Artificial intelligence being trained to predict risk of developing oral cancer

Source: thestreetjournal.org
Author: staff, NHS

The diagnosis of oral cancer could be ‘revolutionised’ by using artificial intelligence to predict whether someone is likely to develop the disease, experts have said.

Experts led from the Universities of Sheffield and Warwick have teamed up to investigate how machine learning could be applied to aid doctors in early detection.

Diagnoses of oral cancers — including those of the mouth, tongue and tonsils — have increased by almost 60 per cent over the last decade, team noted. The risk of such cancers is heightened by such factors as alcohol consumption, increasing age, insufficient fruit and vegetables, tobacco and viral infection.

Doctors evaluate the likelihood of pre-cancerous changes in the lining of the mouth — so-called oral epithelial dysplasia — developing into cancer using 15 criteria. As this approach is highly subjective, however, there is considerable variation in how patients are treated following biopsy — and a more objective system is needed.

The diagnosis of oral cancer could be ‘revolutionised’ by using artificial intelligence to predict whether someone is likely to develop the disease, experts have said.

‘The precise grading of oral epithelial dysplasia is a huge diagnostic challenge, even for experienced pathologists, as it is so subjective,’ said clinical dentist Ali Khurram of the University of Sheffield.

‘At the moment a biopsy may be graded differently by different pathologists, the same pathologist may even grade the same biopsy differently on a different day.’

‘Correct grading is vital in early oral cancer detection to inform treatment decisions, enabling a surgeon to determine whether a lesion should be monitored or surgically removed,’ he added.

‘Machine learning and artificial intelligence can aid tissue diagnostics by removing subjectivity, using automation and quantification to guide diagnosis and treatment.’

‘Until now this hasn’t been investigated, but artificial intelligence has the potential to revolutionise oral cancer diagnosis and management by ensuring accuracy, consistency and objectivity.’

The researchers plan to use samples of tissue — alongside at least five years of patient follow up data — to train an algorithm to consider the statistical correlation between classifiers and survival rates.

This will then guide doctors as to help them make an informed decision on what to recommend for the given patient’s treatment.

‘People often feel threatened by AI, however rather than replacing a doctor’s expertise, exceptionally high-level of training and experience, the technology can help to assist their decision-making and compliment their skills,’ added Dr Khurram.

‘This will help them to give a more accurate assessment and enable them to recommend the most beneficial treatment pathway for individual patients which will hope will help to improve survival rates.’

‘The pilot project will pave the way towards the development of a tool that can help identify pre-malignant changes in oral dysplasia, said computational pathologist Nasir Rajpoot of the University of Warwick.

This, he explained, is ‘crucial for the early detection of oral cancer.’

‘Successful completion of this project carries significant potential for saving lives and improving patient healthcare provision.’

What is Mouth Cancer?
Mouth cancer, also known as oral cancer, is where a tumour develops in the lining of the mouth. It may be on the surface of the tongue, the insides of the cheeks, the roof of the mouth (palate), or the lips or gums.

Tumours can also develop in the glands that produce saliva, the tonsils at the back of the mouth, and the part of the throat connecting your mouth to your windpipe (pharynx). However, these are less common.

Symptoms of mouth cancer include:

  • sore mouth ulcers that don’t heal within several weeks
  • unexplained, persistent lumps in the mouth that don’t go away
  • unexplained, persistent lumps in the neck that don’t go away
  • unexplained looseness of teeth, or sockets that don’t heal after extractions
  • unexplained, persistent numbness or an odd feeling on the lip or tongue
  • sometimes, white or red patches on the lining of the mouth or tongue – these can be early signs of cancer, so they should also be investigated
  • changes in speech, such as a lisp

See your GP or dentist if these symptoms don’t heal within three weeks, particularly if you drink or smoke heavily.

Source: NHS

2020-11-04T12:05:12-07:00November, 2020|Oral Cancer News|

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.

Should we be drinking less?

Source: www.nytimes.com
Author: Anahad O’Connor

Can a daily drink or two lead to better health?

For many years, the federal government’s influential dietary guidelines implied as much, saying there was evidence that moderate drinking could lower the risk of heart disease and reduce mortality.

But now a committee of scientists that is helping to update the latest edition of the Dietary Guidelines for Americans is taking a harder stance on alcohol. The committee said in a recent conference call that it plans to recommend that men and women who drink limit themselves to a single serving of wine, beer or liquor per day. Do not drink because you think it will make you healthier, the committee says: It won’t. And it maintains that drinking less is generally better for health than drinking more.

That message is a departure from previous guidelines, which since 1980 have defined “moderate” drinking as up to two drinks a day for men and one for women. Government agencies have also long defined a standard drink as 12 ounces of regular beer, five ounces of wine, or one and a half ounces of distilled spirits (40 percent alcohol), amounts often exceeded in Americans’ typical “drink.”

Between 1990 and 2010, many editions of the guidelines, which are updated every five years, discouraged heavy drinking and warned pregnant women and people with certain medical conditions not to drink. But they also noted that moderate drinking was linked to fewer heart attacks and lower mortality. The 2010 guidelines mentioned that moderate drinking may even “help to keep cognitive function intact with age.”

The new recommendation would be a victory for experts who have long questioned the health halo around moderate drinking. They say that studies showing it can protect health are deeply flawed, and that any potential cardiovascular benefits would be outweighed by the fact that alcohol is a leading preventable cause of cancer. According to the National Cancer Institute, even one drink a day increases the risk of breast, esophageal and oral cancer.

“This is significant because the committee has finally gotten away from this idea that a small amount of alcohol is good for you,” said Thomas Gremillion, the director of food policy at the Consumer Federation of America, a public interest group that has pushed for cancer warnings on alcohol. “They’re really taking a stand and saying drinking less is always better. That’s the right message and I think they deserve credit for making that change.”

The new advice is not yet final. The advisory panel is expected to include it in a report that it will release publicly in mid-July and submit to the Department of Agriculture and the Department of Health and Human Services. Those two agencies are scheduled to publish the official dietary guidelines later this year.

If accepted, the new recommendation would make the United States the latest country to issue stricter guidelines on alcohol consumption. In recent years, Britain, Australia, France and other countries have issued new guidelines lowering their recommended limits on daily and weekly alcohol intake. Health authorities in those countries have said that recent evidence suggests consuming less alcohol is safer and that even one drink a day increases cancer risk.

The scientific debate over moderate drinking dates at least back to the 1970s, when researchers in California noticed that teetotalers seemed to have more heart attacks than people who drank moderately. In the decades that followed, many observational studies looking at large populations documented what is known as a J-shaped curve between alcohol and mortality from all causes, especially heart disease: Mortality rates dipped for moderate drinkers compared to nondrinkers and then climbed higher among people whose intake exceeded one or two drinks daily.

But observational studies can show only correlations, not causation. And they have other limitations. One major confounding factor is that socioeconomic status is a strong predictor of health and life span — and it tracks closely with drinking levels. Studies show that compared to heavy drinkers and abstainers, people who drink moderately tend to be wealthier and have higher levels of education. They tend to have better health care, exercise more, eat healthier diets, and have less obesity.

One study that compared nondrinkers to moderate drinkers — defined as having two drinks daily for men and one for women — found that 27 out of 30 well established risk factors for heart disease were “significantly more prevalent” among nondrinkers. Rather than causing better health, in other words, moderate drinking may be a marker for higher socioeconomic status and other lifestyle factors that promote a longer life.

Another problem with observational studies is selection bias. In some large studies, people categorized as “nondrinkers” may actually be former heavy drinkers, or they may have health issues that cause them not to imbibe. Studies have found that nondrinkers have higher rates of physical disabilities, psychiatric problems and pre-existing illnesses. When rigorous studies take these factors into account, they find that the protective effect of moderate drinking disappears.

“The appearance of protection vanishes like the mist on an autumn day as the sun comes up,” said Timothy Stockwell, an alcohol researcher and director of the Canadian Institute for Substance Use Research at the University of Victoria. “All of these thousands of studies, when you do a forensic examination of them, most of them have these horrendous flaws and are open to these systematic biases.”

One way to get around these limitations is through genetic studies. Some people carry a genetic variant that disrupts their ability to metabolize alcohol, causing them to develop skin flushing, irritation and other unpleasant symptoms when they drink alcohol. As a result, they tend to abstain or drink very little. If alcohol was good for heart health, these people should in theory have more heart disease compared to others. Instead, as one large analysis published in BMJ in 2014 found, they have “a more favorable cardiovascular profile and a reduced risk of coronary heart disease than those without the genetic variant.”

The study concluded: “This suggests that reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health.”

Not everyone agrees that the health benefits of moderate drinking are illusory. Alcohol has blood-thinning properties, and red wine in particular contains polyphenols that have beneficial effects on the microbiome, said Dr. Erik Skovenborg, a family doctor and member of the International Alcohol Forum, an international group of scientists who study alcohol and health. Alcohol also raises HDL cholesterol, often referred to as the “good” kind, though recent studies have cast doubt on it being cardioprotective.

Dr. Skovenborg said the observational data makes it clear that moderate drinking is more than a marker for a healthy lifestyle.

“In these studies you have many participants that have all the healthy lifestyle factors,” he said, “and if you add moderate alcohol consumption on top of that, it increases the benefits regarding longer life and fewer health problems.”

Dr. Skovenborg said his general advice to patients who drink is to follow the Mediterranean tradition: Have a little wine with your meals, drink slowly, enjoy it, and don’t drink to get drunk. Exercise regularly, avoid smoking, eat nutritious foods, and maintain a normal weight. “It’s a pattern of things you should be doing, not just one thing,” he added.

Showing definitively that moderate drinking protects heart health requires doing a lengthy clinical trial, one that randomly assigns some people to have a drink daily and others to abstain. In 2014, the National Institutes of Health launched a clinical trial designed to do just that. But it was shut down in 2018 after a New York Times investigation revealed that N.I.H. officials had lobbied beer and liquor companies for funding and suggested that the results of the trial would support moderate drinking. As it turns out, experts have long raised concerns about industry influence on alcohol studies.

Members of the advisory committee declined to comment on their recommendations until their report is released. Dr. Stockwell said he agreed with the one-drink-a-day recommendation but he would word it slightly differently. “I’d probably say seven drinks a week for men and women and no more than two drinks on one day,” he said. “I would have a little flexibility.”

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”.

Healthy diet may avert nutritional problems in head, neck cancer patients

Source: medicalxpress.com
Author: University of Illinois at Urbana-Champaign

At least 90 percent of head and neck cancer patients develop symptoms that affect their ability or desire to eat, because of either the tumor itself or the surgery or radiation used to treat it. These problems, called nutrition impact symptoms, have wide-ranging negative effects on patients’ physical and mental health and quality of life.

However, patients who eat foods high in antioxidants and other micronutrients prior to diagnosis may reduce their risks of developing chronic nutrition impact symptoms up to one year after being diagnosed with head or neck cancer, according to a recent study led by researchers at the University of Illinois.

The scientists analyzed the dietary patterns of 336 adults with newly diagnosed head and neck cancers and these patients’ problems with eating, swallowing and inflammation of the digestive tract. This painful inflammatory condition, called mucositis, is a common side effect of radiation treatment and chemotherapy.

The mitigating effects of a healthy diet were particularly significant in people who had never smoked and in patients who were underweight or normal weight at diagnosis, who often experience the greatest eating and digestive problems during treatment, said Sylvia L. Crowder, the paper’s first author.

Crowder is a research fellow in the Cancer Scholars for Translational and Applied Research program, a collaborative initiative of the U. of I. and Carle Foundation Hospital in Urbana, Illinois.

“While previous work has established that the presence of nutrition impact symptoms is associated with decreased food intake and weight loss, no studies have examined how pre-treatment dietary intake may influence the presence of these symptoms later in the course of the disease,” Crowder said.

In the early 2000s, researchers hypothesized that consuming antioxidant supplements might protect patients’ normal cells from damage during radiotherapy, enabling them to better tolerate treatment and higher dosages.

Accordingly, prior research by Anna E. Arthur, a professor of food science and human nutrition at the U. of I. and the current study’s corresponding author, indicated that eating a diet of whole foods abundant in antioxidants and phytochemicals improved recurrence and survival rates in head and neck cancer patients.

Like Arthur’s prior research, the new study was conducted with patients of the University of Michigan Head and Neck Specialized Program of Excellence.

Data on patients’ tumor sites, stages and treatment were obtained from their medical records. More than half of these patients had stage 4 tumors at diagnosis.

Prior to starting cancer treatment and again one year post-diagnosis, the patients completed a questionnaire on their diet, tobacco and alcohol use, and quality of life. Patients reported whether they experienced any of seven nutrition impact symptoms—such as pain or difficulty chewing, tasting or swallowing foods and liquids—and rated on a five-point scale how bothersome each symptom was.

In analyzing the patients’ eating habits, the scientists found that they followed either of two major dietary patterns—the Western pattern, which included high amounts of red and processed meats, fried foods and sugar; or the prudent pattern, which included healthier fare such as fruits and vegetables, fish and whole grains.

Patients who ate healthier at diagnosis reported fewer problems with chewing, swallowing and mucositis one year after treatment, the scientists found.

“While the origin and development of nutrition impact symptoms are complex and varied, they generally share one common mechanism—cell damage due to inflammation,” said Arthur, who is also an oncology dietitian with the Carle Cancer Center. “The prudent dietary pattern has the potential to reduce inflammation and affect the biological processes involved in the pathogenesis of these symptoms.”

The scientists hypothesized that some patients may begin eating healthier after being diagnosed with cancer, potentially counteracting the pro-inflammatory effects of their previous dietary habits.

Reverse causation was possible too, they hypothesized—patients’ lack of symptoms may have enabled them to consume a broader range of foods, including healthier whole foods, before their cancer was discovered.

Alcohol use high among cancer survivors

Source: www.medwirenews.com
Author: Shreeya Nanda

Over half of cancer survivors report being current drinkers, including about a fifth who appear to engage in excessive drinking behaviors, finds a US study.

“Given that alcohol intake has implications for cancer prevention and is a potentially modifiable risk factor for cancer-specific outcomes, the high prevalence of alcohol use among cancer survivors highlights the need for public health strategies aimed at the reduction of alcohol consumption,” write the study authors in JNCCN—Journal of the National Comprehensive Cancer Network.

They used data from 34,080 participants of the US National Health Interview Survey interviewed between 2000 and 2017 who reported a history of cancer.

In all, 56.5% of the total cohort reported being current drinkers, including 34.9% who exceeded moderate drinking limits – defined as a daily intake of more than one drink for women and more than two drinks for men – and 21.0% who engaged in binge drinking, which was defined as at least five drinks per day on at least one occasion in the past year.

Researcher Nina Sanford (University of Texas Southwestern Medical Center, Dallas, USA) and colleagues caution that for the blood alcohol concentration to reach the threshold for binge drinking, drinks generally need to be consumed within 2 hours, but the survey did not collect information on the duration of alcohol intake and therefore participants who reported binge drinking may not have reached the biologic threshold.

They also investigated factors linked to alcohol use, finding that younger age (18–34 years vs other age groups), current or former smoking status, and later survey period (2010–2014 and 2015–2017 vs 2000–2004) were significantly associated with a greater likelihood of current drinking, exceeding moderate drinking limits, and binge drinking.

For other factors, such as sex and ethnicity, associations were observed for some of the levels of current drinking but not all – for instance, female sex was significantly associated with exceeding moderate limits, but male sex was a significant predictor of reporting current drinking and binge drinking.

The prevalence rates and predictive factors were similar in sensitivity analyses that included just the 20,828 participants who had been diagnosed at least 5 years prior to survey administration.

“By reporting the demographic and socioeconomic variables associated with alcohol intake, our work begins to identify subgroups toward whom alcohol-based interventions could be targeted, and could serve as a benchmark for assessing changes in drinking behavior in the population of patients with cancer,” say Sanford et al.

Individuals with a history of cervical or testicular cancer were significantly more likely to report current drinking, exceeding moderate limits, and binge drinking compared with participants reporting other tumor types. Additionally, those with a history of head and neck cancer or melanoma were also significantly more likely to report binge drinking.

This finding is “likely a reflection of the predominant demographic characteristics—particularly younger age—associated with these cancer diagnoses, rather than an intrinsic association between cancer type and alcohol use,” comment the researchers.

Sanford and colleagues highlight the need for further research, “including large-scale systems-based research on alcohol use in cancer survivors.”

And they conclude: “For the time being, because oncologists have a responsibility to promote the overall health and well-being of their patients, efforts should be undertaken to accurately assess alcohol intake among cancer survivors and to inform these individuals of the potential harms associated with continued drinking.”

Test that looks at your spit to tell if you have mouth or throat cancer caused by HPV ‘could save thousands of lives if rolled out for doctors to use’

Source: www.dailymail.co.uk
Author: Connor Boyd, Health Reporter

A saliva test that diagnoses mouth and throat cancer caused by HPV could save thousands of lives each year, a study suggests. Scientists at Duke University in North Carolina discovered the test was 80 per cent accurate at spotting the killer diseases.

Doctors say it is able to detect the cancers early on, giving patients much higher hopes of surviving their battle. Before it can be used in hospitals around the world, further trials will be needed to confirm the technology works. But the researchers are hopeful, claiming the cheaper test – which gives results in as little as 10 minutes – has significant ‘potential’.

Rates of oral cancers are soaring in the Western world, with the number of patients diagnosed in the UK having doubled in a generation. US doctors have also seen a similar spike in the diseases, which can be caused by human papilloma virus (HPV).

The infection – spread through oral sex, as well as anal and vaginal intercourse – is thought to cause around 70 per cent of all cases. Other risk factors include drinking excessive amounts of alcohol over long periods of time and smoking cigarettes.

Professor Tony Jun Huang, study co-author, said there are around 115,000 cases of oropharyngeal cancers each year across the world. He said it is ‘one of the fastest-rising cancers in Western countries due to increasing HPV-related incidence, especially in younger patients’.

Orophayngeal cancer starts in the oropharynx, the back of the throat which includes the base of the tongue and tonsils. It sits under the branch of head and neck cancers, which also includes mouth cancer – another type that can be caused by HPV. Detecting the disease early can boost survival odds from 50 per cent to 90 per cent, according to the NHS. But patients are often not diagnosed until they become advanced, partly because their location makes them difficult to see during routine clinical exams.

The new test uses a chip developed to isolate tiny micro-particles, known as exosomes, in saliva.These particles are secreted into body fluids and several types of cancers are known to multiply their numbers. Exosomes are responsible for transferring molecules between cancer and various cells.

The new test isolates them by filtering out larger particles in the saliva and probing the exosomes for DNA shed by tumours. It also scans fluid in the mouth for HPV-16, one strain of the STI that can put people at risk of oropharyngeal cancer. The test takes five minutes to conduct and a further five to process the results. Experts also said it is cheap – but did not elaborate on the cost. In comparison, current biopsies take around eight hours because they need to be sent away to be assessed by a surgeon.

Professor Huang said: ‘It is paramount that surveillance methods are developed to improve early detection and outcomes.’ He added the successful detection of HPV from saliva ‘offers advantages including early detection, risk assessment, and screening’.

The test was a collaboration between Duke University, the University of California and University of Birmingham in Britain.

Orophayngeal cancer killed 2,722 Britons last year and took the lives of 9,750 people in the US, figures show. New cases of the disease in the UK have risen to 8,302 a year, a jump of 135 per cent compared with 20 years’ ago.

According to the researchers, this technology can also be used to analyse blood, urine, and plasma. The findings were published in the Journal of Molecular Diagnostics.

The Oral Health Foundation last month urged people to wise up to the causes of the ‘devastating’ disease, mainly HPV and alcohol. Dr Nigel Carter OBE, chief executive of the OHF, said: ‘While most cancers are on the decrease, cases of mouth cancer continue to rise at an alarming rate.

‘Traditional causes like smoking and drinking alcohol to excess are quickly being caught by emerging risk factors like the human papillomavirus (HPV).

‘We have seen first-hand the devastating affect mouth cancer can have on a person’s life.’

2019-12-14T11:12:24-07:00December, 2019|Oral Cancer News|

Research to examine possible links between periodontal disease and oral cancer

Source: eu.dental-tribune.com
Author: Dental Tribune International staff

As worldwide oral cancer rates continue to climb, our understanding of what causes the disease to occur, thankfully, also continues to grow. Tobacco use and excessive alcohol consumption have been established as primary risk factors, and researchers are now investigating another potential source for this condition: the bacteria that cause periodontal disease.

The research is being led by Dr Louise Belfield, a lecturer in biomedical science at the University of Plymouth’s Peninsula Dental School, in collaboration with the university’s Institute of Translational and Stratified Medicine. Since cancer requires blood vessels to grow and metastasise, the research team is planning to build on existing evidence that shows how certain bacteria that cause periodontal disease are linked to angiogenesis.

To do so, the research team will develop miniature tumours and blood vessels in a laboratory setting, adding the bacteria with the aim of clarifying how they function and what effect they have on the blood vessels.

According to a press release from the university, if the research ascertains that the bacteria make the blood vessels grow more rapidly and similarly to those associated with tumours and identifies the process by which this is achieved, the results could form the basis of a new screening programme to detect oral cancer risk earlier. This would make it possible to begin treatment in a more timely manner.

“We know that tumours in the mouth, unlike many other tumours, are in constant contact with bacteria, but we don’t know exactly how the bacteria affect tumour and vessel growth yet,” said Belfield.

“The bacteria may not cause the cancer, but they may do something to make the progression of the cancer speed up. One way they could do this is via the blood vessels, encouraging them to grow more rapidly or in a way which helps the tumour to grow. So if we find out what this is and how it works, it can help us develop and put screening processes in place to detect and reduce the numbers of those bacteria,” she continued.

Dental Tribune International (DTI) has previously reported on a study which confirmed the crucial role of dental professionals in detecting oral cancer early. This early detection can greatly improve the prognosis of sufferers.

“Oral cancer is a horrific disease with poor survival rates—only around 50% of those diagnosed are alive five years later. It is an in-your-face, no-hiding, disfiguring disease, and the treatment can be very protracted, complex and costly,” said Dr David Conway, Professor of Dental Public Health at the University of Glasgow’s School of Medicine, Dentistry and Nursing, in an interview with DTI last year.

“The earlier it is detected, however, the better the outcome can be,” Conway added.

2019-11-06T09:45:25-07:00November, 2019|Oral Cancer News|

Oral sex blamed for rise of mouth cancer in UK

Source: www.medicaldaily.com
Author: Darwin Malicdem

The number of people diagnosed with mouth cancer has significantly increased by 135 percent over the past 20 years in the United Kingdom. Experts believe the increase comes amid the growing number of Brits engaging in oral sex.

Nonprofit Oral Health Foundation (OHF) issued a report showing oral cancer rates “have more than doubled in a generation” across the U.K. In 2018 alone, seven people died every day from the disease in Great Britain and Northern Ireland.

“While most cancers are on the decrease, cases of mouth cancer continue to rise at an alarming rate,” Nigel Carter, chief executive of the OHF, told the Daily Mail. “It changes how somebody speaks, it makes eating and drinking more difficult, and often changes a person’s physical appearance.”

The foundation said the sexually transmitted human papillomavirus (HPV) caused 73 percent of the oropharyngeal mouth cancers. But drinking alcohol also contributed to the higher rates of the disease in the U.K.

OHF said 33 percent of mouth cancer diagnoses over the past decades were linked to consumption of alcoholic beverages. Smoking was associated with 17 percent of the cases.

The foundation launched Mouth Cancer Action Month in early November that aims to spread awareness of mouth cancer and its signs and symptoms.

“We want everyone to be more mouth aware during this year’s campaign,” Carter said in a press release. “This means being able to identify the signs and symptoms of mouth cancer, understand what is more likely to put us at greater risk, and importantly, know where to go if you spot anything out of the ordinary.”

He added early diagnosis has been effective to prevent deaths in the past years. Philip Lewis, of the Mouth Cancer Foundation, also highlighted that public awareness programs and self examination would help address the health issue.

In the U.S., the number of mouth cancer is also increasing. The Oral Cancer Foundation reported that nearly 54,000 Americans are being diagnosed with the disease every year.

Mouth cancer kills one person per hour in the country, leading to 13,500 deaths every year.

2019-11-05T09:21:13-07:00November, 2019|Oral Cancer News|

Say No to Glow: Reducing the Carcinogenic Effects of ALDH2 Deficiency

Source: blogs.plos.org
Author: Catherine Chang et al.

Turning red after consuming alcohol may seem like a mere social inconvenience. Yet, behind this red complexion lies a far more serious problem. ALDH2 deficiency, more commonly known as Alcohol Flushing Syndrome or Asian Glow, is a genetic condition that interferes with the metabolism of alcohol. As a result, people with ALDH2 deficiency have increased risks of developing esophageal and head and neck cancers . Globally, this deficiency affects 540 million people — 8% of the world population. In East Asia (which includes Japan, China, and Korea), this is a much bigger problem, where 36% of the population is affected [1]. In our home, Taiwan, approximately 47% of the population carries this genetic mutation — the highest percentage in the world [2]!

Normally, ethanol is first converted to acetaldehyde (a toxic intermediate) by the enzyme alcohol dehydrogenase (ADH). A second enzyme, aldehyde dehydrogenase 2 (ALDH2), then converts toxic acetaldehyde into acetate, a compound which can be safely metabolized in the body. For people who carry wild type ALDH2*1, acetaldehyde can be broken down quickly. People with ALDH2 deficiency, however, have a point mutation which leads to the less efficient mutant ALDH2*2 [3], [4]. Enzymatic activity in ALDH2-deficient individuals can be as low as 4% compared to wild type [4], [5], [6], [7]. As a result, acetaldehyde accumulates and induces an inflammatory response that causes the skin to flush after drinking alcohol [8]. Turning red is the most obvious result of ALDH2 deficiency, but symptoms also include headaches, dizziness, hypotension, and heart palpitations [5], [9].

Acetaldehyde accumulates in ALDH2-deficient individuals. Ethanol is first converted to a toxic intermediate, acetaldehyde, by ADH, then converted to acetate by wild type ALDH2*1. The mutant form, ALDH2*2, cannot fully convert acetaldehyde into acetate, and toxic acetaldehyde accumulates as a result.

For people who are ALDH2-deficient and drink, acetaldehyde can accumulate to toxic levels. The International Agency for Research on Cancer classifies acetaldehyde associated with alcohol consumption as a Group 1 carcinogen [10]. Acetaldehyde levels over 50 μM are considered toxic and cause mutations in DNA, and studies show that the strongest effects are seen in the mouth [11], [12]. After consuming roughly 2 to 3 servings of alcohol (0.5-0.6 g alcohol/kg body weight), salivary acetaldehyde levels in ALDH2-deficient individuals reached over 100 μM, compared to normal levels of <20 μM without drinking [13], [14], [15], [16]. Because of the increased salivary acetaldehyde, people with ALDH2 deficiency are 2 to 8 times more likely to develop head and neck cancers (including oral cancer, pharyngeal cancer, laryngeal cancer, etc.), and 2 to 12 times more likely to develop esophageal cancer compared to people with normal ALDH2*1 [17-25].

Our ALDH2*1 probiotic candy significantly reduces acetaldehyde levels in simulated oral conditions. (A) The conversion of acetaldehyde to acetate by ALDH2 uses NAD+ and produces NADH. (B) Experimental setup. The candies were dissolved, the probiotic (Nissle) was lysed to release ALDH2 enzymes, and the supernatant was placed into artificial saliva. NADH concentration was measured by taking absorbance readings at 340 nm. (C) Enzymatic activity of ALDH2*1 and ALDH2*2 from the probiotic candies. A negative control of candy without Nissle was also included (gray). Under these conditions, the ALDH2*1 candies metabolized significantly more acetaldehyde compared to both the ALDH2*2 candies and the negative control. Error bars represent standard error.

To directly address the increased esophageal and head and neck cancer risks, we developed a probiotic (E. coli Nissle 1917) candy carrying recombinant human ALDH2*1 to maintain normal acetaldehyde levels in the mouths of ALDH2-deficient individuals. We tested the candy’s ability to break down acetaldehyde by measuring NADH, a byproduct of acetaldehyde metabolism. In simulated oral conditions, we observed a significant decrease in acetaldehyde levels when we added the contents of our ALDH2*1 candy (compared to the mutant ALDH2*2 or control candy). Through mathematical modeling, we also determined the exact amount of recombinant ALDH2*1 needed in each piece of candy. Our modeling shows that if a consumer eats our candy while drinking, the released ALDH2*1 will be able to combat the high salivary acetaldehyde levels and match the normally low levels found in wild type individuals.

 

Our final product, an ALDH2*1 probiotic candy!

Nearly half of Taiwan’s population is ALDH2 deficient. To combat the increased cancer risks associated with this deficiency, we developed and tested a method to regulate acetaldehyde levels in ALDH2-deficient individuals.

The TAS_Taipei iGEM Team have produced a full research article detailing their project. You can access that article here.

Note:Please note that the team’s full research article has not been peer-reviewed.

Authors: Catherine Chang, Tim Ho, Iris Huang, Justin Wu

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2019-09-10T04:23:56-07:00September, 2019|Oral Cancer News|
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