Five reasons boys and young men need the HPV vaccine, too

Source: www.mskcc.org
Author: Memorial Sloan Kettering Cancer Center, News and Information

Rich Delgrosso found the lump while shaving. It was on the left side of his neck and it seemed to grow bigger by the day. He made an appointment with his ear, nose, and throat doctor.

“He said the odds were 50/50 that it was an infection,” recalls the 56-year-old father of two from Pleasantville, New York. “I asked, ‘What’s the other 50?’”

It was a possibility no one wanted to hear: Cancer. Rich underwent a biopsy and learned he had squamous cell carcinoma that had originated on the base of his tongue. His cancer, the doctor told him, was caused by the human papillomavirus (HPV).

Rich was shocked. “I knew HPV could cause cancer,” he says, “but I thought it was only cervical cancer in women.”

It’s true that HPV, a sexually transmitted virus, does cause the majority of cervical cancer cases in women. But it can also cause a variety of cancers in men, too, some of which are on the rise.

HPV led to a five-fold increase of head and neck cancers in young men from 2001 to 2017, according to data released at the 2021 American Society for Clinical Oncology annual meeting.

Memorial Sloan Kettering’s David Pfister, a medical oncologist who cares for people with head and neck cancer, says these cancer cases are just now emerging in people infected with the virus many years ago.

“Once the association between HPV infection and throat cancers was established, we better understood the significant increase in the rate of these cancers,” he says. “There is a delay between infection and the development of cancer, so there is a big reservoir of people already potentially at risk.”

But there is a way to prevent more than 90% of cancers caused by this virus: Get the HPV vaccine. It protects against head and neck cancers as well as anal cancer in both men and women. In men, it also protects against penile cancer, and in women, cervical cancer, vaginal cancer, and vulvar cancer. The vaccine is recommended for all children and can be given as early as age 9. It’s also approved for adults up to age 45.

Amidst growing concern about falling vaccination rates, MSK joined other National Cancer Institute-designated cancer centers in a May 2021 statement urging physicians, parents, and young adults to begin or keep up with HPV vaccinations, after they were interrupted by COVID-19. Early in the pandemic, HPV vaccination rates among adolescents fell by 75%. Since March 2020, an estimated one million doses of HPV vaccine have been missed by adolescents who have public insurance. That’s a decline of 21% from pre-pandemic levels.

Moreover, parents of boys are increasingly hesitant to have their sons vaccinated, according to a study in the journal Pediatrics.

MSK’s HPV Center is working to increase vaccination rates for everyone. Here are five reasons why it’s especially important for males.

1. Men get cancers caused by HPV in large numbers, too.
From 2013 to 2017, there were approximately 25,000 cases of HPV-associated cancers in women and 19,000 in men, according to the Centers for Disease Control and Prevention. More than four out of every ten cases of cancer caused by HPV are in men.

“HPV should be of concern to all since men and women are affected virtually the same by this virus,” says Abraham Aragones, an MSK physician who also studies public health.

2. There are now more cases of head and neck cancers than cervical cancers in America; HPV causes 70% of them, according to the CDC.
“My doctor told me that tumors of the neck and throat were getting more common in men,” Rich recalls.

Head and neck cancers are four times as common in men as they are in women.

3. There is no test for HPV cancers in males.
A Pap test detects early-stage cervical cancer in women. No such test exists for penile, anal, or head and neck cancers.

“Developing something like a Pap test for throat cancer would be a game-changer,” says Dr. Pfister. “When you compare the throat to the cervix, the anatomy of sites like the tonsils and the base of the tongue have hard-to-reach crevices the virus can hide in. Until an effective and reliable screening test is developed, patients should stay up to date on their HPV vaccines, know how the disease is acquired, and take any suspicious symptoms like a lump in the neck or blood in the phlegm to their doctor or dentist.”

4. The odds of getting HPV-related cancer increases with age.
“Today’s men are living longer than ever before, and that gives cancer more time to develop,” Dr. Aragones says. “Vaccination protects men from HPV-related cancers in the short and long term.”

5. The vaccine is just as safe for boys as it is girls.
The HPV vaccine went through years of rigorous safety testing before it was approved in 2006 to prevent cervical cancer in women and in 2009 to prevent HPV-related cancers in males. Since then, more than 100 million doses of the HPV vaccine have been given in the United States. Like any vaccine, there can be side effects, but they are minor, like arm soreness and fatigue. “The benefits of vaccinating against HPV far outweigh any potential risk of side effects,” says Dr. Aragones.

Rich made sure his teenage son got the HPV vaccine and says his younger daughter will follow suit.

“I didn’t want them to go through what I went through,” he says. After radiation and chemotherapy three years ago, Rich thankfully has shown no evidence of disease.

HPV-related cancers are usually able to be treated successfully. But preventing a cancer is far better than treating it, which makes the HPV vaccine a valuable weapon against cancer.

Naveris’ new saliva test detects head and neck cancer

Source: www.biospace.com/
Author: staff

A new clinically-validated saliva test has been shown to detect HPV-associated head and neck cancer with high accuracy, a first-of-its-kind study result.

Researchers at Washington University School of Medicine in St. Louis used the Naveris, Inc. test to analyze saliva for sequences of the human papilloma virus (HPV) genome that are specific for HPV DNA released from malignant tumors. The test successfully distinguishes this tumor-tissue modified virus from non-cancerous sources of HPV DNA and precisely measures the number of tumor-tissue modified viral HPV (TTMV-HPV) DNA strands present in a saliva sample.

The study results point to the potential for a significant improvement in early detection of the most common type of head and neck cancer, HPV-associated oropharyngeal squamous cell carcinoma.

“Naveris’ patient-friendly saliva test has the potential to radically advance early detection of HPV-positive head and neck cancer, which has been growing rapidly among men in the United States. Early detection of these cancers would make a dramatic difference in patient outcomes,” said Piyush Gupta, PhD, CEO of Naveris.

The study quantified participants’ tumor-tissue modified viral HPV DNA in saliva samples and compared it to the levels found in their blood by utilizing Naveris’ NavDx® test. The results showed that TTMV-HPV DNA was commonly found in the saliva of HPV-associated head and neck cancer patients (44/46 cases), and at 18 times higher levels in the saliva samples than in the blood samples. One sample had undetectable TTMV-HPV and one was indeterminate for HPV DNA.

Washington University researchers are presenting an abstract of the study at the American Society of Clinical Oncology (ASCO) 2021 annual meeting.

“The results of our study highlight the potential of accurately analyzing saliva to improve the early detection of HPV-associated oropharyngeal squamous cell carcinoma. If validated in larger studies, this test could lead to earlier diagnosis and treatment,” said the study’s principal investigator Jose P. Zevallos, MD, chief of the division of Head and Neck Surgery in the Department of Otolaryngology at Washington University School of Medicine.

Naveris’ new saliva test is based upon the proprietary technology employed by the NavDx® blood test that is in use at centers of excellence treating HPV-associated oropharyngeal cancer across the United States. NavDx® is a liquid biopsy test that detects HPV-associated head and neck cancer earlier than is possible with imaging and is provided exclusively in the United States through the Naveris national reference CAP-accredited laboratory.

About Oropharyngeal Cancer:
Oropharyngeal cancer, which can develop at the base of the tongue, tonsils, and the middle part of the throat, used to be closely associated with smoking and heavy drinking. Today, however, oropharyngeal cancer is primarily caused by human papillomavirus (HPV) infection, the most common sexually transmitted virus and infection in the United States. More than one of five U.S. adults are infected with a high-risk strain of HPV that can potentially develop into cancer.1

Cases of HPV-positive oropharyngeal cancer have been increasing at an exponential rate among men in the United States over the last two decades2. About 54,000 cases of oropharyngeal and oral cavity cancer are expected in the nation this year and more than 10,000 deaths.3

Oropharyngeal cancers usually are not identified early because they grow slowly in locations that are not easy to see. By the time the cancers are recognized they frequently have spread to the lymph nodes and are difficult to treat. Early detection, however, enables highly effective treatment.

About Naveris, Inc.
Naveris, Inc. is a molecular diagnostics company developing and commercializing novel blood and saliva tests to enhance the early detection and clinical management of viral-associated cancers. The company’s NavDx® blood test, which uses proprietary technology to detect tumor tissue modified HPV, is in use at leading cancer treatment centers and academic medical centers throughout the United States.

New therapy shortens treatment for HPV-related cancers of the tonsils, tongue

Source: medicalxpress.com
Author: From Mayo Clinic News Network, Mayo Clinic News Network

Patients with HPV-related oropharyngeal cancer who undergo surgery and are treated with chemotherapy, may be able to forgo significant radiation therapy without increasing the risk of their cancer spreading, according to the results of a clinical trial led by researchers at Mayo Clinic.

“We found that decreasing the amount of radiation therapy after a minimally invasive robotic surgery improved the quality of life of patients with HPV-related oropharyngeal cancer while delivering excellent cure rates,” says Dr. Eric Moore, a Mayo Clinic otolaryngologist. “In essence, we found exactly the right amount of treatment to deliver without over-treating these patients.”

Dr. Moore and his colleagues compared 79 patients treated at Mayo Clinic for HPV-related tonsil and tongue cancer with surgery and two weeks of radiation therapy to a group of 115 patients with the same cancer who were treated with surgery, and the standard six weeks of radiation therapy and chemotherapy.

Dr. Moore and his colleagues found no decrease in survival or cancer recurrence in the group that received two weeks of radiation therapy, compared to the group that received six weeks of radiation therapy. He says that by decreasing the amount of radiation therapy after minimally invasive robotic surgery, physicians were able to improve the quality of life of patients and achieve excellent cure rates.

“In essence, we found exactly the right amount of treatment to deliver without overtreating,” says Dr. Moore.

Dr. Moore says Mayo Clinic now offers dose de-escalation radiation therapy to appropriately selected patients with HPV-related cancers of the tonsils and tongue.

“This approach shortens the treatment time for these patients by several weeks and reduces side effects without sacrificing the effectiveness of the treatment,” Dr. Moore says.

Genetic changes in head and neck cancer, immunotherapy resistance identified

Source: MedicalXPress
Date: April 26th, 2021
Author: University of San Diego-California

A multi-institutional team of researchers has identified both the genetic abnormalities that drive pre-cancer cells into becoming an invasive type of head and neck cancer and patients who are least likely to respond to immunotherapy.

“Through a series of surprises, we followed clues that focused more and more tightly on specific genetic imbalances and their role in the effects of specific immune components in tumor development,” said co-principal investigator Webster Cavenee, Ph.D., Distinguished Professor Emeritus at University of California San Diego School of Medicine.

“The genetic abnormalities we identified drive changes in the immune cell composition of the tumors that, in turn, dictates responsiveness to standard of care .”

Reporting in the April 26, 2021 online issue of the Proceedings of the National Academy of Sciences, researchers describe the role of somatic copy-number alterations—abnormalities that result in the loss or gain in a copy of a gene—and the loss of chromosome 9p in the development of human papillomavirus (HPV)-negative and .

The loss of chromosome 9p and the deletion of JAK2 and PD-LI, two neighboring genes found on chromosome 9p, was associated with resistance to immune checkpoint inhibitors, a type of cancer immunotherapy that uses antibodies to make tumor cells visible to a patient’s immune system.

“Although programmed death-1 (PD-1) immune checkpoint inhibitors represent a major breakthrough in , only 15 percent of patients with HPV-negative head and neck cancer respond to treatment,” said co-principal investigator Scott M. Lippman, MD, senior associate dean, associate vice chancellor for and care and Chugai Pharmaceutical Chair in Cancer at UC San Diego School of Medicine.

“The ability to predict a patient’s response or resistance to this class of therapies, a major unmet clinical need, is a unique and novel discovery. Knowing who will not respond avoids losing several months to ineffective therapy with huge financial costs and impacts to quality of life,” said Lippman, director of UC San Diego Moores Cancer Center and medical oncologist who specializes in the treatment of patients with head and neck cancer at UC San Diego Health, San Diego’s only National Cancer Institute-designated comprehensive cancer center.

For this study, co-led by New York University Langone Health’s Teresa Davoli, Ph.D., and The University of Texas MD Anderson Cancer Center’s William N. William, MD, with co-investigator Steve Dubinett, MD, of UCLA Jonsson Comprehensive Cancer Center, researchers prospectively followed 188 patients at MD Anderson Cancer Center to study genomic and immune drivers of the transition to invasive HPV-negative head and neck cancer. They reviewed comprehensive genomic and transcriptomic data of 343 HPV-negative head and neck cancer patients from The Cancer Genome Atlas and 32 HPV-negative head and neck cancer cell lines from the Cancer Cell Line Encyclopedia project, and analyzed patient survival after immunotherapy in real-world evidence cohort data from Caris Life Sciences.

In 2021, the National Cancer Institute estimates approximately 54,000 new cases of head and neck cancers will be diagnosed in the United States, with 10,850 deaths. HPV-negative head are the most common, increasing and lethal subtype of this malignancy worldwide, said Lippman.

“The data serves as a powerful predictive marker, transforming standard of care for precision immunotherapy for patients with advanced, recurrent head and ,” said Lippman. “And, while we focused in an unprecedented extensive interrogation of the most globally lethal form of head and neck squamous cancer, accounting for more than 300,000 deaths annually, the application may be useful in a wide variety of solid tumors for which immune checkpoint inhibitors comprises standard of care.”

Dental Professionals Should Remember the HPV Vaccine Too

Source: Dentistry Today
Date: April 13th, 2021
Author: Jo-Anne Jones

We live in a viral world as we patiently await the end of the COVID-19 pandemic. Many people already have chosen to be vaccinated to protect themselves from getting the virus, or, at the very least, minimize its severity.

The harsh nature of the pandemic has led to expediency in developing the vaccine, which has not been typical, historically speaking. While the COVID-19 vaccine took less than a year to develop, the mumps vaccine took four years. The polio vaccine took 13 years. The human papillomavirus (HPV), flu, and chicken pox vaccines took 17, 27, and 28 years, respectively.

Looking back in the annals of history, we have the remarkable work of Edward Jenner to thank for his development of the first vaccine. His work involved deliberately infecting a human being with a mild dose of smallpox. His rigorous trials were controlled, repeatable, and documented in his 1798 publication, “An Inquiry Into the Causes and Effects of the Variolæ Vaccinæ.”

Jenner devoted the remainder of his life advocating for the safe and effective administration of the vaccine. In 1972, routine smallpox vaccination ended in the United States, followed by the World Health Organization declaring the disease’s elimination in 1980.

Another such vaccine victory is the polio vaccine, which was first available in the United States in 1955. Thanks to its widespread use, the United States has been polio-free since 1979.

And while the United States government has said that dentists can now administer the COVID-19 vaccine, there is another vaccine that we should bring to the attention of every adult who visits our practice: the HPV vaccine.

The Rise of Oropharyngeal Cancer

The fastest-growing segment of oropharyngeal cancers is attributed to HPV. Yet it can be prevented by the Gardasil HPV nine-valent vaccine (Gardasil 9 [9vHPV]). More than 270 million doses of the Gardasil HPV vaccine have been given worldwide, including 120 million doses in the United States.

Gardasil 9 is a non-infectious recombinant vaccine prepared from virus-like particles (VLPs) of the protein of HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

We accept vaccination due to perceived risk. Are your patients aware of the ubiquitous nature of this virus and the fact that merely being alive and sexually active may place them at inherent risk? Many of our patients who do not possess a history of tobacco or alcohol use do not perceive a risk of oral or oropharyngeal cancer.

But according to the Centers for Disease Control and Prevention, more than 70% of oropharyngeal cancers are related to HPV. HPV-related oropharyngeal cancer has now surpassed HPV-related cervical cancer as the leading HPV-associated cancer.

Cervical cancer used to be the leading cause of cancer death for women in the United States. But in the past 40 years, the number of cervical cancer cases and the number of cervical cancer deaths have decreased significantly. This decline is primarily the result of opportunistic screening practices and the HPV vaccine.

Most sexually active Americans will clear the virus without consequence. Many of them will not be aware of even having the virus. However, for persistent infection with a high-risk strain such as HPV-16, the risk for malignant transformation is real.

In 2020, the Food and Drug Administration approved an expanded indication for Gardasil 9 for the prevention of oropharyngeal and other head and neck cancers caused by HPV types 16, 18, 31, 33, 45, 52, and 58. The vaccine is also indicated to prevent cervical, vulvar, vaginal, anal, and penile cancer.

2021 is a year defined and impacted by an overstretched healthcare system. We have longer wait times and backlogs for cancer treatments than ever before. For a cancer that is essentially preventable by a vaccine, it is frustrating beyond words to know that many of our dental patients are unaware of its existence.

HPV is responsible for a small number of oral cancers, as the vast majority are caused by lifestyle behaviors including smoking and alcohol use—once again, preventable.

We are not powerless. Our patients do not have to fall victim to the collateral damage of COVID-19. We can encourage our patients to perform a self-examination of the oral cavity between professional visits. We can educate them about the subtle symptoms that may be associated with HPV-related oropharyngeal cancer.

A North American campaign entitled Check Your Mouth was developed to educate the public about the importance of oral self-examination. It is the result of collaboration between the Oral Cancer Foundation and Holland Healthcare, developer of the Throat Scope and TelScope.

The Throat Scope is the world’s first all-in-one illuminated tongue depressor. The TelScope is a seamless oral telehealth delivery system capable of capturing real-time high-resolution images and emailing them to an oral healthcare provider via encrypted email.

Empower your patients. Share the science that we are most fortunate to have and recognize that we can proactively fight back in a viral world.

Ms. Jones is an award-winning speaker who has given over a thousand presentations across the United States, Canada, England, Ireland, and Bermuda. She also joins the Dentistry Today’s Leaders in Continuing Education for the eleventh consecutive year. With her frank and open lecture style, focus on direct knowledge translation to practice, and educational and clinical resources, she has earned many loyal followers both nationally and internationally. She may be reached at jjones@jo-annejones.com.

 

2021-04-13T12:57:09-07:00April, 2021|OCF In The News|

HPV vaccine leads to more than 80% drop in infections: What parents need to know

Source: Good Morning, America
Date: April 2nd, 2021
Author: Kathleen Kindalen

 

A new study has shown the effectiveness of the HPV vaccine, and found a dramatic decline in human papillomavirus infections in both vaccinated and unvaccinated teen girls and young women in the United States.

“This study shows that the vaccine works very well against a common virus, HPV,” Dr. Hannah Rosenblum, lead author of the study and medical epidemiologist at the Centers for Disease Control and Prevention (CDC), told “Good Morning America.”

“HPV can cause serious health problems later in life, including some cancers in both women and men,” she said. “HPV vaccination is cancer prevention — by vaccinating children at age 11 or 12, we can protect them from developing cancers later in life.”

HPV is the most common sexually transmitted infection in the United States and can cause health problems like genital warts in addition to cancer, which are most commonly cervical cancer in women and throat cancer in men, according to the CDC.

The HPV vaccine was first authorized in the U.S. for females in 2006, and for males in 2011. There has since been a more than 80% decline in HPV infections nationally, according to the CDC study.

The newly-released data from the CDC shows an 88% decrease in HPV infections among 14 to 19-year-old females and an 81% decrease among 20 to 24-year-old females.

There has also been a drop in unvaccinated females, according to Rosenblum, who warned that does not mean people should let their guard down.

“We also see an effect among unvaccinated females in these age groups due to less spread of the virus, however, unvaccinated persons are not immune and are still at risk of getting HPV,” she said. “They should talk to their doctor about getting vaccinated if they are 26-years-old or younger.”

HPV viruses are found in 80 million people in the United States, according to the CDC. There are hundreds of subtypes of HPV, and 1 in 4 people in the U.S. are infected with HPV at some point in their lives.

The CDC recommends two doses of the HPV vaccine, taken six to 12 months apart, for all girls and boys ages 11 to 12, but says the vaccine can be given to children as young as 9.

Teens and older who are not vaccinated are encouraged to do so by the age of 26. People ages 15 and older need three doses of the vaccine, according to the CDC.

The timing of the vaccine has to do with the state of children’s immune systems and also trying to vaccinate pre-teens before they are sexually active, Dr. Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine and New York-Presbyterian in New York City, told “GMA.”

“Your immune system [at ages 11 and 12] is such that you have a robust response to this vaccine, and it lasts for a really long time,” she said. “But if you haven’t had it, still continue talking to your doctor about getting it up to age 26.”

Riley said she hopes the CDC’s new data — which stands out for being a 10-year study — combined with the safety of the HPV vaccine eases any remaining concerns parents may have about getting their children vaccinated against HPV.

“When [the HPV vaccine] first rolled out, the message wasn’t quite clear, so instead of people recognizing that you were going to prevent your kid from getting cancer, people were focused on the fact that HPV is a sexually transmitted disease,” she said. “The education has to continue so that parents can understand the real benefit of this vaccine.”

“The real benefit is to prevent your child from getting cervical cancer,” Riley said. “The fact that you can prevent [cervical cancer] with a vaccine that has been used for years and has shown to be safe, why wouldn’t you do it?”

Long-lasting infection with certain types of HPV is the main cause of cervical cancer, which has the best survival rates if detected early according to the CDC. Doctors routinely screen for cervical cancer with the Pap test and HPV DNA testing depending on age and risk factors.

“We need to make sure that the teenagers and pre-teens are getting the benefit of the HPV vaccine, because it really is an anti-cancer vaccine,” said Riley. “[Cervical cancer] is a really devastating disease.”

Globally, a woman loses her life to cervical cancer every two minutes, according to a 2019 article published in the medical journal The Lancet.

In the U.S., doctors on the frontlines like Riley said more must continue to be done to educate parents about the HPV vaccine and make sure that all children across the country have access to the vaccine. As of 2018, nearly 40% of adults ages 18 to 26 reported receiving one or more doses of the HPV vaccine, according to the CDC.

“We need to make sure that we work on access to this vaccine and make sure that all girls of all races and ethnicities have the access,” said Riley. “And we need to be sure that the message is clear so that everyone gets the two doses of the vaccine, because that’s what is associated with the best protection.”

More parents balking at giving kids cancer-fighting HPV vaccine

Source: www.usnews.com
Author: Steven Reinberg

From 2012 to 2018, more doctors recommended their patients get vaccinated with the HPV vaccine — from 27% to 49%. But at the same time, the number of parents who were reluctant to have their kids vaccinated increased from 50% to 64%, researchers found.

“Overall, more U.S. teens are getting the HPV vaccine, and the nation is making progress towards reaching the HPV vaccination goals; however, if parental reluctance continues to grow, the current rate of our progress might plateau or possibly decline,” said lead study author Kalyani Sonawane. She’s an assistant professor in the department of management, policy and community health at the University of Texas Health Science Center in Houston.

“In the long term, the lost opportunity to protect our teens from HPV might contribute to cases of HPV-associated cervical, oropharyngeal, penile, anal, vaginal and vulvar cancers in the future,” Sonawane said.

Parents’ reluctance to have their kids vaccinated rose more for girls, from 54% to 68%, compared with 44% to 59% for boys, the researchers noted. The report was published online Feb. 9 in the journal Pediatrics.

To increase the number of boys and girls who get vaccinated, doctors need to strongly recommend it, Sonawane said.

“Further improvements in provider recommendations can be made, given that it is the most important factor for improving HPV vaccine uptake,” she said. “Providers should be prepared to tackle hesitancy by conveying the importance of HPV vaccination to parents and debunking vaccine misinformation. Increasing vaccine confidence in parents will be key to attaining HPV vaccination goals in the U.S.”

The reluctance is largely due to safety concerns, Sonawane said. In a study, she and her colleagues found that the most common reason parents cite for their reluctant to HPV vaccine is concerns regarding adverse effects.

“The public message about the HPV vaccine should highlight that the vaccine protects against cancers. It is important to emphasize to parents that the vaccine offers protection for up to six cancers, because data indicates that many people are not aware of this fact,” Sonawane said.

In another study, Sonawane found that less than one-third of Americans know that HPV causes anal, penile and oral cancers.

Sonawane added that the anti-vaxxer movement is likely contributing to the growing reluctance of parents to have their children vaccinated, and she is concerned that the “negative coverage of the COVID vaccine will trickle down to HPV vaccine and affect perceptions regarding vaccines.”

HPV is a sexually transmitted infection that is the cause of most cervical, vagina and vulva cancers, penis cancer and cancer in the back of the throat. It can take years for these cancers to develop, but children can be protected by getting the HPV vaccine at ages 11 to 12, according to the U.S. Centers for Disease Control and Prevention.

One pediatrician unconnected to the study noted the importance of the marketing for the vaccine.

“When this vaccine first hit the market, they didn’t focus the messaging around it being a cancer preventer vaccine. They focused on the sexually transmitted infections,” said Dr. David Fagan, vice chairman of pediatric administration-ambulatory at Cohen Children’s Medical Center in New Hyde Park, N.Y.

Fagan believes, however, the message should be that the vaccine prevents cancer. “Wouldn’t you, as a parent, want to do everything you could for your child to prevent the possibility of your child getting a cancer — this vaccine does that,” he said.

He also thinks that the quality of the recommendation is key to convincing parents to vaccinate their children.

The American Academy of Pediatrics is doing a lot to educate pediatricians in motivational interviewing techniques, Fagan said.

The tetanus booster, the meningitis vaccine and the HPV vaccine are those recommended for adolescence.

Evidence shows, if you offer the HPV in first or second place as opposed to third place, parents are more likely to opt for it, Fagan said.

“If you do tetanus, meningitis, HPV, they are less likely to accept HPV, but if you put HPV first or even second, there’s evidence that there’s better uptake. So messaging is really, really important,” he said.

The vaccine is safe, Fagan said. A study has shown that no serious side effects have been seen since the vaccine was released.

“You know these things on social media about the safety of the vaccine, obviously that’s crazy stuff,” he said.

“I tell parents if this vaccine was unsafe, it would have been pulled from the market,” Fagan said. “Additionally, you would be reading about multimillion dollar legal settlements in the press, and that has not happened. So the take-home message is this vaccine is safe and effective in preventing cancers caused by HPV.”

More information
For more on the HPV vaccine, go to the U.S. Centers for Disease Control and Prevention.

Sources:
Kalyani Sonawane, Ph.D., assistant professor, department of management, policy and community health, University of Texas Health Science Center at Houston; David Fagan, MD, vice chairman, Pediatric Administration-Ambulatory, Cohen Children’s Medical Center, New Hyde Park, N.Y.; Pediatrics, Feb. 9, 2021, online

2021-02-10T10:56:54-07:00February, 2021|Oral Cancer News|

Timing and intensity of oral sex may affect risk of oropharyngeal cancer

Source: www.eurekalert.org
Author: Research News

Human papillomavirus (HPV) can infect the mouth and throat to cause cancers of the oropharynx. A new study published early online in CANCER, a peer-reviewed journal of the American Cancer Society, has found that having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer. The study also shows that having oral sex at a younger age and more partners in a shorter time period (oral sex intensity) were associated with higher likelihoods of having HPV-related cancer of the mouth and throat.

Previous studies have shown that performing oral sex is a strong risk factor for HPV-related oropharyngeal cancer. To examine how behavior related to oral sex may affect risk, Virginia Drake, MD, of Johns Hopkins University, and her colleagues asked 163 individuals with and 345 without HPV-related oropharyngeal cancer to complete a behavioral survey.

In addition to timing and intensity of oral sex, individuals who had older sexual partners when they were young, and those with partners who had extramarital sex were more likely to have HPV-related oropharyngeal cancer.

“Our study builds on previous research to demonstrate that it is not only the number of oral sexual partners, but also other factors not previously appreciated that contribute to the risk of exposure to HPV orally and subsequent HPV-related oropharyngeal cancer,” said Dr. Drake. “As the incidence of HPV-related oropharyngeal cancer continues to rise in the United States, our study offers a contemporary evaluation of risk factors for this disease. We have uncovered additional nuances of how and why some people may develop this cancer, which may help identify those at greater risk.”

Full Citation:
“Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer.” Virginia E. Drake, Carole Fakhry, Melina J. Windon, C. Matthew Stewart, Lee Akst, Alexander Hillel, Wade Chien, Patrick Ha, Brett Miles, Christine G. Gourin, Rajarsi Mandal, Wojciech K. Mydlarz, Lisa Rooper, Tanya Troy, Siddhartha Yavvari, Tim Waterboer Nicole Brenner, David W. Eisele, and Gypsyamber D’Souza. CANCER; Published Online: January 11, 2021 (DOI: 10.1002/cncr.33346).

Personalized vaccines: the new frontier in cancer treatment

Source: www.wildcat.arizona.edu
Author: Udbhav Venkataraman

Exciting results from a new clinical study showed that a personalized vaccine combined with an immunotherapy drug had a promising response rate in patients with advanced incurable head and neck cancer.

Dr. Julie Bauman, chief of Hematology and Oncology at the University of Arizona College of Medicine — Tucson, led a phase one clinical trial with the pharmaceutical company, Moderna, to test the combined use of personalized vaccines created from tumor DNA with the immunotherapy drug pembrolizumab.

Of the 10 patients involved in the study, five of the them responded to the treatment, meaning 30% of the cancer mass had decreased. Furthermore, two of the patients completely responded, meaning that cancer could not be detected.

Molly Cassidy is one of those two patients. What was initially determined to be a stress-related ear-ache turned out to be an aggressive case of squamous cell carcinoma, a form of head and neck cancer.

Head and neck cancers impact the linings of the mouth and throat. Risk factors for this disease include alcohol consumption, smoking and other environmental carcinogens that we are all exposed to. It can also be caused by human papillomavirus (HPV).

Cassidy did not fit this profile at all.

“I’m HPV-negative. I didn’t drink. I didn’t smoke. I’m a woman. I was the first person in my family to have cancer. I was 35 when I got my diagnosis,” Cassidy said. “I was also in really good health … To hear that I had cancer was really surprising.”

With an initial prognosis that the cancer was curable, Cassidy underwent a standard but invasive surgery followed by a grueling series of radiation and chemotherapy sessions over the next few months.

Just a week after completing Cassidy’s initial treatment plan, the cancer returned aggressively. She had several tumors in her neck and they were spreading to her lungs. Her prognosis became bleaker.

“Having such a quick recurrence was not a good sign … they put me on a palliative plan and I was told I need to get my affairs in order,” Cassidy said. “I wasn’t expected to live for more than a year.”

Cassidy now had advanced incurable head and neck cancer which occurs when an initial cancer treatment fails and the cancer returns. This combined with the fact that she was HPV negative made her eligible for Bauman’s clinical study.

One of the recent frontiers of cancer research has been immunotherapy — harnessing our immune systems to fight cancer. Our immune system is able to detect and attack foreign invaders in our bodies, including cancer cells. However, these cells develop ways to hide from the immune system.

Immunotherapy can involve using medication to activate and train the immune system to recognize and eliminate these cancer cells. When this treatment is effective, the response can be long-lived.

“I can give you chemo and drive you to a complete response, but as soon as chemo is not there, the cells that are left become resistant and grow back,” Bauman said. “Immunotherapy leaves behind an army of T-cells that if the cancer rears its ugly head again, will presumably kill it.”

According to Bauman, the current U.S. Food and Drug Administration-approved therapies are non-specific. These therapies generally activate the T-cells of the immune system which recognize foreign invaders. This method means that T-cells that recognize cancer cells would be activated. This method of therapy however has a low effectiveness rate.

“In head and neck cancer, this class of therapy is successful 10-15%of the time … We want that to be more often,” Bauman added.

Furthermore, there can be auto-immune side effects because T-cells that recognize our own healthy tissues may start attacking those very tissues.

This is where new and fascinating technology comes into the picture: personalized vaccines. This approach is a specific approach, where T-cells are activated based on the mutations of the patient’s cancer.

After taking a sample of cancer cells from the patient, those cells’ DNA is sequenced. Using a computational algorithm, the cancer DNA is compared to the patient’s healthy DNA to find the specific mutations present in that patient’s cancer. From all those mutations, Moderna is able to synthesize a messenger RNA vaccine, which can be used to train the appropriate T-cells to recognize abnormal proteins from these cancer cells.

A helpful video about the process can be found at the UA Health Sciences website. The clinical trial consisted of using both this personalized vaccine approach with the FDA approved T-cell activator pembrolizumab.

“The trial is the combination of using those mutations almost like a trojan horse … educating the immune system to see those mutated proteins at the same time as we give the unbridled T-cell activator,” Bauman said. “We’re awakening T-cells, but we’re saying this is the particular class of T-cells that we are calling.”

For the trial, each patient was given two doses of pembrolizumab over six weeks. During this time, the vaccine was developed by Moderna. After the vaccines were created, the patients received one dose of their vaccine every three weeks for nine weeks along with the pembrolizumab, and the cancer was monitored using a CAT scan.

And the results show that the vaccines are safe. This seems really promising and exciting to pursue.

“Although it is only 10 patients, and we have to not only overpromise … it is a really strong signal to expand the study and to see if we continue to see what we saw with these 10 patients,” Bauman said.

“When I was going into treatment, I was really ill and the treatments themselves were pretty hard on me. Cancer treatment is no walk in the park,” Cassidy said. “But once I got through the treatment’s initial side effects, I started to notice an increase in my energy and I wasn’t in as much pain.”

Having completely responded to her treatment, Cassidy is now able to live a normal life. She has spoken with various dentists and used her platform to help educate people about the prevalence and signs of oral cancers and the importance of understanding what the inside of our mouths are supposed to look like.

“It also brought forth what are the most important things for me — my son and husband and the importance of slowing down and enjoying my time with my family,” Cassidy said.

There are many new things that Bauman is looking into researching further. As they expand the trial to 40 participants for the next phase of trials, she is exploring how to optimize the vaccine.

“If we can selectively educate the immune system … we can have a therapy that is active, could drive a permanent response and not be toxic or harsh on the rest of the body,” Bauman said.

Bauman also mentioned that this optimization might mean potentially experimenting with a different drug than pembrolizumab for treatment, although this is a great start. They have also taken samples of the T-cells from the patients to see which types of mutations the T-cells respond best to.

“People who have advanced in cancer … have extraordinary suffering because cancer is uncontrolled in this area where things are critical to our humanity, like talking and breathing and eating and kissing and smiling. To be able to reverse that suffering and offer that hope is uniquely gratifying,” Bauman said.

2020-12-09T06:51:37-07:00December, 2020|Oral Cancer News|

Mouth cancer in the UK at record high

Source: www.hippocraticpost.com
Author: staff

New cases of mouth cancer in the UK have risen to a record high, according to the findings of a new report.

  • New figures show there have been 8,722 new cases of mouth cancer in the UK last year.
  • This is an increase of 58% compared to ten years ago and 97% compared to 20 years ago.
  • Data released in a new report to coincide with November’s Mouth Cancer Action Month.

Figures collected by the Oral Health Foundation show that 8,722 people in the UK were diagnosed with the disease last year, increasing by 97% since 2000.

Mouth cancer cases in the UK have soared for the 11th year in a row and have more than doubled within the last generation.

The findings are part of the charity’s new State of Mouth Cancer UK Report 2020/21 and have been released to coincide with November’s Mouth Cancer Action Month.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, believes with mouth cancer cases continuing to rise, more must be done to raise awareness of the disease.

Dr Carter says: “While many cancers are seeing a reduction in the number of people affected, mouth cancer is one of very few that is sadly going the other way. Established risk factors like smoking and excessive alcohol have been joined by emerging causes like the human papillomavirus (HPV). This has changed the profile of the disease quite considerably over recent years and mouth cancer can now affect anybody.

“The disease can have a devastating and lasting effect on a person’s life. It can change how somebody speaks, it makes eating and drinking more difficult, and often leads to changes to a person’s physical appearance. Because of this, it also takes a heavy toll on a person’s mental health too.

“One of the biggest challenges we face regarding mouth cancer is how little educational support it receives from government and public health bodies. As part of Mouth Cancer Action Month, we will be working with thousands of organisations to improve awareness of the disease so that more people are able to recognise the early warning signs.”

Statistics from governing health bodies across the UK show around two-in-three (67%) mouth cancers are recorded in men while three-in-four (78%) are in the over 55’s.

Mouth cancer is most likely to occur in the tongue, contributing to more than one-in-three (34%) cases. Mouth cancer can also appear in the tonsils, the roof and floor of the mouth, lips and gums.

The early warning signs of the disease include mouth ulcers that do not heal within three weeks, red or white patches in the mouth, or unusual lumps and swellings. Persistent hoarseness could also be a symptom.

Dr Catherine Rutland, Clinical Director at Denplan, part of Simplyhealth, speaks about the importance of knowing how to spot mouth cancer early and acting quickly if you notice anything out of the ordinary.

Dr Rutland says: “Self-checks and regular dental visits are extremely important for spotting mouth cancer in its initial stages, yet public awareness of mouth cancer actually remains very poor – around 3 out of 4 people said they did not know what the symptoms of mouth cancer are in the Oral Health Foundation’s latest research. Many mouth cancer cases are caught far too late. For a significant proportion of patients, a delay of three to six months in diagnosis and treatment will affect the likelihood of achieving long-term survival.

“Be ‘mouthaware’ and alert to any unusual changes to the mouth, head or neck. Mouth ulcers lasting more than three weeks, unexplained persistent lumps, red patches and white patches are all signs that should be checked by a dentist. If you notice anything out of the ordinary, don’t wait. Book an appointment with your dentist so that they can examine you.

“For Mouth Cancer Action Month this November, make sure you know the basics. Learn how to perform a quick self-check (visit mouthcancer.org), know what to look for and where mouth cancer occurs. By doing this, you give yourself the best possible chance of overcoming mouth cancer.”

Roy Templeton (59) from Beauly, Inverness, was diagnosed with mouth cancer of the tonsils. Now given the all clear, Roy says his experience of mouth cancer will never leave him.

Roy says: “Although I had heard of mouth cancer, I wasn’t aware how terribly common it was, and I didn’t know anybody personally who had had it. Any conversations I’d heard about people with mouth cancer had given me the impression it happens to much older people and especially those who heavily drank or smoke. I didn’t smoke and I was a moderate drinker, so the diagnosis really came as a shock.

“Going through cancer treatment had a big effect on me mentally. It crystallised in my own mind that life is quite precious. When it comes to opportunities arising in your life, either in work or your personal life, you want to grab every moment more than ever before.

“I was quite fortunate that I went to my GP early when I found something not right. If you have any inkling something is wrong, I would urge you to get it looked at. Getting checked out early could save your life.”

Spotting mouth cancer early is crucial for beating the disease. Early detection boosts the chances of survival from 50% to 90% while also dramatically improving a person’s quality of life.

Sadly, far too many mouth cancers are caught in the late stages of the disease. Latest annual reports show mouth cancer claims 2,702 lives a year, which on average is one person every hour.

2020-11-04T11:53:47-07:00November, 2020|Oral Cancer News|
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