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  • Targeted radiation, drug therapy combo less toxic for recurrent head, neck cancers

    Wed, Sep 17, 2014

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    Source: medicalxpress.com
    Author: University of Pittsburgh Schools of the Health Sciences

    Patients with a recurrence of head and neck cancer who have previously received radiation treatment can be treated more quickly, safely and with fewer side effects with high doses of targeted radiation known as Stereotactic Body Radiation Therapy (SBRT) in combination with a drug that also carefully targets cancerous tumors. These findings from a UPMC CancerCenter study were presented today at the American Society of Radiation Oncology (ASTRO) annual meeting in San Francisco.

    SBRT uses concentrated radiation beams in high doses to destroy tumors in difficult or hard-to-reach areas. The treatment is noninvasive, which minimizes damage to surrounding healthy tissue and organs. Clinicians at UPMC CancerCenter, partner with the University of Pittsburgh Cancer Institute (UPCI), used SBRT in combination with the drug cetuximab for patients who had a recurrence of squamous cell carcinoma of the head and neck after going through radiation.

    “The prognosis for patients who have a recurrence of head and neck cancer that cannot be surgically removed is already poor. Traditional treatments can be associated with significant side effects so severe that patients give up on the therapy altogether,” said Dwight E. Heron, M.D., vice chairman of radiation oncology at UPCI and director of Radiation Oncology Services at UPMC CancerCenter. “By taking these patients through an abbreviated course of targeted drug and SBRT, we minimize the side effects of treatment.”

    Doctors treated 48 patients with the combination therapy between July 2007 and March 2013. All of the patients were able to complete the treatments, which were administered in a span of about two weeks compared to traditional therapies which can take up to nine weeks. Severe toxicity was reported at 12 percent using the combination therapy, compared to upwards of 85 percent using conventional therapies.

    “The good news here is that we improved their quality of life and did it safely,” said John Vargo, M.D., a radiation oncology resident at UPMC CancerCenter and one of the lead authors of the study.

    “Unfortunately, outcomes using this approach are still challenging so the next part of our research will concentrate on continuing to find ways to improve outcomes by integrating additional novel systemic agents.”

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    The Debate Over E-Cigarettes Begins

    Wed, Sep 10, 2014

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    Source: TIME.com
    Author: Mandy Oaklander
     

    The debate over the safety of e-cigarettes, and whether they will help smokers to quit, or simply make it easier for them to start or continue lighting up, heated up this week.

    On one side of the disagreement are those pushing for regulation. In 2013, the World Health Organization (WHO) began a review of data on e-cigarettes and based on studies conducted so far, last month recommended tighter regulation of the devices to protect consumers’ health. But in a new article published in the journal Addiction, other scientists argue that the WHO misinterpreted the data in a “misleading” way and that the group’s advice for more stringent oversight is problematic.

    In the Addiction paper, the authors take issue with nine of WHO’s conclusions, some of which surround the safety of e-cigarettes, their toxin levels, and how likely younger people are to adopt them. They cite some of the same data as the original WHO review did, but interpret it differently, arguing that the benefits of e-cigarettes, especially as an effective tool in helping some smokers to quit, outweigh potential risks from the chemicals and nicotine used in the devices. Therefore, they say, e-cigarettes should be more accessible than the WHO recommendations would allow.

    “…The WHO’s approach will make it harder to bring these products to market than tobacco products, inhibit innovation and put off smokers from using e-cigarettes, putting us in danger of foregoing the public health benefits these products could have,” said Ann McNeill, lead author of the paper and professor of tobacco addiction at King’s College London, in a press release. They’re not the only ones who have pushed back against the recommendations. More than 50 experts in public health signed a letter calling for a lighter approach, reported the New York Times.

    Why the opposing interpretations of the same data? E-cigarettes are so new that research hasn’t had a chance to catch up with their meteoric rise in popularity. Some of the data based on earlier models of the devices, for example, might not even apply to e-cigs as we know them today, since the product has evolved so rapidly. The body of research is small. And because the devices are so new, much of it is funded by e-cigarette manufacturers.

    In the latest paper in Addiction, for example, some of the work by one of the heavily-cited authors of the paper was conducted with funding from the e-cigarette industry.

    On the first page in the “competing interests” section, the article discloses the following about Konstantinos Farsalinos of the Onassis Cardiac Surgery Center in Greece:

    Some studies performed by KF were carried out using funds provided to his institution (Onassis
    Cardiac Surgery Center) by e-cigarette companies.

    In the paper’s 45 references, Farsalinos is listed as an author in nine of them; it’s unknown which of those studies were conducted with the help of e-cigarette funding.

    It’s not uncommon for someone who makes a product to then sponsor research on that product, and it doesn’t mean the findings are worthless, says Steven Schroeder, a professor in the department of medicine and head of the Smoking Cessation Leadership Center at the University of California, San Francisco. (Schroeder does not conduct research on e-cigarettes.) But it also doesn’t mean the results are entirely objective, either. The potential for bias leads journal editors such as those at the peer-reviewed Addiction to require conflict disclosures from both its authors and its senior editorial staff.

    It’s not clear yet whether e-cigarettes will turn out to hurt or help smokers. It’s probable that they will contribute to a range of health effects, both positive — as a smoking cessation device — and negative — as a potential gateway to tobacco-based cigarettes or other drugs. The evidence, at the moment, points in both directions.

     

    *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy. 
     
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    HPV vaccine: Why boys are less likely to get it

    Tue, Sep 9, 2014

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    Source: http://topnews.us/
    Author: Prakash Sharma

    A Conservative MP’s tongue and throat cancer alarm is reigniting the verbal confrontation over whether young people ought to get the HPV antibody free of charge.

    Amid his nine-month episode of cancer, Peter Kent says, specialists persuaded him its vital to inoculate young men against human papillomavirus.

    MP beats throat malignancy, urges HPV immunization for young men.

    Two sorts of HPV reason 70 per cent of cervical malignancy in ladies, as indicated by the Canadian Cancer Society. In men, the infection is in charge of a high rate of mouth, nose and throat growths, and also a few malignancies of the penis and anus.

    Young ladies between ages nine and 13 going to class anyplace in Canada can pick to get a free HPV inoculation.

    Just two regions, Alberta and Prince Edward Island, offer the same option to youngsters. Outside of those two areas, young men can in any case be immunized, yet just if their guardian or watchman decides to pay out-of-pocket.

    “Our huge concern is that its out there and that individuals aren’t exploiting it,” Dr. Robert Nuttall, the Canadian Cancer Society’s executive of cancer control policy, said.

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    Oral Cancer Survivor Eva Grayzel Talks About Her Efforts to Make A Difference

    Wed, Sep 3, 2014

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    Source: www.lehighvalleylive.com
    Author: Andrew James Sheldon

     

    As an oral cancer survivor, Eva Grayzel knows how lucky she is.

    She organizes an annual awareness walk for what she says is an often overlooked disease.

    “I was diagnosed sixteen years ago and I am so lucky to be articulate,” she said. “I can’t ethically live my life as I do without doing whatever I can to make sure what happened to me doesn’t happen to other people.”

    Grayzel survived stage four oral cancer, which is the most serious of the four stages. She has served as the chair of the oral cancer awareness walk in Bethlehem Township, Pennsylvania, for six years. This year’s walk is Sept. 27.

    Grayzel says that raising awareness is the key step to catching the disease early before it can do the most damage. Other survivors will join her in the walk.

    “There are going to be 20 survivors who have all been diagnosed late and most of them have facial disfigurements. They can’t speak normally, some of them can’t speak,” she said. “It’s devastating. Oral cancer steals things we take for granted such basic human needs, everything social.”

    Grayzel’s group helped organize a continuing education class for dentists to learn about oral cancer and its connection with the human papillomavirus. Symptoms of oral cancer are sometimes unrecognized by sufferers and doctors.

    Eileen Ciszak lost her daughter as a result of a misdiagnosis.

    “The doctor gave her an antibiotic and told her to see her dentist, that she probably had a cracked tooth,” she said. “By the time she got there, the dentist knew immediately she needed to pursue this and the next day she was having a biopsy done.”

    Thanks to the support of people like Ciszak, the walk has been growing. They had attended the walk once several years ago, but stopped after their daughter died.

    “The first year we attended the walk, at that time my daughter had just had her oral cancer surgery, and we wanted to show our support,” Ciszak said. “Ten months after we attended the walk, she had passed away and it was just very difficult for us to really get involved at that point.”

    After some healing, Ciszak decided to return.

    “We just wanted to try to help organize, to create awareness with our story, be there to support others who have lost loved ones and support the survivors,” she said.

    Eva GrayzelEva Grayzel, walk chairwoman, attended the 2013 Oral Cancer Foundation Walk for Awareness with her husband, Ken Cohen.

    *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
     
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    Three shots that could stop cancer

    Tue, Aug 26, 2014

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    Source: tucson.com
    Author: Meredith Wadman

    Not so long ago, when my sons still had smooth cheeks and children’s voices, I had them vaccinated against human papillomavirus, the most common sexually transmitted disease. It was late 2011, and the Centers for Disease Control and Prevention had just recommended that boys join girls in being vaccinated at age 11 or 12. I was certainly receptive: HPV, as it’s commonly called, causes cervical cancer, cancer of the tonsils, cancer of the back of the tongue and, less often, cancers of the vulva, vagina, anus and penis. It seemed important to ensure that my kids were protected.

    Yet numbers released last month by the CDC show that my sons, now 14 and 15, are among a small minority of adolescent males who have been vaccinated. In 2013, just 14 percent of American boys ages 13 to 17 had received all three recommended doses of the HPV vaccine. (The CDC also recommends “catch-up” vaccination for males up to age 21.)

    Not that parents are rushing to have their girls vaccinated either, even though the CDC first recommended the vaccine for prepubescent girls in 2007 and virtually all insurers pay for it. In 2013, fewer than 38 percent of American girls between 13 and 17 had received the full three-dose course.

    It is heartbreaking to watch a safe, effective vaccine go unused. Consider this: The CDC estimates that increasing the vaccination rate of American girls to 80 percent would prevent 53,000 cervical cancers during the lifetimes of girls who are now 12 and younger.

    When I had my sons vaccinated, it was partly with girls in mind. After all, if fewer young men are infected, fewer young women will be exposed to the virus that causes cervical cancer — currently the most common cancer prevented by the vaccine. But now I am realizing that HPV poses a growing risk to boys.

    A new breed of cancer of the back of the tongue and tonsils, caused by HPV, is rising in incidence — likely caused, researchers suspect, by increases in premarital sex and oral sex over the past several decades. These cancers afflict men far more often than women, and at relatively younger ages than do other head and neck cancers, which typically appear in men older than 60. Middle-aged men who don’t die from their HPV-linked cancer often must live for years with the side effects of intensive chemotherapy and radiation delivered to the back of the throat. These can include the permanent inability to swallow and the appearance later of new, aggressive, radiation-induced cancers.

    If this trend continues, we are going to see more cancer of the back of the tongue and the tonsils caused by HPV. One recent analysis of 30 studies, conducted by University of Wisconsin researchers, found that the proportion of such cancers caused by HPV rose from 21 percent before 1990 to 65 percent after 2000. Anil Chaturvedi of the National Cancer Institute and his colleagues have estimated, based on recent trends, that by 2020 there will be more new cases of these HPV-induced throat cancers in the United States each year than new cervical cancer cases.

    So the actor Michael Douglas did us all a service when he was so frank with Britain’s Guardian newspaper last year. When asked if his throat cancer had been caused by heavy drinking and smoking, which are also risk factors for the disease, the actor replied: “No. I mean, without getting too specific, this particular cancer in tests is caused by something called HPV, which actually comes about from cunnilingus.”

    Many parents don’t like to think of their 11- and 12-year-olds as sexual creatures. Ironically, the CDC recommendation assumes not that kids are sexually active at this tender age but rather that they are not: The point of vaccination is to close the door before the horse is out of the barn.

    It’s no use telling yourself that your child isn’t “that kind” of kid. The fact is, HPV is so common that almost all sexually active adults are infected at some point. Last year, the CDC estimated that about 79 million Americans were infected, most of them in their late teens and early 20s.

    Most people who get HPV have a transient infection that their immune system clears with no lasting damage. But in some people, the virus takes up residence and goes on to cause cancer. I am grateful that, thanks to the HPV vaccine, I will never have to find out if my sons fell into that second, unlucky group.

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    Finding better ways to treat, prevent HPV

    Tue, Aug 26, 2014

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    Source: www.fhcrc.or
    Author: Diane Mapes – Fred Hutch News Service

    Twenty-nine years ago, scientists didn’t know what caused many of the genital-tract cancers they studied, much less how to stop them.

    Today, not only has human papillomavirus been pinpointed as the viral perpetrator behind nearly all genital-tract and some head and neck cancers, there’s now an incredibly effective vaccine that can prevent high-risk HPV infections from ever developing into cancer.

    “You can almost say on the street, ‘I’m doing HPV research’ and ordinary people will know what that is,” said Aaro Turunen, an HPV researcher from the University of Turku in Finland. “It’s a sexy subject, especially for the media.”

    While scientific advancements, public awareness and yes, media coverage, have grown exponentially in the last three decades, there is still much to learn and do – particularly with regard to getting the vaccine to the people who most need it, both here in the U.S. and around the world.

    That’s where the International Papillomavirus Conference, currently in its twenty-ninth year, comes in. The HPV2014 conference, now underway at the Washington State Convention Center in Seattle, has drawn the brightest minds in HPV research, including nearly 1,300 basic scientists, public health researchers, physicians, providers and others dedicated to eliminating the suffering caused by the human papillomavirus. The goal of the conference is to share cutting-edge scientific advances in the field of HPV infection and disease and come up with new ways to collaborate to advance science and public health.

    The conference officially began today but kicked off early Wednesday with two days of clinical and public health pre-conference workshops covering everything from HPV infection and disease in HIV-infected men to implementing and evaluating two-dose vaccine schedules to a peek at the next generation of HPV vaccines coming down the pike.

    Conference chair Dr. Denise Galloway, who holds a joint appointment with Fred Hutch’s Human Biology and Public Health Sciences divisions, said she was thrilled the conference was taking place in the Hutch’s back yard.

    “I’m excited that the HPV meeting will be here as it recognizes the strength and breadth we have in HPV research in Seattle,” she said. “Our main goal was to provide a setting where people from all over the world who study various aspects of papillomavirus biology, disease and prevention could come together to share their data and ideas.”

    Galloway, who has been investigating the link between cancer and viruses since 1978, was instrumental in both discovering HPV’s association with many cancers and paving the way for a vaccine able to check cervical cancer before it starts in hundreds of thousands of women worldwide.

    These days, she’s researching B cell memory in order to determine how effective the HPV vaccine is over a person’s lifetime.

    “If a vaccine is going to work, it’s not just important how well this will stimulate the immune system, which you can measure within a couple of months after you get the vaccine,” she said. “You also want to know, is it going to be durable? Are you going to have a response 10 years, 20 years or 30 years from now? We’re trying to figure that out by looking at the cells that are there and available to make the responses in 10 and 15 years.”

    Long-term efficacy is just one of many topics covered at the conference, which boasts an ambitious lineup of over 700 abstract presentations, nine satellite sessions, four symposia and four plenary sessions, all highlighting basic, clinical and public health science topics ranging from molecular virology to novel cancer screening and treatment strategies to global public health.

    Also represented at the conference are pharmaceutical companies such as Merck, producer of the HPV vaccine Gardasil, and Roche, developer of the cobas HPV test. Also present are medical device manufacturers such as QIAGEN, which along with support from Seattle’s PATH, developed the careHPV test, a field-friendly and inexpensive test that allows women, particularly in developing countries, to gather screening samples themselves.

    On Friday morning, Dr. Freddie Bray of the International Agency for Research on Cancer talked about the need for quality data and cancer registries, especially in developing countries and and Dr. Scott Ramsey of Fred Hutch’s HICOR division spoke about the value of prevention-based studies and interventions.

    “There was a nice study done by the CDC a few years ago that looked at the cost effectiveness of HPV vaccination of young girls in the U.S.,” he said. “This is a slide I wish I could produce as a health economist more often. HPV vaccines in this population are among the most cost effective interventions we have in the U.S.“

    Despite the efficacy and overall cost effectiveness of the vaccine, however, delivery and implementation of the vaccine remain a problem, said Galloway.

    “We need to find better strategies to get girls and boys to take the vaccine,” she said. “In other countries, where they have school-based programs, they’re doing much better than in the U.S.”

    Saturday’s plenary will feature talks on the natural history of HPV infection and cervical cancer, the natural history of oral HPV and its progression of oropharyngeal cancer and the “genetic arms race” between host and viral genomes, presented by Fred Hutch’s Dr. Harmit Malik. Vaccines will be covered in the Sunday plenary session with talks on Merkel cell carcinoma by Fred Hutch’s Dr. Paul Nghiem, an update on Australia’s HPV vaccination program and a presentation on vaccine dosage.

    “There is a growing consensus of switching from three doses to two and it will be exciting to hear more about that,” said Galloway.

    Finnish researcher Turunen, whose research focuses on the relationship between HPV and the Epstein-Barr virus, said he was amazed at how much the field – and the International Papillomavirus Conference — had grown, adding that a much smaller HPV conference took place in Seattle 20 years ago.

    “Both HPV researchers were there,” he quipped.

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    The Cancer Cure Parents Aren’t Using

    Mon, Aug 25, 2014

    0 Comments

    Source: washingtonpost.com
    Author: Meredith Wadman

     

    Not so long ago, when my sons still had smooth cheeks and children’s voices, I had them vaccinated against human papillomavirus, the most common sexually transmitted disease. It was late 2011, and the Centers for Disease Control and Prevention had just recommended that boys join girls in being vaccinated at age 11 or 12. I was certainly receptive: HPV, as it’s commonly called, causes cervical cancer, cancer of the tonsils, cancer of the back of the tongue and, less often, cancers of the vulva, vagina, anus and penis. It seemed important to ensure that my kids were protected.

    Yet numbers released last month by the CDC show that my sons, now 14 and 15, are among a small minority of adolescent males who have been vaccinated. In 2013, just 14 percent of American boys ages 13 to 17 had received all three recommended doses of the HPV vaccine. (The CDC also recommends “catch-up” vaccination for males up to age 21.)

    Not that parents are rushing to have their girls vaccinated either, even though the CDC first recommended the vaccine for prepubescent girls in 2007 and virtually all insurers pay for it. In 2013, fewer than 38 percent of American girls between 13 and 17 had received the full three-dose course.

    It is heartbreaking to watch a safe, effective vaccine go unused. Consider this: The CDC estimates that increasing the vaccination rate of American girls to 80 percent would prevent 53,000 cervical cancers during the lifetimes of girls who are now 12 and younger.

    When I had my sons vaccinated, it was partly with girls in mind. After all, if fewer young men are infected, fewer young women will be exposed to the virus that causes cervical cancer — currently the most common cancer prevented by the vaccine. But now I am realizing that HPV poses a growing risk to boys.

    A new breed of cancer of the back of the tongue and tonsils, caused by HPV, is rising in incidence — likely caused, researchers suspect, by increases in premarital sex and oral sex over the past several decades. These cancers afflict men far more often than women, and at relatively younger ages than do other head and neck cancers, which typically appear in men older than 60. Middle-aged men who don’t die from their HPV-linked cancer often must live for years with the side effects of intensive chemotherapy and radiation delivered to the back of the throat. These can include the permanent inability to swallow and the appearance later ofnew, aggressive, radiation-induced cancers.

    If this trend continues, we are going to see more cancer of the back of the tongue and the tonsils caused by HPV. One recent analysis of 30 studies, conducted by University of Wisconsin researchers, found that the proportion of such cancers caused by HPV rose from 21 percent before 1990 to 65 percent after 2000. Anil Chaturvedi of the National Cancer Institute and his colleagues have estimated, based on recent trends, that by 2020 there will be more new cases of these HPV-induced throat cancers in the United States each year than new cervical cancer cases.

    So the actor Michael Douglas did us all a service when he was so frank with Britain’s Guardian newspaper last year. When asked if his throat cancer had been caused by heavy drinking and smoking, which are also risk factors for the disease, the actor replied: “No. I mean, without getting too specific, this particular cancer in tests is caused by something called HPV, which actually comes about from cunnilingus.”

    Many parents don’t like to think of their 11- and 12-year-olds as sexual creatures. Ironically, the CDC recommendation assumes not that kids are sexually active at this tender age but rather that they are not: The point of vaccination is to close the door before the horse is out of the barn.

    It’s no use telling yourself that your child isn’t “that kind” of kid. The fact is, HPV is so common that almost all sexually active adults are infected at some point. Last year, the CDC estimated that about 79 million Americans were infected, most of them in their late teens and early 20s.

    Most people who get HPV have a transient infection that their immune system clears with no lasting damage. But in some people, the virus takes up residence and goes on to cause cancer. I am grateful that, thanks to the HPV vaccine, I will never have to find out if my sons fell into that second, unlucky group.

     *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
     
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    Curt Schilling Reveals his Diagnosis of Oral Cancer and Believes Chewing Tobacco was the Cause

    Wed, Aug 20, 2014

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    Source: boston.com
    Author: Steve Silva
     

    Curt Schilling, the former Red Sox pitcher and ESPN analyst, announced today during the WEEI/NESN Jimmy Fund Radio Telethon that he was diagnosed with squamous cell carcinoma — which is cancer in the mouth — in February.

    “This all came about from a dog bite,” Schilling said. “I got bitten by a dog and I had some damage to my finger and I went to see a doctor, and the day that I went to see the doctor, I was driving and I went to rub my neck and I felt a lump on the left side of my neck. And I knew immediately it wasn’t normal. So there happened to be an ENT [Ear, Nose, and Throat] right next door to the hand doctor, and I thought what the heck, let me just stop in and see and so I waited in the office and went in there and they did the biopsy, and two days later, they diagnosed me with squamous cell carcinoma.

    “You know what the amazing thing was? And I was just dumbfounded by it. You’ve just been told you have cancer and you walk out into the public and the world’s still going on and it was really a challenge to wrap my head around that. My second thought was, ‘Yeah, really, you think I can handle this too?’ So after a couple of tests, I got sent over to Brigham and Women’s and Dana-Farber and that’s where I met Dr. Haddad and the amazing team of people that got me through my treatment.”

    Dr. Robert Haddad, from the Dana-Farber Cancer Institute, described Schilling’s cancer.

    “Commonly this is known as mouth cancer,” Dr. Haddad said. “This is the type of the cancer we call the squamous cell carcinoma. It’s cancer of the lining of the mouth and the lump in the neck is why most patients go to the doctor first, because they feel the lump in the neck so that’s the lymph node that’s enlarged and that’s the most common presentation for these cancers. It often presents as a lump in the neck that drives the patient to go see the doctor, and then the biopsy is done and then that shows squamous cell carcinoma, and that’s the type of the cancer.”

    The 47-year-old Schilling — who weighed just over 200 pounds prior to his cancer diagnosis — lost 75 pounds during his treatment. Most of the weight loss was due to the fact that he was unable to swallow. He also has lost his ability to taste and smell.

    The former Red Sox righthander stressed the importance of getting in for treatment early.

    “One of the amazing things was early on when I was talking to [Dr. Haddad] about this, I literally went to see a doctor like five days after I felt the lump, he said the average time for a patient is 10 months,” Schilling said. “Ten months from the time they notice something to the time they say something. I can’t believe… people need to be more self-aware.

    “I didn’t talk about it for two reasons. No. 1, I didn’t want to get into the chewing tobacco debate, which I knew was going to come about, which to me, I’ll go to my grave believing that was why I got what I got… absolutely, no question in my mind about that. And the second thing was I didn’t want people to feel sorry for me. I didn’t want the pity or any of that stuff because early on… I ended up spending about six months in the hospital because I had a bad reaction. I had a staph infection. I had what’s called C. diff. I had a couple different problems and there was a week there, there’s a week of my life I don’t remember while I was in the hospital going through this.

    “The second or third day — I got chemo and radiation for seven weeks — and I came back to the room and my family was sitting there and I thought, ‘You know what, this could be so much worse. It could be one of my kids, it’s not. I’m the one guy in my family that can handle this,’ and so from that perspective it never, ever said ‘Why me? And I never will. I do believe without a doubt, unquestionably that chewing is what gave me cancer and I’m not going to sit up here from the pedestal and preach about chewing. I will say this: I did for about 30 years. It was an addictive habit. I can think of so many times in my life when it was so relaxing to just sit back and have a dip and do whatever, and I lost my sense of smell, my taste buds for the most part. I had gum issues, they bled, all this other stuff. None of it was enough to ever make me quit. The pain that I was in going through this treatment, the second or third day it was the only thing in my life that had that I wish I could go back and never have dipped. Not once. It was so painful.”

    According to Schilling, the most painful part of the treatment was the radiation, which he received five days a week over seven weeks. Schilling’s doctors created a pliable mask to protect his face. Schilling called it “the straitjacket for when they are giving you radiation.”

    “The first day I went in, they clamped [the mask] down, they do the radiation into the tumors,” Schilling said. “The second day they did it. And about the third day I started developing almost a phobia and I literally had to be medicated for the seven weeks to go and do that. I couldn’t control myself under the mask… If this happened again, I’m not sure if I would go through the treatment again, it was that painful.”

    Dr. Haddad concurred that chewing tobacco leads to the mouth cancer Schilling was diagnosed with.

    “One of the directs for oral cancer is smokeless tobacco, just what we’re talking about here,” Dr. Haddad said. “So it is not a question mark. This is shown repeatedly and the National Cancer Institute clearly makes the case that any form of tobacco is harmful and should not be used.”

    Schilling spoke about the day he found out about Tony Gwynn’s death. Gwynn – a Hall of Famer — died of salivary gland cancer on June 16 at the age of 54. Gwynn blamed his mouth cancer on his habit of dipping smokeless tobacco during his 20-year career with the San Diego Padres.

    “I knew a while ago that things were not going well just because he went radio silent after everything that happened,” Schilling said. “From the people I talked to, he was in very, very bad shape at the end. Again, I got lucky. There’s so may other places this could have come up and they could have had to take half my jaw. I met a guy — so I was Brigham and Women’s palliative care floor, the fifth floor, which is kind of a new thing and an amazing thing — who had, smoker, who had cancer of the mouth and they had to cut off half of his tongue and they went down and grafted from his forearm and rebuilt it back. Just the stuff was mind boggling…

    “I’ve seen Dana-Farber from the other side. As someone who’s been around spring training with the kids. I’ve been over there and visited a couple of times, but being on this side of it was mind boggling.”

    Schilling spoke about what lies ahead for him from hereon out.

    “I’m in remission,” he said. “Doc and I are going to be meeting each other on and off for the next five years. It’s the recovery that’s a challenge because there are so many things that are damaged during the process. I don’t have any salivary glands so I can’t taste anything and I can’t smell anything right now so and there’s no guarantee they’ll come back.”

    Dr. Haddad stressed that these types of cancers are treatable and that his sense of taste and smell should come back.

    “Without discussing this specific case, in head and neck cancers or cancers of the mouth, these are treatable cancers, these are curable cancers in a large percentage of patients,” Dr. Haddad said. “But the treatment is very tough, it’s very grueling, a lot of side effects. Those side effects are acute, meaning they happen [during] the first year of treatment like we’re seeing now with Curt: the dry mouth and the trouble swallowing and eating, the infections, and there’s the long-term side effects, So that is the recovery process that can take up to five years but these cancers are treatable, are curable, they do require a lot of specialties coming together.”

    Clay Buchholz and Dustin Pedroia, two Red Sox stars with young children, addressed their chewing habit at Fenway Park in June.

    “Cancer runs in my family,” said Buchholz, as he sat in front of his locker with a wad of smokeless tobacco wedged between his lower lip and gums. “There’s been people that have never smoked a cigarette or had a dip or chew and they’ve died of lung cancer.

    “Everybody here is a grown man, and I think that’s how everybody views it. I don’t dip during the offseason, it’s only during baseball. It’s more of a stress-reliever type of thing for me.”

    I’m trying to stop,” said Pedroia. “It’s not a good habit. It’s one of those things, you try like heck. I wish I had never started.

    “Everyone crushes me about it. You don’t want any kid to start doing it. Obviously, it’s addicting. It’s not good for you and can cause a lot of problems.

    “You try the best you can to stop or not start it. It’s like any bad habit. People do things that aren’t good for you. A lot of things can hurt yourself, whether its drinking or tobacco. It’s hard to stop. I’ve stopped a few times and started back up. But I’ve cut back a lot.”

    “I’m addicted to it, former Sox pitcher Josh Beckett told the Los Angeles Times after Gwynn’s death. “It’s more than just the nicotine. Its the oral fixation. I don’t think anyone does it just for the nicotine thing, or wed probably all be on the patch.”

    The 2011 labor agreement between the players’ union and Major League Baseball included certain limits on the use of smokeless tobacco, but did not ban its use entirely. Players are not allowed to carry tobacco packages in their uniform pockets, and tobacco use during televised interviews and non-game functions is prohibited. Also, teams cannot provide tobacco for players.

    In June, nine major medical and public health organizations have written to MLB and the players’ union urging them to agree to a complete prohibition on tobacco use at ballparks and on camera.

    In April, Schilling’s wife Shonda, herself a melanoma survivor, tweeted that Schilling had finished radiation.

    On Facebook that month, Schilling wrote, To the many, many amazing folks at Dana Farber, [Brigham and Women's Hospital] and [Massachusetts General Hospital], thank you and to the amazing team these last 5 months. I’ve been told my cancer is in remission, start the 5-year clock.

    In May, a weakened Schilling took the field at Fenway as part of the 10th anniversary celebration of the 2004 championship team. Schilling was aided onto the field by his son Gehrig and said he was back in the hospital two days later.

    “I was in the hospital at the time, and they wouldn’t let me come over here and go back,” Schilling said. “So I had to determine if I was OK and ready to be discharged and I said ‘yeah, yeah, yeah, OK,’ and two days later I was back in the hospital. That’s why Gehrig walked out with me because I was afraid I was going to fall on the way in because I was so discombobulated. But it was nice. It was good to see the guys.”

    On June 25, Schilling tweeted: “As of yesterday I am in remission. Start the 5 year clock!”

    Schilling, who spent four seasons of his 20-year major league career with the Red Sox and was instrumental in their World Series victories in 2004 and ’07, joined ESPN as a studio analyst for ESPN’s “Baseball Tonight” in 2010.

    In December, he was chosen to replace Orel Hershiser for the high-profile role as a color analyst on ESPN’s “Sunday Night Baseball” broadcasts alongside Dan Shulman and John Kruk.

    Schilling pitched for five teams during his major league career, winning 216 games and compiling 3,116 strikeouts. He made six All-Star teams, won at least 21 games in a season three times — including in 2004 with the Red Sox. He won his first of three World Series titles with the 2001 Diamondbacks.

    Schilling had found his niche as an analyst after enduring some difficult times in recent years. A video game business suffered a prominent and costly failure in Rhode Island, one that cost the state tens of millions of dollars and Schilling the bulk of his baseball fortune. He revealed to the Globe’s Stan Grossfeld in an August 2013 story that he suffered a heart attack in November 2011 that required surgery to implant a stent in an artery.

     
    *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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    New Study Finds Editing HPV Genes Kills Cancer

    Thu, Aug 14, 2014

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    Source: drbicuspid.com
    Author: DrBicuspid Staff

     

    August 14, 2014 – Researchers have hijacked a defense system normally used by bacteria to fend off viral infections and redirected it against human papillomavirus (HPV), the virus that causes cervical, head and neck, and other cancers, according to a new study in the Journal of Virology (August, 6, 2014).

    Using a genome editing tool, researchers from Duke University were able to selectively destroy two viral genes responsible for the growth and survival of cervical carcinoma cells, causing the cancer cells to self-destruct.

    The study findings validate an approach only recently attempted in mammalian cells, and they could help in the development of antiviral strategies against other DNA-based viruses such as hepatitis B and herpes simplex.

    “Because this approach is only going after viral genes, there should be no off-target effects on normal cells,” said senior study author Bryan R. Cullen, PhD, a professor of molecular genetics and microbiology at the Duke University School of Medicine, in a statement. “You can think of this as targeting a missile that will destroy a certain target. You put in a code that tells the missile exactly what to hit, and it will only hit that, and it won’t hit anything else because it doesn’t have the code for another target.”

    When examining the genomes of different types of bacteria, researchers noted long stretches where the same genetic sequence was repeated. But in between these repeated stretches were DNA sequences that varied from bacteria to bacteria. About a decade ago, researchers determined that these varied sequences, clustered regularly interspaced short palindromic repeats (CRISPR), were derived from viruses that had infected the bacteria.

    When bacteria are infected, a small portion of the offending viral DNA is copied and placed between the repeat elements for future reference. When the bacteria come into contact with that virus again, it has a “memory” of it, which activates the bacterial protein Cas9, which destroys any recognized offenders before they can hurt the bacteria again.

    The CRISPR system is now being repurposed by researchers for many purposes, including introducing mutations for study or to repair genetic defects.

    In the current study, Cullen decided to target HPV. Specifically, he and his colleagues went after two oncogenes that block the host’s efforts to keep cancer cells at bay, viral genes E6 and E7.

    To accomplish this, the researchers needed the target code for E6 or E7, consisting of a short strip of RNA sequence, and the Cas9 protein, which would cut any DNA that could line up and bind to that RNA sequence.

    They packed the antiviral concoction into a viral vector based on a disabled version of HIV and infected cervical carcinoma cells in a lab dish with this genetically engineered virus. Researchers then assessed whether it could effectively destroy HPV infection and block cancer cell growth.

    The carcinoma cells that received the anti-HPV guide RNA/Cas9 combination immediately stopped growing. In contrast, cells that had received a control virus, containing a random guide RNA sequence, continued to grow.

    The researchers then looked at the consequences of destroying E6 or E7 in cancer cells. E6 normally blocks protein p53, which activates the so-called “suicide” pathways in a cell when it senses that something has gone wrong. In this study, targeting E6 enabled p53 to resume its normal function, causing the death of the cancer cell.

    E7 works in a similar way, blocking a protein called retinoblastoma (Rb) that can trigger growth arrest and senescence, another form of cell death. As expected, the researchers found that targeting E7 also set this second tumor suppressor back in motion.

    “As soon as you turn off E6 or E7, the host defense mechanisms are allowed to come back on again, because they have been there this whole time, but they have been turned off by HPV,” Cullen said. “What happens is the cell immediately commits suicide.”

    Cullen and his colleagues are now working on developing a viral vector based on the adeno-associated virus, to deliver their CRISPR load into cancer cells. Tests in animal models will follow once that is in place

    “What we would hope to see in an HPV-induced cancer is rapid induction of tumor necrosis caused by loss of E6 or E7,” Cullen said. “This method has the potential to be a single-hit treatment that will dramatically reduce tumor load without having any effect on normal cells.”

    The researchers are also targeting other viruses that use DNA as their genetic material, including the hepatitis B virus and herpes simplex virus.

     
    *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
     
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    Top cancer organizations push for FDA to regulate all tobacco products

    Wed, Aug 13, 2014

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    Source: medicalexpress.com
    Author: Staff

    The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO), in a joint letter responding to a proposal by the U.S. Food and Drug Administration (FDA) to extend its regulatory authority over tobacco products, today urged the agency to regulate electronic cigarettes (e-cigarettes), cigars, and all other tobacco products and to strengthen the proposed regulations for newly deemed products.

    “There is no safe form of tobacco use,” said Margaret Foti, PhD, MD (hc), chief executive officer of the AACR. “Tobacco is the leading cause of preventable deaths in the United States, and among its dire health consequences are 18 different types of cancer. It is imperative that the FDA takes action to regulate all tobacco products. The future health of the American people, in particular our nation’s children, depends on it.”

    The AACR and ASCO applauded the FDA’s proposal to regulate e-cigarettes. “We believe it is vitally important for the FDA to begin regulating these products, especially because we don’t know much about the health effects of e-cigarette use. We are also quite concerned that e-cigarettes may increase the likelihood that nonsmokers or former smokers will use combustible tobacco products or that they will discourage smokers from quitting,” said Peter P. Yu, MD, FASCO, president of ASCO.

    “There are insufficient data on the long-term health consequences of e-cigarettes, their value as tobacco cessation aids, or their effects on the use of conventional cigarettes. Any benefits of e-cigarettes are most likely to be realized in a regulated environment in which appropriate safeguards can be implemented,” said Roy S. Herbst, MD, PhD, chair of the AACR Tobacco and Cancer Subcommittee and chief of medical oncology at Yale Comprehensive Cancer Center.

    The AACR and ASCO support many of the FDA’s proposals for regulating e-cigarettes and other products, but urge the agency to do more. Specifically, preventing children from using tobacco products is crucial and can be achieved by efforts such as banning youth-oriented advertising and marketing, self-service product displays, and tobacco company sponsorship of youth-oriented events, in addition to restricting sales to minors and implementing age-verification procedures for internet sales.

    Expressing grave concern about the proliferation of flavored e-cigarettes, the AACR and ASCO encouraged the agency to ban e-cigarette flavors or flavor names that are brand names of candy, cookies, soda, and other such products, and to prohibit e-cigarettes containing candy and other youth-friendly flavors, unless there is evidence demonstrating that they do not encourage young people to use these products.

    The AACR and ASCO strongly discouraged the FDA from exempting “premium” cigars from regulation, an option the agency is considering. “All cigars pose serious health risks,” said Graham Warren, MD, PhD, chair of ASCO’s Tobacco Cessation and Control Subcommittee. “As the FDA itself noted in the proposed rule, even cigar smokers who do not inhale have a seven to 10 times higher overall risk of mouth and throat cancer compared with individuals who have never smoked. Exempting these dangerous products from FDA regulation is clearly not in the best interest of public health.”

    Noting that both large and small cigars are of increasing interest to youth and adult users, the AACR and ASCO underscored that the continued availability of premium cigars in an unregulated market, compounded with the ability of the tobacco industry to strategically market its products to youths and young adults, could reverse the progress made in reducing youth tobacco use.

    Finally, the AACR and ASCO urged the FDA to drop the “consumer surplus” discount used to assess the net impact of the proposed deeming rule. This discount allows the FDA to only consider 30 percent of the benefits achieved via tobacco cessation due to the costs associated with this proposed regulation, including the “lost pleasure” of smoking. The AACR and ASCO stressed that addiction is an unwelcome burden for many tobacco users and that many consumers are not making rational and fully informed choices when initiating and continuing their use of tobacco products.

    More information: Read the joint AACR and ASCO letter to the FDA.

    Provided by American Association for Cancer Research

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