Evaluation of salvage surgery in heavily irradiated cancer of the buccal mucosa

Article Abstract:

Cancer of the mucous lining of the mouth is not particularly common in the United States, but in some parts of India it is the most common cancer among men and the third most common among women. This seems to be a result of the common use of betel quid, a chewing mixture containing tobacco and other herbs. These cancers of the buccal mucosa are generally treated with radiation. However, if the cancer returns after radiotherapy, then surgery must be used to salvage the case. In a retrospective analysis of 78 patients with recurrent oral cancer, men were found to outnumber women by more than two to one. Fifty-six of the patients required hemimandibulectomy, or a removal of much of the jaw because of the presence of invasive cancer. In 54 patients, enough tissue had to be removed from the mouth that reconstructive surgery was required to close the surgical wound. The five-year disease-free survival rate after the surgical salvage treatment was 59.7 percent. As might be expected, the stage of the recurrent tumor was a primary determinant of the ultimate survival of the patient. Also significant to the ultimate case outcome was the degree to which the tumor had infiltrated the skin. A total of 31 patients experienced recurrence of the cancer after surgery, but in five of these cases it was possible to complete a second salvage operation. At present, these five patients are alive without evidence of disease. These results suggest that surgery is far superior to chemotherapy as a means for salvaging cases of cancer of the mouth mucosa after recurrence following radiotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Surgery, Cancer invasiveness, Combined modality therapy, Betel

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Potential role of beta-carotene in prevention of oral cancer

Article Abstract:

Cancer of the oral cavity (mouth) is common, and the incidence varies according to geographic location. Previous studies have suggested that carotenoids and retinoids (forms of vitamin A) may be effective in preventing oral epithelial cancer in persons at risk. Vitamin A is important for the normal development and maintenance of the oral epithelium. In clinical trials, retinoids have been shown to reverse oral leukoplakia, or smoker's tongue, (opalescent and leathery patches on the tongue). However, retinoids are toxic at high doses, thus precluding their clinical use. Beta-carotene is less toxic and may have greater clinical potential. In one study, leukoplakia was reduced in 71 percent of 24 patients treated with beta-carotene (30 milligrams per day) for three to six months, and it was especially encouraging that none of the subjects experienced toxicity from the treatment. Future research will investigate whether patients already treated for oral cancer can be protected from recurrence of the cancer with beta-carotene. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Remission of precancerous lesions in the oral cavity of tobacco chewers and maintenance of the protective effect of beta-carotene or vitamin A

Article Abstract:

Oral leukoplakia (OL), or smoker's tongue, is common in smokers and tobacco chewers. It is characterized by the presence of leathery patches or plaques (precancerous lesions) on the surface of the tongue. The ability of vitamin A and beta-carotene (a precursor of vitamin A) to reverse OL was evaluated in fishermen from India who chewed tobacco on a daily basis. Treatment with vitamin A (60 milligrams per week) for six months caused complete remission of OL in 57 percent of the tobacco chewers, and micronucleated (abnormal) cells were reduced in 96 percent of the tobacco chewers. Beta-carotene (2.2 millimoles per week) reduced micronucleated cells in 98 percent of the cases and caused remission of OL in 14.8 percent of the cases. When treatment with either vitamin A or beta-carotene was stopped, the leukoplakia and cell abnormalities reappeared. It was found that lower doses of these vitamins were able to maintain the beneficial effects of the initial, higher-dose treatments for at least eight more months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Vitamin A, Tobacco chewing

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