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Management strategies for oral potentially malignant disorders

Source: www.medscape.com Author: Joel M. Laudenbach, DMD Oral potentially malignant disorders (OPMDs) include oral leukoplakia (OL), oral erythroplakia, oral submucous fibrosis, oral lichen planus, proliferative verrucous leukoplakia, and actinic keratosis. Once an OPMD has been clinically diagnosed, execution of management strategy is critical. When formulating the strategy, healthcare providers should consider histopathology, lesion characteristics (ie, surface texture, unifocal, multifocal), lesion location in the mouth (ie, tongue, floor of mouth), patient risk factor assessment, and a detailed medical/cancer history. In this newly published article, Nadeau and Kerr[1] detail various parameters surrounding evaluation and management of OPMDs. The authors make it clear that OPMDs are challenging, each with their own nuances regarding risk for malignant transformation. For example, when OL is unifocal, nonhomogeneous, nodular, or verrucous, there is a much higher chance of the OL becoming dysplastic (12.63-fold) or demonstrating a focus of carcinoma (8.9-fold) when compared with homogeneous types of OLs.[1] Provider knowledge of these variables is critical when counseling patients about their diagnosis and management options and when selecting interventions along with follow-up care. Although progression to malignancy is difficult to predict with OPMDs, clinicians can account for multiple risk factors such as smoking/alcohol status, high-risk location in the oral cavity, and size of lesion (>200 mm2) to help formulate a tailored management plan for each patient. Consultation with an oral pathologist to discuss the histologic appearance in the context of specific patient history and lesion characteristics can provide additional perspective and/or recommendations. Modifiable oral cavity cancer risks related to [...]

Oral Cancer Foundation News Team - A2018-03-16T07:46:35-07:00March, 2018|Oral Cancer News|

HPV is causing an oral cancer epidemic in men by outwitting natural defenses

Source: www.philly.com Author: Marie McCullough, staff writer Five years ago, when actor Michael Douglas candidly revealed that his throat cancer was linked to having oral sex, two things happened. He made headlines that mortified his family. And he helped publicize the fact that a pervasive, sexually transmitted virus called HPV was unleashing an epidemic of oral cancer among men. Since then, scientists have made headway in figuring out why HPV, the human papillomavirus, has this glaring gender bias. Men are four times more likely than women to be diagnosed with oral cancer, a hard-to-detect, hard-to-treat disease that has overtaken cervical cancer as the most common HPV-related malignancy in the United States. To be sure, changes in sexual norms over the last few generations have played a role in this alarming trend. But research increasingly shows the real problem is something men have practically no control over: their immune response. Compared with women, men are more likely to get infected with HPV — including “high-risk” cancer-causing strains. They also are less able to wipe out infection on their own, and more likely to get reinfected. The reasons are unclear. “There is good evidence that men acquire oral infections more readily than women, even if they have similar sex practices,” said Ashish A. Deshmukh, a University of Florida HPV researcher. “And more than the acquisition, it’s the persistence of the virus. The clearance rate is not that fast in men.” Michael Becker of Yardley has stepped up as the face of this [...]

Oral Cancer Foundation News Team - A2018-03-06T16:31:36-07:00March, 2018|Oral Cancer News|

Chronic heartburn might increase chance of neck, head cancers

Source: www.upi.com Author: HealthDay News Millions of American seniors suffer the discomfort of chronic acid reflux. Now, new research suggests the condition might raise their odds for even more dangerous foes -- head and neck cancers. The research can't prove cause-and-effect, and the odds of any one person with chronic heartburn developing one of these relatively rare cancers remains low, experts noted. But the study of nearly 28,000 Americans over the age of 65 did show a heightened risk. Overall, a history of gastroesophageal reflux disease -- the clinical term for chronic heartburn -- was linked to nearly triple the odds of developing cancers of the voice box (larynx); about a 2.5 greater odds for cancers of the pharynx (top of the throat); a doubling of risk for cancers of the tonsils; and a 40 percent higher odds for cancers in the sinuses. Head and neck cancers of the respiratory and upper digestive tracts cause more than 360,000 deaths worldwide each year, the researchers noted. The new study was led by Dr. Edward McCoul, of the Ochsner Clinic Foundation in New Orleans, and published Thursday in the journal JAMA Otolaryngology Head & Neck Surgery. One gastroenterologist said the findings aren't surprising, given what's known about the effect of acid reflux on sensitive tissues. "Reflux material from the stomach can rise high in to the esophagus, the food tube between the mouth and the stomach," explained Dr. Anthony Starpoli. He said the same juices "can invade the throat, sinus passages and [...]

Oral Cancer Foundation News Team - A2017-12-22T21:58:58-07:00December, 2017|Oral Cancer News|

Oral sex increases men’s risk of cancer, new study finds

Source: www.deccanchronicle.com Author: staff An alarming new study found men who have performed oral sex on five or more partners are at risk of head and neck cancer related to HPV, according to a report by the Daily Mail. Johns Hopkins researchers warn men may not be aware of this risk, particularly if they smoke. "Among men who did not smoke, cancer-causing oral HPV was rare among everyone who had less than five oral sex partners, although the chances of having oral HPV infection did increase with number of oral sexual partners, and with smoking," lead author Dr Amber D'Souza, associate professor at the Johns Hopkins Bloomberg School of Public Health told the Daily Mail. For the study, data was analysed of 13,089 people part of the National Health and Nutrition Examination Survey (NHANES) and tested for oral HPV. That information was compared to data with federal figures on oropharyngeal cancer diagnoses. The results indicated that men had a higher risk of developing the disease compared to women. The new study's findings suggest it is crucial for boys to get the HPV vaccine. While there are 100 different kinds of HPV, only few cause cancer. HPV strains 16 and 18 trigger most cervical cancer. HPV16 also causes oropharyngeal cancer. Identifying who is at risk is will help curb the disease. "For these reasons, it would be useful to be able to identify healthy people who are most at risk of developing oropharyngeal cancer in order to inform potential screening strategies, [...]

Oral Cancer Foundation News Team - A2017-10-20T08:11:22-07:00October, 2017|Oral Cancer News|

Halving radiation therapy for HPV-related throat cancer offers fewer side effects, similar outcomes

Source: www.eurekalert.org Author: Mayo Clinic press release Mayo Clinic researchers have found that a 50 percent reduction in the intensity and dose of radiation therapy for patients with HPV-related throat cancer reduced side effects with no loss in survival and no decrease in cure rates. Results of a phase II study were presented today at the 59th Annual Meeting of the American Society for Radiation Oncology in San Diego by Daniel Ma, M.D. a radiation oncologist at Mayo Clinic. "A common approach for treating HPV-related throat cancer is a combination of surgery followed by daily radiation therapy for six to 6½ weeks," says Dr. Ma. "However, the radiation treatment can cause a high degree of side effects, including altered taste, difficulty swallowing, dry mouth, stiff neck and damage to the jaw bone." Dr. Ma says that patients with HPV-related throat cancer tend to be young and, once treated, are likely to live a long time with possibly life-altering side effects from the standard treatment. "The goal of our trial was to see if an aggressive reduction of radiation therapy (two weeks of radiation twice daily) could maintain excellent cure rates, while significantly reducing posttreatment side effects, improving quality of life and lowering treatment costs." Researchers followed 80 patients with HPV-related oropharyngeal squamous cell cancer with no evidence of residual disease following surgery and a smoking history of 10 or fewer pack years. That's the number of years smoking multiplied by the average packs of cigarettes smoked per day. At two [...]

Oral Cancer Foundation News Team - A2017-09-26T07:17:21-07:00September, 2017|Oral Cancer News|

Big tobacco fuels nicotine replacement addiction, UCSF study shows

Source: http://www.sfgate.com Author: Lizzie Johnson Date: August 17, 2017 Nicotine patches, lozenges, inhalers and gum have long been marketed as ways of helping addicts break the habit. But such products by themselves won’t do the job — something tobacco companies themselves have taken advantage of to boost their profits, new research from UCSF says. Nicotine replacement therapy products, which have been sold over the counter at drugstores since 1996, are effective only when paired with counseling, according to a UCSF study released Thursday. Without that, relying on such products can actually make it harder to kick tobacco, the study found. UCSF researchers who reviewed millions of pages of internal tobacco company documents said the firms have long known that such products by themselves don’t wean users off cigarettes, and market their own smokeless nicotine to keep users addicted. “Those products should not be used unless they are done in the proper way,” said Stanton Glantz, an author of the study, professor of medicine at UCSF and the director of the Center for Tobacco Control Research and Education. “The problem is, without the behavioral support, they actually inhibit quitting,” he said. “Unfortunately, a lot of people think they are making progress and quitting when that’s not so. That’s what tobacco companies have known for decades. They’re developing products under the guise of nicotine replacement therapy.” Some of the biggest tobacco companies, including RJ Reynolds, Philip Morris and British American Tobacco, have developed nicotine accessories. Many corner stores stock the products, some [...]

Charlotte Parker2017-08-18T08:14:58-07:00August, 2017|Oral Cancer News|

HPV-related oral cancers have risen significantly in Canada

Source: www.ctvnews.ca Author: Sheryl Ubelacker, The Canadian Press The proportion of oral cancers caused by the human papillomavirus has risen significantly in Canada, say researchers, who suggest the infection is now behind an estimated three-quarters of all such malignancies. In a cross-Canada study, published Monday in the Canadian Medical Association Journal, the researchers found the incidence of HPV-related oropharyngeal cancers increased by about 50 per cent between 2000 and 2012. "It's a snapshot of looking at the disease burden and the time trend to see how the speed of the increase of this disease (is changing)," said co-author Sophie Huang, a research radiation therapist at Princess Margaret Cancer Centre in Toronto. Researchers looked at data from specialized cancer centres in British Columbia, Alberta, Ontario and Nova Scotia to determine rates of HPV-related tumours among 3,643 patients aged 18 years or older who had been diagnosed with squamous cell oropharyngeal cancer between 2000 and 2012. HPV is the most common sexually transmitted infection worldwide. Most people never develop symptoms and the infection resolves on its own within about two years. "In 2000, the proportion of throat cancer caused by HPV was estimated at 47 per cent," said Huang. "But in 2012, the proportion became 74 per cent ... about a 50 per cent increase." Statistics from a Canadian Cancer Society report last fall showed 1,335 Canadians were diagnosed in 2012 with HPV-related oropharyngeal cancer and 372 died from the disease. HPV is the most common sexually transmitted infection worldwide. Most people [...]

Oral Cancer Foundation News Team - A2017-08-14T12:10:46-07:00August, 2017|Oral Cancer News|

Calgary cancer patient asks why smokers are near hospitals if grounds are supposed to be ‘smoke-free’

Source: globalnews.ca Author: Heather Yourex-West At just 47-years-old, Tim Allsopp is battling throat cancer. He doesn’t smoke but during he’s his treatment, he says, he’s been exposed to second-hand cigarette smoke more often because he often passes by people smoking on his way to treatment at Calgary’s Tom Baker Cancer Centre. “Everyday when we come to therapy, we notice that there’s people smoking outside the building,” Allsopp said. “That’s confusing to me because the policy states, no smoking on Alberta Health Services property, this includes buildings, grounds and parking lots.” “I’m at the point now where I’m very susceptible to infection and that could land me in the emergency department in almost life threatening condition.” While AHS has had a smoke-free hospital grounds policy for years, it doesn’t take long to spot people lighting up. AHS says it tries to enforce its policy, but it’s not easy. WATCH: Smokers ignore no smoking signs in front of Winnipeg hospitals “Our protective services people try to use an educational approach first but if that’s not successful, then they have the power to issue a ticket,” said Dr. Brent Friesen, lead medical officer of health for Alberta Health Services’ tobacco reduction strategy. Friesen says the problem is that AHS can only issue tickets for people breaking either provincial law or city by-law, not AHS policy. That means, while AHS may say no smoking is allowed on hospital grounds, the province only requires people keep a five-metre distance from hospital doors. “If they’re further [...]

Oral Cancer Foundation News Team - A2017-07-25T08:35:20-07:00July, 2017|Oral Cancer News|

Teens drink less if they know alcohol causes cancer — but most don’t — study finds

Source: http://www.adelaidenow.com.au/ Author: Tim Williams, Education Reporter Teens are less likely to drink if they know that alcohol is a major cause of cancer, but most are unaware of the link, a South Australian study has found. More than 2800 school students aged 12-17 were surveyed about their drinking behaviour by Adelaide University and South Australian Health and Medical Research Institute (SAHMRI) researchers. Those aged 14-17 were deterred from drinking if they knew about the link between alcohol and cancer, but only 28 per cent of students were aware of the connection. Parental disapproval was another deterrent, while smoking and approval from friends resulted in higher rates of drinking. Most students had tried alcohol by age 16 and a third drank at least occasionally. Wealthy students were more likely to drink. Cancer Council SA chief executive Lincoln Size said there was clear evidence drinking caused cancers of the mouth, pharynx, larynx and oesophagus, as well as bowel cancer in men and breast cancer in women. It likely raised the risk of liver cancer and bowel cancer in women too. “Any level of alcohol consumption increases the risk of developing an alcohol-related cancer; the level of risk increases in line with the level of consumption,” he said. “This latest evidence highlights the need to educate young people about the consequences of alcohol consumption and for parents to demonstrate responsible drinking behaviour. “We need to get the message through that what may be considered harmless fun actually has lifelong consequences.” Lead author [...]

Oral Cancer Foundation News Team - A2017-07-20T09:05:48-07:00July, 2017|Oral Cancer News|

Trans oral robotic surgery saves public Australian hospital patients from disfiguring procedure

Source: www.smh.com.au Author: Kate Aubusson The cancerous tumour growing at the back of Brian Hodge's tongue was about as hard-to-reach as cancers get. The 73-year-old was told he'd need radical, invasive surgery to remove the 50¢-sized tumour. His surgeon would make an incision almost from ear-to-ear and split his jaw in two for the 10-12 hour surgery. After five days in intensive care, another three weeks in hospital and four to six months recovery, re-learning how to eat and talk Mr Hodge would have been left with disfiguring scars, and a voice that he may not recognise as his own. "My kids didn't want me to have it," Mr Hodge said. "But I'm not one to throw in the towel ... Then the unbelievable happened," he said. Mr Hodge became one of the first public patients to undergo robotic surgery for head, neck and throat cancer at Nepean Hospital, the state's only hospital offering the service to patients who can't afford private healthcare. Mr Hodge's surgeon, Associate Professor Ronald Chin, performed the trans oral robotic surgery (TORS) by guiding the robot's arm into his patient's open mouth to remove the cancerous tumour. "I went in on Monday morning for the surgery and I was discharged Tuesday night," Mr Hodge said of his surgery performed on June 19. "It's just amazing. Two days compared to six months recovering. "What's got me is that before it was only available to people who could pay the big money. I've worked all my life, [...]

Oral Cancer Foundation News Team - A2017-07-17T07:29:27-07:00July, 2017|Oral Cancer News|