Monthly Archives: January 2008

Scientists Developing Swish-and-Spit Cancer Test

  • 1/31/2008
  • web-based article
  • staff
  • FoxNews.com

Screening for some cancers may one day be as easy as gargling.

Scientists at Johns Hopkins Kimmel Cancer Center say a new mouth-rinse cancer test holds promise for screening people at high risk for head and neck cancers, including heavy tobacco and alcohol users.

Lead investigator, Dr. Joseph Califano, said his research group at Johns Hopkins asked 211 head and neck cancer patients and 527 individuals without cancers of the mouth, larynx or pharynx to brush the inside of their mouths, then rinse and gargle with a salt solution.

The researchers collected the rinsed saliva and filtered out cells thought to contain one or more of 21 bits of chemically altered genes common only to head and neck cancers. Tumor and blood samples also were collected.

One panel correctly identified 66 out of 154 patients (42.9 percent) with the disease and accurately ruled out the disease in 203 of 248 healthy subjects (81.9 percent), according to the study published in the Jan. 1 issue of Clinical Cancer Research.

Although the blood test was more accurate than the saliva test at detecting cancer in patients with the disease (34 out of 37), there was a trade-off in the number of healthy individuals it spotted (53 of 173), the authors say.

“Few tests can be perfect 100 percent of the time in identifying both normal and cancerous cells,” Califano said in a news release. “Because head and neck cancers are not widespread, it makes more sense to screen those at high risk and to focus on a test’s ability to accurately rule out healthy people.”

A saliva test also is easy to do, painless and cheap, capturing cells from a wide area of the mouth, Califano said. Some head and neck tumors do not shed genetic material into the blood, making the saliva test a better bet, he said.

Researchers said more studies are needed to refine the test and automate it before multi-institutional clinical trials can begin. One of the first clinical uses for such a test could be to detect recurrence in current head and neck cancer patients, according to the study’s authors.

January, 2008|Archive|

Renowned Chef Overcomes Cancer To Return To His Kitchen

  • 1/30/2008
  • Chicago, IL
  • Regine Schlesinger
  • WBBMNewsRadio (www.wbbn780.com)

A renowned Chicago chef says he has many reasons to celebrate these days. WBBM’s Regine Schlesinger explains.

Just this week, Alinea, the Lincoln Park restaurant owned by chef Grant Achatz, once again won the coveted 5-star rating from Mobil Travel guide, one of only two chicago restaurants to get it. The other is Charlie Trotter’s.

But for Achatz an even bigger triumph is his victory over a form of cancer that threatened his life and his career.

Just 6 months ago he was diagnosed with a stage 4 cancer of the tongue that could have cost him his taste buds.

But, his doctors at the University of Chicago found another way to treat him using chemotherapy and radiation instead of surgery. Now, after completing his treatments in November, he’s cancer free.

Once again, cooking and supervising his kitchen staff.

He says he’s grateful and feels blessed. Cooking he says, is his life. In his words, “It’s who I am.”

January, 2008|Archive|

Addition of Radiation Improves Survival in Head and Neck Cancer

  • 1/29/2008
  • Ketchum, ID
  • staff
  • CancerConsultants.com

According to an article recently published in the journal Cancer, the addition of radiation therapy following surgery improves survival in locally advanced head and neck cancer.

Head and neck cancers originate in the oral cavity (lip, mouth, tongue), salivary glands, paranasal sinuses, nasal cavity, pharynx (upper back part of the throat), larynx (voice box), and lymph nodes in the upper part of the neck. Worldwide, head and neck cancer is diagnosed in approximately 640,000 people annually and is responsible for approximately 350,000 deaths each year.

Squamous cell carcinoma of the head and neck (HNSCC) is the most common type of head and neck cancer. It originates in squamous cells, which are commonly part of the outermost layers of tissues. Locally advanced HNSCC refers to cancer that has spread from its site of origin to nearby lymph nodes or tissues. Standard treatment for this stage of disease typically consists of surgery and radiation therapy with or without chemotherapy. The impact of radiation therapy on survival, however, has not been clearly established.

Researchers from the Mount Sinai School of Medicine in New York recently conducted a clinical study to evaluate data from the Surveillance, Epidemiology, and End Results (SEER) database to determine the effect that radiation therapy has on survival for patients with locally advanced HNSCC. This study included 8,795 patients whose cancer had spread to their lymph nodes. They were treated either with surgery alone or surgery plus radiation therapy. Patients had been diagnosed with cancer between 1988 and 2001. The median follow-up was just over four years.

– At five years survival was improved among patients treated with radiation therapy (43.2%) compared with those treated with surgery only (33.4%).

– Death caused by the cancer occurred in approximately 50% of patients treated with surgery and radiation therapy compared with 78% of patients treated with surgery only.

The researchers concluded that the addition of “RT [radiation therapy] resulted in an approximately 10% absolute increase in 5-year cancer-specific survival and overall survival for patients with lymph node-positive HNSCC compared with surgery alone. Despite combined surgery and adjuvant RT, outcomes in this high-risk population remain suboptimal, emphasizing the need for continued investigation of innovative treatment approaches.”

Reference:
Lavaf A, Genden E, Cesaretti J, Packer S, Kao J. Adjuvant radiotherapy improves overall survival for patients with lymph node-positive head and neck squamous cell carcinoma. Cancer. 2008; 12: 535 – 543.

January, 2008|Archive|

Michelson Diagnostics announces successful OCT imaging of oral cancer tissue

  • 1/26/2008
  • United Kingdom
  • press release
  • MTB Europe (www.mtbeurope.info)

UK optical imaging company Michelson Diagnostics Ltd (MDL) has announced successful initial results from clinical testing, on oral cancer tissue, of its groundbreaking optical coherence tomography (OCT) imaging technology by partner University College Hospital, London (UCH).

The tests, performed by UCH scientists on cancerous and suspected cancerous human oral issue, were designed to establish the potential for MDL’s optical imaging technology to revolutionise head and neck cancer diagnosis and treatment. The tests involved comparing images taken by the MDL scanner of the tissue samples, with histopathology images analyzed by trained pathologists.

“We are very excited about the breakthrough in image quality that this system offers,” said Mr Colin Hopper, Senior Maxillofacial Surgeon at UCH.

“OCT could revolutionise the surveillance of pre-cancers in the mouth and eliminate the waiting time for biopsy results. It should also minimise surgery through improved disease mapping. This will provide cost- effective treatments with improved cure rates.”

In the tests, 25 oral tissue samples were collected from 14 patients of the UCH National Medical Laser Centre. The samples were scanned with the MDL OCT imaging system and then prepared for analysis by Pathologist Dr Brendan Conn.

Clinical Research Fellow Mr Waseem Jerjes said, “The histopathology results showed that it is possible to identify surface structures such as keratin and epithelial layers, the epidermal–dermal junction and areas of cellular crowding, as well as any pathological changes that occur at that level; this is very exciting, this method seems to hold great promises for early in vivo tumour diagnosis.”

The company’s optical probe technology provides sub-surface OCT images for research applications in cancer surgery guidance, surveillance and diagnosis.

January, 2008|Archive|

Camera in a pill can spot signs of cancer

  • 1/26/2008
  • London, England
  • Roger Highfield
  • Telegraph.co.uk

A “camera in a pill” that can be swallowed whole to check for warning signs of cancer is being tested by American doctors.

The capsule measures one quarter of an inch by three quarters, small enough to be comfortably swallowed, and creates a high-resolution colour picture of a person’s insides.

Devised by a team at the University of Washington, Seattle, the pill records 15 colour images every second. It is attached to a tether which allows doctors to control more accurately what they view than with previous devices.

Its first use will be to screen for signs of oesophageal cancer – cancer of the gullet. The disease is currently diagnosed in around 8,000 people annually in the UK.

“This could be the foundation for the future of endoscopy,” says lead author Dr Eric Seibel, whose findings will be described in the journal IEEE Transactions on Biomedical Engineering.

Oesophageal cancer is linked to smoking and drinking and often follows a condition called Barrett’s oesophagus, a change in the gullet lining. This can be healed, avoiding the cancer that results in around 10 per cent of cases.

But because internal scans are expensive, most people don’t discover they are affected until it has progressed to cancer. By that stage the survival rate is less than 15 per cent.

Even though the camera’s single eye sees only one spot – pixel – of the image at a time, it combines all the information as it swings around at 5,000 times per second to build up a high-resolution picture.

The device is half as big as a rival that is about the width of an adult fingernail and twice as long. And the conventional pill widely used for “capsule endoscopy” offers only a single fly-by view before it is excreted up to 72 hours later.

January, 2008|Archive|

Cobra to Support Manufacturing of GenVec’s Late-Stage Cancer Therapy

  • 1/25/2008
  • New Rochelle, NY
  • staff
  • Genetic Engineering News (www.genengnews.com)

GenVec entered into a manufacturing development agreement with Cobra Biomanufacturing related to its anticancer agent, TNFerade™. The therapy is being evaluated as a treatment for pancreatic, head and neck, and rectal cancers as well as metastatic melanoma. The most advanced program is a Phase II/III trial in in the pancreatic indication.

The agreement will cover technology transfer, scale-up, and validation of the manufacturing process for TNFerade through cGMP consistency lots. These will be produced at Cobra’s facility in Oxford, U.K.

“Activities under this agreement will establish a clear path for the submission of the chemistry, manufacturing, and controls portion of a biological license application for TNFerade as GenVec works towards the completion of our current Phase III clinical trial,” says Bryan Butman, Ph.D., svp of vector operations at GenVec.

The firm is developing TNFerade for use in combination with radiation and/or chemotherapy. The treatment is an adenovector, which contains the gene for tumor necrosis factor-alpha. After administration, TNFerade reportedly stimulates the production of TNFá in the tumor.

January, 2008|Archive|

UK Co Lab21 Launches New Test For Cancer Drug Gene

  • 1/24/2008
  • London, England
  • staff
  • CNNMoney.com

U.K. diagnostics company Lab21 Ltd. said Thursday it’s developed a test for a gene which plays a vital role in whether or not cancer patients will respond to certain drugs. The Cambridge, England-based firm said the test is for the analysis of the K- ras gene.

In around 40% of cancer patients this gene is mutated and the resulting protein can limit the effectiveness of some cancer therapies, it said.

Scientists showed recently that cetuximab, a treatment for colorectal and head and neck cancer marketed by Bristol-Myers Squibb Co. (BMY) as Erbitux, is poorly responsive if the tumors carry a mutated K-ras gene.

Research has also shown mutations in K-ras confer resistance to erlotinib, Genentech Inc. (DNA) and Roche Holding AG’s (RHHBY) treatment for lung and pancreatic cancer, sold under the brand name Tarceva.

Using the test means patients with the mutated K-ras gene could be given alternative drugs, which would improve their chances of successful treatment, reduce their exposure to potential toxicities and save cash, according to Graham Mullis, Lab21 Chief Executive Officer.

“This form of personalized medicine whereby drugs are tailored to the genetic background of the target patient is becoming more important as more drugs are being developed which have clinical benefits for these specifically targeted patients,” said Mullis.

One well-known example is Herceptin, Genentech and Roche’s blockbuster breast cancer treatment. It’s designed for the treatment of cancers which overexpress a protein called HER-2 and patients are tested for this protein before treatment.

Cambridge-based Lab21 said it is now launching a fully-approved commercial testing system for K-ras

January, 2008|Archive|

Cigarette Smoke May Enhance HPV And Increase Risk Of Cervical Cancer

  • 1/23/2008
  • web-based article
  • staff
  • ScienceDaily.com

For the first time researchers from Pennsylvania State University College of Medicine suggest a direct interaction between cigarette smoke carcinogens and the human papillomavirus that may lead to increased risk of cervical cancer. They report their findings in the January 2008 issue of the Journal of Virology.

Cervical cancer is the third leading cancer type in women worldwide. Over 90% of the cases presented have been linked to human papillomavirus (HPV). Many women unknowingly carry HPV and the virus naturally regresses on its own over time. HPV will only progress into cervical cancer in a small percentage of women, but past studies have proposed cigarette smoking to be a likely influence.

HPV types 16, 18, and 31 are the most commonly associated with cervical cancer. In the study researchers detected benzo[a]pyrene (BaP), a major carcinogen in cigarette smoke, in the cervical mucus and tested its interaction with HPV. Levels of HPV type 31 increased by 10-fold following exposure to high concentrations of the BaP carcinogen. Levels of HPV types 16 and 18 were also elevated after exposure to BaP.

“Overall, BaP modulation of the HPV life cycle could potentially enhance viral persistence, host tissue carcinogenesis, and permissiveness for cancer progression,” say the researchers.

Reference:
S. Alam, M.J. Conway, H.S. Chen, C. Meyers. 2008. The cigarette smoke carcinogen benzo[a]pyrene enhances human papillomavirus synthesis. Journal of Virology, 82. 2: 1053-1058.

Note:
Adapted from materials provided by American Society for Microbiology, via EurekAlert!, a service of AAAS.

January, 2008|Archive|

Makers of device hope it will help with early detection of malignancies in patients who are not showing symptoms

  • 1/22/2008
  • Houston, TX
  • Lynn Cook
  • Houston Chronicle (www.chron.com)

One American dies every hour from oral cancer.

It’s a startling statistic and one the dentist or hygienist might tell you about at your next routine teeth cleaning. That’s because a growing number of dentist offices are asking patients to pay for a special oral cancer screening or sign a waiver acknowledging they refused the test.

At least 100 area dentist offices are offering patients ViziLite Plus, an exam that typically costs $65 and is rarely covered by insurance. And more dentists are signing up for the swish-spit-and-survey tests, said Jeff Mazzarella, vice president of sales and marketing for Zila, the Phoenix-based pharmaceutical company marketing ViziLite.

Tobacco users and heavy drinkers have long been considered the risk pool for cancers of the mouth. But a third cause — human papillomavirus — has emerged recently, said Grady Basler, director of the Dental Oncology Education Program associated with Texas A&M and Baylor universities.

A recent article in the New England Journal of Medicine links sexually transmitted HPV — especially strains 16 and 18 that cause the overwhelming majority of cervical cancers — to oral cancer incidents in young people between 18 and 39.

After years of declining case reports, cancers of the tongue, tonsils, palate and back of the throat are on the rise again.

Data from the American Cancer Society show more than 34,000 new cases in the U.S. in 2007 — up 11 percent from 2006 and 24 percent over five years. Most oral cancers, which tend to show up as white or red patches, are not found until they have reached later stages or even metastasized into the lymph nodes.

Even though oral cancer only accounted for 2 percent of all cancer diagnoses in the U.S. in 2007, its five-year survival rate has hovered around just 55 percent for more than 40 years.

What has changed over the years is the rate of oral cancer in women.

In the 1950s, it was primarily a male disease, with six men affected for every one woman. Lifestyle factors — including an increasing number of female smokers as well as the rise of HPV, the most common sexually transmitted disease — appear to have narrowed that ratio to 2-to-1.

Peggy Kampa, Zila’s director of clinical operations, said ViziLite’s hope is early detection of oral cancer in patients who don’t have symptoms.

Zila will not disclose how many ViziLite kits have been purchased or how much dentists pay wholesale for the test, but the company says 10,000 dentist offices across the country are using it, and revenue is up almost tenfold year over year.

Patients receiving the test rinse their mouths with a solution that is, essentially, vinegar. That solution removes dead tissue, dries out the mouth and makes potentially dangerous lesions stand out when they might not otherwise be visible to the naked eye.

Then the dentist or hygienist dims overhead lights in the office and uses a disposable light wand to look inside the mouth. Problematic patches of skin shine white.

Dr. Nadarajah Vigneswaran, a professor of diagnostic sciences at the University of Texas Dental Branch at Houston, said it’s debatable whether the latest oral cancer screening exams, including ViziLite and MicroLux, another light-based screening technique, are truly helpful to a broad number of patients.

“With less experienced people like public health workers, then yes, I’m sure this could show them something they missed,” he said.

“The mouth, unlike the prostate or the colon, is right there. You can see it. A good clinician should be able to look around the mouth and identify anything that is abnormal. The oral exam is still the gold standard of care.”

“It’s important to distinguish: This is a cancer screening device, not a diagnostic test. Further evaluation through a biopsy is still the only way to be sure there is cancer,” he said.

Houston dentist Dr. Charles Moser started offering ViziLite three weeks ago and estimates three out of four patients accept the screening.

It has not revealed symptoms requiring follow-up in any of about 60 patients Moser has examined.

“It’s easy and it’s affordable, which is the name of the game. By the time we can find oral cancer visually, it’s usually at Stage 3. While you’re still treatable, obviously, early detection is the key,” he said.

ViziLite’s Web site features success stories, such as an account from Atlanta about a 29-year-old male nonsmoker whose early-stage malignancy was detected under ViziLite.

The “patient has since referred five new patients to our office to have this ViziLite screening performed,” the dental practice reported.

The company’s marketing push to dentists includes a script with information to give callers while on hold — “Alarmingly, more than 25 percent of oral cancer victims have no lifestyle risk factors.”

Zila also encourages dentists to ask patients to sign a consent-to-treatment form if they get the test and a waiver if they decline it.

“You get the test the doctor recommends,” Zila’s Mazzarella said. “The consent-waiver form is about providing consistent care.”

The company also tells dentists it is possible the waiver could mitigate some malpractice issues in the event of a lawsuit involving an oral cancer diagnosis.

Andrew Hung of Missouri City said he and his wife didn’t feel like they were getting a hard sell from their dentist, exactly, but they weren’t comfortable paying out of pocket on the spot for an exam they don’t know much about.

“My impression is that if it were legitimately useful, there should be more insurance coverage of it,” he said. “If it’s truly useful then I will, but I’m low-risk. I’m 35. I don’t smoke or use tobacco, and I don’t even drink. I wouldn’t think I’d need it.”

January, 2008|Archive|

Camera puts the heat on cancer treatment side effects

  • 1/20/2008
  • Chicago, IL
  • Mallika Rao
  • Medill Reports (news.medill.northwestern.edu)

A military detection device designed by scientists at Illinois-based Argonne National Laboratory may soon help head-and-neck cancer patients battle the painful side effects of treatment.

The device, a thermal imaging camera able to detect temperature differences smaller than a tenth of a degree, came out of scientists’ work on a national security project. It could soon enable head-and-neck oncologists to predict individual patients’ reactions to therapy, says a team of Argonne researchers and University of Chicago doctors, and to tailor treatment accordingly.

The combined radiation/chemotherapy administered to most patients nearly always results in minor inflammation immediately, says Dr. Ezra Cohen, an oral oncologist who is heading up the University of Chicago team. “That inflammation should be accompanied by an increase in temperature,” he adds, one that the camera is equipped to sense. “Those who have a big increase, those we think are the patients that are going to have the bad side effects.”

The group has studied six patients so far, a few of whom have experienced both a dramatic early rise in temperature and severe side effects. The evidence is still too small to arrive at any significant conclusions, cautions Cohen, but the findings are encouraging.

While head-and-neck cancer accounts for only 3 to 5 percent of nationwide cancer incidence and is usually treatable, according to the National Institute of Health website, side effects from the most common therapies can be emotionally devastating and physically unbearable.

Radiation therapy, in which energy in the form of waves is used to destroy cells, is often the most effective treatment for head-and-neck cancers. It is not however, precise, and the radiation beam injures healthy as well as malignant cells. Though normal cells can eventually heal, the temporary damage leaves nearly 75 percent of patients with a short-lived condition known as mucositis, where sores in the mouth sometimes larger than 4 centimeters in diameter can render a patient unable to talk and reliant on a feeding tube, says Cohen. There are currently no products on the market that alleviate the symptoms of mucositis, according to an Argonne press release.

“The base of your tongue to the top of your mouth is pretty much just riddled with sores,” explains Cindy Bajda, a data manager at the University of Chicago Cancer Research Center. Bajda was diagnosed with buccal cancer nearly three years ago; her treatment brought on four months of mucositis. Because of her knowledge of head-and-neck cancer from work, however, she knew to expect it.

“My family was who I was concerned about,” she said. “I accepted it more than they did.”

Bajda’s intolerance for the combination radiation/chemotherapy was high, leaving her unable to eat even ice cream. “I could taste the salt in it,” she explains. She sustained herself on protein drinks and pain medications that induced her to “sleep through the pain”, and lost fifty pounds during the process.

The severity of reactions like Bajda’s could be lessened, Cohen says, if there is indeed a connection between temperature changes in radiation-treated areas and a susceptibility to mucositis. “There may be some patients where we can scale back on treatment,” he says. “Chances are a small reduction in treatment doesn’t affect the outcome.”

Though a therapy’s intensity does not necessarily correlate to its success, Cohen says starting every patient at a reduced level of treatment is not an option. “The paradigm of oncology is to try and use the highest amount possible, especially in a curative setting,” he explains.

Currently, patients who develop dangerously high toxicity or serious infections from radiation must simply delay treatment. If the camera identifies those patients before their reactions begin, that kind of upset could become avoidable, Cohen says.

For Bajda, who was the study’s first subject, the camera only echoed a possibility she already knew to be highly likely. But she says for those not familiar with the disease, it will provide a valuable service by helping them to prepare for a potentially disturbing experience.

“If you have colon cancer you don’t see what’s going on down there,” she says. “But mucositis is visible. It’s scary.”

And importantly, says Cohen, it attacks the body parts most significant in how people interact with the world.

“Speaking, eating – which is really a social endeavor, our sense of smell. When you begin to impair those things, it really has a profound impact on a patient’s sense of self.”

January, 2008|Archive|