8/25/2003 New York Reuters Health / Arch Otolaryngol Head Neck Surg 2003;129:709-711. Photodynamic therapy (PDT) utilizing meta-tetra(hydroxyphenyl)chlorin (mTHPC) is a feasible alternative to surgery or radiotherapy in patients with early-stage squamous cell carcinoma of the oral cavity and oropharynx, a study suggests. Second-generation photosensitizers such as mTHPC (Foscan; Scotia Pharmaceuticals, Stirling, Scotland) are "more effective and less phototoxic to the skin than their forerunners," Dr. Marcel P. Copper, and colleagues from the Netherlands Cancer Institute in Amsterdam note in the July issue of Archives of Otolaryngology - Head and Neck Surgery. They prospectively evaluated the long-term outcome of PDT using mTHPC in 25 patients with 29 T1-T2 NO tumors of the oral cavity and/or oropharynx. Follow-up lasted a mean of 37 months. In all patients, necrosis of the illuminated area occurred within 24 hours but subsided within 4 to 6 weeks after treatment. Complete remission of the primary tumor was achieved in 25 (89%) of 29 tumors. The complete remission rate was 95% for T1 tumors and 57% in T2 tumors. Surgery and/or radiotherapy effectively salvaged all four patients that developed recurrent local disease. Five patients who developed lymph node metastasis were treated by radical (modified) neck dissection and four underwent postoperative radiotherapy. None of the patients in the study experienced any long-term functional or cosmetic deficits. In comments to Reuters Health, Dr. Copper said: "The most important findings of this study are that mTHPC PDT gives excellent cure rates in small cancers of the mouth and pharynx, without the [...]

8/13/2003 Chicago Journal of Hem / Onc Adding paclitaxel to a cisplatin and 5-fluorouracil (5-FU) regimen led to significantly longer survival in patients with locally advanced head and neck cancer, according to a phase-3 study presented here at the 39th Annual Meeting of ASCO. “This new chemotherapy combination may soon become the standard treatment option for some patients with head and neck cancer,” said lead researcher Ricardo Hitt, MD, from the Hospital ‘12 de Octubre’ in Madrid. The expanded combination also halted tumor progression more effectively than the standard regimen, and patients who received the three-drug combination were more likely to retain the ability to speak and swallow, as well as exhibit less mucocitis. The study involved 384 patients who had various types of head and neck cancer, particularly tumors of the oropharynx, larynx and oral cavity. All patients were treatment naive. In the standard arm, patients received 100 mg/m2 of cisplatin daily, and 1 gm/m2 of 5-FU on days 1 through 5 of a 21-day cycle. In the expanded regimen, patients received 100 mg/m2 of cisplatin daily, 500 mg/m2 of 5-FU on days 1 through 5, and 175 mg/m2 of paclitaxel on the first day of a 21-day cycle. The trial “appeared to demonstrate a superior outcome and far better tolerability by adding paclitaxel to 5-FU and cisplatin for head and neck cancer in a dose schedule associated with less toxicity,” said Robert Mayer, MD, the director of the Center for Gastrointestinal Oncology at Dana-Farber Cancer Institute in Boston.

8/11/2003 New York Reuters Health In patients with squamous cell carcinoma of the oral tongue (SCCOT), pathologic lymph node staging based on neck dissection is more reliable in predicting treatment outcomes than clinical lymph node staging based on physical examination and/or radiographic studies. That's according to Dr. Jeffrey N. Myers from M.D. Anderson Cancer Center in Houston and others who retrospectively reviewed all 266 patients who underwent surgical resection for SCCOT including a neck dissection. In analyses comparing clinical outcomes with respect to clinical and pathologic lymph node stages, statistically significant differences in survival emerged for both clinical (cN0-N2) and pathologic (pN0-N2) stages. However, the differences in survival and disease-free interval reached a higher level of statistical significance for pathologic lymph node staging (p < 0.0001) than for clinical lymph node staging (p < 0.002). "This disparity can be explained by stage migration," according to the team. That is, patients with cN0-1 disease had a more advanced lymph node stage at the time of pathologic review, they explain in the August 1 issue of the journal Cancer. Neck dissection identified occult lymph node disease in 34 percent of the cN0 group, with extracapsular spread in 19 percent. Moreover, 43 percent of cN1 patients had greater than pN2b disease and 50 percent had extracapsular spread on pathologic review. "For patients with tongue cancer, we can more accurately determine their prognosis by performing a neck dissection and analyzing the pathology specimen than we can by assessing the lymph node status purely on [...]

8/7/2003 Washington Stacie Crozier ADA The ADA joined some 40 national health and other organizations in signing a Feb. 25 letter urging the Federal Trade Commission to reject a smokeless tobacco manufacturer’s request to make positive health claims in its product advertising. The coalition letter, coordinated by the Campaign for Tobacco-Free Kids, says that the smokeless tobacco company’s request is, in essence, asking that the Federal Trade Commission “review, revise and overturn the scientific conclusions of the U.S. Surgeon General, the National Cancer Institute and every other major scientific and public health agency that has examined the health effects of smokeless tobacco.” On Feb. 5, The U.S. Smokeless Tobacco Co. petitioned the FTC for an advisory opinion that would allow it to claim through advertising that its products offer less of a health risk than smoking cigarettes. A company statement says “there is considerable agreement among researchers that use of smokeless tobacco involves significantly less risk of adverse health effects than cigarette smoking, and there is growing support in the public health community that cigarette smokers who have not quit should be encouraged to switch to smokeless tobacco. Such a harm reduction strategy is being debated in the public health community as representing a pragmatic component of a comprehensive public health policy on cigarette smoking.” “I suppose you could argue that shooting yourself in the leg poses less of a health risk than shooting yourself in the head,” says ADA President D. Gregory Chadwick in a statement available online. “But [...]

8/6/2003 Chicago Associated Press Pulitzer Prize winning film critic Roger Ebert will undergo radiation treatment for cancer next month. The treatment will be for a cancerous tumor in Ebert's salivary gland, the Chicago Sun-Times reported in its Wednesday editions. The 61-year-old critic underwent surgery twice in February 2002 for cancer in his thyroid and salivary gland. He said treatment for the malignant tumor will begin later this month after he returns from a family trip to France. "I will, however, continue to see movies, write reviews and do the 'Ebert & Roeper' television show," Ebert wrote in an e-mail message to friends on Tuesday. The treatments are a follow up to earlier surgery, and I look forward to a complete recovery; this is not considered to be a life-threatening form of cancer. "P.S. By the way, my thyroid cancer has been completely vanquished." Ebert said he has had a tumor in his salivary gland "in one form or another" for 16 years. He said the treatments will take 20 minutes a day, five days a week for eight weeks. Ebert has been a film critic at the Chicago Sun-Times since 1967. He won the Pulitzer Prize for criticism in 1975, the same year he teamed up with the late Gene Siskel of the rival Chicago Tribune to launch their movie-review show.