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Jaw can be reconstructed with abdominal fat, says expert

Tue, Sep 2, 2014

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Source: www.deccanchronicle.com
Author: Uma Kannan

Director of Balaji Dental and Craniofacial Hospital at Teynampet and famous facio-maxillary surgeon Dr S.M. Balaji, says more specialists are needed in this particular field. Noted for making a great difference to the confidence and life of his patients, Dr Balaji is known for some of the most dynamic innovations in his field of specialty. In an interview to Deccan Chronicle, Dr Balaji explains how patients with jaw defects can expect to be completely normal people after surgery.

Excerpts from the interview:
Q) You are a pioneer in applying latest technology of tissue engineering. Can you explain the recent developments in the field?
A) Earlier, we used to remove the tumour of the jaw and take the bone from the hip or the leg and do a microvascular surgery for reconstruction of the jaw. It used to be a long procedure as it would go on for 10-12 hours. Also, anaesthesia is prolonged and the scar is so visible in the leg.
Now you can take the abdominal fat to reconstruct the jaw. Adipose stem cells present in the fat have inherent ability to grow into other tissues like bone, cartilage and tendons. People do liposuction and throw away the fat but it can be utilised. Since this technique is new, so far only three patients have undergone the reconstruction using abdominal fat.

Q) What kinds of defects are seen?
A) If somebody meets with an accident, a part of the bone, say, in the upper jaw, is lost and reconstruction is needed.
In case of oral cancer, after the cancer treatment, the person has to undergo reconstruction, otherwise there will be disfigurement. Given the incidence of oral cancer, more specialists are required in this field and the cost of reconstruction is affordable. Reconstruction of facial defects has evolved over the recent years due to latest technological advancements. Craniofacial defects, be they congenital (by birth) or acquired (by accidents) or removal of tumour or cysts, they could be successfully rehabilitated.

Q) Recently, you rehabilitated a one-year-old Maldivian child with a rare type of facial bone disorder. Please explain.
A) He was born with a disorder in which the jaw bones are destroyed and gradually replaced by fibrous tissue which would cause difficulties in eating, speaking and disfigured appearance. His jaw tumour was entirely removed through the mouth without any scar in the facial region.
Using rhBMP-2 and titanium plate we reengineered the jaw bone and six months later, we could see a good amount of normal bone jaw formation and the boy was given fixed dental implants to replace his missing teeth. For the first time in the world, a rare type of jaw bone disorder was rehabilitated completely.

Q) What is rhBMP-2 and explain its benefits.
A) Recombinant human bone morphogenetic protein-2 is a biotechnologically engineered version of a protein that is otherwise normally found in the human bone.
Yes, this miracle protein stimulates the body’s own cells to convert into bone forming cells. Such cells lay down new bone at the site where the protein is placed.
By using this technology, the second additional surgery for grafting bone from the hip or rib to close the defect is entirely avoided. This technique is a boon in cases for closure of bone defects, such as alveolar cleft, a common birth defect (gap in the teeth-bearing region of the jaw).

Distraction osteogenesis is another revolutionary new technology that besides lengthening the bone, associated structures such as skin, soft tissues, nerves and blood vessels are also created. In cases that require extensive removal of jaw bone in case of tumour or cysts, the residual jaw defect is reconstructed using plate-guided transport distraction osteogenesis that enables growth of new bone and soft tissues along the customised plate in accordance with each patient.

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Wellington scientist scores cancer research breakthrough

Tue, Sep 2, 2014

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Source: www.scoop.co.nz
Author: press release

A young Wellington research student has made a breakthrough that could change the way tongue cancers are treated. Ranui Baillie (24) is an Otago University student currently working under the team led by Dr Swee Tan at the Gillies McIndoe Research Institute (GMRI) in Wellington.

She has identified a unique population of cancer stem cells in tongue cancer and a patent registration has now been filed in the United States covering this work.

“Cancer stem cells have been demonstrated in other cancers but this is the first time we have identified a unique population of these cells within tongue cancer,” Ms Baillie says.

These cells are thought to be the driving force behind the development and progression of cancer.

“This is very much a first step towards finding a new treatment for tongue cancer. We can now study these stem cells and learn how to manage them. Hopefully, this will lead to improved outcomes for patients.”

Tongue cancer is one of the most lethal cancers. It kills 50 percent of sufferers within five years, a mortality rate that has not changed in over 40 years, despite significant advances in cancer treatment in that time.

Ms Baillie says that these cancer stem cells have been shown to be resistant to traditional chemotherapy and radiation therapy.

So, while the cancer cells may respond to treatment, the underlying cause – the cancer stem cells – don’t.

“We need to find a new way of thinking about cancer biology and treatment, and that’s what we aim to do at the GMRI,” Ms Baillie said.

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Oral cancer rates higher among rural men

Tue, Sep 2, 2014

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Source: medicalxpress.com
Author: Rob Payne

Oral cancer in Western Australia is on the rise with trends showing a regional-urban divide, two recent studies contend. The research drew on de-identified data provided by the Western Australian Cancer Registry from 1982 to 2009 for incidences of oropharyngeal cancer, affecting the pharynx (throat), tongue and major salivary glands/parotid. Over the 27-year testing period, 2801 cases were reported in WA, with three-quarters of those afflicted being male, and rural and remote areas hardest hit.

“The age-standardised rates for pharyngeal cancers were statistically significantly higher among rural and remote WA residents than urban dwellers,” UWA Professor Estie Kruger says.

“Rates were also higher in rural areas for tongue and parotid gland cancers, but were not significantly higher.

“Reasons for this divide might include the higher exposure to risk factors for oral cancer among those outside city centres, and indicates the need for a common-risk factor approach when attempting to improve country health in WA.”

Risk factors include tobacco and alcohol use, which have been linked in particular to cancer of the pharynx.

While smoking has steadily decreased in Australia, researchers note Australians living outside major cities are more likely to be smokers and drink alcohol in hazardous quantities. In addition, remote and rural dwellers face practical hurdles to diagnosis and treatment, with cancer centres located primarily in city centres, making access to services more difficult.

Over the testing period, cancer of the pharynx was the most prevalent form of the disease, increasing from 1.6 to 3.5 (per 100,000 persons) from 1982 to 2009. Cancer of the tongue ranked second, increasing from 1.8 to 2.9 (per 100,000 persons), far exceeding national rates.
Overall, all forms of oropharyngeal cancer increased.

Prof Kruger says this upward trend is projected to continue over the next 15 years for pharynx and tongue cancers, due in part to an ageing population, with cancer being an age-related disease. It also reflects more current trends, with researchers constructing their projections using both a traditional linear method and an estimated weighted moving average (EWMA) that places greater weight on more recent data.

Prof Kruger says her team’s research fundamentally shows a rural-urban difference for oral cancer and offers important information for policy planners.

“Our hope is that these predictions, based on long-term incidence figures over 27 years, will prompt efficient planning in terms of future resource requirements to manage the disease burden,” Prof Kruger says.

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Three shots that could stop cancer

Tue, Aug 26, 2014

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Source: tucson.com
Author: Meredith Wadman

Not so long ago, when my sons still had smooth cheeks and children’s voices, I had them vaccinated against human papillomavirus, the most common sexually transmitted disease. It was late 2011, and the Centers for Disease Control and Prevention had just recommended that boys join girls in being vaccinated at age 11 or 12. I was certainly receptive: HPV, as it’s commonly called, causes cervical cancer, cancer of the tonsils, cancer of the back of the tongue and, less often, cancers of the vulva, vagina, anus and penis. It seemed important to ensure that my kids were protected.

Yet numbers released last month by the CDC show that my sons, now 14 and 15, are among a small minority of adolescent males who have been vaccinated. In 2013, just 14 percent of American boys ages 13 to 17 had received all three recommended doses of the HPV vaccine. (The CDC also recommends “catch-up” vaccination for males up to age 21.)

Not that parents are rushing to have their girls vaccinated either, even though the CDC first recommended the vaccine for prepubescent girls in 2007 and virtually all insurers pay for it. In 2013, fewer than 38 percent of American girls between 13 and 17 had received the full three-dose course.

It is heartbreaking to watch a safe, effective vaccine go unused. Consider this: The CDC estimates that increasing the vaccination rate of American girls to 80 percent would prevent 53,000 cervical cancers during the lifetimes of girls who are now 12 and younger.

When I had my sons vaccinated, it was partly with girls in mind. After all, if fewer young men are infected, fewer young women will be exposed to the virus that causes cervical cancer — currently the most common cancer prevented by the vaccine. But now I am realizing that HPV poses a growing risk to boys.

A new breed of cancer of the back of the tongue and tonsils, caused by HPV, is rising in incidence — likely caused, researchers suspect, by increases in premarital sex and oral sex over the past several decades. These cancers afflict men far more often than women, and at relatively younger ages than do other head and neck cancers, which typically appear in men older than 60. Middle-aged men who don’t die from their HPV-linked cancer often must live for years with the side effects of intensive chemotherapy and radiation delivered to the back of the throat. These can include the permanent inability to swallow and the appearance later of new, aggressive, radiation-induced cancers.

If this trend continues, we are going to see more cancer of the back of the tongue and the tonsils caused by HPV. One recent analysis of 30 studies, conducted by University of Wisconsin researchers, found that the proportion of such cancers caused by HPV rose from 21 percent before 1990 to 65 percent after 2000. Anil Chaturvedi of the National Cancer Institute and his colleagues have estimated, based on recent trends, that by 2020 there will be more new cases of these HPV-induced throat cancers in the United States each year than new cervical cancer cases.

So the actor Michael Douglas did us all a service when he was so frank with Britain’s Guardian newspaper last year. When asked if his throat cancer had been caused by heavy drinking and smoking, which are also risk factors for the disease, the actor replied: “No. I mean, without getting too specific, this particular cancer in tests is caused by something called HPV, which actually comes about from cunnilingus.”

Many parents don’t like to think of their 11- and 12-year-olds as sexual creatures. Ironically, the CDC recommendation assumes not that kids are sexually active at this tender age but rather that they are not: The point of vaccination is to close the door before the horse is out of the barn.

It’s no use telling yourself that your child isn’t “that kind” of kid. The fact is, HPV is so common that almost all sexually active adults are infected at some point. Last year, the CDC estimated that about 79 million Americans were infected, most of them in their late teens and early 20s.

Most people who get HPV have a transient infection that their immune system clears with no lasting damage. But in some people, the virus takes up residence and goes on to cause cancer. I am grateful that, thanks to the HPV vaccine, I will never have to find out if my sons fell into that second, unlucky group.

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Finding better ways to treat, prevent HPV

Tue, Aug 26, 2014

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Source: www.fhcrc.or
Author: Diane Mapes – Fred Hutch News Service

Twenty-nine years ago, scientists didn’t know what caused many of the genital-tract cancers they studied, much less how to stop them.

Today, not only has human papillomavirus been pinpointed as the viral perpetrator behind nearly all genital-tract and some head and neck cancers, there’s now an incredibly effective vaccine that can prevent high-risk HPV infections from ever developing into cancer.

“You can almost say on the street, ‘I’m doing HPV research’ and ordinary people will know what that is,” said Aaro Turunen, an HPV researcher from the University of Turku in Finland. “It’s a sexy subject, especially for the media.”

While scientific advancements, public awareness and yes, media coverage, have grown exponentially in the last three decades, there is still much to learn and do – particularly with regard to getting the vaccine to the people who most need it, both here in the U.S. and around the world.

That’s where the International Papillomavirus Conference, currently in its twenty-ninth year, comes in. The HPV2014 conference, now underway at the Washington State Convention Center in Seattle, has drawn the brightest minds in HPV research, including nearly 1,300 basic scientists, public health researchers, physicians, providers and others dedicated to eliminating the suffering caused by the human papillomavirus. The goal of the conference is to share cutting-edge scientific advances in the field of HPV infection and disease and come up with new ways to collaborate to advance science and public health.

The conference officially began today but kicked off early Wednesday with two days of clinical and public health pre-conference workshops covering everything from HPV infection and disease in HIV-infected men to implementing and evaluating two-dose vaccine schedules to a peek at the next generation of HPV vaccines coming down the pike.

Conference chair Dr. Denise Galloway, who holds a joint appointment with Fred Hutch’s Human Biology and Public Health Sciences divisions, said she was thrilled the conference was taking place in the Hutch’s back yard.

“I’m excited that the HPV meeting will be here as it recognizes the strength and breadth we have in HPV research in Seattle,” she said. “Our main goal was to provide a setting where people from all over the world who study various aspects of papillomavirus biology, disease and prevention could come together to share their data and ideas.”

Galloway, who has been investigating the link between cancer and viruses since 1978, was instrumental in both discovering HPV’s association with many cancers and paving the way for a vaccine able to check cervical cancer before it starts in hundreds of thousands of women worldwide.

These days, she’s researching B cell memory in order to determine how effective the HPV vaccine is over a person’s lifetime.

“If a vaccine is going to work, it’s not just important how well this will stimulate the immune system, which you can measure within a couple of months after you get the vaccine,” she said. “You also want to know, is it going to be durable? Are you going to have a response 10 years, 20 years or 30 years from now? We’re trying to figure that out by looking at the cells that are there and available to make the responses in 10 and 15 years.”

Long-term efficacy is just one of many topics covered at the conference, which boasts an ambitious lineup of over 700 abstract presentations, nine satellite sessions, four symposia and four plenary sessions, all highlighting basic, clinical and public health science topics ranging from molecular virology to novel cancer screening and treatment strategies to global public health.

Also represented at the conference are pharmaceutical companies such as Merck, producer of the HPV vaccine Gardasil, and Roche, developer of the cobas HPV test. Also present are medical device manufacturers such as QIAGEN, which along with support from Seattle’s PATH, developed the careHPV test, a field-friendly and inexpensive test that allows women, particularly in developing countries, to gather screening samples themselves.

On Friday morning, Dr. Freddie Bray of the International Agency for Research on Cancer talked about the need for quality data and cancer registries, especially in developing countries and and Dr. Scott Ramsey of Fred Hutch’s HICOR division spoke about the value of prevention-based studies and interventions.

“There was a nice study done by the CDC a few years ago that looked at the cost effectiveness of HPV vaccination of young girls in the U.S.,” he said. “This is a slide I wish I could produce as a health economist more often. HPV vaccines in this population are among the most cost effective interventions we have in the U.S.“

Despite the efficacy and overall cost effectiveness of the vaccine, however, delivery and implementation of the vaccine remain a problem, said Galloway.

“We need to find better strategies to get girls and boys to take the vaccine,” she said. “In other countries, where they have school-based programs, they’re doing much better than in the U.S.”

Saturday’s plenary will feature talks on the natural history of HPV infection and cervical cancer, the natural history of oral HPV and its progression of oropharyngeal cancer and the “genetic arms race” between host and viral genomes, presented by Fred Hutch’s Dr. Harmit Malik. Vaccines will be covered in the Sunday plenary session with talks on Merkel cell carcinoma by Fred Hutch’s Dr. Paul Nghiem, an update on Australia’s HPV vaccination program and a presentation on vaccine dosage.

“There is a growing consensus of switching from three doses to two and it will be exciting to hear more about that,” said Galloway.

Finnish researcher Turunen, whose research focuses on the relationship between HPV and the Epstein-Barr virus, said he was amazed at how much the field – and the International Papillomavirus Conference — had grown, adding that a much smaller HPV conference took place in Seattle 20 years ago.

“Both HPV researchers were there,” he quipped.

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The Cancer Cure Parents Aren’t Using

Mon, Aug 25, 2014

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Source: washingtonpost.com
Author: Meredith Wadman

 

Not so long ago, when my sons still had smooth cheeks and children’s voices, I had them vaccinated against human papillomavirus, the most common sexually transmitted disease. It was late 2011, and the Centers for Disease Control and Prevention had just recommended that boys join girls in being vaccinated at age 11 or 12. I was certainly receptive: HPV, as it’s commonly called, causes cervical cancer, cancer of the tonsils, cancer of the back of the tongue and, less often, cancers of the vulva, vagina, anus and penis. It seemed important to ensure that my kids were protected.

Yet numbers released last month by the CDC show that my sons, now 14 and 15, are among a small minority of adolescent males who have been vaccinated. In 2013, just 14 percent of American boys ages 13 to 17 had received all three recommended doses of the HPV vaccine. (The CDC also recommends “catch-up” vaccination for males up to age 21.)

Not that parents are rushing to have their girls vaccinated either, even though the CDC first recommended the vaccine for prepubescent girls in 2007 and virtually all insurers pay for it. In 2013, fewer than 38 percent of American girls between 13 and 17 had received the full three-dose course.

It is heartbreaking to watch a safe, effective vaccine go unused. Consider this: The CDC estimates that increasing the vaccination rate of American girls to 80 percent would prevent 53,000 cervical cancers during the lifetimes of girls who are now 12 and younger.

When I had my sons vaccinated, it was partly with girls in mind. After all, if fewer young men are infected, fewer young women will be exposed to the virus that causes cervical cancer — currently the most common cancer prevented by the vaccine. But now I am realizing that HPV poses a growing risk to boys.

A new breed of cancer of the back of the tongue and tonsils, caused by HPV, is rising in incidence — likely caused, researchers suspect, by increases in premarital sex and oral sex over the past several decades. These cancers afflict men far more often than women, and at relatively younger ages than do other head and neck cancers, which typically appear in men older than 60. Middle-aged men who don’t die from their HPV-linked cancer often must live for years with the side effects of intensive chemotherapy and radiation delivered to the back of the throat. These can include the permanent inability to swallow and the appearance later ofnew, aggressive, radiation-induced cancers.

If this trend continues, we are going to see more cancer of the back of the tongue and the tonsils caused by HPV. One recent analysis of 30 studies, conducted by University of Wisconsin researchers, found that the proportion of such cancers caused by HPV rose from 21 percent before 1990 to 65 percent after 2000. Anil Chaturvedi of the National Cancer Institute and his colleagues have estimated, based on recent trends, that by 2020 there will be more new cases of these HPV-induced throat cancers in the United States each year than new cervical cancer cases.

So the actor Michael Douglas did us all a service when he was so frank with Britain’s Guardian newspaper last year. When asked if his throat cancer had been caused by heavy drinking and smoking, which are also risk factors for the disease, the actor replied: “No. I mean, without getting too specific, this particular cancer in tests is caused by something called HPV, which actually comes about from cunnilingus.”

Many parents don’t like to think of their 11- and 12-year-olds as sexual creatures. Ironically, the CDC recommendation assumes not that kids are sexually active at this tender age but rather that they are not: The point of vaccination is to close the door before the horse is out of the barn.

It’s no use telling yourself that your child isn’t “that kind” of kid. The fact is, HPV is so common that almost all sexually active adults are infected at some point. Last year, the CDC estimated that about 79 million Americans were infected, most of them in their late teens and early 20s.

Most people who get HPV have a transient infection that their immune system clears with no lasting damage. But in some people, the virus takes up residence and goes on to cause cancer. I am grateful that, thanks to the HPV vaccine, I will never have to find out if my sons fell into that second, unlucky group.

 *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
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Curt Schilling Reveals his Diagnosis of Oral Cancer and Believes Chewing Tobacco was the Cause

Wed, Aug 20, 2014

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Source: boston.com
Author: Steve Silva
 

Curt Schilling, the former Red Sox pitcher and ESPN analyst, announced today during the WEEI/NESN Jimmy Fund Radio Telethon that he was diagnosed with squamous cell carcinoma — which is cancer in the mouth — in February.

“This all came about from a dog bite,” Schilling said. “I got bitten by a dog and I had some damage to my finger and I went to see a doctor, and the day that I went to see the doctor, I was driving and I went to rub my neck and I felt a lump on the left side of my neck. And I knew immediately it wasn’t normal. So there happened to be an ENT [Ear, Nose, and Throat] right next door to the hand doctor, and I thought what the heck, let me just stop in and see and so I waited in the office and went in there and they did the biopsy, and two days later, they diagnosed me with squamous cell carcinoma.

“You know what the amazing thing was? And I was just dumbfounded by it. You’ve just been told you have cancer and you walk out into the public and the world’s still going on and it was really a challenge to wrap my head around that. My second thought was, ‘Yeah, really, you think I can handle this too?’ So after a couple of tests, I got sent over to Brigham and Women’s and Dana-Farber and that’s where I met Dr. Haddad and the amazing team of people that got me through my treatment.”

Dr. Robert Haddad, from the Dana-Farber Cancer Institute, described Schilling’s cancer.

“Commonly this is known as mouth cancer,” Dr. Haddad said. “This is the type of the cancer we call the squamous cell carcinoma. It’s cancer of the lining of the mouth and the lump in the neck is why most patients go to the doctor first, because they feel the lump in the neck so that’s the lymph node that’s enlarged and that’s the most common presentation for these cancers. It often presents as a lump in the neck that drives the patient to go see the doctor, and then the biopsy is done and then that shows squamous cell carcinoma, and that’s the type of the cancer.”

The 47-year-old Schilling — who weighed just over 200 pounds prior to his cancer diagnosis — lost 75 pounds during his treatment. Most of the weight loss was due to the fact that he was unable to swallow. He also has lost his ability to taste and smell.

The former Red Sox righthander stressed the importance of getting in for treatment early.

“One of the amazing things was early on when I was talking to [Dr. Haddad] about this, I literally went to see a doctor like five days after I felt the lump, he said the average time for a patient is 10 months,” Schilling said. “Ten months from the time they notice something to the time they say something. I can’t believe… people need to be more self-aware.

“I didn’t talk about it for two reasons. No. 1, I didn’t want to get into the chewing tobacco debate, which I knew was going to come about, which to me, I’ll go to my grave believing that was why I got what I got… absolutely, no question in my mind about that. And the second thing was I didn’t want people to feel sorry for me. I didn’t want the pity or any of that stuff because early on… I ended up spending about six months in the hospital because I had a bad reaction. I had a staph infection. I had what’s called C. diff. I had a couple different problems and there was a week there, there’s a week of my life I don’t remember while I was in the hospital going through this.

“The second or third day — I got chemo and radiation for seven weeks — and I came back to the room and my family was sitting there and I thought, ‘You know what, this could be so much worse. It could be one of my kids, it’s not. I’m the one guy in my family that can handle this,’ and so from that perspective it never, ever said ‘Why me? And I never will. I do believe without a doubt, unquestionably that chewing is what gave me cancer and I’m not going to sit up here from the pedestal and preach about chewing. I will say this: I did for about 30 years. It was an addictive habit. I can think of so many times in my life when it was so relaxing to just sit back and have a dip and do whatever, and I lost my sense of smell, my taste buds for the most part. I had gum issues, they bled, all this other stuff. None of it was enough to ever make me quit. The pain that I was in going through this treatment, the second or third day it was the only thing in my life that had that I wish I could go back and never have dipped. Not once. It was so painful.”

According to Schilling, the most painful part of the treatment was the radiation, which he received five days a week over seven weeks. Schilling’s doctors created a pliable mask to protect his face. Schilling called it “the straitjacket for when they are giving you radiation.”

“The first day I went in, they clamped [the mask] down, they do the radiation into the tumors,” Schilling said. “The second day they did it. And about the third day I started developing almost a phobia and I literally had to be medicated for the seven weeks to go and do that. I couldn’t control myself under the mask… If this happened again, I’m not sure if I would go through the treatment again, it was that painful.”

Dr. Haddad concurred that chewing tobacco leads to the mouth cancer Schilling was diagnosed with.

“One of the directs for oral cancer is smokeless tobacco, just what we’re talking about here,” Dr. Haddad said. “So it is not a question mark. This is shown repeatedly and the National Cancer Institute clearly makes the case that any form of tobacco is harmful and should not be used.”

Schilling spoke about the day he found out about Tony Gwynn’s death. Gwynn – a Hall of Famer — died of salivary gland cancer on June 16 at the age of 54. Gwynn blamed his mouth cancer on his habit of dipping smokeless tobacco during his 20-year career with the San Diego Padres.

“I knew a while ago that things were not going well just because he went radio silent after everything that happened,” Schilling said. “From the people I talked to, he was in very, very bad shape at the end. Again, I got lucky. There’s so may other places this could have come up and they could have had to take half my jaw. I met a guy — so I was Brigham and Women’s palliative care floor, the fifth floor, which is kind of a new thing and an amazing thing — who had, smoker, who had cancer of the mouth and they had to cut off half of his tongue and they went down and grafted from his forearm and rebuilt it back. Just the stuff was mind boggling…

“I’ve seen Dana-Farber from the other side. As someone who’s been around spring training with the kids. I’ve been over there and visited a couple of times, but being on this side of it was mind boggling.”

Schilling spoke about what lies ahead for him from hereon out.

“I’m in remission,” he said. “Doc and I are going to be meeting each other on and off for the next five years. It’s the recovery that’s a challenge because there are so many things that are damaged during the process. I don’t have any salivary glands so I can’t taste anything and I can’t smell anything right now so and there’s no guarantee they’ll come back.”

Dr. Haddad stressed that these types of cancers are treatable and that his sense of taste and smell should come back.

“Without discussing this specific case, in head and neck cancers or cancers of the mouth, these are treatable cancers, these are curable cancers in a large percentage of patients,” Dr. Haddad said. “But the treatment is very tough, it’s very grueling, a lot of side effects. Those side effects are acute, meaning they happen [during] the first year of treatment like we’re seeing now with Curt: the dry mouth and the trouble swallowing and eating, the infections, and there’s the long-term side effects, So that is the recovery process that can take up to five years but these cancers are treatable, are curable, they do require a lot of specialties coming together.”

Clay Buchholz and Dustin Pedroia, two Red Sox stars with young children, addressed their chewing habit at Fenway Park in June.

“Cancer runs in my family,” said Buchholz, as he sat in front of his locker with a wad of smokeless tobacco wedged between his lower lip and gums. “There’s been people that have never smoked a cigarette or had a dip or chew and they’ve died of lung cancer.

“Everybody here is a grown man, and I think that’s how everybody views it. I don’t dip during the offseason, it’s only during baseball. It’s more of a stress-reliever type of thing for me.”

I’m trying to stop,” said Pedroia. “It’s not a good habit. It’s one of those things, you try like heck. I wish I had never started.

“Everyone crushes me about it. You don’t want any kid to start doing it. Obviously, it’s addicting. It’s not good for you and can cause a lot of problems.

“You try the best you can to stop or not start it. It’s like any bad habit. People do things that aren’t good for you. A lot of things can hurt yourself, whether its drinking or tobacco. It’s hard to stop. I’ve stopped a few times and started back up. But I’ve cut back a lot.”

“I’m addicted to it, former Sox pitcher Josh Beckett told the Los Angeles Times after Gwynn’s death. “It’s more than just the nicotine. Its the oral fixation. I don’t think anyone does it just for the nicotine thing, or wed probably all be on the patch.”

The 2011 labor agreement between the players’ union and Major League Baseball included certain limits on the use of smokeless tobacco, but did not ban its use entirely. Players are not allowed to carry tobacco packages in their uniform pockets, and tobacco use during televised interviews and non-game functions is prohibited. Also, teams cannot provide tobacco for players.

In June, nine major medical and public health organizations have written to MLB and the players’ union urging them to agree to a complete prohibition on tobacco use at ballparks and on camera.

In April, Schilling’s wife Shonda, herself a melanoma survivor, tweeted that Schilling had finished radiation.

On Facebook that month, Schilling wrote, To the many, many amazing folks at Dana Farber, [Brigham and Women's Hospital] and [Massachusetts General Hospital], thank you and to the amazing team these last 5 months. I’ve been told my cancer is in remission, start the 5-year clock.

In May, a weakened Schilling took the field at Fenway as part of the 10th anniversary celebration of the 2004 championship team. Schilling was aided onto the field by his son Gehrig and said he was back in the hospital two days later.

“I was in the hospital at the time, and they wouldn’t let me come over here and go back,” Schilling said. “So I had to determine if I was OK and ready to be discharged and I said ‘yeah, yeah, yeah, OK,’ and two days later I was back in the hospital. That’s why Gehrig walked out with me because I was afraid I was going to fall on the way in because I was so discombobulated. But it was nice. It was good to see the guys.”

On June 25, Schilling tweeted: “As of yesterday I am in remission. Start the 5 year clock!”

Schilling, who spent four seasons of his 20-year major league career with the Red Sox and was instrumental in their World Series victories in 2004 and ’07, joined ESPN as a studio analyst for ESPN’s “Baseball Tonight” in 2010.

In December, he was chosen to replace Orel Hershiser for the high-profile role as a color analyst on ESPN’s “Sunday Night Baseball” broadcasts alongside Dan Shulman and John Kruk.

Schilling pitched for five teams during his major league career, winning 216 games and compiling 3,116 strikeouts. He made six All-Star teams, won at least 21 games in a season three times — including in 2004 with the Red Sox. He won his first of three World Series titles with the 2001 Diamondbacks.

Schilling had found his niche as an analyst after enduring some difficult times in recent years. A video game business suffered a prominent and costly failure in Rhode Island, one that cost the state tens of millions of dollars and Schilling the bulk of his baseball fortune. He revealed to the Globe’s Stan Grossfeld in an August 2013 story that he suffered a heart attack in November 2011 that required surgery to implant a stent in an artery.

 
*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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New Study Finds Editing HPV Genes Kills Cancer

Thu, Aug 14, 2014

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Source: drbicuspid.com
Author: DrBicuspid Staff

 

August 14, 2014 – Researchers have hijacked a defense system normally used by bacteria to fend off viral infections and redirected it against human papillomavirus (HPV), the virus that causes cervical, head and neck, and other cancers, according to a new study in the Journal of Virology (August, 6, 2014).

Using a genome editing tool, researchers from Duke University were able to selectively destroy two viral genes responsible for the growth and survival of cervical carcinoma cells, causing the cancer cells to self-destruct.

The study findings validate an approach only recently attempted in mammalian cells, and they could help in the development of antiviral strategies against other DNA-based viruses such as hepatitis B and herpes simplex.

“Because this approach is only going after viral genes, there should be no off-target effects on normal cells,” said senior study author Bryan R. Cullen, PhD, a professor of molecular genetics and microbiology at the Duke University School of Medicine, in a statement. “You can think of this as targeting a missile that will destroy a certain target. You put in a code that tells the missile exactly what to hit, and it will only hit that, and it won’t hit anything else because it doesn’t have the code for another target.”

When examining the genomes of different types of bacteria, researchers noted long stretches where the same genetic sequence was repeated. But in between these repeated stretches were DNA sequences that varied from bacteria to bacteria. About a decade ago, researchers determined that these varied sequences, clustered regularly interspaced short palindromic repeats (CRISPR), were derived from viruses that had infected the bacteria.

When bacteria are infected, a small portion of the offending viral DNA is copied and placed between the repeat elements for future reference. When the bacteria come into contact with that virus again, it has a “memory” of it, which activates the bacterial protein Cas9, which destroys any recognized offenders before they can hurt the bacteria again.

The CRISPR system is now being repurposed by researchers for many purposes, including introducing mutations for study or to repair genetic defects.

In the current study, Cullen decided to target HPV. Specifically, he and his colleagues went after two oncogenes that block the host’s efforts to keep cancer cells at bay, viral genes E6 and E7.

To accomplish this, the researchers needed the target code for E6 or E7, consisting of a short strip of RNA sequence, and the Cas9 protein, which would cut any DNA that could line up and bind to that RNA sequence.

They packed the antiviral concoction into a viral vector based on a disabled version of HIV and infected cervical carcinoma cells in a lab dish with this genetically engineered virus. Researchers then assessed whether it could effectively destroy HPV infection and block cancer cell growth.

The carcinoma cells that received the anti-HPV guide RNA/Cas9 combination immediately stopped growing. In contrast, cells that had received a control virus, containing a random guide RNA sequence, continued to grow.

The researchers then looked at the consequences of destroying E6 or E7 in cancer cells. E6 normally blocks protein p53, which activates the so-called “suicide” pathways in a cell when it senses that something has gone wrong. In this study, targeting E6 enabled p53 to resume its normal function, causing the death of the cancer cell.

E7 works in a similar way, blocking a protein called retinoblastoma (Rb) that can trigger growth arrest and senescence, another form of cell death. As expected, the researchers found that targeting E7 also set this second tumor suppressor back in motion.

“As soon as you turn off E6 or E7, the host defense mechanisms are allowed to come back on again, because they have been there this whole time, but they have been turned off by HPV,” Cullen said. “What happens is the cell immediately commits suicide.”

Cullen and his colleagues are now working on developing a viral vector based on the adeno-associated virus, to deliver their CRISPR load into cancer cells. Tests in animal models will follow once that is in place

“What we would hope to see in an HPV-induced cancer is rapid induction of tumor necrosis caused by loss of E6 or E7,” Cullen said. “This method has the potential to be a single-hit treatment that will dramatically reduce tumor load without having any effect on normal cells.”

The researchers are also targeting other viruses that use DNA as their genetic material, including the hepatitis B virus and herpes simplex virus.

 
*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
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Top cancer organizations push for FDA to regulate all tobacco products

Wed, Aug 13, 2014

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Source: medicalexpress.com
Author: Staff

The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO), in a joint letter responding to a proposal by the U.S. Food and Drug Administration (FDA) to extend its regulatory authority over tobacco products, today urged the agency to regulate electronic cigarettes (e-cigarettes), cigars, and all other tobacco products and to strengthen the proposed regulations for newly deemed products.

“There is no safe form of tobacco use,” said Margaret Foti, PhD, MD (hc), chief executive officer of the AACR. “Tobacco is the leading cause of preventable deaths in the United States, and among its dire health consequences are 18 different types of cancer. It is imperative that the FDA takes action to regulate all tobacco products. The future health of the American people, in particular our nation’s children, depends on it.”

The AACR and ASCO applauded the FDA’s proposal to regulate e-cigarettes. “We believe it is vitally important for the FDA to begin regulating these products, especially because we don’t know much about the health effects of e-cigarette use. We are also quite concerned that e-cigarettes may increase the likelihood that nonsmokers or former smokers will use combustible tobacco products or that they will discourage smokers from quitting,” said Peter P. Yu, MD, FASCO, president of ASCO.

“There are insufficient data on the long-term health consequences of e-cigarettes, their value as tobacco cessation aids, or their effects on the use of conventional cigarettes. Any benefits of e-cigarettes are most likely to be realized in a regulated environment in which appropriate safeguards can be implemented,” said Roy S. Herbst, MD, PhD, chair of the AACR Tobacco and Cancer Subcommittee and chief of medical oncology at Yale Comprehensive Cancer Center.

The AACR and ASCO support many of the FDA’s proposals for regulating e-cigarettes and other products, but urge the agency to do more. Specifically, preventing children from using tobacco products is crucial and can be achieved by efforts such as banning youth-oriented advertising and marketing, self-service product displays, and tobacco company sponsorship of youth-oriented events, in addition to restricting sales to minors and implementing age-verification procedures for internet sales.

Expressing grave concern about the proliferation of flavored e-cigarettes, the AACR and ASCO encouraged the agency to ban e-cigarette flavors or flavor names that are brand names of candy, cookies, soda, and other such products, and to prohibit e-cigarettes containing candy and other youth-friendly flavors, unless there is evidence demonstrating that they do not encourage young people to use these products.

The AACR and ASCO strongly discouraged the FDA from exempting “premium” cigars from regulation, an option the agency is considering. “All cigars pose serious health risks,” said Graham Warren, MD, PhD, chair of ASCO’s Tobacco Cessation and Control Subcommittee. “As the FDA itself noted in the proposed rule, even cigar smokers who do not inhale have a seven to 10 times higher overall risk of mouth and throat cancer compared with individuals who have never smoked. Exempting these dangerous products from FDA regulation is clearly not in the best interest of public health.”

Noting that both large and small cigars are of increasing interest to youth and adult users, the AACR and ASCO underscored that the continued availability of premium cigars in an unregulated market, compounded with the ability of the tobacco industry to strategically market its products to youths and young adults, could reverse the progress made in reducing youth tobacco use.

Finally, the AACR and ASCO urged the FDA to drop the “consumer surplus” discount used to assess the net impact of the proposed deeming rule. This discount allows the FDA to only consider 30 percent of the benefits achieved via tobacco cessation due to the costs associated with this proposed regulation, including the “lost pleasure” of smoking. The AACR and ASCO stressed that addiction is an unwelcome burden for many tobacco users and that many consumers are not making rational and fully informed choices when initiating and continuing their use of tobacco products.

More information: Read the joint AACR and ASCO letter to the FDA.

Provided by American Association for Cancer Research

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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The National Academies of Science supports Report on Carcinogens assessments – formaldehyde still causes cancer

Tue, Aug 12, 2014

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Source: switchboard.nrdc.org
Author: Jennifer Sass 
 

The National Academies of Science (NAS) issued its assessment of the cancer risks from formaldehyde, a common and highly toxic chemical found in our furniture, home building materials, and clothing. The National Academies conducted a thorough and rigorous scientific review, and concluded that it posed a threat to humans for three types of cancer: nasopharyngeal cancer; sinonasal cancer; and myeloid leukemia.

And, in 2009 the World Health Organization also confirmed the science that formaldehyde causes cancer in people.

What makes this NAS review novel is not the cancer findings, because those had already been identified by various international and national government scientific assessments. No, this review was politically motivated, the result of a campaign by the chemical industry and its allies in Congress to protect formaldehyde and styrene, another common chemical linked to cancer. Part of that effort has been a vicious attack on government scientific assessments, to distort and discredit any evidence linking toxic chemicals to diseases, disabilities, or death. In a “kill the messenger” campaign, the Report on Carcinogens – the prestigious biennial government report that alerts the public to chemicals that may cause cancer in people – was compelled to undergo review by the National Academies after it listed formaldehyde and styrene as “known” and “reasonably anticipated” to cause cancer, respectively.

This NAS formaldehyde report, along with the recent NAS styrene report are the strongest possible statement from the scientific community that:

  • the Report on Carcinogens got it right the first time;
  • formaldehyde – and styrene – may cause cancer in humans; and
  • our government scientists are doing the best job possible of providing thorough and credible scientific information to the public about the health risks from chemicals.

I couldn’t agree more!

In particular, the NAS committee identified the risks of myeloid leukemia associated with formaldehyde, based on several occupational studies of workers with this type of cancer. Although the chemical industry had disputed this evidence, science won the day, and now hopefully workers will be better protected and future cancers will be prevented.

The NAS also noted that although the mechanism of cancer is not completely understood, it is not necessary to know the mechanism to know that an agent causes cancer (NAS page 9). This refutes a frequent industry argument that demands more complete understanding of the cellular mechanism of disease before it can be linked to their chemical product.

The NAS did have one suggestion for improvement – that the Report on Carcinogens could have done a better job of discussing why “weaker, uninformative, inconsistent, or conflicting evidence did not alter [its] conclusions”. I read this as saying that the explanation for why many industry-sponsored studies didn’t alter the conclusions could have been better explained. I guess the explanation is that good science shouldn’t be subsumed by bad science that attempts to create a false controversy – no different than tobacco or climate change.

But, the American Chemistry Council – the trade group representing big chemical manufacturers that make formaldehyde, styrene, and other highly profitable hazardous chemicals – issued a press release today with the blatantly false title, “The Safety of Formaldehyde is Well-Studied and Supported By Robust Science”. The statement makes several arguments.

  • First, that formaldehyde is only dangerous if a person is exposed. That is, cigarettes can kill you, but only if you smoke them. Good point, chemical industry. Unfortunately, people can’t avoid formaldehyde because it leaches as a gas from glues used in plywood and compressed wood products in people’s homes, such as furniture frames, kitchen cupboards, bed frames, and shelving. Remember the temporary housing trailers that people were provided after Hurricane Katrina, that later had to be evacuated because indoor air formaldehyde levels were dangerously high? That’s the problem with formaldehyde – it off-gases into the surrounding air.
  • Second, the ACC was “perplexed” that this report “appears to conflict” with an earlier review of formaldehyde by the NAS in 2011. The ACC notes that the 2011 report noted, “Inconsistencies in the epidemiologic data, the weak animal data, and the lack of mechanistic data”. There is that tobacco and climate change argument again……the science isn’t complete, and the controversy means that formaldehyde somehow must be “safe”. Sorry, chemical industry, but science doesn’t work that way. As the NAS stated, weaker, uninformative, inconsistent, or conflicting information doesn’t change what we know from the stronger, well-conducted studies showing that formaldehyde causes cancer. How many cancers will it take to convince the ACC? Too many.

When put under the spotlight of scientific scrutiny, the chemical industry allegations against the Report on Carcinogens added up to little more than a baseless defense of their toxic products. The chemical industry needs to start producing safer products, and stop attacking independent science and defending cancer-causing chemicals.

We look forward to more assessments from the National Toxicology Program and other government chemical assessment programs, so that the public and regulators can move forward with their job of protecting American families from cancer-causing chemicals.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
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