Monthly Archives: May 2007

Cancer Expected to Skyrocket in Asia

  • 5/30/2007
  • Singapore
  • Margie Mason

Asia is bracing for a dramatic surge in cancer rates over the next decade as people in the developing world live longer and adopt bad Western habits that greatly increase the risk of the disease.

Smoking, drinking and eating unhealthy foods – all linked to various cancers – will combine with larger populations and fewer deaths from infectious diseases to drive Asian cancer rates up 60 percent by 2020, some experts predict.

But unlike in wealthy countries where the world’s top medical care is found, there will likely be no prevention or treatment for many living in poor countries.

“What happened in the Western world in the ’60s or ’70s will happen here in the next 10 to 20 years as life expectancy gets longer and we get better control on more common causes of deaths,” said Dr. Jatin P. Shah, a professor of surgery at Memorial Sloan-Kettering Cancer Center in New York, who attended a cancer conference last month in Singapore.
“The habit of alcohol consumption, smoking and dietary changes will increase the risk of Western world cancers to the Eastern world,” Shah said.

An estimated 40 percent of cancers worldwide can be prevented by exercise, eating healthy foods and not using tobacco, according to the World Health Organization.

But more people in Asia are moving into cities and becoming overweight and obese from inactivity. They are replacing fruits and vegetables with fatty meals full of meat and salt, which is leading to increases in stomach and colon cancers. Meanwhile, traditional diseases like malaria are killing fewer people – building an aging population that’s a prime target for cancer.

The effect is already startling, with the Asia-Pacific making up about half of the world’s cancer deaths and logging 4.9 million new cases, or 45 percent, of the global toll in 2002.

That number is projected to leap to 7.8 million by 2020 if nothing changes, according to Dr. Donald Max Parkin, a research fellow at the University of Oxford who is a leading authority on global cancer patterns and trends.

(AP) Student medical technologists look through microscopes as they study blood smears from a cancer…
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China alone, with its booming economy and 1.3 billion people, is home to about one-fifth of the world’s new cases, compared to about 13 percent in the U.S. and 26 percent in Europe, Parkin said. Heart disease remains the top killer in China, but cancer is a close second.

Cancer deaths are slowly dropping in the United States, with slight declines recorded in 2003 and 2004. A decrease in smoking, coupled with early detection and better treatment of tumors is credited with the positive results – the first U.S. decline in cancer deaths since 1930.

Smoking is on the rise in Asia, where it’s common to see people lighting up in airports, restaurants and even hospitals. Lung cancer makes up the bulk of all cases regionwide, followed by stomach and liver cancers. It also remains the biggest cancer killer worldwide.

“Lung cancer is the big one because of cigarette smoking. There are many tobacco advertisements – everywhere,” said Dr. You-Lin Qiao from the Cancer Institute and Hospital in Beijing, who added that the odds are stacked against those diagnosed in China. “No matter if you’re rich or poor, if you get lung cancer you die. There’s no treatment at all.”

While Americans and Europeans have been abandoning smoking, an estimated 300 million men are puffing away in China – equal to the entire U.S. population. If nothing changes, a third of Chinese men under age 30 are predicted to die from tobacco, with lung cancer already the biggest cancer killer there.

Smokeless tobacco is also a big problem in Asia’s other giant, India, where many men and women chew some form of tobacco. Mouth cancer makes up half of all new cases in parts of the country.

A lack of vaccines that prevent cancer-causing viruses is another obstacle for Asia, which is home to about three-quarters of the world’s liver cancers, caused largely by Hepatitis B infections.

A vaccine guarding against the virus has been available since the early 1980s and is routinely given to children in Western countries, but it is still not reaching large swaths of the Asia-Pacific.

Some experts worry it could take years before the new vaccine for the sexually transmitted human papillomavirus, or HPV, is available to women in developing countries. The three shots currently cost about $350 in the U.S. and are 70 percent effective against preventing HPV, the main cause of cervical cancer. It is already the No. 2 cause of cancer among women in Asia, after breast cancer.

“The problem is so huge that it’s very difficult for us to know where to start,” said Dr. Franco Cavalli, president of the nonprofit International Union Against Cancer. “All the new cancer treatments are so expensive, that already in the affluent countries we are not able to pay for them. … So imagine what that means for low-income countries where you have $20 a year per person for health expenditures.”

Regular screening, such as Pap smears and mammograms, is too costly for many poor countries. Treatment with radiation or chemotherapy is unfathomable for most. And in Asia, many patients seek help from hospitals in the late stages of disease after traditional medicine has failed to cure them.

Monika Bardhan of Malaysia’s NCI Cancer Hospital has seen a dramatic increase in cancer patients over the past four years. “It’s staggering. Every day I see a patient with breast cancer – I just hold my own and say a prayer.”

May, 2007|Archive|

Racial disparity in stage at diagnosis and survival among adults with oral cancer in the US

  • 5/30/2007
  • San Francisco, CA
  • CH Shiboski et al
  • Community Dent Oral Epidemiol, June 1, 2007; 35(3): 233-40

To explore distribution of stage at diagnosis and relative survival rates among US adults with oral cavity cancer in relation to race, and over time.

We obtained 1973-2002 oral cancer incidence data from the Surveillance, Epidemiology, and End Results (SEER) Program, and computed proportions for each oral cavity site by stage at diagnosis, tumor size, and 5-year relative survival rates among Whites and Blacks.

A total of 46 855 cases of oral cavity cancer were reported to the SEER registry among adults >/=20 years between 1973 and 2002. African-Americans had a significantly higher proportion of cancer, mainly in the tongue, that had spread to a regional node or to a distant site at diagnosis than Whites: 67% versus 49% of tongue cancers reported from 1973 to 1987 (P < 0.001), and 70% versus 53% of those reported from 1988 to 2002 (P < 0.001). They had a significantly higher proportion of tongue cancer that were >4 cm in diameter at time of diagnosis (59% versus 44%; P < 0.001), and black men in particular experienced lower 5-year relative survival rates than white men, in particular, for tongue cancer (25% versus 43% from 1973 to 1987, and 31% versus 53% from 1988 to 2002).

There are significant racial disparities with respect to stage at diagnosis and survival among adults with oral cancer reported to the SEER registry from 1973 to 2002. One possible explanation for the lower survival among Blacks may be a difference in access to, and utilization of, healthcare services.

CH Shiboski, BL Schmidt, and RC Jordan

Authors’ affiliations:
Department of Orofacial Sciences, Division of Oral Pathology, Oral Medicine, Oral Radiology, School of Dentistry, University of California San Francisco, and Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA

May, 2007|Archive|

You snus you lose?

  • 5/28/2007
  • web-based article
  • David Holmes
  • Nature Reviews Cancer 7, 406 (June 2007)

An oral smokeless tobacco known as snus is continuing to stir up controversy, after two new articles published in the Lancet found that although snus users did not experience an increased risk of lung or mouth cancer compared with people who had never smoked, they were twice as likely to develop pancreatic cancer.

The first study, led by Coral Gartner of the University of Queensland in Australia, modelled the potential effect of snus if it were to be introduced in Australia, and found that there would be little difference in health-adjusted life expectancy between smokers who gave up all tobacco and those who switched to snus, concluding that, “Snus could produce a net benefit to health at the population level if it is adopted in sufficient numbers by inveterate smokers” (, 10 May 2007).

The second study, led by Olaf Nyrén of the Karolinska Institutet in Sweden, was more cautionary. Snus is widely used in Sweden, so the authors surveyed around 280,000 Swedish construction workers on their tobacco consumption from 1978 to 1992, and then followed them until 2004. They found that although snus use did not increase the risk of lung or mouth cancer, those who used snus had double the risk of developing pancreatic cancer.

Whether or not the net effect of snus is positive or negative has been a contentious issue for some time. Nyrén stresses that, “We don’t only need reliable and accurate measures of the risks of both smoking and taking snus, we also need to know the effects of other, alternative methods to cut smoking. We also have to be certain that an increase in snus marketing will not cause addictions in young people who otherwise wouldn’t have started to smoke” (, 11 May 2007).

May, 2007|Archive|

HPV vaccine – It’s not about sex, it’s about cancer prevention

  • 5/28/2007
  • New York, NY
  • Wendy Anne Epstein, M.D
  • new York News (

In a May 22 Community View (“HPV vaccine: Pressure leaves parents confused”), Bob Moffitt gives merit to the argument that mandatory vaccination with the HPV vaccine will encourage “reckless behavior such as sexual promiscuity.” Implicit in this argument is that once vaccinated an individual would feel freer to engage in sexual behavior because they felt immune to contracting cancer-causing HPV.

However, human papilloma virus is only one sexually transmitted disease. There is no vaccine for herpes, Hepatitis C, HIV. Implicit in this argument is that sexual contact is necessary to become infected with the cancer-causing strains of HPV, and by avoiding sexual contact one is guaranteed not to contract HPV. Unfortunately, sexual contact is not necessary for the transmission of cancer-causing HPV. Abstinence will not guarantee that your children are protected against developing cervical cancer.

Hand-to-hand contact can transmit cancer-causing HPV. After all, that’s how most people get ordinary warts caused by HPV. Most warts do not cause cancer, because most warts on the hands and fingers are caused by non-cancer-associated HPVs. However, cancer-causing strains of HPV, including strains 16 and 18, can also be found on the hands and fingers. Squamous cell carcinoma of the finger is almost exclusively caused by HPV strains 16 and 18, the same cause of 70 percent of cervical cancer. These cancers are potentially very aggressive and can reoccur or even metastasize if not adequately treated.

I have treated several patients that had persistent warts on their hands or fingers caused by cancer-causing strains of HPV. I have seen several women with cancer-causing strains of HPV warts on the fingers that also had atypical Pap smears of the cervix. Since most warts on the hands and fingers are treated without biopsies or special testing to see which HPV strain caused the warts, we don’t know what percentage of “ordinary”-appearing warts on the hands are caused by cancer-causing strains of HPV.

Human papilloma virus is the major cause of cervical cancer. Worldwide, cancer of the cervix is the No. 1 cause of cancer death in women. The vaccine, Gardasil, can prevent infection with the two most common cancer-causing strains of the virus.

Perhaps it is unfortunate that Gardasil is marketed solely as a prevention of cervical cancer. HPV strains 16 and 18 cause several other forms of cancers in males and females. HPV strains 16 and 18 can cause cancer of the esophagus, mouth, throat, larynx, tongue, tonsils, rectum, uncircumcised penis and skin.

It is my opinion that our culture continues its basic disdain for female sexual behavior. While the portrayal and consumption of female sexuality is in utmost demand, females engaging in sexual behavior are still morally devalued. Insidiously, under the guise of morality, female sexual behavior is to continue to be punishable by cervical cancer.

Abstinence alone does not guarantee that your children are protected against developing cervical cancer, because sexual contact is not necessary to become infected with cancer causing strains of HPV.

Vaccination with Gardasil should not lull anyone into a false sense of security because it will not immunize against all strains of cancer causing HPVs. One should try to avoid touching another person’s HPV-infected skin, be it on their genitals or fingers. The problem is that there is no way to know if someone is infected with cancer-causing HPV unless they know and tell you. Not all HPV-infected skin produces a visible wart. Vaccination therefore is important because it can prevent an infection that you or the person you are touching is unaware that they have.

While practicing dermatology for more than two decades, both in private practice and as a New York University School of Medicine faculty member teaching at Bellevue Hospital, I have witnessed how conservative cultural ideals conflict with actual human behavior. Viruses are apolitical, and so must we be in preventing the cancers they cause.

It is my opinion that all non-infected human beings, irrespective of sex or age, be offered vaccination against certain strains of HPV to prevent cancer.

The writer is a dermatologist, a faculty member of New York University School of Medicine and health officer of the village of Grand View.

May, 2007|Archive|

Breakthrough in cancer screening

  • 5/28/2007
  • London, England
  • Mark Henderson and Lewis Smith
  • The Times (

A revolution in cancer screening and treatment within 15 years is heralded today with the announcement of a leap in the ability to identify genes that cause the disease.

Researchers are confident that their findings will allow a screening programme, in which the inherited risk of developing cancer can be assessed for every patient, to be in place in an estimated 12-15 years.

Four common genes were identified and a fifth is on the verge of being pinpointed by researchers investigating the causes of breast cancer, almost doubling the number of known rogue genes.

One of the new genes, when found in a mutated form, increases the risk of developing the cancer by up to 60 per cent — giving a woman a one in six chance of the disease. Its most damaging variant is carried by one in six women, making it much more common than previously identified genes that contribute to breast cancer.

The success of a new “trawling technique” to assess 200,000 blocks of DNA simultaneously instead of one by one is expected to transform the search for treatments for all common cancers.

While the research concentrated on identifying genes linked to breast cancer, the same technique can equally well be used for other types of the disease and work has already started on applying it to prostate, bowel and lung cancer.

One scientist described the findings as the most important in breast cancer genetics since 1993 and 1995 when the first identification of genes that increase the risk of developing the cancer was made.

The research is the first success for a new approach to scanning large stretches of the human genome for cancer genes. Instead of focusing on one gene and trying to work out if it increased the likelihood of cancer developing, researchers were able to compare 200,000 blocks of DNA, or tags, of 800 women to narrow down the suspect genes.

Professor Bruce Ponder, of the University of Cambridge, led the study and said that the technique should speed up the rate of gene identification enormously for a range of cancers.

“Previously scientists have had to search for new cancer genes one at a time, but we have been able to search two thirds of the genome in one go,” he said. “Rather than fish for new genes one at a time with a rod and line, we have trawled the pool. This is not only a more efficient approach, it gets round the bias of previous studies in which scientists only examined genes they already knew something about.”

The discovery could help doctors to calculate a woman’s predisposition to develop breast cancer over a lifetime.

The genes identified in the latest research present a comparatively small added risk of cancer developing in any woman who has mutated versions of them.

However, they are much more common and while individually only increase the risk by a small proportion, the more mutated versions a woman has, the greater the chance of developing the disease.

In time, and if there are the resources within the NHS, researchers anticipate that patients could be tested for all the inherited genetic mutations and given a comprehensive risk assessment.

Only a fraction of the total number of genes with inherited mutations causing cancer have yet been identified but researchers are certain that they will find more as they carry out further studies and fine-tune their techniques.

The research was an international collaboration involving scientists from across Britain and the world and is published in several papers in the journals Nature and Nature Genetics. Harpal Kumar, chief executive of Cancer Research UK, said that this was “an outstanding discovery” that would “open doors across the globe.”

Independent cancer specialists welcomed the research. Professor Karol Sikora of Imperial College School of Medicine in London said: “This set of incredible papers points to the future.”

May, 2007|Archive|

Carcinoma Metastatic to Cervical Lymph Nodes From an Occult Primary Tumor: The Outcome After Combined-Modality Therapy

  • 5/26/2007
  • Paolo Boscolo-Rizzo, MD et al
  • Annals of Surgical Oncology 14:1575-1582 (2007)

The aim of this retrospective analysis was to analyze the results of treatment of patients with cervical node metastases from carcinoma of occult primary with a policy including neck dissection and postoperative comprehensive radiotherapy.

Ninety patients were treated with curative intent from 1990 to 2002.

The actuarial rate of neck disease control was 68.8% at 5 years (95% confidence interval [CI], 58.9%–78.7%). On multivariate analysis, the rate of neck disease control was significantly related to lymph nodal metastatic level (P = .006).

The actuarial rate of developing head and neck primary tumors at 5 years was 8.9% (95% CI, 2.6%–15.2%). The 5-year actuarial rate of distant metastases was 19.1% (95% CI, 9.4%–28.9%).

In multivariate analysis, a statistically significant difference in the rate of distant metastasis was obtained when patients were stratified according to the level of nodal involvement (P = .01) and the presence of extracapsular extension (P = .013). At the time of analysis, 50 of the 90 patients were alive. A total of 32 (35.6%) had died from causes related to their primary disease. Actuarial disease-specific survival at 2 and 5 years was 73.6% (95% CI, 64.3%–82.9%) and 62.8% (95% CI, 51.9%–73.7%), respectively. In multivariate analysis, a statistically significant difference in disease-specific survival was obtained when patients were stratified according to the level of nodal involvement and the presence of extracapsular extension.

Our study seems to support the use of combined-modality therapy in patients with neck metastases from carcinoma of occult primary. However, in the absence of randomized trials, comprehensive irradiation cannot be routinely advised.

Paolo Boscolo-Rizzo, MD1, Alessandro Gava, MD2 and Maria Cristina Da Mosto, MD1

Authors’ affiliations:
1 ENT Department and Regional Center for Head and Neck Cancer, University of Padua, School of Medicine, Treviso Regional Hospital, Treviso, Italy
2 Department of Radiation Oncology, Treviso Regional Hospital, Treviso, Italy

May, 2007|Archive|

Coaxing cancer researchers to take your money

  • 5/23/2007
  • web-based article
  • Amy Dockser Marcus

In 2004, Marnie Kaufman was diagnosed with a rare, little-understood cancer. There was no effective chemotherapy. Her husband Jeffrey’s first thoughts turned to how to jump-start research. “Jeff wanted to raise money and give it to anyone walking down the hall of the hospital,” Mrs. Kaufman recounts.

But after meeting with David Sidransky, director of head-and-neck-cancer research at Johns Hopkins University, and asking him to work on the organization they started, Dr. Sidransky told them to think about an issue they never anticipated: What if no one wanted their cash?

Budgets are tight at the National Institutes of Health, labs are scrambling to find funding, and many private foundations and pharmaceutical companies don’t invest in research for rare cancers. But for many patient advocates, there is a further obstacle. Sometimes they raise money and get no takers.

A friend of the Kaufmans who started his own rare-cancer advocacy group gave the phenomenon a name: the doom loop. Some researchers — tired of getting turned down for grants and fearing there will be no funding to sustain long-term research — don’t bother applying even when money becomes available.

To avoid that trap, the Kaufmans tried something different. They raised more than $700,000 for Mrs. Kaufman’s disease, a salivary-gland tumor called adenoid cystic carcinoma, or ACC, and then, instead of sending out a call for proposals and waiting for responses that might never arrive, they took matters into their own hands. Working with a small, four-person scientific board, they came up with their own list of projects they wanted done. They did research into who had expertise in those areas. Then they went out and essentially hired these experts to work on specific projects.

The Kaufmans used a combination of approaches to lure experts who might never have sought grant money on their own. Sometimes they targeted researchers doing work for other cancers and persuaded them to apply that work toward ACC. They offered not just money, but other support, such as help collecting data or materials. And they sped up the often monthslong traditional grant process by going straight to the researchers with a plan in place. They either signed business contracts or gave out grants, but they always listed specific goals and strict time frames. Generally, the Kaufmans made it easy to say yes.

Getting results

The approach is beginning to speed up results for ACC, which affects fewer than 1,000 people a year. There are now new mouse models for the disease — lab mice that carry the tumor — that will be used to test more drugs. And a lab is conducting gene sequencing on tumor samples, among other projects.

It hasn’t been easy. The effort requires a level of resources and commitment that not everyone can muster. The couple, who have no medical background themselves, had to become extremely knowledgeable about Mrs. Kaufman’s disease and work closely with their scientific advisers. Some researchers are also wary of starting a project on a rare cancer like ACC, for fear funding down the road could dry up. But the Kaufmans see their work on ACC as a possible blueprint for other small, overlooked diseases. “Once a handful of us go through it, we can help others do it,” Mr. Kaufman says.

Other groups are getting more aggressive also. The Cystic Fibrosis Foundation used to spend the majority of its research funds on investigator-initiated ideas. Last year, only 34% of the money was used that way, according to a foundation spokeswoman. Now the foundation is more likely to pursue companies it wants to do drug trials. Organizations such as the Juvenile Diabetes Research Foundation and the Michael J. Fox Foundation have also escaped the doom loop by putting up millions of dollars to get pharmaceutical companies to test drugs.

When Mrs. Kaufman, now 41, was diagnosed, her youngest boy, Max, was only one. The Kaufmans, who live in Needham, Mass., have three other children: Ben, 11, Skyler, 9, and Toby, 7. Because there is no known chemotherapy that is effective for ACC, Mrs. Kaufman had surgery to remove her tumor and then seven weeks of daily radiation. “The huge Frankenstein scar on the side of my neck seems to be the focal point for the kids right now,” Mrs. Kaufman wrote in an email that she sent out to friends and family after her surgery. “Toby can’t look at me unless he looks at the other side.”

She finished the last radiation treatment in October 2004, the same day “the Red Sox whupped the Yankees and made it to the World Series. … Coincidence? I don’t think so,” she wrote.

In that email, she struggled to explain to them — and to herself, she says — the kind of uncertainty that shadowed her even after treatment. Unlike many cancers, ACC is typically slow growing. But it is insidious and relentless, typically invading nerves and spreading throughout the body. While five-year survival rates are pretty good, at 15 years, the survival rate drops to only 40%. Many people with ACC undergo numerous surgeries or live with painful tumors that spread to other parts of the body, such as the lungs and bones.

“The good news is,” she added in that email, “it is reasonable to hope that if it ever came back … it may not be for many years, at which time there could be a better cure.”

That was the driving idea behind setting up the Kaufmans’ Adenoid Cystic Carcinoma Research Foundation. In the nine months after that last email, the couple met with researchers and other patient advocates trying to figure out the fastest way to get the work done. They joined an online patient-support group started by Prudence Jackson, who founded the Adenoid Cystic Carcinoma Organization International in 2003. That organization raised money for research, including at least 12 $30,000 grants given out with the National Organization for Rare Disorders. These grants resulted in, among other things, ACC gene research.

Waiting for proposals

But Mary Jean Sawey, a member of NORD’s medical advisory board who reviewed ACC proposals, said that the drawback in waiting passively for proposals is that “some are very innovative and work out great and others are just fishing expeditions.”

Dr. Sawey says the Kaufmans’ approach has its own difficulties. “When researchers come to you with an idea, it’s because they want to do it,” she said. “This way, you have to convince them to do what you want to do, and you end up having to be a manager.”

Mrs. Kaufman had spent the seven years prior to her diagnosis raising her children. But for many years, she worked as a corporate-foundation fund-raiser for a major hospital in Boston. After starting the ACC organization, she used those skills to tap friends and family. She sent out holiday cards with personal messages explaining their efforts to fight ACC. She mailed ice cream to researchers who met with them. Around the country, supporters ran golf tournaments, 5K races, silent auctions and other events, quickly netting more than $700,000.

Finding the right people

“Raising the money wasn’t the hard part,” Mrs. Kaufman says. “Finding out that raising the money wouldn’t be enough, that I was going to also have to find the right people to give it to, was really hard to accept.”

But fatalism can keep researchers from coming forward on their own. For instance, Barry Ziober, an assistant professor at the University of Pennsylvania, got a $30,000 grant from NORD two years ago to do a project on ACC. But after the money ran out, he felt he still didn’t have enough data to convince the NIH to fund him — so he didn’t even apply. And he felt it would be futile to go back to NORD because he had already received funding, and “organizations like to spread their money to different people.”

But officials at NORD say this is not the case. “Dr. Ziober would have exactly the same chance if he applied again for another grant,” says Stefanie Putkowski, research program administrator at NORD, adding: “We have doctors who get repeat grants.”

The Kaufmans have been in touch with Dr. Ziober about a possible project, but he says he is currently focusing on work that already has funding. So, Dr. Ziober says, his ACC work “is sitting in a folder on my desk.”

After researching where to direct their group’s money, the Kaufmans decided they needed more mouse models. But very few existed. “There is no glory for researchers in growing ACC tumors in mice,” says Mr. Kaufman.

At Dr. Sidransky’s suggestion, they reached out to the Institute for Drug Development in San Antonio, whose researchers develop new treatments for cancer. The Kaufmans offered IDD not just money, but also help in gathering tumor samples. Quickly, they signed a $70,000-plus contract for IDD to expand the number of mouse models and test 14 different compounds to see if one or a combination of them slows or stops the disease. The information discovered will belong to the organization, which can then pursue further drug development.

Earlier this year, the Kaufmans’ organization gave a grant to the Wellcome Trust Sanger Institute in Hinxton, England, to do gene sequencing on ACC tumor samples to search for potential new drug targets. The Kaufmans drew up a list of labs that did such work, requested proposals specific to ACC and compared prices. Rather than wait for a regularly scheduled board meeting to review the proposals, Mr. Kaufman circulated them via email, set up a teleconference the same week, and negotiated the deal with Sanger.

Sample collection

One of the researchers whose help they sought is Adel K. El-Naggar, director of head-and-neck pathology at M.D. Anderson Cancer Center in Houston. He had been collecting samples of tumors from a number of cancers, including ACC. With encouragement and money from the Kaufmans’ group, Dr. El-Naggar has hired people to harvest, annotate and disperse tissue from ACC tumors and collect clinical and follow-up information from the patients. He says he never would have considered requesting money to do such work. For such projects, says Dr. El-Naggar, there has never been “a funding mechanism” for sustained research.

Mrs. Kaufman says she is cancer-free for now, though she is monitored frequently, including magnetic resonance imaging of her head and neck, an annual chest and abdominal CT scan, and her doctor’s manual exam of her neck glands to make sure there are no new tumors. In the past six months, she had to undergo additional tests due to pain in her back that turned out to be caused by benign cysts, and a growth on her head that also was not cancerous.

“This is the kind of cancer that can come back anywhere,” she says.

Mr. Kaufman decided in March to take a one-year leave-of-absence from his job as an investment manager at Putnam Investments in Boston. He went to work full-time, without pay, at the organization because it has been challenging to understand the science and coordinate the different projects. “Even the best-intentioned researchers have huge demands on their time,” he says.

Source: The Wall Street Journal

May, 2007|Archive|

NCCN Updates Head and Neck Cancers Guidelines

  • 5/23/2007
  • Jenkintown, PA
  • staff
  • Natonal Comprehensive Cancer Network (

The National Comprehensive Cancer Network (NCCN) announces updates to the NCCN Clinical Practice Guidelines in Oncology™ – Head and Neck Cancers. The NCCN Guidelines are updated continuously by panels of world-renowned experts and are widely recognized and applied as the standard of care in oncology in the United States in both the community and the academic practice settings.

The NCCN Guidelines contain a newly modified risk categorization to assess whether patients should receive post-operative chemoradiation. The risk categorization lists potential major and minor risk features of the disease. Post-operative chemoradiation is indicated based on how many of these risk features a patient exhibits.

For cancers of the oropharynx, hypopharynx, and glottic and supraglottic larynx, cisplatin (Platinol® – AQ, Bristol-Myers Squibb) is now listed as the preferred agent if using the treatment option of concurrent systemic/radiation therapy. Cetuximab (Erbitux®, ImClone/Bristol-Myers Squibb) plus concurrent radiation therapy has been added as a systemic therapy option for unresectable and recurrent disease and for specific sites (eg, oropharynx, hypopharynx, glottic and supraglottic larynx). Definitive radiation therapy plus cetuximab was added for patients with advanced head and neck cancer not able to tolerate cytotoxic chemotherapy.

The NCCN Clinical Practice Guidelines in Oncology™ are available free of charge at

The guidlines of interest to oral cancer patients can be seen on the OCF web site at

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 21 of the world’s leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives.

The NCCN Member Institutions are:

* City of Hope
* Dana-Farber/Brigham and Women’s Cancer Center
Massachusetts General Hospital Cancer Center
* Duke Comprehensive Cancer Center
* Fox Chase Cancer Center
* Huntsman Cancer Institute at the University of Utah
* Fred Hutchinson Cancer Research Center / Seattle Cancer Care Alliance
* Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University
* The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
* Robert H. Lurie Comprehensive Cancer Center of Northwestern University
* Memorial Sloan-Kettering Cancer Center
* H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida
* Roswell Park Cancer Institute
* Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
* St. Jude Children’s Research Hospital / University of Tennessee Cancer Institute
* Stanford Comprehensive Cancer Center
* University of Alabama at Birmingham Comprehensive Cancer Center
* UCSF Comprehensive Cancer Center
* University of Michigan Comprehensive Cancer Center
* UNMC Eppley Cancer Center at The Nebraska Medical Center
* The University of Texas M. D. Anderson Cancer Center
* Vanderbilt-Ingram Cancer Center

May, 2007|Archive|

Head and neck cancer targeted in virus trial

  • 5/23/2007
  • London, United Kingdom
  • staff
  • CancerResearchUK (

Doctors at the Royal Marsden Hospital are trialling a possible new treatment for head and neck cancer, using a genetically modified virus which is injected directly into the patient’s tumour.

Scientists at the Institute of Cancer Research, supported by Cancer Research UK, have modified a herpes virus so that it is attracted to growing cancer cells, but not to normal healthy tissue.

Dr Alison Ross, science information officer at Cancer Research UK, said: “It’s still early days but this is an exciting study, which highlights the potential of using genetically-modified viruses as a weapon against cancer.

“This is one of a number of similar approaches for treating cancer that Cancer Research UK is supporting. But it’ll be a number of years before we’ll find out whether this particular treatment is effective.”

The modified virus is designed to enter cancer cells and quickly replicate until the cell bursts.

The researchers have also introduced genetic material which produces molecules that the immune system can use to recognise the tumour.

Lead researcher Dr Kevin Harrington told the BBC: “We think this is [an] enormously exciting opportunity to bring virus and gene therapy into front line treatment of cancer.”

A number of other trials are also being conducted using viruses to target other types of cancer, including breast and lung cancer.

May, 2007|Archive|

CEL-SCI Presents Long-Term Cancer Survival Data With Multikine

  • 5/23/2007
  • Hickory, NC
  • staff
  • MaxHealth (

Cancer drug Multikine was shown to significantly increase long term overall survival in a Phase II study of head and neck cancer patients.

The data were presented on May 20, 2007 at the First International Congress of the International Association of Oral Oncology in Amsterdam, the Netherlands, by Dr. Eyal Talor, Senior VP of Research and Manufacturing at CEL-SCI Corporation.

Dr. Talor’s presentation focused on the results obtained in CEL-SCI’s final Phase II clinical trial of Multikine that was conducted in patients with head and neck cancer (oral squamous cell carcinoma — OSCC). This final Phase II clinical trial was designed to assess thoroughly the positive safety and efficacy observations made in patients treated with Multikine in CEL-SCI’s early Phase II trials. In the trial Multikine was given prior to standard care to recently diagnosed and not yet treated cancer patients.

The addition of Multikine to the first treatment (standard of care) of these patients resulted in a 33% improvement in the median overall survival at 3-1/2 years post-surgery, when compared to the survival results reported in 55 OSCC clinical trials published in the scientific literature between 1987 and 2007.

Multikine first-line treatment also resulted in an improvement of the 2- year local regional over the published local regional control rate. It is clinically recognized that recurrence of disease in head and neck cancer is associated with a very poor prognosis. Multikine treatment did not result in any severe adverse events (SAE) in this Phase II clinical trial and no SAEs related to Multikine have been reported in other trials conducted with Multikine either.

CEL-SCI received clearance from the United States Food and Drug Administration (FDA) to proceed to a Phase III clinical trial with Multikine earlier this year. The same treatment regimen that was used in CEL-SCI’s final Phase II trial will be used in the upcoming Phase III trial that CEL-SCI will undertake since the results obtained in the final Phase II trial are thought to be indicative of the results one might expect in any Phase III trial of Multikine. The Phase III trial is designed to demonstrate a 10% increase in overall survival of patients treated with adjuvant Multikine therapy versus those treated only with the current standard of care.

Dr. Talor said, “Having shown a 33% increase in overall survival with no safety concerns in the final Phase II study, we are very hopeful that we will successfully reach the 10% increase in overall survival that is the primary endpoint of our Phase III trial. To further enhance the probability of meeting our primary endpoint, we are over-enrolling the study.”

Documented data were available for 19 of the 22 patients in the follow-up portion of this clinical trial. Of the three patients who could not be evaluated in the follow-up study, one patient was known to be alive, but failed to give informed consent, and the other two were lost to follow-up. One patient died the day after definitive surgery, unrelated to Multikine therapy.

Head & neck cancer is an aggressive cancer that affects over 500,000 -600,000 people per annum worldwide.

CEL-SCI Corporation is developing new immune system based treatments for cancer and infectious diseases. The Company has received the go-ahead from the U.S. FDA and the Canadian Regulators to conduct a Phase III clinical trial in advanced primary head and neck cancer patients with its lead product Multikine.

May, 2007|Archive|