oropharyngeal cancer

Robotic surgery less invasive on HPV-related oral cancers

Source: Dr.Bicuspid.com March 1, 2012 -- Robotic surgery conducted through patients' mouths provides excellent results in removing squamous cell carcinoma at the back of the throat, especially in patients with HPV, according to a new Mayo Clinic study (Mayo Clinic Proceedings, March 2012, Vol. 87(3), pp. 211-212). "We were surprised that the cancer cure results were even better than the traditional treatments that we have been doing, but that is probably almost as much of a matter that these cancers are HPV-mediated for the most part, and they respond much better to treatment," said study author Eric Moore, MD, a head and neck surgeon at Mayo Clinic. "Importantly, the treatment preserved patients' ability to swallow, and their speech performance was excellent." Dr. Moore and his team followed 66 patients with oropharyngeal cancer who underwent transoral robotic surgery with the da Vinci robotic surgical system. Every few months, the patients underwent imaging studies, scans, and exams to determine if cancer was recurring. After two years, the researchers found that the patients' survival rates were greater than 92%, which is as high as some other surgical and nonsurgical treatments for oropharyngeal cancer. Because traditional surgery techniques to remove throat tumors can be traumatic, requiring cutting and reconstructing the mandible, neck, and tongue, the researchers were also interested in patients' healing after robotic surgery. "We found that with transoral robotic surgery, 96% of patients could swallow a normal diet within three weeks of treatment," Dr. Moore said. Less than 4% required a gastrostomy [...]

Charlotte Parker2012-03-01T16:21:18-07:00March, 2012|Oral Cancer News|

CD4 counts predict chemo response in laryngeal cancer

Source: www.oncologyreport.com/ Author: Miriam E. Tucker Pretreatment CD4 levels predicted response to induction chemotherapy among 97 patients with advanced laryngeal cancer, but not for 66 patients with advanced oropharyngeal cancer, according to a retrospective analysis of data from two clinical trials. The two groups of head and neck cancer patients were enrolled in two identical prospective, phase II trials of induction chemotherapy and organ preservation, in which tumor response after one cycle of cisplatin and 5-fluorouracil was used to select those who would undergo surgery or definitive chemoradiation (J. Clin. Oncol. 2006;24:593-8 in laryngeal cancer; J. Clin. Oncol. 2008;26:3138-46 in oropharyngeal cancer). Several lymphocyte subsets were measured before treatment via routine flow cytometry in peripheral blood in the laryngeal cancer patients, but only CD4 (helper cell) levels were significantly associated with chemotherapy response. Both absolute CD4 counts and CD4 percentages were higher among induction chemotherapy responders than nonresponders (P = .006 and P = .04, respectively). Investigators also saw a trend for responders to have an increased percentage of CD3 cells (P = .13), decreased percentage of CD8 cells (P = .11), and higher CD4/CD8 ratios. "Host immune parameters are important factors in treatment outcome, and may be useful in identifying subsets of patients with cancers that are responsive to organ-preserving therapy," said Dr. Gregory T. Wolf, who presented the data at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. "It is likely that immunobiology of head and neck cancers differ significantly by tumor [...]

Oral Cancer Foundation News Team - A2012-02-26T09:53:59-07:00February, 2012|Oral Cancer News|

HPV a gender-neutral killer

Source: DailyPress.com Socially conservative lawmakers will likely repeal Virginia's requirement that schoolgirls get vaccinated against a sexually transmitted virus called HPV that can, and now will, kill many of them. They're repealing it in the name of sexual abstinence, family values and apple pie. In the name of keeping government out of private health-care decisions — and, yes, they say that with a straight face. A body count doesn't bother them. Virtually all cervical cancer is caused by the human papillomavirus, which infects about 80 percent of sexually active adults by age 40. Most don't even know they have it. But, in some women, the virus mutates cells lining the cervix, turning them into cancerous lesions. About 12,000 women each year are diagnosed with cervical cancer, and 4,000 of them will die of it, according to the National Cancer Institute. This vaccine would prevent nearly all that cancer. All that death. Yet for moral reasons, not medical, the GOP-controlled House voted last month to eliminate the state's 2007 requirement that girls receive the vaccine before enrolling in sixth grade. (The vaccine is most effective before the onset of sexual activity.) The bill now goes to the GOP-controlled Senate, where it's also expected to pass. Lawmakers in Richmond weren't swayed by appeals to conscience, to logic or to medicine. They didn't care that the law already allows parents to decline the vaccine for their child for any reason whatsoever. They even rejected an amendment by a socially conservative colleague, Del. Chris [...]

Charlotte Parker2012-02-15T10:16:31-07:00February, 2012|Oral Cancer News|

New Indicator May Help Identify Patients With Increased Risk From Throat Cancer

Source: Marketwatch.com ANN ARBOR, Mich., Jan. 16, 2012 /PRNewswire via COMTEX/ -- Independent of other factors, such as smoking history and HPV status, matted lymph nodes appear to signal increased chance of oropharyngeal cancer spreading to other parts of the body. Researchers at the University of Michigan Health System have found a new indicator that may predict which patients with a common type of throat cancer are most likely have the cancer spread to other parts of their bodies. Patients with oropharyngeal squamous cell carcinoma who had "matted" lymph nodes - nodes that are connected together - had a 69 percent survival rate over three years, compared to 94 percent for patients without matted nodes, according to a study published online ahead of print publication in Head & Neck. The oropharynx is an area that includes the back of the tongue, soft palate, throat and tonsils. "The spread of cancer throughout the body accounts for about 45 percent of the deaths from oropharyngeal carcinoma," says the study's senior author, Douglas B. Chepeha, M.D., M.S.P.H., an associate professor of otolaryngology head and neck surgery at the U-M Medical School. "Our findings may help doctors identify patients who are at higher risk for having their cancer metastasize and who would benefit from additional systemic therapy. Conversely, some patients without matted nodes may benefit from a reduction of the current standard treatment, which would cut down on uncomfortable side effects." Notably, the findings indicate an increased risk independent of other established prognostic factors, [...]

Charlotte Parker2012-01-16T10:04:24-07:00January, 2012|Oral Cancer News|

Success of HPV vaccination is now a matter of coverage

Source: The Lancet Oncology, Volume 13, Issue 1, Pages 10-12, January 2012 In a pair of articles in The Lancet Oncology, Lehtinen and colleagues and Wheeler and colleagues present 4-year end of study data from a trial of a prophylactic human papillomavirus (HPV)-16/-18 vaccine (Cervarix, GlaxoSmithKline) in young women aged 15-25 years. From a public-health perspective, these studies have several important contributions. The results assure us that among HPV-naive women in the 15—25 year age range, Cervarix has extremely high efficacy against HPV-16/-18-associated persistent infection, CIN2, and CIN3 or worse, the best ethical surrogate endpoint for prospective studies of invasive cervical cancer risk. Combined with other trials of Cervarix and Merck's quadrivalent Gardasil vaccine against HPV-16/-18/-6/-11,3 the evidence is strong for near 100% prophylactic vaccine efficacy in HPV-naive women at any age. Nonetheless, even with vaccine efficacy near 100% in HPV-naive women, the efficacy in the total vaccinated cohort decreased steeply with increasing age, showing an absence of therapeutic effect against already-acquired infections and associated lesions. We know from natural history studies that new HPV transmission (incidence, not prevalence) decreases with age in most cultures.4 Together, natural history data and results of trials for both vaccines suggest that vaccination before sexual debut, or around the time of menarche, will achieve the greatest reduction in cervical cancer rates. The 4-year trial data shows no decline in vaccine efficacy in HPV-naive women with time since vaccination.1 We know from other trials of the two vaccines that the duration of protection is several [...]

Oral Cancer Foundation News Team - A2012-01-05T16:54:57-07:00January, 2012|Oral Cancer News|

Preventing Cancer with Vaccines: Progress in the Global Control of Cancer

Source: CancerPreventionResearch.AACJournals.org Abstract The cancer control community is largely unaware of great advances in the control of major human cancers with vaccines, including the dramatic control of hepatocellular (liver) cancer with hepatitis B virus (HBV) vaccine, now used routinely in more than 90% of countries. The biotechnology revolution has given us a new generation of highly effective vaccines against major global killers, global funding for immunization is orders of magnitude higher than ever before, and the vaccine delivery infrastructure has improved very significantly even in the poorest countries. Liver cancer is the greatest cause of cancer deaths in men of sub-Saharan Africa and much of Asia. Even in highly endemic countries such as China, the prevalence of HB surface antigen carriers has fallen from 10% to 1%–2% in immunized cohorts of children, and liver cancer has already fallen dramatically in Taiwanese children. The Global Alliance for Vaccines and Immunization (now called the GAVI Alliance) has greatly expedited this success by providing HBV vaccine free for five years in most of the world's 72 poorest countries. HBV vaccination can serve as a model for the global control of human papillomavirus (HPV)–related cervical and other cancers with HPV vaccines. Cervical cancer is the greatest cause of cancer death in women in many developing countries; HPV vaccines are highly effective in preventing HPV infection and precancerous lesions in women, and the quadrivalent vaccine also prevents genital warts in men and women and precancerous anal lesions in men. HPV is causing a growing proportion [...]

Oral Cancer Foundation News Team - A2012-01-04T10:18:40-07:00January, 2012|Oral Cancer News|

The Oral Cancer Foundation Helps Sponsor HPV/Oral Cancer Study

Source: Jada.org An increase in the incidence and survival of oropharyngeal cancer in the United States since 1984 can be attributed to the human papilloma-virus (HPV) infection, say researchers in an article published online Oct. 3 in Journal of Clinical Oncology. The results of previous studies have shown that oropharyngeal cancers can be divided into two separate diseases with distinct causes: HPV-negative cancers, which are associated with tobacco and alcohol use; and HPV-positive cancers, which are linked to certain types of HPV, a sexually transmitted virus. Patients with HPV-positive oropharyngeal cancer tend to be younger than and to have better survival rates than patients with HPV-negative cancer. To determine HPV infection’s role, researchers led by Anil K. Chaturvedi, PhD, National Cancer Institute, National Institutes of Health, Bethesda, Md., tested for HPV infection 271 archived samples of cancerous oropharyngeal tissue collected between 1984 and 2004 at three population-based cancer registries located in Hawaii, Iowa and Los Angeles in the National Cancer Institute’s Surveillance, Epidemiology and End Results Residual Tissue Repositories Program. By using a variety of molecular assays, researchers found that the proportion of oropharyngeal cancers that were HPV-positive—particularly among men—increased over time, from 16.3 percent for cancers diagnosed from 1984 to 1989 to 72.7 percent for cancers diagnosed from 2000 to 2004. They also found that the incidence of HPV-negative oropharyngeal cancers declined by 50 percent between 1988 and 2004, likely due to declines in smoking and tobacco use. According to senior author Maura Gillison, MD, PhD, a professor of [...]

Oral Cancer Foundation News Team - A2011-11-01T09:48:55-07:00November, 2011|OCF In The News, Oral Cancer News|

HPV Vaccine Recommended for Boys aged 11 to 12 Years

Source: HemOncToday.com The CDC's Advisory Committee on Immunization Practices today approved routine recommendation in favor of administering the quadrivalent HPV vaccine for boys aged 11 to 12 years. Committee members decided that the vaccine (Gardasil, Merck) was safe, efficacious and cost-effective enough to warrant routine usage in this population. The recommendation issued in 2009 was permissive, meaning providers could give the vaccine to boys, but it was not routinely administered. This change would put the HPV vaccine into the regular vaccination schedule. The three-vaccination series can start as early as age 9 years. "The committee recommended that routine vaccination of males aged 11 or 12 years with three doses of quadrivalent vaccine be given to prevent HPV infection and HPV-related disease," Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, said in a phone call with reporters. "Boys and young men 13 to 21 years of age who have not already received the vaccine should be vaccinated." Anne Schuchat, MD Insurance companies typically cover HPV vaccine in boys, but that is not necessarily the case for a permissive recommendation, according to Schuchat, who said a routine recommendation for a vaccine usually translates into coverage without co-pays. The committee voted 8-5 with one abstention in favor of recommending vaccination for young men up to age 21 years with permissive recommendation for men aged 22 to 26 years. The committee considered recommending vaccination up to age 26 years, which would have harmonized recommendations for men and women, [...]

Oral Cancer Foundation News Team - A2011-10-26T10:31:59-07:00October, 2011|Oral Cancer News|

CDC Committee Recommends Boys Receive HPV Vaccine

Source: CNN.com A federal government advisory committee voted Tuesday to recommend that boys and young men, from ages 11 to 21, be vaccinated against the human papilloma virus, commonly referred to as HPV. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices says the vaccine series can be started as early as age 9. Twelve members of the committee voted in favor of a recommendation that 11- and 12-year-old boys be vaccinated; one member abstained. A separate vote involving males age 13 to 21 was split. Eight voted for it; five voted against, and one abstained. The same recommendation said males age 22 through 26 may be vaccinated. HPV is the No. 1 sexually transmitted disease in the United States. At least 50% of sexually active people will get it at some point in their lives. Study: Males should get HPV vaccine too The HPV votes took place as part of the advisory committee's meeting in Atlanta, Georgia. The HPV vaccine is already recommended for females between the ages of 9 and 26 to reduce the risk of cervical cancer. The CDC recommends girls get the vaccine at age 11 or 12. The FDA approved the first HPV vaccine, Gardasil, back in 2006. The second vaccine, Cervarix, was approved in 2009. The vaccine is given in three doses. Gardasil also protects against most genital warts and has been shown to protect against anal, vaginal and vulvar cancers, all of which are associated with HPV, according to the [...]

Oral Cancer Foundation News Team - A2011-10-25T13:47:57-07:00October, 2011|Oral Cancer News|

Head and Neck Cancer Study

Source: American Journal of Neuroradiology BACKGROUND AND PURPOSE: Radiographic determination of viable disease in cervical adenopathy following RT for head and neck cancer can be challenging. The purpose of this study was to evaluate the utility of US, with or without FNA, in regard to the postradiotherapy effects on documented metastatic adenopathy in patients with oropharyngeal cancer. MATERIALS AND METHODS: This study included 133 patients with node-positive oropharyngeal cancer who were irradiated from 1998 to 2004. Sonographic evaluation was performed within 6 months of completion of radiation. Posttreatment US results were compared with pretreatment CT images and were recorded as the following: progression, suspicious, indeterminate, posttreatment change, or regression (positive) versus nonsuspicious or benign (negative). FNAC was classified as nondiagnostic, negative, indeterminate, or positive. Results of US and US-guided FNAC were correlated with findings at neck dissection and disease outcome. RESULTS: Of 203 sonographic examinations, 90% were technically feasible and yielded a nonequivocal imaging diagnosis. Of 87 US-guided FNAs, 71% yielded a nonequivocal tissue diagnosis. The PPV and NPV of initial posttreatment US were 11% and 97%. Sensitivity and specificity were 92% and 28%. The PPV and NPV of US-guided FNA were 33% and 95%, and the sensitivity and specificity were 75% and 74%. On serial sonographic surveillance, of 33 patients with nonsuspicious findings, only 1 (3%) had neck recurrence. Of 22 patients with questionable findings on CT and negative findings on US, none had a neck recurrence. CONCLUSIONS: In experienced hands, serial US is an inexpensive noninvasive reassuring follow-up [...]

Oral Cancer Foundation News Team - A2011-07-18T09:25:41-07:00July, 2011|Oral Cancer News|