9/29/2005 Boston, MA staff CancerConsultants (professional.cancerconsultants.com) Researchers from Massachusetts General Hospital have reported that the dose of Taxol® (paclitaxel) given with hyperfractionated radiotherapy can be dose escalated in patients receiving Ethyol (amifostine). The details of this dose escalation trial were reported in the October 1, 2005, issue of Cancer . Combined radiation therapy and chemotherapy are standard treatments for patients with advanced head and neck cancers, but most patients have recurrent disease after treatment. Ethyol is a radiation protector and the only drug of this class that has been approved by the FDA for this use in patients receiving radiation therapy for cancers of the head and neck. Clinical trials have demonstrated that Ethyol can reduce both acute and late radiation-induced side effects. In the pivotal trial involving patients with head and neck cancer, Ethyol reduced the incidence of xerostomia but had no effect on the incidence or severity of oral mucositis. Ethyol has also been shown to reduce the incidence of grade 2-3 bladder and GI toxicities in patients receiving pelvic radiation therapy and more recently has been associated with decreased toxicities in patients receiving high-dose melphalan. The current study was a multi-institution phase I clinical trial that included 36 patients with advanced head and neck cancer. Patients were treated with radiation therapy plus weekly Taxol. The number of doses of Taxol was escalated from a minimum of three to a maximum of six. Twenty-eight of these patients received Ethyol; eight received no Ethyol. Patients not receiving Ethyol tolerated [...]

9/29/2005 Bethesda, MD Ann O'Mara Journal of Clinical Oncology, Vol 23, No 28 (October 1), 2005: pp. 6820-6821 Throughout the last decade, caring for a loved one with a cancer diagnosis has developed both in the sheer numbers of people providing the service and in the complexity of tasks required by cancer patients. Between 1997 and 2005, the number of Americans diagnosed with cancer has grown from 900,000 to 1.3 million, and the number of survivors has grown from 7.4 million to 9 million.1 With cancer care now routinely being delivered on an outpatient basis, informal caregivers' responsibilities have gone far beyond the tasks of transportation, shopping, household chores, and personal care. Administering oral and parenteral medications, performing wound care, and monitoring signs and symptoms are a few of the more demanding, yet routine tasks. The selection of an informal caregiver, like the diagnosis of cancer itself, is a random event, and there are no training programs to prepare individuals to be one. Thus, it comes as no surprise when we read of a new study, once again, highlighting the physical, emotional, and economic burdens that caregiving has placed on families and friends. What have these studies taught us throughout the years? Just as we have learned that cancer is not one disease, but a constellation of many, informal caregiving is not a simple occurrence, as the caring reflects the variability associated with the type and stage of disease, age of the patient, and the treatment modalities. However, these variables [...]

9/28/2005 Leicester, England D E Brenner and A J Gescher British Journal of Cancer (2005) 93, 735-739 The concept of delaying or preventing epithelial transformation remains a viable and attainable goal for the future. Drug-based strategies for chemoprevention of the future may predominantly rely upon targeted therapies with tolerable but defined toxicities for treatment of individuals diagnosed with intraepithelial neoplasias. Foods, diet manipulation strategies, or nutraceuticals may be more appropriate to delay or prevent carcinogenesis progression in healthy populations with genetic or epidemiologic evidence of risk for future transformation. Three recent publications have demonstrated an unacceptable therapeutic index due to cardiovascular toxicity of selective cyclooxygenase-2 inhibitors when used for cancer preventive or anti-inflammatory indications (Bresalier et al, 2005; Nussmeier et al, 2005; Solomon et al, 2005). These data have focused the debate on whether pharmacologic interventions aimed at delaying or preventing the transformation of organ epithelia should proceed. Further, bad news for proponents of the cancer chemoprevention approach emerged recently from a trial of -tocopherol supplements in patients with stage I or II head and neck cancer treated by radiation therapy (Bairati et al, 2005). In these patients, the incidence of second primary cancers was higher (hazard ratio: 2.88) than that in patients who received the placebo. The corollaries of these clinical results have been amply debated (for example, see Alberts et al, 2005; Drazen, 2005; Meyskens and Szabo, 2005). In this minireview, we wish to distill some crucial issues from that debate, and re-evaluate current and prospective chemoprevention strategies [...]

9/26/2005 United Kingdom staff British Dental Journal (2005); 199, 323. doi: 10.1038/sj.bdj.4812840 Smokers who give up are much less likely to lose their teeth prematurely than those who don't kick the habit, according to research conducted at the University of Newcastle-upon-Tyne. Dental researchers observed a group of cigarette smokers with chronic gum disease over one year and found some symptoms were more likely to improve in the people who quit during the study period. The researchers' findings were revealed in the Journal of Clinical Periodontology, and the study, The effect of quitting smoking on chronic periodontitis by PM Preshaw et al, followed 49 smokers with chronic gum disease over one year. All were encouraged to stop smoking through counselling and, in some cases, using nicotine replacement therapy and/or medication. All of the patients also received treatment for their gum disease. One-fifth of the patients quit smoking, and in those patients, gum health was significantly improved compared to those who continued to smoke over the 12 months. Dr Philip Preshaw a clinical lecturer in periodontology with Newcastle University's School of Dental Sciences, led the research. He said, “Our study shows that people should stop smoking now if they want to increase their chances of keeping their teeth into old age. Dentists have known for some time that smokers have worse oral and gum health than non-smokers but for the first time we have shown that quitting smoking together with routine gum treatment results in healthier gums.” The Department of Health has [...]

9/26/2005 Japan Madhup Rastogi et al. Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyi155 Objective: The purpose of this study was to evaluate the efficacy of radiotherapy and concurrent mitomycin-C (MC) plus 5-fluorouracil (5FU) infusion in locally advanced squamous cell carcinoma of head and neck (SCCHN). Methods: Sixty-nine patients with SCCHN (6 Stage III and 63 Stage IV patients) were treated with external beam radiotherapy (70 Gy) and simultaneous intravenous chemotherapy with 5FU (600 mg/m2/day, Days 1-5) and MC (10 mg/m2, Days 5 and 36). Results: After a mean follow-up of 28.5 months, 59.4% of patients were alive without disease. Complete response was seen in 76.8% of patients. The 3 years overall survival, locoregional relapse-free survival and disease-free survival was 62.3, 89.8 and 49.5%, respectively. Treatment was well tolerated (Grade III mucositis in 43.5% and Grade II leukopenia in 5.8%). Conclusions: This concurrent chemoradiotherapy regimen offers a curative option for our patients where primary and nodal disease is fairly large resulting in hypoxic radioresistant tumors. Authors: Madhup Rastogi 1, Madhu Srivastava 1, Kundan S. Chufal 2, M. C. Pant 1, Kirti Srivastava 1, and Madanlal B. Bhatt 1 Authors' affiliations: 1 Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India 2 Department of Oncology, Batra Hospital and Medical Research Center, New Delhi, India

9/26/2005 Scotland staff News.scotsman.com Increasing numbers of young people are being hit by mouth cancer, sparking new warnings about the disease. Mouth cancer was once considered to mostly affect older men, but it is now becoming more common in younger people and women. It is possible that binge-drinking and smoking could be helping to fuel rising rates of the disease as these are key risk factors. Now the British Dental Health Foundation (BDHF) is warning people of all ages that they need to start checking their mouths regularly if rising rates of mouth cancer are to be stopped. The ratio of women to men suffering mouth cancer has grown by a third in the last 10 years, although men are still twice as likely to develop the disease. Mouth cancer is sometimes called oral cancer and can affect the lips, tongue, cheeks and throat. Every year in the UK, there are 4,300 new cases diagnosed and 1,700 deaths. The most common causes of mouth cancer are smoking and drinking alcohol to excess - people who do both are up to 30 times more likely to develop the condition than those who do not. Having a poor diet is also linked to the disease. But the BDHF said about 25% of mouth cancer cases in younger people involved none of these common risk factors. The foundation said this meant it was vital people learnt to be aware of the possible symptoms, even if they led a healthy lifestyle.

9/25/2005 Iowa City, IA M Yao et al. Int J Radiat Oncol Biol Phys, October 1, 2005; 63(2): 410-21 Purpose: To review the University of Iowa experience with intensity-modulated radiotherapy (IMRT) in the treatment of head-and-neck squamous cell carcinoma. Methods and Materials: From October 1999 to April 2004, 151 patients with head-and-neck squamous cell carcinoma were treated with IMRT for curative intent. One patient was lost to follow-up 2 months after treatment and therefore excluded from analysis. Of the remaining 150 patients, 99 were treated with definitive IMRT, and 51 received postoperative IMRT. Sites included were nasopharynx, 5; oropharynx, 56; larynx, 33; oral cavity, 29; hypopharynx, 8; nasal cavity/paranasal sinus, 8; and unknown primary, 11. None of the patients treated with postoperative IMRT received chemotherapy. Of 99 patients who had definitive IMRT, 68 patients received concurrent cisplatin-based chemotherapy. One patient received induction cisplatin-based chemotherapy, but no concurrent chemotherapy was given. Three clinical target volumes (CTV1, CTV2, and CTV3) were defined. The prescribed doses to CTV1, CTV2, and CTV3 in the definitive cohort were 70-74 Gy, 60 Gy, and 54 Gy, respectively. For high-risk postoperative IMRT, the prescribed doses to CTV1, CTV2, and CTV3 were 64-66 Gy, 60 Gy, and 54 Gy, respectively. For intermediate-risk postoperative IMRT, the prescribed doses to CTV1, CTV2, and CTV3 were 60 Gy, 60 Gy, and 54 Gy. Results: The median follow-up was 18 months (range, 2-60 months). All living patients were followed for at least 6 months. There were 11 local-regional failures: 7 local failures, [...]

9/25/2005 Virginia, USA staff myDNA (www.mydna.com) Upper aerodigestive tract cancer patients used to have few treatment options. Fortunately, radiation therapy (RT) has proven to be an effective treatment - either on its own or in combination with surgery. But, despite the benefits, RT can also be associated with several long-term side effects, including depression. Many cross-sectional and longitudinal studies have looked at the impact that this treatment modality can have on the long-term quality of life of head and neck cancer survivors. On the other hand, few studies have assessed the effect of acute toxicities of radiation therapy on the quality of life during the treatment process. These acute toxicities can be more severe when chemotherapeutic agents that have a synergistic effect on the cancerous and normal tissues are used concomitantly. The quality of life of head and neck cancer patients during radiation has not been explored before. British researchers planned a prospective study to assess the impact that radiation therapy has on the quality of life during the treatment process. They speculated that the health related quality of life would decrease over the period of radiation therapy and that patients would be increasingly depressed as the treatment progressed caused by the side effects of the treatment. The authors of "Deterioration in Quality of Life and Depressive Symptoms during Radiation Therapy for Head and Neck Cancer," are Mr. Vinidh Paleri FRCS, Carol Downes, and Charles Kelly FRCR, all from the Freeman Hospital, University of Newcastle upon Tyne, United Kingdom. Their [...]

9/25/2005 Bethesda, MD press release Journal of the National Cancer Institute, Vol. 97, No. 18, 1315, September 21, 2005 A new study of French women has found that high beta-carotene intake—through a combination of diet or supplementation—is associated with a higher risk of tobacco-related cancers in smokers, but the risk of these cancers decreases with increasing beta-carotene intake in nonsmokers. The study appears in the September 21 issue of the Journal of the National Cancer Institute. Some observational studies have found that beta-carotene consumption is associated with a decreased risk of cancer. However, some intervention studies have suggested that high doses of the antioxidant, given through supplementation, may be associated with an increased risk of lung cancer and digestive cancers in smokers. To investigate the relationships of beta-carotene intake from both diet and supplementation with the risk of tobacco-related cancers—which include colorectal, thyroid, ovarian, cervical, and lung cancers in addition to less common cancers—Marie-Christine Boutron-Ruault, M.D., Ph.D., of INSERM in Villejuif, France, and colleagues used information from questionnaires given in 1994 to nearly 60,000 women from the French Etude Epidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective study. The researchers assessed diet, supplement use, and smoking status in these women and followed them for a median of 7.4 years. During the follow-up period, 700 women developed a type of cancer known to be related to smoking. Among women who never smoked, beta-carotene intake was inversely associated with the risk of developing a tobacco-related cancer, with a [...]

9/22/2005 England Rachel Stevenson The Independent (news.independent.co.uk) Imperial Tobacco, the group behind the Regal, John Player and Superkings cigarette brands, said yesterday it was entering the market for smokeless tobacco despite a ban on the product in the EU. The company has bought a 43.2 per cent stake in Skruf, a Swedish manufacturer of smokeless tobacco known as "snus". The EU banned "snus" and most other forms of smokeless tobacco in 1992, but Sweden, where the product is hugely popular, negotiated an exemption from the ban when it joined the EU in 1995. "Snus", sold in tins, is moist, loose tobacco put in small teabag-like pouches that are placed under the lip. They produce a similar experience to smoking a cigarette. The product was banned because it was deemed attractive to children, who could become easily hooked and move on to cigarettes. There is also research to suggest the product could increase the risk of oral cancer. Imperial hopes to capture some of the huge Swedish demand for "snus". While cigarette sales have been in decline there, more than 200 million tins of "snus" are sold every year and rising. Skruf's chairman and founder, Adam Gillberg, said: "With this alliance, we will get the resources and the muscles that we need to grow." The company has 1 per cent of the Swedish market. The tobacco industry claims "snus" is far less harmful than cigarettes, containing less of the carcinogenic chemicals that are in cigarettes. It also eradicates the danger of [...]