Awareness

HPV-Related Head and Neck Cancers on the Rise

Head Neck CancerHead and neck cancer causes almost 200,000 deaths each year and is now recognized as one of the major health concerns both in the United States and worldwide. In particular, there has been a noted increase in the incidence of oropharynx cancer (OPC), mainly tonsil and base of tongue cancers, that are linked to infection with the human papilloma virus (HPV).

According to the National Cancer Institute, HPV infections are the most common sexually transmitted infections in the US and more than half of sexually active people are infected with one or more HPV types at some point in their lives. Most HPV infections occur without any symptoms and go away without any treatment over the course of a few years. However, HPV infections sometimes persist for many years and can increase a person’s risk of developing cancer.

The human papilloma virus 16 (HPV16) infection linked to oropharynx cancers is a sexually transmitted virus that seems to affect mostly young Caucasian males. Traditionally the non-HPV related head and neck cancers are strongly linked to smoking, but patients with HPV related cancers are usually not tobacco users. HPV-related head and neck cancers are a distinct disease entity which has particular molecular, epidemiological, and clinical characteristics. Multiple studies have shown that HPV-related oropharynx cancers are easier to cure compared to the head and neck cancers caused by tobacco and alcohol use, but smoking still seems to affect the chances of curing patients with HPV related OPC. There is also recent evidence suggesting that smoking is linked to a higher risk of having HPV-related OPC.

Still, sexual transmission of HPV is believed to be the main risk factor for HPV-related head and neck cancers and oral sexual behavior has been linked to an increased risk of HPV-related oropharyngeal squamous cell carcinoma. For example, studies have shown the odds of developing oral HPV infection among a group of college-aged men increased with increases in the number of recent oral sex partners or open-mouthed kissing partners, but not vaginal sex partners.

The Food and Drug Administration (FDA) has approved two vaccines that are highly effective in preventing infection with HPV types 16 and 18. Because research clearly shows that vaccination makes a difference in preventing cervical cancer, which is very closely linked to HPV-16, the HPV vaccine has been recommended for girls aged 11 to 12. There is also a more recent recommendation from the Advisory Committee on Immunization Practices (ACIP) for boys of the same age to receive the HPV vaccine. Even though vaccination for HPV-related oropharynx cancers has been an active area of research, the implementation of such an approach is still limited.

For the majority of cancers of the head and neck that do not originate from the area of the oropharynx (non-OPC), HPV does not seem to be a significant risk. However, of interest, HPV is still apparently linked to some patients who have non-OPC. The significance of this link is not clearly known and more studies are needed to understand the role of HPV in patients with non-OPC.

About Dr. Saba

Nabil Saba, MDNabil Saba, MD, FACP, is a nationally recognized expert in the treatment of head and neck and esophageal cancer. As principal investigator on several head and neck cancer trials, he has initiated studies focusing on novel approaches for treating these diseases. Dr. Saba is a member of the ECOG Head and Neck Cancer steering committee, and an elected member of the American Head and Neck Society (AHNS). He also serves on the American College of Radiology appropriateness criteria panel for Head and Neck Cancer.

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Takeaways from Dr. Saba’s Head and Neck Cancer Chat
Local Firefighter Stomps Out Head and Neck Cancer

Getting the Best Cancer Treatments into Outlying Communities

Cancer Treatment in CommunitiesThe purpose of the community outreach program I oversee at Winship Cancer Institute of Emory University is to bring our clinical and population-based research to communities throughout Georgia and surrounding states in order to benefit patients in those areas. By partnering with community oncologists, we can offer our expertise and best practices to help them successfully treat patients with types of cancer that are less common or more difficult to treat.

A great example of this is a program we’ve developed to treat patients with acute promyelocytic leukemia (APL), an uncommon but highly aggressive disease. We actually call it the heart attack of leukemias because a third of the patients do not survive the first month of treatment. We have chemotherapeutic drugs that are very effective in treating APL, but because it is a rare condition, physicians who treat it in the community may not be familiar with the potential complications that patients may develop during treatment.

Yet it is a highly curable disease, and at Winship we have come up with a simple approach that is keeping these patients alive during the first, most crucial month. This method decreases mortality from an estimated 30 percent to less than five percent.

We started by taking a very complicated treatment algorithm and simplifying it to a page and a half, and then used that to develop a three-step process to help community oncologists treat patients quickly and effectively. As soon as we get a call from a community physician, we send the simplified algorithm via smart phone. Then we talk to the physician on the phone and figure out what the patient is going through. Lastly, we give them a treatment plan to get them through the first month and follow up with emails, phone calls or text messages.

We’re grateful that community doctors are receptive to the guidance offered by Winship. By taking swift action, they are giving their APL patients the best chance of survival. It’s extremely gratifying to see people in outlying parts of Georgia and South Carolina receive this treatment protocol and survive this disease.

Watch Dr. Jillella explain the way Winship is helping save patients’ lives following diagnosis of acute promyelocytic leukemia in the video below:

About Dr. Jillella

Anand Jillella, MDAnand Jillella, MD, is a national leader in bone marrow transplantation and has led the development of a strategy to decrease induction mortality for acute promyelocytic leukemia. He leads the efforts of the Winship Cancer Network and is expanding Winship’s role in bringing clinical and population-based cancer research to communities throughout Georgia and surrounding states.

Latest in Breast Cancer Research

According to the National Breast Cancer Foundation, 10%-20% of diagnosed breast cancers are determined to be triple negative breast cancer. It tends to primarily affect younger, premenopausal women and is more aggressive than other types of breast cancer. Studies show that African-American and Hispanic women are more likely to be diagnosed with triple negative breast cancer than white women. Triple negative breast cancers don’t have the three types of receptors that most commonly fuel breast cancer growth — estrogen, progesterone and the HER2 gene — so they don’t respond to hormonal therapies and treatments that target those receptors. Chemotherapy is typically used for treatment, but there is an urgent need to find more precise therapies.

LaTonia Taliaferro-Smith, PhD, is one of the Winship Cancer Institute of Emory University’s scientists who have taken up the challenge to develop more targeted therapies. In her lab research, Taliaferro-Smith searches for alternative targets in the triple negative breast cancer cell. She works closely with Winship physician-researchers toward the goal of developing drugs that will benefit patients with this disease.

“I’m very hopeful about the research we’re doing here and what Winship is offering to triple negative breast cancer patients,” says Taliaferro-Smith. “Oftentimes when patients hear a triple negative diagnosis, they think there are no options and ultimately their endpoint is death. But we’re very encouraged here at Winship because we do have active research that is trying to find alternative therapies for these particular patients, so we can let them know that you will have treatment options available hopefully in the near future.”

Check out the video below as Dr. Taliaferro- Smith discusses the continuous work research teams at Winship are doing to develop more precise treatment therapies for triple negative breast cancer:

Related Resources

Learn more about breast cancer care at Winship at Emory. October is Breast Cancer Awareness Month and our breast care teams want you to know that early detection is key to survival. Have questions about the role of screening in early breast cancer detection? Join us for a live web chat with a breast imaging expert on October 21, 204.

Winship’s Win the Fight 5K Exceeds Fundraising Goal to Help Battle Cancer

Winship Win the Fight 5K RecapThis past weekend,  Winship Cancer Institute of Emory University raised a record amount of money towards cancer research in Georgia. Fundraising support, through the 4th annual Winship Win the Fight 5K, which was held on Saturday, September 27, 2014, surpassed its half-million dollar goal and brought in more than $582,000. Over three thousand runners and walkers gathered Saturday morning to participate in the event that started and ended on the Emory campus and wound its way through the surrounding Druid Hills-area.

“We are so grateful to all the supporters who joined us at this year’s Winship 5K,” says Walter J. Curran, Jr., MD, executive director of Winship. “The money raised will support more than a dozen cancer research projects at Winship and will lead us to more and more success stories in our fight against cancer.”

The Winship Win the Fight 5K is a unique event because it allows participants to select the specific area(s) of cancer research they want their tax-deductible donations to benefit. Donations are still being accepted until November 14, 2014. For more information, visit the Winship Win the Fight 5K website.

And make sure to mark your calendars for the 5th annual Winship Win the Fight 5K, which will be held on Saturday, October 3, 2015.

Advancements in Imaging for Early Breast Cancer Detection

Advancements in Breast Imaging ChatBreast cancer is the most common cancer among American women, according to the Centers for Disease Control and Prevention (CDC). October is Breast Cancer Awareness month and the breast care specialists across Emory Healthcare want you to know the importance of screening and early detection.

The American Cancer Society recommends that women (without breast cancer symptoms), age 40 and older should have a mammogram every year as long as they are in good health. Getting yearly screening mammograms increases the chance of detecting cancers in the early stages, before they start to cause symptoms. By detecting cancer early, screening exams also help increase the chance of survival and lower the risk of mortality.

At Emory Healthcare, we are proud to offer patients with leading breast screening techniques, including the latest in breast imaging technology, called tomosynthesis, or 3D mammography.

Learn more about breast screening guidelines and advancements in breast imaging by joining us on Tuesday, October 21 at 12:00 pm EST for a live web chat on “Advancements in Imaging for Early Breast Cancer Detection.” Dr. Michael Cohen, Director, Division of Breast Imaging for Emory’s Department of Radiology, will be available to answer questions such as: what is the latest in breast imaging technology? When should I start getting screened? To register for the chat, click here.

Also, during October, the Emory Breast Imaging Centers are offering extended and weekend hours for women needing a screening mammogram. Dates and details are below:

Extended Hours: Thursday, October 9, Tuesday, October 21, Thrusday October 23; 7:30 a.m – 7:00 p.m. at the Emory Breast Imaging Center on Clifton Road.

Saturday Hours: October 18, 8 a.m. – 2 p.m. at Emory University Hospital Midtown.

Registration: To schedule an appointment, call 404-778-PINK (7465). Standard rates apply.

Chat Details:

Date: Tuesday, October 21, 2014
Time: 12:00- 1:00 pm EST
Chat Leader: Dr. Michael Cohen
Chat Topic: Advancements in Imaging for Early Breast Cancer Detection

Chat Sign Up

Winship Win the Fight 5K

Winship Fight 5KThe Winship Win the Fight 5K is this Saturday, September 27, 2014 and already a HALF A MILLION DOLLARS has been raised towards cancer research at Winship Cancer Institute of Emory University.

There’s still time to be a part of this special event! Today is the last day to register online for Saturday’s event. If you cannot be present to run or walk this weekend, register as a “Sleep-In Warrior” to support cancer research from wherever you will be this weekend.

For more information, or to register, visit the Winship Win the Fight 5K website. Also, check out this inspiring video below featuring WSB-TV’s Mark Winne’s wife, Kate, a cancer survivor and Winship patient. Mark and Kate’s story not only shows the crucial role cancer research plays in the continuous fight for a world without cancer, but also the hope it beings to patients and families, here and now.

Related Resources:

Cancer Researchers, Patients Support Winship 5K Side-by-Side
Why I Run: To Raise Awareness & Funding For My Dad’s Cancer
Running to Carry Forth a Father’s Passion to Make a Difference…

Take Steps to Prevent Skin Cancer

Skin ExamI am a dermatologist in the Emory Clinic and my focus is medical dermatology with a monthly melanoma clinic. I see patients of all skin types but a large part of my practice is seeing patients for total body skin exams (TBSE). We recommend that patients with all skin types get a total body skin exam, but patients who have a family history of melanoma, atypical mole syndrome or non-melanoma skin cancer should be particularly proactive about scheduling their skin checks. As a broad rule, once a year skin checks should suffice. These checks become more frequent in patients who have a personal history of melanoma or non-melanoma skin cancer.

A skin exam entails wearing a gown at the dermatologist’s office and getting all parts of your skin looked at for moles that may appear abnormal or growths that may be non-melanoma skin cancers such as basal cell skin cancer or squamous cell skin cancer. If we see anything suspicious, the spot is biopsied, which involves removing a small sample of skin tissue. It takes five minutes or less to perform a biopsy and the results are usually available in a few days.

During this visit, we educate patients to be good about self-examination. I recommend that patients pick the first of every month and put it on their calendar to examine their skin head to toe. They should look for any changing moles or any new bumps that may have come up. It can be difficult to know what to worry about or not, but in general a melanoma can show up as a new mole or a changing or bleeding mole. A basal or squamous cell generally presents as a new bump or flat lesion that can bleed, or hurt, or just be new and growing. If you are worried about something, you should make an appointment to be checked by your dermatologist right away.

Sun protection is a big part of preventing skin cancers. The AAD (American Academy of Dermatology) recommends everyone use sunscreen that is broad spectrum (protects against UVA and UVB), has a sun-protection factor (SPF) of 30 or greater and is water resistant. And you need to apply an adequate amount of sunscreen for it to be effective: generally one ounce (enough to fill a shot glass) for the exposed parts of your body for each application. This needs to be repeated every 2 hours on continued sun exposure. Remember to apply sunscreen at least 15 minutes before going outdoors.

You can use any type of sunscreen that works for you, such as lotions, creams, gels, sticks or even sprays. Sprays, though, have the disadvantage of accidental inhalation and it’s sometimes hard to know when using a spray if you have applied an adequate amount.

Tanning bed use has been proven to increase the risk of melanoma and also accelerate photo-aging. It should be avoided at all cost. Sunbathing and a history of blistering sunburns also increase your risk of skin cancer. It is very important to avoid the sun between 10 am and 2 pm, when the rays are the strongest, and to use additional protective clothing such as long sleeved shirt, pants, a wide-brimmed hat and sunglasses.

As you get ready for fun summer weekends, here’s a checklist to help you prevent skin cancer: avoid the sun when it’s at its strongest, use sunscreen and protective clothing any time you are out in the sun, never use a tanning bed, and when in doubt, check it out! Schedule an appointment with a dermatologist along with your annual physical visit, and for accurate information about safe sun practices, check the AAD website.

About Dr. Bhandarkar

Sulochana Bhandarkar, MDSulochana Bhandarkar, MD, is an assistant professor of dermatology at the Emory School of Medicine. She completed her medical school education from her home country, India, at Kasturba Medical College in Mangalore, where she also did a three-year dermatology residency with a special interest in vitiligo, a condition affecting skin pigmentation. After moving to the U.S., she did a clinical research fellowship at the University of California San Francisco, as well as a melanoma research fellowship at Emory University. She did her residency in dermatology at Emory University and became a faculty member at Emory in 2011. Her clinical interests are vitiligo and melanoma.

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Clinical Trials Responsible for Advances in Medical Treatment

Tamara Mobley, 38 and married with 8 and 12 year old sons, has been battling multiple myeloma for five years now under the care of Dr. Sagar Lonial at the Winship Cancer Institute of Emory University. She went on a clinical trial at Winship in order to get the most advanced drug for treating this blood cancer. Because of that trial, the drug is now FDA-approved and is helping Tamara maintain her active life.

Clinical trials are responsible for most advances in medical treatment, but they can’t take place without volunteer participants like Tamara. Unfortunately, there are still many misconceptions about clinical trials that keep people from participating.

For instance, some believe joining a clinical trial is a last resort in the treatment process, which was not the case for Tamara and many other Winship patients. For Tamara, enrolling in a clinical trial was a good option once her standard cancer drugs stopped working.

In the video below, Fox 5 Atlanta talked to Tamara and Dr. Lonial about the decision to participate in a clinical trial.

Atlanta News, Weather, Traffic, and Sports | FOX 5

It is important to speak with your physician about participating in a clinical trial. For more information about a specific trial, please contact the lead research coordinator.

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Growing Hope Together!

Mary BrookhartI was diagnosed with breast cancer at the young age of 33. A cancer diagnosis always comes as a shock, but it’s particularly unexpected at that age. Because my mother had breast cancer at a young age, a new provider sent me for my base line screening mammogram and that turned out to be my first and only mammogram. I can say without a doubt that a mammogram saved my life.

I was treated here at Winship, by Dr. Toncred Styblo and Dr. David Lawson. Twenty-five years later, all three of us are still here. I came back to Winship six years ago, but not as a patient. I took a job as supervisor of business operations for the Glenn Family Breast Center at Winship, and I am one of the organizers of the Celebration of Living event coming up this Sat., June 21.

That’s why the Celebration of Living event is so near and dear to my heart. This is a chance to get together with other survivors, and discover that part of being a survivor is learning that it’s ok to let fun and humor back into your life. Learn to let the fear go and not let it rule your life. Coming to the Celebration of Living event can be a first step toward getting back out into the world, or it can be a continuation of your on-going journey. We all know that battling cancer has very dark moments, but I hope we can bring some hope and lightness into your life.

So I invite all cancer survivors, their family members and friends to come share this special day. There will be workshops for the mind, body and soul, as well as music, food and companionship. It’s free and open to all. Detailed information is available on our website.

I see more and more people surviving cancer because of new and better treatments and earlier detection. In the time since I got my screening mammogram, the technology has greatly improved. Emory and Winship are now offering state-of-the-art 3D mammograms (also called tomosynthesis) at no additional charge above the cost of standard mammograms, so that all women can benefit from this more precise screening technology. For more information about this new service and where it’s available, check out this video about 3D mammography at Emory Healthcare.

For some, the idea of living a normal lifespan with cancer as a chronic disease is a reality.

My hope is that one day, all cancer patients will enjoy a lifetime of survivorship.

Mary Brookhart,
Cancer Survivor

About Mary Brookhart

Mary Brookhart grew up in Ohio before moving to Georgia to get away from the snow. There she enjoyed a 20+ year career in advertising and design. In 2008, looking for something more rewarding, Mary returned to Winship, this time, not as a patient, but as supervisor of business operations for the Emory Glenn Family Breast Center. Besides serving as an advocate for breast cancer patients, Mary coordinates screenings for mammograms and the Emory’s Breast Cancer Seminar for the Newly Diagnosed breast cancer patient. She currently lives in rural Conyers, with her husband of 37 years, and their three horses.

3D Mammography: More Detail in Imaging Can Reduce Call-Backs

According to the American Cancer Society, about 10 percent of women who have mammograms will be called back for additional testing. However, only 8-10 percent of those women will need a biopsy, and 80 percent of the biopsies will turn out to be benign.

While that sounds encouraging, the emotional toll of a call-back can increase a woman’s anxiety about having future mammograms. To help reduce call backs and false positives, three hospitals in the Emory Healthcare system now use an advanced breast imaging technology, called 3D mammography, which provides radiologists with a much more detailed view of a patient’s breast tissue.

Watch CNN’s segment about Ivory Poser’s experience and how Emory Healthcare is using 3D mammography at three of its hospitals to help reduce call-backs and false positives.

“Compared with 2D mammography, a 3D exam allows radiologists to view the breast in small slices providing more detailed pictures of specific areas,” says Michael A. Cohen, MD, director of Breast Imaging for Emory Healthcare. “The state of the art technology is proven to reduce call-backs by 20 to 40 percent and finds more cancers, particularly in women with dense breast tissue.”

In addition, Emory offers this FDA-approved mammography technology, which is typically not covered by insurance, at no additional charge above the cost of a traditional 2D digital mammogram for patients getting their annual screening mammogram.

“Breast tomosynthesis is a real game changer in the early detection of breast cancer,” explains Leonel A. Vasquez, MD, director of Community Radiology and chief of service for Emory Johns Creek Hospital. “The fact that we are offering this advanced technology at no additional cost is both a real value and the best care for our patients.”

The advantages of 3D mammography are:

  • Greater chance for cancer detection
  • Reduction in false-positives
  • Reduction in call-backs (especially for women with dense breasts)
  • Better visualization and confidence for physicians
  • Less anxiety for patients

Mammogram screenings have been shown to detect breast cancer in earlier stages, which can lead to better chances for a cure. According to the American Cancer Society, deaths related to breast cancer have been declining since 1990, partly due to early detection through screenings and advanced treatments. Screening mammograms are recommended for all women at average risk for breast cancer starting at age 40.

3D mammography is currently available at Emory’s breast imaging centers at the Winship Cancer Institute on Emory’s Clifton Campus, Emory University Hospital Midtown and Emory Johns Creek Hospital.

Emory Breast Imaging Center located at
Emory University Hospital Midtown
550 Peachtree Street NE
Atlanta, Georgia 30308

To make an appointment: 404-778-7465

Emory Breast Imaging Center located at
Winship Cancer Institute of Emory University
1365 Clifton Road NE
Building C, 1st Floor
Atlanta, Georgia 30322

To make an appointment: 404-778-7465

Center for Breast Care located at
Emory Johns Creek Hospital
Emory Physicians Plaza
6335 Hospital Parkway, Suite 106
Johns Creek, GA 30097

To make an appointment: 678-474-7465

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