Monthly Archives: June 2002

Pet/Ct better at detecting cancer

  • 6/24/2002
  • University of Pittsburgh

University of Pittsburgh researchers have found the combined PET/CT scanner is the most powerful imaging tool available for localizing, evaluating and therapeutic monitoring of head and neck cancer and may be equally useful for other cancers that are difficult to pinpoint.

Results of a study showing PET/CT has a distinct advantage over PET or CT alone were presented today at the annual meeting of the Society of Nuclear Medicine. According to the researchers, the prototype of the combined PET/CT machine at the University of Pittsburgh Medical Center is able to effectively localize cancerous activity in the head and neck, an area of the body that presents substantial challenges to other imaging methods because of densely packed tissue structures and the frequent involvement of lymph nodes.

Separately, computed tomography (CT) and positron emission tomography (PET) do not provide images with the necessary combination of clear structural definition and metabolic activity that is achieved with the PET/CT. “The PET/CT tells us the exact size, shape and location of the cancer and provides a specific target for surgery or other treatment,” said Carolyn Cidis Meltzer, M.D., associate professor of radiology and psychiatry and medical director of the UPMC PET Facility. “The PET/CT can also be used to help us develop the best course of treatment for an individual, then monitor that individual’s progress during treatment.”

Head and neck cancers often have already involved lymph nodes when first discovered and can spread rapidly if they are not found and treated quickly. Images from the combined PET/CT scanner are particularly useful in allowing a radiologist to see cancerous activity at a metabolic level and pinpoint its exact location in the tissue so a biopsy can be performed and proper treatment begun. Tumors among the skeletal muscle, salivary glands and lymphoid tissue in the head and neck area are difficult to separate from healthy tissue in standard PET images, which look like blotches of color amidst fuzzy structures. With CT, unless they are clearly swollen, cancerous lymph nodes may look normal.

Size matters when radiologists evaluate lymph nodes for signs of cancer. Seen by CT, lymph nodes under one centimeter are considered normal and not biopsied. The PET/CT, developed in part by David Townsend, Ph.D., senior PET physicist, professor of radiology at the University of Pittsburgh School of Medicine, and a co-director of the University of Pittsburgh PET facility, works by combining PET technology, in which the scanner reads cellular metabolism of glucose, and CT, which builds a clear cross section of tissue structures using x-rays. “Because head and neck cancer starts small and spreads rapidly, the PET/CT will provide doctors with a means for earlier diagnosis and treatment to potentially save lives,” said Dr. Townsend. “With PET/CT an accurate diagnosis of cancer could be provided months earlier than with any other imaging method.”

The groundbreaking research done by Drs. Townsend and Meltzer in Pittsburgh led the FDA to approve the PET/CT, known commercially as the Biograph, earlier this year for use as a diagnostic and therapeutic tool for cancer treatment. Other authors that contributed to the research are Carl H. Snyderman, Melanie B. Fukui, Daphne A. Bascom, Subash Chander, Jonas T. Johnson, Eugene N. Myers, Marsha A. Martinelli and Paul E. Kinahan.

June, 2002|Archive|

Dying smoker awarded $37.5 million

  • 6/12/2002
  • Miami, FL
  • Catherine Wilson
  • Associated Press

A jury ordered three cigarette makers Tuesday to pay $37.5 million in damages to a lawyer who lost his tongue to cancer. John Lukacs blamed his 30 years of smoking up to three packs a day for his oral and bladder cancer.

Philip Morris, Brown & Williamson and Liggett Group claimed his 20 cancer-free years after he quit smoking pointed to another cause.
The jury deliberated less than eight hours before awarding Lukacs the amount of compensatory damages suggested by his attorneys.

Philip Gerson, one of Lukacs’ lawyers, said the 76-year-old Miami real-estate lawyer and former Navy fighter pilot won’t live long enough to see any money from his courtroom victory. “He knows he will never see any of this money,” Gerson said. Miles McGrane, another lawyer in the case and Lukacs’ son-in-law, said, “We’d give every penny back for another year for him.” Lukacs’ attorneys said he was sobbing when they telephoned him with word of the verdict.

The two-week trial on compensatory damages covered actual medical expenses as well as intangibles, including pain and suffering, for Lukacs and his wife, Yolanda.

The case was an outgrowth of a $145 billion punitive-damage award issued in a class-action suit covering all sick Florida smokers two years ago. That verdict is nearing its first appeal hearing. William Ohlemeyer, associate general counsel for Philip Morris Cos., said Lukacs’ case should not have gone to trial while the tobacco industry is appealing the earlier verdict.

“I think [the trial] was a waste of time and effort and judicial resources,” Ohlemeyer said. Jeff Raborn, Brown & Williamson’s attorney, said Tuesday’s verdict wasn’t surprising, considering the jury had to accept “the faulty findings” of the previous jury. Calls to Liggett were not immediately returned.

Lukacs’ damage claim is the only one allowed by a state appeals court to go to trial since the verdict. His doctors give him seven months to live. Lukacs sued cigarette makers based on the brands he smoked, including free cigarettes in his military rations, until quitting in 1971 or ’72. He was diagnosed with bladder cancer in 1991 and oral cancer in 1997.

The jury split liability among Liggett at 50 percent, Philip Morris and Brown & Williamson at 22.5 percent each and Lukacs at 5 percent. But Lukacs’ attorneys say his fraction disappears, based on findings of fraud and conspiracy by the original jury that produced the punitive-damage verdict. Miami-Dade Circuit Judge Amy Steele Donner will have to decide that question.

Steve Hunter, another Lukacs’ attorney, said the 5 percent figure is the lowest liability assigned by a jury in any smoker verdicts.

“People are tired of all the denials and all the lies [by the cigarette companies]. They told us that in this case,” Gerson said.

June, 2002|Archive|

The role of diet and specific micronutrients in the etiology of oral carcinoma

  • 6/6/2002
  • Chicago, IL
  • American Cancer Society / Cancer 2002;94:2981-8

Carcinoma of the oral cavity is one of the most common cancers worldwide. Tobacco smoking and the consumption of alcoholic beverages are significant risk factors but to the authors’ knowledge the role of nutrition is not adequately understood. The authors undertook an epidemiologic study of oral carcinoma occurring in Greece, where tobacco smoking and alcohol consumption are common but the incidence of the disease is among the lowest reported in Europe.

Methods
One hundred six patients with histologically confirmed incident oral carcinoma and an equal number of control subjects matched for age and gender were studied. Dietary information was assessed through a validated extensive food frequency questionnaire and the data were analyzed using conditional logistic regression.

Results
After adjustment for energy intake, tobacco smoking, and alcohol consumption, there was evidence that the consumption of cereals, fruits, dairy products, and added lipids (which in Greece are represented mostly by olive oil) was found to be associated inversely with the risk of oral carcinoma. Only with respect to meat and meat products was there adequate evidence of a positive association with the risk of oral carcinoma. Among the micronutrients studied, riboflavin, magnesium, and iron appeared to be correlated inversely with the disease.

Conclusions
Fruits, cereals, dairy products, and olive oil appear to convey protection against oral carcinoma and their effects may be mediated through higher intakes of riboflavin, iron, and magnesium. The low incidence of oral carcinoma reported in Greece may be explained in part by the higher consumption of the food groups and micronutrients that appear to protect against the disease.

Source: Cancer 2002;94:2981-8

June, 2002|Archive|