Development of Oral Cancer (eBook)

Ala-Eddin Al Moustafa currently works, as a Professor/Principal Investigator, in the area of Cancer Biology & Metastasis at the College of Medicine, Qatar University, having previously been a project director at the Lady Davis Institute for Medical Research (LDI) and assistant professor in the Oncology Department of McGill University (Montreal, Canada). Dr. Al Moustafa gained a Master’s degree and a PhD in the field of Oncogenes in the Embryo from the Institute of Embryology of the CNRS and Collège de France and Paris XIII University in 1988 and 1992, respectively, and subsequently completed his training as a postdoctoral fellow at the LDI. He was responsible for founding the Middle-Eastern Association for Cancer Research in 2010 and the Association’s journal (Clinical Cancer Investigation) in 2011. He has published more than 70 international journal papers and book chapters. Dr. Al Moustafa’s research focuses especially on the roles of oncogenes, gene cooperation, and oncoviruses in human carcinogenesis and metastasis. 

Preface 5
Contents 7
1: Human Oral Cancer (Epidemiology and Characteristic) 9
1.1 Introduction 9
1.2 Oral Cancer Epidemiology 10
1.2.1 Incidence and Mortality 10
1.2.2 Age and Gender 15
1.2.3 Site 17
1.2.4 Trends and Variations 17
1.2.5 2035 Projection 18
1.2.6 Survival 19
1.3 Clinical Characteristics 21
1.4 Early Detection and Prevention of Oral Cancer 23
1.4.1 Primary Prevention 23
1.4.2 Secondary Prevention (Screening) 24
References 25
2: Novel Developments in the Molecular Genetic Basis of Oral Squamous Cell Carcinoma (OSCC) 30
2.1 Introduction 30
2.2 Transcriptional Factors 31
2.3 Tumor Suppressor Genes or Anti-oncogenes 31
2.4 Proto-oncogenes and Oncogenes 32
2.5 Gene Expression 33
2.6 Cell Surface Receptors 34
2.7 Epigenetic Changes 34
2.8 Chromosomal Instability and Copy Number Variation 35
2.9 mtDNA Mutation 36
2.10 Telomeres and Telomerase 36
2.11 Microsatellite Instability and Alteration 36
2.12 Noncoding RNA 37
2.13 MicroRNA (miRNA) 37
2.14 Long Noncoding RNAs (lncRNAs) 38
References 41
3: Oral Cancer: After the Completion of the Human Genome Project 45
3.1 Gene Profiling: (A Personal Journey) 45
3.2 Drug Design to Shut Off Bad Genes 50
References 54
4: Smoking and Oral Cancer 55
4.1 Introduction 55
4.2 History of Tobacco Usage 55
4.3 Cigarettes and Other Forms of Tobacco Preparations 56
4.4 Composition and Carcinogenesis 57
4.5 Effects on Oral Health 59
4.5.1 Oral Hygiene and Aesthetics 60
4.5.2 Oral Mucosal Diseases: Nonmalignant 60
4.5.3 Oral Premalignant Disorders 60
4.5.4 Oral Cancer 61
4.6 Prevention Strategies 61
References 62
5: Alcohol and Oral Cancer 66
5.1 Introduction 66
5.2 Alcohol and Oral Cancer: Epidemiological Evidence 67
5.3 Alcoholic Beverages and Weekly Consumption 68
5.4 Topical Effects 71
5.5 Systemic Effects 72
5.6 Synergistic Effects with Tobacco Use 73
5.7 Alcohol-Related Oral Carcinogenesis 73
5.8 Alcohol-Containing Mouthwashes and Oral Cancer 76
5.9 Prevention 79
References 80
6: High-Risk Human Papillomaviruses and Epstein-Barr Virus Presence and Crosstalk in Human Oral Carcinogenesis 88
6.1 Introduction 88
6.2 High-Risk Human Papillomaviruses (HPVs) in Human Cancer 89
6.3 Epstein-Barr Virus (EBV) in Human Cancer 90
6.4 High Risk of HPVs and EBV in Human Oral Cancer 91
6.5 Conclusion and Perspectives 94
References 95
7: Oral Cancer: Epidemiology and Infections (Bacterial and Fungal) Global Incidence 100
7.1 Introduction 100
7.2 Worldwide Incidence of Oral Cancer by Gender, Age and Primary Site 102
7.3 Oral Cancer Mortality and Survival 108
7.4 Bacteria and Cancer 109
7.4.1 Anatomy 110
7.4.2 Clinical Presentation 110
7.4.3 Pathology 110
7.4.4 Virus 112
7.4.4.1 HPV 112
7.4.4.2 Human Immunodeficiency Virus 112
7.4.4.3 Herpes Simplex Virus 113
7.4.5 Dental Considerations 113
7.4.5.1 Hygiene 113
7.4.5.2 Dentures 113
7.4.5.3 Oral Cancer in the UAE 113
References 115
8: Oral Cancer and Chewing Habits 119
8.1 Introduction 119
8.2 Oral Cancer Statistics: Global Incidence, Prevalence, Mortality, and Survival 119
8.3 Epidemiology in Asia: A Region with High Burden of Oral Cancer 120
8.4 Risk Factors 120
8.4.1 Betel Quid and Tobacco Chewing 120
8.4.1.1 Preparations of Chewing Products and Geographic Prevalence of Usage 121
8.4.1.2 Cultural Significance: Accounting for Widespread Use 122
8.4.1.3 Pan Masala and Gutka: Betel Quid Alternative Products 123
8.4.1.4 Carcinogenesis 124
8.4.1.5 Oral Manifestations 125
8.4.1.6 Betel Chewer’s Mucosa 125
8.4.1.7 Betel Quid Lichenoid Lesion 125
8.4.1.8 Potentially Premalignant Disorders (PMDs): Leukoplakia, Erythroplakia, and OSF 125
8.4.1.9 Oral Squamous Cell Carcinoma (OSCC) 126
8.4.1.10 Systemic Effects and Addictive Potential 127
8.4.2 Tobacco Smoking and Alcohol Consumption 127
8.4.3 Human Papillomavirus (HPV) 127
8.4.4 Socioeconomic Status (SES) 128
8.4.5 Diet 129
8.4.6 Oral Hygiene 129
8.5 Primary Prevention 129
8.6 Secondary Prevention: Screening Methods 130
References 131
9: Role of Qat Chewing and Mate Consumption in Human Oral Carcinogenesis 137
9.1 Introduction 137
9.2 Qat and Oral Cancer 138
9.3 Mate Drinking and Its Role in Oral Carcinogenesis 142
References 146
10: Photodynamic Diagnosis and Therapy for Oral Potentially Malignant Disorders and Cancers 150
10.1 Introduction 150
10.2 Brief History 151
10.3 Concept Behind PDD and PDT 151
10.4 Elements of PDD and PDT 153
10.4.1 Photosensitizer (PS) 153
10.4.2 Light 155
10.4.3 Tissue Oxygen 156
10.5 Cell Death Mechanisms After PDT 156
10.5.1 Apoptosis, Necrosis, and Autophagy 156
10.5.2 Vascular Cessation 159
10.5.3 Immunostimulation 160
10.6 Major Advantages of PDD and PDT in Oral Cancer Diagnosis and Therapy 161
10.6.1 Easily Combined with Standard Diagnostics and Therapies 161
10.6.2 Better Selectivity and Less Side Effects 162
10.6.3 Repetitive Treatment Does Not Evoke Cancer Resistance 162
10.6.4 Noninvasive Method for Both Diagnosis and Treatment 163
10.6.5 Early Stage of Cancer Development Can Be Diagnosed Accurately and Treated 163
10.7 Clinical Studies of PDT and PDD in Oral Cancer Management 164
10.8 Where Does PDD/PDT Currently Stand? 167
10.9 Limitations and Possible Side Effects 167
10.10 Future Aspects 168
10.10.1 Photochemical Internalization (PCI) 168
10.10.2 New Drug Delivery Systems: The Road for Third-­Generation PS 168
10.10.3 Administration of PDD and PDT Response: Enhancers 169
References 170
11: Role of Nutrition in Oral and Pharyngeal Cancers: From Etiology to Prevention 179
11.1 Introduction 179
11.2 Food Groups and Risk of OPC 180
11.2.1 Fruits and Vegetables 180
11.2.2 Legumes and Plant-Based Proteins 182
11.2.3 Meats and Animal Foods 183
11.2.4 Dietary Fats 184
11.3 Micronutrients and Risk of Oral and Pharyngeal Cancers 185
11.3.1 Vitamin A 185
11.3.2 Vitamin E 186
11.3.3 Vitamin C 186
11.3.4 Selenium 187
11.3.5 Iron 187
11.3.6 Folate 188
11.4 Bioactive Phytochemicals and Risk of Oral and Pharyngeal Cancers 189
11.4.1 Carotenoids 189
11.4.2 Flavonoids 189
11.5 Chemopreventive and Etiological Mechanisms of Action of Dietary Factors 190
11.5.1 Etiological Mechanisms 190
11.5.2 Chemopreventive Mechanisms 191
References 191
12: Prevention of Oral Cancer 195
12.1 Introduction 195
12.2 Primary Prevention 197
12.2.1 Relevant Exposures 197
12.2.2 HPV Vaccination as Primary Prevention 200
12.2.3 Approaches to Support Exposure Reduction 200
12.2.4 Barriers to Primary Prevention 201
12.3 Secondary Prevention 202
12.3.1 Understanding Screening 202
12.3.2 Treating Chronic Infections 204
12.3.3 Secondary Chemoprevention 206
12.4 Tertiary Prevention 208
12.4.1 Genetic Screening and Counseling 208
12.4.2 Chemoprevention, Oncolytic Therapy, and Immunotherapy 211
12.4.3 Oral Cancer Prevention and Immunosuppression 212
12.4.4 Barriers to Secondary and Tertiary Preventions 213
References 215