Dentists, primary care physicians catch cancers of the head and blood

The connection between smoking and lung cancer has been known for decades. It’s not hard to fathom, then, that since the conduit to get the nicotine and tar into your lungs is through your mouth, oral cancers bear the brunt of smoking and related habits as well — whether it’s cigarettes, chewing tobacco or vaping.

“Alcohol is also inflammatory and increases many different cancers,” said Emily Kamen, M.D., head and neck surgical oncologist at Ochsner’s St. Tammany Cancer Center.

“Essentially, you’re bathing the area in something irritating, which can either be at the surface level, or later incite DNA damage, which causes cancer,” she said. “These substances interrupt your cell’s normal way of doing things.”

We’re not talking about social drinking, considered to be one drink a day for women and two for men. We’re talking about excessive drinking and binge drinking, where someone may have all seven drinks allotted for the week at one time.

We now know that the virus known as HPV, the primary cause of cervical cancer, is also a major contributing factor to throat cancer. Doctors are now recommending the vaccine for those age 9 to 46.

Although oral cancers, which affect the esophagus, larynx, pharynx, trachea, sinuses, mouth, tongue, and salivary glands, account for only 3% of all cancers, the surgery that’s sometimes required to remove these cancers can not only be disfiguring, but can cause permanent problems with swallowing, speaking and breathing.

See your doctor if you have any of these symptoms: an ulcer that doesn’t go away, loose teeth, a cut in your mouth that doesn’t heal for two weeks or more, swollen salivary glands or lymph nodes.

It’s a good idea to have regular dental checkups. Dentists are critical in discovering these cancers.

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Apart from cancers that manifest as solid tumors, there are blood cancers like leukemia, myeloma, and lymphoma, often called liquid cancers.

“Blood cancers originate in the bone marrow or the lymphoid tissue,” said Suki Subbiah, M.D., LSU hematologist and oncologist. “They are not treated surgically, can involve stem cell transplants, depending on the particular type of blood cancer, and spread differently than solid tumors.”

According to Subbiah, patients often see a primary doctor complaining initially of enlarged lymph nodes somewhere on the body, fevers, nightsweats, weight loss, fatigue, easy bruising or bleeding, chest pain or shortness of breath.

Those at greatest risk have had exposure to chemicals or radiation or have a predisposition to bone marrow conditions. Patients who have received chemotherapy or radiation treatments in the past may also be at risk for the various blood cancers.

Although some forms of these cancers can be very aggressive, like acute lymphoblastic leukemia, modern treatment is helping patients survive.

New chemotherapies, innovative immunotherapies, and CAR-T treatment, which involves removing a patient’s own T-cells, re-engineering them, and putting them back, allow the patient essentially to help heal himself.

“As research continues, doctors are hoping for more targeted therapies and less stem cell transplants,” said Subbiah. “For all of us, the hope is more effective therapy with less toxicity.”

A promising partnership bring cutting-edge cancer treatment to Louisiana

The advances that have been made in the field of cancer have come about largely because of patients who are willing to work alongside researchers to find new and better treatments.

The importance of clinical trials that require patients to explore the efficacy, interactions and side effects of experimental drugs, modalities and vaccines cannot be overstated.

To that end, it is often in the best interest of patients if information from one center is shared with another, especially when a noted research facility consistently ranking at the top of U.S. cancer centers takes on partners in order to have a broader and more diverse patient base.

Ten years ago, the University of Texas MD Anderson Cancer Center in Houston started a partnership program. It provided a shared vision for research and problem solving.

Banner – University Health in Phoenix was the first partner. Along with partners now in San Diego, San Antonio, Jacksonville, Camden, New Jersey and Indianapolis, Ochsner Health in New Orleans is the latest center to come on board as a partner.

In a 10-year deal with the No. 1 ranked cancer center in the country (U.S. News & World Report), Ochsner will collaborate with the Texas facility on patient care and therapies, as well as clinical drug trials.

For decades Louisianians have headed for Texas to be a part of cutting edge trials, which in many instances will now become integrated into Ochsner, as well as the other six nationwide centers.

“Although we draw from a 250-mile radius, a substantial number of people who had been diagnosed here with cancer were leaving the state to be treated at MD Anderson in Houston,” said Brian Moore, M.D., medical director of the Ochsner MD Anderson Cancer Center, who did his fellowship in head and neck oncology at the Texas giant.

“We approached them five years ago as we wanted to do more for the people of this state, having access to the clinical trials that people travel from around the world to partake in,” he said.

The partnership with Ochsner and others allows MD Anderson to have a broader population base, which is always important for data with any research.

In 2021 MD Anderson came to Ochsner to determine whether the facility would meet their tough criteria for being a partner.

“They investigated everything — from how we take care of instruments and how well trained our clinicians are, to how much time each specialist spends on which cancers,” Moore explained. “We were evaluated based on some very tough criteria, and MD Anderson determined they wanted to move forward.”

The idea is that when a patient comes in, there is an aggregated team of specialists with a team ready to go from Day 1.

If the patient wants, Ochsner doctors can ask questions or confer with other Texas doctors or ask about a trial to see if a patient here might become a part of that.

They can present their case to both the tumor board both here at Ochsner as well as the board at UT MD Anderson.

Conferring back and forth optimizes good outcomes for the patients in Louisiana, and for all of the partners who share information.

Cancer has far and away been medicine’s deepest, darkest mystery. Unraveling its causes and subsequent treatments has been the life’s work of researchers all over the world.

Advances are coming quickly with more fine-tuned precision medicine for every individual cancer, and most scientists feel that with new immune therapies, better more targeted chemotherapies, and revolutionary vaccines, there may finally be light at the end of a deep, dark tunnel.