chewing tobacco

Lawmaker proposes ‘smokeless tobacco’ ban at all baseball venues

Author: David E. Early, Bay Area News Group

For decades, Major League Baseball’s goofy love affair with chewing tobacco was so passionate that the gooey stuff was stocked by teams in clubhouses as surely as jocks and socks. Nearly all ball players had golf-ball-sized cheek bumps, and part of the show was spitting streams of saliva in dugouts from coast to coast.

But now the end may be near.

If a bill formally introduced in the state Capitol Tuesday becomes law, the use of “smokeless tobacco” will be banned in every baseball venue in the state — from San Jose sandlots to San Francisco’s AT&T Park. They would join minor league parks, which already outlaw it.

“This is all about helping young people. We want to stop youth from being exposed to cancer,” said freshman Assemblyman Tony Thurmond, D-Richmond, author of the bill. “Kids emulate ball players. If they see them use it, they will use it as well.”

The legislation was touted Tuesday at news conferences in Sacramento and San Francisco, where leaders of the Campaign for Tobacco-Free Kids took the podium. Their program, called “Knock Tobacco Out of the Park,” included commentary about oral cancer taking down beloved Hall of Famer Tony Gwynn, a retired San Diego Padre, in 2014 at age 54. And now retired Red Sox pitcher Curt Schilling is battling cancer that he openly blames on his longtime chewing habit.

Opio Dupree, Thurmond’s chief of staff, said Tuesday that the penalties for violating the proposed ban have not yet been determined.

As news about the bill flew like foul balls on Tuesday, baseball players at spring training in Arizona Tuesday had a range of reactions.

Avid dipper Andrew Susac, the San Francisco Giants’ backup catcher, said he wasn’t too pleased. “I’ll have to quit,” Susac said. But, he quickly added, “it would be a good thing for me.”

“My mom and my future wife, they’re hassling me all the time to quit,” added Susac, 24, who tries not to chew on the field or in public.

Oakland Athletics pitcher Dan Otero, who doesn’t dip, said: “I think it will be good to deter young players from maybe getting started.”

In a statement Tuesday, Major League Baseball said it is in favor of getting rid of smokeless tobacco. “We have sought a ban of its use on-field in discussions with the Major League Baseball Players Association,” the statement said.

In the ‘90s, baseball announcer Joe Garagiola led the movement against chewing tobacco by teaming with retired major leaguer Bill Tuttle, who had mouth cancer. The pair traveled to ball parks to show the deformities — the loss of his teeth and gums, his jaw and his right cheekbone — Tuttle suffered from 40 years of chewing. He died in 1998.

While the players association had no response on Tuesday, Matthew Myers, president of the Campaign for Tobacco-Free kids, said the bill is the start of a national movement by nine national organizations.

“California seemed like the logical place to start this effort. It has the most teams in baseball. But it’s also important because of the death of Tony Gwynn,” Myers said. “He just meant so much to baseball and California, and he made it very clear before he died that he didn’t want another generation of young people to follow him in using smokeless tobacco. We hope California can be a catalyst.”

Thurmond, 46, elected last fall in a special election, said he has devoted his life to protecting youth.

“My mom died from cancer when I was 6 years old,” he said.

Meanwhile at spring training, Giants pitcher Tim Hudson, a non-chewer, predicted a number of players will not go down easily and will test the limits of the regulations.

“It all depends on what the fines and penalties are going to be,” Hudson said. “Guys have habits and are pretty stubborn, and they make a lot of money in here. They can pay a lot of whatever fines they want to give them. That’s going to be the biggest challenge — catching guys. Guys are sneaky.”

February, 2015|Oral Cancer News|

Curt Schilling Reveals his Diagnosis of Oral Cancer and Believes Chewing Tobacco was the Cause

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.
August, 2014|Oral Cancer News|

Salivary gland cancers rare, but sometimes deadly

Author: Andrea K. Walker

Professional baseball great Tony Gwynn Sr., also known as Mr. Padre, died last month of salivary gland cancer, which he believed was caused by years of using smokeless chewing tobacco. The cancer is a rare form that begins in any of the salivary glands in the mouth, neck or throat. Two adults in 100,000 are diagnosed with salivary gland cancer each year. The chances of survival drop if the cancer has spread to other parts of the body. Dr. Patrick K. Ha, with Johns Hopkins Head and Neck Surgery at Greater Baltimore Medical Center, says new types of treatments and therapies are in the works to treat the disease.

What is salivary gland cancer and how common is it?
Salivary gland cancers are a diverse group of rare malignancies that can involve any of the major salivary glands (the parotid, submandibular and sublingual) or minor salivary glands, which are found within the lip, palate, tongue base, nasal cavity or sinuses. There are numerous different cancers that may arise from the salivary glands, and these may behave differently based on their cell of origin.

What causes it, and who is more likely to get it?
Little is known about the causes of salivary gland cancers. Unlike the more common head and neck cancers, which have a clear association with smoking, drinking or even the human papillomavirus (HPV), salivary gland cancers do not have such strong associations. There may be a link between significant radiation exposure (i.e., treatment level doses) in the development of salivary gland cancers, as well as with some environmental exposures such as nickel alloy, asbestos or woodworking materials. Tony Gwynn believed using chewing tobacco throughout his professional baseball career was the cause of his cancer, but salivary gland cancers aren’t as strongly linked to tobacco use as some other types of cancers. Nonetheless, we advise against smoking, using smokeless tobacco or even e-cigarettes. They are all addictive and tobacco products contain carcinogens relevant to other cancers.

We do know that men are more likely to get this type of cancer, with the average age of onset in the mid-60s.

What are the symptoms of salivary gland cancer?
Unfortunately, salivary gland cancers most often present as painless masses in the cheek, neck, or within the sinuses/tongue base. Because most of these masses are slow growing, the development of symptoms occurs relatively late. Depending on which gland is involved, the symptoms may include a visible lump, difficulty breathing, swallowing problems or pain. Late symptoms might include facial weakness/drooping, numbness or visual changes.

How is it diagnosed and is it hard to detect?
The ultimate diagnosis is made with a biopsy. A distinction can often be made between benign and cancerous masses with a small needle biopsy, but sometimes requires complete removal of the mass to make this determination. Imaging with a CT scan or MRI can be helpful, especially for operative planning. Depending on where the tumor is located, detection can be more difficult. For example, a mass on the outer surface of the parotid or submandibular gland will be more easily felt than a mass growing in the sinus.

How is it treated and what is the likelihood of survival?
Most salivary gland cancers are treated with surgery up front for complete removal, and possibly radiation afterwards, depending on how serious the disease appeared at the time of surgery and under the microscope. Chemotherapy is less well proven to be helpful in these cancers but could sometimes be considered as additional therapy along with radiation. While some forms of salivary gland cancer can be aggressive, most are relatively well treated, and the five-year survival rate can be upwards of 75 percent.

What new therapies are on the horizon for salivary gland cancers?
Currently, there are trials available to examine the role of chemotherapy in salivary gland cancer treatment. Additionally, work is being done to look into targeted therapy which can better treat the cancers without the significant side effects. Unfortunately, because these are rare cancers, we need to perform the basic research to understand how these cancers arise before we can really make significant advancements in their treatment.

Gwynn’s death sparks dip debate

Author: Nick Peruffo

The death of San Diego Padres icon Tony Gwynn due to oral cancer Monday resonated across the baseball world — including the Trenton Thunder clubhouse.

In addition to being a person tragedy for the Gwynn family, the news also put a renewed focus on the use of chewing tobacco in baseball. Officially, tobacco in any form has been banned in the minor leagues since 1993. If caught with chewing tobacco on the field, players face a $300 fine, while managers are docked $1,000.

Away from the field, however, it is clear that some players continue to dip.

“There are so many guys that do it,” said catcher Tyson Blaser, who does not use chewing tobacco. “It’s very common in the major leagues, and even though obviously in the minor leagues you are not supposed to do it, some people don’t adhere to that. To see an icon like (Gwynn) lose his battle with cancer because of a habit a lot of people do, I assume it’d be eye opening to some people.”

Gwynn, who was just 54, blamed his cancer on dipping tobacco.

Despite that, manager Tony Franklin conceded that while the coaching staff does its best to dissuade players from using, what they do on their own time is ultimately their own decision.

“We encourage them not to do it, but they are adults with choices to make,” Franklin said. “The choices they make could be very beneficial and save their lives, so we hope they make the right choices. I will always continue to encourage them not to (chew tobacco).”

Franklin, who spent 11 seasons as an infield instructor with the Padres, knows of what he speaks. A longtime smoker and chewer, he said he was motivated to quit in part due to peers who had biopsies come back positive.

“It was probably one of the hardest things that I’ve done,” Franklin said.

Pitching coach Tommy Phelps — who spent parts of three big league seasons with the Florida Marlins and Milwaukee Brewers — recalled a jarring experience during his first big league camp with the Montreal Expos in 1996 that kept him away from chew.

Bill Tuttle, a former major league outfielder who had lost half his jaw to cancer, visited the team to show them first hand the potential effects of chewing. Tuttle died two years later.

“Just seeing that happens makes it real for everybody, that you are not going to be young forever,” Phelps said. “It’s dangerous.”

According to the Oral Cancer Foundation, an estimated 43,250 Americans will be diagnosed with oral or pharyngeal cancer this year, and 8,000 will die.

Hall of Famer and ‘Mr. Padre’ Tony Gwynn dies at 54 from Oral Cancer

Author: Bernie Wilson

Tony Gwynn could handle a bat like few other major leaguers, whether it was driving the ball through the “5.5 hole” between third base and shortstop or hitting a home run off the facade in Yankee Stadium in the World Series.

He was a craftsman at the plate, whose sweet left-handed swing made him one of baseball’s greatest hitters.

Gwynn loved San Diego.

San Diego loved “Mr. Padre” right back.

Gwynn, a Hall of Famer and one of the greatest athletes in San Diego’s history, died Monday of oral cancer, a disease he attributed to years of chewing tobacco. He was 54.

“Our city is a little darker today without him but immeasurably better because of him,” Mayor Kevin Faulconer said in a statement.

In a rarity in pro sports, Gwynn played his whole career with the Padres, choosing to stay in the city where he was a two-sport star in college, rather than leaving for bigger paychecks elsewhere. His terrific hand-eye coordination made him one of the game’s greatest pure hitters. He had 3,141 hits — 18th on the all-time list — a career .338 average and won eight batting titles to tie Honus Wagner’s NL record.

He struck out only 434 times in 9,288 career at-bats. He played in San Diego’s only two World Series — batting a combined .371 — and was a 15-time All-Star. He had a memorable home run in Game 1 of the 1998 World Series off fellow San Diegan David Wells, and scored the winning run in the 1994 All-Star Game despite a bum knee.

Gwynn never hit below .309 in a full season. He spread out his batting titles from 1984, when he batted .351, to 1997, when he hit .372.

Gwynn was hitting .394 when a players’ strike ended the 1994 season, denying him a shot at becoming the first player to hit .400 since San Diego native Ted Williams hit .406 in 1941.

Gwynn befriended Williams and the two loved to talk about hitting. Gwynn steadied Williams when he threw out the ceremonial first pitch before the 1999 All-Star Game at Boston’s Fenway Park.

Fellow Hall of Famer Greg Maddux tweeted, “Tony Gwynn was the best pure hitter I ever faced! Condolences to his family.”

Gwynn was known for his hearty laugh and warm personality. Every day at 4 p.m., Gwynn sat in the Padres’ dugout and talked baseball or anything else with the media.

Tim Flannery, who was teammates with Gwynn on the Padres’ 1984 World Series team and later was on San Diego’s coaching staff, said he’ll “remember the cackle to his laugh. He was always laughing, always talking, always happy.”

“The baseball world is going to miss one of the greats, and the world itself is going to miss one of the great men of mankind,” said Flannery, the San Francisco Giants’ third base coach. “He cared so much for other people. He had a work ethic unlike anybody else, and had a childlike demeanor of playing the game just because he loved it so much.”

Gwynn had been on a medical leave since late March from his job as baseball coach at San Diego State, his alma mater. He died at a hospital in suburban Poway, agent John Boggs said.

“He was in a tough battle and the thing I can critique is he’s definitely in a better place,” Boggs said. “He suffered a lot. He battled. That’s probably the best way I can describe his fight against this illness he had, and he was courageous until the end.”

Gwynn’s wife, Alicia, and other family members were at his side when he died, Boggs said.

Gwynn’s son, Tony Jr., was with the Philadelphia Phillies, who later placed him on the bereavement list.

“Today I lost my Dad, my best friend and my mentor,” Gwynn Jr. tweeted. “I’m gonna miss u so much pops. I’m gonna do everything in my power to continue to … Make u proud!”

Gwynn had two operations for cancer in his right cheek between August 2010 and February 2012. The second surgery was complicated, with surgeons removing a facial nerve because it was intertwined with a tumor inside his right cheek. They grafted a nerve from Gwynn’s neck to help him eventually regain facial movement.

Gwynn had been in and out of the hospital and had spent time in a rehab facility, Boggs said.

“For more than 30 years, Tony Gwynn was a source of universal goodwill in the national pastime, and he will be deeply missed by the many people he touched,” Commissioner Bud Selig said.

Fans paid their respects by visiting the statue of Gwynn on a grassy knoll just beyond the outfield at Petco Park.

Gwynn was last with his San Diego State team on March 25 before beginning a leave of absence. His Aztecs rallied around a Gwynn bobblehead doll they would set near the bat rack during games, winning the Mountain West Conference tournament and advancing to the NCAA regionals.

Last week, SDSU announced it was extending Gwynn’s contract one season. The Aztecs play at Tony Gwynn Stadium, which was built in the mid-1990s with a $4 million donation by then-Padres owner John Moores.

Gwynn was born in Los Angeles on May 9, 1960, and attended high school in Long Beach.

He was a two-sport star at San Diego State in the late 1970s and early 1980s, playing point guard for the basketball team — he still holds the game, season and career record for assists — and in the outfield on the baseball team.

Gwynn always wanted to play in the NBA, until realizing during his final year at San Diego State that baseball would be the ticket to the pros.

He was drafted by both the Padres (third round) and San Diego Clippers (10th round) on the same day in 1981.

After spending parts of just two seasons in the minor leagues, he made his big league debut on July 19, 1982. Gwynn had two hits that night. After Gwynn hit a double, all-time hits leader Pete Rose, who been trailing the play, said to him: “Hey, kid, what are you trying to do, catch me in one night?”

In a career full of highlights, Gwynn had his 3,000th hit on Aug. 9, 1999, a first-inning single to right field at Montreal’s Olympic Stadium.

Gwynn retired after the 2001 season and became a volunteer assistant coach at SDSU in 2002. He took over as head coach after that season.

He and Cal Ripken Jr. — who spent his entire career with the Baltimore Orioles — were inducted into the Hall of Fame in 2007.

“I had no idea that all the things in my career were going to happen,” Gwynn said shortly before being inducted. “I sure didn’t see it. I just know the good Lord blessed me with ability, blessed me with good eyesight and a good pair of hands, and then I worked at the rest.”

Gwynn also is survived by a daughter, Anisha.

Boggs said services were pending.

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

June, 2014|Oral Cancer News|

CDC reveals no drop in smokeless tobacco use among U.S. workers

Author: Margaret Steele, HealthDay Reporter

THURSDAY, June 5, 2014 (HealthDay News) — Cigarette smoking continues to decline among Americans who work, but use of smokeless tobacco — a known cause of cancer — has held steady since 2005, U.S. health officials reported Thursday. Certain types of jobs — construction and mining, especially — are hotbeds of smokeless tobacco use, according to a study conducted by the U.S. National Institute for Occupational Safety and Health. Looking at tobacco use over five years, the researchers found a decline in cigarette smoking among working adults — from about 22 percent in 2005 to 19 percent in 2010. But use of smokeless tobacco products such as chewing tobacco and snuff inched up slightly — from 2.7 percent in 2005 to 3 percent in 2010.”These findings can help health professionals direct assistance to working men and women to stop using smokeless tobacco, a known cause of oral, esophageal and pancreatic cancer,” the researchers from the U.S. Centers for Disease Control and Prevention reported. The CDC called on employers to try to snuff out all forms of tobacco use. New smokeless tobacco products such as snus (finely ground moist snuff) and candy-flavored dissolvable tobacco, combined with increased marketing, might explain smokeless tobacco’s steady use, the CDC authors said. However, snus and some other products weren’t included in the questionnaire so it’s possible smokeless tobacco use is underestimated, study author Dr. Jacek Mazurek, of the division of respiratory disease studies, and colleagues noted. Chewing tobacco and snuff aren’t safe, research has shown. These products may contain more nicotine than cigarettes, according to the U.S. National Institutes of Health. Nicotine is highly addictive, which is why it’s so hard to quit smoking. For the report, researchers analyzed data from the National Health Interview Survey. About 19 percent of mining workers acknowledged use of smokeless tobacco, the survey found. Adults involved in oil and gas extraction also reported heavy use of smokeless tobacco, with about 11 percent using the products, according to the study published in the June 6 issue of the CDC’s Morbidity and Mortality Weekly Report. The percentage of cigarette smokers who also use smokeless tobacco was relatively unchanged during the study period — about 4 percent, the researchers said. Employers can step up efforts to curb smokeless tobacco use, the CDC suggested. Making workplaces tobacco-free, offering information on the health risks of tobacco and the benefits of quitting can help reduce these destructive habits. Promoting work-based tobacco-cessation services, including health insurance that covers treatment for tobacco dependence, is another valuable aid, the CDC report said.The finding that 3 percent of working adults used smokeless tobacco in 2010 indicates that much work is needed to meet the Healthy People 2020 target of 0.3 percent or less for U.S. adults.

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

New study shows a rise in smokeless tobacco sales, especially among youth

Source: UMass Medical School Communications (
Author: Sandra Gray


The number of smokeless tobacco products sold in Massachusetts is soaring, as are the levels of nicotine packed into many of them, according to a new analysis from UMass Medical School and the Massachusetts Department of Public Health (DPH).

“Nationwide, cigarette smoking control has been very successful and we have experienced a steady decline, but that success is being offset by the increased use of smokeless tobacco products, especially by youth,” said UMMS statistical scientist Wenjun Li, PhD. Dr. Li, associate professor of medicine in the Division of Preventive and Behavioral Medicine, co-authored the paper with colleagues from the DPH.

Published in the journal Tobacco Control, the study examines ten years of product data (from 2003 to 2012) that Massachusetts law requires tobacco manufacturers provide to the DPH. Notable findings include a nearly 30 percent increase in the number of moist snuff products and a nearly sixfold increase in the number of snus products sold in Massachusetts; these increases correlate with rising use among high school students.

Nationwide, more than one in eight males in the 12th grade uses smokeless tobacco. In Massachusetts, use among high school students has more than doubled since 2001. A wide variety of smokeless tobacco products on the market include newer inventions like dissolvable lozenges, snus and moist snuff, many of them flavored and colorfully packaged to appeal to youth, along with more traditional forms used by adults including chewing tobacco and dry snuff.

Researchers were particularly interested in unionized, or free nicotine, the form that is most easily absorbed in the mouth. The amount of free nicotine and how it is delivered in both smokable and smokeless tobacco products is associated with a product’s addictive potential—and is determined by modifiable design features as well as the amount of nicotine contained naturally in the tobacco leaf.

They found that while nicotine levels varied, free nicotine increased for several manufacturers. Li and DPH lead author and research analyst Doris Cullen,MA, believe that these as-yet inexplicable variations in nicotine content support the argument that free nicotine levels are controlled in the manufacturing process, and suggests that manufacturers are manipulating products’ addictive potential.

“The current success in tobacco control is very likely undermined without government surveillance, regulation and widespread public disclosure of nicotine levels in these products,” said Cullen.

“Smokeless products are easier for youth to access and use than cigarettes, and harder for parents to monitor,” said Li. “Even though they have less nicotine than cigarettes, more of that nicotine is readily absorbed, making snus and moist snuff a gateway to nicotine addiction and, possibly, future smoking.”

While the study did not focus on smokeless tobacco marketing, he noted that packaging products to look like candy also suggests that the tobacco industry is specifically targeting youth.

“This study supports that the tobacco industry’s manipulation of product design extends to smokeless products,” said corresponding author Lois Keithly, PhD, director of the DPH’s Massachusetts Tobacco Cessation and Prevention Program. “Considering the potential risk for nicotine addiction associated with the use of smokeless tobacco products, and the aggressive marketing of these products, it is critical to continue and expand surveillance of smokeless products at the state and national levels.”


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

March, 2014|Oral Cancer News|

New study claims children who use snus before age 16 are more likely to become cigarette smokers

Source: Reuters Health

Author: Shereen Jegtvig

Norwegians who started using snus before age 16 were more likely to become cigarette smokers than those who started using snus later in life, according to a new study.

Snus is moist smokeless tobacco developed in Sweden. It’s contained in a small pouch, and unlike regular chewing tobacco, it doesn’t make the user spit.

Research suggests snus has lower levels of chemicals called nitrosamines than cigarettes and may be less harmful.

In Norway, snus has become a smoking cessation aid and most older snus users are former smokers.

But snus is also becoming increasingly popular among young Norwegian adults, many of whom have not smoked cigarettes. And although research is divided, the current thinking is that snus use reduces the likelihood of taking up smoking.

The authors of the new study wanted to know more about when people start using snus, to see if that ties into whether they also begin smoking cigarettes.

“I already knew about the research investigating associations between snus use and later smoking, but discovered that snus debut age had not been mentioned in that research,” Ingeborg Lund told Reuters Health in an email.

Lund is a researcher with the Norwegian Institute for Alcohol and Drug Research – SIRUS, in Oslo. She and her colleague Janne Scheffels published their study in Nicotine and Tobacco Research.

The researchers analyzed surveys of Norwegian teenagers and adults conducted from 2005 to 2011.

Out of 8,313 people, 409 were long-term snus users who had started using snus before cigarettes or never used cigarettes. Of the snus users, 30 percent were long-term smokers.

Just over one third of the snus users started using snus before age 16. The researchers discovered those participants had two to three times the odds of becoming lifetime smokers, compared to people who began using snus after age 16.

They also found that early snus users had about the same rate of cigarette smoking as non-snus users. About 23 percent of early snus users were current smokers at the time of the survey, compared to only six percent of people who started using snus when they were older.

“Snus use seems to protect against smoking if the snus debut does not happen too early during adolescence,” Lund said.

She said it’s particularly important to keep teenagers tobacco-free until they are at least 16 years old.

“At younger ages, even if they start with a low risk product such as snus, there is a high risk that they will switch to – or add – other high-risk products, such as cigarettes,” she said. “This risk is reduced when they grow older.”

Since snus use is much less common in other countries, Lund said she doesn’t know if these results can be generalized outside of Norway and Sweden.

Lucy Popova, from the Center for Tobacco Control Research and Education at the University of California, San Francisco, told Reuters Health the new study was “interesting.” She was not involved in the research.

“Earlier initiation of snus basically makes it a gateway to tobacco use, to cigarette use in the future,” she said.

Popova explained that traditional Swedish snus is less dangerous than cigarettes.

“But it’s not harm-free, and (what) is really bad is when people start using both products because of increased rates of cardiovascular disease, pancreatic cancers and other problems,” she said.

Snus is fairly new to the U.S., and Popova said the version made in the U.S. isn’t like the traditional Swedish product.

“A research study found that it’s different from the traditional low-nitrosamine snus in Sweden – it’s not necessarily going to be as low-harm,” she said.

Popova is concerned with heavy promotion for smokeless tobacco products like snus.

“There’s been a lot of studies showing that more advertisement for tobacco products makes it more likely that children will use tobacco products,” she said, “and it’s important to keep youth tobacco-free as long as possible.”

RESEARCH SOURCE: Nicotine and Tobacco Research, online February 5, 2014.

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

February, 2014|Oral Cancer News|

Spike in oral cancers puzzles experts

Author: Victoria Colliver/San Francisco Chronicle

Christine Schulz has never visited England, but she speaks with the clipped inflection of a vaguely British accent. It’s not an affectation but, rather, the mystifying after-effect of an 18-hour surgery she endured in 2009 to remove about half her tongue due to a cancerous growth that had spread to her lymph nodes.

Surgeons used skin from her wrist and upper leg to re-create the missing portions of her tongue. Through long term speech therapy, Schulz, 47, of Hollister, Calif., re-learned how to eat and talk with her reconstructed tongue. If she sounds as if she’s from a different country, Schulz isn’t complaining.

“At the moment I woke up from surgery, I realized exactly what a huge deal it was,” she said, describing how she had an incision in her throat to allow her to breathe and was prohibited to speak in her earliest days of healing.

Oral cancers, which include those of the mouth and tongue, are most common in men over 60 with a long history of smoking or chewing tobacco, often combined with heavy drinking. But in recent years, a spike in the incidence of oral cancers is being attributed to human papilloma virus or HPV.

But Schulz’s cancer was neither HPV– nor tobacco-related. That puts her in a camp of fewer than 7 percent of all oral cancers that have no identifiable cause, according to the Oral Cancer Foundation, an advocacy group based in Newport Beach, Calif.

“Surprisingly, a high percentage of tongue cancers — 45 percent — is not related to the virus. The cause, we don’t know,” said Dr. Steven Wang, a head and neck surgeon at the University of California San Francisco with expertise in microvascular reconstructive surgery.

Tongue cancer is relatively rare, diagnosed last year in about 13,000 U.S. patients — more than 9,000 men and 3,700 women. It leads to some 2,000 annual deaths, according to the National Cancer Institute. Overall, there were 42,000 diagnoses of the broader category of oral cancers, which include the mouth cavity, lips and the oropharynx, or the part of the throat at the back of the mouth. Oral cancers combined kill about 8,000 each year.

While statistics show many cancer types leveling off or even decreasing in recent years, the incidence of oral cancer has increased, due in large part to HPV. Between 1988 and 2004, the percentage of HPV-related oropharynx cancers skyrocketed by 225 percent, according to a 2011 study published in the Journal of Clinical Oncology. But that doesn’t explain the rise in oral cancers among patients with no known cause.

“It could be a genetic predisposition or it could be an outside source, a causal agent that hasn’t been discovered yet,” said Brian Hill, the Oral Cancer Foundation’s executive director.

Wang, who reconstructed Schulz’s tongue, said nonsmoking-related oral cancers tend to be less responsive to chemotherapy and radiation than HPV- and smoking-related tongue cancers. And often the symptoms are overlooked. His latest research, to be published in the journal Otolaryngology — Head and Neck Surgery, found that former or current smokers with a form or tongue cancer called squamous cell carcinoma had a better chance of surviving than patients with the same cancer who never smoked.

“People always notice the sore or the ulcer in the mouth, but they’re not thinking it’s cancer,” he said. “They’re thinking, ‘I’ve never smoked, I’m too young.’ And, unfortunately, their doctors are thinking the same thing.”

Because treatment is frequently delayed, Wang said nonsmokers with tongue cancer are more likely to have the disease treated aggressively. Surgeons are able to reconstruct the tongue, but they have yet to find a way to re-create its function.

For Schulz, what started as a bump in the back of her tongue that wouldn’t go away turned into a life-altering experience. Her marathon surgery and reconstruction was followed by chemotherapy, radiation and a year and a half of speech therapy.

Most extremely sweet foods do not register on what’s left of her taste buds, although she loves chocolate more than ever. She avoids bread and crackers because those kinds of foods turn to cement in her mouth, and she finds salads just too much work.

“Putting food in my mouth still feels foreign,” she said, adding that it takes her a long time to eat. “I have to chew it. I have to have a thought about where it is inside my mouth and make sure it stays there, chew enough so I know I have to swallow and then I have to have water.”

Here are some signs and symptoms of the disease:

– Patches inside your mouth or on your lips
– A sore on your lip or in your mouth that doesn’t heal
– Bleeding in your mouth
– Loose teeth
– Difficulty or pain when swallowing
– Difficulty wearing dentures
– A lump in your neck
– An earache that doesn’t go away
– Numbness of lower lip and chin

Sources: National Cancer Institute; Oral Cancer Foundation

March, 2013|Oral Cancer News|

New gene test detects early mouth cancer risk


Researchers from Queen Mary, University of London have developed a new gene test that can detect pre-cancerous cells in patients with benign-looking mouth lesions. The test could potentially allow at-risk patients to receive earlier treatment, significantly improving their chance of survival.

The study, published online in the International Journal of Cancer, showed that the quantitative Malignancy Index Diagnostic System (qMIDS) test had a cancer detection rate of 91-94 per cent when used on more than 350 head and neck tissue specimens from 299 patients in the UK and Norway. Mouth cancer affects more than 6,200 people in the UK each year and more than half a million people worldwide, with global figures estimated to rise above one million a year by 2030*. The majority of cases are caused by either smoking or chewing tobacco and drinking alcohol.

Mouth lesions are very common and only five to 30 per cent may turn into cancers. If detected in the early stages treatment can be curative, but until now no test has been able to accurately detect which lesions will become cancerous.

The current diagnostic gold standard is histopathology – where biopsy tissue taken during an operation is examined under a microscope by a pathologist . This is a relatively invasive procedure and many mouth cancers are being diagnosed at later stages when the chances of survival are significantly reduced. For patients presenting with advanced disease, survival rates are poor (10-30 per cent at five years).

Lead investigator and inventor of the test Dr Muy-Teck Teh, from the Institute of Dentistry at Queen Mary, University of London, said: “A sensitive test capable of quantifying a patient’s cancer risk is needed to avoid the adoption of a ‘wait-and-see’ intervention. Detecting cancer early, coupled with appropriate treatment can significantly improve patient outcomes, reduce mortality and alleviate long-term public healthcare costs.”

The qMIDS test measures the levels of 16 genes which are converted, via a diagnostic algorithm, into a “malignancy index” which quantifies the risk of the lesion becoming cancerous. It is less invasive than the standard histopathology methods as it requires only a 1-2 mm piece of tissue (less than half a grain of rice), and it takes less than three hours to get the results, compared to up to a week for standard histopathology.

Consultant oral and maxillofacial surgeon, Professor Iain Hutchison, founder of Saving Faces and co-author on the study, said: “We are excited about this new test as it will allow us to release patients with harmless lesions from regular follow-up and unnecessary anxiety, whilst identifying high-risk patients at an early stage and giving them appropriate treatment. Mouth cancer, if detected early when the disease is most receptive to surgical treatment, has a very high cure rate.”

Dr Catherine Harwood, a consultant dermatologist and a co-author on the study, said: “Our preliminary studies have shown promising results indicating that the test can potentially also be used for identifying patients with suspicious skin or vulva lesions, offering the opportunity of earlier and less invasive treatments.”

Whilst this proof-of-concept study validates qMIDS as a diagnostic test for early cancer detection, further clinical trials are required to evaluate the long-term clinical benefits of the test for mouth cancers.

With further development it could potentially be applied to other cancer types as the test is based on a cancer gene – FOXM1 – which is highly expressed in many cancer types. In this study the researchers used the qMIDS test to detect early cancer cells in vulva and skin specimens with promising results.

Dr Teh’s earlier research on FOXM1 – which showed that when FOXM1 is overexpressed the protein loses its control over cell growth, allowing cells to proliferate abnormally –was awarded ‘Molecule of the Year 2010’ by the International Society for Molecular and Cell Biology and Biotechnology Protocols and Research.

1. This study was jointly funded by the Facial Surgery Research Foundation – Saving Faces (UK), the Bergen Medical Research Foundation, Norwegian Cancer Research Association, British Skin Foundation and Cancer Research UK.

2. Teh M-T, et al. (2012) ‘Exploiting FOXM1-Orchestrated Molecular Network for Early Squamous Cell Carcinoma Diagnosis and Prognosis’ is published in the peer-reviewed journal International Journal of Cancer.

October, 2012|Oral Cancer News|