an additional 135 patients had been referred ― a 300% increase from earlier. The list of chemotherapies delivered went from two to seven, with more coming. "We're not the pilot anymore ― we're the standard of care," Laughlin told Medscape Medical News. "The impact [on patients] is amazing," she said. "As long as you are selecting the right patients and right therapy, it is feasible and even preferable for a lot of patients." For example, patients with hormone-positive breast cancer who receive leuprolide (to shut down the ovaries and suppress estrogen production) ordinarily would have to visit a Penn facility for an injection every month, potentially for years. Now, a nurse can meet patients at home (or before the COVID-19 pandemic, even at their place of work) and administer the injection, saving the patient travel time and associated costs. This home-based chemotherapy service does not appear to be offered elsewhere in the United States, and a major oncology organization [...]

Oral Cancer Foundation News Team - A2020-04-11T05:51:26-07:00April, 2020|Oral Cancer News|