Latest Oral Cancer Research

Our scientific and clinical research spans a broad spectrum from basic research at the cellular level to innovative new techniques for surgical reconstruction.

Below we summarize some of our latest research findings in regards to:

Incidence of oral cancer, risk factors and diagnosis
Early cancer detection
Cancer pain
Treatment of oral cancers
Educating the dental professional

Incidence of Oral Cancer, Risk Factors and Diagnosis

Primary mucosal melanoma arising from the eustachian tube with CTLA-4, IL-17A, IL-17C, and IL-17E upregulation.
Wei C, Sirikanjanapong S, Lieberman S, Delacure M, Martiniuk F, Levis W, Wang BY.
Ear Nose Throat J. 2013 Jan;92(1):36-40.

A rare case report about a primary malignant melanoma arising from the eustachian tube.

Malignant melanoma metastatic to the larynx: treatment and functional outcome.
Lanson BG, Sanfilippo N, Wang B, Grew D, DeLacure MD.
Curr Oncol. 2010 Aug;17(4):127-32

This review considers management strategies for malignant melanoma metastatic to the larynx, a rare clinical entity, for which there are no clear treatment recommendations.

Squamous cell carcinoma of the oral cavity in nonsmoking women: a new and unusual complication of chemotherapy for recurrent ovarian cancer?
Cannon TL, Lai DW, Hirsch D, Delacure M, Downey A, Kerr AR, Bannan M, Andreopoulou E, Safra T, Muggia F.
Oncologist. 2012;17(12):1541-6.

This paper discusses occurrences of oral squamous cell carcinoma (SCC) in patients who had received long-term pegylated liposomal doxorubicin (PLD) for treatment of ovarian cancer.

Exploring the reasons for delay in treatment of oral cancer.
Peacock ZS, Pogrel MA, Schmidt BL.
J Am Dent Assoc. 2008 Oct;139(10):1346-52.

Oral cancer continues to be diagnosed and treated at a late stage, which has a negative effect on outcomes. In this paper, the authors identified the time intervals from first becoming aware of symptoms to beginning definitive treatment.

Racial disparity in stage at diagnosis and survival among adults with oral cancer in the US.
Shiboski CH, Schmidt BL, Jordan RC.
Community Dent Oral Epidemiol. 2007 Jun;35(3):233-40.

The authors found that, at the time of diagnosis, African-Americans have a significantly higher proportion of oral cancer that has spread to a lymph node or to a distant site and a lower 5-year relative survival rate than Whites.

Disparities in oral and pharyngeal cancer incidence, mortality, and survival among black and white Americans.
Morse DE, Kerr AR.
J Am Dent Assoc 2006;137:203-212

From 1975 through 2002, the rates for incidence and mortality were higher among males than among females and highest for black males.

Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20-44 years.
Shiboski CH, Schmidt BL, Jordan RC.
Cancer. 2005 May 1;103(9):1843-9.

From 1973 to 2001, the incidence of cancer of the tonsil and tongue increased whereas it decreased or remained the same for all other oral cancers.

Tobacco smoking history and presentation of oral squamous cell carcinoma.
Schmidt BL, Dierks EJ, Homer L, Potter B.
J Oral Maxillofac Surg. 2004 Sep;62(9):1055-8.

Oral cancer is highly associated with a history of smoking. Nevertheless, this study demonstrates that approximately one third of oral cancer patients has never smoked. Smokers show a high incidence of cancer of the tongue and floor of mouth.

An academic dental center grapples with oral cancer disparities: current collaboration and future opportunities.
Kerr AR, Changrani JG, Gany FM, Cruz GD.
J Dent Educ. 2004 May;68(5):531-41.

This article reviews the epidemiology of oral cancer in the United States, explores the complex reasons for its disproportionate burden in minority groups, and describes the efforts of New York University's College of Dentistry to address these oral cancer disparities.

Early Oral Cancer Detection

Clinical assessment to screen for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults.
Walsh T, Liu JL, Brocklehurst P, Glenny AM, Lingen M, Kerr AR, Ogden G, Warnakulasuriya S, Scully C.
Cochrane Database Syst Rev. 2013 Nov 21;11:CD010173.

How accurate are various diagnostic techniques such as conventional oral examination, vital rinsing, light-based detection, biomarkers or mouth self examination in the early detection of cancer of the lip and oral cavity in apparently healthy adults?

Standard examination and adjunctive techniques for detection of oral premalignant and malignant lesions.
Kerr AR, Shah SS.
J Calif Dent Assoc. 2013 May;41(5):329-31, 334-42
This article outlines how to perform a comprehensive extraoral and intraoral examination for the early detection of oral cancer and premalignant lesions.

Bowman birk inhibitor concentrate and oral leukoplakia: a randomized phase IIb trial.
Armstrong WB, Taylor TH, Kennedy AR, Melrose RJ, Messadi DV, Gu M, Le AD, Perloff M, Civantos F, Goodwin WJ, Wirth LJ, Kerr AR, Meyskens FL Jr.
Cancer Prev Res (Phila). 2013 May;6(5):410-8.

The authors evaluate Bowman Birk Inhibitor (BBI) formulated as BBI Concentrate (BBIC) as a nontoxic agent with cancer preventive activity.

EDNRB and DCC Salivary Rinse Hypermethylation Has a Similar Performance as Expert Clinical Examination in Discrimination of Oral Cancer/Dysplasia versus Benign Lesions.
Schussel J, Zhou XC, Zhang Z, Pattani K, Bermudez F, Jean-Charles G, McCaffrey T, Padhya T, Phelan J, Spivakovsky S, Brait M, Li R, Yoo Bowne H, Goldberg JD, Rolnitzky L, Robbins M, Kerr AR, Sirois D, Califano JA.
Clin Ca±±+**ncer Res. 2013 Jun 15;19(12):3268-3275.

This prospective study of a high-risk population shows that endothelin receptor type B (EDNRB) promoter methylation in salivary rinses is a useful biomarker for oral cancer and premalignancy.

Surveying proteolytic processes in human cancer microenvironments by microdialysis and activity-based mass spectrometry.
Hardt M, Lam DK, Dolan JC, Schmidt BL.
Proteomics Clin Appl. 2011 Dec;5(11-12):636-43.

The methods described offer unprecedented views of in vivo targets of proteases without disrupting the cancer or surrounding tissueology. They can be adapted to other physiological conditions in which proteolytic mediators are involved and where a comparison of normal and pathological tissue is sought.

Two distinct routes to oral cancer differing in genome instability and risk for cervical node metastasis.
Bhattacharya A, Roy R, Snijders AM, Hamilton G, Paquette J, Tokuyasu T, Bengtsson H, Jordan RC, Olshen AB, Pinkel D, Schmidt BL, Albertson DG.
Clin Cancer Res. 2011 Nov 15;17(22):7024-34.

The identification of patients at risk for tumor recurrence, metastasis (spreading of cancer) and progression of precancers to cancer is a problem for the management of oral cancers or precancers. The objective of this study was to clarify the role of genomic aberrations in oral cancer progression and metastasis.

Gauze padding: a simple technique to delineate small oral cavity tumors.
Dillon JK, Glastonbury CM, Jabeen F, Schmidt BL.
AJNR Am J Neuroradiol. 2011 May;32(5):934-7. Epub 2011 Mar 31.

Preoperative imaging evaluation (such as MRI) is essential for the development of a treatment plan for oral cancer patients. Since small tumors are an imaging challenge, the authors developed a simple and easy to use method that significantly improved tumor localization.

Understanding oral cancer in the genome era.
Viet CT, Schmidt BL.
Head Neck. 2010 Sep;32(9):1246-68.
The completion of the human genome project approximately 15 years ago was followed closely by advancements in array technology leading to indepth knowledge about chromosome, gene, mRNA, and protein alterations that characterize oral cancer. In this review, the authors summarize how those studies have provided insight into the process of oral carcinogenesis.

Endothelin Receptor Type B Gene Promoter Hypermethylation in Salivary Rinses Is Independently Associated with Risk of Oral Cavity Cancer and Premalignancy.
Pattani KM, Zhang Z, Demokan S, Glazer C, Loyo M, Goodman S, Sidransky D, Bermudez F, Jean-Charles G, McCaffrey T, Padhya T, Phelan J, Spivakovsky S, Yoo Bowne H, Goldberg JD, Rolnitzky L, Robbins M, Kerr AR, Sirois D, and Califano JA.
Cancer Prev Res 2010;3:1093-1103
The results of this complex study may lead to the development of a test that allows classifying patients at risk for oral premalignant and malignant lesions in settings without access to a skilled dental practitioner.

Methylation array analysis of preoperative and postoperative saliva DNA in oral cancer patients.
Viet CT, Schmidt BL.
Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3603-11.
The authors performed methylation array analysis of 807 cancer-associated genes in the saliva of oral cancer patients before and after surgery. The results show proof of principle that this specific saliva analysis can produce a set of specific cancer-related genes and can be used as a composite biomarker for the early detection of oral cancer.

Adjunctive techniques for Oral Cancer Examination and Lesion Diagnosis: A Systematic Review of Literature.
Patton LL, Epstein JB, Kerr AR.
J Am Dent Assoc 2008; 139(7):896-905

The authors undertook a systematic review of the current literature to evaluate the effectiveness of adjunctive techniques (e.g. vital tissue staining, brush biopsies) that facilitate the early detection of oral precancer and cancer. They conclude that a thorough oral mucosal examination supported by specialty referral and/or tissue biopsy is still the gold standard in oral cancer diagnostics.

DNA promoter hypermethylation in saliva for the early diagnosis of oral cancer.
Viet CT, Jordan RC, Schmidt BL.
J Calif Dent Assoc. 2007 Dec;35(12):844-9.
The authors developed a noninvasive saliva test that could detect oral precancer / cancer and drastically improve the quality of life for patients. The developed method could potentially be applied into a clinical setting.

Elevated salivary endothelin levels in oral cancer patients—a pilot study.
Pickering V, Jordan RC, Schmidt BL.
Oral Oncol. 2007 Jan;43(1):37-41. Epub 2006 Jun 6.
The analysis of saliva has been proposed as a fast, non-invasive method to monitor and diagnose patients with oral disease. The purpose of this study was to determine if the analysis of salivary endothelin-1 (ET-1) levels can be used to monitor patients at risk for oral cancer.

Clinical evaluation of chemiluminescent lighting: an adjunct for oral mucosal examinations.
Kerr AR, Sirois DA, Epstein JB.
J Clin Dent. 2006;17(3):59-63.

The results of this study suggest that oral chemiluminescent lighting, when used as a screening adjunct following the standard visual oral examination, enhances visualization of mucosal lesions, particularly those "clinically suspicious" for oral pre-cancer or cancer.

Overexpression of matrix metalloproteinase-1 and -9 mRNA is associated with progression of oral dysplasia to cancer.
Jordan RC, Macabeo-Ong M, Shiboski CH, Dekker N, Ginzinger DG, Wong DT, Schmidt BL.
Clin Cancer Res. 2004 Oct 1;10(19):6460-5.

Epithelial dysplasia (or precancer) is an important risk factor for oral cancer, although not all oral precancers will progress to cancer. The results of this study suggest that levels of the enzyme MMP-1 and -9 mRNA may be markers of malignant transformation of oral dysplasia to oral cancer.

Alphavbeta6-Fyn signaling promotes oral cancer progression.
Li X, Yang Y, Hu Y, Dang D, Regezi J, Schmidt BL, Atakilit A, Chen B, Ellis D, Ramos DM.
J Biol Chem. 2003 Oct 24;278(43):41646-53. Epub 2003 Aug 12.

The aim of this study was to show how integrin beta6 promotes oral tumor progression.

Management of Cancer Pain

What pain tells us about cancer.
Schmidt BL.
Pain. 2015 Apr;156 Suppl 1:S32-4.

Cancer pain sends a message. It is frightening to the patient. It heralds progression or recurrence to the oncologist. It is a biological readout of the cancer-nerve interaction for the scientist. Nerves have been considered bystanders within the cancer microenvironment. However, emerging information suggests that nerves are recruited and participate in the carcinogenic process. These newly formed fibers respond to mediators secreted by constituents of the cancer microenvironment. In this manner, these nerves serve as bellwethers and sensors embedded within the cancer. When we rigorously assess patients' cancer pain, we gain insight into the action of cancer. An enhanced understanding of cancer pain offers biological questions that if answered might not only provide relief from cancer pain but might also improve survival.

TRPV1 expression level in isolectin B4-positive neurons contributes to mouse strain difference in cutaneous thermal nociceptive sensitivity.
Ono K, Ye Y, Viet CT, Dang D, Schmidt BL.
J Neurophysiol. 2015 Mar 18:jn.00973.2014.

TMPRSS2, a novel membrane-anchored mediator in cancer pain.
Lam DK, Dang D, Flynn AN, Hardt M, Schmidt BL.
Pain. 2015 Feb 13. [Epub ahead of print]

This study discusses a novel role of TMPRSS2, a membrane-bound serine protease, as a cell membrane-anchored mediator in cancer pain.

Demethylating drugs as novel analgesics for cancer pain.
Viet CT, Dang D, Ye Y, Ono K, Campbell RR, Schmidt BL.
Clin Cancer Res. 2014 Sep 15;20(18):4882-93.

The study establishes the regulatory role of methylation in cancer pain and discusses the analgesic effect of demethylating drugs.

Review of preclinical studies on treatment of mucositis and associated pain.
Viet CT, Corby PM, Akinwande A, Schmidt BL.
J Dent Res. 2014 Sep;93(9):868-75.

Oral mucositis in cancer patients treated with radiation or chemotherapy often hinder definitive cancer treatment. Pain is its most distressing symptom, leading to loss of orofacial function and poor quality of life.

Adenosine triphosphate drives head and neck cancer pain through P2X2/3 heterotrimers.
Ye Y, Ono K, Bernabé DG, Viet CT, Pickering V, Dolan JC, Hardt M, Ford AP, Schmidt BL.
Acta Neuropathol Commun. 2014 Jun 5;2:62.
The results of this study identify a key peripheral mechanism in cancer pain and highlight the clinical potential of specifically targeting nociceptors.

The neurobiology of cancer pain.
Schmidt BL.
Neuroscientist. 2014 Oct;20(5):546-62.

This review covers clinical and preclinical studies and highlights peripheral and central mechanisms responsible for cancer pain. The author discusses the challenges facing neuroscientists and clinicians studying and ultimately treating cancer pain.

IB4(+) and TRPV1(+) sensory neurons mediate pain but not proliferation in a mouse model of squamous cell carcinoma.
Ye Y, Bae SS, Viet CT, Troob S, Bernabé D, Schmidt BL.
Behav Brain Funct. 2014 Feb 13;10:5. doi: 10.1186/1744-9081-10-5.

The authors use a mouse model to research involvement of sensory neurons in cancer pain.

Bossis AP, Grob CS, Griffiths RR. Chapter: Use of the Classic Hallucinogen Psilocybin for Treatment of Existential Distress Associated with Cancer. In: Psychological Aspects of Cancer: A Guide to Emotional and Psychological Consequences of Cancer, Their Causes, and Their Management. Springer; November 30, 2012, ISBN-10: 1461448654, ISBN-13: 978-1461448655

Novel animal models of acute and chronic cancer pain: a pivotal role for PAR2.
Lam DK, Dang D, Zhang J, Dolan JC, Schmidt BL.
J Neurosci. 2012 Oct 10;32(41):14178-83.
The authors developed three novel cancer models in mice that together recapitulate acute and chronic head and neck cancer pain in humans. They show that serine proteases such as trypsin induce acute cancer painand are associated with chronic cancer pain as well.

Analgesia targeting IB4-positive neurons in cancer-induced mechanical hypersensitivity.
Ye Y, Dang D, Viet CT, Dolan JC, Schmidt BL.
J Pain. 2012 Jun;13(6):524-31.

This study investigated the role of IB4 (+) and IB4 (-) neurons which control thermal and mechanical pain in a mouse oral cancer model.

Beyond the unexplainable pain: relational world of patients with somatization syndromes.
Landa A, Bossis AP, Boylan LS, Wong PS.
J Nerv Ment Dis. 2012 May;200(5):413-22.

Re-expression of the methylated EDNRB gene in oral squamous cell carcinoma attenuates cancer-induced pain.
Viet CT, Ye Y, Dang D, Lam DK, Achdjian S, Zhang J, Schmidt BL.
Pain. 2011 Oct;152(10):2323-32.

Using a mouse cancer pain model, the authors show that ET(B) receptor re-expression attenuates cancer-induced pain identifying EDNRB methylation as a novel regulatory mechanism. They suggest that demethylation therapy targeted at the cancer microenvironment has the potential to thwart pain-producing mechanisms at the source.´

Biologic Mechanisms of Oral Cancer Pain and Implications for Clinical Therapy.
Viet CT, Schmidt BL.
J Dent Res. 2012 May;91(5):447-53.

With innovations in treatment, cancer patients are surviving longer, but pain often creates a poor quality of life. Oral cancer is unique in that it causes intense pain at site of the tumor and significantly impairs speech, swallowing, and masticatory functions. This paper proposes that oral cancer pain has underlying biologic mechanisms that are generated within the cancer microenvironment and explores novel cancer pain therapeutics which could improve quality of life in oral cancer patients.

Nerve growth factor links oral cancer progression, pain, and cachexia.
Ye Y, Dang D, Zhang J, Viet CT, Lam DK, Dolan JC, Gibbs JL, Schmidt BL.
Mol Cancer Ther. 2011 Sep;10(9):1667-76.
Cancers often cause excruciating pain and rapid weight loss, both of which are strongly linked with chronic inflammation. Based on the knowhledge that nerve growth factor (NGF) plays a cardinal role in this process, the authors showed that NGF blockade decreased cancer proliferation, nociception as well as weight loss and suggest that anti-NGF could be an important mechanism-based therapy for oral cancer and its related symptoms.

Orofacial pain onset predicts transition to head and neck cancer.
Lam DK, Schmidt BL.
Pain. 2011 May;152(5):1206-9.

The authors compared orofacial pain sensitivity in groups of patients with normal oral mucosa, oral precancer, and newly diagnosed oral cancer. Contrary to the common belief that early head and neck cancer is painless, the results show that cancer patients experience significant and rather function-related than spontaneous pain at the time of initial diagnosis. The screening of patients who have new-onset orofacial pain may lead to an early diagnosis and may improve survival for head and neck cancer patients.

Mechanism of cancer pain.
Schmidt BL, Hamamoto DT, Simone DA, Wilcox GL.
Mol Interv. 2010 Jun;10(3):164-78.

Although pain is a primary concern for the cancer patient, the etiology of cancer pain remains unclear. This article summarizes the current knowledge of the mechanisms that underlie cancer pain and suggests that, as scientists' understanding of those mechanisms increases, targeted analgesics for the cancer patient will likely be developed.

Serine proteases and protease-activated receptor 2-dependent allodynia: a novel cancer pain pathway.
Lam DK, Schmidt BL.
Pain. 2010 May;149(2
The authors describe a previously unrecognized cancer pain pathway with important therapeutic implications for the treatment of cancer pain.

Peripheral endothelin B receptor agonist-induced antinociception involves endogenous opioids in mice.
Quang PN, Schmidt BL.
Pain. 2010 May;149(2):254-62.
Endothelin-1 (ET-1) is produced by various cancers and known to be responsible for inducing pain. This study assessed how molecular cancer-induced processes attenuate carcinoma pain.

Nociceptive sensitization by endothelin-1.
Hans G, Schmidt BL, Strichartz G.
Brain Res Rev. 2009 Apr;60(1):36-42
This review article discusses endogenous peptide endothelin-1 (ET-1) which plays a role in a number of painful conditions including cancer.

Diagnosis and Treatment of Oral Cancer

Decitabine rescues cisplatin resistance in head and neck squamous cell carcinoma.
Viet CT, Dang D, Achdjian S, Ye Y, Katz SG, Schmidt BL.
PLoS One. 2014 Nov 12;9(11):e112880.
Cisplatin resistance in head and neck squamous cell carcinoma (HNSCC) reduces survival. This study provides direct evidence that decitabine restores cisplatin sensitivity and that a combination treatment of cisplatin and decitabine significantly reduces head and neck cancer growth and cancer pain.

Changes in abundance of oral microbiota associated with oral cancer.
Schmidt BL, Kuczynski J, Bhattacharya A, Huey B, Corby PM, Queiroz EL, Nightingale K, Kerr AR, DeLacure MD, Veeramachaneni R, Olshen AB, Albertson DG; Muy-Teck Teh.
PLoS One. 2014 Jun 2;9(6):e98741.

The study begins to develop a framework for exploiting the oral microbiome for monitoring oral cancer development, progression and recurrence.

Investigation of HOXA9 promoter methylation as a biomarker to distinguish oral cancer patients at low risk of neck metastasis.
Uchida K, Veeramachaneni R, Huey B, Bhattacharya A, Schmidt BL, Albertson DG.
BMC Cancer. 2014 May 21;14:353.

HOXA9 methylation is frequent in oral cancers and levels are higher in tumors with greater risk of metastasis.

Quality of Life After Maxillectomy and Prosthetic Obturator Rehabilitation.
Chigurupati R, Aloor N, Salas R, Schmidt BL.
J Oral Maxillofac Surg. 2013 Mar 26.
The results of this pilot study suggest that postoperative radiation therapy was the strongest variable affecting quality of life in patients with maxillectomy and prosthetic obturator reconstruction.

Quantification of the effect of treatment duration on local-regional failure after definitive concurrent chemotherapy and intensity-modulated radiation therapy for squamous cell carcinoma of the head and neck.
Platek ME, McCloskey SA, Cruz M, Burke MS, Reid ME, Wilding GE, Rigual NR, Popat SR, Loree TR, Gupta V, Warren GW, Sullivan M, Hicks WL Jr, Singh AK.
Head Neck. 2013 May;35(5):684-8.

This retrospective chart review of patients with squamous cell carcinoma of the head and neck after definitive concurrent chemotherapy and intensity-modulated radiation therapy shows that treatment duration is a significant predictor of loco regional progression of the cancer.

Sliding anterior hemitongue flap for posterior tongue defect reconstruction.
Lam DK, Cheng A, Berty KE, Schmidt BL.
J Oral Maxillofac Surg. 2012 Oct;70(10):2440-4.

This paper describes a novel surgical approach to allow reconstruction of moderate resection defects of the posterior tongue to avoid distortion of the tongue and functional impairment.

MR assessment of oral cavity carcinomas.
Hagiwara M, Nusbaum A, Schmidt BL.
Magn Reson Imaging Clin N Am. 2012 Aug;20(3):473-94.

Imaging plays an essential role in the preoperative evaluation of oral cavity carcinomas. Advanced MR imaging techniques may potentially better delineate true tumor extent, determine lymph node metastases, and predict treatment response.

Oral maxillary squamous carcinoma: an indication for neck dissection in the clinically negative neck.
Montes DM, Carlson ER, Fernandes R, Ghali GE, Lubek J, Ord R, Bell B, Dierks E, Schmidt BL.
Head Neck. 2011 Nov;33(11):1581-5
Squamous carcinomas of the maxilla (upper jaw) show an aggressive regional metastatic behavior. Based on the results of this multicenter study, the authors recommend a selective neck dissection at the time of resection of T2, T3, and T4 maxillary squamous carcinomas.

Local drug delivery for oral mucosal diseases: challenges and opportunities.
Sankar V, Hearnden V, Hull K, Juras DV, Greenberg MS, Kerr AR, Lockhart PB, Patton LL, Porter S, Thornhill M.
Oral Dis. 2011 Apr;17 Suppl 1:73-84
Local or topic therapy provides a more targeted and efficient drug-delivery than systemic (or oral) delivery, but has been proven difficult to be used to treat diseases of mouth. Among the numerous obstacles are enzymatic degradation, taste and accidental swallowing. In this paper, the authors identified those mucosal diseases currently being treated, the challenges that must be overcome and the potential of novel therapies.

A systematic review of medical interventions for oral submucous fibrosis and future research opportunities.
Kerr AR, Warnakulasuriya S, Mighell AJ, Dietrich T, Nasser M, Rimal J, Jalil A, Bornstein MM, Nagao T, Fortune F, Hazarey VH, Reichart PA, Silverman S, Johnson NW.
Oral Dis. 2011 Apr;17 Suppl 1:42-57
Oral submucous fibrosis is a chronic disease caused by areca nut use and is associated with pain, an reduced oral opening and increased risk for developing into oral cancer. This systematic review explored and updated the current medical interventions available for the management of oral submucous fibrosis.

Lymph node central necrosis on computed tomography as predictor of extracapsular spread in metastatic head and neck squamous cell carcinoma: pilot study.
Zoumalan RA, Kleinberger AJ, Morris LG, Ranade A, Yee H, DeLacure MD, Myssiorek D.
J Laryngol Otol. 2010 Dec;124(12):1284-8.

Lymph node central necrosis (but not lymph node diameter) viewed on pre-operative computed tomography scans is a useful indicator of metastatic lymph node extracapsular spread.

Toxicity of head-and-neck radiation therapy in human immunodeficiency virus-positive patients.
Sanfilippo NJ, Mitchell J, Grew D, DeLacure M.
Int J Radiat Oncol Biol Phys. 2010 Aug 1;77(5):1375-9.

Based on this study, HIV-positive patients appear to tolerate treatment for head and neck cancer, with toxicity similar to that in HIV-negative individuals.

Head and neck radiotherapy compliance in an underserved patient population.
Sethi RA, Stamell EF, Price L, DeLacure M, Sanfilippo N.
Laryngoscope. 2010 Jul;120(7):1336-41

This retrospective study analyses factors affecting compliance in medically underserved patients who received radiotherapy for head and neck cancer in a large municipal hospital setting in New York City.

Validation of the histologic risk model in a new cohort of patients with head and neck squamous cell carcinoma.
Brandwein-Gensler M, Smith RV, Wang B, Penner C, Theilken A, Broughel D, Schiff B, Owen RP, Smith J, Sarta C, Hebert T, Nason R, Ramer M, DeLacure M, Hirsch D, Myssiorek D, Heller K, Prystowsky M, Schlecht NF, Negassa A.
Am J Surg Pathol. 2010 May;34(5):676-88.

Half of the patients with head and neck squamous cell carcinoma can be expected to fail therapy, indicating that more aggressive treatment is warranted for this group. The authors developed and report on the performance of a novel risk model that can become a basis for developing new treatment paradigms.

Management of the N0 neck in oral squamous cell carcinoma.
Cheng A, Schmidt BL.
Oral Maxillofac Surg Clin North Am. 2008 Aug;20(3):477-97.

Oral cancer has an unpredictable capacity to spread to the neck, an event that dramatically worsens prognosis. Metastasis occurs even in earlier stages when no neck lymph node involvement is clinically detectable (N0). This article presents the controversies surrounding the management of early-stage oral cancer as well as the benefits and pitfalls of different approaches used in evaluation and treatment.

Education the Dental Professional

Oral medicine: defining an emerging specialty in the United States.
Sollecito TP, Rogers H, Prescott-Clements L, Felix DH, Kerr AR, Wray D, Shirlaw P, Brennan MT, Greenberg MS, Stoopler ET.
J Dent Educ. 2013 Apr;77(4):392-4.
Oral medicine is a specialized area of study within the scope of dental medicine. It is recognized as a dental specialty throughout most of the world and currently represents an emerging specialty in the United States.

Current topics in oral cancer research and oral cancer screening.
Schmidt BL.
J Dent Hyg. 2012 Winter;86(1):7-8.

English and Spanish oral cancer information on the Internet: a pilot surface quality and content evaluation of oral cancer websites.
Irwin J, Thyvalikakath T, Spallek H, Wali T, Kerr AR, Schleyer T.
J Public Health Dent 2011;71(2):106-16

Oral and pharyngeal cancer control and early detection.
Silverman S Jr, Kerr AR, Epstein JB.
J Cancer Educ. 2010 Sep;25(3):279-81.
This study indicated that continuing education courses had a positive influence on dentists' knowledge about oral cancer and their behavior, which potentially could make a difference on prevention and early detection.

Oral cancer. Practical prevention and early detection for the dental team.
Kerr AR, Cruz GD.
N Y State Dent J. 2002 Aug-Sep;68(7):44-54.


Metastatic epithelioid angiosarcoma to the mandible: report of a case and review of the literature.
Peacock ZS, Lam DK, Cox DP, Schmidt BL.
Int J Oral Maxillofac Surg. 2013 Jun;42(6):702-6.

Angiosarcoma and its epithelioid variant are vascular malignancies that rarely affect the facial skeleton. Epithelioid angiosarcoma resembles carcinoma and can be difficult to diagnose. This paper describes a case and reviews related publications.

Effects of exercise on swallowing and tongue strength in patients with oral and oropharyngeal cancer treated with primary radiotherapy with or without chemotherapy.
Lazarus CL, Husaini H, Falciglia D, Delacure M, Branski RC, Kraus D, Lee N, Ho M, Ganz C, Smith B, Sanfilippo N.
Int J Oral Maxillofac Surg. 2013 Dec 10. pii: S0901-5027(13)01162-4.

Tongue strength is reduced in patients treated with chemoradiotherapy for oral/oropharyngeal cancer. This study examines the efficacy of tongue strengthening exercises on tongue strength, swallowing, and quality of life.

Nanotechnology meets oral cancer: how, why, and when?
Kerr AR.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Jun;115(6):703-4

The role of dietary counseling and nutrition support in head and neck cancer patients.
Platek ME.
Curr Opin Support Palliat Care. 2012 Dec;6(4):438-45.

Dietary counseling is appropriate for all head and neck cancer patients to enable adequate oral intake from diagnosis through rehabilitation; however, some patients require nutrition support.

Giant cell lesions of the jaws: does the level of vascularity and angiogenesis correlate with behavior?
Peacock ZS, Jordan RC, Schmidt BL.
J Oral Maxillofac Surg. 2012 Aug;70(8):1860-6.

This immunohistochemical study determined a higher expression of growth factors in giant cell lesions than non-aggressive ones, resulting in a higher vascularity and level of angiogenesis.

Pretreatment nutritional status and locoregional failure of patients with head and neck cancer undergoing definitive concurrent chemoradiation therapy.
Platek ME, Reid ME, Wilding GE, Jaggernauth W, Rigual NR, Hicks WL Jr, Popat SR, Warren GW, Sullivan M, Thorstad WL, Khan MK, Loree TR, Singh AK.
Head Neck. 2011 Nov;33(11):1561-8.

This study compares patient factors, tumor characteristics, and nutritional status indicators between patients with and without locoregional failure.

Pretreatment weight status and weight loss among head and neck cancer patients receiving definitive concurrent chemoradiation therapy: implications for nutrition integrated treatment pathways.
Platek ME, Myrick E, McCloskey SA, Gupta V, Reid ME, Wilding GE, Cohan D, Arshad H, Rigual NR, Hicks WL Jr, Sullivan M, Warren GW, Singh AK.
Support Care Cancer. 2013 Jun 7.

Pretreatment weight status, a very crude indicator of nutrition status, may have prognostic value in patients with squamous cell carcinoma of the head and neck undergoing definitive concurrent chemoradiation therapy. Inadequate nutritional status in these patients has been associated with poor clinical outcomes and decreased quality of life.