squamous cell carcinoma

Second primary cancers after an index head & neck cancer: subsite-specific trends in the era of hpv–associated oropharyngeal cancer

Source: American Society of Clinical Oncology Authors: Luc G.T. Morris, Andrew G. Sikora, Snehal G. Patel, Richard B. Hayes and Ian Ganly Abstract Purpose Patients with head and neck squamous cell carcinoma (HNSCC) are at elevated risk of second primary malignancies (SPM), most commonly of the head and neck (HN), lung, and esophagus. Our objectives were to identify HNSCC subsite-specific differences in SPM risk and distribution and to describe trends in risk over 3 decades, before and during the era of human papillomavirus (HPV) –associated oropharyngeal SCC. Methods Population-based cohort study of 75,087 patients with HNSCC in the Surveillance, Epidemiology, and End Results (SEER) program. SPM risk was quantified by using standardized incidence ratios (SIRs), excess absolute risk (EAR) per 10,000 person-years at risk (PYR), and number needed to observe. Trends in SPM risk were analyzed by using joinpoint log-linear regression. Results In patients with HNSCC, the SIR of second primary solid tumor was 2.2 (95% CI, 2.1 to 2.2), and the EAR was 167.7 cancers per 10,000 PYR. The risk of SPM was highest for hypopharyngeal SCC (SIR, 3.5; EAR, 307.1 per 10,000 PYR) and lowest for laryngeal SCC (SIR, 1.9; EAR, 147.8 per 10,000 PYR). The most common SPM site for patients with oral cavity and oropharynx SCC was HN; for patients with laryngeal and hypopharyngeal cancer, it was the lung. Since 1991, SPM risk has decreased significantly among patients with oropharyngeal SCC (annual percentage change in EAR, −4.6%; P = .03). Conclusion In patients with HNSCC, the risk and distribution of SPM differ [...]

Charlotte Parker2011-01-03T19:06:39-07:00January, 2011|Oral Cancer News|

Cancer survivor Byers driving to help others

Source: Standart.net Author: Staff Among the dozens of cars at this weekend's ARCA race at Pocono Raceway, one will stand out. Not for the color scheme or the lines. For the decals. When the No. 48 of Ricky Byers Racing rolls out onto the track, it won't be sporting the usual array of auto parts or alcoholic beverage stickers. Byers' red-and-black Ford Fusion will decorated for those who have made his dream a reality, the 90 or so people who have given the two-time throat cancer survivor a chance to fight back at the disease that nearly cost him his life. "It's the greatest feeling of my life," Byers said. "Those are the people who support what I'm doing, believe in what I'm doing and they've given me a chance to go out there and race for cancer." Byers has been around motorsports long as he can remember. His dad was a lifelong racer and little Ricky spent his early days racing motocross and go-carts before moving on to full-sized cars. The Birmingham, Ala., native went on to race for 20 years, winning five different track championships in Pony, Super Pony, Dwarf and Late Model cars. But when Byers was 33, his career took a back seat to something much bigger: a race for his life. Byers had lost his voice and wasn't able to get it back for weeks, but six different doctors told him it just was a sinus infection, that he had nothing to worry about. Then [...]

Charlotte Parker2010-07-30T16:13:29-07:00July, 2010|Oral Cancer News|

Head and neck cancer among lifelong never-smokers and ever-smokers: matched-pair analysis of outcomes after radiation therapy

Source: HighWire Medline Author: Am J Clin Oncol From the Departments of *Radiation Oncology and daggerOtolaryngology-Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, CA. PURPOSE:: An increasing proportion of patients with head and neck cancer have no history of smoking. The purpose of this analysis was to compare the clinical outcomes between patients without a history of smoking (never-smokers) and those with a previous history of smoking (ever-smokers) treated by radiation therapy. METHODS AND MATERIALS:: Seventy patients with newly diagnosed squamous cell carcinoma of the oropharynx or oral cavity without a previous history of smoking were matched to a control ever-smoker with a positive tobacco history (>10 pack-years) based on age, gender, ethnicity, Karnofsky Performance Status, primary tumor site, disease stage, primary treatment, radiation dose, and start date. Outcome was compared using Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer radiation toxicity criteria. RESULTS:: With a median follow-up of 33 months, lifelong never-smokers had an increased 3-year overall survival (86% vs. 69%), disease-free survival (82% vs. 65%), and local-regional control (85% vs. 70%) compared with the ever-smoker control population (P < 0.05, for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of grade 3+ complications was also significantly lower among never-smokers compared with ever-smokers (10% vs. 29%, P = 0.01). CONCLUSIONS:: Prognosis differed significantly between never-smokers and ever-smokers with head and neck [...]

Charlotte Parker2010-07-20T14:11:01-07:00July, 2010|Oral Cancer News|

New strategies in head and neck cancer: understanding resistance to epidermal growth factor receptor inhibitors

Source: HighWire Author: Staff The epidermal growth factor receptor (EGFR) is a validated target in squamous cell carcinoma of the head and neck (HNSCC). However, despite high expression of EGFR in these cancers, EGFR inhibitor monotherapy has only had modest activity. Potential mechanisms of resistance to EGFR-targeted therapies involve EGFR and Ras mutations, epithelial-mesenchymal transition, and activation of alternative and downstream pathways. Strategies to optimize EGFR-targeted therapy in head and neck cancer involve not only the selection for patients most likely to benefit but also the use of combination therapies to target the network of pathways involved in tumor growth, invasion, angiogenesis, and metastasis.

Charlotte Parker2010-06-30T13:03:30-07:00June, 2010|Oral Cancer News|

Human papillomavirus-active head and neck cancer and ethnic health disparities

Source: Medical College of Georgia Authors: PM Weinberger, MA Merkley, SS Khichi, JR Lee, A Psyrri, LL Jackson, and WS Dynan OBJECTIVES/HYPOTHESIS: Mortality for black males with head and neck squamous cell carcinoma (HNSCC) is twice that of white males or females. Human papillomavirus (HPV)-active HNSCC, defined by the concurrent presence of high-risk type HPV DNA and host cell p16(INK4a) expression, is associated with decreased mortality. We hypothesized that prevalence of this HPV-active disease class would be lower in black HNSCC patients compared to white patients. STUDY DESIGN:: Multi-institutional retrospective cohort analysis. METHODS:: Real-time polymerase chain reaction was used to evaluate for high-risk HPV DNA presence. Immunohistochemistry for p16(INK4a) protein was used as a surrogate marker for HPV oncoprotein activity. Patients were classified as HPV-negative (HPV DNA-negative, p16(INK4a) low), HPV-inactive (HPV DNA-positive, p16(INK4a) low), and HPV-active (HPV DNA-positive, p16(INK4a) high). Overall survival and recurrence rates were compared by Fisher exact test and Kaplan-Meier analysis. RESULTS:: There were 140 patients with HNSCC who met inclusion criteria. Self-reported ethnicity was white (115), black (25), and other (0). Amplifiable DNA was recovered from 102/140 patients. The presence of HPV DNA and the level of p16(INK4a) expression were determined, and the results were used to classify these patients as HPV-negative (44), HPV-inactive (33), and HPV-active (25). Patients with HPV-active HNSCC had improved overall 5-year survival (59.7%) compared to HPV-negative and HPV-inactive patients (16.9%) (P = .003). Black patients were less likely to have HPV-active disease (0%) compared to white patients (21%) (P = .017). [...]

Charlotte Parker2010-06-23T11:16:51-07:00June, 2010|Oral Cancer News|

Combining surgery for removal of tissue and reconstruction

Source: MedicalNewToday Author: Staff Restoring people's health and returning them to their daily lives as soon as possible is the goal following any surgery. When a person's ability to eat and speak is affected, as with cancer in the mouth, surgery is particularly disruptive, creating a greater challenge. A one-step surgery can remove cancerous tissue and reconstruct bone and teeth functionality immediately, positively impacting the patient's quality of life. A case study in the June issue of the Journal of Oral Implantology describes a one-step surgery performed on a 65-year-old woman with squamous cell carcinoma. A two-year follow-up of this patient showed the one-step procedure to be successful. Typically, ablative surgery is first performed to remove cancerous bone and tissue. The surgery is followed by radiotherapy, and often tooth loss. Reconstructing the jaw and placing a dental implant at this point are taxing due to the side effects of radiotherapy and poor patient tolerance. The procedure outlined in this article permitted an impression to be taken immediately after the jaw reconstruction and implant installation during the initial surgery. A rigid prosthesis was fabricated and screw-secured to the implants 48 hours later. Complementary radiotherapy began six weeks following the surgery and implant. The prosthesis was modified as necessary six months after completion of the radiotherapy. The advantages of single surgery include a reduced risk of osteonecrosis-disease in the jawbone-which can occur with postradiation surgery. A single surgery also can decrease the need for hyperbaric oxygen therapy. The authors emphasize that this one-step surgery is [...]

Charlotte Parker2010-06-18T19:07:35-07:00June, 2010|Oral Cancer News|

Accelerated schedule of radiotherapy for HNSCC is more effective than conventional fractionation

Source: Lancet Oncology 4-2010 Author: Staff An accelerated schedule of radiotherapy for squamous-cell carcinoma of the head and neck (HNSCC) is more effective than conventional fractionation, and since it does not require additional resources it might be a suitable new global standard baseline treatment for radiotherapy of HNSCC, according to a study published online April 9 in the Lancet Oncology. The findings of the study called the International Atomic Energy Agency (IAEA) trial showed that accelerated radiotherapy (increasing the number of treatments from five to six a week) prevented local disease recurrence and improved disease-free survival, with no increase in late radiation-induced side-effects, in HNSCC patients in resource-limited settings. Jens Overgaard, MD, chief of the experimental clinical oncology department at Aarhus University Hospital in Denmark and international colleagues from Asia, Europe, the Middle East, Africa and South America recruited 908 patients with HNSCC of the larynx, pharynx and oral cavity who were eligible for curative radiotherapy from Jan. 6, 1999 to March 31, 2004. Patients were randomly assigned to an accelerated schedule of six fractions of radiotherapy per week of 2 Gy (458 patients) or to a conventional radiotherapy schedule of five fractions per week of 2 Gy (450 patients), up to a total dose 66-70 Gy in 33-35 fractions, according to Overgaard and colleagues. The median treatment time was 40 days in the accelerated group and 47 days in the conventional group. Five year locoregional control was 12 percent better in patients given the accelerated regimen (42 percent) compared with [...]

Charlotte Parker2010-04-16T11:09:55-07:00April, 2010|Oral Cancer News|

Small atypical cervical nodes detected on sonography in patients with squamous cell carcinoma of the head and neck

Source: Journal of Ultrasound in Medicine Author: Staff Probability of Metastasis Heung Cheol Kim, MD, Dae Young Yoon, MD, Suk Ki Chang, MD, Heon Han, MD, So Jung Oh, MD,Jin Hwan Kim, MD, Young-Soo Rho, MD, Hwoe Young Ahn, MD, Keon Ha Kim, MD andYoon Cheol Shin, MD Department of Radiology, Kangwon National University College of Medicine, Chuncheon, Korea (H.C.K., H.H.); Department of Radiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea (H.C.K.); Departments of Radiology (D.Y.Y., S.K.C.) and Otorhinolaryngology and Head and Neck Surgery (S.J.O., J.H.K., Y.-S.R., H.Y.A.), Ilsong Memorial Institute of Head and Neck Cancer, and Department of Thoracic Surgery (Y.C.S.), Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea; and Department of Radiology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea (K.H.K.). Address correspondence to Dae Young Yoon, MD, Department of Radiology, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong, Kangdong-gu, Seoul 134-701, Korea. E-mail: [email protected] Objective. The purpose of this study was to assess the probability of metastasis of small atypical cervical lymph nodes detected on sonography in patients with squamous cell carcinoma (SCC) of the head and neck. Methods. We reviewed, retrospectively and blindly, sonographic findings of 148 patients (118 men and30 women; mean age, 58.2 years) who underwent curative neck dissection. Each lymph node was classified by using a 4-point scale: 1, definitely benign; 2, indeterminate (small [short-axis diameter <10 mm for levels I and II and <7 mm for levels III–VI] atypical node); 3, definitely metastatic; and [...]

Charlotte Parker2010-04-10T10:22:24-07:00April, 2010|Oral Cancer News|

Cancer survivor tells his experience with smokeless tobacco

Source: Lifestyles Author: Nicole Printz Just like the trucks on every corner in Abilene, rings on back jean pockets are a common sight. Gruen Von Behrens, who visited Abilene High School on Wednesday, knows all about smokeless tobacco. He began with snuff at 13 years old. He asked the packed high school auditorium if the students knew someone who smoked cigarettes. A sea of hands rose at the question, with almost the same number rising for his next question – did they know someone who used smokeless tobacco? “I think about half our school smokes or uses smokeless tobacco,” Dynae Whiteley, a junior, said. “I mean, not to get anyone in trouble or anything.” “I have friends and relatives that use tobacco,” said senior Matt Bowers. “I think smokeless tobacco is safer because the use of cigarettes affects more people through second-hand smoke. Smokeless tobacco only affects that person.” Collin Sexton, a sophomore, also thought smokeless tobacco would be safer than smoking. Dynae Whiteley and Paige Piper, both juniors, thought all tobacco was “equally bad.” According to the Communities That Care 2009 survey, 23.1 percent of Dickinson County students sixth through 12th grade have used smokeless tobacco, and 27.4 percent had smoked a cigarette. Almost half of all seniors in Dickinson County had smoked a cigarette at least once. This statistics are almost double the state average. Von Behrens, one of the eight members of the National Spit Tobacco Education Program’s speakers bureau, continued his life story. He said “not [...]

Charlotte Parker2010-03-08T10:41:41-07:00March, 2010|Oral Cancer News|

Introducing OraRisk HPV salivary diagnostic test by OralDNA Labs

Source: RDHmag Author: Staff NASHVILLE, Tennessee--OralDNA Labs , a leader in advancing wellness in dentistry through salivary diagnostics and a subsidiary of Quest Diagnostics, recently introduced a OraRisk HPV test. The test is a noninvasive, screening tool to identify the type(s) of oral human papillomavirus (also called HPV). Oral HPV is a mucosal viral infection that is a known risk factor for oral, head, and neck cancers. High-risk types of HPV that persist present an increased risk for cancers in these regions. This test will provide the dental clinician with the ability to establish risk for HPV-related cancers of the oral, head, and neck regions, and determine appropriate referral and monitoring conditions. Squamous cell carcinoma of the head and neck, which can be found in the oral cavity, tongue, tonsils, oropharynx, and larynx, affects approximately 40,000 individuals in the United States each year. The most common symptoms of SCCHN include sore throat, earache, hoarseness--and often--enlarged lymph nodes in the neck. Early detection of oral HPV presents an important opportunity to detect those at risk for these types of cancers before symptoms appear. According to OralDNA Labs' Medical Director Ronald C. McGlennen, MD, "The availability of the OraRisksm HPV test marks an important and timely advance in oral diagnostics, because the at-risk profile for oral cancer is rapidly changing." The use of tobacco and heavy alcohol consumption has traditionally been considered to be the primary risk factor for SCCHN, but an alarming number of new cases are being diagnosed each year [...]

Charlotte Parker2010-03-05T21:50:15-07:00March, 2010|Oral Cancer News|