Oral Cancer Detection

Evaluating patients for oral cancer includes a thorough head and neck exam. Special attention needs to be given to the neck to evaluate the lymph nodes for possible metastases. Some oral cancers begin as:

(1.) Leukoplakia - white lesions

(2.) Erythroplakia - red patches, or

(3.) Non-healing sores that are present for more than 14 days

There are risk factors that increase ones chances of developing oral cancer. Risk factors include smoking, chewing tobacco, and drinking alcohol. Recently, it has been discovered that being sexually active can increase the risk of oral cancer due to HPV (human papilloma virus).

Although cancers of the head and neck only account for 5 percent of all cancers reported yearly, 30 percent of these cancers occur in the oral cavity. That is roughly 22,000 new cases per year, if cancers of the lip are not included. Between 6,000 and 7,000 deaths per year occur because of oral cancer. The disease claims twice as many lives as cervical cancer.

Early detection is key, just like with any other cancer. That’s why we offer the Velscope exam, recommended once a year for all patients in conjunction with our oral cancer exam. The Velscope exam emits a safe blue light that allows us to find tissue changes that we may not be able to see with just the naked eye. Thus, finding precancerous lesions early increases the odds of survival. Seeing your dentist regularly helps promote a healthy mouth as well as prolong your life.

- Dr. Jessica Eugenio, Highlands Office

Cigarette Ads/Packages Must Include Oral Cancer Warnings

Cigarette ads, packages must include oral cancer warnings, says FDA

By Craig Palmer, ADA News staff

Oral Cancer

Washington—The Food and Drug Administration will require use of a “cancerous lesion on lip” image in cigarette advertising and packaging for its potential to motivate positive behavioral change, influence youth and young adults in particular and inform the public that cigarettes cause oral cancer.

 Flexing its regulatory muscle on the second anniversary of the Family Smoking Prevention and Tobacco Control Act, which was signed into law June 22, 2009, the FDA unveiled nine graphic health warnings to be placed on all cigarette packs, cartons and ads no later than Sept. 22, 2012.

“The nine new health warning statements and the accompanying graphic images selected by FDA convey information that is factual and uncontroversial,” the agency said in the regulatory notice.

The FDA simultaneously announced a public inquiry and request for comments on the public health impact of modified risk tobacco products sold or distributed for use to reduce harm or the risk of tobacco-related disease associated with commercially marketed tobacco products. The FDA scheduled a public forum Aug. 25-26 to obtain information on “the scientific issues associated with assessment and ongoing review of MRTPs.” These include smokeless and other products promoted as alternatives to cigarette smoking.

The Association supported the 2009 tobacco control law, and has advised the FDA on using the law to shape public tobacco policy. “Dentists are the first line of defense in the war against oral cancer and many other tobacco-related diseases,” the Association told the FDA in commenting on tobacco product regulation.

Cigarettes Cause Cancer

“As a matter of public health, we have become increasingly alarmed by recent attempts to market smokeless tobacco as a healthier (or less harmful) alternative to cigarettes,” the Association’s Oct. 9, 2009 statement said. “Smokeless tobacco is not a healthy alternative to cigarette smoking; both products pose health risks.”

FDA issued the requirement for larger, graphic health warnings for cigarette packages and advertisements in a June 22, 2011 Federal Register document dense with analysis and research rejecting tobacco industry arguments against the proposal and explaining how and why these images and warnings will get public attention and reduce smoking-related disease and death.

An image the FDA describes as “cancerous lesion on lip” will illustrate a “WARNING: Cigarettes cause cancer” statement chosen, the agency said, for scoring high in focus group testing on emotional and cognitive reaction scales and a “difficult to look at” measure.

“First, ‘cancerous lesion on lip’ was the only image among the images proposed for use with this warning statement that had a positive impact on beliefs about the health risks of smoking and secondhand smoke exposure in one of the study samples (adults viewing a hypothetical advertisement),” the FDA said in the regulatory document.

“Furthermore, as is stated in several comments…the selected image ‘cancerous lesion on lip’ is likely to have particular relevance for youth. As explained in some of these comments, the research literature suggests that youth are likely to relate to and be susceptible to cigarette warnings depicting the negative short-term impacts of smoking on their personal appearance, including their lips and teeth.

“Several comments noted that the image could be especially effective with younger audiences and could positively influence such audiences by illustrating how the health effects caused by smoking negatively affect their physical appearance. The comments indicated that adolescents can relate to and will be susceptible to this message.

“We agree with these comments,” the FDA said in responding to the comments on image effectiveness. “It is important to include content in the required warnings that is relevant to youth. The image ‘cancerous lesion on lip’ has the potential to positively impact youth behavior in addition to adult and young adult behavior.”

The FDA disagreed with comments that the image was “too gross” to be effective and that oral cancer was an odd choice of cancers to depict in the graphic warning, noting that “the research literature indicates that images that evoke strong emotional reactions can promote greater awareness and better recollection of the health risks of smoking and can increase the likelihood smokers will reduce their smoking, make an attempt to quit, or quit altogether.

“Furthermore, the choice of cancers depicted in the required warning is appropriate and will help inform the public that cigarettes cause oral cancers and thus increase public awareness of the negative consequences of smoking.”

The National Tobacco Quitline phone number, 1-800-QUIT-NOW, must accompany the nine new warnings.

Information for professionals and the public to assist in tobacco cessation efforts can be found on ADA.org.

Post credit.

HPV Linked Oropharyngeal Cancer Rates Rise Dramatically

In the 1980s just over 16% of patients with oropharyngeal cancers tested positive to HPV, compared to over 70% during the last decade, researchers reported in the Journal of Clinical Oncology. The authors add that if the rise in incidence continues at its present pace, the incidence of oropharyngeal cancers will overtake that of cervical cancer.

What is HPV?

HPV stands for human papillomavirus 

Oropharyngeal cancer is cancer which develops in the tissue of the oropharynx, the middle part of the throat, including the base of the tongue, tonsils, the soft palate, and the walls of the pharynx.

According to prior studies, oropharyngeal cancers can be divided into:

• HPV-negative cancers - which are usually linked to alcohol and tobacco use
• HPV-positive cancers - which are associated with some types of HPV, a sexually transmitted virus. Those with this type of oropharyngeal cancer are usually younger than HPV-negative cancer patients.

"Patients generally have better survival rates with this type of cancer."

Said senior author Maura Gillison, MD, PhD, professor of medicine and Jeg Coughlin Chair of Cancer Research at The Ohio State University Comprehensive Cancer Center in Columbus, wrote:

"We used to think of oropharyngeal cancer as one cancer, and now we know the disease is comprised of two biologically and epidemiologically distinct cancers. This new understanding will increasingly enable us to improve and better personalize care for patients with each form of the disease."

The team had previously demonstrated that survival rates and incidence for oropharyngeal cancers rose considerably in America between 1973 and 2004, while incidence rates for other cancers of the head and neck, such as oral cavity, dropped during the same period.

They tested 271 archived oropharynx cancer tissue samples from 5,755 patients for HPV infections. The samples came from three registries in Los Angeles, Iowa and Hawaii that had been collected between 1984 and 2004.

Using several molecular assays they demonstrated that the percentage of oropharyngeal cancers that were HPV-positive rose considerably during that period, from 16.3% between 1984 and 1989 to 72.7% between 200 and 2004.

In 1988, there were 0.8 cases of HPV-positive cancers per 100,000 people, compared to 2.6 in 2004 - a 225% increase. As smoking rates during the same period had dropped, HPV-negative oropharyngeal cancer rates dropped by 50%.

By 2020, HPV-positive oropharyngeal cancers will be the major form of cancer for the head and neck, and the leading HPV-linked cancer, overtaking cervical cancer if current trends continue, the authors added.

Post credits: http://www.medicalnewstoday.com/