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Poor oral health could lessen survival from head and neck cancer

An international study has revealed strong associations between oral health and survival among people diagnosed with head and neck cancer. Specifically,…

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An international study has revealed strong associations between oral health and survival among people diagnosed with head and neck cancer. Specifically, better oral health, as evidenced by the number of natural teeth and dental visits prior to the time of diagnosis, was associated with increased survival. Importantly, those who had more frequent dental visits were more likely to have their cancer diagnosed at an earlier, and less deadly, stage of the disease than those who had few or no dental visits.

Credit: Jason Tasoulas

An international study has revealed strong associations between oral health and survival among people diagnosed with head and neck cancer. Specifically, better oral health, as evidenced by the number of natural teeth and dental visits prior to the time of diagnosis, was associated with increased survival. Importantly, those who had more frequent dental visits were more likely to have their cancer diagnosed at an earlier, and less deadly, stage of the disease than those who had few or no dental visits.

The study, by researchers at UNC Lineberger Comprehensive Cancer Center and UNC Adams School of Dentistry, Chapel Hill, North Carolina, and Moffitt Cancer Center, Tampa, Florida, in partnership with the International Head and Neck Cancer Epidemiology (INHANCE) consortium, appeared Sept. 19, 2023, in the Journal of the National Cancer Institute.

“The INHANCE consortium’s patient data allowed us to be as thorough as possible and identify robust associations between oral health and survival,” said lead author Jason Tasoulas M.D., DMD, a current Ph.D. candidate. “We assembled a diverse and experienced team to examine records of approximately 2,500 patients from eight countries to carry out our state-of-the-art statistical analyses.”

Head and neck cancer patients were asked to self-report aspects of their oral health and hygiene, including gum bleeding, tooth brushing frequency and mouthwash use, as well as the number of natural teeth and frequency of dental visits they had during a 10-year period prior to their cancer diagnosis.

Those who had frequent dental visits (more than five visits in a reported decade) had higher overall survival at five and 10 years (74% and 60%, respectively) compared to those with no dental visits (54% at five years and 32% at 10 years). This finding was most pronounced among people with cancers of the oropharynx, which consists of the structures in the back of the throat, including the base of the tongue, tonsils and soft palate. Having no natural remaining teeth was associated with a 15% lower five-year overall survival compared to those with more than 20 natural teeth. Survival differences of less than 5%, which were not significant, were found for patient-reported gum bleeding, tooth brushing and mouthwash use.

While survival has improved during the past decades due to treatment advances, head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide and accounts for about 4% of all cancers in the United States. In 2023, an estimated 66,920 people will be diagnosed with the disease in the U.S. The main environmental risk factor for the disease is tobacco use but alcohol consumption and testing positive for the human papillomavirus also increase a person’s risk for the disease.

“This current research effort capitalizes on previous data collection efforts by our team in North Carolina through the Carolina Head and Neck Cancer Epidemiology (CHANCE) study to investigate the role of oral health in patients with head and neck squamous cell carcinoma. The present report is based on a larger-scale study, accounting for geographic variability and capturing more oral health variables,” said Kimon Divaris, DDS, Ph.D., study author and James Bawden Distinguished Professor at the UNC Adams School of Dentistry and UNC Gillings School of Global Public Health.

“Inspired by Dr. Divaris’ previous work, we sought out opportunities to collaborate with a larger network of epidemiologists, surgeons, physicians, dentists and scientists from all over the world to address an important but often overlooked problem for patients with head and neck squamous cell carcinoma,” said corresponding author Antonio L. Amelio, Ph.D., vice chair of research in the Head and Neck Oncology Department and associate member of the Tumor Biology Department at Moffitt Cancer Center, and an adjunct associate professor at the UNC Department of Otolaryngology-Head and Neck Surgery. “Our hope is that these findings become a standard part of guidelines implemented for the prevention and management of head and neck squamous cell carcinomas in the near future.”

Carole Fakhry, M.D., MPH, the Charles W. Cummings M.D. Professor of Otolaryngology at Johns Hopkins School of Medicine, who was not involved in the research, called the findings significant. “This is an important study that highlights the interplay between oral health and head and neck squamous cell carcinoma and overall survival. While we seek biomarkers to predict which patient will do well, this study points out features of a history and examination that are associated with survival. Additionally, this may lead us down the road of prevention of these cancers.”

Authors and disclosures

In addition to Tasoulas, Divaris and Amelio, the article’s other authors from UNC include Siddharth Sheth DO, MPH, Wendell G. Yarbrough M.D., MMHC, and Trevor Hackman M.D., UNC Lineberger and UNC School of Medicine; Douglas R. Farquhar M.D., MPH, and Chris B. Agala Ph.D., UNC School of Medicine; and Andrew F. Olshan Ph.D., UNC Lineberger and UNC Gillings. A complete listing of authors is available in the paper published online.

Amelio is a global advisory board member and paid consultant for the LG Chem Life Sciences Innovation Center. Sheth receives honoraria from Naveris, Medscape; Speakers’ Bureau: Exelixis; research funding from AstraZeneca/MedImmune, Merck, Inovio Pharmaceuticals; Exelixis and Regeneron. Yarbrough is a consultant for Olympus Medical Systems. All other authors declare no potential conflicts of interest.

The study was funded by:

The INHANCE Consortium was supported by NIH grants NCI R03CA113157 and NIDCR R03DE016611.

Studies participating in the pooled analysis were supported in the following locations:

  • Latin America: Fondo para la Investigacion Cientifica y Tecnologica (FONCYT) Argentina, IMIM (Barcelona), Fundação de Amparo à Pesquisa do Estado de Sao Paulo (FAPESP) (No. 01/01768-2), and European Commission (IC18-CT97-0222).
  • North Carolina (1994–1997): NIH (R01CA061188), and in part by a grant from the National Institute of Environmental Health Sciences (P30ES010126).
  • Central Europe: World Cancer Research Fund and the European Commission INCO-COPERNICUS Program (Contract No. IC15-CT98-0332).
  • The Sao Paulo & Sao Paulo2 studies were supported by the Sao Paulo Research Foundation – FAPESP (GENCAPO 04/12054-9, 10/51168-0.
  • Western Europe study: Supported by European Community (5th Framework Programme, grant QLK1-CT-2001-00182).

The HN5000 study was funded by the National Institute for Health Research (NIHR) grant RP-PG-0707-10034). Support was also provided, in part, by the NCI Center Core Support Grant 5P30CA016080-42 to the UNC Lineberger Comprehensive Cancer Center, University Cancer Research Fund, a UNC Lineberger Tier 3 Developmental Award, and NIH/NIDCR R01DE030123, and by monies from the State of Florida to Moffitt Cancer Cente


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Guerilla gardening: how you can make your local area greener without getting into trouble

Many people are gardening on land that is not theirs – here are some things to consider to avoid getting into trouble.

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What are your rights if you want to become a guerrilla gardener? Goami/Shutterstock

When Richard Reynolds first started gardening around London’s streets, he was so worried he might be arrested that he worked under the cover of darkness. Reynolds was one of the UK’s first modern guerrilla gardeners, a movement that encourages people to nurture and revive land they do not have the legal rights to cultivate.

Gardening, in general, offers physical and mental health benefits. But as many as one in eight British households have no access to a garden or outdoor space of their own.

This issue is particularly pronounced among city dwellers, ethnic minorities and young people. A 2021 survey conducted in England revealed that those aged 16-24 were more than twice as likely to lack access to a garden or allotment compared to those aged over 65.


Quarter life, a series by The Conversation

This article is part of Quarter Life, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.

You may be interested in:

How community gardening could ease your climate concerns

Three ways to get your nature fix without a garden

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Guerrilla gardening is a particularly good option for these groups of people. It can involve planting herbs or vegetables for a whole community to enjoy, spreading seeds or plants, tidying weeds, or even something as simple as picking up litter.

But if you’re considering becoming a guerilla gardener, it’s important to understand your rights. Could you be arrested for it? And should you wait until after dark?

Can you be prosecuted?

It’s important to remember that much of the unused or abandoned land that is potentially suitable for guerilla gardening in towns and cities throughout the UK is owned by local councils. Common examples of such locations include broken pavements with missing slabs, wasteland and the central areas of roundabouts.

Although much of this land is already open for the public to walk over, actively gardening on it would become an act of trespass.

The law of trespass sounds scary. However, gardening on this land would be a breach of civil law rather than a crime. This means that most guerrilla gardeners are unlikely to receive a fine or a criminal record.

Landowners do have the legal right to use “reasonable force” to remove trespassers from their land. But, fortunately, it seems most councils have ignored guerrilla gardeners, having neither the time, money or inclination to bring legal action against them.

Colchester Council, for example, were unable to track down the identity of the “human shrub”, a mysterious eco-activist who restored the flowers in the city’s abandoned plant containers in 2009. The shrub returned again in 2015 and sent a gift of seeds to a local councillor.

In other areas of the UK, the work of guerilla gardeners has been cautiously welcomed by local councils. In Salford, a city in Greater Manchester, there is a formal requirement to submit an application and obtain permission to grow on vacant spots in the city. But the local authority tends not to interfere with illegal grow sites.

There seems to be an unwritten acceptance that people can garden wherever they want, given the abundance of available space and the lack of active maintenance. This also offers the additional advantage of saving both time and money for the local council.

You should still be careful about where you trespass though. In some areas, guerrilla gardening can lead to unwelcome attention. During the May Day riots of 2000, for example, guerrilla gardeners were accused of planting cannabis seeds in central London’s Parliament Square.

Gardening at night may draw the wrong attention too, particularly if you are carrying gardening tools that might be misunderstood by the police as threatening weapons.

How can you start?

There are many different types of guerrilla gardening that you could get involved in, from planting native plant species that benefit pollinators and other wildlife to tidying derelict land to create safer places for the local community.

One of the simplest forms of guerilla gardening is planting seeds. Some environmental projects circulate “seed bombs” and others use biodegradable “seed balloons” that are filled with helium and deflate after a day, distributing seeds by air.

Whatever you try, as a guerrilla gardener you shouldn’t harm the environment or spoil other people’s enjoyment of the space around you. Remember that weeds and wilderness have an environmental value too. And think carefully about the species you are going to plant so that you can protect local plants and wildlife.

A man dropping a seed bomb on the ground in front of a grey building.
Some projects circulate seed bombs. Miriam Doerr Martin Frommherz/Shutterstock

The most attractive species to humans might not provide the best home or food for wildlife. Some can even outcompete native plants and drive them towards extinction. Planting certain harmful, invasive or poisonous species like ragwort, knotweed or Himalayan balsam is even prohibited by law.

That said, some guerrilla gardeners have used social media to organise “balsam bashing” events, where people come together to pull up this harmful invasive plant.

Guerrilla gardening takes many forms and can bring great benefits for people and the environment. You’re unlikely to be arrested for planting and growing trees and other greenery in public spaces. But remember that these spaces should be shared with everyone, including your local wildlife.

Ben Mayfield does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Fractyl Health’s GLP-1 gene therapy spurs 25% weight loss in obese mice, clinical trials slated for 2024

One of the biggest problems facing the burgeoning class of weight loss drugs is that people must take them day after day, week after week. When the injections…

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One of the biggest problems facing the burgeoning class of weight loss drugs is that people must take them day after day, week after week. When the injections of semaglutide — the ingredient in Ozempic and Wegovy — stop coming, so do the benefits. Lost weight is regained.

But researchers at Fractyl Health, a Lexington, MA-based biotech, believe they have a solution to that problem: a one-time gene therapy injected into the pancreas that lets the body make its own GLP-1 agonists in perpetuity.

New data slated to be presented today at a diabetes conference in Germany suggest that obese mice injected with the therapy lost nearly 25% of their body weight after just two weeks, according to a copy of the company’s presentation obtained by Endpoints News.

The results leave many questions unanswered, including how safe and effective the approach will be beyond the first two weeks, although the presentation indicated that such studies are ongoing. Fractyl declined requests for an interview.

The company previously announced plans to begin testing the treatment in people with diabetes and obesity in 2024. It’s a bold step towards moving gene therapy beyond the rare diseases typically pursued by biotech companies.

Randy Seeley

“It’s hard to get people to take injections once a week, and if we can figure out how to do something closer to one and done, that would be a big step for patients,” Randy Seeley, who directs an obesity research center at the University of Michigan School of Medicine, told Endpoints in an interview.

“But how permanent this will be can’t really be answered in a mouse,” he added. Seeley is a consultant to Fractyl, and the company supports research in his lab.

Fractyl was originally just developing the GLP-1 gene therapy for type 2 diabetes. In a diabetic mouse model, human pancreatic islets and human beta cell lines, the treatment significantly enhanced glucose-stimulated insulin secretion, improving blood sugar levels.

GLP-1 needs to act on receptors in the brain for its weight loss effects, and since the therapy is injected directly into the pancreas, the company didn’t expect the diabetic mice would lose weight, Seeley said. But surprisingly, they did, shedding 23% of their mass after four weeks compared to a control group.

Those results spurred the company to test its gene therapy in a diet-induced obesity mouse model. Twenty mice were fed a high fat diet for 25 weeks before half of them got a single injection of the gene therapy while the other half received daily injections of semaglutide.

Both groups of mice began losing weight a day after the injections. Within five days, the mice who got the gene therapy were losing weight faster and shed 24.8% of their body weight after just two weeks, even as they maintained their high fat diet. The mice on semaglutide lost 18.4% of their weight, according to the data presented at the European Association for the Study of Diabetes Scientific Congress.

“The most surprising part of the data is how much weight these animals lose,” Seeley said. “it’s better than semaglutide, and it’s not exactly clear how that occurs.”

Given the uncertain long-term effects of taking GLP-1 drugs for weight loss, a potentially permanent gene therapy approach is sure to raise many questions.

“If you’re taking your once-a-week version, if something goes wrong, we can turn it off and we just take it away,” Seeley said. “But with gene therapy, there’s no way to turn it off. It’s unknown what happens, and so it is going to take both some careful thought.”

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Trans To Be Banned From Female Hospital Wards In UK

Trans To Be Banned From Female Hospital Wards In UK

Authored by Steve Watson via Summit News,

The UK Health Secretary is to issue a proposal…

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Trans To Be Banned From Female Hospital Wards In UK

Authored by Steve Watson via Summit News,

The UK Health Secretary is to issue a proposal to ban trans patients from female hospital wards in the UK, as well as reinstating ‘sex specific’ language in National Health Service materials, according to reports.

The Daily Mail reports that “Steve Barclay will unveil the plans to push back against ‘wokery’ in the health service amid concerns that women’s rights are being sidelined.”

The proposal would see only people of the same biological sex sharing wards, with care coming from doctors and nurses of the same sex, when it comes to intimate health matters.

“We need a common-sense approach to sex and equality issues in the NHS. That is why I am announcing proposals for clearer rights for patients,” Barlcay stated, adding “It is vital that women’s voices are heard in the NHS and the privacy, dignity and safety of all patients are protected.”

He added “And I can confirm that sex-specific language has now been fully restored to online health advice pages about cervical and ovarian cancer and the menopause.”

As we previously highlighted, the word ‘women’ was removed from such materials and replaced with non-gendered terms to be “more inclusive”:

A source close to the Health Secretary told the Telegraph that “The Secretary of State is fed up with this agenda and the damage it’s causing, language like “chestfeeding”, talking about pregnant “people” rather than women. It exasperates the majority of people, and he is determined to take action.”

“He is concerned that women’s voices should be heard on healthcare and that too often wokery and ideological dogma is getting in the way of this,” the source added.

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