Monthly Archives: July 2006

FasL gene therapy: a new therapeutic modality for head and neck cancer

  • 7/24/2006
  • Charleston, SC
  • S ElOjeimy et al
  • Cancer Gene Therapy (2006) 13, 739–745. doi:10.1038/sj.cgt.7700951

In this study, we investigated the in vitro and in vivo efficacy of Fas ligand (FasL) gene therapy for the treatment of head and neck cancer.

Three head and neck squamous cell carcinoma (HNSCC) cell lines (SCC-1, SCC-12, and SCC-14a) were treated with the Fas agonist CH-11, a monoclonal antibody to the Fas receptor, or with a replication-incompetent adenovirus (AdGFPFasL) expressing a modified murine Fas ligand gene fused to green fluorescent protein (GFP). A replication-incompetent adenovirus containing the GFP gene alone was used as a control for viral transduction toxicity (AdGFP).

Cell death was quantified using a tetrazolium-based (MTS) assay. Cells were analyzed by flow cytometry to determine the expression of adenoviral and Fas receptors on the surface of the cells.

Our results showed that the head and neck cancer cell lines are resistant to cell death induction when treated with the anti-Fas monoclonal antibody CH-11. This resistance can be overcome with AdGFPFasL, which was able to induce cell death in all three cell lines. Apoptosis induction was demonstrated using Western blotting by evaluating poly(ADP-ribose) polymerase, and caspase 9 cleavages. In addition, intratumoral injections of AdGFPFasL into SCC-14a xenografts induced significant growth suppression of tumors, indicating that FasL gene therapy may provide a new efficient therapeutic modality for HNSCC that is worthy of a clinical trial.

Authors:
S ElOjeimy1,3, J C McKillop1,3, A M El-Zawahry1, D H Holman1, X Liu1, D A Schwartz1, T A Day2, J-Y Dong1 and J S Norris1

Authors’ affiliations:
1Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
2Department of Otolaryngology – Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA

July, 2006|Archive|

YM BioSciences reports anti-EGFr drug nimotuzumab approved in India for treatment of head and neck cancer

  • 7/21/2006
  • New York, NY
  • press release
  • PRNewswire (www.prnewswire.com)

BioSciences Inc., a company engaged in the acquisition, development and commercialization of oncology and acute care products, today reported that India’s Drug Controller General has granted marketing approval to nimotuzumab, an anti-EGFr monoclonal antibody, for the treatment of head & neck cancer. Biocon Biopharmaceuticals Ltd, a joint venture between Biocon and CIMAB SA (Havana, Cuba), has rights to the drug from CIMAB for the Indian subcontinent.

“While our license for nimotuzumab does not extend to India, this approval is an important validation of the safety and efficacy of the drug. In addition, a significant amount of additional clinical data in head & neck cancer will be now generated in India as nimotuzumab is commercialized,” said David Allan, Chairman and CEO of YM BioSciences. “YM has been advised that in the trials undertaken by Biocon Biopharmaceuticals Ltd to gain approval for nimotuzumab no cases were observed of the severe rash commonly produced by similar agents with the same target, consistent with previous study results. The absence of this debilitating side-effect should prove a key differentiator for nimotuzumab in the marketplace.”

Nimotuzumab is currently in a Phase IIl trial in Europe in combination with radiation for the treatment of pediatric pontine glioma. YM BioSciences and CIMYM BioSciences Inc. are preparing to file for authorization to conduct a trial in North America in pediatric pontine glioma. In addition, YM is developing nimotuzumab for non-small cell lung cancer and pancreatic cancer and proposes to pursue the clinical development of the drug in adult glioma, esophageal cancer and colorectal cancer. YM’s licensor, CIMAB SA and its parent, the Center of Molecular Immunology, are conducting trials with nimotuzumab in glioma, breast, esophageal, uterine cervix, prostate and head and neck cancers.

Data from trials with nimotuzumab were submitted to the ASCO 2006 Annual Meeting in Atlanta, Georgia in June 2006, and included safety data from a pharmacodynamic/pharmacokinetic study of nimotuzumab conducted by The Princess Margaret Hospital. Full PD/PK results will be presented at the 18th EORTC-NCI-AACR Symposium on “Molecular Targets and Cancer Therapeutics”, which will be held in Prague, Czech Republic from November 7-10, 2006.

About YM BioSciences
YM BioSciences Inc. is a cancer product development company. Its lead drug, tesmilifene, is a small molecule chemopotentiator currently undergoing a 700-patient pivotal Phase III trial in metastatic and recurrent breast cancer. In addition to tesmilifene, YM BioSciences is developing nimotuzumab, an anti-EGFr humanized monoclonal antibody, in a number of indications and AeroLEF(TM), a unique inhalation delivered formulation of the established drug, fentanyl, to treat acute pain including cancer pain. YM BioSciences is also developing its anti-GnRH, anti-cancer vaccine, Norelin(TM), and owns a portfolio of preclinical compounds.

July, 2006|Archive|

Chew not about to take a dip

  • 7/21/2006
  • Iowa City, IA
  • Angela Meng
  • Iowa City Press Citizen (www.press-citizen.com)

Health experts worry about rise of fruity flavors

Every time a new flavor of smokeless tobacco comes out, Matt Walters, 26, is curious to see what it tastes like.

“People may not like Skoal straight, but now they have apple, cherry and jolly rancher flavors, and they taste a lot better than plain or original tobacco,” the North Liberty resident said. “The tobacco industry is doing a good job of getting people to try chew.”

Although statistics have shown a decrease in smokeless tobacco use, some think an increase is in the near future.

“I think it may well increase now for two reasons: the increasing movement to smoke-free environments and the great interest of the large tobacco companies in smokeless tobacco,” said Christopher Squier, University of Iowa associate dean of the College of Dentistry and a member of the Dows Institute for Dental Research at UI.

According to a report by the Centers for Disease Control and Prevention, use of chewing tobacco, snuff or dip by middle school and high school students in the United States decreased from 11.4 percent in 1995 to 8 percent in 2005. In Iowa, usage decreased from 12.8 percent in 1997 to 7.9 percent in 2005. However, health experts say the tobacco industry is promoting smokeless tobacco in ways that will soon escalate use.

“The tobacco industry is starting this ‘harm reduction’ theme — which is a great market,” Squier said. “They market smokeless tobacco as an alternative, which just isn’t true.”

Squier said the tobacco industry promotes smokeless tobacco mainly to young, blue-collar men by using hunting and climbing themes that are “very enticing to young males.”

Kelly Richeal, 20, a Hy-Vee employee who regularly sells tobacco products, said more and more people are buying the “fruity flavors instead of the regular kind.”

“If a new flavor comes out, we sell more, and they seem to go faster,” Richeal said. “The younger kids that come in seem to be the ones buying the flavored kinds — it’s like a trend — and the older people just buy the regular kinds.”

Richeal said she thinks more people might purchase the smokeless tobacco because the fruity flavors are more appealing to those who have not chewed before.

“I think people will keep coming in and buying (smokeless tobacco) until they find a flavor that they like,” she said.

However, Deb Schnyder, supervisor of 16 Cigarette Outlet stores in Iowa, including one in Iowa City, said she does not think an increase in usage is in the near future.

“As cigarette prices go up, so do chew prices,” Schnyder said. “Some chew if they can’t smoke, but people won’t quit smoking and go to chew.”

However, Schnyder added, she is noticing more interesting packaging and an increase in the variety of flavors.

“There are more and more flavors. They’re trying to attract the young with these flavors,” she said.

Walters is one of many who began chewing at a young age. He said he first tried smokeless tobacco out of curiosity when he was 18 years old, and it grew on him. He chews about twice a day when there is “ideal time” and nothing else to do. He said smokeless tobacco is a habit one gets addicted to.

“I see a lot of 18-year-old boys getting ID’d when I buy chew,” Walters said. “The majority of people I see seem my age and younger, and the new flavors definitely seem to be attracting more people.”

Matt Schmitt, 32, a North Liberty resident, also began chewing when he was young.

“I started chewing when I was 15,” Schmitt said. “I go through about three cans a week.”

Schmitt said he has tried the flavored smokeless tobacco but prefers the original kind. Schmitt said he thinks younger users are more attracted to the flavored kinds because it tastes better than the original kind — which they are not used to.

“It seems like a lot more people are doing it now than when I was in high school,” Schmitt said. “But it’s really not a cool thing.”

Health experts agree.

Smokeless tobacco can cause changes in the mouth’s lining and erosions in the gums as well as tooth loss. It also can cause lesions in the mouth — a white patch where one puts the chew — called leukoplakia, which has a low risk of leading to cancer, Squier said.

“Generally, males 16 to 28 chew, and they start at a young age and get addicted,” Squier said. “Because of the high level of nicotine, it’s very addictive. Once you start using it frequently, it’s harder to stop than cigarettes.”

According to the CDC Web site, smokeless tobacco contains 28 cancer-causing agents or carcinogens. The two main types of smokeless tobacco in the U.S. are chewing tobacco and snuff. Chewing tobacco comes in the form of loose leaf, plug or twist. Snuff is finely ground tobacco that can be dry, moist or in bag-like pouches.

Chuck Lynch, professor of epidemiology in the College of Public Health at the University of Iowa and a principal investigator and medical director of the State Health Registry of Iowa, said tobacco is the No. 1 modifier for risking cancer. He said it increases oral cancer on the lip, tongue, cheek and roof of the mouth.

Lynch said he also thinks smokeless tobacco use will increase, but health experts might not see an increase in oral cancer for another 20 to 30 years.

“You don’t develop a disease after a single exposure,” Lynch said. “It’s not unusual to develop a disease after a few decades.”

July, 2006|Archive|

Precision of radiation therapy aids cancer fight

  • 7/21/2006
  • Appleton, WI
  • Wendy Harris
  • Post Crescent (www.postcrescent.com)

What seemed like your average winter sore throat eventually gave Janelle Zempel the shock of her life.

She had cancer in her neck.

“I thought that was it,” said Zempel, now 57, who figured she’d just be given a death sentence in the spring of 2003 when her persistent sore throat by then had grown into a door knob-sized tumor.

By the time she arrived at Froedtert Hospital in Milwaukee for treatment, doctors gave her hope that she could survive. But the initial plan they offered was horrendous.

“They told me they’d have to (operate on) my larynx, the jugular vein on the left side of my neck, my esophagus, and another vein in my shoulder,” said Zempel, of Fremont. “And I’d have to have a feeding tube for a year until they could reconstruct my esophagus.”

And then they gave her another option — a new diagnostic and treatment approach that was being tested by Dr. Dian Wang, assistant professor of radiation oncology at the Medical College of Wisconsin, who practices at Froedtert.

Wang was conducting a study involving head and neck cancer patients that used combined images from PET and CT scans to more accurately visualize tumors, and then attack them with a very precise form of radiation, called intensity-modulated radiation therapy.

Traditionally, CT scans — an X-ray test that takes pictures of thin slices of the body, are used for seeing tumors. A PET scan, meanwhile, uses a short-lived radioactive solution, which, when injected into the body, lights up organs — and tumors. While PET scan pictures don’t show as much detail as CT scans, combining the two creates a much more detailed picture of cancerous tumors, Wang found.

With nothing to lose, Zempel agreed to join the study.

“I did radiation five days a week for seven weeks and had three different five-hour chemo treatments,” she said.

She has now been cancer-free for nearly three years. And so far, she’s had no surgery.

Wang’s study, published in the May 2006 issue of the “International Journal of Oncology, Biology, Physics” — the official journal of the American Society for Therapeutic Radiology and Oncology, is the first report of clinical results using this fused technology in head and neck cancer patients.

“With more accurate tumor definition, patients with head and neck cancer who receive radiation therapy may have a greater chance of achieving tumor control,” Wang said.

Additionally, the precision of the radiation therapy decreases the likelihood of damaging adjacent tissues.

“I only lost my hair from my ears on down,” Zempel said.
Of the 28 patients who were followed for more than six months after treatment, 16 showed no signs of recurrence, the study found. Also, the combined images from both the PET and CT scans resulted in very different treatment plans in 14 of 16 patients whose plans had been initially designed using CT scanning alone. Zempel said she remains incredibly grateful to Wang, not only for his innovation, but his support.

“Dr. Wang is remarkable,” she said. “He sticks with you and keeps you positive.”

Wang believes the new approach can potentially save more lives.
“We’re hoping this study will encourage our colleagues to use PET/CT fusion regarding radiation therapy,” he said.

July, 2006|Archive|

Saliva tests for oral cancer

  • 7/21/2006
  • Austin, TX
  • staff
  • www.news8austin.com

Oral cancer is the sixth most common cancer in the U.S. The survival rate of oral cancer is lower than that of cervical cancer, Hodgkin’s disease, cancer of the brain, liver, testes, kidneys and skin. It is the cause of nearly 8,000 deaths a year in the U.S. That means one patient dies from oral cancer every hour.

Worldwide, oral cancer can affect 350,000 annually. Smoking and other tobacco use are associated with 70 to 80 percent of oral cancer cases. Men are affected twice as often as women, particularly men older than age 40. Other than the lips, the most common areas for oral cancer are on the tongue and floor of the mouth.

Oral cancer is particularly dangerous because it has a high risk of producing second, primary tumors. Early detection is the key. The mortality rate of this cancer is high because it’s often discovered too late in development. Cancer is diagnosed in stages I-IV. Detection of an oral cancer in stage I will carry a likely prognosis of an 80 percent survival rate. However, the same lesion, if progressed to stage III, will carry a 20 percent survival rate. Despite numerous advances in treatment, oral squamous cell carcinoma has just an approximately 50% at five-years from diagnosis survival rate, which is the worst of all cancer death rates. The five-year survival rate has not improved in the last three decades.

Currently, the most definitive procedure to detect oral cancer involves a visit to the physician’s office, a scalpel biopsy usually on the tongue or gums, followed by a histopathologist evaluation by a pathologist.

Now, saliva is being viewed as a way to screen for the cancer. Dr. David Wong, refers to saliva as “the mirror of the body, in the sense that it is the perfect medium to be explored for health and disease surveillance.”

Saliva contains specific biomarkers associated with either a healthy or diseased state. Because collecting saliva is noninvasive, it is the preferable way to detect and monitor the biomarkers. Doctors hope that in the future, a patient will be able to simply spit into a vial and avoid a more invasive biopsy.

The use of saliva for oral cancer screening is still in its infancy, but it does look very promising. To date, two salivary proteins, IL8 and thioredoxin, which can discriminate saliva of oral cancer from control subjects, have been discovered. IL8 is significantly higher in saliva of oral cancer patients and is highly discriminatory of detecting oral cancer in saliva.

Miniaturized diagnostic technologies will be able, with minute amounts of body fluids, specifically saliva, to yield critical patient information reflecting a healthy or diseased status. Lifestyle choices still remain the biggest cause of oral cancer. Some things you can do to prevent cancer: minimize or avoid smoking or other tobacco use, minimize or avoid alcohol use, practice good oral hygiene and have dental problems corrected.

July, 2006|Archive|

‘Smokeless’ means trading addictions

  • 7/19/2006
  • Indianapolis, IN
  • staff
  • The Indianapolis Star (Indystar.com)

Dr. Stephen J. Jay, chair of the Indiana University School of Medicine’s Department of Public Health, discusses smokeless tobacco products.

Question: What are smokeless tobacco products?

Answer: They come in lots of different forms, such as chewing tobacco, but it’s basically putting tobacco in your mouth and absorbing nicotine and lots of different chemicals into your body instead of inhaling them. You don’t generate any smoke. We used to refer to this as “spit tobacco,” since one of the things you do when you use it is you spit. But some newer products don’t require you to do that.

Q: Are smokeless tobacco products better for you than cigarettes?
A: They’re highly addicting. And the companies don’t have to adhere to any standards or regulations because there are none for these products, so the consumer really has no idea what is in the product.
What you do when you use smokeless tobacco is you just trade your cancer. Instead of getting lung cancer, you get cancers of the lip, tongue, and head and neck cancers, which are just horrible cancers. The disfiguration and surgical procedures needed to treat many of these tumors are just terrible. You have other problems, some of which you also have with smoking, like periodontal disease, dental diseases of gum, including tooth decay and tooth loss.

Q: How about Taboka, the new spitless tobacco that’s being tested in Indianapolis?
A: We have no scientific evidence that I’m aware of that Taboka is any less addicting or less harmful than other smokeless tobacco. It could be less harmful and less addicting. It could be the same or it could be more. We just have no clue.

Our concern from a public health standpoint is that Taboka and products like it will create a whole new group of tobacco users, many of whom otherwise would not have used tobacco at all because they’re concerned about tobacco, and on the flip side we’re concerned that many people who are smoking cigarettes will see these new products as an excuse not to quit.

What tobacco companies do when there’s concern about the safety of their products, they cleverly come up with a new product and market it with a message that the consumer interprets as something that’s better for my health.

Will some people think this is a safer product and instead of smoking choose this? Will people who would otherwise quit using tobacco altogether shift to this kind of product? None of these important questions regarding the health of the public has been answered.

July, 2006|Archive|

Nutritional Interventions and Outcome in Patients With Cancer or Preinvasive Lesions: Systematic Review

  • 7/19/2006
  • Bristol, United Kingdom
  • Anna A. Davies et al.
  • Journal of the National Cancer Institute, Vol. 98, No. 14, 961-973, July 19, 2006

Background:
Dietary modifications and supplements are used widely by patients with cancer and preinvasive lesions as an adjunct to standard treatment. Given the widespread use of nutritional modifications and supplements by such patients and concerns about the lack of benefit and possible harm, we conducted a systematic review of randomized controlled trials to examine the effect of nutritional interventions on patients with cancer or preinvasive lesions.

Methods:
We searched electronic databases and reference lists to locate all eligible trials and analyzed trial quality. Outcome measures were all-cause and cancer mortality, disease-free survival, cancer recurrence, second primary cancer, recurrence of a preinvasive lesion, or progression to cancer. Results of individual trials were combined by use of random-effects meta-analyses.

Results:
We identified 59 eligible trials, 25 in patients with cancer and 34 in patients with preinvasive lesions, respectively. Trial quality was generally low; only three trials (two of cancer and one of preinvasive lesions) had adequate methods for generating the allocation sequence, allocation concealment, and masking both outcome assessors and participants. The combined odds ratio (OR) for the effect of a healthy diet—given alone or with dietary supplements, weight loss, or exercise—on all-cause mortality was 0.90 (95% confidence interval [CI] = 0.46 to 1.77). There was no evidence of an association between the use of antioxidant (OR = 1.01, 95% CI = 0.88 to 1.15) or retinol (OR = 0.97, 95% CI = 0.83 to 1.13) supplements and all-cause mortality. Meta-analyses of all other outcomes did not show clear evidence of benefit or harm.

Conclusions:
The impact of most nutritional interventions cannot be reliably estimated because of the limited number of trials, many of which were of low quality. There is no evidence that dietary modification by cancer patients improves survival and benefits disease prognosis.

Authors:
Anna A. Davies, George Davey Smith, Roger Harbord, Geertruida E. Bekkering, Jonathan A. C. Sterne, Rebecca Beynon, Steven Thomas

Authors’ affiliation:
Department of Social Medicine (AAD, GDS, RH, GEB, JACS, RB), Division of Maxillofacial Surgery (ST), University of Bristol, Bristol, UK

July, 2006|Archive|

Researchers Discover Inhibitor Of Infection By HPV

  • 7/19/2006
  • San Francisco, CA
  • staff
  • Biocompare.com

Researchers have discovered a potent inhibitor of the human papilloma viruses (HPV), particularly those types that cause cervical cancer and genital warts, according to a study published in PLoS Pathogens. The inhibitor is found in commercially available products, including sexual lubricants and baby food.

In laboratory tests, carrageenan, a compound derived from red algae, prevented HPV infection by both genital wart and cancer-causing types. “We were floored by how much better it worked than anything else we have tested. It’s effective at 100-fold lower concentration than the next best inhibitor we’ve found,” said Dr. John Schiller, senior investigator at the National Cancer Institute.

Normally, HPV attacks cells by attaching to proteins on their surface and then chemically manipulating access to the cells. Carrageenan thwarts this process by attaching to HPV and preventing its entry into cells.

Christopher Buck, lead author of the study and post-doctoral fellow at the National Cancer Institute, searched for candidate inhibitory compounds by looking for substances that were structurally similar to a key cell surface component involved in HPV infection.

“When carrageenan came up to be the clear winner, Chris started to search for products that might contain it,” said Schiller. “It quickly became clear that it is widely used as a thickening agent in many foods and topically applied products. So he decided to search for sexual lubricants that might contain it as the gelling agent and came up with several. Although carrageenan was identified in a systematic screen, the serendipity that this seaweed-derived compound is already used in over-the-counter products for genital application is really quite amazing.”

In spite of these promising results, it is not realistic to suggest that people rush out to buy carrageenan-containing products to prevent HPV infections. “Our results do not prove that carrageenans will work as a practical HPV topical microbicide,” Schiller said. “The potent inhibition of infection of cells in dishes, coupled with the fact that carrageenan-based products are already in use for genital application, are promising, but we will need to do a well controlled clinical trial before use of any of these products as an HPV inhibitor could be recommended.”

Such a product, if identified or developed, could complement the HPV vaccine recently approved by the Food and Drug Administration, according to Schiller, who also contributed to the initial development of the HPV vaccine.

This vaccine is virtually 100% effective against some HPV strains, but it doesn’t prevent infections against every strain and its cost — about $360 for the three necessary doses — could be prohibitive, especially for women in developing countries.

“An effective HPV microbicide could reduce the burden of HPV-related genital disease in women,” Schiller said. About 10,000 American women are diagnosed with cervical cancer each year, and about 250,000 women worldwide die from the disease annually.

Source:
Public Library of Science

July, 2006|Archive|

CIGNA Dental Expands its DHMO Product Suite; Provides Greater Access to Preventive Dental Care

  • 7/19/2006
  • Plantation, FL
  • press release
  • biz.yahoo.com

CIGNA Dental today announced the expansion of its DHMO product suite to include a new series of schedules that highlight the importance of preventive care and wellness through a new split copay differential, oral cancer detection offerings, greater access to dental sealants, and more.

“These DHMO plan enhancements are part of the overall broad product suite that we offer our employer customers. In fact, we are experiencing increased employer interest in adding DHMO to their plan offerings as another cost savings approach,” says Rebekah Whitehouse, chief marketing officer of CIGNA Dental.

The CIGNA Dental Care 06 Patient Charge Schedules (PCS), effective August 1, 2006, include procedures and copays that build upon its flexible and innovative dental plan offerings, giving CIGNA one of the most extensive national DHMO product lines.

“With rising health care costs, employers are looking for ways to manage benefit expenses while maintaining healthy and productive employees,” added Whitehouse. “Through wellness and cost savings features, these new plans provide a cost-effective option for employers and employees. The 06 Plans provide flexibility while focusing on comprehensive coverage and the importance of preventive care.”

Studies show that preventive dental care can help members avoid paying more money in the long-term for restorative and emergency treatment. This new product series offers members coverage for a wide range of dental services, with most preventive services covered at no or low cost. “Structuring dental plans that encourage use of preventive dental care supports our mission to provide affordable dental benefits with an emphasis on enhancing oral health outcomes, resulting in improved overall health,” said Miles Hall, D.D.S., M.B.A., national dental director for CIGNA Dental.

July, 2006|Archive|

M.D. Anderson opens new proton therapy center

  • 7/17/2006
  • Houston, TX
  • Juan A. Lozano
  • Chron.com

Knees bent and hands above his head, Francis Maloy lay on his back on a narrow, metallic table inside a white chamber, waiting for a giant wheel-like device to bombard the tumor in his chest with protons.

“I had never heard of proton therapy. The last time I heard about protons I was in college taking physics,” said Maloy, a 68-year-old retired Army colonel from Stuart, Fla., just before the procedure.

Maloy, who has advanced lung cancer, is one of the first patients being treated at the University of Texas M.D. Anderson Cancer Center’s new $125 million Proton Therapy Center.

It is the largest of the nation’s four such facilities that treat cancer by targeting protons narrowly on the tumor itself, sparing the healthy tissue that with traditional X-ray radiation therapy is blasted along with the cancer cells.

From inside one of five treatment rooms in the 94,000 square-foot center, the gantry looks like the airlock of a science-fiction spaceship. But behind it sits the bending magnets, electrical wires and monitors that make up the gantry, encased in a steel barrel, three stories tall and weighing 190 tons.

The protons, which are stripped from the nucleus of hydrogen atoms in a tubular device called an injector, are sent to a compact particle accelerator — actually a ring of magnets about 20 feet in diameter — called a synchrotron. There they circle around until they gather enough energy to irradiate a tumor before being sent toward the patient.

Dr. James Cox, chief of radiation oncology at M.D. Anderson, wasn’t always a believer in the technology.

“Studies have showed proton therapy allows an increased dose to a tumor but you have a decreased dose to healthy tissue and have fewer side effects” such as loss of appetite, diarrhea and headache, he said. “That was the breakthrough, what changed my mind.”

Cox said proton therapy can be used to treat cancers of the prostate, eye, lung, brain, head and neck and possibly tumors in the liver. It also helps treat cancer in children, who are more sensitive than adults to the side effects of radiation therapy.

But Cox said proton therapy, which is covered by Medicare and most insurance companies, is about three times more expensive than traditional radiation, in part because of the cost of the facilities.

Some doctors worry that the benefits to a few cancers don’t outweigh the enormous costs, especially when recent advances in traditional radiation make it safer to use.

Dr. Eric Horwitz, clinical director of the Department of Radiation Oncology at Fox Chase Cancer Center in Philadelphia, said proton therapy has an advantage in treating relatively rare cancers such as those in children or of the spinal cord.

More study needs to be done to see whether proton therapy is more effective for common cancers, such as prostate and lung, than newer forms of traditional radiation therapy that can also be focused on a tumor, he said.

Reducing radiation’s side effects could translate into lower health care costs in the long run, said Dr. Nancy Mendenhall, chair of the Department of Radiation Oncology at the University of Florida’s College of Medicine.

“I think it will be a part of mainstream radiation oncology if we fully embrace its advantages,” said Mendenhall, who is also medical director of the Florida Proton Therapy Institute, a new center set to open this summer in Jacksonville, Fla. “Conventional radiation therapy will always be a part of cancer treatment.”

A study that appeared last September in the Journal of the American Medical Association concluded that men who were treated for prostate cancer with higher doses of radiation, in part through proton therapy, were less likely to have cancer return than men who got traditional X-ray radiation treatment.

An accompanying editorial to the study by Drs. Theodore DeWeese and Danny Song with Johns Hopkins University School of Medicine in Baltimore questioned whether higher doses of radiation are the best way to improve outcomes.

“As such, this study has not answered the important question of whether patients should accept the modest but real incremental risk of higher radiation doses for the uncertain ultimate benefit derived,” DeWeese and Song wrote.

Maloy will get proton therapy five days a week for about two months. He also gets chemotherapy once a week.

Each treatment session takes 30 to 45 minutes, much of that time spent taking X-rays of Maloy’s tumor and positioning the gantry’s protruding snout that the protons shoot out of.

The procedure is just like an old-fashioned X-ray: Just before the protons started flowing, an alarm went off, warning everyone to leave the room. After a few minutes the treatment stopped and nurses and doctors repositioned the snout to hit the tumor from a different angle.

“I feel nothing in there, except it’s uncomfortable laying on their machine,” Maloy said. “You don’t know anything is happening. It’s magical.”

Proton therapy has been around since the mid-1950s but was done mostly at research facilities, according to the National Association for Proton Therapy.

Loma Linda University Medical Center in California opened the world’s first hospital-based treatment facility in 1990, and Indiana University and Massachusetts General Hospital in Boston also have such centers. But M.D. Anderson’s is the largest.

July, 2006|Archive|