biopsy

Dentists don’t need tools to screen for oral cancer

Source: auburnpub.com Author: Dr. Michael Keating A comment from a patient the other day inspired this month’s topic. I had gone down to the room of one of the hygienists on my team to examine a patient at their six-month preventive therapy visit. I sat down and began examining the skin of the face and neck when the patient asked me what exactly I was looking for. It made me think. Maybe our patients don’t know what we are looking for as we dentists examine them. The exam is much more than coming in, picking up a mirror and explorer and checking just the teeth. Each dentist has their own method and technique of performing the exam. Rest assured, this important step is not missed. So what is it I am looking for? This particular patient that prompted me to discuss oral cancer asked me the question as I was looking along their hairline and lifting back their bangs so I could examine the scalp and forehead. If you were to look at the Skin Cancer Foundation website (www.skincancer.org) you would find that basal cell carcinoma is found mainly on the face, scalp, ears, neck, shoulders and back. Let’s see, four out of six of those are right front and center to me when I go to look at a patient at their recall exam. Sure makes sense for me to check! So for this patient I told them I was looking for any signs of skin cancer, and if [...]

Oral Cancer Foundation News Team - A2010-09-30T14:04:25-07:00September, 2010|Oral Cancer News|

HPV is changing the face of head and neck cancers

Source: www.hemonctoday.com Author: Christen Cona In February, at the Multidisciplinary Head and Neck Cancer Symposium in Chandler, Ariz., Maura Gillison, MD, PhD, professor and Jeg Coughlin Chair of Cancer Research at The Ohio State University in Columbus, presented data that showed that the proportion of all head and neck squamous cell cancers that were of the oropharynx — which are most commonly HPV-positive cancers — increased from 18% in 1973 to 32% in 2005. In addition, studies from the United States, Europe, Denmark and Australia indicate that HPV-positive patients have a more than twofold increased cancer survival than HPV-negative patients, according to Gillison. With the rising incidence of HPV-related oropharynx cancers, it will soon be the predominant type of cancer in the oral or head and neck region, according to Andy Trotti, MD, director of radiation oncology clinical research, H. Lee Moffitt Cancer Center & Research Institute, in Tampa, Fla. “We should be focusing on HPV-related oropharyngeal cancer because it will dominate the field of head and neck cancers for many years,” he said during an interview with HemOnc Today . “It is certainly an important population for which to continue to conduct research.” Because HPV-associated oropharyngeal cancer is emerging as a distinct biological entity, the recent rise in incidence will significantly affect treatment, and prevention and screening techniques, essentially reshaping current clinical practice. Social change driving incidence In the analysis performed by Gillison and colleagues, trends demonstrated that change in the rates of head and neck cancers [...]

Oral Cancer Foundation News Team - A2010-06-27T10:24:39-07:00June, 2010|Oral Cancer News|

Isn’t it about time? Overcoming the real barriers to complete oral cancer screening

Source: www.dentistryiq.com Author: Jonathan A. Bregman, DDS, FAGD In the previous articles of this series, I discussed four barriers I see as stopping those in the dental profession from doing a complete oral cancer screening examination. In Part 1, the barrier I discussed is the overall lack of confidence in doing a complete extra-/intraoral cancer screening exam. The rationale: “not doing the exam at all puts me at less risk than doing it and missing something.” In Part 2, the barrier I discussed is being unclear about who to examine: the changing target population, especially the influence of the human papillomavirus (HPV 16/18). In Part 3, the uncertainties of how the complete cancer screening examination should be done, plus communicating the reasons for doing it for patients. In Part 4: Uncertainty about how to properly record the cancer screening examination Barrier 5: Uncertainty about how to best and most effectively deliver the message of a positive finding The more we look, the more we find. The more we look, the closer we look, the more abnormalities we will detect with our cancer screening exam. This makes sense, of course. The same goes for the complete periodontal examination, the complete occlusal analysis, the complete updated radiographic evaluation, etc. In each area — tissue abnormalities, periodontal abnormalities, occlusal abnormalities — we must address the needs of the patient in a way that sets the stage for understanding of the problem(s) and presenting possible options/solutions to correct the problems. Build on what you [...]

Oral Cancer Foundation News Team - A2010-04-19T22:33:02-07:00March, 2010|Oral Cancer News|

Sentinel nodes predict spread in oral cancer

Source: www.medpagetoday.com Author: Michael Smith, North American Correspondent, MedPage Today In early oral squamous cell carcinoma, a sentinel node biopsy correctly predicted an absence of lymphatic metastasis in all but 4% of patients, researchers said. For T1 and T2 lesions that were clinically node-negative, the procedure -- combined with additional sectioning and immunohistochemistry -- yielded a negative predictive value of 96%, according to Francisco Civantos Jr., MD, of the University of Miami, and colleagues. For T1 lesions, the value was 100%, while for T2 cancers it was 94%, the researchers reported online in the Journal of Clinical Oncology. The finding may position the procedure as an intermediate option between watchful waiting and selective neck dissection, the researchers said, asserting that it's now "reasonable" to conduct a head-to-head trial of sentinel node biopsy and neck dissection. The procedure has significantly increased the sensitivity for detecting lymphatic metastasis in melanoma and breast cancer patients, Civantos and colleagues noted. But in oral cancer, many surgeons prefer a completion neck dissection, they added, despite the "measurable morbidity" that's associated with the procedure. On the other hand, because of that morbidity, other specialists prefer watchful waiting and elective neck irradiation. To investigate the issue, Civantos and colleagues conducted a multicenter trial in which patients with early invasive oral cancers were treated with both procedures -- a sentinel node biopsy, followed by completion selective neck dissection. The primary goal was to see if a negative hematoxylin and eosin finding on the sentinel node biopsy accurately predicted [...]

Oral Cancer Foundation News Team - A2010-02-09T21:42:01-07:00February, 2010|Oral Cancer News|

Routine oesophageal screening recommended for patients previously treated for head and neck cancer

Source: www.docguide.com Author: Kristina Rebelo Patients who have been treated for head and neck cancer (HNCA) should be screened for oesophageal pathologies about 3 months out whether they are symptomatic or not, according a poster presentation here October 4 at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting 2009. Oesophageal pathology is extremely common in patients who have been treated for HNCA, according to the researchers. "When we talk about HNCA, the 5-year survival rate for this cancer is 50%," Peter C. Belafsky, MD, Head and Neck Oncological Surgery, University of California at Davis, and the Voice and Swallowing Center, Davis, California, told DocGuide. "We took a look at the oesophagus in patients after treatment for head and neck cancer and we did oesophagoscopy and biopsy, as indicated, on all of them. We successfully performed the oesophagoscopy on all 100 patients without complication and we had only 13% of the entire cohort who had a normal examination." The study included 100 patients who had chemoradiation and underwent follow-up oesophagoscopy. Patient demographics, symptom surveys, treatments received, reflux medications prescribed and oesophageal findings were prospectively determined. Findings on oesophagoscopy included stricture (22%), candidiasis (9%), peptic oesophagitis (67%), Barrett's (8%), and new primary tumours -- 1 hypopharynx, 2 oesophageal, and 1 stomach (4%); 13% had a normal oesophagoscopy. The mean age of the cohort was 64 years and 74% were male. The mean time between the cessation of treatment and endoscopy was 40 months and 77% of the HNCA [...]

Oral Cancer Foundation News Team - A2009-10-12T12:05:11-07:00October, 2009|Oral Cancer News|

Hills attorney boasts ‘largest jury verdict’

Source: www.hometownlife.com Author: Stacy Jenkins It may be the largest jury verdict award for a dental malpractice lawsuit, but Michigan's tort laws prevent the $15 million award from becoming a reality. Farmington Hills attorney Robert Gittleman said he is “thrilled” by the $15 million verdict reached Aug. 27 by an Oakland County Circuit Court jury because “it sends a strong message.” But the tort laws, he says, are “ludicrous and unfair.” Under Michigan's tort laws, his client will receive $500,000 instead of the $15 million the jury thought she deserves. “It's not tort reform, it's tort deform,” he said. “It's an oppressive law that messes up the jury (process) because the jury speaks, then the judge has to (rule) something else.” Gittleman represented Herta Hopton, 61, of Novi, in the jury trial in Circuit Court Judge Steven Andrews' courtroom in August. Hopton, who was referred to board-certified oral surgeon Warren Vallerand, in Novi, had pain in her lower right jaw in 2005. She visited her general dentist at that time, and again in February 2006 when three lower teeth became loose in the area of the jaw pain. She was referred to a periodontist, who recommended the teeth be pulled and a bridge be inserted. A white lesion in her mouth at that time was considered to be “aspirin burn,” according to court documents. The lesion cleared up, but another surfaced in May 2006. Hopton was then referred to oral surgeon Vallerand for lesion evaluation and a possible biopsy. “His [...]

Oral Cancer Foundation News Team - A2009-09-14T06:58:22-07:00September, 2009|Oral Cancer News|

New oral cancer tests: crucial or wasteful?

Source: nytimes.com Author: Laurie Tarkan Though relatively rare, it is one of the easiest cancers to spot and diagnose. And if treated early, it is usually curable. So why do experts find oral cancer so vexing? Despite the many advances against cancer in recent decades, the statistics on this form of it remain discouraging: more than 60 percent of cases are diagnosed in the late stages, and the five-year survival rate is a disappointing 59 percent. Moreover, oral cancer is increasing in people traditionally at low risk, a phenomenon partly attributed to the rise of the cancer-causing human papillomavirus, or HPV, which can be transmitted through oral sex. Now some dentists — whose visual examinations have long been a first line of defense against oral cancer — are using screening devices that they say may help identify cancers and premalignant lesions. But these new tests have set off a debate over cost and effectiveness. Experts are divided on whether they will reduce mortality from oral cancer or simply lead to a wave of expensive and unnecessary biopsies. An estimated 35,300 Americans learned they had oral cancer last year, and about 7,600 died from the disease. For survivors, oral cancer can be painful and disfiguring, and can destroy the ability to taste and enjoy food. Smokers and heavy drinkers are considered at highest risk for the disease, but 25 percent of those who receive a diagnosis are neither. Still, the lifetime risk of oral cancer — about 1 in 99 — [...]

Oral Cancer Foundation News Team - A2009-02-03T20:50:30-07:00February, 2009|OCF In The News, Oral Cancer News|

Survival after surgical resection of pulmonary metastases and second primary squamous cell lung carcinomas in head and neck cancer

Source: Head Neck, October 28, 2008 Authors: Thomas W Geurts et al. Background: Patients with head and neck squamous cell carcinoma (HNSCC) are at risk for developing both pulmonary metastasis and second primary lung cancer (SPLC). The objective of this study was to determine survival characteristics of patients with pulmonary lesions after curative treatment for HNSCC. Methods: Lung resection or biopsy specimens of 36 patients, curatively treated for HNSCC between 1978 and 2002, were defined as second primary squamous cell lung cancer or metastasis by loss of heterozygosity (LOH analysis). Twenty-two of them underwent surgical resection. Survival characteristics were estimated using Kaplan-Meier analysis according to the LOH characterization. Results: The number of resected lung lesions ranged from 1 to 3. Median overall survival after lung surgery was 23.1 months for SPLC (n = 14) and 25.1 months for lung metastases (n = 8). Fourteen patients, SPLC (n = 6) and metastases (n = 8), did not undergo surgical resection, and their median overall survival was 3.7 and 4.4 months, respectively. Conclusion: Survival after resection of metachronic lung lesions following curative treatment of HNSSC is similar for lesions characterized as second primary squamous cell lung cancer and those characterized as metastases. Authors: Thomas W Geurts, Alfons J M Balm, Marie-Louise F van Velthuysen, Harm van Tinteren, Jacobus A Burgers, Nico van Zandwijk, and Houke M Klomp Authors' affiliation: Department of ORL, Academic Medical Center, Amsterdam, The Netherlands

Oral Cancer Foundation News Team - A2008-11-03T09:49:47-07:00November, 2008|Oral Cancer News|

Unnecessary Biopsies Reduced By Team Work, St. Louis University Researchers Find

Source: www.medicalnewstoday.com Author: press release Unnecessary biopsies could be a thing of the past for patients undergoing treatment for head and neck cancer. New Saint Louis University research found that when nuclear medicine clinicians and treating physicians work together to interpret PET-CT scan results, the accuracy dramatically improves, sparring patients unnecessary pain and suffering. Often used prior to and after cancer treatment, the highly sensitive PET-CT has improved the ability to detect and treat head and neck cancer. However, it can give a significant number of false positive results, which then require a biopsy to rule out cancer that could have been left behind during the initial treatment. According to Mark Varvares, M.D., the study's lead author and the Donald and Marlene Jerome Endowed Chair in Otolaryngology - Head and Neck Surgery at Saint Louis University, both nuclear medicine and treating physicians have become better at interpreting PET-CT scans. "If we improve the accuracy of the scans by including clinical information, the treating physician or cancer specialist will be able to say with confidence that we do not need to biopsy something - that it's just post-operative inflammation." Unnecessary biopsies are dangerous for head and neck cancer patients who have already undergone intensive radiation and chemotherapy. It can create a non-healing situation that can result in a catastrophic event, such as needing to remove the voice box, Varvares explained. Varvares and his colleagues studied the scan results of 180 head and neck cancer patients who had undergone evaluation with PET-CT [...]

Oral Cancer Foundation News Team - A2008-07-23T19:12:20-07:00July, 2008|Oral Cancer News|