3/31/2005 A. Falanga and L. Zacharski Annals of Oncology, doi:10.1093/annonc/mdi165 Patients with cancer have long been recognised to be at high risk of venous thromboembolism (VTE), although the condition remains under diagnosed and under treated in these patients. As a consequence, the morbidity and mortality due to deep venous thrombosis and pulmonary embolism remains unacceptably high in this group. Furthermore, the management of VTE in the presence of malignancy is complex, due both to the effects of the cancer itself and its treatments. Conventional long-term management of VTE involves the use of vitamin K antagonists (VKAs), such as warfarin, to reduce the risk of recurrence. However, this approach is associated with a range of practical difficulties including the need for regular laboratory monitoring, the potential for drug interactions, in addition to the risk of treatment resistance and bleeding in patients with cancer. Recent research indicates that the use of low molecular weight heparin (LMWH) therapy instead of VKAs may be beneficial in these patients. In particular, evidence from a large clinical trial of the LMWH dalteparin indicates that this agent offers an effective alternative to VKAs in the long-term management of VTE, that is free from the practical problems associated with the use of VKAs and without increasing the risk of bleeding. Authors: A. Flanga (1) L. Zacharski (2) Authors' Affiliations: (1) Department of Hematology-Oncology, Ospedali Riuniti, Bergamo, Italy (2) VA Medical Center, White River Junction, Vermont, USA

3/31/2005 Ann Arbor, MI University of Michigan Health System as reported by Newswise.com Alice Lundsten thought it was just a cough that wouldn’t go away. But it turned out to be much more than that. Sounding hoarse, and feeling like there was something stuck in her throat, Alice went to her doctor for a checkup. The doctor suspected something was wrong but couldn’t see it, so she sent Alice to a specialist. And that’s when Alice learned she had cancer — on one of her vocal cords. After laser microsurgery to remove the tumor, and voice therapy to optimize the quality of her voice, Alice is sounding so good that she’s been able to work as a church receptionist. But her experience should be a lesson for others, she warns. “It would’ve been helpful if I had listened to my own voice earlier and gone to the doctor” sooner, she says. “Now I know that that’s the thing to do — not to wait.” The voice specialist who discovered and treated Alice’s cancer couldn’t agree more. “She’s the perfect example of why it’s important to pay attention to a voice change,” says Norman D. Hogikyan, M.D., F.A.C.S., who heads the University of Michigan’s Vocal Health Center. “People need to be aware that a voice change can indicate health problems.” He notes that voice specialists have designated April 16 as World Voice Day to bring attention to the many voice problems that can occur, and ways to prevent them. Hogikyan is [...]

3/31/2005 Alexandria, VA Michael Stahl et al. Journal of Clinical Oncology, Vol 23, No 10 (April 1), 2005: pp. 2310-2317 Purpose: Combined chemoradiotherapy with and without surgery are widely accepted alternatives for the curative treatment of patients with locally advanced esophageal cancer. The value of adding surgery to chemotherapy and radiotherapy is unknown. Patients and Methods: Patients with locally advanced squamous cell carcinoma (SCC) of the esophagus were randomly allocated to either induction chemotherapy followed by chemoradiotherapy (40 Gy) followed by surgery (arm A), or the same induction chemotherapy followed by chemoradiotherapy (at least 65 Gy) without surgery (arm B). Primary outcome was overall survival time. Results: The median observation time was 6 years. The analysis of 172 eligible, randomized patients (86 patients per arm) showed overall survival to be equivalent between the two treatment groups (log-rank test for equivalence, P < .05). Local progression-free survival was better in the surgery group (2-year progression-free survival, 64.3%; 95% CI, 52.1% to 76.5%) than in the chemoradiotherapy group (2-year progression-free survival, 40.7%; 95% CI, 28.9% to 52.5%; hazard ratio [HR] for arm B v arm A, 2.1; 95% CI, 1.3 to 3.5; P = .003). Treatment-related mortality was significantly increased in the surgery group than in the chemoradiotherapy group (12.8% v 3.5%, respectively; P = .03). Cox regression analysis revealed clinical tumor response to induction chemotherapy to be the single independent prognostic factor for overall survival (HR, 0.30; 95% CI, 0.19 to 0.47; P < .0001). CONCLUSION: Adding surgery to chemoradiotherapy improves [...]

3/31/2005 Houston, TX CancerWise (www.cancerwise.org) New Devices May Help Detect Tumors Earlier In the hope of finding an often-devastating cancer before it has a chance to develop, researchers are designing a series of probes that will literally highlight suspicious lesions in the mouth that may harbor fledgling tumors. These devices — a “scanner” that first bathes the mouth with light to pick out problem areas and a follow-up probe that shines a concentrated diagnostic beam on the lesions— are scheduled for testing at M. D. Anderson this spring and summer. If they fare well, the device designers foresee a time when community dentists or physicians turn to the probes to help screen for spots that can be difficult to pick out by observation alone. “I can’t always tell which mouth lesions might be precancerous. They can be tiny white, pink or red areas that are really hard to tell apart from normal tissue,” says Ann Gillenwater, M.D., an associate professor in M. D. Anderson’s Department of Head and Neck Surgery. “Now, our only choice is to biopsy an area that looks suspicious, and this can be more invasive than is necessary.” "More research needs to be done, but with these devices it may be possible to find oral cavity cancers when they are at their most treatable,” says Gillenwater, who has been conducting studies on the technology for several years. “When found later, as many of these cancers are, the effects of surgery and radiation treatment can impact a patient’s [...]

3/31/2005 Amanda Gardner Forbes (www.forbes.com) Despite gains, a new report finds that half of all cancers could still be prevented through early detection and lifestyle changes. Tobacco use, physical inactivity, obesity and poor nutrition remain the major preventable causes of cancer and other diseases in the United States, according to the American Cancer Society (ACS) report released Thursday. "We have sufficient knowledge of cancer causes and prevention that could prevent cancer burden in the U.S. by at least half," said Vilma Cokkinides, one of the lead authors of the report and program director of risk factor surveillance for the ACS in Atlanta. "A healthy lifestyle coupled with early detection and treatment is the best personal weapon each of us has to fight this disease." "It just reinforces the two messages: quit smoking or don't start, and get screened [for cancer]," added Dr. Ronald Blum, director of Beth Israel Cancer Center in New York City. "The message bears repeating." The ACS estimates that about one-third (570,280) of cancer deaths in this country in 2005 can be traced back to poor nutrition, lack of exercise, overweight and obesity and other lifestyle factors. And although tobacco use is down, the society predicts that this year smoking will still be the underlying cause of more than 168,140 cancer deaths. Overweight and obesity could cause as many as one in seven cancer deaths in men and one in five such deaths in women, the report adds. Having a high body mass index increased death rates [...]

3/31/2005 Toronto, Ontario, Canada cancerconsultants.com According to a recently completed clinical trial, a vaccine that is injected directly into the site(s) of cancer produces promising results in patients with head and neck cancer who have stopped responding to standard therapies. Approximately 40,000 people in the United States are diagnosed with head and neck cancer every year. Cancers of the head and neck comprise several types of cancer, including the nasal cavity and sinuses, oral cavity, nasopharynx, oropharynx, and other sites located in the head and neck area. Once the cancer stops responding to standard therapeutic approaches, which typically consists of chemotherapy and/or radiation therapy, it is referred to as “refractory”. Patients with refractory head and neck cancer currently have very limited effective treatment options, with overall survival being dismal in this group of patients. There are currently no treatment modalities that have demonstrated an improvement in survival in the treatment of refractory head and neck cancer. Several clinical trials are underway to evaluate novel therapeutic approaches for the treatment of this disease. A novel vaccine Proxinium™ recently completed an early-phase clinical trial in the evaluation of advanced head and neck cancer. Proxinium™ is comprised of a monoclonal antibody, which is a protein that is targeted against and binds to a specific component of a cell. The monoclonal antibody portion of Proxinium™ is targeted against EpCAM, a molecule that is often highly expressed in head and neck cancer cells. Proxinium™ also contains the toxin produced by the bacterium Pseudomonas. When the [...]

3/30/2005 Chesapeake, VA U.S. Newswire Chesapeake, Va. resident Minnie Ashworth, who successfully battled oral cancer two years ago, wants fewer people to have to withstand the ordeal she survived. She has joined a national effort to reduce the death rate from the disease, which can be conquered if caught in its early stages. A Walk for Awareness will take place Saturday, April 9, at Chesapeake City Park in Chesapeake, Va. Proceeds will benefit the non-profit Oral Cancer Foundation - Web: http://www.oralcancerfoundation.org Event Includes Free, Fast, and Painless Oral Cancer Screenings During the fund-raising walk, doctors from the VCU School of Dentistry and from the Eastern Virginia Medical School will conduct free oral cancer screenings. These quick and painless examinations of the mouth, if conducted as part of everyone's annual dental exam, could dramatically reduce the number of deaths from oral cancer. 30,000 individuals are newly diagnosed with oral cancer each year in the US, and it kills almost 9,000 Americans annually. The five-year survival rate is only about 50 percent. Early detection would drastically reduce the death rate. It was a dentist who raised the alarm when Ashworth told him her gum still hadn't healed long after she'd had a tooth extracted. The dentist immediately referred Ashworth to an oral surgeon, whose biopsy revealed cancer. Ashworth underwent radiation to shrink the tumor, then surgery to remove half her lower jaw, which was reconstructed using bone from her lower leg. During her recovery, Ashworth discovered the Oral Cancer Foundation's web site, [...]

3/30/2005 Tempe, AR Summer Robertson www.asuwebdevil.com It's a sign of the times. Kids are getting a lot more street smart. When they see an advertisement that reads: "Free money!" they begin to ask questions. The majority of us know it's just another ploy from some not-so-creative advertisers. The same goes with movies. If someone tells you to see a movie about which you know nothing, you're going to ask why. So why aren't the same questions being asked when it involves something more dangerous, say, hookah? Sure, opponents of smoking have televised ads that tell you to say no. But most of the time, they are so short that they don't say why. Or they will tell you the same old information: Tobacco may cause cancer, discoloration of the teeth, etc. But there's a reason to say no. So before you go out and buy your own hookah, perhaps you should take a few things into account. Hookah and shisha have been around for ages, originating in the Middle East. Because it is relatively new to the U.S., there have been next to no studies done on it. A lot of people are under the misconception hookah is healthier than cigarettes. Although hookah waters down tobacco, it doesn't water down the effects tobacco has on your body. Your lung tissue will still be damaged, and you will be more susceptible to smoking-related diseases such as lung, throat and mouth cancer. Another misconception is that hookah contains far less tobacco and [...]

3/30/2005 Toronto, Ontario, Canada Newswire Canada (www.newswire.ca) Stick out your tongue at your dentist. It's good for your health! A visit to your dentist is good for your health and well-being. That is the message being delivered to Ontario communities by the Ontario Dental Association in April, which is Oral Heath Month. This year, ODA-member dentists are undertaking a wide range of programs across the province. An important element is the ODA's oral cancer awareness program which is designed to raise public awareness of a potentially fatal disease. Last year, there were more than 3,100 new cases of oral cancer diagnosed nationally, accounting for approximately 2.1 percent of all new cancer cases in Canada. To reach younger audiences, the ODA and ODA-member dentists are also sponsoring the Brush-a-mania challenge designed to improve the oral health habits of elementary school students. "No matter what your age, oral health is important to your overall health," said Dr. Steve Goren, President of the Ontario Dental Association. "Dentists are part of your primary health-care team." This year, the ODA's oral cancer awareness efforts include an outdoor advertising campaign in 11 Ontario communities to increase public awareness. This disease has a greater mortality rate than either breast cancer or prostate cancer. ODA-member dentists are also conducting oral cancer checks at select shopping malls across the province. For schoolchildren, the ODA is teaming up with the Rotary Club and the Toronto Dental Academy to bring the Brush-a-mania program to about 35,000 students at 120 elementary schools [...]