tobacco

Vaping e-cigarettes could increase the risk of oral disease, study finds

Source: technology.inquirer.net
Author: staff

New American research has found that individuals who use e-cigarettes could be at risk of developing oral diseases in the future, which could range from gum disease to cancer.

Carried out by researchers at The Ohio State University, the new study looked at a group of 123 people with no signs of oral disease. The group included 25 smokers, 25 non-smokers, 20 e-cigarette users, 25 former tobacco smokers who used e-cigarettes and 28 people who smoked both tobacco cigarettes and e-cigarettes.

The team collected plaque samples taken from under the gums of the participants to analyze the bacteria in this part of the mouth; bacteria here is the last line of defense against disease as it is the least likely to be disrupted by environmental changes in the mouth, such as food, toothpaste and tobacco.

The researchers then carried out DNA deep sequencing of the bacteria’s genomes to identify what types of microbes were living in participants’ mouths and what their functions were.

The findings, published in the journal Science Advances, showed that although the e-cigarette users didn’t have signs of active disease, their oral bacteria composition was similar to that of people with severe periodontitis, a severe gum infection that can lead to health problems such as tooth loss, and, if left untreated, is a risk factor for serious conditions such as heart and lung disease.

The effect of e-cigarette smoking was also seen with or without nicotine, which the researchers say suggests that it is the heated and pressurized liquids in e-cigarette cartridges that are making vapers’ mouths a welcoming environment for a dangerous combination of microbes.

Even long-term current and former cigarette smokers had worse oral profiles linked to using e-cigarettes after just three to 12 months of vaping.

“Vaping is such a big assault on the oral environment, and the change happens dramatically and over a short period of time,” said Purnima Kumar, senior author of the study.

“If you stop smoking and start vaping instead, you don’t move back toward a healthy bacterial profile but shift up to the vaping profile,” Kumar explains. “Knowing the vaping profile is pathogen-rich, you’re not doing yourself any favors by using vaping to quit smoking.”

The researchers say this is the first human study on the effects of e-cigarette exposure in the mouth, and like previous research into e-cigarettes, also questions their safety.

Another vaping hazard: less-healthy mouths

Source: www.usnews.com/
Author: Serena Gordon, HealthDay Reporter

Your lungs might not be your only concern if you’re trying electronic cigarettes — your mouth may pay the price, too. Vaping alters the natural bacteria found in the mouth, leaving you more vulnerable to oral infections and inflammation, a new study reports.

The researchers said this study is the first to show that vaping can alter the natural balance of beneficial bacteria (microbiome) in the mouth, adding to the list of potential health effects associated with e-cigarette use.

“Cells that are exposed to e-cigarettes are more susceptible to infections,” said the study’s senior author, Deepak Saxena. He’s a professor of basic science and craniofacial biology at NYU College of Dentistry in New York City.

Saxena said that e-cigarettes also lead to increased inflammation, which harms oral health. And once someone develops inflammation, it’s possible to develop white patches in the mouth called leukoplakia that sometimes develop into cancer. However, this study doesn’t have enough long-term evidence to show whether or not these changes could lead to oral cancers in the future, Saxena said.

“Our study is just one piece of this big puzzle on e-cigarettes, and I would advise people to not use them. If you have not started, don’t start. Nicotine is highly addictive,” he said.

A U.S. Centers for Disease Control and Prevention report from November suggested that as many as one out of every five U.S. high school students had vaped in the last month. That’s especially concerning since more than 2,500 Americans have been hospitalized with lung injuries traced back to e-cigarette use. An additive sometimes used when people vape is suspected as a trigger for these injuries. Fifty-four people have died as a result.

People who smoke traditional tobacco cigarettes are known to have a higher risk of gum disease and oral infections. Tobacco causes changes in the mouth’s usual environment that dampen the immune system response and let bad bacteria flourish, the researchers explained.

E-cigarettes have been considered less harmful, but there hasn’t been a lot of research, particularly long-term studies on the new devices.

For the new study, the research team recruited 119 participants, including roughly equal numbers of people who didn’t smoke or vape, people who smoked tobacco cigarettes, and those who had only used e-cigarettes. The researchers performed oral exams and collected saliva samples to test for the bacteria living in the participants’ mouths.

Almost three-quarters of tobacco smokers showed signs of gum disease or infection. Forty-three percent of e-cigarettes users also showed signs of these problems. Only 28% of the nonsmokers had signs of gum disease or infection.

When they tested for bacteria, the researchers found different types of predominant bacteria in the three groups.

“We found there is a shift in the microbiome of e-cigarette users, making it much closer to that of regular cigarette smokers,” Saxena said.

Co-author Xin Li, an associate professor at NYU College of Dentistry, noted that the researchers can’t say if e-cigarettes are more dangerous for oral health than traditional tobacco cigarettes.

“We saw a similar trend to inflammation and periodontitis (a serious gum infection), but I don’t think we can draw any conclusions about whether e-cigarettes are more harmful,” she said.

If you vape and have concerns about these potential changes, Saxena suggested taking greater care with your oral health and perhaps seeing your dentist more frequently. Li said maybe probiotics can help restore the microbiome in the mouth. But both noted these steps haven’t been studied yet.

Li said if you are using e-cigarettes to help with quitting traditional tobacco cigarettes, try to use e-cigarettes for the shortest time you can. Plan on how you’ll cut back. Don’t plan to use e-cigarettes indefinitely, she advised.

Ronald Burakoff is chairman of dental medicine at Long Island Jewish Medical Center and North Shore University Hospital in New York. He said the study’s findings make sense.

“This article describes in detail some of the adverse outcomes associated with [e-cigarette] usage. Firstly, it increases the amount of bacteria in the mouth; secondly, it promotes inflammation of the gums,” Burakoff said. He added that these changes could lead to an increased risk of infection.

Note: The study was published online Feb. 26 in iScience.

February, 2020|Oral Cancer News|

Healthy diet may avert nutritional problems in head, neck cancer patients

Source: medicalxpress.com
Author: University of Illinois at Urbana-Champaign

At least 90 percent of head and neck cancer patients develop symptoms that affect their ability or desire to eat, because of either the tumor itself or the surgery or radiation used to treat it. These problems, called nutrition impact symptoms, have wide-ranging negative effects on patients’ physical and mental health and quality of life.

However, patients who eat foods high in antioxidants and other micronutrients prior to diagnosis may reduce their risks of developing chronic nutrition impact symptoms up to one year after being diagnosed with head or neck cancer, according to a recent study led by researchers at the University of Illinois.

The scientists analyzed the dietary patterns of 336 adults with newly diagnosed head and neck cancers and these patients’ problems with eating, swallowing and inflammation of the digestive tract. This painful inflammatory condition, called mucositis, is a common side effect of radiation treatment and chemotherapy.

The mitigating effects of a healthy diet were particularly significant in people who had never smoked and in patients who were underweight or normal weight at diagnosis, who often experience the greatest eating and digestive problems during treatment, said Sylvia L. Crowder, the paper’s first author.

Crowder is a research fellow in the Cancer Scholars for Translational and Applied Research program, a collaborative initiative of the U. of I. and Carle Foundation Hospital in Urbana, Illinois.

“While previous work has established that the presence of nutrition impact symptoms is associated with decreased food intake and weight loss, no studies have examined how pre-treatment dietary intake may influence the presence of these symptoms later in the course of the disease,” Crowder said.

In the early 2000s, researchers hypothesized that consuming antioxidant supplements might protect patients’ normal cells from damage during radiotherapy, enabling them to better tolerate treatment and higher dosages.

Accordingly, prior research by Anna E. Arthur, a professor of food science and human nutrition at the U. of I. and the current study’s corresponding author, indicated that eating a diet of whole foods abundant in antioxidants and phytochemicals improved recurrence and survival rates in head and neck cancer patients.

Like Arthur’s prior research, the new study was conducted with patients of the University of Michigan Head and Neck Specialized Program of Excellence.

Data on patients’ tumor sites, stages and treatment were obtained from their medical records. More than half of these patients had stage 4 tumors at diagnosis.

Prior to starting cancer treatment and again one year post-diagnosis, the patients completed a questionnaire on their diet, tobacco and alcohol use, and quality of life. Patients reported whether they experienced any of seven nutrition impact symptoms—such as pain or difficulty chewing, tasting or swallowing foods and liquids—and rated on a five-point scale how bothersome each symptom was.

In analyzing the patients’ eating habits, the scientists found that they followed either of two major dietary patterns—the Western pattern, which included high amounts of red and processed meats, fried foods and sugar; or the prudent pattern, which included healthier fare such as fruits and vegetables, fish and whole grains.

Patients who ate healthier at diagnosis reported fewer problems with chewing, swallowing and mucositis one year after treatment, the scientists found.

“While the origin and development of nutrition impact symptoms are complex and varied, they generally share one common mechanism—cell damage due to inflammation,” said Arthur, who is also an oncology dietitian with the Carle Cancer Center. “The prudent dietary pattern has the potential to reduce inflammation and affect the biological processes involved in the pathogenesis of these symptoms.”

The scientists hypothesized that some patients may begin eating healthier after being diagnosed with cancer, potentially counteracting the pro-inflammatory effects of their previous dietary habits.

Reverse causation was possible too, they hypothesized—patients’ lack of symptoms may have enabled them to consume a broader range of foods, including healthier whole foods, before their cancer was discovered.

January, 2020|Oral Cancer News|

How the ADA Oral Cancer Policy Amendment Will Affect Your Practice

Source: Dentistry Today
Date: November 29th, 2019
Author: Jo-Anne Jones

The ADA recently announced an expansion to its policy on oral cancer detection recommending that dentists and dental hygienists perform routine examinations for oral cancer includingoropharyngeal cancer for all patients.

Passed by the ADA House of Delegates in September, this change was brought about to align with concerns from the Centers for Disease Control and Prevention (CDC) over the escalating numbers of diagnosed cases of oropharyngeal cancer linked to the human papillomavirus (HPV).

While HPV-related oropharyngeal cancer has risen by 225% over the past two decades, oral cancer linked to the historical etiologic pathways of tobacco and alcohol use has declined by 50%. The ADA’s policy also aligns with support for the HPV vaccine, as 70% of oropharyngeal cancers in the United States are related to HPV, according to the CDC.

Dentists and dental hygienists play a critical role in opportunistic screening on all adult patients despite whether they possess the historical risk factors of using tobacco products or alcohol. There is a distinct knowledge gap in today’s population to fully understand that a non-smoker and non-drinker may in fact be at risk for oral and oropharyngeal cancer due to HPV.

It is our responsibility to educate our dental patients about all of the risk factors that exist for both oral and oropharyngeal cancer. Now more than ever, it is critically important to extend our screening practices, both visual and tactile, to every adult in the practice on an annual basis.

Only about a third of adults in the United States report being screened for oral cancer, representing a strong disconnect in our ability to improve earlier discovery rates and improve treatment outcomes.

As dental professionals, it is critical that we elevate our understanding of the escalating profile of HPV-related oropharyngeal cancer. Researchers once predicted that cases of HPV-related oropharyngeal cancer would surpass the leading HPV-related cervical cancer by 2020. Yet recent data from national registries has now confirmed that HPV-related oropharyngeal cancer became the leading HPV-associated cancer in 2015.

How common is HPV-related oropharyngeal cancer? About 53,000 Americans will be diagnosed with oral and oropharyngeal cancer this year. Close to 20,000 of those cases will occur in the oropharyngeal area, with 70% related to HPV.

The CDC also reports that HPV is so common that almost all sexually active adults will have an infection in their lifetimes, with most of the population clearing the infection with no repercussions. In contrast, a persistent infection with a high-risk strain such as HPV-16 can transform into oral or oropharyngeal cancer.

This transformation may take anywhere between 15 and 30 years. It seems to be targeting a much younger profile of white, non-smoking males age 35 to 55 with a four-to-one incidence of gender predisposition of males over females.

HPV has an affinity for lymphoid tissues and occurs most commonly in the tonsillar areas and the base of the tongue, with a smaller percentage occurring anteriorly in the oral cavity. Due to limited visual acuity, it is important to know and recognize the subtle symptoms that may accompany a posteriorly positioned tumor of HPV origin.

The following symptoms may be among the first distinguishable signs of the presence of oropharyngeal cancer:

  • Bleeding in the mouth or throat
  • Hoarseness or a change in the voice
  • A lump in the throat or the feeling that something is stuck in the throat
  • Continual lymphadenopathy or persistent neck masses despite antibiotic therapy
  • Slurred speech or difficulty articulating certain sounds
  • A tongue that tracks to one side when stuck out
  • Asymmetry in the tonsillar area
  • A persistent or recurring throat infection that doesn’t fully resolve with antibiotics
  • Unilateral earache
  • A persistent cough

Oral cancer can be very subtle, so it is extremely important to use magnification such as loupes and a dedicated light source or headlight to be able to discern early visible changes. The paradox that exists is that abnormal cellular differentiation typically starts at the basement membrane. By the time it becomes visible, it has progressed to a later stage of development.

Tactile palpation is paramount in uncovering any areas of hardness or induration possibly suggesting a mass or a tumor that is not yet clinically visible.

Enhanced oral cancer screening with a device such as the VELscope Vx from Apteryx Imaging may reveal what is not visible to the naked eye. It employs direct fluorescence visualization, which has been used successfully in the cervix, lungs, and colon. Using a proprietary wavelength, it gives clinicians the opportunity to visually penetrate the tissue surface to reveal the basement membrane.

The VELscope Vx is an assessment tool, however, and it does not convey a diagnosis. The golden rule always applies. Any oral abnormality that exists beyond 14 days is suspect and requires referral for further evaluation.

The Oral Cancer Foundation offers comprehensive information to help healthcare professionals and the general public to learn more about HPV’s connection with oral and oropharyngeal cancer. In April of 2019, the group launched the “Check Your Mouth” campaign to educate the public about the importance of self-examination of the oral cavity between dental appointments.

The impetus behind this project was to improve earlier discovery rates by having the public self-refer should they find anything new or abnormal that persists beyond 14 days. Cards may be ordered free of charge from the Oral Cancer Foundation store for distribution to dental patients.

Lastly, sharing information regarding the HPV vaccine is one of the strongest prevention methods we have today to make positive inroads in minimizing this type of cancer. The Food and Drug Administration has approved the HPV vaccine for both boys and girls and expanded the use of Gardasil 9 to include individuals age 27 through 45.

Together, we can have an impact on the earlier discovery of oral and oropharyngeal cancer.

Disclosure: Jo-Anne Jones is a KOL and consultant with Apteryx Imaging.

Ms. Jones is the president of RDH Connection, an educational and clinical training company dedicated to quality education and team training. In the midst of preparing to present her extensive research on HPV-related oropharyngeal cancer to her national association, a loved one was diagnosed with late stage HPV-positive tonsillar cancer and lost her life 16 months later. Jo-Anne proudly partners with the Oral Cancer Foundation in conveying the urgent need for changing the way in which we screen for oral cancer to meet the needs of today’s population. She can be reached at jjones@jo-annejones.com.

Research to examine possible links between periodontal disease and oral cancer

Source: eu.dental-tribune.com
Author: Dental Tribune International staff

As worldwide oral cancer rates continue to climb, our understanding of what causes the disease to occur, thankfully, also continues to grow. Tobacco use and excessive alcohol consumption have been established as primary risk factors, and researchers are now investigating another potential source for this condition: the bacteria that cause periodontal disease.

The research is being led by Dr Louise Belfield, a lecturer in biomedical science at the University of Plymouth’s Peninsula Dental School, in collaboration with the university’s Institute of Translational and Stratified Medicine. Since cancer requires blood vessels to grow and metastasise, the research team is planning to build on existing evidence that shows how certain bacteria that cause periodontal disease are linked to angiogenesis.

To do so, the research team will develop miniature tumours and blood vessels in a laboratory setting, adding the bacteria with the aim of clarifying how they function and what effect they have on the blood vessels.

According to a press release from the university, if the research ascertains that the bacteria make the blood vessels grow more rapidly and similarly to those associated with tumours and identifies the process by which this is achieved, the results could form the basis of a new screening programme to detect oral cancer risk earlier. This would make it possible to begin treatment in a more timely manner.

“We know that tumours in the mouth, unlike many other tumours, are in constant contact with bacteria, but we don’t know exactly how the bacteria affect tumour and vessel growth yet,” said Belfield.

“The bacteria may not cause the cancer, but they may do something to make the progression of the cancer speed up. One way they could do this is via the blood vessels, encouraging them to grow more rapidly or in a way which helps the tumour to grow. So if we find out what this is and how it works, it can help us develop and put screening processes in place to detect and reduce the numbers of those bacteria,” she continued.

Dental Tribune International (DTI) has previously reported on a study which confirmed the crucial role of dental professionals in detecting oral cancer early. This early detection can greatly improve the prognosis of sufferers.

“Oral cancer is a horrific disease with poor survival rates—only around 50% of those diagnosed are alive five years later. It is an in-your-face, no-hiding, disfiguring disease, and the treatment can be very protracted, complex and costly,” said Dr David Conway, Professor of Dental Public Health at the University of Glasgow’s School of Medicine, Dentistry and Nursing, in an interview with DTI last year.

“The earlier it is detected, however, the better the outcome can be,” Conway added.

November, 2019|Oral Cancer News|

Twitter lends insight to HPV-associated oral cancer knowledge

Source: www.oncnursingnews.com
Author: Brielle Benyon

The incidence of human papillomavirus (HPV)-associated oral cancer has risen in recent years, and the virus has now surpassed tobacco and alcohol use as the leading cause of the disease. In fact, while the HPV vaccine is typically associated with preventing cervical cancer, there have been more cases of HPV-associated oral cancer than there have been cervical cancer.1

While the link between oral cancer and HPV may be well-known to healthcare professionals, researchers at Howard University recently took to Twitter to get a glimpse into the public’s knowledge about the topic.

“By looking at the social media data, we wanted to know what people are hearing about oral cancer – especially HPV-caused oral cancer,” study co-author Jae Eun Chung, PhD, associate professor in the Department of Strategic, Legal & Management Communication at Howard University, said. “We wanted to see what the gaps are between the knowledge of the healthcare professionals and the public.”

The researchers collected 3,229 unique tweets over the course of 40 weeks using search terms such as “HPV or papilloma” and “mouth or oral or throat or pharyngeal or oropharyngeal.” They then used a program called nVivo 12.0 to conduct a content analysis that looked at certain phrasing, terms, and themes that commonly appeared.

More than half (54%; 1679 total) of the tweets had information about prevention, while 29% (910) were about the causes of oral cancer. Far fewer tweets were about treatment (5%; 141), diagnosis (3%; 97), symptoms (1%; 42), and prognosis (1%; 25).

Interestingly, the researcher discovered a prominence on the risk of HPV-associated oral cancer in men, with tweets that referred to males outnumbering tweets that referred to females in a 3:1 ratio. Also, the most popular hashtag used in the dataset was #jabsfortheboys, appearing in 89 tweets.

“There was a heavy emphasis on the risk of HPV-associated (oropharyngeal cancer) among men, which is different than what we see with HPV vaccination among girls,” Chung said. “That was very positive news to us, because HPV-associated (oral cancer) rates are higher among the male population and HPV vaccination rates are higher among girls.”

While spreading HPV vaccination and oral cancer is important on a global scale, the United States might have some catching up to do, as the 5 most mentioned Twitter users discussing the topic were located outside of the US–1 in New Zealand, 2 in Australia, and 2 in the United Kingdom.

“That’s kind of sad, because there are more Twitter users from the United States than from any other country,” Chung said.

Ultimately, Chung explained, these findings outlined an area where the country can benefit from more education and social media campaigns.

“In conclusion, this study provides some insight as to how the public makes sense of HPV-associated oral cancer,” she said. “More education and campaigns are needed, and US residents can benefit from more active involvement of US-based health education.”

Reference
1. Chung JE, Mustapha I, Gu X, Li J. Understanding public perception about human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) through Twitter. Presented at: D.C. Health Communication Conference; Fairfax, Virginia; April 26-27, 2019.

April is Oral Cancer Awareness Month: Self-exams, early detection can save lives

Source: www.prnewswire.com
Author: press release

Because early detection of oral cancer offers a greater chance of a cure, the American Association of Oral and Maxillofacial Surgeons (AAOMS) is reminding the public during Oral Cancer Awareness Month of the importance of performing monthly self-exams.

AAOMS promotes self-exams and screenings every April with the Oral Cancer Foundation, which predicts about 53,000 new cases of oral cancer will be diagnosed in 2019 in the United States – leading to more than 9,000 deaths.

“A monthly self-exam takes only minutes and could potentially save your life,” said AAOMS President A. Thomas Indresano, DMD, FACS. “If done on a regular basis, you’re increasing the chances of identifying changes or new growths early. The survival rate for oral cancer is between 80 and 90 percent when it’s found at early stages of development.”

Oral and maxillofacial surgeons (OMSs) encourage a six-step oral cancer self-exam that involves looking and feeling inside the mouth for suspicious sores and feeling the jaw and neck for lumps. Using a bright light and a mirror:

  1. First remove any dentures.
  2. Look and feel inside the lips and the front of the gums.
  3. Tilt the head back to inspect and feel the roof of the mouth.
  4. Pull the cheek out to inspect it and the gums in the back.
  5. Pull out the tongue and look at its top and bottom.
  6. Feel for lumps or enlarged lymph nodes in both sides of the neck, including under the lower jaws.

Oral cancer symptoms may include one or more of the following if they are persistent and not resolving:

  • Red, white or black patches in the soft tissue of the mouth.
  • A sore in the mouth that fails to heal within two weeks and bleeds easily.
  • An abnormal lump or hard spot in the mouth.
  • A painless, firm, fixated mass or lump felt on the outside of the neck that has been present for at least two weeks.
  • Difficulty in swallowing, including a feeling food is caught in the throat.
  • Chronic sore throat, hoarseness or coughing.
  • A chronic earache on one side.

The risk factors for oral cancer include smoking and tobacco use, alcohol consumption and the human papillomavirus (HPV).

“About 25 percent of oral cancer patients have no known risk factors,” Dr. Indresano said. “It’s important that everyone perform a monthly self-exam. And if you have any of the symptoms for more than two weeks, promptly contact an oral and maxillofacial surgeon. OMSs are experts in diagnosing and surgically treating oral cancer.”

April, 2019|Oral Cancer News|

E-cigarette users show cancer-linked genetic changes

Source:news.usc.edu
Author: Leigh Hopper

If you think vaping is benign, think again.

While studies have indicated that vaping can help smokers quit, USC researchers say the health consequences of using a e-cigarettes may be worse than widely believed. (Photo/Pixabay)

A USC study in 93 people shows that e-cigarette users develop some of the same cancer-related molecular changes in oral tissue as cigarette smokers, adding to the growing concern that e-cigarettes aren’t a harmless alternative to smoking.

The research, published this week in the International Journal of Molecular Sciences, comes amid a mushrooming e-cigarette market and mounting public health worries. On a positive note, recent research found vaping is almost twice as effective as other nicotine replacement therapies in helping smokers quit. But among adolescents, vaping now surpasses smoking, and there’s evidence that e-cigarette use leads to nicotine addiction and future smoking in teens.

“The existing data show that e-cig vapor is not merely ‘water vapor’ as some people believe,” said Ahmad Besaratinia, an associate professor at Keck School of Medicine of USC and the study’s senior author. “Although the concentrations of most carcinogenic compounds in e-cig products are much lower than those in cigarette smoke, there is no safe level of exposure to carcinogens.”

E-cigs and cancer: Early warning in oral cells
Besaratinia emphasized that the molecular changes seen in the study aren’t cancer, or even pre-cancer, but rather an early warning of a process that could potentially lead to cancer if unchecked.

The researchers looked at gene expression in oral cells collected from 42 e-cigarette users, 24 cigarette smokers and 27 people who didn’t smoke or vape. Gene expression is the process by which instructions in our DNA are converted into a functional product, such as a protein. Certain alterations in gene expression can lead to cancer.

They focused on oral epithelial cells, which line the mouth. More than 90 percent of smoking-related cancers originate in epithelial tissue, and oral cancer is associated with tobacco use.

Both smokers and vapers showed abnormal expression, or deregulation, in a large number of genes linked to cancer development. Twenty-six percent of the deregulated genes in e-cig users were identical to those found in smokers. Some deregulated genes found in e-cig users, but not in smokers, are nevertheless implicated in lung cancer, esophageal cancer, bladder cancer, ovarian cancer and leukemia.

E-cigs and cancer: What’s next?
Besaratinia and his team plan to replicate his findings in a larger group of subjects and explore the mechanisms that cause gene deregulation. He’s also launching another experiment in which smokers switch to e-cigs; he wants to see whether any changes in gene regulation occur after the switch.

“For the most part, the participants are as curious as we are to know whether these products are safe,” he said.

In addition to Besaratinia, the study’s other authors are first author Stella Tommasi, Andrew Caliri, Amanda Caceres, Debra Moreno, Meng Li, Yibu Chen and Kimberly Siegmund, all of USC.

February, 2019|Oral Cancer News|

Tobacco 21 — its time has come

Source: vtdigger.org
Author: Nevin Zablotsky, DMD

As we approach the holiday season I am reminded of the gifts of love we share with our families, as well as the New Year’s resolutions we make and try to keep after Jan. 1 history.

I am a periodontist having practiced in Burlington and South Burlington for the past 40 years. In that time I have treated patients that have been severely compromised by tobacco. Some have lost teeth from advanced periodontal disease and some have lost parts of their tongue and jaw due to oral cancer, leaving them significantly compromised functionally as well as well as emotionally. I have had to advise teenagers and their families that their tobacco chewing habit had caused significant enough changes in their mouth to warrant a biopsy of the involved area. This caused great stress to them as they waited a week to find out the results. Some may think that it takes many years for tobacco use to compromise one’s health, but teenagers can die a horrible death from tobacco use if they are one of the unlucky ones who is genetically predisposed to oral cancer.

Over the years, I have traveled throughout Vermont teaching about tobacco and nicotine addiction to elementary, junior and senior high school students. I feel that I have a good sense of what kids are thinking about these subjects. The elementary school students seem to understand that cigarettes are bad for them. When one talks to the middle school kids, there are some that are beginning to think that cigarettes and smokeless tobacco use is cool, and when speaking to high school students, there is a larger percentage of them that have begun to use a variety of these products, ranging from cigarettes and cigars, to hookahs, to a variety of e-cigarettes, with the newest product, Juul, going viral. This product has become so much of a problem local schools have sent letters to parents warning them of its sudden increase in usage .

It is legal for anyone over 18 to purchase all of these tobacco and nicotine products. Here are some facts to chew on.

About 95 percent of adult smokers begin smoking before they turn 21. Two-thirds of 10th grade students and nearly half of eighth grade students say it is easy to get cigarettes. More 18- and 19-year-olds using in high school means younger kids have daily contact with students who can legally purchase tobacco products.

I am often told that when one reaches the age of 18 they are mature enough to vote, or join the military, so therefore they are mature enough to decide on using tobacco products.

Tobacco use costs the military about $1.6 billion annually in lost productivity and health care expenses tied to respiratory problems, cardiovascular disease and slower healing, according to the Department of Defense data. That’s expected to climb to $19 billion during the next 10 years and result in 175,000 premature deaths. The Air Force bans tobacco in recreation facilities, and the Navy banned tobacco on all submarines. The Vermont National Guard also stated that they would abide by Tobacco 21 legislation if it passed, again citing readiness and fitness.

An argument has been made that tobacco retailers’ businesses will be irreparably harmed if tobacco 21 is implemented. Studies show that its impact over the first 5-8 years will be between one quarter and one half of a percent.

Vermont law does not allow the sale of alcohol to anyone under 21, and the new marijuana law passed last year also restricts its usage to those over 21. Given the proven health risks of tobacco use, why does the present law allow tobacco usage at age 18?

It has been calculated that 10,000 kids now under 18 and alive in Vermont will ultimately die prematurely from the smoking habit they began in their teenage years.

Six states have passed tobacco 21 legislation. This includes Massachusetts and Maine, with New York likely to join this group. Do we really want kids coming from our surrounding states coming here to get their cigarettes or e-cigarettes?

Even Altria and R.J. Reynolds, two of the largest tobacco companies in the world have stated that the age of sale should be 21.

So as we approach the new year I want to appeal to our representatives, to resolve to pass tobacco 21 in the 2019 legislative session, and remind them about how much suffering they can prevent. The decisions they make will have major consequences for generations to come. What a great resolution to keep. What a great holiday gift for us all.

Note: This commentary is by Nevin Zablotsky, DMD, a retired periodontist who practiced in South Burlington and the Coalition for a Tobacco Free Vermont.

December, 2018|Oral Cancer News|

Early detection, treatment helps conquer oral cancer

Source: www.newsbug.info
Author: Bob Moulesong

According to the Oral Cancer Foundation, almost 50,000 cases of oral cancer will be diagnosed in the U.S. in 2018. The American Cancer Society reports that 10,000 people will die from the disease this year. Half of all people diagnosed with oral cancer will be alive in five years, according to both sources.

While those are disquieting statistics, Region physicians say routine checkups and early diagnosis improve the odds.

Oral cancer
Oral cancer includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, saliva glands, and throat.

“People we see usually come to us for a lesion or ulcer found in the mouth or throat,” says Dr. Akta Kakodkar, an ear, nose and throat specialist with Community Healthcare System. “Some of them experience no pain but notice a growth or patch of discolored tissue in their mouth, cheek or gum.”

Kakodkar, who with her husband and fellow Community ENT physician, Dr. Kedar Kakodkar, treats oral cancer patients, is quick to point out that not every lesion, ulcer or mouth sore is cancer.

“We see hundreds of nervous patients who have bacterial or fungal infections,” she says. “Treatment with antibiotics or antifungal medications clear up many of these lesions. There are also many white and red patches that clear up on their own.”

The only way to know is a thorough examination.

Types and risk factors
“Most cases of oral cancer are linked to use of tobacco, alcohol and betel nuts, or infection with HPV,” Kakodkar says. “There are major risks associated with tobacco use, whether it’s smoking or chewing.”

There are two main types of oral cancer. Most prevalent is squamous cell carcinoma, accounting for more than 90 percent of cancers that occur in the oral cavity and oropharynx. Slow-growing verrucous carcinoma makes up more than 5 percent of oral cavity tumors.

First steps
Kakodkar says prevention is the best defense. “Your primary care physician may examine your head, neck, mouth and throat for abnormalities,” she says.

Self-exam may uncover a lesion or sore. “Remember, many of these are very treatable and are not cancer,” Kakodkar says. “But don’t wait. Cancer never goes away by itself.”

When Kakodkar discovers a suspicious lesion, she recommends a biopsy: “Depending on several variables, we might do the biopsy in clinic, or we may do it in a hospital setting.”

Once the results return, a plan of action can be established. “Usually, the next steps include imaging, such as a CT scan,” she says. “We also order a PET scan, which tells us what stage the cancer is in and whether or not it has spread.”

Treatment
Kakodkar says she prefers to go straight to surgery. “Many oral cancers are still small and local,” she explains. “Removing them completely is the best way to stop the spread of the cancer.”

Depending on the type and stage of the cancer, radiation and/or chemotherapy may be used.

“I want people to know that surgery for oral cancer is frequently a simple procedure,” Kakodkar says. “Oral cancer is frequently found early due to its visibility. Almost 90 percent of cancer patients in stage 1 or 2 recover and survive.”

A dental checkup
“Oral cancer screening is crucial during a dental examination,” says Dr. Ami Pandya, dentist at Family Dental Care in Valparaiso. “Recognizing abnormal tissue in a patient’s mouth could indicate precancerous tissues, and when identified early could save your life.”

A dentist will perform a thorough head and neck exam, which includes an oral cancer screening. “Dentists will complete extraoral examinations by palpating your jaw line to feel for any suspicious lumps that are not routinely present in these areas,” Pandya says.

A dentist will examine the intraoral tissues of your mouth and look for any suspicious lesions. “We examine the patient’s tongue, the floor of their mouth, and their gingival tissue,” Pandya says. Red and/or white patches can become cancerous.

Many doctors including Pandya have begun using VELscope, a light-based technology to detect precancerous tissues. It’s a wireless hand-held device that scans tissue, with abnormalities showing up as a dark black color.

“VELscope can detect abnormalities before they have a clinical presentation,” Pandya says. “It’s an incredible aid with oral cancer screening.”

Pandya recommends an annual VELscope examination for low-risk adults. Higher risk patients should get a VELscope exam each appointment.

Under the VELscope, cancer shows up as black, says Dr. Ami Pandya

If the dentist detects an abnormality, he or she informs the patient, noting the size, color and location of the lesion. A two-week follow-up is standard. “Oftentimes, these lesions resolve,” Pandya says. If it doesn’t resolve after two weeks, the patient is referred for further evaluation.

Note: This article originally ran on nwitimes.com.

November, 2018|Oral Cancer News|