Dental oncology: Meeting a growing need

Source: Dr.Biscuspid.com The good news is more cancer patients are surviving than ever before. The bad news is it creates new challenges for the medical community to provide adequate and appropriate aftercare and treat the many short- and long-term side effects of cancer treatment. For example, chemotherapy and radiation often cause oral problems such as mucositis, xerostomia, oral and systemic infections, and accelerated caries development. But many dentists refuse to treat cancer patients with these conditions due to the increased risk of osteonecrosis from radiation treatment or bisphosphonate use. Enter Ryan Lee, DDS, MPH, MHA, who is finishing a postgraduate clinical fellowship in dental oncology at Memorial Sloan-Kettering Cancer Center in New York City. He hopes to help solve the shortage of dentists with the training to treat the growing number of cancer patients who need specialized oral care. Ryan Lee, DDS, is one of a handful of dentists specializing in dental oncology. Dr. Lee is one of two fellows in Sloan-Kettering's dental oncology fellowship program, which has been offering the specialty training for at least a decade. "All along I've liked working on medically complex cases with dental needs, so cancer fit into that niche very well," he told DrBicuspid.com. "I've come to realize how much of a growing need it is and how little is available to meet that need," he explained. Currently, only two cancer hospitals offer fellowship training programs for dental oncology: the Memorial Sloan-Kettering Cancer Center and the University of Texas MD Anderson Cancer Center. [...]

2012-06-07T10:09:20-07:00June, 2012|Oral Cancer News|

The UK’s first robotic mouth cancer operation

Source: www.privatehealth.co.uk Author: staff Pioneering surgery which allows doctors to remove cancer in the mouth using a minimally invasive technique is now available at the Wellington Hospital. Traditionally, the only way to remove Squamous Cell Carcinoma – cancer of the oropharynx which encompasses the tonsils and base of the tongue – has been to split the jaw, take out the cancer and repair the neck with tissue from the forearm. This 10-hour procedure requires two surgical teams and often has complications. Patients are in hospital for at least three weeks and need months of rehabilitation to help them swallow and speak again. Because the treatment is so invasive, many doctors try to avoid it using chemotherapy and radiotherapy instead. However, surgery is often the best chance of a cure. The new one-hour technique called Transoral Robotic Surgery allows the cancer to be removed without splitting the jaw or taking tissue from other parts of the body. Instead, the tonsils are accessed through the mouth using a specially designed robotic machine. Developed in the US in 2009 and now approved by the American Food and Drug Administration and licensed for use in the UK, it uses the Da Vinci robot to access this difficult to reach area. It gives the surgeon greater precision, dexterity and accuracy while carrying out the procedure and the patient has no stitches. Infection rates are reduced which speeds up recovery rates, patients are in hospital for just a week and are able to swallow normally soon afterwards [...]

Oral sex may cause more oral cancer than smoking in men, researchers say

Source: www.bloomberg.com Author: Robert Langreth A virus spread by oral sex may cause more cases of throat cancer in men than smoking, a finding that spurred calls for a new large-scale test of a drug used against the infection. Researchers examined 271 throat-tumor samples collected over 20 years ending in 2004 and found that the percentage of oral cancer linked to the human papillomavirus, or HPV, surged to 72 percent from about 16 percent, according to a report released yesterday in the Journal of Clinical Oncology. By 2020, the virus-linked throat tumors -- which mostly affected men -- will become more common than HPV-caused cervical cancer, the report found. HPV is known for infecting genitals. The finding that it can spread to the throat and cause cancer may increase pressure on Merck & Co., the second-largest U.S. drugmaker, to conduct large-scale trials to see if its vaccine Gardasil, which wards off cervical cancer in women, also prevents HPV throat infections. “The burden of cancer caused by HPV is going to shift from women to men in this decade,” Maura Gillison, an oncologist at Ohio State University and study senior author, said in a telephone interview. “What we believe is happening is that the number of sexual partners and exposure to HPV has risen over that same time period.” Gillison said she worked with researchers at Whitehouse Station, New Jersey-based Merck several years ago to design a study in men. After Merck acquired Schering-Plough Corp. in 2009, though, the trial “was canceled,” [...]

Actor’s Diagnosis Puts Spotlight on Oral Cancer

Source: DrBicuspid.com May 9, 2012 -- Actor Michael Douglas' recent revelation that he has stage IV oropharyngeal cancer has highlighted the growing incidence of oral cancer, and experts say dentists can help stem the alarming increase of the disease by checking for it during routine examinations. The actor's cancer includes a walnut-sized tumor at the base of his tongue, and he will require radiation therapy, chemotherapy, and surgery. Douglas says his doctors told him he has an 80% survival rate if it hasn't spread to his lymph nodes. While tobacco was the prime cause of oral cancer in the past, recent studies have attributed the steady increase of the disease to the human papillomavirus (HPV). There are approximately 130 versions of HPV but only nine cause cancers, and the HPV16 version causes almost half of the oral cancers in the U.S., said Brian Hill, executive director of the Oral Cancer Foundation. "Tobacco is no longer the only bad guy," he told DrBicuspid.com. “HPV16 is increasing in incidence as the causative etiology, and if it continues on this trend line, it will replace tobacco as the primary cause of oral cancers." Dentists can play a key role in catching the disease in its early stages if they check for it during examinations, Hill pointed out. "But many dentists think it's such a rare disease that they don't bother to screen for it," he said. "Most Americans have never even heard of oral cancer, but it's not as rare or uncommon as [...]

2012-05-17T09:43:19-07:00May, 2012|Oral Cancer News|

Actor Michael Douglas Partners With Oral Cancer Foundation For Early Detection PSA Campaign

LOS ANGELES, May 14, 2012 /PRNewswire-USNewswire/ -- Actor and producer Michael Douglas has donated his time to help create a television public service announcement (PSA) on behalf of the Oral Cancer Foundation (OCF), a non-profit organization dedicated to helping those affected by the disease. The PSA will support the Foundation's efforts to educate the public about the need for annual screenings to catch oral cancers in their early, most survivable stages. The public service announcement will begin airing in June, and will continue to air nationwide through summer and autumn. Approximately 40,000 people in the US will be newly diagnosed with oral cancer in 2012. This includes those cancers that occur in the mouth itself, in the very back of the mouth known as the oropharynx, and on the exterior lip of the mouth. There are two distinct pathways by which most people come to oral cancer. One is through the use of tobacco and alcohol, and the other is through exposure to the HPV-16 virus (human papilloma virus version 16), a newly identified etiology, and the same virus which is responsible for the vast majority of cervical cancers in women. While oral cancer has historically been linked to tobacco and alcohol use, this is not simply a smoker's disease any longer. New data shows that the fastest-growing segment of newly diagnosed cases is now young, non-smokers. Most startling, is the fact that while many other cancers have been in decline in recent years, the occurrence of oral / oropharyngeal [...]

2012-05-14T19:59:49-07:00May, 2012|OCF In The News, Oral Cancer News|

Radiotherapy May Be Enough for HPV-Positive Throat Cancer

Source: Medscape Today May 11, 2012 (Barcelona, Spain) — Radiotherapy alone might be just as effective as more toxic regimens in the treatment of light smokers or nonsmokers with human papillomavirus (HPV)-positive advanced oropharyngeal carcinomas, according to research presented here at ESTRO 31: European Society for Radiotherapy and Oncology 2012 Annual Conference. "Moderately accelerated radiotherapy as a single modality may be a safe and presumably morbidity-sparing treatment strategy for these patients," said Pernille Lassen, MD, a resident in medical and radiation oncology at Aarhus University Hospital in Denmark. "What we are suggesting — knowing that it's not randomized and knowing that it's not a very large series — is that perhaps we don't need to treat these patients with chemotherapy and all the other things that we do," she told Medscape Medical News. We're "not recommending one treatment over another; this is a contribution to the ongoing debate. But [we're] showing that we really cure a lot of patients with radiotherapy alone in this select group of nonsmokers or light smokers and HPV positivity." The researchers examined 181 patients from the Danish Head and Neck Cancer Group (DAHANCA) database who had advanced oropharyngeal cancer that had metastasized to the lymph nodes or beyond (stage III and IV). Cumulative smoking history was categorized as greater than or less than 10 pack-years (1 pack-year is equivalent to 20 cigarettes per day for 1 year), and pretreatment tumor immunohistochemistry was assessed on the basis of HPV-associated p16 expression (positive or negative). "p16 expression is a striking [...]

2012-05-11T10:55:04-07:00May, 2012|Oral Cancer News|

Alberta committee suggests free HPV vaccine for boys

Source: CBC News Cost to the province estimated between $5 million and $8 million The province is considering offering boys free immunizations against the human papillomavirus. The HPV vaccination is currently offered on a voluntary basis to all girls in Alberta entering Grade 5. The vaccine is said to prevent 70 per cent of cervical cancers, according to Alberta Health and Wellness. Two strains of HPV are also thought to be a cause of anal, penile and oral cancers. Susan Morgan's husband was diagnosed with Stage 4 oral cancer, which they later found out was caused by the HPV virus. She has been lobbying to have the vaccine for boys covered by the province and was astounded the HPV vaccination was only free for girls. Morgan says the effects of the radiation and chemotherapy treatment for the cancer were horrific. "You have open sores in your mouth,” she said. “You start to lose your ability to swallow; you end up on a feeding tube." Free vaccine for boys recommended A report by an advisory committee in Alberta recommends extending HPV coverage to boys. Chief medical officer Dr. Andre Corriveau says that would cost between $5 million and $8 million. Now he'll review the report and advise the province by the end of the month. "I have a responsibility right now to make sure our system has the capacity to deliver," he said. But, for the Morgans, waiting is not an option and they have decided to pay hundreds of dollars [...]

2012-05-07T13:25:56-07:00May, 2012|Oral Cancer News|

Photographer inspires others with throat cancer survival

Source: www.getsurrey.co.uk Author: Rebecca Younger When Thames Ditton photographer, Keith Hern, was diagnosed with throat cancer five years ago, he dealt with it the only way he knew how – by taking pictures. Through an incredibly honest and stark photographic portrayal of his treatment, Keith captured everything from the first bout of chemotherapy at the Royal Marsden Hospital in London to the making of his radiotherapy mask and the eight-inch scar left on his neck after an operation to remove dead cancer cells. The candid imagery appears in Keith’s book, Bangers & Mash, which he started writing shortly after he was first diagnosed in 2007. “I’d started writing a couple of days after diagnosis as the only way I could maintain some semblance of mental control, it would later become therapeutic,” he recounted. “My treatment consisted of five days of 24x7 chemotherapy, 11 days off, five days of chemotherapy again, 11 days off, then radiotherapy for six weeks daily with two top-up chemo sessions in weeks one and five. “Radiotherapy side effects kicked in at the end of week one – I could no longer eat, then lost my taste, then I couldn’t sleep (my mouth was so dry I was sipping water 24x7), I lost two-and-a-half stone in the six weeks.” Keith worked with a Neurolinguistic Programming (NLP) coach to stay positive and it was while talking to her about writing a book of his experiences that the idea for a photo diary came about. “She laughed at the [...]

Robotic Surgery Is Useful Option for Oral Cancer

Source: Onclive.com Minimally invasive transoral robotic surgery (TORS), used alone or combined with adjuvant therapy, provides good functional and oncologic outcomes in patients with oropharyngeal squamous cell carcinoma (OPSCC), new research suggests. The results were especially impressive in patients with human papillomavirus (HPV) infection, which is currently the most common cause of OPSCC in Europe and the United States. Eric J. Moore, MD, associate professor of Otolaryngology at the Mayo Clinic in Rochester, Minnesota, and coauthors reviewed a prospective database of patients with previously untreated OPSCC arising in the tonsil or base of the tongue who underwent TORS at their institution during a recent 2-year period. In 2011, about 12,000 individuals in the United States were diagnosed with OPSCC, according to the authors. The most common sites are the tonsillar fossa and base of the tongue. Customarily, OPSCC has been treated with combined modality therapy, including open surgical resection through mandibulotomy, neck dissection, and adjuvant radiation therapy or combined chemotherapy and radiation therapy. TORS was later introduced to improve access to these tumors. Functional outcomes of the study included gastrostomy tube dependence and tracheostomy dependence. Oncologic outcomes included local, regional, and distant control and disease-specific and recurrence-free survival. Overall, 66 patients who underwent TORS as their primary treatment were followed for a minimum of 2 years. Sixty-four patients, or 97%, were able to tolerate an oral diet and maintain their nutritional needs before initiating adjuvant therapy at 4 weeks. Only 3 patients, or 4.5%, required long-term gastrostomy tube use, and [...]

2012-04-30T17:14:50-07:00April, 2012|Oral Cancer News|
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