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Smoking is Bad for You! FDA has Pictures to Prove

2 Mar
FDA Cigarette Warning Label 1

This image provided by the Food and Drug Administration shows one of nine new warning labels cigarette makers will have to use by the fall of 2012.

FDA Cigarette Warning Label 2

Each label includes a national quit smoking hotline number. The labels will take up the top half -- both front and back -- of a pack of cigarettes. Warning labels also must appear in advertisements and constitute 20% of an ad.

FDA Cigarette Warning Label 3

Mandates to introduce new graphic warning labels were part of a law passed in 2009 that, for the first time, gave the federal government authority to regulate tobacco, including setting guidelines for marketing and labeling, banning certain products and limiting nicotine.

FDA Cigarette Warning Label 4

In recent years, more than 30 countries or jurisdictions have introduced labels similar to those being introduced by the FDA. The U.S. first mandated the use of warning labels stating "cigarettes may be hazardous to your health" in 1965. Current warning labels -- a small box with black and white text -- were put on cigarette packs in the mid-1980s.

FDA Cigarette Warning Label 5

The FDA says the new labels will "clearly and effectively convey the health risks of smoking" aimed at encouraging current smokers to quit and discourage non-smokers and youths from starting to use cigarettes.

FDA Cigarette Warning Label 6

The new labels come as the share of Americans who smoke has fallen dramatically since 1970, from nearly 40% to about 20%. The rate has stalled since about 2004.

FDA Cigarette Warning Label 7

The FDA estimates the new labels will reduce the number of smokers by 213,000 in 2013, with smaller additional reductions through 2031.

FDA Cigarette Warning Label 8

The World Health Organization said in a survey done in countries with graphic warning labels that a majority of smokers noticed the warnings and more than 25% said the warnings led them to consider quitting.

FDA Cigarette Warning Label 9

Canada introduced similar warning labels in 2000. Since then, its smoking rates have declined from about 26% to about 20%.

Source: U.S. Food and Drug Administration

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Oral Cancer

21 Nov
Throat Anatomy

Throat Anatomy

Oral cancer is cancer of the mouth.  Alternative names used are “Cancer – mouth”; “Mouth cancer”; “Head and neck cancer”; “Squamous cell cancer – mouth”.  In the U.S. there are 8,000 new cases of oral cancer diagnosed each year, killing roughly one person per hour.

Causes

Oral cancer most commonly involves the tissue of the lips or the tongue. It may also occur on the floor of the mouth, cheek lining, gums (gingiva), or roof of the mouth (palate).

Most oral cancers look very similar under the microscope and are called squamous cell carcinomas. These are malignant and tend to spread rapidly.

Smoking and other tobacco use are associated with 70 – 80% of oral cancer cases. Smoke and heat from cigarettes, cigars, and pipes irritate the mucous membranes of the mouth. Use of chewing tobacco or snuff causes irritation from direct contact with the mucous membranes. Heavy alcohol use is another activity associated with increased risk for oral cancer.

Other factors that increase the risk of oral cancer include poor dental and oral hygiene and chronic irritation (such as from rough teeth, dentures, or fillings). Some oral cancers begin as a white plaque ( leukoplakia) or as a mouth ulcer. Recently, infection with HPV (human papilloma virus) has been shown to be a risk factor.

Oral cancer accounts for about 8% of all malignant growths. Men get oral cancer twice as often as women do, particularly men older than 40.

Symptoms

Mucous membrane lesion, lump, or ulcer:

  • May be a deep, hard-edged crack in the tissue
  • Most often pale colored, may be dark or discolored
  • On the tongue, lip, or other mouth area
  • Usually painless at first (may develop a burning sensation or pain when the tumor is advanced)
  • Usually small

Additional symptoms that may be associated with this disease:

  • Abnormal taste in the mouth
  • Mouth sores
  • Swallowing difficulty
  • Tongue problems

Tests & Diagnosis

An examination of the mouth by the health care provider or dentist shows a visible or palpable (can be felt) lesion of the lip, tongue, or other mouth area. As the tumor enlarges, it may become an ulcer and bleed. Speech difficulties, chewing problems, or swallowing difficulties may develop, particularly if the cancer is on the tongue.

Currently, there are several ways to test for oral cancer.  Commonly, a tongue biopsy, gum biopsy, and microscopic examination of the lesion confirm the diagnosis of oral cancer.  However, researchers in the U.S. and the United Kingdom are developing a new test to detect oral cancer.  The new test would involve no scalpels, biopsies, or off-site laboratories.  Instead, it can be performed by collecting cells from a patient’s mouth with a simple brush, placing the cells on a chip, and inserting the chip into an analyzer, leading to a result in 8-10 minutes.

Treatment

Surgical removal of the tumor is usually recommended if the tumor is small enough. Radiation therapy and chemotherapy would likely be used when the tumor is larger or has spread to lymph nodes in the neck. Surgery may be necessary for large tumors.

Rehabilitation may include speech therapy or other therapy to improve movement, chewing, swallowing, and speech.  There is an encouraging news in the fight against cancer.  Doctors are developing a new treatment at the Institute of Cancer and Research and The Royal Marsden NHS Foundation Trust in the U.K. Seventeen patients suffering from mouth, neck, and head cancer were given injections of genetically engineered version of the herpes virus, as well as chemotherapy and radiotherapy treatments.  The virus, known as OncoVex, was modified to multiply only inside cancer cells and not in healthy ones.  The virus bursts and kills the cancerous cells, as well as releasing a human protein to help stimulate patients’ immune system.  Results showed tumor shrinkage in 14 of the 17 patients. 

Prognosis

Approximately half of people with oral cancer will live more than 5 years after diagnosis and treatment. If the cancer is detected early, before it has spread to other tissues, the cure rate is nearly 75%.  Unfortunately, more than half of oral cancers are advanced at the time the cancer is detected. Most have spread to the throat or neck.  Approximately 25% of people with oral cancer die because of delayed diagnosis and treatment.

Complications

  • Complications of radiation therapy, including dry mouth and difficulty swallowing
  • Other metastasis (spread) of the cancer
  • Postoperative disfigurement of the face, head, and neck

When to contact a doctor

Oral cancer may be discovered when the dentist performs a routine cleaning and examination.

Call for an appointment with your health care provider if you have a lesion of the mouth or lip or a lump in the neck that does not go away within 1 month. Early diagnosis and treatment of oral cancer greatly increases the chances of survival.

Prevention

You should have the soft tissue of the mouth examined once a year. Many oral cancers are discovered by routine dental examination.

Other tips:

  • Have dental problems corrected
  • Minimize or avoid alcohol use
  • Minimize or avoid smoking or other tobacco use
  • Practice good oral hygiene

 

References

National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Head and Neck Cancers. National Comprehensive Cancer Network; 2008. Version 2.2008.

Posner M. Head and neck cancer. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 200.

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