6/13/2005 England N. M. H. McLeod, N. R. Saeed and E. A. Ali British Dental Journal (2005); 198, 681-684. doi: 10.1038/sj.bdj.4812381 Oral cancer accounts for around 1% of all new cancers diagnosed in the United Kingdom every year. Mortality rates remain relatively high and prognosis is worst in cases of more advanced disease at time of diagnosis. Early identification of malignant lesions and speedy referral to a specialist for treatment are therefore important. The reasons and extent of the delays at the different stages between a patient first noticing an oral lesion and attending a health care professional and then being referred for specialist care have previously been studied and consistently found to be longer than desired. The National Oral Cancer Awareness Week (NOCAW), first run in 1995, aimed to increase the awareness of oral cancer amongst health care professionals and the public. It has since been repeated and is now an annual event. Alongside publications by the British Dental Association and guidelines circulated by the Department of Health on oral cancer diagnosis and referral, it is hoped this will lead to a decrease in the delay between the onset of oral cancer and patients receiving appropriate treatment. We looked at the previously published data on referral delay in oral cancer both in the United Kingdom and overseas and then identified delays in referral of oral cancer patients in a region that had been studied before NOCAW was introduced, to see if this was having any effect on referral delays. [...]

6/13/2005 Boston, MA Todd Golub et al. Medical News Today (www.medicalnewstoday.com) Despite significant progress in understanding the genetic changes in many different cancers, diagnosis and classification of tumor type remain, at best, an imperfect art. This could change quickly, thanks to the findings of a group of researchers from the Broad Institute of MIT and Harvard, the Dana-Farber Cancer Institute, MIT, and St. Jude's Children's Research Hospital in Memphis, TN. In the June 9 issue of Nature, the scientists describe two important breakthroughs: (1) a surprisingly accurate correlation of the 217 known human microRNAs (miRNAs - small noncoding RNA molecules that control the levels of proteins made from transcribed genes) with the development and differentation of tumors, and (2) the development of a technology that not only enabled this exciting discovery but that could be the basis for an easy and inexpensive diagnostic test. "This study opened our eyes to how much more there is to learn about genomic approaches to cancer," said Todd Golub, senior author of the paper. Golub is a core faculty member and director of the Cancer Program at Broad Institute, the Charles A. Dana Investigator in Human Cancer Genetics at the Dana-Farber Cancer Institute, and a Howard Hughes Medical Institute (HHMI) investigator at Harvard Medical School. "That microRNA profiles have such potential diagnostic utility was a big surprise to us, and one we're keen to validate in future studies." MiRNAs were first identified in the worm C. elegans, and were shown to control development and [...]

6/12/2005 Oxford, England Rupan Banga et al. Red Nova (rednova.com) Abstract We present the first reported case of a squamous cell carcinoma recurrence on a reconstructed flap in the pharynx treated successfully with topical chemotherapy. The patient, treated for a pharyngeal cancer with resection and reconstruction with a free radial forearm flap, and post-operative radiotherapy, developed a tumour on the flap more than two years after surgery. The recurrence was also squamous carcinoma, but there was only superficial infiltration. This was treated with 5-fluorouracil paste placed in the pharynx, with resolution of the tumour. The patient was alive and well more than 28 months after this treatment, with no sign of disease recurrence. Topical chemotherapy for treatment of oral cancer is well described for early disease, but we show that it may be a useful treatment in recurrent disease in selected patients. Case history A 76-year-old male ex-smoker was referred to the Oxford Head and Neck Centre with a T^sub 4^ N^sub 1^ post-cricoid carcinoma. He had been treated 22 years previously with primary external beam radiotherapy for a tongue-base squamous cell carcinoma. The post- cricoid tumour presented within the field of the previous external beam radiotherapy. This tumour was treated with intent to cure in February 2000 with a total laryngectomy, partial pharyngectomy, left hemi- thyroidectomy, left radical neck dissection and a right selective neck dissection. The pharyngeal defect was reconstructed with a left radial forearm free flap. A salivary fistula through the posterior wall of the trachea complicated [...]

6/11/2005 Oslo, Norway MacLeans (macleans.ca) Smokers in particular may benefit from nonsteroidal anti-inflammatory drugs. Smokers might reduce their risk for developing cancer of the mouth by taking pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include Aspirin and ibuprofen as well as COX-2 inhibitors such as Celebrex, which have been the subject of recent controversy over whether they increase the risk for heart disease. Other studies suggest NSAIDs may protect against colorectal and breast cancer. "The results of a significant reduction in oral cancer risk -- particularly in light to moderate active smokers -- suggest that NSAID use may provide an anti-carcinogenic effect while the smokers are subjecting themselves to tobacco insult," says Dr. Jon Sudbø, a cancer researcher from the Norwegian Radium Hospital in Oslo. Sudbø and his colleagues studied data on more than 3,200 people judged to be at high risk for oral cancer because of their tobacco habits. The 454 people diagnosed with oral cancer were matched with 454 people who were smokers but did not develop oral cancer. Twice as many people in the cancer-free group used NSAIDs. Light to moderate active smokers who took NSAIDs daily for at least six months had a 65 per cent lower risk of oral cancer than smokers who went without NSAIDs. The drugs worked best for smokers who had consumed 30 or fewer pack-years of tobacco. A pack-year is the equivalent of smoking one pack of cigarettes each day for a year.

6/10/2005 Japan Tomoya Aie, Yuki Takaymana, Msahiko Idegawa The Asai Shimbun (www.asahi.com) As if undergoing cancer treatment isn't harrowing enough, some patients find that where they live can cost them dearly. Just getting to a qualified care center can add frequent long-distance travels to their life, not to mention tens of thousands of yen to their monthly budget. A 33-year-old cancer patient in Kochi Prefecture has to travel more than 1,500 kilometers to and from Tokyo almost every week for chemotherapy. A 63-year-old Tokyo resident who needed radiation therapy for his tongue cancer had to fly to Sapporo five years ago to get treatment. "We are like refugees desperately searching for a doctor to rescue us," said a participant at the first national convention of cancer patients in Osaka in May. About 2,000 people, including patients and their relatives, took part in the meeting, which called for improved treatment levels across Japan. It was organized by 23 patients groups. Even a panel of the Ministry of Health, Labor and Welfare acknowledges a glaring disparity among regions in the quality of cancer treatment. It says there is a gap of up to 10 percentage points in the five-year survival rates for cancers of the stomach, large intestine and lung among six prefectures, including Osaka and Yamagata, that it studied. No simple nationwide comparison is possible because of a lack of long-term statistics on incidences of cancer and survival rates. But a separate survey of 30 cancer hospitals nationwide recently found gaps [...]

6/8/2005 Kolkata, India Biplab Das Drinking black tea could help prevent oral cancer, say researchers at the Vivekanada Institute of Medical Sciences in Kolkata, India. They monitored white patches called 'leukoplakia' in the mouths of patients drinking black tea three times a day for one year. "About half of the white patches in the mouth ultimately lead to oral cancer," says co-author Madhusnata De. In the first 15 patients to complete the trial, the precancerous patches disappeared completely. India's National Tea Research Foundation funded the study, whose initial results were published in the latest issue of the Journal of Environmental Pathology, Toxicology and Oncology. Although the findings relate to a small number of patients, lead researcher Ajanta Haldar says the patches also disappeared in a further seven patients who have completed the trial since publication of the initial results. Sixty more patients are being studied and will complete the trial by April 2006. Haldar believes that chemicals in black tea called polyphenols reverse cancer-causing changes to the DNA of cells lining the mouth. The next phase of the study will assess whether the white patches reappear in patients who have completed the year-long trial and then ceased drinking black tea for six months, says Haldar. In 2002, oral cancer claimed 145,500 lives, two-thirds of which were in developing countries. It is the most common form of malignant cancer found in adult Indian men and the third most common in adult Indian women. In 1998, researchers at the Memorial Sloan-Kettering Cancer [...]

6/8/2005 New York, NY MSNBC News (msnbc.msn.com) Drug may prevent spread of head and neck cancer. Biotechnology firm ImClone Systems Inc. said Wednesday that data from a late-stage study confirmed that its Erbitux drug, when used in combination with radiation therapy, prevents the spread of head and neck cancer more effectively than radiation therapy alone. Erbitux is already approved by the Food and Drug Administration to treat colorectal cancer. The disclosure on Erbitux came a day after ImClone said financier Carl Icahn had filed with antitrust regulators for clearance to invest more than $100 million in the company, including already acquired shares. The filing sets an investment ceiling of $500 million. As of March 15, the billionaire investor owned about 5 million ImClone shares, or close to 6 percent of its outstanding stock. In the latest announcement on Erbitux, ImClone said overall survival and progression-free survival, secondary endpoints of the Phase III study, showed statistically significant improvements with the addition of Erbitux to radiation. ImClone said the study was an international, randomized trial that enrolled 424 patients with advanced squamous cell carcinoma of the oropharynx (the area of the throat at the back of the mouth), the larynx (or voice box) or hypopharynx — the cavity at the back of the mouth that opens into the esophagus — that had spread through the head and neck region. “Head and neck cancer remains a disease with too few treatment options and no new therapeutic product approvals in over a decade,” said [...]

6/5/2005 El Dorado, KS Steve Smith El Dorado Times (www.eldoradotimes.com) When Mike Wheeler talks to the audience at Galen Blackmore Stadium Friday evening "cancer clinical trials" will be the three words he will want his audience to particularly remember. Those three words, he says, are the reason he will be able to stand in front of those people. Wheeler, of El Dorado, is chairman of the Butler County Commission. He is also honorary chair of this year's El Dorado Relay for Life event benefitting research and activities of the American Cancer Society. Relay for Life will begin at 7 p.m. Friday and continue until 9 a.m. the following morning. It has now been two years since the Memorial Day time period of 2003 when Wheeler was diagnosed with squamous cell cancer, which for him created a tumor the size of a golfball at the base of his tongue. He'd had trouble breathing, eating and swallowing for about six months prior to his diagnosis, and there had also been a bout with pneumonia in both lungs during that time. Even with the severety of his symptoms, he said, "I thought I'd get over it. I thought maybe it was a sinus infection or a sore throat. "I blew it off; I'm not real big on going to doctors, and I just thought 'well, I'll just ride it out.' "I just never got any better," he said, "so my physician and I finally decided I should go see an ear, nose and [...]

6/4/2005 Norway Jon Sudbo Clin. Med. Res., November 1, 2004; 2(4): 233-242 The rationale for molecular-targeted prevention of oral cancer is strong. Oral cancer is a major global threat to public health with 300,000 new cases diagnosed worldwide on an annual basis. Notably, the great morbidity and mortality rates of this devastating disease have not improved in decades. Oral cancer development is a tobacco-related multistep and multifocal process involving field carcinogenesis and intraepithelial clonal spread. Biomarkers of genomic instability, such as aneuploidy and allelic imbalance, can accurately measure the cancer risk of oral premalignant lesions or intraepithelial neoplasia (IEN). Retinoid-oral IEN studies (e.g., retinoid acid receptor-beta, p53, genetic instability, loss of heterozygosity, and cyclin D1) have advanced the overall understanding of the biology of intraepithelial carcinogenesis and preventive agent molecular mechanisms and targets, important advances for monitoring preventive interventions, assessing cancer risk, and pharmacogenomics. Clinical management of oral IEN varies from watchful waiting to complete resection, although complete resection does not prevent oral cancer in high-risk patients. New approaches, such as interventions with molecular-targeted agents and agent combinations in molecularly defined high-risk oral IEN patients, are urgently needed to reduce the devastating worldwide consequences of oral cancer. Author's Affiliation: Department of Medical Oncology and Radiotherapy, The Norwegian Radium Hospital, Oslo, Norway

6/4/2005 Germany H Heibel et al. Mund Kiefer Gesichtschir, May 31, 2005 Introduction: Radiation therapy of the oral and maxillo-facial region increases the risk of an infected osteoradionecrosis (IORN) which is a severe complication. Therefore, perioperative antibiotics for the prophylaxis of ORN is a standard in clinical oncology. The combination therapy of ampicillin and sulbactam (Unacid) promises a good therapeutic and prophylactic outcome. Patients: We compared the concentration of Unacid in bone and blood specimens of 22 irradiated patients. All patients were irradiated with 39.6 Gy prior to surgery. The specimens were obtained during the operation 3 weeks after the end of the radiation therapy. Results: The concentration of ampicillin/sulbactam in the blood was 124.9/64.5 microg/ml. The bone specimens showed a concentration of ampicillin/sulbactam of 5.54/1.21 microg/g. The concentration of the antibiotic in the bone was three to four times lower than in non-irradiated patients. Nevertheless, this concentration exceeds the minimum inhibitory concentration for bacteria in the oral cavity such as streptcoccae (MHK(90)<0.25 microg/ml) or staphylococcae (MHK(90)=0.12-2.0 microg/ml). Conclusions: The results of this study suggest, that Unacid is an effective antibiotic in the prophylaxis of ORN in irradiated patients with head and neck tumors. Authors: H Heibel, M Scheer, T Reuther, M Hahn, R Trittler, H Egle, K Kummerer, and A C Kubler