cancer

NYU’s Bluestone Center Receives a $369,250 High Priority, Short Term Project Award from NIDCR to Study Oral Cancer Pain

Source: www.nyu.edu/news
Author: Christopher James
 

Drs. Yamano and Schmidt have developed a novel non-viral gene delivery method, and the proposed studies are designed to test whether this could be used to treat cancer pain effectively and safely.

Up to 90% of cancer patients suffer from pain, with oral cancer ranked consistently as one of the most painful cancers. The quality of life for oral cancer patients is the lowest of any patients suffering from cancer because the intense uncontrolled pain interferes with necessary oral functions including eating, talking and swallowing.

“Oral cancer pain is more severe, and the opioid requirement is higher, than pain from any other cancer,” said Dr. Brian L. Schmidt, DDS, MD, PhD, professor in the Department of Oral and Maxillofacial Surgery, and director of NYU’s Bluestone Center for Clinical Research and the NYU Oral Cancer Center. “And in the end, pharmacological agents used to treat cancer pain often lack anatomical specificity and produce off-target effects that create additional suffering.”

“Gene therapy is emerging as an exciting prospect and alternative to opioids for the treatment of cancer pain,” said Dr. Seiichi Yamano, DDS, PhD, DMD, MMSc, assistant professor of prosthodontics at NYU College of Dentistry. “We seek to eliminate oral cancer pain by reversing epigenetic changes using gene therapy and set the stage for a new class of medicines that selectively disrupt nociceptive signaling with limited off-target effects.”

To further their research, the National Institute of Dental and Craniofacial Research (NIDCR), part of the National Institute of Health (NIH) has awarded Drs. Schmidt and Yamano a one-year, $369,250 High Priority, Short-Term Project Award (R56) to study the efficacy of a novel non-viral gene delivery method. The proposed studies are designed to test whether nonviral gene delivery into the oral cancer could be used to treat cancer pain effectively and safely.

“Viral vector-based treatment of cancer pain has been evaluated in preclinical studies but problems with immune response, limited DNA carrying capacity, recombination and high cost have been encountered,” said Dr. Schmidt. “Synthetic, non-viral vectors are potential alternatives to viral vectors that preclude these obstacles.”

To improve non-viral gene transfer efficiency, Dr. Yamano recently created two novel nonviral hybrid vectors: a cell-permeable peptide (CPP) combined with either a cationic lipid (CPP/lipid) or a cationic polymer (CPP/polymer). These nonviral vectors have excellent transfection efficiency with little cytotoxicity across a range of cell lines including different types of cancer cells.

The researchers also found that the transfection efficiency using the nonviral vector in oral cancer cells has a significantly higher expression (~8-fold) than normal cells and has a higher expression (~65%) than an adenoviral vector (~50%). In vivo transfection with either of these nonviral vectors leads to high and long-term transgene expression (~7 months) after intramuscular injection of the vectors.

“We recently demonstrated that OPRM1 (the gene for the µ-opioid receptor) is methylated and down regulated in oral cancer compared to matched normal tissues in the same patients; these patients reported pain at the site of cancer,” said Dr. Schmidt. “We further demonstrated that OPRM1 re-expression with viral transduction significantly reduced cancer pain in a mouse model.”

Based on their preliminary work, the researchers hypothesize that re-expression of the OPRM1 gene within oral cancer using our non-viral vectors will attenuate cancer pain and restore orofacial function without excessive toxicity. Their research has three specific aims:

  1. To determine the efficacy of ex vivo OPRM1 gene transfer with non-viral vectors to attenuate cancer-induced pain, with the goal to move their method of non-viral transfection to the clinic, with the goal of clinicians directly inoculating their non-viral vector into an oral cancer;
  2. To determine the feasibility and efficacy of in vivo OPRM1 gene transfer (i.e. directly into the tongue cancer) with non-viral vectors for attenuation of cancer-induced pain; and
  3. To analyze toxicity and immune response in the cancer mice treated with non-viral OPRM1 gene delivery.

“The proposed research is significant because we will use a local delivery technique directly into the cancer to reduce the potential side effects of systemic drugs,” continues Dr. Yamano. “Our approach is innovative because we will transduce the cancer cells for the treatment of cancer pain and our non-viral vector more efficiently targets oral cancer cells relative to normal cells. Ultimately, these studies might facilitate the development of an effective therapy to treat cancer pain.”

The researchers note that, tragically, approximately half of all oral cancer patients will not be cured with surgery, chemotherapy or radiation therapy. Oral cancer is the sixth most common cancer in the US; more patients are afflicted with oral cancer than with melanoma, cervical cancer, or ovarian cancer. The intensity of oral cancer pain escalates with disease progression, and terminal patients generally experience debilitating pain during their final months of life.

NIH NIDCR R56 grant number: R56DE025393 (Schmidt/Yamano)

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

The Cost of Cancer Drugs

Source: www.cbsnew.com
Author: Lesley Stahl
 

The following is a script of “The Cost of Cancer Drugs” which aired on October 5, 2014, and was rebroadcast on June 21, 2015. Lesley Stahl is the correspondent. Richard Bonin, producer.

Cancer is so pervasive that it touches virtually every family in this country. More than one out of three Americans will be diagnosed with some form of it in their lifetime. And as anyone who’s been through it knows, the shock and anxiety of the diagnosis is followed by a second jolt: the high price of cancer drugs.

They are so astronomical that a growing number of patients can’t afford their co-pay, the percentage of their drug bill they have to pay out-of-pocket. As we first reported in October, this has led to a revolt against the drug companies led by some of the most prominent cancer doctors in the country.

Dr. Leonard Saltz: We’re in a situation where a cancer diagnosis is one of the leading causes of personal bankruptcy.

Dr. Leonard Saltz is chief of gastrointestinal oncology at Memorial Sloan Kettering, one of the nation’s premier cancer centers, and he’s a leading expert on colon cancer.

Lesley Stahl: So, are you saying in effect, that we have to start treating the cost of these drugs almost like a side effect from cancer?

Dr. Leonard Saltz: I think that’s a fair way of looking at it. We’re starting to see the term “financial toxicity” being used in the literature. Individual patients are going into bankruptcy trying to deal with these prices.

Lesley Stahl: The general price for a new drug is what?

Dr. Leonard Saltz: They’re priced at well over $100,000 a year.

Lesley Stahl: Wow.

Dr. Leonard Saltz: And remember that many of these drugs, most of them, don’t replace everything else. They get added to it. And if you figure one drug costs $120,000 and the next drug’s not going to cost less, you’re at a quarter-million dollars in drug costs just to get started.

Lesley Stahl: I mean, you’re dealing with people who are desperate.

Dr. Leonard Saltz: I do worry that people’s fear and anxiety are being taken advantage of. And yes, it costs money to develop these drugs, but I do think the price is too high.

The drug companies say it costs over a billion dollars to bring a new drug to market, so the prices reflect the cost of innovation.

The companies do provide financial assistance to some patients, but most people aren’t eligible. So many in the middle class struggle to meet the cost of their co-payments. Sometimes they take half-doses of the drug to save money. Or delay getting their prescriptions refilled.

Dr. Saltz’s battle against the cost of cancer drugs started in 2012 when the FDA approved Zaltrap for treating advanced colon cancer. Saltz compared the clinical trial results of Zaltrap to those of another drug already on the market, Avastin. He says both target the same patient population, work essentially in the same way. And, when given as part of chemotherapy, deliver the identical result: extending median survival by 1.4 months, or 42 days.

Dr. Leonard Saltz: They looked to be about the same. To me, it looked like a Coke and Pepsi sort of thing.

Then Saltz, as head of the hospital’s pharmacy committee, discovered how much it would cost: roughly $11,000 per month, more than twice that of Avastin.

Lesley Stahl: So $5,000 versus $11,000. That’s quite a jump. Did it have fewer side effects? Was it less toxic? Did it have…

Dr. Leonard Saltz: No…

Lesley Stahl: …Something that would have explained this double price?

Dr. Leonard Saltz: If anything, it looked like there might be a little more toxicity in the Zaltrap study.

He contacted Dr. Peter Bach, Sloan Kettering’s in-house expert on cancer drug prices.

Lesley Stahl: So Zaltrap. One day your phone rings and it’s Dr. Saltz. Do you remember what he said?

Dr. Peter Bach: He said, “Peter, I think we’re not going to include a new cancer drug because it costs too much.”

Lesley Stahl: Had you ever heard a line like that before?

Dr. Peter Bach: No. My response was, “I’ll be right down.”

Lesley Stahl: You ran down.

Dr. Peter Bach: I think I took the elevator. But yes, exactly.

Bach determined that since patients would have to take Zaltrap for several months, the price tag for 42 days of extra life would run to nearly $60,000. What they then decided to do was unprecedented: reject a drug just because of its price.

Dr. Peter Bach: We did it for one reason. Because we need to take into account the financial consequences of the decisions that we make for our patients. Patients in Medicare would pay more than $2,000 a month themselves, out-of-pocket, for Zaltrap. And that that was the same as the typical income every month for a patient in Medicare.

Lesley Stahl: The co-pay.

Dr. Peter Bach: Right. 20 percent. Taking money from their children’s inheritance, from the money they’ve saved. We couldn’t in good conscience say, “We’re going to prescribe this more expensive drug.”

And then they trumpeted their decision in the New York Times. Blasting what they called “runaway cancer drug prices,” it was a shot across the bow of the pharmaceutical industry and Congress for passing laws that Bach says allow the drug companies to charge whatever they want for cancer medications.

Dr. Peter Bach: Medicare has to pay exactly what the drug company charges. Whatever that number is.

Lesley Stahl: Wait a minute, this is a law?

Dr. Peter Bach: Yes.

Lesley Stahl: And there’s no negotiating whatsoever with Medicare?

Dr. Peter Bach: No.

Another reason drug prices are so expensive is that according to an independent study, the single biggest source of income for private practice oncologists is the commission they make from cancer drugs. They’re the ones who buy them wholesale from the pharmaceutical companies, and sell them retail to their patients. The mark-up for Medicare patients is guaranteed by law: the average in the case of Zaltrap was six percent.

Dr. Leonard Saltz: What that does is create a very substantial incentive to use a more expensive drug, because if you’re getting six percent of $10, that’s nothing. If you’re getting six percent of $10,000 that starts to add up. So now you have a real conflict of interest.

But it all starts with the drug companies setting the price.

Dr. Peter Bach: We have a pricing system for drugs which is completely dictated by the people who are making the drugs.

Lesley Stahl: How do you think they’re deciding the price?

Dr. Peter Bach: It’s corporate chutzpah.

Lesley Stahl: We’ll just raise the price, period.

Dr. Peter Bach: Just a question of how brave they are and how little they want to end up in the New York Times or on 60 Minutes.

That’s because media exposure, he says, works. Right after their editorial was published, the drug’s manufacturer, Sanofi, cut the price of Zaltrap by more than half.

Dr. Peter Bach: It was a shocking event. Because it was irrefutable evidence that the price was a fiction. All of those arguments that we’ve heard for decades, “We have to charge the price we charge. We have to recoup our money. We’re good for society. Trust us. We’ll set the right price.” One op-ed in the New York Times from one hospital and they said, “Oh, okay, we’ll charge a different price.” It was like we were in a Turkish bazaar.

Lesley Stahl: What do you mean?

Dr. Peter Bach: They said, “This carpet is $500” and you say, “I’ll give you $100.” And the guy says, “Okay.” They set it up to make it highly profitable for doctors to go for Zaltrap instead of Avastin. It was crazy!

But he says it got even crazier when Sanofi explained the way they were changing the price.

Dr. Peter Bach: They lowered it in a way that doctors could get the drug for less. But patients were still paying as if it was high-priced.

Lesley Stahl: Oh, come on.

Dr. Peter Bach: They said to the doctor, “Buy Zaltrap from us for $11,000 and we’ll send you a check for $6,000.” Then you give it to your patient and you get to bill the patient’s insurance company as if it cost $11,000. So it made it extremely profitable for the doctors. They could basically double their money if they use Zaltrap.

“High cancer drug prices are harming patients because either you come up with the money, or you die.”

All this is accepted industry practice. After about six months, once Medicare and private insurers became aware of the doctor’s discount, the price was cut in half for everyone.

John Castellani: The drug companies have to put a price on a medicine that reflects the cost of developing them, which is very expensive and takes a long period of time, and the value that it can provide.

John Castellani is president and CEO of PhRMA, the drug industry’s trade and lobbying group in Washington.

Lesley Stahl: If you are taking a drug that’s no better than another drug already on the market and charging twice as much, and everybody thought the original drug was too much…

John Castellani: We don’t set the prices on what the patient pays. What a patient pays is determined by his or her insurance.

Lesley Stahl: Are you saying that the pharmaceutical company’s not to blame for how much the patient is paying? You’re saying it’s the insurance company?

John Castellani: I’m saying the insurance model makes the medicine seem artificially expensive for the patient.

He’s talking about the high co-pay for cancer drugs. If you’re on Medicare, you pay 20 percent.

Lesley Stahl: Twenty percent of $11,000 a month is a heck of a lot more than 20 percent of $5,000 a month.

John Castellani: But why should it be 20 percent instead of five percent?

Lesley Stahl: Why should it be $11,000 a month?

John Castellani: Because the cost of developing these therapies is so expensive.

Lesley Stahl: Then why did Sanofi cut it in half when they got some bad publicity?

John Castellani: I can’t respond to a specific company.

Sanofi declined our request for an interview, but said in this email that they lowered the price of Zaltrap after listening “to early feedback from the oncology community and … To ensure affordable choices for patients…”

Dr. Hagop Kantarjian: High cancer drug prices are harming patients because either you come up with the money, or you die.

Hagop Kantarjian chairs the department of leukemia at MD Anderson in Houston. Inspired by the doctors at Sloan Kettering, he enlisted 119 of the world’s leading leukemia specialists to co-sign this article about the high price of drugs that don’t just add a few weeks of life, but actually add years, like Gleevec.

It treats CML, one of the most common types of blood cancer that used to be a death sentence, but with Gleevec most patients survive for 10 years or more.

Dr. Hagop Kantarjian: This is probably the best drug we ever developed in cancer.

Lesley Stahl: In all cancers?

Dr. Hagop Kantarjian: So far. And that shows the dilemma, because here you have a drug that makes people live their normal life. But in order to live normally, they are enslaved by the cost of the drug. They have to pay every year.

Lesley Stahl: You have to stay on it. You have to keep taking it.

Dr. Hagop Kantarjian: You have to stay on it indefinitely.

Gleevec is the top selling drug for industry giant Novartis, bringing in more than $4 billion a year in sales. $35 billion since the drug came to market. There are now several other drugs like it. So, you’d think with the competition, the price of Gleevec would have come down.

Dr. Hagop Kantarjian: And yet, the price of the drug tripled from $28,000 a year in 2001 to $92,000 a year in 2012.

Lesley Stahl: Are you saying that the drug companies are raising the prices on their older drugs.

Dr. Hagop Kantarjian: That’s correct.

Lesley Stahl: Not just the new ones. So you have a new drug that might come out at a $100,000, but they are also saying the old drugs have to come up to that price, too?

Dr. Hagop Kantarjian: Exactly. They are making prices unreasonable, unsustainable and, in my opinion, immoral.

When we asked Novartis why they tripled the price of Gleevec, they told us, “Gleevec has been a life-changing medicine … When setting the prices of our medicines we consider … the benefits they bring to patients … The price of existing treatments and the investments needed to continue to innovate…”

[Dr. Hagop Kantarjian: This is quite an expensive medication.]

Dr. Kantarjian says one thing that has to change is the law that prevents Medicare from negotiating for lower prices.

Dr. Hagop Kantarjian: This is unique to the United States. If you look anywhere in the world, there are negotiations. Either by the government or by different regulatory bodies to regulate the price of the drug. And this is why the prices are 50 percent to 80 percent lower anywhere in the world compared to the United States.

Lesley Stahl: Fifty percent to 80 percent?

Dr. Hagop Kantarjian: Fifty percent to 80 percent.

Lesley Stahl: The same drug?

Dr. Hagop Kantarjian: Same drug. American patients end up paying two to three times more for the same drug compared to Canadians or Europeans or Australians and others.

Lesley Stahl: Now, Novartis, which makes Gleevec, says that the price is fair because this is a miracle drug. It really works.

Dr. Hagop Kantarjian: The only drug that works is a drug that a patient can afford.

The challenge, Dr. Saltz at Sloan Kettering says, is knowing where to draw the line between how long a drug extends life and how much it costs.

Lesley Stahl: Where is that line?

Dr. Leonard Saltz: I don’t know where that line is, but we as a society have been unwilling to discuss this topic and, as a result, the only people that are setting the line are the people that are selling the drugs.

Since we first broadcast our story, President Obama asked Congress to change the law and allow Medicare to negotiate prices with drug manufacturers. Few believe, however, that Congress will let that happen anytime soon.

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

 

Professional Rodeo Competitors Join Fight Against Oral Cancer

Source: www.upr.org
Author: Melissa Allison

 

The number of oral cancer deaths related to tobacco use is on the rise nationwide according to the Oral Cancer Foundation. Brian Hill is the founder of the OCF and a survivor of the disease.

Kiser-OCFCody Kiser encourages the youth to not start using tobacco to help secure good health. Oral Cancer Foundation

 

“Up until about (the year) 2000 this was primarily a disease of older men who had smoked a lot or chewed tobacco during their lifetime,” Hill said. “About that point in time we started to see a shift in the cause of the disease.”

Hill said tobacco is still a primary cause of oral cancers and adds that the oral human papillomavirus type 16 (HPV16) is new etiology that has forced the number of cases to accelerate.

According to an October 2014 study by Johns Hopkins researchers the HPV16 causes cancers of the mouth and throat and that any form of tobacco use increases the risk of the virus. The research suggests as few as three cigarettes a day can increase the risk of infection by almost one-third.

Hill created the foundation in 1999 to promote change by educating the public about risk factors that contribute to the disease. Among those risks is the use of spit tobacco.

“The world of rodeo has been the realm of sponsorship by the tobacco industry for decades,” Hill said. “With the nicotine content in a can of dip equaling approximately that of 80 cigarettes, this addiction can be one of the hardest to break. We hope to educate parents and youth about the dangers before they even get started.”

The OCF is turning to professional rodeo competitors to serve as positive role models during a national campaign.

Cody Kiser is a professional bareback bronc rider from Reno, Nevada.  He was in Delta, Utah recently where he competed at the Millard County Fairgrounds. Kiser told parents at the rodeo that nearly 15 percent of high school boys in the United States use smokeless tobacco.

“My dad was a cowboy, so I know what it’s like looking up to cowboys as heroes for my whole life. Health and fitness have always been incredibly important to my family. My dad was a positive role model in my life growing up in that regard, and the idea of using spit tobacco never appealed to me,” Kiser said. “Right now, I’m pursuing rodeo as a passion of mine, and if at the same time I can do some good in the world and set the right example for young kids who might look up to me, then I’m honored and eager to do so.”

Kiser said cowboys have a reputation that is second only to baseball players for being users of tobacco in the world of sports.  He wants to change that reputation throughout the country and in Utah, where rodeo is popular.

“From my point of view, Utah seems to be on the front lines of health and fitness,” he said.  “I’ve been very impressed with Utah as far as a healthy lifestyle, people who don’t smoke and chew so it’s good to see in Utah that they don’t do that as much.”

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

A Disorder That’s Hard to Swallow

www.usnews.com
Source: www.usnews.com
Author: Anna Medaris Miller

 

Ed Steger’s​ last meal was a bowl of soup in Las Vegas. “I remember it all too clearly, as if it were yesterday,” he says. But it wasn’t yesterday – it was 2006. “Life is very different” now, says Steger, a 63-year-old former program manager in Houston.

Steger was diagnosed with head and neck cancer​ in 2005. In addition to 36 rounds of radiation and eight regimens of chemotherapy, he underwent six surgeries, including one that replaced a portion of his pharynx and removed parts of his left jawbone, tongue, epiglottis and soft palate.

“The part that makes it odd is that I’m alive after having four recurrences,” Steger says. The part that makes it distressing is that he can’t eat solid foods.

“There are many case studies I’ve seen where patients have said [their] swallowing disorder is the worst part of their disease – and I believe this to be true,” says Steger, who’s president of the National Foundation of Swallowing Disorders. His daily diet consists of four 8-ounce cans of the nutritional drink Boost Plus, along with two to four bottled​ Starbucks Frappuccinos, which he buys at his local supermarket. “It’s a very boring diet that allows me to maintain my weight,” says Steger, who’s 5 feet 10 inches tall and 155 pounds.

It’s unknown how many people have dysphagia, or difficulty swallowing, but the condition can be caused by any one of 30 diverse health events, Steger says. While his dysphagia is a result of surgery, other people have difficulty swallowing due to neurological conditions such as Parkinson’s disease or stroke, digestive disorders including acid reflux or head injuries. Children with developmental disabilities like autism also often have dysphagia.

“[Dysphagia] isn’t a disease, it’s a sign or an outcome of a disease,” says James Coyle​, an associate professor in the University of Pittsburgh’s School of Health and Rehabilitation Sciences who specializes in treating adults with swallowing disorders.

Difficulty swallowing can also be a part of normal aging, suggests research led by Teresa Lever​, an assistant professor of otolaryngology at the University of Missouri School of Medicine. But that doesn’t mean it’s without consequence. For example, people with dysphagia are at risk for choking, dehydration, malnutrition and pneumonia, which can be triggered when food or drink enter the lungs.

“If you can’t walk, you don’t die. If your skin looks horrible, you don’t die. But if you can’t eat and drink, you die,” Lever says. “[Swallowing] is a vital biological function that is a hugely overlooked contribution to morbidity and mortality.”

Aiming to Eat and Drink Again

How clinicians treat dysphagia depends on its cause. If, for example, the condition is brought on by a stroke that paralyzes one side of the throat, a swallowing specialist like a speech-language pathologist first ​might use an imaging test to identify what exactly is going wrong, and then coach the patient on ways to tilt his or her head while eating in order to better prevent food from getting into the airway.​ Such “compensatory strategies,” Coyle says, are “more or less exploiting either gravity or using the change in position to redirect the swallowed material more efficiently and with better airway protection.”

Steger, for one, was trained to swallow by holding his breath, reclining and “letting the liquid flow” down the back of his esophagus and avoiding the airway. “When I swallow, I need to concentrate very hard,” he says.

Mouth and throat exercises can also help patients boost their swallowing abilities. One mouthpiece-like device called SwallowSTRONG, for instance, senses how hard the patient pushes the tongue against the roof of the mouth and progressively guides him or her in resistance exercises.​ “It’s like weightlifting,” Coyle says. “You start off doing low levels of exercise, and we increase the targets every two weeks until the tongue is stronger.”

Other exercises use a similar technique but to improve respiratory function rather than tongue strength. When patients blow against progressively increasing resistance, for example, they’ll develop a better cough reflex. That, in turn, will make it more likely that any food particles or liquids inhaled into the airways will be expelled and not enter the lungs to cause harm, Coyle says. “Dysphagia doesn’t always go away,” he says. “Sometimes we have to teach the person to swallow differently, sometimes we have to beef up other parts of the body to compensate for the fact that the swallowing isn’t going to get better.”

If dysphagia is caused by dementia or another condition that compromises someone’s ability to learn, clinicians must defer to environmental or dietary modifications like prescribing a diet of thickened liquids. The route is a last resort, Coyle says, since “gobs of studies” show that people don’t like thickened liquids, don’t drink them and therefore, are at risk for dehydration.

“All of our cases aren’t successful,” he says, “but when we do have a successful case, it’s so rewarding – the ability to restore a person’s ability to eat and drink.”

Food is Secondary

If Steger woke up tomorrow without dysphagia, he’d eat a T-bone steak grilled with Lawry’s spice, a baked potato with all the fixings and crème brulee for dessert.​ But what he’d look forward to most is going to a restaurant with friends, ordering anything he wants and keeping pace with his companions. “The food is secondary at this point,” he says.

Living with dysphagia isn’t just a medical risk, but can also hamper one’s quality of life and mental health. People with the condition can feel isolated not only because they avoid social eating situations, but also because many of them have medical conditions that affect their voices and compromise their communication. In the support groups for people with Parkinson’s that Steger sometimes attends, the participants, many of whom have dysphagia, “are embarrassed to go out, they’re ashamed, it’s sad,” he says.

One of his goals is to boost funding for dysphagia research, which is slow-going since major funding organizations like the National Institutes of Health are more focused on the diseases that underlie the condition, Steger says. “[Swallowing] is never top of mind when you have head and neck cancer or Parkinson’s until it happens to you,” he says .​But a focus on swallowing itself is not trivial since, for example, hospital patients with dysphagia stay in the hospital 40 percent longer than patients without it, Coyle says. “It’s very important to identify early.”

It’s also important to dedicate resources to the disorder since it will affect more and more people as the population ages, Lever says. She’s now working to identify traits that protect mice – and hopefully, people – from developing dysphagia as they grow old. “Now that we can diagnose dysphagia, we can identify which mouse models have it, and then we can use those mouse models to try to understand what is going wrong to cause dysphagia,” she says. That, in turn, “can then give [us] some targets for treatment.”

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

Merck immunotherapy appears effective in head and neck cancer – study | Reuters

Source: www.firstpress.com
Author: Bill Berkrot

 

A Merck & Co drug that helps the immune system fight cancer was about twice as effective as the current standard therapy for patients with recurrent or advanced head and neck cancers, according to study data released on Friday.

A quarter of the 132 patients who received the drug, Keytruda (pembrolizumab), saw their tumors shrink by at least 30 percent. Fifty-six percent of patients experienced at least some tumor shrinkage in the ongoing single drug Phase I study dubbed Keynote-012, researchers reported.

“This is remarkable because we don’t usually see this level of activity with new agents. We have a track record of failure,” said Dr. Tanguy Seiwert, lead investigator of the study from the University of Chicago.

Advanced head and neck cancer is currently treated with Eli Lilly’s Erbitux, known chemically as cetuximab, which typically has a response rate of 10 percent to 13 percent.

“The only thing that works is cetuximab and this looks at least twice as good,” said Seiwert, who was presenting the Keytruda data at the American Society of Clinical Oncology meeting in Chicago.

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Merck shares rose more than 1 percent to $60.43 on the New York Stock Exchange.

Keytruda and Opdivo from Bristol-Myers Squibb Co are at the forefront of a promising new class of drugs called PD-1 inhibitors that block a mechanism tumors use to evade the immune system. Keytruda is approved to treat advanced melanoma and awaits a decision for use in lung cancer. It is being tested against 30 types of cancer alone and in various combinations.

While overall survival data was not yet available, Keytruda and Opdivo have extended survival for some patients in other cancers.

“Response rate doesn’t do this justice,” Seiwert said. “A fraction of those patients will probably have long term survival. It can really make a difference for some patients who have incurable metastatic disease.”

The drug appeared to work as well for patients whose cancer tested positive for human papillomavirus as those who were HPV negative. Some older treatments may be less effective in HPV positive patients, researchers said.

Keytruda was well tolerated with few side effects, Seiwert said. Serious immune-related side effects, such as inflammation of the lungs or colon, were reported in a very small number of patients in the study.

Head and neck cancer is the sixth most common cancer worldwide. Patients with recurrent or metastatic head and neck cancer are usually expected to live about 10 to 12 months.

Reporting by Bill Berkrot in New York; Editing by Diane Craft.

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

A Study Finds Smoking’s Toll On Your Body and Health Worse Than Previously Thought

Source: nytimes.com
Author: Denise Grady
 

However bad you thought smoking was, it’s even worse.

A new study adds at least five diseases and 60,000 deaths a year to the toll taken by tobacco in the United States. Before the study, smoking was already blamed for nearly half a million deaths a year in this country from 21 diseases, including 12 types of cancer.

The new findings are based on health data from nearly a million people who were followed for 10 years. In addition to the well-known hazards of lung cancer, artery disease, heart attacks, chronic lung disease and stroke, the researchers found that smoking was linked to significantly increased risks of infection, kidney disease, intestinal disease caused by inadequate blood flow, and heart and lung ailments not previously attributed to tobacco.

Even though people are already barraged with messages about the dangers of smoking, researchers say it is important to let the public know that there is yet more bad news.

“The smoking epidemic is still ongoing, and there is a need to evaluate how smoking is hurting us as a society, to support clinicians and policy making in public health,” said Brian D. Carter, an epidemiologist at the American Cancer Society and the first author of an article about the study, which appears in The New England Journal of Medicine. “It’s not a done story.”

In an editorial accompanying the article, Dr. Graham A. Colditz, from Washington University School of Medicine in St. Louis, said the new findings showed that officials in the United States had substantially underestimated the effect smoking has on public health. He said smokers, particularly those who depend on Medicaid, had not been receiving enough help to quit.

About 42 million Americans smoke — 15 percent of women and 21 percent of men — according to the Centers for Disease Control and Prevention. Research has shown that their death rates are two to three times higher than those of people who have never smoked, and that on average, they die more than a decade before nonsmokers. Smokers are more than 20 times as likely as nonsmokers to die of lung cancer. Poor people and those with less formal education are the most likely to smoke.

Mr. Carter said he had been inspired to dig deeper into the causes of death in smokers after taking an initial look at data from five large health surveys being conducted by other researchers. The participants were 421,378 men and 532,651 women 55 and older, including nearly 89,000 current smokers.

As expected, death rates were higher among the smokers. But diseases known to be caused by tobacco accounted for only 83 percent of the excess deaths in people who smoked.

“I thought, ‘Wow, that’s really low,’ ” Mr. Carter said. “We have this huge cohort. Let’s get into the weeds, cast a wide net and see what is killing smokers that we don’t already know.”

The research was paid for by the American Cancer Society, and Mr. Carter worked with scientists from four universities and the National Cancer Institute.

The study was observational, meaning that it looked at people’s habits, like smoking, and noted statistical correlations between their behavior and their health. Correlation does not prove a cause-and-effect relationship, so this kind of research is not considered as strong as experiments in which participants are assigned at random to treatments or placebos and then compared. But people cannot ethically be instructed to smoke for a study, so a lot of the data on smoking’s effects on people comes from observational studies.

Analyzing deaths among the participants from 2000 to 2011, the researchers found that, compared with people who had never smoked, smokers were about twice as likely to die from infections, kidney disease, respiratory ailments not previously linked to tobacco, and hypertensive heart disease, in which high blood pressure leads to heart failure. Smokers were also six times more likely to die from a rare illness caused by insufficient blood flow to the intestines.

Mr. Carter said he had confidence in the findings because, biologically, it made sense that those conditions were related to tobacco. Smoking can weaken the immune system, increasing the risk of infection, he said. It is also known to cause diabetes, high blood pressure and artery disease, all of which can lead to kidney problems. Artery disease can also choke off the blood supply to the intestines. Lung damage from smoke, combined with increased vulnerability to infection, can lead to multiple respiratory illnesses.

Two other observations supported the findings, he said. One was that the more heavily a person smoked, the greater the added risks. The second was that among former smokers, the risks diminished over time. In general, such effects, known as a dose response, suggest that an observed correlation is more than a coincidence.

The study also found small increases in the risks of breast and prostate cancer among smokers. Mr. Carter said those findings were not as strong as the others, adding that additional research could help determine whether there were biological mechanisms that would support a connection.

A 2014 report by the surgeon general’s office said the evidence for a causal connection between smoking and breast cancer was “suggestive but not sufficient.” The same report found no evidence that smoking caused prostate cancer, but it noted that in men who did have prostate cancer, smoking seemed to worsen the outcome.

The diseases that had previously been established by the surgeon general as caused by smoking were cancers of the esophagus, stomach, colon, liver, pancreas, larynx, lung, bladder, kidney, cervix, lip and oral cavity; acute myeloid leukemia; diabetes; heart disease; stroke; atherosclerosis; aortic aneurysm; other artery diseases; chronic lung disease; pneumonia; influenza; and tuberculosis.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
February, 2015|Oral Cancer News|

Why the “Cancer Due to Bad Luck” Story Needs Revising

Source: medscape.com
Author: Zosia Chustecka
 

UPDATED January 16, 2015 // There has been quite a backlash to the recent news that many cancers are due to “bad luck” of random mutations, which was proclaimed in headlines around the world, and based on a report published in the January 2 issue of Science.

The International Agency for Research on Cancer (IARC), the World Health Organization’s specialized cancer agency, put out a press release to say that it “strongly disagrees with the conclusion,” and warning that the message could harm cancer research and public health.

“We already knew that for an individual to develop a certain cancer there is an element of chance, yet this has little to say about the level of cancer risk in a population,” explained IARC director Christopher Wild, PhD. “Concluding that ‘bad luck’ is the major cause of cancer would be misleading and may detract from efforts to identify the causes of the disease and effectively prevent it.”

As previously reported by Medscape Medical News, the researchers, from Johns Hopkins University in Baltimore, reported that in about two-thirds (22 of the 31) of cancer tissue types they had investigated, the cancer could be largely explained by the bad luck of random mutations that arise during DNA replication in normal noncancerous stem cells.

However, many of the news stories reported a distorting simplification of the findings, and stated that two-thirds of all cancers are due to bad luck.

There has been fierce criticism of the way that the media reported the story, but an expert argues that journalists were misled.

The Science report was accomapnied by an editorial entitled “The Bad Luck of Cancer,” and the subheading added: “Analysis suggests most cases can’t be prevented.”

But the data do not support either of these ideas, noted George Davey-Smith, MD, a clinical epidemiologist at Bristol University, United Kingdom, in a BBC News report. He also noted that “in the press release [from the Johns Hopkins School of Medicine], the authors say they’ve come up with a method to quantify the contribution of these stochastic or chance factors, which their method doesn’t,” he adds.

“It’s both in the journal and in the press release so it’s just not fair to attribute the mis-reporting of this to journalists,” Dr Davey-Smith commented.

In reaction to the huge media uptake of the story, the study authors issued further comments in a Johns Hopkins University statement, which also included the press release that had been “ammended for clarity.” The public relations officer for Johns Hopkins University, Vanessa Wasta, MBA, noted that the press release was updated to change reference from “incidence” to “risk” as a clarification in the first paragraph, but pointed out to Medscape Medical News that the original news release contained no reference to “cases” or “all” cancers, but referred to “risk” many times.

Dr Tomasetti also said that many scientists and statisticians had also needed clarification, and that the team is now working on a technical report with additional details.

In the end, the amount of media attention given to this study was not justified by the findings, Dr Davey-Smith said in the BBC News report. “Explaining the difference in risk between the leg and the lung is of no interest to anyone and says nothing about the contribution to cancers in the population,” he commented.

The research does contain an important message for people who have cancer and lead a healthy lifestyle, according to another commentator. P.Z. Myers, PhD, a biologist and associate professor at the University of Minnesota, Morris, told the BBC: “What’s important about the study is that it does say that if you have cancer — and I think this is something people who have cancer would like to hear — it’s not something you should blame yourself for.”

Half of All Cancers Can Be Prevented, Says IACR

The IACR took issue with the study conclusion “that random mutations (or ‘bad luck’) are the major contributors to cancer overall, often more important than either hereditary or external environmental factors.”

The authors of the report, Dr Tomasetti and Bert Vogelstein, MD, Clayton Professor of Oncology at Johns Hopkins and codirector of the Ludwig Center, argue that for many cancers, there should be a greater focus on the early detection of the disease rather than on prevention of its occurrence. But the IACR warns that “if misinterpreted, this position could have serious negative consequences from both cancer research and public health perspectives.”

The agency points out that, although it has long been clear that the number of cell divisions increases the risk for mutation and, therefore, for cancer, a majority of the most common cancers occurring worldwide are strongly related to environmental and lifestyle exposures, and therefore they are, in principle, preventable.

“Based on current knowledge, nearly half of all cancer cases worldwide can be prevented,” the agency states. “This is supported in practice by rigorous scientific evidence showing decreases in cancer incidence after preventive interventions. Notable examples include drops in rates of lung cancer and other tobacco-related cancers after reductions in smoking, and declines in hepatocellular carcinoma rates among people vaccinated against hepatitis B virus.”

In addition, the agency points out that the past 5 decades of international epidemiological research have shown that most cancers that are frequent in one population are relatively rare in another and that these patterns vary over time. For example, esophageal cancer is common among men in East Africa but rare in West Africa. Colorectal cancer, once rare in Japan, has increased 4-fold in incidence in just 2 decades.

“These observations are characteristic of many common cancers and are consistent with a major contribution of environmental and lifestyle exposures, as opposed to genetic variation or chance,” the agency comments.

Criticisms of the Study

The agency also points out several limitations of the study itself. These include the emphasis on very rare cancers (e.g., osteosarcoma, medulloblastoma) that together make only a small contribution to the total cancer burden. The report also excludes, because of the lack of data, common cancers for which incidence differs substantially between populations and over time. The latter category includes some of the most frequent cancers worldwide (for example, those of the stomach, cervix, and breast, each known to be associated with infections or lifestyle and environmental factors). Moreover, the study focuses exclusively on the United States population as a measure of lifetime risk. The comparison of different populations would have yielded different results, the agency contends.

Other researchers have also raised questions over the way in which the research was conducted, and the research has stimulated much detailed discussion, including several blog posts from scientists, and a lengthy blog post from US oncologist David Gorski, MD, on the Science-based Medicine website. He comments that the message from the study is unpopular, adding that “human beings don’t want to hear that cancer is an unfortunately unavoidable consequence of being made of cells that replicate their DNA imperfectly over the course of our entire lives. There’s an inherent hostility to any results that conclude anything other than that we can prevent most, if not all, cancers if only we understood enough about cancer and tried hard enough.”

 
*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
January, 2015|Oral Cancer News|

Doctors Trying To Remind Americans That The HPV Vaccine Isn’t All About Sex

Source: thinkprogress.org
Author: Tara Culp-Ressler

 

Dr. Ronald A. DePinho is on a mission.

 
DePinho, who’s been a cancer researcher for decades and currently serves as the president of the University of Texas MD Anderson Cancer Center, wants to reframe the national conversation about the HPV vaccine to drive home a fundamental point.

 
“It’s important to appreciate that this is a cancer vaccine. A cancer vaccine!” DePinho said in an interview with ThinkProgress. “It’s a dream come true that we’ve converted knowledge into something that can actually save lives and avoid getting cancer in the first place. It’s really what we have been hoping for, and now we have it.”
Since the introduction of the HPV vaccine in 2006, the rate of human papillomavirus in teenage girls has plummeted. And the research in this field continues to advance. On Thursday, the Food and Drug Administration approved an updated version of the Gardasil vaccine that protects against nine strains of the cancer-causing virus — more than twice as many as the 2006 version, which covered just four strains.

 
According to DePinho, that’s a really significant advance for cancer care. He doesn’t want it to get lost in the ongoing controversy about HPV vaccination, a round of shots that some parents still worry is unsafe or inappropriate for their kids.
There’s a persistent myth, for instance, that giving teen girls the shots will spur them to become more “promiscuous” because they know they’ll be protected from a sexually transmitted infection. Large scientific studies have debunked the notion that there’s any link between the HPV vaccine and sexual activity, but inoculation rates still lag behind in some of the Southern states that are wary to provide teens with preventative tools to protect their sexual health.
In general, HPV vaccination rates in the U.S. are still much too low, hovering around 30 percent. Public health professionals are aiming to increase those rates dramatically, to at least 80 percent — closer to the percentage of people who get vaccinated against the virus in other developed countries.

 
To accomplish that, the health professionals who have dedicated their lives to treating HPV-related cancers want to move the conversation away from sexuality altogether. Instead of framing Gardasil as vaccine that protects against an STD — which might give some Americans the impression that they don’t need to worry about it — they want to present it as a vaccine that protects against cancer.

 
“It doesn’t seem like it makes sense to see it in terms of a vaccine for a sexually transmitted disease necessarily,” Dr. Erich Sturgis, an expert in head and throat cancer who works as the program director for the MD Anderson Oropharynx Program, said in an interview with ThinkProgress. “Most of us will have an HPV infection at some point in our lifetime and we’ll never know it.”
Nearly all sexually active Americans get HPV at some point in their lives, according to the Centers for Disease Control and Prevention. An estimated 80 percent of people are infected at some point, and most never realize it because the infection resolves itself on its own. But certain strains of the virus go on to cause cervical, vulvar, anal, penile, and oropharyngeal cancers.

 
Without the HPV vaccine, men in particular are put at risk of developing neck and throat cancers. Unlike cervical cancers, which can be detected with regular Pap smears, there’s no way to screen men.

 

Sturgis treats mostly middle aged male patients, and he estimated that about 60 percent of the cancers he deals with are caused by HPV. He said it’s important to increase the rates of vaccination among both girls and boys because it will be another 30 to 40 years before today’s kids hit the point when these type of throat cancers may start displaying themselves.
“To let your kids potentially suffer later in life is just a tragedy. That’s really the message here,” he said.

 
Both cancer doctors are optimistic that once more parents are educated about what’s at stake, they’ll start vaccinating their kids at higher rates. There’s a big information gap — one recent study found that 70 percent of U.S. adults didn’t realize the HPV vaccine has any connection to cancer whatsoever — that they believe can be corrected with more investment from primary care doctors who are on the front lines of recommending the shots.

 
“It’s really about empowering parents and health care professionals, and making them recognize that this is a childcare responsibility and a priority for all of us,” DePinho said. “It begins with interviews like this and just having the media getting this information out there.”

 
“Doctors are probably not as good at messaging to the public as we could be. We need some help,” Sturgis agreed.

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
December, 2014|Oral Cancer News|

New Study Finds Editing HPV Genes Kills Cancer

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.
 
August, 2014|Oral Cancer News|

Top cancer organizations push for FDA to regulate all tobacco products

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.
August, 2014|Oral Cancer News|