Patients with HPV-positive oropharynx cancer should receive chemoradiation

Source: medicalxpress.com Author: provided by European Society for Medical Oncology Patients with human papilloma virus (HPV)-positive throat cancer should receive chemoradiotherapy rather than cetuximab with radiotherapy, according to late-breaking research reported at the ESMO 2018 Congress in Munich. "Many patients have been receiving cetuximab with radiotherapy on the assumption that it was as effective as chemotherapy with radiotherapy and caused less side effects but there has been no head-to-head comparison of the two treatments," said study author Prof Hisham Mehanna, Chair, Head and Neck Surgery, Institute of Cancer and Genomic Sciences, University of Birmingham, UK. Throat cancer is rapidly becoming more common in Western countries. For example in the UK, incidence was unchanged in 1970 to 1995, then doubled in 1996 to 2006, and doubled again in 2006 to 2010.The rise has been attributed to HPV, a sexually transmitted infection. Most throat cancer was previously caused by smoking and alcohol and affected 65-70 year-old working class men. Today HPV is the main cause and patients are around 55, middle class, working, and have young children. HPV-positive throat cancer responds well to a combination of cisplatin chemotherapy and radiotherapy, and patients can survive for 30-40 years, but the treatment causes lifelong side effects including dry mouth, difficulty swallowing, and loss of taste. Patients deemed unable to tolerate chemotherapy, for example because of poor kidney function or older age, receive cetuximab, an epidermal growth factor receptor (EGFR) inhibitor, and radiotherapy. This study compared side effects and survival with the two treatments in [...]

A case for second opinions in cancer care

Source: healthblog.uofmhealth.org Author: Beth Uznis Johnson Jim Sitko expected minor surgery to remove a small lesion that his dentist discovered under his tongue during a routine checkup in July 2017. An oral surgeon near his home in Clarkston, Michigan, took several samples to biopsy, a procedure that left Sitko’s tongue badly damaged. Resulting pain left the patient barely able to swallow for more than a week. And the pathology report revealed devastating news: squamous cell carcinoma of the tongue. Treatment, Sitko was told, would include major surgery to remove a portion of his tongue and rebuild it with veins and tissue from other parts of his body. Rehabilitation would be extensive and might also require radiation therapy once the patient healed. Because he had received successful treatment for prostate cancer six years earlier at the University of Michigan Rogel Cancer Center, Sitko opted to return and meet with surgeon Steven Chinn, M.D., MPH. Sitko’s mouth was still healing from his initial surgery, so Chinn relied on the outside pathology report to prep for the complicated surgery ahead. He ordered additional pathology testing by Rogel Cancer Center head and neck specialists — an essential step to confirm an advanced cancer diagnosis. Meanwhile, the thought of having tongue cancer overwhelmed Sitko. “The complications aside from taking care of the cancer were unbelievable,” the 70-year-old says. “I might have a breathing tube and feeding tube. I took a retreat to my condo in northern Michigan to review 25 pages of paperwork for two [...]

Oral cancer a risk when consuming cannabis, warns orthodontist

Source: www.cbc.ca Author: staff Eating or smoking pot can pose some deadly health risks, according to the president of the Essex County Dental Association. "One of the more common ones that you hear about is oral cancer," said Dr. Mark Parete​, adding cannabis contains known carcinogens, similar to what's found in tobacco. He said the ingestion of tetrahydrocannabinol (THC), marijuana's main psychoactive ingredient, into a person's blood stream weakens their immune system and leaves gums and teeth prone to infection. "Just like nicotine, it actually causes a generalized inflammation which ultimately breaks down collagen and bone — which is the support system of your teeth," said Parete​. Full disclosure between patients and medical professionals is extremely important in treating heath events. Parete​ said people shouldn't be shy of revealing cannabis use to their dentist or orthodontist. "When the patients come in, we always update our medical history ... Inform us if you have any new medications, including using marijuana for recreational or medicinal purposes," he said. Indirect health impacts can occur through cannabis use, Parete​ warns. He said when the "munchies" come calling, cannabis users aren't usually making the best choices in terms of their oral health. "It's probably not your healthy fruits and vegetables. So, if you can, we really advise our patients to swish your mouth some water after eating just to make sure you're flushing any kind of sugars off the teeth to prevent dental cavities."

Why oral cancer threatens men

Source: www.scientificamerican.com Author: Claudia Wallis, Scientific American November 2018 Issue Back in 2006, when the vaccine for human papillomavirus (HPV) was introduced, I rushed to get my teenage daughters immunized. Here, amazingly, was a vaccine that could actually prevent cancer. By blocking HPV infection, it protects girls from the leading cause of cervical malignancies. I didn't give much thought to my son, and neither did the medical establishment. It wasn't until 2011 that health authorities recommended the vaccine for boys. In hindsight, that delay was a mistake, though perfectly understandable: the vaccine was developed with cervical cancer in mind and initially tested only in girls. Today, however, we see a rising tide of cancers in the back of the throat caused by HPV, especially in men, who are three to five times more vulnerable than women. This surge of oropharyngeal cancers, occurring in many developed nations, took doctors by surprise. Oral cancers were expected to decline as a result of the drop in smoking that began in the 1960s. Smoking-related oropharyngeal cancers are, in fact, down. But making up the difference, particularly in men, are those related to HPV, which have more than doubled over the past two decades. With cervical cancer waning (thanks to screening and prevention), this oral disease is now the leading HPV-related cancer in the U.S. Nearly 19,000 cases were reported in 2015, according to a recent report by the Centers for Disease Control and Prevention. Roughly nine out of 10 involve a nasty strain called [...]

Long-term implant failure in patients treated for oral cancer by external radiotherapy: a retrospective monocentric study

Source: Journal of Oral Medicine and oral Surgery, JOMOS Date: October 10th, 2018 Authors: Aline Desoutter, Sophie Deneuve, Sophie-Charlotte Condamin and Anne-Gaëlle Chaux-Bodard Abstract Introduction: The placement of dental implants in irradiated bone has allowed functional rehabilitation for many oral cancer patients. Nonetheless, there is only few data about implant failure in irradiated tissues and their consequences. This retrospective study aims to highlight the rate and circumstances of implant failure. Material and method: Patients treated with external radiotherapy for oral carcinoma and who received dental implants were included. Patients reconstructed with free bone flaps were excluded. Results: Eighteen patients were included. Forty implants were placed between 2004 and 2007, 8 failed, of whom one osteoradionecrosis was observed. Time interval between radiotherapy and implantation was 44.6 (6–182) months. Mean dose was 51.8 (50–66) Gy. Discussion: In the series, the implant failure rate is 20%, which corroborates the literature's data. Failures occur more often for doses over 50 Gy. The placement of dental implant in irradiated bone leads to soft tissue complications but also increases the risk of osteoradionecrosis. The recent reimbursement of dental implants in oral cancer patients by the National Social Health system will probably increase the indications. Multidisciplinary staffs should be aware of benefit/risk ratio for each patient. Introduction Dental implants in patients treated for upper aerodigestive tract (UADT) cancers have facilitated the functional and aesthetic rehabilitation of patients whose postoperative anatomy did not allow for the placement of conventional prostheses. Several studies have been conducted and the success rates have varied [...]

2018-10-16T13:03:44-07:00October, 2018|Oral Cancer News|

As HPV-related cancer rates climb, experts scrutinize barriers to HPV vaccination

Source: www.cancertherapyadvisor.com Author: Bryant Furlow Oropharyngeal squamous cell carcinomas (SCCs) are now the most commonly diagnosed human papillomavirus (HPV)-associated cancers in the United States, with 15,479 men and 3438 women diagnosed in 2015, according to an analysis by the Centers for Disease Control and Prevention (CDC).1 Between 1999 and 2015, cervical cancer and vaginal squamous cell carcinoma (SCC) rates declined, by 1.6% and 0.6% per year, respectively. But rates for vulvar SCC increased by 1.3% annually during the same period. Anal SCC rates also climbed by approximately 2% a year among men and 3% among women.1 Rates of oropharyngeal SCC — cancers of the throat and tongue — climbed as well, particularly among men (2.7% a year vs 0.8% in women). All told, more than 43,000 Americans were newly diagnosed with HPV-related cancers in 2015, the analysis showed, up from 30,115 in 1999.1 Most people diagnosed with HPV-associated malignancies are older than 49 years.1 Most women diagnosed with cervical cancer are older than 30 years.1 “We don't actually know what caused the increase in HPV infections but we know now that we have a safe and effective vaccine that can prevent infections,” said Lois Ramondetta, MD, professor of gynecologic oncology and reproductive medicine at the University of Texas MD Anderson Cancer Center, Houston. “We're seeing people who were infected decades ago developing these cancers,” Dr Ramondetta said. “We'll see rates continue to rise over the coming years because the vaccine wasn't available before 2006.” HPV vaccination rates are improving, Dr [...]

Adam Kay picks the best books about living with cancer

Source: www.theguardian.com Author: Adam Kay As Orson Welles so cheerily put it, we are born alone, we live alone and we die alone. But none of us has to struggle through cancer alone, thanks to a vast pool of literature, non-fiction and poetry that tackles the subject. In C: Because Cowards Get Cancer Too, columnist and self-confessed hypochondriac John Diamond writes with almost unbearable honesty about his fears as he is diagnosed with throat cancer. As he puts it, this is his “attempt to write the book I was looking for the night I got the bad news”, and it explains “what it’s like to be a person with cancer, to deal with the pain and the fear and the anger”. While his feelings vacillate between hope and despair, his dark humour sings through. Taking the reader on a gripping and emotional journey, this account captures the unpalatable but essential truth that not all those living with cancer are “bravely battling” – some are just plain scared. Diamond is one of a handful of writers who can make me snort out loud in public through the magic of their words, and is much missed. The true story beautifully told by Rebecca Skloot in The Immortal Life of Henrietta Lacks is astonishing. Henrietta was a penniless black tobacco farmer who died in 1951, but whose cervical cells changed the shape of medicine. Taken without permission, cells from her tumour have since been multiplied and shared around the world to advance our [...]

AN E-CIGARETTE COMPANY PUT VIAGRA AND CIALIS IN ITS VAPING LIQUIDS, AND THE FDA IS NOT PLEASED

Source: newsweek.com Date: 10/13/18 Author: Kelly Wynne A vape company, HelloCig Electronic Technology Co., has included Viagra and Cialis in its liquids, and has raised the ire of the Food and Drug Administration. One liquid was called e-Cialis, a popular erectile dysfunction drug, and was displayed with photos of the real product, according to Ars Technica. A weight loss drug, whose brand was banned in Europe, was allegedly adapted into the liquid form as well, though FDA testing proved it instead contained the erectile dysfunction medication found in Viagra. The FDA sent a warning letter to HelloCig on Thursday. It urged the company to make the necessary changes to properly market their products and asked they comply with FDA regulations to continue selling any type of drug. HelloCig alleged they responded to the FDA in a statement sent to USA Today Saturday. “Our aim is to fully comply with all FDA regulations, both in letter and spirit," the statement read. The FDA also released a statement, written by FDA Commissioner Scott Gottlieb, on the illegal sale of these liquids on Thursday. “There are no e-liquid products approved to contain prescription drugs or any other medications that require a doctor’s supervision,” the statement read. “Prescription drugs are carefully evaluated and labeled to reflect the risks of the medications and their potential interactions with other medicines, and vaping active drug ingredients is an ineffective route of delivery and can be dangerous.” Gottlieb considers the e-cigarette usage among teenagers an epidemic, he clarified in a statement last [...]

2018-10-15T14:38:04-07:00October, 2018|Oral Cancer News|

Oral treatment may not be far off for head and neck cancer patients

Source: app.secure.griffith.edu.au Author: staff, Griffith University A highly promising approach to treating HPV-driven head and neck cancer is on the way, and it could be in the shape of a simple oral medication. This is according to new breakthrough research led by Griffith University, which has conducted trials showing that the drug, Alisertib, tested in trials to treat other cancers such as lung and kidney, can also successfully destroy the cancer cells associated with head and neck cancer. Human Papilloma Virus (HPV) is the main culprit in head, neck and oral cancers. The virus is thought to be the most common sexually transmitted infection (STI) in the world, and most people are infected with HPV at some time in their lives. The latest trials – which have taken place over the past three years at Griffith’s Gold Coast campus – have shown a particular enzyme inhibitor in the drug, has the ability to prevent proliferation of HPV cancer cells in advanced head and neck cancers. A 100 per cent success rate Led by Professor Nigel McMillan, program director from Griffith’s Menzies Health Institute Queensland, the trials have shown a 100 per cent success rate in the drug eradicating the cancerous tumours in animals. “Head and neck cancers can unfortunately be very difficult to treat, just by the very nature of where they are located in and around the throat, tongue and mouth,” says Professor McMillan. “This part of the body contains some delicate areas such as the vocal chords and [...]

New risk factor for mouth cancer uncovered

Source: www.medicalnewstoday.com Author: Tim Newman, fact checked by Paula Field In some regions, mouth cancer incidence has risen. A recent study investigates a new risk factor for mouth cancer. In certain parts of the world, over the past couple of decades, mouth cancer rates have soared. For instance, in the United Kingdom, rates of mouth cancer have increased by 68 percent. They rose from eight cases per 100,0000 in 1992–1995 to 13 cases per 100,000 in 2012–2014. In the United States, mouth cancer and mortality rates have declined overall. However, when examined at a state level, the data reveal a more complex picture. For instance, mouth cancer deaths have risen significantly in Nevada, North Carolina, Iowa, Ohio, Maine, Idaho, North Dakota, and Wyoming. Some known risk factors for mouth cancer include smoking tobacco, drinking alcohol, human papillomavirus (HPV), and chewing betel quid, which is a mix of natural ingredients wrapped in a betel leaf that is popular in some parts of Southeast Asia. In India, mouth cancers are the most common cause of cancer-related deaths in men aged 30–69 years old. Scientists think that chewing betel quid could be responsible for many of these deaths. New risk factor for mouth cancer Although scientists have confirmed some risk factors, there is still much to learn about how and why mouth cancer affects certain individuals and not others. Recently, scientists set out to investigate another potential risk factor: air pollution. The researchers, funded by the Ministry of Science and Technology in Taiwan, [...]

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