9/27/2004 TAMPA, FL Ivanhoe Broadcast News HealthCentral.com Combining radiation and chemotherapy to kill cancer cells is often very difficult on patients because of the side effects, but new research shows the results may be worth it. Days like this with her family make it all worthwhile for Ruth Toseland. Three years ago, she was diagnosed with tongue cancer. A portion of her tongue was removed, but the cancer came back. After two more surgeries, she opted for an extreme treatment -- radiation combined with chemotherapy. Oncologist Julie A. Kish, M.D., of Moffitt Cancer Center in Tampa, Fla., was involved in a national study that may change the treatment of choice for patients at high risk for recurrence. "At two years, the recurrence rate was lower in patients that had the combined treatment as opposed to radiation alone," she tells Ivanhoe. But the treatment is very hard on the patient. Researchers say four of the 228 patients in the study died as a result of the combined therapy. Still, Dr. Kish says, for some, the tough approach is worth it. "If you can prolong the time until the cancer comes back, which potentially, at some point in time, it may not come back, which we never say because we can't predict that, it's worth going through it." Ruth finished her treatment two and half years ago. So far, the cancer has not returned. Her husband, Michael, says, "We've got a lot to be thankful for. It was touch and go for [...]

9/27/2004 Ritesh Gupta, MD, MPH; Hitinder Gurm, MD; John R. Bartholomew, MD Archives of Internal Medicine, 2004;164:1845-1849 This article discusses the evolution of smokeless tobacco in the United States and interprets the available data on cardiovascular risk factors and cardiovascular mortality associated with its use. There has been a resurgence of smokeless tobacco use since 1970. Smokeless tobacco consistently produces levels of nicotine higher than those seen with smoking and causes similar sympathetic neural stimulation and acute cardiovascular effects. However, there is conflicting evidence from prospective and case-control studies about cardiovascular mortality or myocardial infarction caused by smokeless tobacco use. Smokeless tobacco use is also associated with oral cancers and high-risk behavior in adolescents. Although the evidence is not conclusive, the adverse cardiovascular effects of smokeless tobacco use are less than those caused by smoking but are more than those found in nonusers. It is advisable to counsel all current users of smokeless tobacco to quit. Behavioral counseling, sustained-release bupropion hydrochloride therapy, and nicotine replacement therapy may be safe therapeutic modalities for treatment of smokeless tobacco use. From the Departments of Internal Medicine (Dr Gupta) and Cardiovascular Medicine (Drs Gurm and Bartholomew) and the Section of Vascular Medicine (Dr Bartholomew), The Cleveland Clinic Foundation, Cleveland, Ohio.

9/30/2004 Houston, TX Journal of Clinical Oncology A new study shows that a history of smoking affects survival in patients with cancer of the head and neck. Patients who had smoked fewer than 100 cigarettes in their lifetime were three times more likely to have better overall survival, disease-specific survival, and recurrence-free survival compared with patients who had a current or previous history of regular smoking. There are approximately 38,000 new cases of head and neck cancer cases in the U.S. each year, the vast majority of which occur in smokers. The study, to be published October 1 in the Journal of Clinical Oncology, is the first to compare survival in pairs of head and neck cancer patients who differ in smoking status but are matched for other factors. The study provides a more accurate assessment of the link between smoking status and survival by limiting other factors that could affect observed disease outcome. "These findings support previous studies indicating that molecular differences exist between the tumors of smokers and non-smokers and may actually reflect two separate types of head and neck cancer," said Erich M. Sturgis, MD, MPH, in the Department of Head and Neck Surgery at the University of Texas M. D. Anderson Cancer Center and senior author of the study. "Our study suggests that the changes that occur in smokers may lead to a more aggressive form of the disease that results in poorer survival." Although the relative risk of developing head and neck cancer is three [...]

9/30/2004 Volkert B. Wreesmann, Weiji Shi et al. Journal of Clinical Oncology, Vol 22, No 19, 2004: pp. 3965-3972 PURPOSE The goal of this study was to identify chromosomal aberrations associated with poor outcome in patients with head and neck squamous cell carcinoma (HNSCC). PATIENTS AND METHODS We assessed the global genomic composition of 82 HNSCCs from previously untreated patients with comparative genomic hybridization (CGH). The CGH data were subcategorized into individual cytogenetic bands. Only genomic aberrations occurring in more than 5% of cases were analyzed, and redundancies were eliminated. Each aberration was submitted to univariate analysis to assess its relationship with disease-specific survival (DSS). We used Monte Carlo simulations (MCS) to adjust P values for the log-rank approximate 2 statistics for each abnormality and further applied the Hochberg-Benjamini procedure to adjust the P values for multiple testing of the large number of abnormalities. We then submitted abnormalities whose univariate tests resulted in an adjusted P value of less than .15 together with significant demographic/clinical variables to stepwise Cox proportional hazards regression. We again verified and adjusted P values for the 2 approximation of the final model by MCS. RESULTS CGH analysis revealed a recurrent pattern of chromosomal aberrations typical for HNSCC. Univariate analysis revealed 38 abnormalities that were correlated with DSS. After controlling for multiple comparisons and confounding effects of stage, five chromosomal aberrations were significantly associated with outcome, including amplification at 11q13, gain of 12q24, and losses at 5q11, 6q14, and 21q11 (MCS adjusted P = .0009 to [...]

9/28/2004 University of Michigan BY PATRICIA ANSTETT Detroit Free Press Kenji Izumi enters a small sterile room at the University of Michigan Medical Center, scrubbed and covered head to toe in white plastic disposable garments. A research scientist, he's the caretaker for a collection of cells that will grow to millions in just two weeks. When he gets enough -- he needs a supply the size of a quarter -- the cells will be harvested as mouth grafts, for surgical treatment of oral cancers and periodontal disease. Eventually, the product could be used for other skull and facial problems. But oral surgeons found problems using such grafts in the mouth to repair wounds after surgery for oral and throat cancers and periodontal disease. Kenji Izumi, a visiting assistant research scientist at U-M, is the caretaker of a group of cells that will grow to millions in two weeks. Skin grafts are rigid, don't always last long and some -- heaven forbid -- grow hair like real skin does, says Dr. Stephen Feinberg, professor and associate chair of research at U-M's section of Oral & Maxillofacial Surgery, in the Department of Surgery. The grafts the U-M team are working on do not grow hairbecause the cells come from inside a person's mouth. Last month, Feinberg's U-M team began clinical studies with EVPOME, the oral mucosal tissue product for which the team has a pending patent application. The product is made from cells obtained from the oral mucosal tissue that covers most [...]

9/28/2004 TN Toporcov, JL Antunes, and MR Tavares Oral Oncology, 40(9): 925-31 This case-control study evaluated fat food habitual intake in the context of the Brazilian diet as a risk factor for oral cancer. A food frequency questionnaire was applied to 70 patients with oral carcinoma and an equal number of controls treated in the same hospital for acute non-neoplastic conditions. Participants were paired for age, gender and smoking status, and matched by frequency for the use of dental prostheses and length of smoking history. Conditional logistic regression for multivariate analysis indicated as risk factors the habitual intake of foods rich in animal and saturated fat: pork meat, soup, cheese, bacon and fried food. The multivariate model also indicated the protective effect of non-cooked butter or margarine, probably the most effective vehicle for vitamin A ingestion in the Brazilian diet. These findings suggest that there is a non-negligible scope for the prevention of oral cancer through the improvement of diet.

9/27/2004 Hanover, NH By Kevin Garland The Dartmouth College, online Diane Harper's HPV study is slated to enroll hundreds of women during the next few months.Women in the Hanover area now have the opportunity to receive a vaccination for human papillomavirus, a treatment that past studies have shown can help prevent 76 percent of cervical cancer cases. The vaccination will be available only if they sign up for a study being conducted by the Dartmouth Hitchcock Medical Center, as it will not be available to the public for almost a decade. All strands of the HPV virus are responsible for causing cervical cancer, but the primary strands, 16 and 18, are included in this vaccine. According to the Centers for Disease Control and Prevention, 80 percent of American women will have acquired a genital HPV infection by age 50. Few HPV cases, however, develop to the point of cancer. "Most people clear [the disease] in a year or so with their own immune system, but if you don't take good care of yourself, or if your cells [mutate], it does progress to serious HPV infection and then to cervical cancer if left untreated," said Ako Takakura, a research assistant for the Gynecologic Cancer Center at DHMC. Comprehending how this particular virus causes cancer could help scientists create other vaccines against other forms of the disease. "If we can find the way in which HPV actually interacts with the host genome, we can look with other cancers as well and see [...]

9/27/2004 UK MICHAEL N PEMBERTON MBCHB, FDSRCS(EDIN) & RIGEL B ALLAN MBCHB, FDSRCS The Practitioner ·What are the common benign anatomical variations of the tongue? ·What investigations should be considered in burning tongue? ·When should the GP suspect the presence of oral cancer? The tongue is an accessible organ that has been used for millennia as an indicator of health in both Western and Eastern medical philosophies. This article outlines the most common conditions affecting the tongue, from variations of normal to conditions affecting quality of life and potentially life-threatening lesions. ·Variations of normal Patients are often concerned when a self- examination of the mouth, perhaps prompted by minor injury, irritation or cancer concern, reveals a variety of seemingly pathological lesions. Once noted by patients these variations of normal' can cause psychological distress out of all proportion to their seriousness. It is therefore important to be able to diagnose' anatomical variations and differentiate these from more serious underlying pathologies. Normally, posterior tongue anatomy is difficult to visualize by oneself; however, edentulous patients can often extend the tongue further than when dentate. ·Foliate papilla and lingual tonsils Foliate papillae are slit-like structures found at the extreme posterior aspect of the lateral borders of the tongue. They are associated with lymphoid aggregates (lingual tonsils), which are components of the upper respiratory tract lymphoid ring (Waldeyer's ring). Hyperplasia secondary to upper respiratory tract infection or irritation from teeth makes these areas hyperplastic and uncomfortable and liable to further trauma. ·Circumvallate papillae are the [...]

9/23/2004 no attribution wsoctv.com - Medstar American men have about a one in two risk of developing cancer during their lifetime. For women, the risk is about one in three. This year alone the American Cancer Society estimates 1,368,030 cases will be diagnosed in the U.S. Cancer is the second leading cause of death in this country (after heart disease). About 563,700 Americans will die of cancer in 2004. Although cancer can occur at any age, it is rare in children (about 9,200 cases of childhood cancer will be diagnosed this year). More than three-quarters of all cancers are diagnosed in people 55 and older. The most common cancers in men are: prostate, lung and colon/rectum. In women, the leading cancers are breast, lung and colon/rectum. The leading causes of cancer death for men are lung, prostate and colon/rectum. For women, the top cancer killers are: lung, breast and colon/rectum. More cancers are being detected in early, more treatable stages. In addition, researchers have developed better treatment methods. Nearly 10 million Americans are surviving with a diagnosis of cancer (some are cancer-free while others are still undergoing treatment). Overall, the five-year survival rate for all cancers is about 63 percent. The four main types of cancer treatment are surgery, chemotherapy, radiation therapy and biologic therapy. Traveling for Cancer Treatment Many patients must travel some distance for their treatments. In some cases, local hospitals don't offer treatments for a particular kind of cancer. In other instances, specialized treatment is only available [...]

9/22/2004 E. Cheong, K. Ivory, J. Doleman, M.L. Parker, M. Rhodes and I.T. Johnson Carcinogenesis vol.25 no.10 © Oxford University Press 2004 Epidemiological studies suggest that the use of NSAIDs and/or a high intake of fruit and vegetables reduce the risk of oesophageal adenocarcinoma. Since COX-2 is up-regulated in Barrett's oesophageal carcinogenesis, the protective effect of NSAIDs and natural food components might reflect COX-2 inhibition. We explored the effects of quercetin, a natural flavonoid with a potent COX-2 inhibitory activity, and two commercially available selective COX-2 inhibitors (NS-398 and nimesulide) on cell proliferation, apoptosis, PGE2 production and COX-2 mRNA expression in a human oesophageal adenocarcinoma cell line (OE33). Changes in the relative numbers of adherent and floating cells were quantified and apoptotic cells were identified using ethidium bromide and acridine orange staining under fluorescence microscopy. Flow cytometric analysis of adherent and floating cells was used to quantify apoptosis and to examine the effects of the agents on the cell cycle. After 48 h exposure at concentrations of 1 µM both COX-2 inhibitors and quercetin suppressed cell proliferation (P < 0.01) and increased the fraction of floating apoptotic cells. At higher concentrations (50 µM) and longer exposure (48 h) the effects of quercetin were significantly greater than those of the selective COX-2 inhibitors (P < 0.01). Cell cycle analyses showed that quercetin blocked cells in S phase, while the selective COX-2 inhibitors blocked cells in G1/S interphase. COX-2 mRNA expression was suppressed by quercetin and the synthetic COX-2 inhibitors in a [...]