Unnecessary Biopsies Reduced By Team Work, St. Louis University Researchers Find

Source: www.medicalnewstoday.com Author: press release Unnecessary biopsies could be a thing of the past for patients undergoing treatment for head and neck cancer. New Saint Louis University research found that when nuclear medicine clinicians and treating physicians work together to interpret PET-CT scan results, the accuracy dramatically improves, sparring patients unnecessary pain and suffering. Often used prior to and after cancer treatment, the highly sensitive PET-CT has improved the ability to detect and treat head and neck cancer. However, it can give a significant number of false positive results, which then require a biopsy to rule out cancer that could have been left behind during the initial treatment. According to Mark Varvares, M.D., the study's lead author and the Donald and Marlene Jerome Endowed Chair in Otolaryngology - Head and Neck Surgery at Saint Louis University, both nuclear medicine and treating physicians have become better at interpreting PET-CT scans. "If we improve the accuracy of the scans by including clinical information, the treating physician or cancer specialist will be able to say with confidence that we do not need to biopsy something - that it's just post-operative inflammation." Unnecessary biopsies are dangerous for head and neck cancer patients who have already undergone intensive radiation and chemotherapy. It can create a non-healing situation that can result in a catastrophic event, such as needing to remove the voice box, Varvares explained. Varvares and his colleagues studied the scan results of 180 head and neck cancer patients who had undergone evaluation with PET-CT [...]

Presence of Human Papillomavirus Infection Has No Prognostic Value in Tongue Cancer Patients: Presented at AHNS

Source: Doctors Guide (www.docguide.com) Author: Arushi Sinha The presence of human papilloma virus (HPV) infection does not appear to have any prognostic effect in patients treated for base-of-tongue (BoT) cancer, according to research presented here at the American Head and Neck Society (AHNS) 7th International Conference on Head and Neck Cancer. Investigator Mary Reid, PhD, Department of Epidemiology, Roswell Park Cancer Institute, Buffalo, New York, presented the findings in a poster session on July 20. According to Dr. Reid, HPV has been shown to be associated with oral and laryngeal carcinomas. Therefore, the research team conducted the study to identify characteristics of patients diagnosed with BoT carcinomas and outcomes in patients with or without HPV infection. The researchers studied patient charts for 87 patients with BoT; the majority of patients comprised Caucasians (93%) and males (87%). The average age of the study cohort was 59 years. Forty-seven percent of the study population were smokers, 29% were former smokers, and 24% had never smoked at the time of diagnosis. In addition, 24% of patients reported heavy alcohol use. Of the group, 98% were diagnosed with squamous cell carcinoma and 74% had advanced stage IV disease. The researchers identified a smaller subset of 30 patients for whom tissue samples were used to detect the presence of HPV, specifically the HPV 16 strain, using polymerase chain reaction techniques. Twenty of the 30 patients (66%) tested positive for HPV infection. There were similarities among tested and nontested patients with respect to alcohol consumption, race, [...]

Cranberry and Grape Seed Extracts Inhibit the Proliferative Phenotype of Oral Squamous Cell Carcinomas

Source: eCAM Advance Access published online on July 23, 2008 Author: Kourt Chatelain et al. Proanthocyanidins, compounds highly concentrated in dietary fruits, such as cranberries and grapes, demonstrate significant cancer prevention potential against many types of cancer. The objective of this study was to evaluate cranberry and grape seed extracts to quantitate and compare their anti-proliferative effects on the most common type of oral cancer, oral squamous cell carcinoma. Using two well-characterized oral squamous cell carcinoma cell lines, CAL27 and SCC25, assays were performed to evaluate the effects of cranberry and grape seed extract on phenotypic behaviors of these oral cancers. The proliferation of both oral cancer cell lines was significantly inhibited by the administration of cranberry and grape seed extracts, in a dose-dependent manner. In addition, key regulators of apoptosis, caspase-2 and caspase-8, were concomitantly up-regulated by these treatments. However, cranberry and grape seed extracts elicited differential effects on cell adhesion, cell morphology, and cell cycle regulatory pathways. This study represents one of the first comparative investigations of cranberry and grape seed extracts and their anti-proliferative effects on oral cancers. Previous findings using purified proanthocyanidin from grape seed extract demonstrated more prominent growth inhibition, as well as apoptosis-inducing, properties on CAL27 cells. These observations provide evidence that cranberry and grape seed extracts not only inhibit oral cancer proliferation but also that the mechanism of this inhibition may function by triggering key apoptotic regulators in these cell lines. This information will be of benefit to researchers interested in elucidating which [...]

The Biological Mechanisms of Cancer-Related Skeletal Muscle Wasting: The Role of Progressive Resistance Exercise

Author: Sadeeka Al-Majid, RN, PhD et al. Source: Biological Research For Nursing, Vol. 10, No. 1, 7-20 (2008) Cancer results in perturbations in skeletal muscle protein metabolism leading to muscle wasting. Although severe wasting is seen primarily in persons with advanced malignancies, a number of cancer patients show some degree of wasting at presentation. Although cancer-related skeletal muscle wasting is attributable, in part, to decreased muscle protein synthesis, its primary cause appears to be increased muscle protein degradation. Although several proteolytic systems may be involved, compelling evidence suggests that the major system responsible for skeletal muscle protein degradation in cancer is the ATP-dependent ubiquitin— proteasome system. Other contributing factors include proinflammatory cytokines and the tumor-released proteolysis-inducing factor. Decreased physical activity and decreased nutritional intake may also play a role. Cancer-related skeletal muscle wasting is clinically significant because of its profound effects on functional outcomes and quality of life. Nevertheless, no specific interventions have proved to be effective in preventing or reversing the problem. Interventions such as nutritional supplementation and appetite stimulants are only partially helpful. A nonpharmacologic intervention that may attenuate cancer-related skeletal muscle wasting is progressive resistance exercise training (PRT). PRT is a potent stimulus of growth in muscle mass and strength. PRT may attenuate cancer-related skeletal muscle wasting by downregulating the activity of proinflammatory cytokines and by increasing the phosphorylation of intramuscular amino acid—signaling molecules. This article discusses several cancer-related skeletal muscle wasting mechanisms and proposes how PRT might attenuate muscle wasting by counteracting some of these mechanisms. [...]

Cancer survivors now volunteer to help those who need support

Source: Aikens Standard (www.aikenstandard.com) Author: Rachel Johnson Four times cancer has struck the same Aiken household, and four times the Flanagans waged war. In August 2007, the unthinkable happened at the Flanagan home. While shaving one morning, Bill Flanagan's hands stumbled across a lump in his throat area. Having battled cancer in the past, his suspicions were raised. Initially, his wife and doctors thought the problem was a simple inflammation; however, when tests came back, the problem was not so simple. The couple canceled vacation plans, and Bill underwent a series of tests and a biopsy. Despite the diagnosis of stage 4 throat cancer, he was lucky. "I found mine accidentally. It was a little sore. Throat cancer is not usually found until the symptoms are too bad," said Bill Flanagan from his Aiken home. The outlook for Flanagan was bleak. A lover of fine cuisine, he faced feeding tubes, a tracheotomy and loss of voice. Doctors wanted to perform surgery to remove the tumor, and his fate almost certainly included the aforementioned. At 75 years of age, Flanagan knew one thing, he would in time die; but he was not willing to sacrifice his quality of life. "I set the perimeters - no feeding tube, no tracheotomy and no voice loss. I would've rather died from the cancer than lose my quality of life," he said with conviction. Flanagan and his wife of 33 years, Crystal, are no strangers to battling cancer. Crystal is a breast cancer and ovarian [...]

Dead serious – Cancer victim urges smokers to give up

Source: Sunday News (www.stuff.co.nz/sundaynews) Author: Cath Bennett Adrian Pilkington places his finger over his tracheostomy opening in the Ministry of Health advertisements, before giving audiences the grim warning: "It's not worth it, eh." The south Auckland mechanical engineer knows how tragically true his message is his 30-year, 20-a-day habit led to the mouth and lung cancer which will probably cost his life by Christmas. "My life has been ruined because of this but others can learn from my mistake," Adrian, 52, told Sunday News: "Getting cancer from smoking is something that always seems to happen to someone else you don't expect it to affect you. "If people knew the horror of what I've been through the radiation, the pain they wouldn't smoke. "I didn't even realise I could get mouth cancer from smoking before." The once-fit gym-going, karate black belt's future went up in smoke after he discovered a mouth ulcer 18 months ago. His weight plummeted 24kg and the ulcer was diagnosed as mouth cancer leading to a 12-hour operation to remove his entire tongue. It was replaced with a flap of skin and muscles from his stomach, leaving him unable to eat, drink or swallow ever again he is fed liquid nutrition through a tube in his stomach. In March this year, matters got even worse when he was told the cancer had spread to his lungs and he had only six to 12 months to live. "It came as a shock I couldn't believe it," Adrian said. [...]

Influence of years of professional experience in relation to the diagnostic skill of general dental practitioners (GDPs) in identifying oral cancer and precancerous lesions

Source: Int Dent J, June 1, 2008; 58(3): 127-33 Author: P Lopez-Jornet et al. Objective: To evaluate skill in diagnosing cancer and oral precancerous lesions among general dentists in the Autonomous Community of Murcia (Spain). Material and Method:  Twenty randomly distributed clinical images were used, of which 45% corresponded to benign lesions, 35% to oral precancerous lesions, and 20% to oral cancer. Each case was accompanied by a summarised clinical history. The study sample comprised 150 general dentists divided into two groups: group I (60 recently graduated dentists without professional experience) and group II (90 dentists with established professional activity). Results: In group I, the sensitivity of oral cancer diagnosis was 61.3% versus 85.5% in group II (p < 0.001), while the sensitivity of precancerous lesion diagnosis was 71.7% in group I versus 80.7% in group II (p = 0.004). Conclusions: The results obtained show that junior dentists and general dentists with public or private practice need more training and more experience in diagnosing cancer and oral precancerous lesions. Authors: P Lopez-Jornet, F Camacho-Alonso, Y Martinez-Beneyto, and J Seoane-Leston Authors' affiliation: Clínica Odontológica Universitaria Hospital Morales Meseguer, Murcia, Spain

MicroRNA and oral cancer: Future perspectives

Source: Oral Oncol, July 10, 2008 Author: Carolina C Gomes and Ricardo S Gomez MicroRNAs (miRNAs) are small non-coding RNAs that mediate gene expression at the post-transcriptional level by degrading or repressing target messenger RNAs (mRNA). They are about 22 nucleotides in length and regulate mRNA translation by base pairing to partially complementary sites, predominantly in the 3' untranslated region (3' UTR) of mRNA. In this review, we discuss miRNA biogenesis and function, together with its possible involvement in oral cancer. Despite its great importance in normal cell development and diseases, a small number of studies have attempted to investigate miRNA in oral cancer. Overexpression of oncogenic miRNA may reduce protein products of tumor-suppressor genes. On the other hand, loss of tumor-suppressor miRNA expression may cause elevated levels of oncogenic protein. One or both of these alterations could represent new targets for cancer diagnosis and treatment in the future. Many researchers have focused on genetic and epigenetic alterations in oral squamous cell carcinoma cells. The emergence of miRNA knowledge, and its potential interactive action with such alterations, therefore creates a new understanding of cell transformation. Authors' affiliation: Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

Role of Surgery in Multimodal Treatment of Oral and Oropharyngeal Cancer

Source: Laryngorhinootologie, July 15, 2008 Authors: M O Scheithauer and H Riechelmann Background: The value of surgery in multimodal treatment concepts of oral and oropharyngeal cancer, respecting quality of life and survival rates, should be evaluated. Patients: Patients with oral or oropharyngeal cancer were grouped, if tumor-targeted surgery was part of a multimodal treatment concept or if the patients received radiotherapy with or without chemotherapy only. Surgical versus non-surgical therapy, age, disease extent, tumor site and comorbidity as measured by the American Society of Anesthesiologists (ASA) physical status score were included in a Cox proportional hazard analysis. Quality of life was assessed 3 years following treatment employing the EORTC-C30 and H&N35 questionnaires. Results: Patients treated with radiotherapy with or without chemotherapy only (63/140) had a worse survival (hazard ratio 1.7037, 95 % CI 0.9981 to 2.9080, p = 0.0508) than patients treated with surgery (77/140) as a part of a multimodal treatment concept. Disease extent (p < 0.01) and ASA score (p < 0.01) had a significant impact on survival. Quality of life scores were remarkably similar in surgically and non-surgically treated patients. Conclusions: The results of this study indicate that surgery remains a core modality of oral and oropharyngeal cancer treatment. External beam radiotherapy only, also if applied in current fractionation techniques, may not be sufficient to achieve adequate results. Authors' affiliation: Universitäts-HNO-Klinik Ulm (Arztl. Direktor: Prof. Dr. G. Rettinger).

Merck Responds To Questions About Adverse Events Reported Following Vaccination With GARDASIL®

Source: Medical News Today (www.medicalnewstoday.com) Authors: Press Release Merck issued the following statement to address questions about adverse events reported in people who had received GARDASIL [Human Papillomavirus Quadrivalent (Types 6, 11, 16, 18) Vaccine, Recombinant]. Merck has analyzed the adverse events reported for GARDASIL relating to the recent reports of death and paralysis, and based on the data available to Merck, believes that no safety issue related to the vaccine has been identified. These types of events are events that could also be seen in the general population, even in the absence of vaccination. An adverse experience report describes an event that occurred after vaccination and does not necessarily mean that the vaccine caused or contributed to the event. The vast majority of adverse events that have been reported to Merck are non-serious and the most common include dizziness and syncope (fainting). "Merck is proud of the public health benefit that GARDASIL can provide in helping to prevent cervical cancer and other HPV diseases caused by HPV types 6, 11, 16 and 18 throughout the world and we remain confident in the safety profile of GARDASIL," said Richard M. Haupt, executive director, Clinical Research, Merck Research Laboratories. "Merck encourages health care providers and consumers to report any adverse experience associated with GARDASIL to the Company and to the U.S. Vaccine Adverse Event Reporting System so that the Company can continue to thoroughly monitor the safety of this important vaccine." Merck continues to evaluate all safety data in the context [...]

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