Tongue cancer secondary prevention
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Secondary prevention strategies following tongue cancer include monthly follow-ups for the first 12-18 months following therapy. Drugs such as synthetic retinoids, non-steroidal antiinflammatory drugs, EGFR inhibition, and human papilloma virus related oropharyngeal carcinoma vaccine can be used as a secondary chemopreventive agents.
- Postoperative patients are monitored monthly for the first 12-18 months.
- In patients who undergo nonsurgical treatment, follow-up diagnostic imaging studies are recommended in the first 6 months.
- Premalignant lesions have low levels of the nuclear retinoid receptors which control normal growth and differentiation. Retinoid have antiangiogenic activity.
- Synthetic retinoids response rates are 59 to 92%.
Non-steroidal antiinflammatory drugs
- Intake of nonsteroidal antiinflammatory drugs prevents the development of intraepithelial squamous cell carcinomas especially in the colon and rectum due to inhibition COX-2 and diminished synthesis of prostaglandins.
- Endothelial growth factor receptor (EGFR) is highly expressed in SCC of the tongue, suggesting that EGFR inhibition may be effective in these tumors.
- The E6 and E7 HPV viral proteins in HPV 16 are responsible for promoting cell cycle progression and viral DNA replication in differentiated normal mucosal epithelial cells.
- While E6 protein binds to p53 tumor suppressor protein and induces its degradation, the E7 protein ubiquitinates the retinoblastoma tumor suppressor protein.
- This process leads to driving the mucosal cells into S phase and induces cellular DNA synthesis.
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