prognosis – Page 2 – Oral Cancer News

Doctors study link between oral cancer and HPV – suggest males should also be vaccinated

Source: www.theprovince.com Author: Iris Winston, Canwest News Service Oral cancer brings to mind images of longtime chain smokers and grizzled tobacco chewers. But the risk factors for cancers of the mouth and throat now include sexual activity as well as all forms of tobacco use and alcohol consumption. "Over the 20 years I have been in practice, I have treated a few rodeo riders and baseball players who use chewing tobacco or snuff, as well as smokers," says Dr. Joseph Dort, a professor of head and neck surgery at the University of Calgary's faculty of medicine and president of the Canadian Society of Otolaryngology. "Classically, people think of oral cancer as something that occurs in smokers and drinkers and usually among people in their 50s, 60s or even older. But, over the last 10 years or so, we have become aware that the human papillomavirus (HPV) -- the same virus that is associated with cervical cancer -- has now been strongly associated with certain kinds of head and neck cancer, specifically the tonsil and tongue-based cancers, and that they are becoming more prevalent in people who are younger than the usual cohort." Dr. Linda Lee, a specialist in oral pathology and oral medicine who is the staff dentist at Toronto's Princess Margaret Hospital, has seen a similar trend. "Because people are smoking less, we would expect to see a decline in oral cancer," she says, "but it hasn't declined and this is probably because of the HPV factor. We have [...]

Oral Cancer Foundation News Team - A2010-05-16T17:30:33-07:00May, 2010|Oral Cancer News|

Rise in mouth cancer linked to STI’s, primarily HPV16

Source: www.nhs.uk Author: staff The Daily Telegraph reported that a “rise in mouth cancer may be due to sexually transmitted infection”. The newspaper said that there has been a 50% increase in the number of mouth cancers in the last 20 years, and the increase appears to be in those cases related to the human papilloma virus (HPV). The story is based on an editorial in the British Medical Journal by cancer specialists, which highlighted an increase in the numbers of a specific type of throat cancer in the UK. The specialists also discussed studies from other countries that show an increase in the proportion of HPV-related throat cancers. The editorial reported on a very small number of studies, but it shows that there may be a need to investigate the incidence of HPV-related throat cancers in the UK, to track these cases and to see if HPV-related cancers should be treated differently to non-HPV-related throat cancers. There is insufficient evidence at the moment to suggest that the HPV vaccination, currently available for teenage girls, should also be given to boys. Where did the story come from? This editorial was written by Hisham Mehanna, director of the Institute of Head and Neck Studies and Education at University Hospital, Coventry, and colleagues at the University of Liverpool, Université Catholique de Louvain and the University of Texas. The editorial was commissioned and published by the British Medical Journal and was not externally peer reviewed. What was the editorial about? This editorial was [...]

Oral Cancer Foundation News Team - A2010-04-19T22:27:55-07:00March, 2010|Oral Cancer News|

Journal of Nuclear Medicine: 18F-FDG PET+CT cost-effective in screening head and neck cancer patients

Source: www.healthimaging.com Author: staff Whole-body 18F-FDG PET combined with chest CT is cost-effective in pretreatment screening for distant metastases in head and neck squamous cell carcinoma (HNSCC) patients with risk factors, according to a study published in the February issue of the Journal of Nuclear Medicine. The presence of distant metastases at initial evaluation influences the prognosis and the treatment choice in HNSCC patients and hybrid PET/CT scanners was superior in sensitivity and cost effective when compared to FDG PET and CT alone, according to Otto S. Hoekstra, MD, PhD, of the VU University Medical Center in Amsterdam. In the study, 145 patients underwent chest CT and whole-body 18F-FDG PET for screening of distant metastases. The researchers analyzed the cost data of 80 patients in whom distant metastases developed or who had a follow-up of at least 12 months. Hoekstra said that cost-effectiveness analysis, including sensitivity analysis, was performed to compare the results of 18F-FDG PET, CT and a combination of CT and 18F-FDG PET. Hoekstra and colleagues identified distant metastases in 21 percent of patients by pretreatment screening. According to Hoekstra and colleagues, CT plus 18F-FDG PET had the highest sensitivity of 63 percent, while 18F-FDG PET had a sensitivity of 53 percent versus 37 percent with CTand positive predictive value of 80 percent versus 75 percent with CT. “CT + 18F-FDG PET resulted in savings between €203 ($303) and €604 ($903) ”, wrote Hoekstra and colleagues. The average costs in the CT + 18F-FDG PET group was found [...]

Oral Cancer Foundation News Team - A2010-02-23T12:55:19-07:00February, 2010|Oral Cancer News|

Determination of malnourishment in the head and neck cancer patient: assessment tools and nutrition education of radiation oncologists

Source: Support Care Cancer, January 14, 2010 Authors: PV Decicco, SM Wunderlich, and JS Emmolo Purpose: The purpose of this study is to evaluate current assessment practices of malnourishment by radiation oncologists among the head and neck cancer patient population. Methods: A cross-sectional descriptive study was conducted. A 14-question survey was mailed to 333 radiation oncologists self-identified as "interested in the treatment of head and neck cancer." Results: About 87% of radiation oncologists indicated that they used bodyweight as the sole determinant of malnourishment in head and neck cancer patients at initial consultation. Radiation oncologists with 0 to 10 years experience were found to have a higher level of formal nutrition education than those with 11 to 20 years (p = 0.0052). A significant difference was found between radiation oncologists with formal nutrition education vs. those without, in answering whether nutrition interventions play a significant role in the prognosis of such cancer patients (p = 0.0013). In addition, a significant difference was noted in methods used to determine proper caloric intake when the oncologists were stratified by their beliefs about nutrition being a significant variable affecting the prognosis of head and neck cancer patients (p = 0.0024). Conclusion: Assessment or screening for malnourishment in the head and neck cancer patient should be a routine part of the initial consultation. Radiation oncologists and their medical team, including nutritionists, should use an appropriate nutrition screening and assessment tool in addition to the body weight as an indicator of malnourishment. Nutrition education provided [...]

Oral Cancer Foundation News Team - A2010-02-13T18:57:06-07:00February, 2010|Oral Cancer News|

Biodesix: a new way to inform cancer treatment selection

Source: www.rockyradar.com Author: staff "One data point doesn’t tell you very much in most cases,” comments David Brunel, CEO of Biodesix, a medical diagnostics company based in Broomfield, Colorado. This principle guides Biodesix’s approach to developing diagnostics which aim to indentify a patient’s expected response to a particular therapeutic. Biodesix’s technology evaluates multiple biomarkers – identified with a blood sample and analyzed using mass spectrometry – to predict response rather than trying to make a determination based on a single biomarker. VeriStrat® is the company’s first test, categorizing the expected prognosis of patients with non-small cell lung cancer (NSCLC) who receive treatment with a class of targeted cancer drugs know as epidermal growth factor receptor inhibitors or EGFR-Is. Tarceva (erlotinib) is an EGFR-I commonly used to treat NSCLC patients. VeriStrat classifies patients as either VeriStrat Good or VeriStrat Poor and this information can assist a physician’s decision to pursue treatment with Tarceva or another treatment. To complete a VeriStrat test, a patient’s blood is drawn and sent to the Biodesix lab in Aurora, Colorado. There the sample is run through a mass spectrometer and the data generated from the mass spectrometer is then processed through a proprietary software algorithm to determine a patient’s VeriStrat classification. The algorithm was developed using samples and subsequent disease response data from patients who had received treatment with an EGFR-I. According to Brunel, “several markers were identified in the group of patients whose cancer is prone to respond to EGFR-I treatment versus those whose cancer [...]

Oral Cancer Foundation News Team - A2009-10-30T05:37:08-07:00October, 2009|Oral Cancer News|

Wart virus makes for less deadly cancer

Source: www.montrealgazette.com Author: Maggie Fox A wart virus best known for causing cervical cancer may make for a less-deadly kind of head and neck cancer, researchers reported on Thursday. People whose head and neck tumours carried the human papillomavirus virus, or HPV, were 59 percent less likely to die than people whose tumours were not caused by the virus, the researchers said. "A patient who has this actually has a better prognosis than patients with HPV-negative tumours," Dr. Richard Schilsky, president of the American Society of Clinical Oncology and a cancer specialist at the University of Chicago, said in an interview. He said it may be clear now that there are two kinds of head and neck cancers -- those caused by HPV and those linked to other causes, such as smoking and drinking. Not only can patients be treated differently, perhaps waiting longer for toxic chemotherapy if they have an HPV-positive tumour, but there may be ways to prevent these tumours, Schilsky said. Two vaccines -- Cervarix, made by GlaxoSmithKline, and Gardasil, made by Merck & Co Inc -- prevent HPV-16 infection. "There is every reason to think that vaccination with the HPV vaccine will prevent these," Schilsky said. Dr. Maura Gillison and colleagues at Johns Hopkins University in Baltimore studied 317 head and neck cancer patients whose tumours could be tested for HPV. The phase III study confirms earlier work Gillison's lab did linking HPV and these tumours. They said 87 percent of patients with tumours that tested [...]

Oral Cancer Foundation News Team - A2009-10-16T15:43:55-07:00October, 2009|Oral Cancer News|

Low prevalence of HPV infection may be tied to poor prognosis for blacks with head and neck cancer

Source: www.eurekalert.org Author: public release Groundbreaking study seeks to explain major disparity in survival between blacks and whites Researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer have found that head and neck cancer patients who test positive for the human papillomavirus (HPV) have much better survival rates than patients who don't have the virus, according to a new study in the journal Cancer Prevention Research. The researchers also discovered that blacks in the study had a very low rate of HPV infection, and consequently worse survival, which may explain why African-American patients traditionally have had a poor prognosis for head and neck cancer. "For the first time, we have evidence that the major difference in survival between black and white patients with head and neck cancer appears to be the rate of HPV infection. We found an astounding difference in prognosis between patients who are HPV-positive and those who are HPV-negative," says the study's senior author, Kevin J. Cullen, M.D., director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center and professor of medicine at the University of Maryland School of Medicine. Scott Lippman, M.D., chairman of the Department of Clinical Cancer Prevention at the University of Texas M.D. Anderson Cancer Center, called the study, "practice-changing." "Squamous cell carcinoma of the head and neck is one of the fastest growing cancers, and this study gives us a new way to assess prognosis for our patients," says Dr. Lippman, who is editor-in-chief of Cancer Prevention Research, [...]

Oral Cancer Foundation News Team - A2009-07-29T19:36:35-07:00July, 2009|Oral Cancer News|

Genetic signatures of HPV-related and unrelated oropharyngeal carcinoma and their prognostic implications

Source: Clinical Cancer Research 15, 1779, March 1, 200 Author: Jens P. Klussmann et al. Purpose: Patients with human papillomavirus (HPV)-containing oropharyngeal squamous cell carcinomas (OSCC) have a better prognosis than patients with HPV-negative OSCC. This may be attributed to different genetic pathways promoting cancer. Experimental Design: We used comparative genomic hybridization to identify critical genetic changes in 60 selected OSCC, 28 of which were associated with HPV-16 as determined by HPV-specific PCR and fluorescence in situ hybridization analysis and positive p16INK4A immunostaining. The results were correlated with HPV status and clinical data from patients. Results: Two thirds of OSCC harbored gain at 3q26.3-qter irrespective of HPV status. In HPV-negative tumors this alteration was associated with advanced tumor stage (P = 0.013). In comparison with HPV-related OSCC, the HPV-negative tumors harbored: (a) a higher number of chromosomal alterations and amplifications (P = 0.03 and 0.039, respectively); (b) significantly more losses at 3p, 5q, 9p, 15q, and 18q, and gains/amplifications at 11q13 (P = 0.002, 0.03; <0.001, 0.02, 0.004, and 0.001, respectively); and (c) less often 16q losses and Xp gains (P = 0.02 and 0.03). Survival analysis revealed a significantly better disease-free survival for HPV-related OSCC (P = 0.02), whereas chromosome amplification was an unfavorable prognostic indicator for disease-free and overall survival (P = 0.01 and 0.05, respectively). Interestingly, 16q loss, predominantly identified in HPV-related OSCC, was a strong indicator of favorable outcome (overall survival, P = 0.008; disease-free survival, P = 0.01) and none of these patients had a [...]

Oral Cancer Foundation News Team - A2009-03-01T21:12:27-07:00March, 2009|Oral Cancer News|

Genetic signatures of HPV-related and unrelated oropharyngeal carcinoma and their prognostic implications

Source: Clinical Cancer Research, 10.1158/1078-0432 Authors: Jens P. K et al. Purpose: Patients with human papillomavirus (HPV)-containing oropharyngeal squamous cell carcinomas (OSCC) have a better prognosis than patients with HPV-negative OSCC. This may be attributed to different genetic pathways promoting cancer. Experimental Design: We used comparative genomic hybridization to identify critical genetic changes in 60 selected OSCC, 28 of which were associated with HPV-16 as determined by HPV-specific PCR and fluorescence in situ hybridization analysis and positive p16INK4A immunostaining. The results were correlated with HPV status and clinical data from patients. Results: Two thirds of OSCC harbored gain at 3q26.3-qter irrespective of HPV status. In HPV-negative tumors this alteration was associated with advanced tumor stage (P = 0.013). In comparison with HPV-related OSCC, the HPV-negative tumors harbored: (a) a higher number of chromosomal alterations and amplifications (P = 0.03 and 0.039, respectively); (b) significantly more losses at 3p, 5q, 9p, 15q, and 18q, and gains/amplifications at 11q13 (P = 0.002, 0.03; <0.001, 0.02, 0.004, and 0.001, respectively); and (c) less often 16q losses and Xp gains (P = 0.02 and 0.03). Survival analysis revealed a significantly better disease-free survival for HPV-related OSCC (P = 0.02), whereas chromosome amplification was an unfavorable prognostic indicator for disease-free and overall survival (P = 0.01 and 0.05, respectively). Interestingly, 16q loss, predominantly identified in HPV-related OSCC, was a strong indicator of favorable outcome (overall survival, P = 0.008; disease-free survival, P = 0.01) and none of these patients had a tumor recurrence. Conclusions: Genetic [...]

Oral Cancer Foundation News Team - A2009-02-22T06:09:58-07:00February, 2009|Oral Cancer News|

Head and neck cancer worse in blacks

Source: www.curetoday.com Author: staff African Americans and economically disadvantaged patients face a worse prognosis than other patients with head and neck cancer, according to a report in the journal Cancer. "The head and neck cancer manuscript is the first in a series of manuscripts we have written to examine disparities in cancer," Dr. Michael Cheung told Reuters Health. "We have observed disparities in a number of different cancers," including those of the esophagus and the reproductive organs. Cheung and colleagues at the University of Miami Miller School of Medicine, sought to determine the impact of race and socioeconomic status on outcomes for almost 21,000 patients with cancers of the head and neck diagnosed between 1998 and 2002. Typical survival times were significantly higher for whites (40 months) than for African Americans (21 months), for Hispanics (47 months) than for non-Hispanics (37 months), and for women (41 months) than for men (36 months), the authors report. Patients living in communities with poverty rates above 15 percent were diagnosed with head and neck cancer at a significantly earlier age, and survival times were decreased across all age groups in such communities. Consistent with previous research, alcohol and tobacco use also adversely affected survival in patients with head and neck cancer, the report indicates. Other predictors of survival included the location and stage of the tumor as well as the surgical, medical, and radiology treatments used. The inequalities seen in the study are "not explained completely by demographics, (other medical) conditions, or undertreatment [...]

Oral Cancer Foundation News Team - A2009-01-01T17:08:51-07:00January, 2009|Oral Cancer News|