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ACS awards $1.7M to study racial disparities in HNC patients

Sat, Jul 12, 2014

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Source: http://www.drbicuspid.com/
Author: DrBicuspid Staff

The American Cancer Society (ACS) has awarded a $1.7 million grant to Philadelphia researchers to investigate factors that may contribute to the racial disparities seen among those diagnosed and treated for head and neck cancers (HNC) — specifically head and neck squamous cell carcinoma (HNSCC).

While head and neck cancers account for only 3% of all cancers in the U.S., a disproportionately high number of African Americans are affected. Recent research has shown that other biological factors, and tobacco and alcohol use, may have a role in the development of these cancers. Other studies suggest that low socioeconomic status and poor healthcare access are the main contributors to this disparity.

“Studies on genes involved in tobacco and drug metabolism and efflux suggest an association of genetic variants with head and neck cancer risk and survival in populations of European and Asian ancestries,” stated Camille Ragin, PhD, an associate professor at the Fox Chase Cancer Center and the study’s principal investigator, in a press release. “Genetic variants associated with the survival disparity of head and neck cancer in African-derived populations, however, is not yet clear.”

An accumulation of cancer-causing compounds occurs when products from tobacco smoke enter the body’s cells, in some cases enabled by alcohol, and are broken down by proteins. Variations in the genetic code that generate these proteins can lead to differences in their function and could affect the way disease may develop or respond to drug therapy. In many cases, the genetic makeup of these proteins differs according to race.

“Our group suggests that genetic factors and the environment work together to contribute to the observed racial disparities in HNSCC incidence and survival,” Ragin said. “With this grant we will be able to use novel techniques to look for variations in the genetic makeup in these genes that are unique to African Americans.”

These findings may help improve early detection and cancer prevention interventions by providing insight into the biology of the disease and factors that contribute to racial disparities.

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Oscar Award winning composer Ryuichi Sakamoto is diagnosed with Throat Cancer

Fri, Jul 11, 2014

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Author: Jun Hongo
Source: blogs.wsj.com/japanrealtime
 

World-renowned Japanese musician and composer Ryuichi Sakamoto says he has throat cancer and has canceled his scheduled shows and activities.

The Oscar-winning composer and anti-nuclear activist said Thursday that he was diagnosed with oropharyngeal cancer at the end of June.

“After much thought and consideration, I have decided to take time off of work in order to concentrate on treating it,” the 62-year-old said in a statement. “I promise to return after a full recovery.”

According to his management agency Avex Music Creative Inc., Mr. Sakamoto will step down as one of the directors of the Sapporo International Art Festival 2014, scheduled to start next week. He will also cancel live shows including a performance at Park Hyatt Tokyo on July 30.

Avex Music Creative said there is no time frame set for Mr. Sakamoto’s return, and that the artist will “dedicate all his time to treatment.” The agency declined to offer details on the current stage of Mr. Sakamoto’s cancer.

The pioneering musician debuted as a member of Yellow Magic Orchestra in 1978, playing a role in the emergence of electro pop and providing inspiration for a generation of electronic music and hip-hop producers. His creativity and prowess as a keyboard player, producer and composer extends to a large swath of genres and styles from pop rock to bossa nova. He won an Academy Award for composing the score music for Bernardo Bertolucci’s 1987 film “The Last Emperor,” a movie he also appeared in as an actor.

Among international honors bestowed on Mr. Sakamoto, he was named an Officier of the Ordre des Arts et des Lettres from the French government in 2009.

In addition to his work in music, producing and acting, Mr. Sakamoto has been one of the most vocal activists against nuclear power following the Great East Japan Earthquake in 2011.

He has also been a leading figure in recent moves to prevent outdated legislation being used to stop people dancing at nightclubs in Japan.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
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Jamie Dimon, CEO of JPChase Morgan, is diagnosed with throat cancer

Wed, Jul 2, 2014

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Author: Jessica Silver-Greenberg
Source: nytimes.com

 

Jamie Dimon the chief executive of JPMorgan Chase, has throat cancer and will begin treatment shortly at Memorial Sloan Kettering Cancer Center, he said in a note to the bank’s employees and shareholders late Tuesday.

Doctors discovered the cancer at an early stage, Mr. Dimon, 58, said, noting that his condition was “curable.”

After a series of tests, he said the doctors confirmed that the cancer had not spread beyond the “original site” and the adjacent lymph nodes on the right side of his neck.

Mr. Dimon assured employees at JPMorgan, the nation’s largest bank, that the prognosis from the doctors was “excellent.”

Mr. Dimon, who has held the dual roles of chief executive and chairman at the bank since 2006, has been atop JPMorgan longer than any other bank chief.

The announcement of his diagnosis came on Mr. Dimon’s 10-year anniversary at JPMorgan. That tenure, which began when JPMorgan acquired Bank One, has been marked by triumph — the bank emerged from the financial crisis in better shape than its rivals — and by tumult.

The bank has worked to mend its frayed relationships with regulators — a painful reconciliation that cost it roughly $20 billion. In November, JPMorgan reached a record $13 billion settlement with a range of government authorities over its sale of questionable mortgage-backed securities in the lead-up to the financial crisis. The bank also reached a $2 billion settlement over accusations that it failed to sound alarms about Bernard L. Madoff’s Ponzi scheme.

JPMorgan has also been buffeted by the departure of several top executives. In the last two years alone, at least 10 senior executives have left JPMorgan.

Most recently, Michael J. Cavanagh, once considered an heir to Mr. Dimon, left the bank to join the Carlyle Group, a private equity firm.

And like its rivals, JPMorgan, which will report second-quarter earnings on July 15, is grappling with a slowdown in its trading business.

It has been a particularly grueling stretch for trading units across Wall Street. The sluggish trading revenue traces, in part, to a spate of rules passed in the aftermath of the financial crisis.

In the past, banks made some of their riskiest wagers — bets that sometimes translated into rich profits — through trading complex derivatives, bonds and commodities. In the new banking landscape, where interest rates remain persistently low, the role of those businesses has been diminished.

In his annual letter to shareholders in April, Mr. Dimon stressed that despite the “constant and intense pressure,” he was proud of the bank’s resiliency and its resolve. Last year, JPMorgan earned $17.9 billion in profit despite the legal costs.

Mr. Dimon reiterated his faith in the leadership of the bank on Tuesday. He did not outline any plans to cede the reins of the bank while he has treatment — a process that he said should last about eight weeks.

In his note, Mr. Dimon emphasized that the company would “continue to deliver first-class results for our customers.”

The illness of any chief executive naturally prompts questions about who is prepared to take over, at least for a little while. But Mr. Dimon emphasized in his note that he would remain immersed in the day-to-day operations of the bank.

JPMorgan’s board has remained firmly behind Mr. Dimon, redoubling support for him. The board awarded Mr. Dimon $20 million in annual compensation for his work in 2013. The raise came one year after the board had cut his compensation to $11.5 million.

Even before Mr. Dimon’s diagnosis the board agreed on various succession plans.

“The board had already established a short-term, medium-term and longer-term succession plan,” said a JPMorgan spokesman, Joseph Evangelisti.

Among the potential successors, people briefed on the matter said, are Gordon Smith, the head of JPMorgan’s consumer bank, and Mary Erdoes, who runs the asset management business.

The inclusion of Mr. Smith and Ms. Erdoes reflected the changing fortunes of banking. JPMorgan’s consumer business, for example, has taken on more prominence as the bank shifts its focus to credit cards and auto loans and away from intricate deal-making and trades that once were the hallmark of Wall Street.
 
 
* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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Tony Gwynn makes statement regarding spit tobacco use weeks before death

Mon, Jun 30, 2014

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Author: Michael Chen
Source: 10news.com
 

SAN DIEGO – One of Tony Gwynn’s last acts was issuing a simple message about the habit he blamed for his cancer.

About two and half months ago, Gwynn received a request from the Professional Baseball Athletic Trainers Society – known as PBATS – to do a taped interview on the dangers of spit tobacco to be shown to players.

“It came back that Tony was entirely sick to do that,” said Neil Romano, adviser to the PBATS.

Romano says Gwynn’s agent then called, saying Gwynn felt bad for not taking part.

Gwynn blamed his decades-long use of chew tobacco for his mouth cancer.

On May 28, less than three weeks before Gwynn’s death, the group got final confirmation through his agent that they could use an emailed statement.

Gwynn’s message: “My advice to anyone would be if they aren’t using spit tobacco, please don’t start. And if you are using, try to quit, if not for yourself then do it for the people you love.”

“The fact that this was one of his last acts goes to his class, his character as a person, and frankly, his love for the game and the players,” said Romano.

When Gwynn was first diagnosed, Major League Baseball banned players from putting tins in pockets and using during interviews, but usage during games is still allowed.

Mark Grudzielanek retired in 2010 after a 15-year career. He never used but said when he started, it was readily available through clubhouse staff.

“Whatever we needed, they went and got it,” said Grudzielanek.

Romano says more than a decade ago, MLB started cracking down on that practice. Chew was also banned in the minors.

About a third of major league players still dip. Critics say that is a prime reason why a federal study found that 20 percent of high school boys chew.

Grudzielanek hopes Gwynn’s final message will make a difference. The five-minute film, which also commemorates Gwynn, was completed on June 13.

A few days ago, Gwynn protégé and pitcher Stephen Strasburg said he is quitting chew for his daughter.

“It’s taken lives and let’s hope this is the last life, and we can control this and get these guys to understand how bad it is for you,” said Grudzielanek. “To stop kids from doing it, it has to stop from the top.”

In recent days, some have called for a spit tobacco ban to be looked at with a new MLB player labor agreement in 2016.

 
*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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Selective apoptotic cell death effects of oral cancer cells treated with destruxin B

Sun, Jun 29, 2014

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Source: 7thspace.com
Author: press release

Recent studies have revealed that destruxins (Dtx) have potent cytotoxic activities on individual cancer cells, however, data on oral cancer cells especial human are absent.

Methods: Destruxin B (DB) was isolated and used to evaluate the selective cytotoxicity with human oral cancer cell lines, GNM (Neck metastasis of gingival carcinoma) and TSCCa (Tongue squamous cell carcinoma) cells, and normal gingival fibroblasts (GF) were also included as controls. Cells were tested with different concentrations of DB for 24, 48, and 72 h by MTT assay.

Moreover, the mechanism of cytotoxicity was investigated using caspase-3 Immunofluorescence, annexin V/PI staining, and the expression of caspase-3, Bax, and Bcl-2 by western blotting after treated with different concentrations of DB for 72 h as parameters for apoptosis analyses.

Results: The results show that DB exhibited significant (p <0.01) and selective time- and dose-dependent inhibitory effects on GNM and TSCCa cells viability but not on GF cells. The data suggested that DB is capable to induce tumor specific growth inhibition in oral GNM and TSCCa cancer cells via Bax/Bcl-2-mediated intrinsic mitochondrial apoptotic pathway in time- and dose-dependent manners.

Conclusions: This is the first report on the anti-proliferation effect of DB in oral cancer cells.

The results reported here may offer further evidences to the development of DB as a potential complementary chemotherapeutic target for oral cancer complications.

Author: Rosa Huang Liu, Shih-Pin Chen, Tsong-Ming Lu, Wei-Yu Tsai, Chung-Hung Tsai, Chi-Chiang Yang, Yew-Min Tzeng
Source: BMC Complementary and Alternative Medicine 2014, 14:207

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Researchers find way to diagnose aggressiveness of oral cancer

Sun, Jun 29, 2014

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Source: www.news-medical.net
Author: staff

Studying mouth cancer in mice, researchers have found a way to predict the aggressiveness of similar tumors in people, an early step toward a diagnostic test that could guide treatment, according to researchers at Washington University School of Medicine in St. Louis.

“All patients with advanced head and neck cancer get similar treatments,” said Ravindra Uppaluri, MD, PhD, associate professor of otolaryngology. “We have patients who do well on standard combinations of surgery, radiation and chemotherapy, and patients who don’t do so well. We’re interested in finding out why.”

Reporting in Clinical Cancer ResearchK/em>, the investigators found a consistent pattern of gene expression associated with tumor spreading in mice. Analyzing genetic data from human oral cancer samples, they also found this gene signature in people with aggressive metastatic tumors.

“We didn’t automatically assume this mouse model would be relevant to human oral cancer,” said Uppaluri, who performs head and neck surgeries at Barnes-Jewish Hospital. “But it turns out to be highly reflective of the disease in people.”

Rather than use genetic methods to induce tumors in the mice, the research team repeatedly applied a known carcinogen, in much the same way humans develop cancer of the mouth.

“Patients often have a history of tobacco and alcohol use, which drive the development of these tumors,” Uppaluri said. “We felt that exposing the mice to a carcinogen would be more likely to produce similar kinds of tumors.”

The researchers, including first author Michael D. Onken, PhD, research assistant professor of cell biology and physiology, showed that this exposure sometimes produced tumors in the mice that did not spread, but other times resulted in aggressive metastatic tumors, similar to the variety of tumors seen in people. Uppaluri’s team then collaborated with Elaine Mardis, PhD, co-director of The Genome Institute at Washington University, to find out whether the mouse and human tumors also were genetically similar. They compared their mouse sequences to human data sets from The Cancer Genome Atlas (TCGA).

“When we sequenced these tumors, we found that a lot of the genetic mutations present in the mouse tumors also were found in human head and neck cancers,” Uppaluri said.

Further analysis identified a common signature in the expression of about 120 genes that was associated with the more aggressive tumors, whether in mice or people. The researchers confirmed this signature using data collected from 324 human patients. Subsequently, using oral cancer samples from patients treated at Washington University, they developed a proof of concept test from their signature that identified the aggressive tumors with about 93 percent accuracy.

Working with the Washington University Office of Technology Management, Uppaluri has a patent pending on this technology and recently received funding from the Siteman Cancer Frontier Fund to develop a laboratory test that predicts aggressive disease and would be easily available for any patient diagnosed with head and neck cancer.

“These kinds of tests are available for other types of cancer, most notably breast cancer,” he said. “They are transformative genetic tests that can alter the clinical management of patients, tailoring therapies especially for them. It’s our goal to develop something like that for head and neck cancer.”

Source:
Washington University School of Medicine

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In one study, lower dose treatment for HPV oropharyngeal cancers is successful

Wed, Jun 25, 2014

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Author: Anthony Cmelak, M.D.
Source: medicalnewstoday.com
 

A new study suggests that lowering the dose of radiation therapy for some head and neck cancer patients may improve outcomes and cause fewer long-term side effects.

The research was presented by lead author Anthony Cmelak, M.D., professor of Radiation Oncology at Vanderbilt-Ingram Cancer Center (VICC), during the 50th annual meeting of the American Society of Clinical Oncology (ASCO), held recently in Chicago.

The study focused on patients with newly-diagnosed oropharyngeal cancers related to the human papilloma virus (HPV). More than two-thirds of new head and neck cancer patients have HPV-positive tumors and the number of these patients is on the rise. Cmelak’s prior cooperative group study found that patients with HPV-positive oropharyngeal cancer have significantly longer survival rates than patients whose tumors are HPV negative.

For the new study, 80 HPV-positive patients with stage III, or IVa,b squamous cell cancer of the oropharynx received inductionchemotherapy, including paclitaxel, cisplatin and cetuximab.

After chemotherapy, 62 of the patients showed no sign of cancer and were assigned to receive a 25 percent lower dose of intensity-modulated radiation therapy – an advanced technology that targets the radiation beam more accurately to treat the tumor without harming surrounding tissue. The rest of the patients received a standard IMRT dose. The drug cetuximab was also given to both groups of patients along with the IMRT treatment.

Two years after treatment, the survival for the low-dose IMRT patients was 93 percent. Those who did not have complete resolution of cancer following induction and went on to get full-dose radiation had an 87 percent two-year survival. Eighty percent of the low-dose patients and 65 percent of standard IMRT patients also showed no evidence of tumor recurrence. Ninety-six percent of those who had minimal or no smoking history had no evidence of tumor recurrence after two years following treatment, and long-term side effects were minimal.

The investigators concluded that patients with HPV-positive cancer who had excellent responses to induction chemotherapy followed by a reduced dose IMRT and cetuximab experienced high rates of tumor control and very low side effects particularly for those with a minimal smoking history.

Treating tumors in the delicate head and neck region often causes side effects that can be troublesome and long-lasting, including difficulty swallowing, speech impairment, dry mouth, problems with taste and thyroid issues, so any therapy option that reduces these side effects can have an impact on patient quality of life.

“Treatment for head and neck cancer can be quite grueling, so it’s very encouraging to see we can safely dial back treatment for patients with less aggressive disease and an overall good prognosis, particularly for young patients who have many years to deal with long-term side effects,” said Cmelak.

He noted that lower-dose IMRT is not recommended for patients with HPV-negative cancer or larger tumors.

The authors note that further studies of reduced-dose IMRT in HPV-positive patients are warranted.

Other investigators include Jill Gilbert, M.D., VICC; Shuli Li, Ph.D., Dana Farber Cancer Institute, Boston, Massachusetts; Shanthi Marur, M.D., William Westra, M.D., Christine Chung, M.D., The Johns Hopkins University School of Medicine, Baltimore, Maryland; Weiqiang Zhao, M.D., Ph.D., Maura Gillison, M.D., Ph.D., The Ohio State University, Columbus, Ohio; Julie Bauman, M.D., Robert Ferris, M.D., University of Pittsburgh Cancer Institute; Lynne Wagner, Ph.D., Feinberg School of Medicine, Northwestern University, Chicago, Illinois; David Trevarthen, M.D., Colorado Cancer Research Program, Denver; A. Demetrios Colevas, M.D., Stanford University, California; Balkrishna Jahagirdar, M.D., HealthPartners and Regions Cancer Care Center, St. Paul, Minnesota; Barbara Burtness, M.D., Fox Chase Cancer Center, Philadelphia, Pennsylvania.

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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FDA’s tobacco regulation draft proposal weakened by the White House

Wed, Jun 25, 2014

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Author: Toni Clarke and Sharon Begley
Source: huffingtonpost.com
 
 

WASHINGTON, June 25 (Reuters) – White House changes to proposed rules for tobacco products significantly weakened language detailing health risks from cigars and deleted restrictions that might have prevented online sales of e-cigarettes, published documents show.

The White House’s Office of Management and Budget (OMB), which analyzes the potential economic consequences of proposed regulations, deleted language in the U.S. Food and Drug Administration’s recently proposed regulations describing how the rules would keep thousands of people from taking up cigar smoking and have enormous public health benefits.

The OMB also weakened language detailing the FDA’s concerns about the safety of e-cigarettes, according to documents published Tuesday in the Federal Register.

Emily Cain, a spokeswoman for OMB, said that as with any rule, OMB’s office of information and regulatory affairs conducted an interagency review process “to ensure that the regulations through which agencies implement policies are efficient, well-designed to achieve their objectives, and based upon the best available evidence.”

“It is routine for agencies to make changes to their draft rules during the course of OMB review,” she added. “The goal is to maximize the effectiveness and benefit of the rules we complete.”

An FDA spokeswoman, Jennifer Haliski, said the FDA does not comment on changes to a proposal during the review process but said the period for the public to comment on the proposal is still open until Aug. 8.

“All comments will be carefully considered as the final rule is being developed,” she said in an email. “As the science base continues to develop for these products, the agency has the ability to take additional regulatory actions designed to further minimize the public health burden of tobacco use in this country.”

The FDA has authority under a 2009 law to regulate cigarettes, smokeless tobacco and roll-your-own tobacco, but must issue new rules before regulating e-cigarettes, cigars, hookahs, water pipes and other tobacco products.

In April, the FDA issued a proposal which would subject the $2 billion e-cigarette industry to federal regulation for the first time. It would ban the sale of e-cigarettes to people under the age of 18 and vending machine sales.

The proposal disappointed public health advocates who criticized the agency’s failure to restrict flavored products or television advertising, which they say attracts children, and criticized the agency for not moving to restrict online sales, where it can be harder to verify a person’s age.

In its draft, the FDA had proposed “prohibition of non-face-to-face sales (e.g. vending machines).” That would have opened the door to a ban on online sales. But OMB edited the sentence so that the prohibition refers only to vending machines.

In another significant change, OMB turned the FDA’s proposal as it relates to cigars from a two-part rule – one for traditional tobacco products and one for products that have not previously been regulated – into a “two-option” rule, one of which would exempt “premium cigars.”

The cigar industry, backed by some members of Congress, had lobbied OMB heavily for such an exemption. In a December 2013 letter to FDA Commissioner Margaret Hamburg and Sylvia Mathews Burwell, who was director of OMB at the time and is now Secretary of Health and Human Services, 24 Republican lawmakers asked that premium cigars be exempt.

“As you know,” they wrote, “premium cigars are a niche product with an adult consumer base, much like fine wines. The majority of people who enjoy a cigar do so occasionally, often in social or celebratory settings.”

When the proposed rule came out in April, some public health advocates expressed dismay.

“The part of the proposal we are deeply troubled by is the sweetheart deal for the cigar industry,” Erika Sward, assistant vice president for national advocacy at the American Lung Association.

OMB also deleted an FDA analysis showing that exempting premium cigars from a proposal to require large warning labels would save manufacturers $1 million to $3 million but incur costs to public health of $32.6 million to $34.2 million.

The White House office also deleted an extensive section in which the FDA calculated how many lives would be saved by regulating cigars, as well as the value of those lives. And it deleted a similar analysis for the improvements in health that would come from dissuading people from smoking cigars, such as through warning labels.

The “welfare gain” from reducing the number of cigar smokers, FDA calculated, would be $16 million to $52 million.

Similarly, OMB modified or deleted FDA concerns about the safety of e-cigarettes, including manufacturing quality.

It deleted FDA draft language saying it would review electronic cigarette cartridges to respond to evidence of poor quality control, variable nicotine content or toxic ingredients such as diethylene glycol, a chemical that the FDA said has caused mass poisonings in products such as the painkiller acetaminophen and cough syrup.

Last week a panel of U.S. senators excoriated the chiefs of two of the biggest e-cigarette companies, blu eCigs, which is owned by tobacco giant Lorillard Inc, and privately held NJoy, saying they were irresponsibly targeting children with advertisements depicting cartoon characters, movie stars and other celebrities.

Both companies defended the advertisements, saying they target adult smokers.

 
* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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Scientists say that E-Cigarettes and Snuff are not harmless

Wed, Jun 25, 2014

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Author: Eliza Gray

Source: time.com

New research casts doubt on nicotine’s safety—even if you aren’t smoking

New research from the American Heart Association journal Circulation shows that patients who stopped using smokeless tobacco after a heart attack had improved life expectancy—similar to that of people who quit smoking. The finding offers new information about the dangers of smokeless tobacco, the risks of which are not as well understood as cigarettes’.

“That was a big surprise for us,” said Dr. Gabriel Arefalk, lead researcher and a cardiologist at Uppsala University Hospital in Uppsala, Sweden. “For smoking, it has been known for decades now that people benefit from discontinuation, especially after having suffered a heart attack, but for snus we had no idea what to expect.

”The researchers reviewed data on 2,474 heart attack survivors under 75 in Sweden who used snus (oral snuff) from 2005 to 2009. About 675 quit. During the two years of follow-up, 69 of those who continued using snus died, compared with only 14 quitters. Based on this data, researchers determined that those who quit snus had almost half the mortality risk of those who didn’t quit, which is similar to the benefit of smoking cessation, according to a release from the American Heart Association.

Dr. Arefalk, who is also a clinician, said the researchers wanted to study the problem because they didn’t know what to tell patients about the risks of using snus after a heart attack. He cautioned that the study was small and far from enough to determine a causal relationship, but added “It’s the best evidence we’ve got so far, so from our perspective at our clinic, [the advice to patients] is probably that you should discontinue all kinds of tobacco,” if you’ve had a heart attack, Dr. Arefalk told TIME

The study is one more piece of evidence that ads to our understanding that smokeless tobacco carries its own risk. Though the study was about snus, it has implications for other kinds of nicotine delivery systems, including e-cigarettes.

The FDA is currently taking comment from experts over the next few weeks as the agency tries to determine the best rules to regulate the nascent e-cig industry, which is approaching nearly $2 billion in U.S. annual sales. And though there isn’t yet enough information or scientific research to back this up, common sense says that e-cigs, which do not burn and contain fewer chemicals than regular tobacco cigarettes, must be better for a smoker’s health. Yet, some cardiologists, as TIME learned, are reluctant to see electronic cigarettes as harm-reduction tools.

For starters, nicotine is not a benign substance, especially when it comes to cardiovascular health. As Dr. Steven Nissen, Department Chair of Cardiovascular Medicine at the Cleveland Clinic, put it, nicotine has “profound effects on the heart.” The highly addictive drug can lead to surges in heart rate, constriction in the blood vessels, and spikes in blood pressure—the very effects that heart medications are designed to counteract.“To come up with new diabolically clever way to addict Americans to nicotine is a terrible idea,” says Dr. Nissen. “[E-cigarette companies] are pitching very hard that they can make smoking safer. [But] nicotine is an addictive drug, no matter if you smoke it or ‘aerosolize’ it. Why you would want to addict another generation to nicotine is beyond me. Public health suggests we should fight electronic cigarettes the same way we fought tobacco.”

Another concern, beyond the possible impact of nicotine, are concerns about small, potentially toxic, particles and what they can do to the sensitive cardiovascular system, says Dr. Aruni Bhatnagar, a professor of medicine at the University of Louisville and spokesperson on electronic cigarettes for the American Heart Association

Dr. Bhatnagar is studying the toxic effects of e-cig vapor on mice. Like all doctors, he is careful to point out that we don’t know enough about these devices. But he says that wishful thinking about harm reduction could be especially problematic when it comes to cardiovascular health. The risk of cardiovascular disease for a person who smokes only 2-3 cigarettes a day is already 80 percent of the risk to a pack-a-day smoke. “Very low levels of smoke are very dangerous for cardiovascular tissues. Cancer is more linear—you have to smoke a large amount for a very long period of time to get lung cancer,” he says. “But reducing harmful levels is not going to mitigate the cardiovascular risk. That is why we are greatly concerned about e-cigarettes when it comes to the high sensitivity of cardiovascular tissues to a low level of these pollutants

”Electronic cigarette manufacturers and their customers often point to the low levels of particles in electronic cigarette smoke as compared to the appropriate levels of air pollution determined by agencies like OSHA. But, Dr. Bhatnagar says, these claims can be misleading because the thresholds take into account the necessity of polluting the air to some degree—they aren’t an endorsement of a safe level of pollution. From a cardiovascular perspective, he says: “There is no threshold, there is no level of these particles that you can say is safe.”

For now: Smokers—and snuffers, and e-cig smokers—beware.

 

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

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Lower radiation dose may be given to HPV-positive head and neck cancer patients

Fri, Jun 20, 2014

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Source: Vanderbilt University
Published: June 19, 2014
By: Dagny Stuart

 

A new study suggests that lowering the dose of radiation therapy for some head and neck cancer patients may improve outcomes and cause fewer long-term side effects.

The research was presented by lead author Anthony Cmelak, M.D., professor of Radiation Oncology at Vanderbilt-Ingram Cancer Center, during the 50th annual meeting of the American Society of Clinical Oncology (ASCO), held May 30 to June 3 in Chicago.

The study focused on patients with newly diagnosed oropharyngeal cancers related to the human papilloma virus (HPV). More than two-thirds of new head and neck cancer patients have HPV-positive tumors and the number of these patients is on the rise. Cmelak’s prior study found that patients with HPV-positive oropharyngeal cancer have significantly longer survival rates than patients whose tumors are HPV negative.

For the new study, 80 HPV-positive patients with stage III, or IVa,b squamous cell cancer of the oropharynx received induction chemotherapy, including paclitaxel, cisplatin and cetuximab.

After chemotherapy, 62 of the patients showed no sign of cancer and were assigned to receive a 25 percent lower dose of intensity-modulated radiation therapy (IMRT) — an advanced technology that targets the radiation beam more accurately to treat the tumor without harming surrounding tissue. The rest of the patients received a standard IMRT dose. The drug cetuximab was also given to both groups of patients along with the IMRT treatment.

Two years after treatment, the survival for the low-dose IMRT patients was 93 percent. Those who did not have complete resolution of cancer following induction and went on to get full-dose radiation had an 87 percent two-year survival. Eighty percent of the low-dose patients and 65 percent of standard IMRT patients also showed no evidence of tumor recurrence. Ninety-six percent of those who had minimal or no smoking history had no evidence of tumor recurrence after two years following treatment, and long-term side effects were minimal.

The investigators concluded that patients with HPV-positive cancer who had excellent responses to induction chemotherapy followed by a reduced dose IMRT and cetuximab experienced high rates of tumor control and very low side effects, particularly for those with a minimal smoking history.

Treating tumors in the delicate head and neck region often causes side effects that can be troublesome and long-lasting, including difficulty swallowing, speech impairment, dry mouth, problems with taste and thyroid issues, so any therapy option that reduces these side effects can have an impact on patient quality of life.

“Treatment for head and neck cancer can be quite grueling, so it’s very encouraging to see we can safely dial back treatment for patients with less aggressive disease and an overall good prognosis, particularly for young patients who have many years to deal with long-term side effects,” said Cmelak.

He noted that lower-dose IMRT is not recommended for patients with HPV-negative cancer or larger tumors.

The authors note that further studies of reduced-dose IMRT in HPV-positive patients are warranted.

Funding was provided by The National Cancer Institute, a division of the National Institutes of Health (CDR0000665170).

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

 

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