Monthly Archives: May 2013

The Oral Cancer Foundation Honored as 2013 Top-Rated Nonprofit New GreatNonprofits.org Award is Based on Positive Online Reviews

Newport Beach, CA May 28, 2013 – The oral Cancer Foundation announced today that is has been honored with a prestigious 2013 Top-Rated Awarded by GreatNonprofits, the leading provider of user reviews about non-profit organizations.

 

“We are honored to be named a Top-Rated 2013 Nonprofit,” says Brian hill, Founder and Executive Director, The Oral Cancer Foundation. “We have found creative means to accomplish our missions; raise awareness, support patients, provide information, and sponsor research to accomplish important goals when our human and financial resources were minimal.”

 

The Top-Rated Nonprofit award was based on a large number of positive reviews that OCF received – reviews written by the patient population they serve and donors. Individuals could contribute more than a yes/no answer about questions regarding their personal experiences with the non-profit. For example, one person wrote, “I was 33 years old when I was diagnosed with Stage IV metastatic oral cancer. The treatments and surgeries that saved my life however left me disfigured, disabled and dependent on the opiate pain medication, Fentanyl. I felt lost and alone, without hope. I found the Oral Cancer Foundation website 11 months after diagnosis and it was a ray of light for me. I was able to connect with survivors and other patients who understood my struggle and related to where I was. With their advice and support I’ve been able to rebuild my body and free myself from the opiates, and begin to live again. I can’t express the gratitude in my heart for the Oral Cancer Foundation or the Angels of mercy who are the staff and volunteers that spend their time helping those in need.”

 

Being on the Top-Rated List gives donors a mechanism to compare and evaluate the worthiness of an organization when giving.

 

“We are gratified by The Oral Cancer Foundation for its work,” said Perla Ni, CEO of GreatNonprofits, “They deserve to be discovered by more donors and volunteers who are looking for a great non-profit for support.”

 

Being on the Top-Rated List gives donors and volunteers more confidence that this is a credible organization. The reviews by patients served and their family members, volunteers, and other donors show the on-the-ground results of this nonprofit. This award is a form of recognition by the community they serve.

 

About The Oral Cancer Foundation

The Oral Cancer Foundation is a non-profit 501(c)3, public service charity that provides information , support, research funding and advocacy related to this disease. It maintains a web site at http://www.oralcancer.org, which receives millions of hits per month. At the forefront of this year’s agenda is the drive to promote solid awareness in the minds of the American public about the need to undergo an annual oral cancer screening, and an outreach to the dental community to provide this service as a matter of routine practice. Supporting the foundation’s goals is a scientific advisory board composed of leading cancer authorities from varied medical and dental specialties, and from prominent cancer educational, treatment and research institutions in the United States.

 

About GreatNonprofits

GreatNonprofits is the leading site for donors and vounteers to find reviews and ratings of nonprofits. Its mission is to inspire and inform donors and volunteers, enable nonprofits to show their impact, and promote greater feedback and transparency. www.greatnonprofits.org

 

Media Contact
Brian Hill
bhill@oralcancerfoundation.org
949-278-4362

 

Noninvasive Detection, Diagnosis of Oral Cancer

Source: Science Daily
Date: May 23, 2013

 

More effective detection and diagnosis of oral cancer could result from an advance in noninvasive imaging of epithelial tissue by a Texas A&M University researcher. The research is thought to have the potential to change the way doctors initially look for precancerous and cancerous areas in a patient’s mouth.

The imaging technique, which is detailed in the Journal of Biomedical Optics, is being developed by Kristen Maitland, assistant professor in the university’s Department of Biomedical Engineering. It combines two separate technologies — confocal microscopy and fluorescence lifetime imaging — to noninvasively evaluate both the structural changes of tissue as well as molecular changes that take place on a cellular and tissue level. These morphological and biochemical changes are key factors in determining if tissue is precancerous or cancerous, Maitland says.

article

 

Fluorescence lifetime imaging with a 16×16 mm2 field of view detects tissue biochemical changes on the macroscopic scale, and (inset) confocal microscopy with a 0.4 mm diameter field of view is used to characterize size, shape, and spacing of cell nuclei to detect oral precancer and cancer (Credit: Texas A&M University)

 

 

Typically, such evaluations are made from lab analysis of biopsies, small amounts of surgically removed tissue. The challenge for doctors, Maitland says, is determining from what areas to take a biopsy. These determinations, she says, are largely based on visual evidence. In other words, doctors rely on the naked eye to look for problematic areas that warrant a biopsy. For doctors and patients both, it’s a bit of an educated guessing game. A biopsy from one area could be negative for cancer, but the tissue around it could be cancerous and remain undiagnosed.

That’s even more of a concern when it comes to oral cancer examinations, Maitland says. Visually determining the areas that warrant a biopsy can be difficult, she explains, because a patient’s mouth can manifest large, heterogeneous lesions that may be both benign and precancerous, which are indistinguishable by eye. Her system is designed to more precisely guide doctors to the troubled areas of a patient’s mouth through the use of optical images.

“We want to enhance a doctor’s ability to detect the worst state of disease in the mouth,” Maitland says. “This is about increasing the diagnostic yield. For example, rather than taking a few biopsies from random sites to represent a large heterogeneous lesion, our system can guide the clinician to biopsy the tissue with the worst state of disease to provide a more accurate diagnosis, as opposed to possibly missing the cancer or precancer.”

Working with Associate Professor Javier Jo, Maitland has paired two different types of imaging technologies into a single imaging system that makes use of macroscopic and microscopic approaches to produce a detailed analysis of tissue.

One technology, known as fluorescence lifetime imaging (FLIM), enables Maitland and Jo to image large areas of oral tissue with ultraviolet light in a manner that shows signs of the molecular changes associated with precancer and cancer, revealing potential trouble areas. Its overall effectiveness, however, is limited because FLIM can be “fooled” by inflamed tissue, which has a similar fluorescent signature to precancer, Maitland notes. To overcome this limitation, Maitland paired the technology with another technology known as confocal microscopy.

In contrast to FLIM, which focuses on greater areas of tissue, confocal microscopy is a single-point measurement (about 0.5 mm in this case) with a high sensitivity, Maitland says. It provides information about the morphological features of tissue — the same types of features a pathologist would examine in a histology section, such as the nuclear size of the cells and how densely packed the cells appear — important indicators of precancer, she notes. But just like FLIM, confocal microscopy has its own limitations, namely an incredibly small field of view (it’s not much bigger than the tip of a pencil). This limited field of view makes it difficult, if not impossible, to image an entire oral cavity with this technology — that’s where FLIM technology comes in, acting as a guide for the confocal microscopy utilized in this approach, Maitland explains.

“We think the combination of these two systems will address the limitations of other optical systems,” she says. “Think of the fluorescence imaging as being used for screening and the confocal microscopy being used for diagnosis. A doctor or dentist would first find the abnormal area with the fluorescence and then go in with the confocal to make the diagnosis because it’s a more specific technique.”

So far, the results have been promising. Maitland has been able to combine the two systems so that the macroscopic and microscopic images produced from each technology can be co-registered, meaning she can correlate those images to the same point on the tissue. Equally as important, each imaging technique is contributing valuable information, she notes.

“We’ve been able to get macroscopic images with the FLIM that show clear differences in signal and spatial features due to biochemical changes in the tissue that correlate with precancer, or the development of cancer,” Maitland says. “With the confocal microscope, we’re able to see changes in the nuclear size, and we have the necessary resolution and the depth of imaging that is required to characterize epithelial changes.”

Maitland cautions that there is still work to be done before this system proceeds to large-scale clinical trials. Her team is working to obtain more data points before claiming the sensitivity and specificity required from a system such as this. She’s in the process of analyzing additional data from a hamster model of oral cancer and working with the Baylor College of Dentistry to evaluate her imaging system on samples of human oral biopsy tissue.

“The hope is we develop a system that is in real time, so it provides accurate diagnostic feedback almost instantaneously, whereas the processing needed for traditional histopathology can commonly take up to a week or two,” Maitland says. “A system like ours could empower doctors with the ability to determine treatment right away rather than having a patient come back weeks later to be treated. It also would enable doctors to noninvasively monitor treatment in order to determine its effectiveness on the diseased tissue.”

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 
May, 2013|Oral Cancer News|

U.S. panel finds lack of evidence for oral cancer screening

Source: Dr. Bicuspid
By: Dr. Bicuspid Staff
April 9, 2013
 

A U.S. government-backed task force issued a statement this week saying that there is not enough published evidence to recommend for or against screening for oral cancer by primary care professionals.

Evidence is lacking on whether screening can accurately detect oral cancer and if earlier treatment of cancers found during those tests improves long-term health, according to the U.S. Preventive Services Task Force (USPSTF).

Their draft recommendation statement applies to people who do not have any signs or symptoms of oral cancer and is meant for primary care professionals screening for oral cancer. It is not a recommendation about the practices of dentists and oral health professionals, the panel noted.

The task force — an independent volunteer panel of national experts in prevention and evidence-based medicine — reviewed the current literature and found:

  • Inadequate evidence that the oral screening examination accurately detects oral cancer
  • Inadequate evidence that screening for oral cancer and treatment of screen-detected oral cancer improves morbidity or mortality
  • Inadequate evidence on the harms of screening; no study reported on harms from the screening test or from false-positive or false-negative test results

Seven studies (n = 49,120) examined the performance characteristics of the oral screening examination. These studies were generally conducted in settings with an increased incidence of and mortality from oral cancer (India, Taiwan) compared with U.S. rates, the panel reported. The studies also had considerable heterogeneity and demonstrated great variation in test performance characteristics. Across the seven studies, sensitivity for oral cancer or potentially malignant disorders ranged from 18% to 94.3% and specificity from 54% to 99.9%. The positive predictive value ranged from 17% to 86.6% and the negative predictive value from 73% to 99.3%.

Two studies in the U.K. looked at oral examinations performed by general dentists among older adults (age 40 years or older) at increased risk because of alcohol and tobacco use and a mixed sample with unknown risk factors. The dental examination in the high-risk sample (n = 2,027) showed a sensitivity of 74%, a specificity of 99%, and a positive predictive value of 67%, while the study of patients with unknown risk factors found a sensitivity of 71%, a specificity of 99%, and a positive predictive value of 86%.

Although the patients in the U.K. study may be similar to the U.S. population, the results of these studies were limited by an imperfect reference standard, by combining the detection of potentially malignant disorders with oral cancer and an unclear delineation of high-risk status, according to the USPSTF.

“The evidence shows that it is difficult to detect oral cancer and that the evidence is not clear whether oral cancer screening improves long-term health outcomes among the general adult population or among high-risk groups,” stated task force member Jessica Herzstein, MD, MPH, said in a news release. “We need more high-quality research on whether screening tests can accurately detect oral cancer and if screening adults for oral cancer in primary care settings improves health outcomes.”

But Brian Hill, executive director of the Oral Cancer Foundation, took issue with the task force’s recommendations.

“I put no weight on what the U.S. Preventive Services Task Force has to say about this since their determination was based on the evidence that no peer-review studies have been done to show that oral cancer screening has any impact on long-term outcomes,” he stated. “Lack of published data showing benefit or harm is only evidence of a lack of published data, not evidence of a negative finding.”

In addition, he said, “We know from the best database of disease rates and outcomes in the U.S., the SEER database [Surveillance, Epidemiology, and End Results] — which is how we track incidence, causes, and outcomes in the U.S. — that stage I oral cancer patients have better outcomes and stage IV patients have poorer outcomes. And stage I people have, besides longer lives, far fewer treatment-related morbidity issues to get to a point of no disease.”

The new recommendations, currently in draft form, are available for public comment April 9 through May 6.

 

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

Study reveals genetic diversity within tumors predicts outcome in head and neck cancer

Source: bionews-tx.com

Researchers at the Massachusetts General Hospital (MGH) and Massachusetts Eye and Ear Infirmary have developed a new way to predict the survival rate of patients who have squamous cell carcinoma of the head and neck, thanks to a study partially funded by a CPRIT grant. One of the problems with treating cancer is the degree of genetic heterogeneity within a tumor. What this means is that there are sub populations of tumor cells within a given tumor that have different mutations. This makes the cancer difficult to treat because some cells due to their different mutations will be resistant to the same treatment. According to Edmund Mroz, PhD at the MGH center for Cancer Research (lead author of a report in Cancer on May 20, 2013), this new method of measuring genetic heterogeneity can be applied to a wide range of cancers. (Additional co-authors included Curtis Pickering, PhD, and Jeffrey Myers, MD, PhD, both from the University of Texas M.D. Anderson Cancer Center.)

stage-2-head-neck-cancer

Prior to this study, genes and proteins that are involved with treatment resistance have been identified, however, there has been no way to measure tumor heterogeneity to predict patient survival. Mroz and his group of researchers working in the lab of James Rocco, MD, PhD at MGH developed this new measure by looking at advanced gene sequencing data to calculate a number that indicates the genetic variance found in sub populations of cells within a tumor. They dubbed this new procedure as the mutant-allele tumor heterogeneity (MATH). This measure of heterogeneity has the ability to predict not only the number of mutations present but how widely the particular mutations are shared within different sub populations of tumor cells. This research was published in Oral Oncology (March 2013) and was only able to demonstrate that patients with known factors predicting poor outcomes had lower survival rates or what is known as high MATH scores. So, further research was needed.

Mzor and colleagues have now looked at the tumors from 74 patients that had squamous cell head and neck cancer and analyzed their genetic data. These patients had completed their treatment and researchers had the outcome data as well. The MATH measure was applied and these researchers found that higher MATH scores were correlated with shorter survival and with patients who had genetic heterogeneity. This demonstrates that the MATH scores were well correlated with outcomes more so than earlier predictions based on what was known at the time as identifiable risk factors.

At the moment, the take home message is that MATH values along with clinical findings can help predict survivability based on tumor cell heterogeneity. Furthermore, MATH may be able to determine what type of therapy the patient is best suited for. For example, if their MATH score is high, this calls for therapies that are more aggressive to ensure tumor cell resistance doesn’t occur. On the hand, patients who have low MATH scores, need less aggressive therapeutic approaches.

Heartburn and throat cancer: is there a link?

Source: www.huffingtonpost.com
Author: staff

Heartburn may raise a person’s risk for throat cancer, but it seems that antacids could have a protective effect, according to a new study.

heartburn

The research, published in the journal Cancer Epidemiology, Biomarkers & Prevention, shows that people with a history of frequent heartburn, also known as acid reflux, have a 78 percent higher risk of developing vocal cord or throat cancers.

But they also found that for people with frequent heartburn, taking antacids can lower risk of these cancers by 41 percent.

“Additional studies are needed to validate the chemopreventive effects of antacids among patients with frequent heartburn,” study researcher Scott M. Langevin, Ph.D., a postdoctoral research fellow at Brown University, said in a statement. “The identification of gastric reflux as a risk factor for throat and vocal cord cancers, however, may have implications in terms of risk stratification and identification of high-risk patients.”

The study included 631 people who were part of a case-control study in Boston, 468 of whom had throat cancer and 163 of whom had vocal cord cancer, as well as 1,234 people with no cancer history. Researchers analyzed family history of cancer, smoking history and drinking history of all the study participants, as well as presence of HPV 16 viral protein antigens since HPV can cause some head and neck cancers.

Researchers found that the increased risk for throat and vocal cord cancers was higher among the people experiencing frequent heartburn, even when they had no history of smoking or drinking. Also, prescription drugs or home remedies didn’t seem to be protective against the increased cancer risk from heartburn.

“Our data show that gastric reflux is an independent risk factor for squamous cancers of the pharynx and larynx,” researchers wrote in the study. “Further studies are needed to clarify the possible chemopreventive role of antacid use for patients with gastric reflux.”

However, it’s important to note that long-term antacid use doesn’t come without risks. Everyday Health reported that chronic use of over-the-counter antacids may raise esophageal cancer risk. And a type of gastroesophageal reflux disease medicine called proton-pump inhibitors may weaken bone density; therefore, people with heartburn who are taking antacids should talk to their doctors about the best options for them.

In a Q&A in the Chicago Tribune, the Mayo Clinic noted that antacids should usually only be used for short amounts of time. And of course, the best way to avoid all these risks — both of heartburn and of long-term antacid use — is to try to solve the root of the heartburn.

Big Data Unveils Exciting Head and Neck Cancer Targets

BioscienceTechnology.com
Cynthia Fox
Monday, May 20, 2013

 

Genome sequencing of head and neck cancers may quickly—and soon—spur new therapies. There are 20 tumor types being studied by the massive, $100 million Cancer Genome Atlas (TCGA) project. Head and neck squamous cell carcinoma (HNSCC) is the eighth to be unveiled. The first, glioblastoma, has been cited in a whopping 2000-plus manuscripts.

“That’s an enormous number of citations,” said University of North Carolina medical oncologist David Hayes at the recent American Association for Cancer Research (AACR) meeting. Yet, “the squamous cell carcinoma of the head and neck dataset is much, much bigger.

“This is a very big project.”

Much clinically relevant HNSCC data was released at AACR, and more will be released at the May American Society of Clinical Oncology meeting, Hayes said in an email. Hayes is national co-chair of TCGA’s Data Analysis Subgroup. The frequently fatal HNSCC is the fifth most common cancer globally; sixth in the US. It is overwhelmingly associated with smoking (80% attributable risk). The rest is linked to an epidemic of the Human Papilloma Virus (HPV).

Conducting an exhaustive series of genomic tests on tumor samples from 279 patients, the overarching find made by Hayes’ hundreds-strong TCGA group was that HNSCCs fall into four clinically relevant subtypes: basal, mesenchymal, atypical, and classical.

Furthermore, there are surprising, major similarities between lung cancer and non-HPV (smoking) related HNSCCs, and between cervical cancer and HPV-related HNSCCs.

For instance, in non-HPV-driven cancers, the group located more than 30 sites of significant “somatic copy number alteration,” or sites of major alteration in gene copy numbers, most of which were identical to those of lung squamous cell carcinoma.

Much of this was unknown. It suggests we can look at cancers like HNSCC as “molecular patterns that can be leveraged and understood,” Hayes said. Drugs for one cancer can be “easily transferred” to cancers once thought different, but are suddenly unveiled as genetically alike.

The findings the HNSCC group is making, as with other cancers exhaustively sequenced for the government-sponsored TCGA, are overwhelming in number. They will keep researchers busy for years. But TCGA groups are also producing data with more immediate clinical potential.

The HNSCC group isolated for the first time the 18 most-mutated HNSCC genes, the “most important genes in this cancer…the driving genes,” Hayes said. Many are potential targets.

Yet their absence can lead to targets, too. The group noted that HPV-driven HNSCCs “almost never have a TP53 mutation.” This isn’t “therapeutically actionable,” as it is not a druggable mutation. But the group saw that those HPV-negative patients who don’t possess the TP53 mutation do tend to have a mutation in a “very druggable gene: H-Ras,” Hayes said. (About 5% of samples possessed this mutation.)

Existing drugs may indeed successfully target H-Ras mutations, the way they can’t other Ras oncogenes, says Frank McCormick, outgoing AACR president, and director of the University of California San Francisco Comprehensive Cancer Center.

“H-Ras is likely to be druggable through inhibition of farnensylation,” McCormick said in a recent email. “Farensyl transferase inhibitors (FTIs) are thought to have failed because K-Ras and N-Ras have a back-up system. Mutations in K-Ras and N-Ras are far more common than H-Ras, as we now know, so most of the tumors on which FTIs were tested didn’t respond. However, tumors driven by H-Ras, though rare, are likely to respond to FTIs. Now that patient selection is feasible (which it wasn’t 20 years ago when FTIs were being tested), it should be possible to select H-Ras-driven cancers up-front, then treat with FTIs.”

Translation: oncologists could start treating that new subset of HNSCC patients with promising drugs—soon.

The HNSCC group has identified at least two other immediate “candidate therapeutic targets,” Hayes said. First, they found that a certain mutation in the gene PIK3CA occurs in almost 40% of HPV-driven tumors. “So that is a very near-term actionable observation.” Drugs inhibiting PIK3CA are in the pipeline for cancers of the breast, among others.

And in HPV-negative samples, the group confirmed there is a large number of high-frequency mutations in genes, including epidermal growth factor receptor (EGFR) and cyclin D1 (CCND1), that could be clinically addressed in the “relative short term,” he said.

Still, not every patient has a druggable mutation, he cautioned. The new data have “complicated” things. Yet they also let researchers “recognize patterns and simplify things.”

In a PLOS One paper, the group explained further: “The differences in the expression patterns found in the (four new) subtypes are clinically relevant.”1 They discovered the gene Np63 is overexpressed in the “basal” subtype. Earlier, another group found exposure to the widely used cancer drug cisplatin led to decreased levels of Np63.2 “So this treatment may be particularly effective for patients in (the “basal” subgroup).”

The group has also found conflicting data arousing “great interest,” says Hayes. EGFR-targeting drugs have been given to all kinds of HNSCC patients ever since other researchers found EGFR is over-amplified in many.3 Indeed, the FDA approved an EGFR-inhibitor for metastatic HPV-positive HNSCC. But Hayes’ group found EGFR expression is low in the new “atypical” subtype, and in those very same HPV-positive cancers. Work is ongoing to “figure out” that one.

The group also revealed in PLOS that P13 Kinase inhibitors may be an attractive option for patients with both the “atypical” and “classical” subtypes. And SOX2 and ALDH1—putative cancer stem cell markers—were found to be highly expressed in the “atypical” and “classical” HNSCCs: two possible future targets.1

The 279 tumor samples have yielded the largest genomic dataset for each typical HNSCC site (e.g., oral cavity, larynx, hypopharynx, oropharynx) by a factor of at least two.

But the landslide of data is far from over. By year’s end, says Hayes, the group will announce analysis results from 200 additional HNSCC samples.

 

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

May, 2013|Oral Cancer News|

Bankruptcy Rate Doubles With Cancer Diagnosis

Nick Mulcahy
May 15, 2013
Medscape Today

 

Adults diagnosed with cancer are 2.65 times more likely to declare bankruptcy than adults without cancer, according to a new study.

In addition, bankruptcy rates are 2- to 5-fold higher among younger cancer patients than among older cancer patients, report the study authors, led by Scott Ramsey, MD, PhD, an internist and health economist at the Fred Hutchinson Cancer Research Center in Seattle, Washington.

Dr. Ramsey and colleagues used various databases to match cancer patients diagnosed from 1995 to 2009 with adults without cancer in western Washington.

Of 197,840 adults who were diagnosed with cancer in that region during the study period, 4408 (2.2%) filed for bankruptcy protection after diagnosis. Of the age- and sex-matched control population without cancer, only 2291 (1.1%) filed for bankruptcy.

“This study found strong evidence of a link between cancer diagnosis and increased risk of bankruptcy,” the authors write in their paper, which was published online today in Health Affairs.

The relation between a cancer diagnosis and bankruptcy is less well understood than that between high medical expenses and the likelihood of a bankruptcy filing, according to a press statement.

“This is an important study,” said Melissa Jacoby, JD, from the University of North Carolina School of Law in Chapel Hill, in an email to Medscape Medical News. She is is an expert in bankruptcy, but was not involved in this research.

The relative — not the absolute — rate of bankruptcy among cancer patients is most notable here, she said.

“Remember that bankruptcy filings, at any given snapshot in time, are a small proportion of the population,” Dr. Jacoby pointed out. “The bankruptcy filing rates are significantly higher in the cancer patients than in the control group; that’s the important takeaway message.”

Furthermore, bankruptcy filings are “the tip of the iceberg” in terms of financial distress, she added. “Many people” qualify to file but do not for reasons that include being too broke for lawyer’s fees. “Yes, you can be too cash-strapped to go bankrupt,” Dr. Jacoby said.

Some people will go to great lengths to avoid bankruptcy, she explained. “They will sell property, deplete all savings, borrow from family and friends. Years later, they may ultimately have to file anyway.”

It is death by a thousand cuts.

She noted that the financial effects of a cancer diagnosis include indirect costs, such as job loss, the related loss of insurance, and the cost of traveling to distant specialty facilities. The direct costs are typically cumulative. “It isn’t necessarily just one giant catastrophic medical bill; it is death by a thousand cuts, so to speak. They pile up quickly.”

Strong Evidence

Dr. Ramsey and colleagues analyzed data from the Cancer Surveillance System of Western Washington, a population-based cancer registry that is part of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. They compared adults with cancer with a random sample of people without cancer matched for age, sex, and ZIP code.

The cancer and control cohorts were both linked to the records of the US Bankruptcy Court for the Western District of Washington; only chapter 7 and chapter 13 bankruptcy filings were included. Chapter 7 debtors liquidate assets such as bank accounts, investments, and second cars or homes to pay creditors and be discharged of debt; chapter 13 debtors pay back their debts over time and retain ownership of most assets.

This study provides the “strongest evidence we have between a disease and risk for severe financial distress,” Dr. Ramsey said in the press statement. “I’ve not seen other studies that linked databases of this quality.”

The authors found that bankruptcy filing rates differed “greatly” by age in the cancer patients. Younger people with cancer experienced the highest bankruptcy rates for all types of cancer. Bankruptcy filing rates were much lower for cancer patients 65 years and older than for those younger than 65 years.

There is an explanation for the age-related risk for bankruptcy, the authors note. “People age 65 or older generally have Medicare insurance and Social Security benefits…. It is likely that having stable insurance (specifically, coverage not tied to employment) plays a major role in mitigating the risk of bankruptcy,” they state.

 

Table. Incidence of Bankruptcy 1 Year After a Cancer Diagnosis

Cancer Type                          Incidence (Per 1000 Person-Years), %
Thyroid 9.3
Lung 9.1
Uterine 6.8
Leukemia/lymphoma 6.2
Colorectal 5.9
Melanoma 5.7
Breast 5.7
Prostate 3.7

 

The high incidence of bankruptcy among patients with thyroid cancer could be related to the fact that thyroid cancer mainly affects younger women. “Compared to men, younger women are more likely to live in single-income households and to have lower wages and lower rates of employment, and therefore less access to high-quality health insurance — leaving them more financially vulnerable,” the researchers explain.

For clinicians who want to inform patients about bankruptcy-related resources, Dr. Jacoby recommends the Access Project at Brandeis University in Boston, Massachusetts. She also pointed out that some cities in the United States have health law projects that might be helpful.

The US Congress has “made it difficult” to file for bankruptcy without legal representation because of complexities in the system, she added. “Some people do file without a lawyer, but they risk making mistakes that can substantially reduce the protection that bankruptcy offers.”

The study was funded by the National Center on Minority Health and Health Disparities at the National Institutes of Health.

Health Affairs. Published online May 15, 2013. Abstract

 

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

May, 2013|Oral Cancer News|

Cancer jabs for girls

Katharine Child & Denise Williams
16 May, 2013 01:15
Source: Times Live
Image by: Gallo Images/Thinkstock

 

Fresh from his battle to reduce HIV infections and make antiretrovirals freely available to almost two million South Africans infected with the virus that causes Aids, Health Minister Aaron Motsoaledi is now taking on cervical cancer.

 

In parliament yesterday, Motsoaledi announced that girls as young as nine at poorer primary schools would be given free vaccinations against human papilloma virus (HPV) from February.

As many as 520000 girls aged between nine and 10 will be vaccinated against HPV, which causes cervical cancer.

It is important that girls be vaccinated before they are sexually active if they are to be protected against HPV.

More South African women are killed by cervical cancer than by any other type of cancer. Black women and HIV-positive women are particularly vulnerable to the disease.

The drive to vaccinate schoolgirls was prompted by the severity and prevalence of the disease in young women, said Motsoaledi.

He said it was not known what the vaccination roll-out would cost but he was negotiating with pharmaceutical companies on the pricing of the vaccine.

“It’s not about the money; it’s about the human suffering … we are obliged at all times to put money aside for treatment but we are not obliged at all times to put money aside for prevention,” said Motsoaledi.

He said about 6000 women were treated each year for cervical cancer in public hospitals at a cost of R100000 a patient. Of these patients, 3500 died each year. In total, the cost to the state of cervical cancer treatment was about R600-million a year.

Cervical cancer, caused by two strains of the HPV, is less prevalent than breast cancer but kills more people. In South Africa, about 80% of cervical cancer fatalities are black women.

The virus is sexually transmitted.

The vaccine costs between R500 and R750 a dose and three doses must be administered over a six-month period forit to be effective.

University of Stellenbosch gynaecologist Haynes van der Merwe said Motsoaledi’s announcement was ”indeed good news” acrobat xi download.

In the US, a similar vaccination programme has been largely ineffective because too few girls were given all three injections over six months. But Australia has effectively rolled out the HPV campaign to schoolgirls aged 12 to 13.

Advocacy group Equal Education welcomed the move. Its deputy general secretary, Doron Isaacs, urged a roll-out of condoms at schools as well.

Motsoaledi’s spokesman, Joe Maila, said the vaccine was not being made available to boys because HPV caused cancer in girls but genital warts in boys.

“Because of this [severe effect on] girls, we have targeted them as a starting point.”

But the Centres for Disease Control in the US, and the SA Dental Association, have called for boys to be vaccinated before they are sexually active.

This is because young men worldwide are contracting deadly oral and throat cancers caused by the HPV.

The increase in throat and oral cancer among people under the age of 45 was “massive”, said University of Pretoria dental professor Andre van Zyl. He said throat cancers were previously most commonly diseases of old people and heavy smokers.

“Oral sex is perceived to be a safer sexual behaviour in an Aids-dominated world,” said Van Zyl.

“However, though it is true that the spread of HIV infection is lowered by non-genital sex, the spread of HPV has become more prevalent and, in turn, the incidence of HPV-related throat cancer has increased dramatically over the past decade,” said Van Zyl.

“These young people could never imagine that they might develop throat cancer so it is imperative that they visit the dentist regularly.”

Van der Merwe urged women to visit a gynaecologist once a year for an examination to detect precancerous cells before they develop into cervical cancer.

“At Tygerberg hospital yesterday we saw 16 patients with cervical cancer. Most present themselves too late for treatment,” said Van der Merwe.

 

 * This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

May, 2013|Oral Cancer News|

Public lacks awareness of head and neck cancer

Source: www.alberniportal.ca
Author: Leatitia Michael

A survey reveals that the general public, including those who smoke, do not know very much about oral, head, and neck cancer (OHNC).

There were nearly 40,000 new cases of oral, head and neck cancer diagnosed last year in the USA, of which 85 per cent could be linked to tobacco use and heavy alcohol consumption. Yet, according to a survey from the Medical University of South Carolina, the public remains largely unaware of the risks.

In the study, over 1,000 members of the public were telephoned and 62 per cent said they were not knowledgeable about OHNC. Among smokers, the lack of awareness ran at 58 per cent. Under half of non-smokers and smokers knew that smoking was a risk factor. Hoarseness was correctly identified as a symptom by only one per cent of smokers and two per cent overall. But 17 per cent of the sample incorrectly named headache as a symptom.

People can spot the signs and symptoms of OHNC themselves, but 94 per cent had not been told to look for problems like mouth sores that do not heal. And only 26 per cent had been check for this by a doctor. Clearly there is some way to go in raising awareness among the public of OHNC.

Michael Douglas: It took doctors nine months to figure out walnut-sized tumor at the back of my tongue was throat cancer

Source: www.nydailynews.com
Author: Corky Siemaszko

Michael Douglas said the tumor at the back of his tongue was the size of a walnut, but it still took doctors nine months to figure out it was throat cancer.

“I knew something was wrong,” he said. “My tooth was really sore, and I thought I had an infection.”

But the ear-nose-and-throat doctors and periodontists he consulted kept giving him antibiotics.

“And then more antibiotics, but I still had pain,” he said.

Finally, in 2010, a doctor in Montreal figured out that thing on his tongue was tumor.

“Two days later, after the biopsy, the doctor called and said I had to come in,” Douglas recalled in a wide-ranging interview with New York magazine. “He told it me it was stage-four cancer. I said, ‘Stage four. Jesus.’

“And that was that. After complaining for nine months and them not finding anything, and then they told me I was stage four? That was a big day.”

Douglas not only talked about his brush with mortality, he also chatted about his Hollywood comeback. He plays flamboyant piano tickler Liberace in an HBO biopic, “Behind the Candelabra,” that airs May 26.

“Liberace loved sex,” he said.

But the “Wall Street” star’s revelation that he had cancer sent a scare through Hollywood, where the words “stage four” were looked at as a death sentence. And for a time, Douglas looked like hell — losing 45 pounds as he subsisted on mostly on matzo ball soup as he healed.

douglas

Weakened by chemotherapy and radiation treatments, Douglas said he spent hours lying on a couch. Douglas looked like hell while recovering from cancer — losing 45 pounds as he subsisted on mostly on matzo ball soup.

“I watched a lot of sports, anything where I didn’t know the ending,” he said.

But Douglas was lucky to have a curable kind of cancer and now he’s back at work feeling a “new rejuvenation.”

Douglas said he believe his illness was “karmic retribution” for his decades of success, including two Academy Awards and four Golden Globes.

“That’s life,” said Douglas, 68. “I was ready for some karmic retribution.”

Douglas may be on the mend, but he’s hit other bumps in the road. His glamorous wife, actress Catherine Zeta-Jones, remains in rehab, where she has been fighting depression.

His troubled 34-year-old son by his first wife is doing time for distributing crystal meth — and recently had nearly five years added to his sentence after he was caught doing drugs in prison.

“I have gone from being a very disappointed but loving father who felt his son got what was due him to realizing that Lady Justice’s blindfold is really slipping,” he said. “I’m not defending Cameron as a drug dealer or drug addict, but I believe, because of his last name, he’s been made an example.”

Douglas, who has two kids with Jones, has expressed regrets in the past about being a lousy dad to Cameron. And he has spoken about growing up in the shadow of his famous father, actor Kirk Douglas.

“Success is expected, and yet the track record of the second generation is not great,” he said. “Only a small group of us, like Jane Fonda, have succeeded.” Fonda’s dad was actor Henry Fonda.

“The good and the bad of being second generation is: There are no illusions,” he said. “I always knew that this was a business. It can be wonderful, but it is a business.”