Radiation-induced Xerostomia in patients with head and neck cancer: Pathogenesis, impact on quality of life, and management

8/6/2004 Houston, TX Mark S. Chambers, DMD, MS, Merrill S. Kies, MD, Adam S. Garden, MD, Jack W. Martin, DDS, MS Head Neck 26: 796-807, 2004 Background. Xerostomia is a common, debilitating complication of radiation therapy (RT) for head and neck cancer. This article reviews the pathogenesis of radiation-induced xerostomia, its impact on quality of life (QOL), and treatment options. Methods. Virtually all patients undergoing RT for head and neck cancers have xerostomia, which causes oral discomfort and pain, increased dental caries and oral infection, and difficulty speaking and swallowing. This significantly impairs QOL and can compromise nutritional intake and continuity of cancer therapy. The literature describing pathogenesis, impact on QOL of radiation-induced xerostomia, and preventive and interventional therapies was reviewed. Results. Current management strategies include stringent dental and oral hygiene; parotid-sparing radiation techniques to prevent or minimize xerostomia; and pharmacotherapies, such as salivary substitutes and sialogogues. Future strategies may include advanced three-dimensional intensity-modulated RT techniques, salivary gland transfer, newer sialogogues, and gene therapy. Conclusions. New treatment approaches to xerostomia from RT for head and neck cancer may result in significant improvement in patient QOL. All Authors are associated with The University of Texas M. D. Anderson Cancer Center, Houston, Texas

2009-03-23T09:06:44-07:00August, 2004|Archive|

Oral cancer screenings held at the track

8/4/2004 Capital News 9 Watch video Some dentists gave visitors to the Saratoga Race Course a reason to smile on Wednesday. They offered track-goers screenings for oral cancer, free of charge. Oral cancer can be fatal, but it's curable if doctors catch it in time. The problem is, the disease usually causes the patient no initial pain. So a trained eye is needed to spot the telltale signs. According to these doctors, the race course is the perfect place to raise awareness. Dr. Robert Trager of Queens said, "A number of the people in the public, such as who come to Saratoga and other outdoors events, are more susceptible to this type of problem. Why? Because they're out in the sun. Their lifestyle unfortunately of possibly drinking, especially smoking and even drugs can lend itself to oral cancers." This is the second year the screenings have been held at the track.

2009-03-22T23:42:05-07:00August, 2004|Archive|

Betel leaf answer to Leukaemia?

8/2/2004 New Delhi, India By: Upali Rupasinghe New Deli Daily News Scientists at the Indian Institute of Chemical Biology (IICB), Kolkata have identified a molecule in betel leaf which they say can be effective in killing blood cancer cells. The use of betel juice for treating diseases is a common practice in rural areas and experiments were carried out on the immuno-protection capabilities of the betel leaf. The initial results have indicated that the betel leaf could highly effective against Leukaemia, IICB Director Samir Bhattacharya said. Scientists have conduced experiments on cancer cells, obtained from USA and Europe. Tests have revealed that chlorogenic acid, code-named icb-101, was effective on blood cancer cells but did not destroy other non-cancerous cells. Elated with their initial results, scientists had referred their work to the international journal Blood which had sought several clarifications and whether the molecule could be effective in curing other forms of cancer, like oral cancer. The scientists have informed the Indian Council for Medical Research about the discovery and the drug trial on human body is expected to start soon. OCF Note: Now wouldn't this be something? The very plant that causes so many cases of oral cancer in this region of the world and in Asia could contain a compound that could be used to TREAT oral cancer.

2009-03-22T23:40:36-07:00August, 2004|Archive|

Clinical Evaluation of a New Molecular Method for Detection of Micrometastases in Head and Neck Squamous Cell Carcinoma

8/1/2004 Carol G. Shores, MD, PhD; Xiaoying Yin, MD; William Funkhouser, MD; Wendell Yarbrough, MD Otolaryngology & Head Neck Surg. Objective To better detect occult cervical metastases. Design RNA from 153 cervical lymph nodes was analyzed for the presence of squamous cell carcinoma using quantitative cytokeratin (CK) 14 real-time reverse transcription polymerase chain reaction (RT-PCR). Detection of CK RNA in pathologically negative nodes was further analyzed by semi-step sectioning and CK immunohistochemistry. Subjects Thirteen consecutive patients with head and neck squamons cell carcinoma (HNSCC) presenting to the Department of Otolaryngology/Head and Neck Surgery of the University of North Carolina at Chapel Hill for neck dissection. Results Cytokeratin detection was deemed nonspecific if expressed at fewer than 50 molecules of CK 14 RNA per nanogram total RNA. Of 35 HNSCCs, 33 expressed CK 14 RNA, and 15 lymph nodes with routine pathologically positive metastasis were also positive for CK 14 RNA. Four lymph nodes that were pathologically negative nodes were positive for CK 14 RT-PCR, with 2 containing metastases detected by semi-step sectioning. Conclusions Cytokeratin 14 RT-PCR is very sensitive for detecting micrometastasis in lymph nodes that are negative by routine pathological examination, with a relatively high false-positive rate. Quantitative CK 14 RT-PCR could be used to identify nodes negative for tumor by standard pathological analysis that should be examined by step sectioning and CK immunohistochemistry. Identification of micrometastases in patients with HNSCC will allow for appropriate and aggressive treatment of patients with metastatic disease. Source: Arch Otolaryngol Head Neck Surg. [...]

2009-03-22T23:40:07-07:00August, 2004|Archive|

Genetic Patterns in Head and Neck Cancers That Contain or Lack Transcriptionally Active Human Papillomavirus

8/1/2004 See end of article for authors Journal of the National Cancer Institute Background: Transcriptionally active high-risk human papilloma viruses (HPVs), particularly HPV type 16 (HPV16), are found in a subset of head and neck squamous-cell carcinomas (HNSCCs). HPV16-associated carcinogenesis is mediated by expression of the viral E6 and E7 oncoproteins, which cause deregulation of the cell cycle by inactivating p53 and pRb, respectively. We tested the hypothesis that HPV-associated HNSCCs display a pattern of genetic alterations different from those of HNSCCs without HPV DNA. Methods: Polymerase chain reaction-based assays were used to examine 143 consecutive HNSCCs (106 of the oral cavity and 37 of the oropharynx) for the presence of HPV DNA and for viral E6 and/or E7 messenger RNA (mRNA) expression. The HPV DNA-and E6 and E7 mRNA-positive HNSCCs and an equal number of HPV DNA-negative HNSCCs were further analyzed for mutations in TP53, the gene encoding p53, and for allelic loss of 28 microsatellite markers at chromosome arms 3p, 6q, 8p, 9p, 13q, 17p, and 18q, including markers located in regions of chromosome arms 9p and 17p that harbor genes involved the p53 and pRb pathways. All statistical tests were two-sided. Results: Twenty-four (16.7%) of the 143 HNSCCs were positive for HPV16 DNA, and 12 of these HNSCCs (8.4% of total number) expressed E6 and E7 mRNAs. None of the HPV DNA-and E6/E7 mRNA-positive tumors had TP53 gene mutations, whereas nine (75%) of the 12 HPV DNA-negative tumors had such mutations (P<.001). Compared with the HPV DNA-negative [...]

2009-03-22T23:39:35-07:00August, 2004|Archive|

Susan T. Buffett, 72, Dies; Wife of Billionaire Investor

7/30/2004 Cody, WY By Matt Schudel Washington Post Susan Thompson Buffett, 72, the wife of billionaire investor Warren Buffett and, in her own right, the 17th richest woman in the world, died July 29 of a stroke while visiting friends in Cody, Wyo. She and Buffett, whose net worth of about $41 billion makes him the second richest man in the world after Bill Gates, were married in 1952 but had lived apart since 1977. Her primary residence was in San Francisco, while he stayed in the house they had bought together in Omaha in 1958. They remained on friendly terms and often traveled together. Warren Buffett was with his wife at a Cody hospital at the time of her death. Mrs. Buffett was a director of Berkshire Hathaway, her husband's holding company, and was president of the Buffett Foundation, which has contributed millions of dollars for education, medical research, population control and other charities. The foundation was criticized by abortion protesters in the 1990s for funding the RU-486 "abortion pill" and groups supporting abortion rights. She was known for her progressive views, had worked for civil rights and volunteered to help people in low-income housing. In evaluating organizations for possible contributions, Mrs. Buffett told the Omaha World-Herald last year in a rare interview, she sought people "who have heart and soul, the ability to organize and also to inspire -- a rare combination." Her shares in her husband's company have a current value of about $3 billion, which made [...]

2009-03-22T23:38:29-07:00July, 2004|Archive|

Patients who received three-drug combination show improved results

7/30/2004 CHICAGO, IL Journal Abstract Journal of Hemotoogy Adding paclitaxel to a cisplatin and 5-fluorouracil (5-FU) regimen led to significantly longer survival in patients with locally advanced head and neck cancer, according to a phase-3 study presented here at the Annual Meeting of ASCO. “This new chemotherapy combination may soon become the standard treatment option for some patients with head and neck cancer,” said lead researcher Ricardo Hitt, MD, from the Hospital '12 de Octubre' in Madrid. The expanded combination also halted tumor progression more effectively than the standard regimen, and patients who received the three-drug combination were more likely to retain the ability to speak and swallow, as well as exhibit less mucocitis. The study involved 384 patients who had various types of head and neck cancer, particularly tumors of the oropharynx, larynx and oral cavity. All patients were treatment naive. In the standard arm, patients received 100 mg/m2 of cisplatin daily, and 1 gm/m2 of 5-FU on days 1 through 5 of a 21-day cycle. In the expanded regimen, patients received 100 mg/m2 of cisplatin daily, 500 mg/m2 of 5-FU on days 1 through 5, and 175 mg/m2 of paclitaxel on the first day of a 21-day cycle. The trial “appeared to demonstrate a superior outcome and far better tolerability by adding paclitaxel to 5-FU and cisplatin for head and neck cancer in a dose schedule associated with less toxicity,” said Robert Mayer, MD, the director of the Center for Gastrointestinal Oncology at Dana-Farber Cancer Institute in Boston.

2009-03-22T23:38:00-07:00July, 2004|Archive|

TOBACCO CARCINOGENS, THEIR BIOMARKERS AND TOBACCO-INDUCED CANCER

7/30/2004 By Stephen S. Hecht Nature Reviews Cancer, Volume 3, #10 Preface The devastating link between tobacco products and human cancers results from a powerful alliance of two factors — nicotine and carcinogens. Without either one of these, tobacco would be just another commodity, instead of being the single greatest cause of death due to preventable cancer. Nicotine is addictive and toxic, but it is not carcinogenic. This addiction, however, causes people to use tobacco products continually, and these products contain many carcinogens. What are the mechanisms by which this deadly combination leads to 30% of cancer-related deaths in developed countries, and how can carcinogen biomarkers help to reveal these mechanisms? Summary * Tobacco products cause a variety of cancers, including those of the lung, oral cavity, nasal cavity, larynx, oropharynx, hypopharynx, oesophagus, stomach, liver, pancreas, bladder, ureter, kidney and cervix, and myeloid leukaemia. The carcinogens contained in tobacco products are responsible for these cancers. * There are more than 60 carcinogens in cigarette smoke and at least 16 in unburned tobacco. Among these, tobacco-specific nitrosamines (such as 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N'-nitrosonornicotine (NNN)), polycyclic aromatic hydrocarbons (such as benzo[a]pyrene) and aromatic amines (such as 4-aminobiphenyl) seem to have an important role as causes of cancer. * Carcinogen biomarkers — DNA adducts, protein adducts and urinary metabolites — provide objective measures of carcinogen uptake and metabolic activation and detoxification in people who use, or are otherwise exposed to, tobacco products. * DNA adducts are central to the carcinogenic process as induced by tobacco [...]

2009-03-22T23:37:31-07:00July, 2004|Archive|

Sore throat was first sign of oral cancer

7/29/2004 Oakland, MI By CASEY CURTIS The Daily Oakland Press Dave Nilson's sore throat lasted almost six months. Assuming it would go away without treatment was his biggest mistake. The pain - which began to spread to his neck and caused a small lump in his mouth - stayed. Eventually, the 44-year-old Troy resident went to his doctor for an examination and was sent home with antibiotics for strep throat. When the lump grew larger over a two week period, Nilson's doctor referred him to an oral cancer specialist who performed a biopsy. On Christmas Eve of 2002, Nilson received the devastating news that the lump was in fact stage three - almost the last stage - of squamous cell carcinoma. Never having smoked, chewed tobacco or drank alcohol, Nilson was utterly overwhelmed. Just a couple of years earlier, Nilson had lost his sister to melanoma and feared the worst. "I was thinking, 'Oh my God, you're going to die, too,' " he says. In February 2003, Nilson underwent a 15-hour procedure to have tissue, several lymph nodes and 60 percent of his tongue removed. His jaw was cracked in half to remove the affected areas and muscle from his chest was stretched upward to replace the tissue lost on the right side of his neck. Everything seemed to be going well, but Nilson developed "deadbone" in his jaw. That meant blood was not flowing to the bone. It restricted him from talking, eating and sometimes breathing. Nilson was given [...]

2009-03-22T23:36:57-07:00July, 2004|Archive|

The Ultimate Cancer Survivor

7/24/2004 The Washington Post Lance Armstrong has seen what W.B. Yeats called "The Cold Heaven". So even on the day that he is expected to cross the finish line in Paris, having beaten all the Spaniards, Italians and French, and after climbing peaks in the face of spitting Germans, sceptics, accusers and naysayers, what Armstrong will prefer that people remember him for was not his sixth Tour de France victory, but his near-death experience. It remains his most significant accomplishment: he lived. Six Tour de France titles is an epic achievement. In 100 years, no one has ever done such a thing; in fact, there's probably no other feat in sport to which it can be compared for sheer effort, pain, will and character. Armstrong rode more than 3200 kilometres over mountains, skirting oceans, in heat and hail, enduring physical and mental agonies. But the size of the record makes it all the more important to see Armstrong in small ways. That phrase "best ever" threatens to detach him from his central humanity; the trouble with becoming a sports immortal is that it puts him at a remove. That's the last thing Armstrong wants, because to him, his most essential quality is his most ordinary one. What's important about Armstrong is what binds him to the rest of us: he has suffered. He has been sick, wounded and tired with cancer. "Listen, I was there," he says. "I haven't forgot it. And I still use it. It's not always easy [...]

2009-03-22T23:36:15-07:00July, 2004|Archive|
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