Brian....You mentioned that as smoking diminishes in the US, viruses are taking its place as causes of OC. I would like to explore this topic more. I recently had an irritated gum (much like the one that became cancerous) in another area (of course, since the original area is gone!) and my periodontist said that it was most likely caused by a virus. It took 2-3 weeks to resolve. I feel like this was what was going on for several years in the area that became cancer. It could not have been malignant for several years, could it? It would have gone everywhere in that time.

Hmmmmmm (again)....I would really like to hear more about non-tobacco causes.....and about viruses other than the HPV virus.

[quote]The fact is that because the fastest-growing segment of the OC population ... is now someone between 20 and 50 who is a non-smoker, predominantly white, educated, and with females slightly edging out males, they believe that HPV is the replacement causative agent keeping the numbers high and where this new sub-demographic is coming from.[/quote]With all the publicity about the new vaccine and HPV as the causative agent for cervical cancer -- the TV and magazine ads are everywhere! -- I wish there was more emphasis on the link to oral cancer as well. According to 2006 estimates on the American Cancer Society website, there will be about 9,700 cases of cervical cancer diagnosed in the US this year -- and about 30,000 cases of oral cancer. Granted, most of those OC cases will likely NOT be HPV-related, but still...

I notice that the prescribing information for Gardasil makes no mention of a connection between HPV and oral cancer. On the main part of the OCF site, I've seen several scientific studies on HPV in OC cases, including one last year from Sweden that found that about 35% of the cases studied were directly attributable to HPV. Brian or Gail, or anyone else who follows the figures and is knowledgeable about HPV, have these numbers just not reached "critical mass"? Is the idea of HPV as a cause for OC still too new that meaningful statistics are not yet available?

The vaccine is described in the prescribing information as "indicated in girls and women 9-26 years of age" -- you'd think that Merck would jump on links between HPV-16 (one of the four types the vaccine protects against, and the one most commonly found in studies of OC tumors) and oral cancer, as that would open the marketing to males as well. (Ka-ching!)

Hi August,

Sores in the mouth that are commonly called "apthous ulcers", are caused by a virus. They will usually go away in 10 days to 2 weeks. They appear as small white craters, with a reddish border and can appear as a single ulcer or in groups. They will appear more commonly when a person is run down and their resistance is low.

I don't agree that constant irritation is not a possible cause of scc. This is not my opinion alone. I have discussed this with the Chairman of the Department of Otolaryngology and Head of Neck Surgery and Immunobiology at Mount Sinai School of Medicine in New York. He referred me to www.pubmed.com

Jerry

When I was Dx'd with Hep C (as part of my cancer workup) they informed me that my case of Hep A in 1977 was actually "C") and they didn't have the diagnostic tools to properly Dx it. Things are always changing in medicine.

Bear in mind that many radiation therapy techniques such as 3D conformal, IMRT and Proton Beam were originally developed for prostate cancer.

Many times when new drugs are developed they have no idea what they will cure so it's practically a "crap shoot".

Gardasil is not yet "indicated" for oral cancer by the FDA hence it would not be mentioned in the patient literature.

EBV is also suspect in OC.

Some current OC clinical trial links:

http://www.clinicaltrials.gov/ct/show/NCT00021424;jsessionid=6DF579B4148C6FFEA19500D0F887AC3A?order=34

http://cancer.uchc.edu/news/releases/oralcancer.html

OCF does indeed have articles on this subject -

See:
http://www.oralcancerfoundation.org/news/story.asp?newsId=1467

http://www.oralcancerfoundation.org/news/story.asp?newsId=1419

http://www.oralcancerfoundation.org/news/story.asp?newsId=1370

Gary --

Thanks. I did my OCF main site search using the term "HPV-16" so missed those.

I was pleased to see in the UPI story (last link) that Merck is indeed looking in this. Poor UPI has fallen hard from its glory days and has only very limited distribution; I know the paper where I work (with one of the largest circulations in the US) does not subscribe.

Well there are lots of questions here, and Gary has answered much of it. First you have to remember that when you go through clinical trials with a new drug or vaccine, that it is a pretty specific process. Guardasil was tested in the trial on WOMEN for HPV prevention related to CERVICAL cancer. They sell based on an approval for that. Does that mean that that is the only thing it will help? Nope, just that that was the basis for the FDA approval, and its use for anything else would be considered

Brian,

I in no way am an authority about the matter of whether or not chronic irritation can lead to cellular changes that could then lead to cancer. My renewed interest in this topic came about as a result of my reading an article by Dr. Eric Genden.

I had been taught in dental school (many moons ago) that chronic irritation could lead to oral cancer. In trying to come up with a possible cause for my cancer, having eliminated the known common ones, Dr. Genden's article prompted me to contact him. His credentials, as listed in my previous post, seemed to indicate to me that he knew quite a bit more about this subject than I did.

Although there may be many authorities that feel that this may not be so, there are others that do. We have to choose to believe those that make the most sense to us. I agree with you that sores caused by dentures probably have nothing to do with the development of oral cancer. Most people would have sore spots adjusted way before they would reach the chronic stage, as they can be very painful. However, there can be areas where long term irritation to tissues could occur without pain and can be ignored by that person.

This is probably a topic that could be debated for a long time and that is not my purpose. I would just like to leave it out there as a possibility.

Jerry

As I said, you are the doctor not me. I am not ever going to be insinuating that I would understand this as well as you. I am completely dependent on the doctors that I have on the advisory board. Their position controls the foundation's positions. I only speak as a patient. If you found good documentation for this, I would like to have copies of it for my next board meeting. I would like to ensure that we are putting out the best information possible. Certianly we can agree on one thing - that while we know where the bulk of oral cancers are generated from, and the genetic links that predispose or protect inividuals from the disease, in cancer there is no such thing as an absolute at this time.

This has been great information.
I have another question, that I don,t think anyone can answer but I will ask anyway.
I heard Smoking 75% cause heavy drinking, poor dental care, life style, HPV.
I know of some that have none of this,still Got OC. I know of others Smoking & heavy drinking has been a part of there life.
There are those that Smoke and drink never brush there teeth, live long lives.
Is there any information why some of us get it others don,t?

It is all in your genes. Some people are genetically protected from a variety of ailments; others are genetically predisposed to get them. Now that we have mapped the human genome, every year there will be discoveries about what genes control what. These discoveries will ultimately lead to many things from disease prevention or cure, to the more gray area of altering human beings in other ways.