9/21/2004 Columbus, Ohio Larry Gierer Ledger Inquirer Still, many survivors and doctors shy away from the word 'cure'. Mary Starke Harper, 85, knows something about cancer. The Columbus resident has doctorate degrees in clinical psychology and medical sociology and a master's in nursing. She's been an adviser on health issues to four Presidents of the United States. And she's had the disease. In 1968, she had her left breast removed. In January, more than 35 years later, cancer was found in her other breast. "I don't think you can use the word 'cured,' " Harper said, "because there is always a chance of recurrence. People who have had cancer are always haunted by it. Every time something goes wrong with their body, they think it has returned." Nearly 10 million Americans have battled cancer, including 1.4 million who had it more than 20 years ago and are called "long-term survivors" by those afraid to call them cured. At a time when more people are cured of cancer than ever before, fewer doctors seem willing to say so. "The medical community has backed off the term 'cured,"' said Julia Rowland, a psychologist who directs the federal Office of Cancer Survivorship, which was started in 1996, the year Lance Armstrong began treatment for testicular cancer that had spread to his lungs and brain. The cyclist has since boasted of beating the disease, and this summer he won his sixth Tour de France. Some cancers -- certain lymphomas and leukemias in particular -- [...]

9/20/2004 S. K. Jain, A. Kumar and J. K. Singh Journal of Clinical Oncology, Annual Proceedings Vol 22, No 14S Background: Since inception goal of radiotherapy is to deliver high dose to tumor with maximum sparing of normal tissue with brachytherpy there is rapid fall of dose beyond implanted area, thus delivering high dose to target with sparing of surrounding normal tissue. In early stage node negative oral cavity cancer surgery and radiotherapy produces equal result but radiotherapy is considered superior as it causes less functional and cosmetic deficit. Method: We present 25 patient of oral cavity cancer treated with HDR brachytherapy alone or in combination with external beam radiotherapy (EBRT). Interstitial implant was done using flexible plastic tubing or rigid stainless steel needles under local or general anesthesia. A dose of 45 to 51 Gy in 15 to 17 fractions, 3 Gy per fraction, two fractions per day with a gap of 6hr in-between, was delivered with HDR brachytherpy alone. When combine with EBRT 24 to 30 Gy was delivered with HDR bracytherapy, and 36 to 40 Gy by EBRT. Result: Complete clinical response was noted, in all the patients at six weeks of completion of RT. Two out of twenty five patients have local recurrence and were salvaged by surgery. Nodal failure was observed in two patients and was managed by radical neck dissection. With mean follow-up of fourteen months, all patients are alive disease free. Localize grade III mucositice was observed in all the patients, no grade [...]

9/20/2004 Bruce H. Campbell et al. Arch Otolaryngol Head Neck Surg. 2004;130:1100-1103 Objective To determine associations between objective assessments (swallowing function and weight change) and subjective quality-of-life (QOL) measures. Design Observational case series using clinical testing and questionnaires. Setting University hospital-based tertiary clinical practice. Patients Convenience sample of 5-year survivors of head and neck cancer (62 nonlaryngectomy survivors were studied). Interventions Objective testing included examination, weight history, videofluoroscopic swallow studies (VFSS), and oropharyngeal swallowing efficiency (OPSE). Subjective testing included QOL questionnaires (University of Washington Quality-of-Life [UWQOL] Scale, Performance Status Scale for Head and Neck Cancer Patients [PSS-HN], Functional Assessment of Cancer Treatment–General [FACT-G] Scales, and Functional Assessment of Cancer Therapy–Head and Neck [FACT-H&N] Scale). Main Outcome Measures Aspiration (identified by VFSS), weight change, and QOL measures. Results Aspiration was associated with the decreased QOL scores in chewing, swallowing, normalcy of diet, and additional concerns of the FACT-H&N Scale. No association was found between aspiration and willingness to eat in public, subjective understandability, or any of the FACT-G scales. Of the nonlaryngectomy survivors, 27 (44%) demonstrated some degree of aspiration during VFSS. Associations were found between aspiration, primary tumor T stage, weight change, and OPSE. Aspirators lost a mean of 10.0 kg from precancer treatment weight, while nonaspirators gained a mean of 2.3 kg (P<.001). Mean OPSE scores were 69 for nonaspirators and 53 for aspirators (P = .01). Conclusions Almost half of long-term nonlaryngectomy head and neck cancer survivors demonstrated at least some degree of aspiration. The presence of aspiration [...]

9/19/2004 J. Sudbø et al Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings Abstract: Background: Oral cancer is a tobacco-related cancer, with high morbidity and mortality. Although there is evidence of a possible protective effect of aspirin on oesophageal cancer, only scattered data exist on its role on cancer of the oral cavity or larynx. Methods: We performed a population-based nested case-control study by combining data from the Norwegian Institute of Public Health and the Norwegian Cancer Registry. Among persons accrued to the health survey in the period 1975-1990, 3275 persons at high risk for oral cancer, as judged by their tobacco habits, were identified through the databases of a population based national health survey, and the occurrence of carcinomas in this group was assessed through cross-linking with the database of the Norwegian cancer Registry. Additional information regarding smoking habits, medication, age, sex and comorbidity was entered in the database of the Norwegian Institute of Public Health. Results: Among the 3275 persons identified to be at risk of oral cancer, 496 were identified with a squamous cell carcinoma of the oral cavity. 454 matches controls were identified among the other 2779 person identified to be at risk of oral cancer. The hazard ration for developing oral cancer was. Among the 992 person included in the analysis (454 person from the case group and 454 person from the matched control group), 690 did not have a history of long-term NSAID use, while 302 did. The hazard ratio for developing oral [...]

9/19/2004 By Christopher Cundy Plastics & Rubber Weekly New research by scientists has concluded that formaldehyde, a chemical used in thermoset plastics and rubber manufacture, does pose a cancer risk to humans. An international study by the International Agency for Research on Cancer, part of the World Health Organisation, concluded that formaldehyde causes nasopharyngeal cancer, a relatively rare form of cancer in developed countries that occurs in the upper throat behind the nose. It had earlier stated that formaldehyde was a probable carcinogen. The group also found limited evidence that the chemical causes cancer of the nasal cavity and paranasal sinuses, and “strong but not sufficient” evidence for leukaemia. More than one million workers in the EU are exposed to some degree. “A very wide range of exposure levels has been observed in the production of resins and plastic products. The development of resins that release less formaldehyde and improved ventilation has resulted in decreased exposure levels in many industrial settings in recent decades,” the agency said.

9/19/2004 By DARLA CARTER The Marion Star, Gannett News Service It's a habit that can leave you with bad breath, mouth lesions and a disfigured face, yet an estimated 7.8 million Americans use smokeless tobacco. Tobacco use carries a risk of oral cancer, but users sometimes avoid seeing a dentist, who can detect early signs, says dentist Dr. Lee Mayer. "A lot of times they don't appear in a dentist's office about anything in their mouth until they either have a toothache, or they have some type of growth or something's going on, and they realize that there's a problem and they get scared," says Mayer, director of community dental health at the University of Louisville School of Dentistry. "This is especially true with the younger crowd." Nationally, 18- to 25-year-olds make up the largest percentage of people who use smokeless tobacco, according to the federal government's 2002 National Survey on Drug Use and Health. Smokeless tobacco includes snuff, finely ground tobacco that's held between the cheek and gum, and chewing tobacco, which is bulkier and comes in leaf and plug form, according to the National Cancer Institute. "It's one of those types of things you can do in secret, you know, and once you're hooked, you're hooked," Mayer says. "There's no telltale smoke from it, and like any tobacco product, it's highly addictive." Smokeless tobacco has been acceptable and common among certain populations, such as rural people, for a long time, Mayer says. It's also popular among some athletes, [...]

9/19/2004 American Society for Therapeutic Radiology and Oncology To help patients understand the importance of radiation therapy in the treatment of head and neck cancer, the American Society for Therapeutic Radiology and Oncology has published the new patient information brochure Radiation Therapy for Head and Neck Cancer: A Patient's Guide to Understanding Treatment. "As a head and neck cancer specialist, I know how a cancer diagnosis can be overwhelming for patients and their families," said Louis Harrison, M.D., Co-chair of the ASTRO Communications Committee and a radiation oncologist at Beth Israel Medical Center in New York. "There have been many advances in radiation therapy to treat head and neck cancer in recent years. The patient literature available hasn't been able to keep up. We hope this brochure will help patients better understand the importance of radiation therapy in the treatment of their cancer." This year, about 62,000 Americans will be diagnosed with cancer of the oral cavity, pharynx, larynx and thyroid. Rates of head and neck cancer are nearly twice as high in men and are greatest in men over age 50. Many of these patients are not aware that radiation therapy is often combined with surgery and/or chemotherapy to treat cancers of the face, mouth and throat. To help patients understand their treatment options, ASTRO has taken the initiative in developing an up-to-date brochure that patients can use to talk with their healthcare providers when contemplating radiation therapy. The brochure also helps patients find support groups and information on [...]

9/16/2004 Paivi Lehtinen Innovations Report: Forum for Science, Industry & Business A Finnish research group has been the first in the world to publish an article in which BNCT (Boron Neutron Capture Therapy) treatment has had an excellent response in a patient with head and neck cancer for whom there was no other treatment available. The case report has been published in the June issue of the prestigious Radiotherapy and Oncology no. 72 (2004) pp. 83 – 84. BNCT treatment, which was developed for treating difficult brain tumours, has since last year also been given to patients with recurrent head and neck cancer for whom no other treatment is available. The treatment has been successful in improving the quality of life for patients with head and neck cancer. ”Further research in this area has been prompted by encouraging results from patients with maxillary sinus cancer,” says professor Heikki Joensuu, Helsinki University and the Department of Oncology at Helsinki University Central Hospital (HUCH). Joensuu is the Scientific Director of the BNCT research project funded by Boneca Corporation. ”The successful treatment of head and neck cancer using BNCT has been proven effective by magnetic pictures and PET. The current research phase I/II aims to investigate the tolerance of BNCT treatment as well as aiming to find the effect of the treatment on the life span of patients with glioblastoma”, Joensuu explains According to the Managing Director of Boneca Corporation, Markku Pohjola, the new research field is an excellent example of the high [...]

9/14/2004 by Doctor W. Gifford Jones Canada Free Press "Stick out your tongue", my dentist invariably requests during my regular dental checkup. I know that shortly he’ll examine my teeth. But for the moment he’s looking for any sign of cancer of either the tongue or the rest of the oral cavity. But what happens if your dentist or doctor detects a malignancy? What I learned over a scotch-and-soda should alarm all of us. Cancer of the tongue is one of the more common types of mouth cancer. It’s curable in about 80 per cent of cases when diagnosed early. Malignancies of the tongue start as a small lump or a thick white patch. Over time this lump turns into an ulcer that has a firm, raised rim and a delicate center that bleeds easily. If the cancer is not treated it spreads to the gums, lower jaw, lymph nodes and the floor of the mouth. Eventually the tumour blocks the throat making swallowing and breathing difficult. If there’s been a growth on the tongue for more than a couple of weeks a biopsy is done to see if cancer is present. This can usually be done under local anesthesia. Most tongue cancers are treated by surgery, which may include post-operative radiation and/or chemotherapy. Usually, however treatment of advanced cancers of the tongue necessitate a radical surgical resection requiring some reconstruction of the tongue, a demanding eight-hour operation. And that’s why I’m writing this particular column. I recently attended a [...]