Oral epithelial dysplasia: What does it really mean?

Source: www.rdhmag.com Author: Nancy W. Burkhart, RDH, EdD Patients are sometimes followed for periods of time for what is called dysplasia, leukoplakia, keratotic lesions, and previous frank carcinoma. With any degree of tissue change, the person should be followed closely and an etiology always needs to be determined. Sometimes, removal of a frictional component is suggested; at other times, the lesion may have a more ominous appearance that will alert the clinician that cancer might be high on the differential list. Obviously, in highly suspicious lesions, a biopsy would occur immediately. Patients will sometimes tell the clinician that they were previously biopsied and the report will note "evidence of dysplasia." Sometimes a diagnosis is made of dysplasia, but the lesion becomes carcinoma over time, even after the initial removal of the lesion. The reverse may be true as well, where the body responds physically and the tissue regains a state of health. Why does one individual develop carcinoma while another person may develop a mild epithelial dysplasia? Perhaps the body is able to stop progression or reverse the state of progression. These are questions that researchers continue to evaluate and study. Frictional keratosis, though, is not in the same category as dysplasia. When the frictional component is removed, the lesion will subside. An example of a common lesion that has a frictional component is cheek chewing or morsicatio buccarum. However, chronic frictional or chemical assault on the tissue over time can also cause dysplastic changes. The body has [...]

Photodynamic therapy shows promise in head/neck cancer

Source: www.drbicuspid.com Author: staff Photodynamic therapy (PDT) has been shown to be effective as a curative therapy for early cancers of the head and neck, according to research presented at the recent International Photodynamic Association World Congress in Innsbruck, Austria. Researchers from Ondine Biomedical presented two studies at the conference. In the first, 469 patients with various neoplastic diseases of the head and neck were treated with PDT with follow-up time of up to 250 months. Patients with primary or recurrent carcinoma in situ and T1 carcinomas responded after one PDT treatment, and 88% remained free of the disease, according to the researchers. The second study focused on the use of PDT to down regulate MMP-9 gene expression in cell cultures of precancerous leukoplakia and oral squamous cell carcinoma. MMP-9 is expressed by squamous cell carcinomas of the head and neck, and is one of the factors responsible for the ability of these cancers to invade into tissue and also to spread to other tissues. After one treatment of methylene blue PDT, gene expression of MMP-9 was significantly decreased in both the precancerous leukoplakia cells and the oral squamous cell carcinoma cells. This work demonstrated that methylene blue mediated PDT can downregulate proteins that promote the spreading of head and neck carcinoma, therefore potentially reducing the ability of these cancers to invade tissue and spread, the researchers noted. "These abstracts clearly confirm a role of PDT in the treatment of head and neck cancer," stated Carolyn Cross, chairman and CEO [...]

Pioglitazone Shows Promise for Oral Cancer Prevention

Laird Harrison Medsscape staff writer San Diego, California — In a phase 2 clinical trial, the thiazolidinedione pioglitazone partially or completely eliminated two thirds of leukoplakia lesions, which can sometimes become cancerous, researchers reported here at the International Association of Dental Research 89th General Session and Exhibition. Pioglitazone (Actos, Takeda Pharmaceuticals) "works pretty well — better than anything we've seen before," principal investigator Nelson Rhodus, DMD, MPH, professor of otolaryngology at the University of Minnesota, Minneapolis, toldMedscape Medical News. Leukoplakia lesions, which are usually caused by irritation, appear on the tongue or sometimes on the insides of the cheek. About 17% of the lesions become invasive cancer, and no treatment has been shown to reliably prevent this, said Dr. Rhodus. They researchers got interested in pioglitazone because it preserves cell differentiation, enhances apoptosis of tumor cells, and prevents tumor angiogenesis. In a previous study, the researchers noticed a decrease in head, neck, and lung neoplasms in a population of diabetic men older than 40 years who took thiazolidinedione agents. For this study, Dr. Rhodus and colleagues from the University of Minnesota, Minneapolis, and the National Cancer Institute in Bethesda, Maryland, recruited 44 patients with lesions characterized histopathologically as either moderate or severe epithelial dysplasia. The researchers randomly divided these patients so that 22 patients received pioglitazone 45 mg daily for 12 weeks and 22 patients served as a comparison group. Dr. Rhodus's team measured the leukoplakia lesions and took biopsies of the involved mucosa to evaluate histologic response in all participants. They [...]

Tongue cancer symptoms: soreness, spots & swellings

Source: www.dentistry.com Author: staff Tongue cancer normally occurs in the squamous, or skin cells. Symptoms of tongue cancer either in the front or middle of your tongue makes it oral cancer - if they're at the base of your tongue it comes under the heading of throat or oropharyngeal cancer. When looking for tongue cancer symptoms, watch out for the following persistent signs: • Red, pink, grey or white spots on tongue • Sore spots on tongue • Leukoplakia or erythroplakia on tongue • Sore throat • Pain when swallowing • Mouth numbness • Unexplained bleeding of tongue • Pain in the ear (very rare) • Changes in your voice • Tongue swelling Red, Pink, Grey or White Spots on Tongue - These symptoms of tongue cancer start small and may look like canker sores, especially if they occur in other places in your mouth. Canker sores tend to go away in a week or two. White spots on tongue might also indicate oral thrush or hairy tongue, but you'll be able to gently scrape these off yourself. Remember, persistency is one of the main factors for symptoms of tongue cancer, along with tongue pain. Leukoplakia & Erythroplakia - These are products of uncontrolled cell growth, one of the very definitions of cancer. But figuring out if they are actual tongue cancer symptoms or just irritations from your dental work depends on a biopsy. They might also be pre-cancerous, so it's best to see your dentist about these swelling or [...]

Clinical significance of phosphatidyl inositol synthase overexpression in oral cancer

Source: 7thspace.co Authors: Jatinder Kaur et al. We reported increased levels of Phosphatidyl Inositol synthase (PI synthase), (enzyme that catalyses phosphatidyl inositol (PI) synthesis-implicated in intracellular signaling and regulation of cell growth) in smokeless tobacco (ST) exposed oral cell cultures by differential display. This study determined the clinical significance of PI synthase overexpression in oral squamous cell carcinoma (OSCC) and premalignant lesions (leukoplakia), and identified the downstream signaling proteins in PI synthase pathway that are perturbed by smokeless tobacco (ST) exposure. Method: Tissue microarray (TMA) Immunohistochemistry, Western blotting, Confocal laser scan microscopy, RT-PCR were performed to define the expression of PI synthase in clinical samples and in oral cell culture systems. Results: Significant increase in PI synthase immunoreactivity was observed in premalignant lesions and OSCCs as compared to oral normal tissues (p=0.000). Further, PI synthase expression was significantly associated with de-differentiation of OSCCs, (p=0.005) and tobacco consumption (p=0.03, OR=9.0). Exposure of oral cell systems to smokeless tobacco (ST) in vitro confirmed increase in PI synthase, Phosphatidylinositol 3-kinase (PI3K) and cyclin D1 levels. Conclusion: Collectively, increased PI synthase expression was found to be an early event in oral cancer and a target for smokeless tobacco. Authors: Jatinder Kaur, Meenakshi Sawhney, Siddartha Datta, GuptaNootan, Shukla, Anurag, Srivastava, Ranju Ralhan Source: BMC Cancer 2010, 10:168

Dentists your first defence in fight against oral cancer

Source: Timescolonist Author: Johnathan Skuba In 2003, an estimated 3,100 Canadians were newly diagnosed with oral cancer. That same year, 1,090 people died of the disease. In the U.S., oral cancer kills roughly one person per hour, 24 hours a day. Of those newly diagnosed, only half will survive five years later, and this terrifying death rate has not declined for decades. Those statistics are frightening, but the good news is that early detection plays a major role in preventing or curing oral cancers. The first line of defence is the dentist. They are specifically trained to recognize even subtle changes in the mouth and take action. Pre-malignant lesions usually manifest as white patches (leukoplakias) that can look like small calluses. They could be benign and nothing but skin thickened by trauma or normal wear and tear of oral tissues. Of greater concern are spots that become ulcers, bleed, rapidly change appearance or that are obviously getting larger. Red patches (erythroplakia) should also be examined as they too could represent cancerous tissue. If any such spots are present and either enlarge or don't improve within 10-14 days, or if they disappear and then recur, patients are advised to see their dentists as soon as possible. Once in the chair, patients will find that dentists do not take chances, especially when the spots appear in areas where normal trauma is unlikely, such as the soft palate of the mouth or under the tongue. When such spots are seen, and particularly when [...]

2009-11-09T12:23:32-07:00November, 2009|OCF In The News, Oral Cancer News|

Understanding the link between HPV and oropharyngeal cancers

Source: www.jaapa.com (Journal of the American Academy of Physician Assistants, October, 2009) Authors: Denise Rizzolo, PA-C, PhD, Mona Sedrak, PA-C, PhD Head and neck cancer is diagnosed in approximately 650,000 patients each year worldwide.1 The term head and neck cancer refers to a group of biologically similar cancers originating from the upper aerodigestive tract, including the lip, oral cavity (mouth), nasal cavity, paranasal sinuses, pharynx, and larynx. Oropharyngeal refers to all the structures of the mouth and pharynx, including the tonsils and tongue. Oral squamous cell carcinoma (OSCC) is the most common form of head and neck cancer.2 Seventy-five percent of all OSCCs are attributable to tobacco and alcohol use.3 People who smoke cigarettes are 4 times more likely to develop oral cancer than nonsmokers. Furthermore, individuals who consume alcohol are 3 times more likely than nondrinkers to develop oral cancer.3 According to the Substance Abuse and Mental Health Services Administration, the prevalence of cigarette smoking has decreased among Americans, and alcohol use has also declined since the 1970s.4,5 However despite this, the incidence of oropharyngeal cancers, including cancer of the base of the tongue and tonsils, has increased, especially in younger patients. These trends have led researchers to investigate other potential risk factors.6-8 New studies suggest that there may be an alternative pathway for the development of oropharyngeal cancers. The high-risk types of human papillomavirus (HPV), especially type 16 (HPV-16), are now thought to be potential etiologic agents.2,3 The concept that HPV plays a role in head and neck [...]

Involvement of potential pathways in malignant transformation from oral leukoplakia to oral squamous cell carcinoma revealed by proteomic analysis

Source: 7thspace.com Author: staff Oral squamous cell carcinoma (OSCC) is one of the most common forms of cancer associated with the presence of precancerous oral leukoplakia. Given the poor prognosis associated with oral leukoplakia, and the difficulties in distinguishing it with cancer lesion, there is an urgent need to elucidate the molecular determinants and key signal pathways underlying the malignant transformation of precancerous to cancerous tissue, and thus to identify novel diagnostic and therapeutic target. Results: We have utilized two dimensional electrophoresis followed by ESI-Q-TOF-LC-MS/MS to identify proteins differentially expressed in six pairs of oral leukoplakia tissues with dysplasia and oral squamous cancer tissues, each pair from the same patient. Approximately 85 differentially and constantly expressed proteins (>two-fold change, P>0.05) were identified, 52 up-regulated and 33 down-regulated. Gene ontological methods were employed to identify the biological processes that were over-represented in this carcinogenic stage. Potential biological networks were also constructed to reveal the link between those protein candidates. Among those proteins, three homologs of proteosome activator PA28 a,b and g were shown to have up-regulated mRNA levels in OSCC cells relative to oral keratinocytes. Conclusions: Amounts of differentially expressed proteins involved in the malignant transformation of oral leukoplakia. Their expression level, bioprocess, interactions networks could be analyzed by bioinformatics approach. All the three homologs of PA28 may be shown to play an important role in the malignant transformation. Our study is an example of a systems biology study, in which functional proteomics was constructed to help to elucidate mechanistic aspects [...]

New products ingenious or insidious?

Source: www.mailtribune.com Author: John Darling The use of smokeless tobacco in Jackson County has steadily risen in recent years among teens and adults — and now, officials fear the introduction earlier this year of new, candy-flavored "dissolvable tobacco" lozenges will make matters worse. Called Orbs, the pellets, which look and taste like breath mints, contain as much nicotine as a cigarette and could cause cancer of the mouth and throat, said Jane Stevenson, tobacco program coordinator for the county. Among eighth-grade males in Jackson County, use of smokeless tobacco jumped from 2 percent in 2001 to 7 percent in 2006, reported Stevenson. Among 11th-grade males, it rose from 10 percent in 2001 to 16 percent in 2006. Among adults here, 3 percent use smokeless tobacco. These figures are 1 to 4 percent higher than the state rates. "The increase of smokeless tobacco use here among teens is significant and alarming — and dissolvable tobacco is just as addictive as smoking," said Stevenson. "They are packaged to look hip and trendy and they carry the Camel logo. Usually, people are very loyal to their tobacco brand." The introduction of dissolvable tobacco pellets is in response to new laws prohibiting smoking in bars, restaurants and the workplace, said Mike Welch, owner of Puff's Magazine & Fine Tobacco, an Ashland smoke shop. The target market for dissolvable pellets, Welch added, is people who buy low-end generic cigarettes. His store won't be selling them, he said, because too many of his customers are concerned [...]

A noninvasive genetic screening test to detect oral preneoplastic lesions

Source: Laboratory Investigation (2005) 85, 1481–1488. published online 29 August 2005 Authors: Jantine F Bremmer et al. Early diagnosis of oral squamous cell carcinoma (OSCC) may have a major impact on survival and quality of life. Recent studies have shown that the majority of OSCC is preceded by precursor lesions characterized by genetic alterations. The aim of this study was to develop and evaluate a noninvasive screening test for oral preneoplastic lesions, based on genetic alterations as marker. Various methods to obtain a high yield of cells by brushing a small area of the oral mucosa were compared. A novel genetic assay, multiplex ligation-dependent probe amplification (MLPA), was applied that enables the measurement of gains and losses at 40 different chromosomal locations in one PCR reaction using 150 ng DNA. MLPA was performed on DNA of normal and dysplastic oral mucosa as well as of OSCC with the intention to select a specific probe set for accurate detection of precursor lesions in the oral cavity. The assay was correlated to loss of heterozygosity analysis using microsatellite markers, and evaluated on noncancer subjects and patients with oral leukoplakia. A noninvasive sampling method was developed with DNA yields ranging from 150 to 600 ng. Using 120 probes, we could detect large differences with MLPA in the number of alterations between normal vs dysplastic and dysplastic vs tumor tissue with P-values <0.001. A significant correlation was found between the number of alterations as detected by MLPA and the analysis for allelic loss. The [...]

2009-02-07T13:21:08-07:00February, 2009|Oral Cancer News|
Go to Top