lung cancer

After a long battle with 3 different types of cancer, a footloose Orlando man takes on a 2,650-mile hike

At 68, John Casterline has beaten advanced-stage lung cancer, prostate cancer and throat cancer. Last month, he finished radiation
treatments. Just one week ago, his doctors pronounced him cancer-free.
So what is he doing to celebrate? 

Forget Disney World. Starting April 28, this Orlando retiree will be hiking 2,650 miles, from Canada to Mexico, along the Pacific Crest Trail — a route that will climb above 13,000 feet elevation and require him to average 20 miles a day.

“I expect that I will experience weather that is too cold, too hot, too wet, too dry and too perfect,” he wrote in his journal a year ago, when he began training seriously for the hike. “I will encounter rattle snakes, bears, and maybe even mountain lions. … The mosquitoes will be horrendous at times, the hills steep, the rocks sharp, the trail blocked, the wind very strong. [Sleep will be] occasionally fitful and I’ll be carrying a backpack with 30-plus pounds.”

But if you have to ask why he’s doing it, he wrote, you wouldn’t understand. 

It is not simply that he hopes to raise $26,500 for the dramatically underfunded battle against lung cancer, a disease expected to claim the lives of 160,000 Americans this year — more than colon, breast and prostate cancers combined.

Nor is it about creating some kind of legacy. Though followers can read his ongoing exploits on lungcancerhike.org, the website is intended to give fellow cancer survivors hope — and to collect donations for the American Lung Association — not to brag.

“John is the guy you want with you in a foxhole,” said Eric Gray, an executive director at the American Lung Association of Florida. “He’s the guy who makes you believe anything is possible.”

Casterline is a favorite at Orlando lung-cancer support-group meetings, and Gray often uses him as a beacon of hope when counseling the newly diagnosed.

“In years past, there hasn’t been a lot to say to people other than, ‘I’m so sorry,’ ” Gray said. But now I can say, ‘Let me tell you about this guy who had Stage 4 lung cancer and this remarkable thing he’s doing …”

Casterline was diagnosed in August 2006, a week after he retired from 21 years working for 7-Eleven preceded by 21 years in the Navy. He had quit smoking seven years earlier — 1999, the same year he took up backpacking at the urging of his eldest son. By the time the disease was detected, it was so far advanced he was given a 3.5 percent chance of surviving the next five years.

“You go through these stages of grief,” he said. “For two or three days, I figured I wouldn’t make it a year.”

It may have been the only time his relentless spirit waned, and even then it didn’t last long. He researched exhaustively, interviewed doctors at five hospitals — including Memorial Sloan-Kettering in his birth state of New York — and ultimately selected M.D. Anderson Cancer Center Orlando. He went through surgery, chemotherapy and more than one round of radiation, and by February 2007 he was officially cancer-free.

That lasted a blissful 3 1/2 years, until he developed prostate cancer. He had just finished surgery for that in November last year when, one month later, doctors discovered the earliest stage of throat cancer. 

“He exercised all through chemotherapy and radiation,” said Dr. Jennifer Tseng, his medical oncologist, who counts herself a fan. “Probably the only time he didn’t exercise is when he was in the hospital after surgery. And even then, he was back on his feet in no time. He’s got an amazing spirit and willpower.”

The average person undergoing radiation would still be trying to eat solid food at this point, she said. Casterline, who began competing in marathons 10 years ago, has been out hiking 14 miles a day wearing a 35-pound backpack. Within the past week, all three of his doctors have given their blessing to the upcoming hike.

In fact, in some ways, Casterline’s wife of 41 years, Sue, has been the toughest sell.

“When he first told me about this trip, I thought, ‘You’re out of your mind,’ ” she admits. “It was just surreal. But he’s a force of nature, and he’s going to do what he’s going to do. I mean, I can’t stop him.”

She did, however, make him update his will.

As she says this, the family room has turned into a staging area with 13 cardboard boxes of food due to be shipped to various post offices near the Pacific Crest Trail. Those are for the times when the nearest store is 20 miles away. Casterline has the spots numbered on spreadsheets that detail his mileage, route-elevation changes, meet-ups with his wife and two grown sons, and notations on the hazards du jour. 

“Water supply contaminated — dead rodents,” he notes for Day 5, a 20-mile stretch through the scrub oak and chaparral of Southern California. “Poison oak about mile 105.”

His gear has been weighed to the nearest tenth of an ounce. All his clothing comes in at 2.56 pounds. His tent, sleeping bag, backpack, ground cover and pad: 7.66 pounds. Total, with cooking and hygiene supplies, medications, emergency whistle, duct tape, bug repellent, iodine tablets, reading glasses and playing cards: 15.97. It’s the food and water that will add an additional 20 or so pounds. Plus there’s the 1-pound ice axe he can ditch after the halfway point.

He has coaxed sponsorships from Nestlé, which owns PowerBar energy products, and Mango International, which sells a small solar panel to recharge his iPhone. He’ll also carry a pocketknife and perhaps a 6-ounce Kindle reader. But he’s still on the fence over a distress signal that alerts rescue workers you need to be airlifted to a hospital.

“It’s 8 to 10 ounces,” he said, frowning. 

Though Casterline feigns fearlessness most of the time, he admits one enormous worry: failure.

“I’m very determined, mentally and physically, and I know I’ve already been tested pretty hard,” he said. “But that’s one of my greatest fears: that I won’t make it.”

On bad days — and there will be bad days — he will remember to look at the names his granddaughter has printed on his backpack in ink. “Alysan F.,” “Judy C.” and “William R.,” they read. There are 100 names in all: lung-cancer patients or their loved ones. Some he has only met online. If not for himself, then at least for them, he must try to persevere.

No one is betting against him.

“Short of getting eaten by a bear,” his wife said, “he’s going to do it.”

 

Source: Orlando Sentinel

April, 2011|Oral Cancer News|

Assessment of human papillomavirus in lung tumor tissue

Source: Journal of the National Cancer Institute

Abstract

Background Lung cancer kills more than 1 million people worldwide each year. Whereas several human papillomavirus (HPV)–associated cancers have been identified, the role of HPV in lung carcinogenesis remains controversial.

Methods We selected 450 lung cancer patients from an Italian population–based case–control study, the Environment and Genetics in Lung Cancer Etiology. These patients were selected from those with an adequate number of unstained tissue sections and included all those who had never smoked and a random sample of the remaining patients. We used real-time polymerase chain reaction (PCR) to test specimens from these patients for HPV DNA, specifically for E6 gene sequences from HPV16 and E7 gene sequences from HPV18. We also tested a subset of 92 specimens from all never-smokers and a random selection of smokers for additional HPV types by a PCR-based test for at least 54 mucosal HPV genotypes. DNA was extracted from ethanol- or formalin-fixed paraffin-embedded tumor tissue under strict PCR clean conditions. The prevalence of HPV in tumor tissue was investigated.

Results Specimens from 399 of 450 patients had adequate DNA for analysis. Most patients were current (220 patients or 48.9%) smokers, and 92 patients (20.4%) were women. When HPV16 and HPV18 type–specific primers were used, two specimens were positive for HPV16 at low copy number but were negative on additional type-specific HPV16 testing. Neither these specimens nor the others examined for a broad range of HPV types were positive for any HPV type.

Conclusions When DNA contamination was avoided and state-of-the-art highly sensitive HPV DNA detection assays were used, we found no evidence that HPV was associated with lung cancer in a representative Western population. Our results provide the strongest evidence to date to rule out a role for HPV in lung carcinogenesis in Western populations.

March, 2011|Oral Cancer News|

Global cancer statistics

Corresponding author: Ahmedin Jemal, DVM, PhD, Surveillance Research, American Cancer Society

The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally.

March, 2011|Oral Cancer News|

Global cancer statistics

Source: HighWire, Stanford University

The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. OCF Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally. CA Cancer J Clin 2011. � 2011 American Cancer Society, Inc.

February, 2011|Oral Cancer News|

Dog Sniffing Out Cancer May Lead to Early Detection Test

Source: Medscape Today

By: Zosia Chustecka

The latest study demonstrating that dogs can sniff out cancer has confirmed the notion that a specific cancer smell does exist, and has added fuel to the idea of developing a test based on odor.

Previous studies have reported on dogs that can detect lung and breast cancer from breath samples, and there has been anecdotal evidence suggesting that dogs can detect melanoma, bladder, and ovarian cancers.

In this latest study, published online January 31 in Gut, a Labrador retriever was trained over several months to sniff out colorectal cancer in breath and watery stool samples.

Hideto Sonoda, MD, and colleagues from Kyushu University in Fukuoka, Japan, report that this dog was then tested with samples obtained from colorectal cancer patients and from volunteers, some of whom had gastrointestinal problems such as ulcers and inflammatory bowel disease.

The dog correctly identified cancer in 33 of 36 breath tests and in 37 of 38 stool tests. This equates to 95% accuracy overall for the breath test and 98% accuracy overall for the stool test, the researchers report.

The highest detection rates were among samples taken from patients with early-stage cancer, they add. Samples taken from smokers and from people with other gastrointestinal diseases, which might be expected to mask or interfere with cancer odors, did not appear to confuse the dog.

“This study shows that a specific cancer scent does indeed exist,” the researchers conclude.

They are not suggesting using dogs in clinical practice, however. They point out that training the dog was expensive and time-consuming, and that ability and concentration vary between individual dogs and even the same dog on different days. OCF The dog’s concentration tends to decrease during the hot summer season; hence, they conducted their test between November and early June.

What they do propose is that this research could be used to develop cancer detection tests based on “odor materials.”

This would involve identifying the cancer-specific volatile organic compounds (VOC) that are being detected by dogs using chemical analysis, and then developing an early cancer detection sensor that would substitute for the dog, they explain.

There has already been some work conducted on VOC in exhaled breath (using gas chromatography and mass spectroscopy) for the early detection of breast and lung cancer, they note, although they add that this work is still preliminary.

“We hope that the results of the present study will provide encouragement for the development of cancer detection and solving the biological character of cancer using odor material,” Dr. Sonoda and colleagues conclude.

February, 2011|Oral Cancer News|

Assessment of human papillomavirus in lung tumor tissue

By: Journal of the National Cancer Institute

Affiliations of authors: Division of Cancer Epidemiology and Genetics, NCI/NIH/DHHS, Bethesda, MD (JK, MR, AKC, AMG, AH, PRT, SW, MTL, NEC); Department of Internal Medicine, Ohio State University Comprehensive Cancer Center–James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH (MLG, HS); DDL Diagnostic Laboratory, Voorburg, the Netherlands (L-JVD, WGVQ, LS); EPOCA Research Center, Department of Occupational and Environmental Health, Università degli Studi di Milano, Milan, Italy (LT, PAB); Epidemiology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy (LT, PAB)

Background Lung cancer kills more than 1 million people worldwide each year. Whereas several human papillomavirus (HPV)–associated cancers have been identified, the role of HPV in lung carcinogenesis remains controversial.

Methods We selected 450 lung cancer patients from an Italian population–based case–control study, the Environment and Genetics in Lung Cancer Etiology. These patients were selected from those with an adequate number of unstained tissue sections and included all those who had never smoked and a random sample of the remaining patients. We used real-time polymerase chain reaction (PCR) to test specimens from these patients for HPV DNA, specifically for E6 gene sequences from HPV16 and E7 gene sequences from HPV18. We also tested a subset of 92 specimens from all never-smokers and a random selection of smokers for additional HPV types by a PCR-based test for at least 54 mucosal HPV genotypes. DNA was extracted from ethanol- or formalin-fixed paraffin-embedded tumor tissue under strict PCR clean conditions. The prevalence of HPV in tumor tissue was investigated.

Results Specimens from 399 of 450 patients had adequate DNA for analysis. Most patients were current (220 patients or 48.9%) smokers, and 92 patients (20.4%) were women. OCF. When HPV16 and HPV18 type–specific primers were used, two specimens were positive for HPV16 at low copy number but were negative on additional type-specific HPV16 testing. Neither these specimens nor the others examined for a broad range of HPV types were positive for any HPV type.

Conclusions When DNA contamination was avoided and state-of-the-art highly sensitive HPV DNA detection assays were used, we found no evidence that HPV was associated with lung cancer in a representative Western population. Our results provide the strongest evidence to date to rule out a role for HPV in lung carcinogenesis in Western populations.

Published by Oxford University Press 2011.

February, 2011|Oral Cancer News|

Wrong way to go smoke-free

Source: Newsobserver.com
By: Joseph G.L. Lee

CHAPEL HILL — So, now R.J. Reynolds Tobacco Company wants to help smokers “break free” from tobacco? That statement should make parents, health care providers and smokers nervous.

Last month, Reynolds promoted its Camel Snus (a “spit-free” tobacco pouch) with advertisements in national magazines that read “If you’ve decided to quit tobacco use, we support you,” under a large “2011 Smoke-free Resolution” banner. Reynolds then offered its smoke-free snus as the solution.

For smokers, the majority of whom try to quit every year, the message should be to quit tobacco use, not to substitute one form of cancer for another. No safe form of tobacco use exists. Smokers who try tobacco snus products are at high risk of becoming addicted to both cigarettes and snus, thus continuing or even adding to their risk for lung, bladder, breast, cervical, oral and pancreatic cancer.

In addition to running these misleading ads in People, Time and Rolling Stone, R.J. Reynolds is continuing a long-standing practice of targeting vulnerable populations such as young people, African-Americans and gays and lesbians.

Last year, research in the medical journal Pediatrics implicated Reynolds’ “Camel No. 9” campaign in an increase in smoking among young teenage girls.

The tobacco industry has long targeted African-Americans by focusing on marketing and so-called “corporate social responsibility” strategies to buy favor with civil rights organizations. Researchers at the University of California, San Francisco estimated that the approximately $25 million in tobacco industry corporate philanthropy that funded African-American community groups, when divided by the number of premature deaths from tobacco in black communities, meant that each African-American death was traded for $555 in corporate support.

In December, a court in Massachusetts found Lorillard, Inc., liable fortargeting black teenagers with free samples of menthol cigarettes.

Now, Reynolds has begun targeting gay and lesbian newspapers across the country.

Our own research at UNC-Chapel Hill shows that gays and lesbians are 50 percent to 100 percent more likely to smoke and thus to die much earlier from tobacco-related diseases. We recently conducted surveys in gay and lesbian bars and Pride Festivals in West Virginia in which 45 percent of those surveyed reported using a tobacco product. These rates of tobacco, cigarettes and snus use are alarming and likely even higher among transgender populations.

Researchers have documented that industry-designed youth prevention programs actually increase youth susceptibility to trying cigarettes. New campaigns that promise a smoke-free life by promoting other addictive tobacco products will likely keep more people addicted to tobacco.

Smokers who want to quit for real should talk to their health care providers, make a quit plan and call the free Quitline at 1-800-QUITNOW or visit www.BecomeAnEX.org.

The evidence is clear: advertisements from the tobacco industry sell death, half-truths and promote health inequalities. Federal judges have let stand industry racketeering convictions resulting from conspiracy to hide health consequences of smoking. Smokers’ resolutions to quit should not be co-opted into deeper addiction by industry advertising.

February, 2011|Oral Cancer News|

Aspirin Cuts Death Rate From Several Common Cancers

Source: Web MD

Taking aspirin over a long period of time can substantially cut the risk of dying from a variety of cancers, according to a study showing that the benefit is independent of dose, gender, or smoking.

It also found that the protective effect increases with age.

The study is by Peter Rothwell, MD, PhD, FRCP, of John Radcliffe Hospital in Oxford, England, and colleagues, and has been published online by the journal the Lancet.

A previous study by the same authors showed that low doses of aspirin (75-300 milligrams) reduced the number of cases of colorectal cancer by a quarter and deaths caused by the disease by more than a third. The latest study confirms the earlier results and concludes that similar effects can be shown for other types of cancers.

The study looked at eight trials examining the effects of a daily dose of aspirin on preventing heart attacks involving 25,570 patients, 674 of whom died from cancer. They showed a 21% reduction in the number of deaths caused by cancer among those who had taken aspirin, compared with people who had not.

The investigation also showed that the benefits of taking aspirin increased over time. After five years, death rates were shown to fall by 34% for all cancers and by 54% for gastrointestinal cancers.

Participants were also followed up after 20 years, by which point 1,634 of the original participants had died as a direct result of cancer. This 20-year follow-up established that the risk of cancer death remained 20% lower among those who had been allocated aspirin than those in the control group for all solid cancers, including lung, prostate, brain, bladder, and kidney cancers, and by 35% for gastrointestinal cancers.

The fall in the risk of death broke down according to individual types of cancer:

Reductions in pancreatic, stomach, and brain cancers were difficult to quantify because of smaller numbers of deaths, the authors say.

Protective Effect Increases Over Time

The protective effect of taking low doses of aspirin varied according to the type of cancer and how long aspirin had been taken, the authors found. For instance, it only became apparent after about five years for esophageal, pancreatic, brain, and lung cancer; about 10 years for stomach and colorectal cancer; and about 15 years for prostate cancer.

Any benefit for lung and esophageal cancer was limited to adenocarcinomas, which are most commonly seen in nonsmokers.

Should Middle-Aged People Take Aspirin?

Previous research has linked aspirin with reductions in heart attacks and strokes, but doctors have been wary when recommending whether people should take daily doses of aspirin because of the risk of gastric bleeding. Rothwell says, “The size of the effect on cancer I think is such that it does more or less drown out those sorts of risks.”

However, he says the authors of the study do not make recommendations on taking aspirin based on this study.

Peter Elwood, MD, DSc, FRCP, an expert on aspirin from Cardiff University who was not involved in the study, says that doctors are often reluctant to recommend aspirin because “the risk of causing a bleed by what the doctor prescribes is going to be uppermost in a doctor’s mind.” A patient might interpret the risk differently, he says.

Rothwell and his colleagues say that more research is required, in particular for the effect on breast cancer and other cancers affecting women as well as the effect on patients beyond the 20-year period. The results of further trials are expected to be published in 2011.

‘Promising Results’

Ed Yong, head of health information and evidence at Cancer Research UK, says in an emailed statement: “These promising results build on a large body of evidence suggesting that aspirin could reduce the risk of developing or dying from many different types of cancer. While earlier studies suggested that you only get benefits from taking high doses of aspirin, this new study tells us that even small doses reduce the risk of dying from cancer provided it is taken for at least five years.

“In addition to the effect on cancer death, aspirin can affect our health in other ways, such as reducing the risk of stroke but increasing the chances of bleeding from the gut. We await trials results expected next year to learn more about these different effects.

“We encourage anyone interested in taking aspirin on a regular basis to talk to their [doctor] first.”

December, 2010|Oral Cancer News|

Smoking cessation funding slashed

Source: Atlantic Drugs

By: Susan Ray

Smoking cessation funding has been cut to its lowest level since 1999.

Despite 20% of the population smoking, the same percentage that were in 2006, the current economic climate and other factors have caused states to reduce funding for stop smoking initiatives.

Around $517 million has been allocated in the fiscal year 2011, which is down 9.2% from the previous year, and 28% less than in 2009.

Alarm

Public health groups are alarmed that people who are looking to quit smoking may now not get the help that they need. There are around 46 million smokers across America, all at an increased risk of developing serious health problems like lung and mouth cancer, and heart disease. Smoking is the biggest cause of preventable death in the US and is responsible for one in five deaths. About 8.6 million people suffer from smoking-related lung and heart disease. Smokers are twice as likely to die from heart attacks in comparison with non-smokers.

Most important step

The US Surgeon General has said, “Smoking cessation (stopping smoking) represents the single most important step that smokers can take to enhance the length and quality of their lives.”

Quitting smoking can be difficult. Some smokers find that the nicotine addictions make it too hard to give up. For others, the mental cravings to smoke are a greater problem. Research has shown that quitting smoking is more ‘mind over matter’ for many people, and that overcoming psychological desires to smoke cigarettes is a large part of giving up. Some smokers find that the anti-smoking medication Champix helps with their smoking cessation efforts.

November, 2010|Oral Cancer News|

Penthouse Founder Bob Guccione Dead at 79

Source: ThirdAge News

Penthouse founder Bob Guccione died on Wednesday in Texas after a long bout with lung cancer, his family said. He was 79 years old.

Guccione also suffered from oral cancer, the Oral Cancer Foundation says. “My cancer was only a tiny tumor about the size of an almond at the base of my tongue,” he explained in an intervie with New York Magazine. “The cure is probably every bit as bad as the disease. It’s affected my ability to swallow . . . the mobility of my tongue . . . it makes it very difficult for me to talk…”

The Wall Street Journal reported his family said in a statement Guccione died at Plano Specialty Hospital in Plano.

Guccione created Penthouse in 1965, immediately setting it apart from Hugh Hefner’s Playboy magazine through its more graphic photos of unclothed women and less reliance on the written word. If Playboy was the publishing world’s version of the Beatles, Penthouse was the Rolling Stones.

“Unlike his future arch-rival Hugh Hefner, he did not suffer from sexual shyness and repression,” John Heidenry, a former Penthouse Forum editor wrote in his book “What Wild Ecstasy.”

“He liked girls, pure and simple, like any average healthy Italian boy from New Jersey, and he was no virgin.”

Guccione diversified into other magazines, movies and other ventures and his fortune at one time was estimated at $400 million but Penthouse’s popularity waned with the advent of Internet pornography.

October, 2010|Oral Cancer News|