5/15/2007 web-based article Carey Cowles Hem/Onc Today (www.hemonctoday.com) Aspirin’s many mechanisms of action against cardiovascular events may also help to explain reported resistance to therapy. Aspirin’s effect on homeostasis is well-known. Low-dose aspirin (acetylsalicylic acid, 81 mg) inhibits the enzyme Cox-1, which produces thromboxane A-2, necessary for platelet aggregation. “The primary effect of aspirin as an anticoagulant is thought to involve platelet function; however, aspirin is also an anti-inflammatory,” said Kenneth Mann, PhD, a professor from the department of biochemistry at the University of Vermont. Less clear are other methods by which aspirin acts as an anticoagulant. In a review article published in "Blood", Mann, Anetta Undas, MD, PhD, and colleagues presented an overview of other possible antithrombotic properties of aspirin. Thrombin formation Thrombin (activated Factor II [IIa]), a serine protease, converts fibrinogen into insoluble strands of fibrin. Fibrin, a protein, crosslinks with Factor XIII enzyme (fibrin stabilizing Factor FXIII) and combines with platelets to form a clot. Studies of microvascular injury models have demonstrated that aspirin at a daily dose of 30 mg administered for one week decreased thrombin formation in healthy patients. Aspirin at higher doses (75 mg and 300 mg) decreased concentrations of thrombin markers similarly, as did a single dose of 500 mg following a period of aspirin therapy. This thrombin-lowering effect was found in healthy individuals and patients with increased risk for coronary artery disease. A seven-day course of low-dose (75 mg) aspirin was associated with slower prothrombin consumption (by 29%), thrombin formation (by 27.2%) [...]

5/15/2007 web-based article Dan Jones Nature Reviews (www.nature.com) With the approval of the first active immunotherapy pending, are we poised to enter the era of clinically effective cancer vaccines? On 29 March this year, the US FDA's Office of Cellular, Tissue and Gene Therapies Advisory Committee met to discuss the fate of Dendreon's leading cancer vaccine candidate Provenge (Sipuleucel-T). The Committee voted by 17–0 that Provenge was safe and 13–4 in favour of its efficacy in the treatment of metastatic, hormone-refractory prostate cancer. If things go in Dendreon's favour, Provenge might be approved as soon as mid-May. Provenge represents an extreme of 'personalized medicine'. Dendritic cells, which mop up antigens and present them to other cells of the immune system to stimulate a response, are taken from patients and then sent to one of Dendreon's repositories where they are treated with the prostate-specific antigen prostatic acid phosphatase (PAP), which is found in 95% of prostate cancers. Once returned to the patient, these activated dendritic cells should, in principle, activate T cells to attack and destroy cancer cells that are expressing PAP, leading to the eradication of the tumours. The cell-based approach taken by Dendreon is one of several options being pursued by cancer vaccine developers. Another popular approach is to use viral vectors to deliver genes encoding proteins that stimulate the immune system to attack cancer cells. Since the first such tumour antigens were identified in the early 1990s by Thierry Boon, a biologist at the Ludwig Institute for Cancer [...]

5/15/2007 Iowa City, IA Min Yao et al. Int J Radiat Oncol Biol Phys, March 20, 2007 Purpose: The objective of this study was to determine regional control of local regional advanced head and neck squamous cell carcinoma (HNSCC) treated with intensity-modulated radiotherapy (IMRT), along with the role and selection criteria for neck dissection after IMRT. Methods and Materials: A total of 90 patients with stage N2A or greater HNSCC were treated with definitive IMRT from December 1999 to July 2005. Three clinical target volumes were defined and were treated to 70 to 74 Gy, 60 Gy, and 54 Gy, respectively. Neck dissection was performed for selected patients after IMRT. Selection criteria evolved during this period with emphasis on post-IMRT [(18)F] fluorodeoxyglucose positron emission tomography in recent years. Results: Median follow-up for all patients was 29 months (range, 0.2-74 months). All living patients were followed at least 9 months after completing treatment. Thirteen patients underwent neck dissection after IMRT because of residual lymphadenopathy. Of these, 6 contained residual viable tumor. Three patients with persistent adenopathy did not undergo neck dissection: 2 refused and 1 had lung metastasis. Among the remaining 74 patients who were observed without neck dissection, there was only 1 case of regional failure. Among all 90 patients in this study, the 3-year local and regional control was 96.3% and 95.4%, respectively. Conclusions: Appropriately delivered IMRT has excellent dose coverage for cervical lymph nodes. A high radiation dose can be safely delivered to the abnormal lymph nodes. There [...]

5/14/2007 Boston, MA staff OakParkJournal.com Pancreatic cancer is the fourth leading cause of cancer death in the U.S.; more than 30,000 Americans are expected to die from the disease this year. It is an extremely difficult cancer to treat and little is known about what causes it. One established risk factor in pancreatic cancer is cigarette smoking; other links have been made to obesity, diabetes type 2 and insulin resistance. In a new study, researchers at the Harvard School of Public Health (HSPH) and Dana-Farber Cancer Institute found that periodontal disease was associated with an increased risk of cancer of the pancreas. "Our study provides the first strong evidence that periodontal disease may increase the risk of pancreatic cancer. This finding is of significance as it may provide some new insights into the mechanism of this highly fatal disease," said lead author Dominique Michaud, assistant professor of epidemiology at HSPH. Periodontal disease is caused by bacterial infection and inflammation of the gums that over time causes loss of bone that supports the teeth; tooth loss is a consequence of severe periodontal disease. Two previous studies had found a link between tooth loss or periodontitis and pancreatic cancer, but one consisted of all smokers and the other did not control for smoking in the analysis, and therefore no firm conclusions could be drawn from these studies. Data for the new study came from the Health Professionals Follow-Up Study, which began in 1986 and includes 51,529 U.S. men working in the health [...]

5/14/2007 London, England staff Telegraph.co.uk Patients suffering from head and neck cancer are to be denied a new drug on the National Health Service because it is claimed it is no more effective than existing drugs. The National Institute for Health and Clinical Excellence (Nice) has rejected Erbitux, also known as cetuximab, for cancer sufferers in England and Wales. The drug is available in Scotland. Nice said the drug, when used in conjunction with radiotherapy, did not offer "better therapeutic value" than existing treatments for locally advanced head and neck cancer. However, according to clinical trials carried out by Merck Serono UK, the drug's manufacturer, patients treated with Erbitux plus radiotherapy survive for an average of 49 months, compared with 29 months for those treated with radiotherapy alone. Campaigners said the move was a blow to patients as the drug is the first licensed in the past 40 years for treating locally advanced head and neck cancer. Andrew Dillon, the chief executive of Nice, said: "The evidence presented to the independent advisory committee did not persuade them that cetuximab works any better or offers better therapeutic value than existing treatments for head and neck cancer. "Sometimes it is possible for the committee to identify a subgroup of patients in whom a drug would be effective, for example, patients for whom other treatments are not suitable. "The committee did consider whether there are any subgroups of patients for whom cetuximab could be clinically and cost effective but they were not presented [...]

5/14/2007 Cape Town, South Africa staff Health24.com A US Food and Drug Administration advisory panel has called for new warnings and additional safety studies on anaemia drugs commonly used to treat patients undergoing kidney dialysis or chemotherapy. These medications have been the subject of controversy since some of their dangerous side effects - including the risk of heart attacks and stroke - came to light earlier this year. In March, the FDA issued stronger label warnings for the popular drugs. On Thursday, the agency's advisory panel of experts voted 15-2 in favour of new prescribing restrictions and 17-0 for new clinical trials to prove the safety of Amgen's Aranesp and Johnson & Johnson's Procrit, Bloomberg reported. "Many of us are concerned on the committee and have a lot of questions," said advisory panel chairwoman Gail Eckhardt, an oncologist at the University of Colorado in Aurora, according to Bloomberg. Insufficient evidence Eckhardt said the questions concerned the design of trials, why regulators have limited access to results from company studies, and why the drugs have been marketed for improving quality of life if there isn't sufficient evidence for the claim. Amgen, of Thousand Oaks, California, claims that 4 million patients have taken the medicines since they were introduced in 1989, and more than 9 000 people have been studied in clinical trials with cancer patients, the Bloomberg report said. "We want to consider the totality of the evidence and consider what's best for patients," Roger Perlmutter, Amgen's head of research and [...]

5/14/2007 Westchester County, NY Linda Lombroso Lower Hudson Online (www.thejournalnews.com) It was nearly five years ago that Margaret Belair received chilling news: The sensitive spot on her tongue was far more than a pizza burn or a cold sore. It was oral cancer. Belair, who'd just given birth to a baby boy, was stunned. "It didn't look or feel hard,'' says the 41-year-old mother of two, who lives in Somers. "It was just a weird irritation of the tongue, just slightly discolored, and it felt like a big canker sore.'' Despite the shock of the diagnosis, Belair was fortunate. After an operation to cut out a portion of her tongue - and the precautionary removal of several lymph nodes in her neck - all she needed was eight weeks of speech therapy (to relearn how to pronounce certain sounds) and eight weeks of physical therapy (to build up the strength in her neck). For Brian Hill, the news was not as good. By the time his oral cancer was caught in 1997, it had metastasized to his lymph nodes. Nobody expected him to survive. Although the treatment was brutal - including radiation that destroyed his salivary glands and destroyed a portion of his neck - Hill ended up beating the odds. He has since founded the Oral Cancer Foundation, a national nonprofit research and advocacy organization, and has become an outspoken champion for early detection of the disease. One of the problems in catching oral cancer early, say experts, has [...]

5/14/2007 web-based article staff CancerConsultants.com Researchers affiliated with an international study have reported that oral infection with human papilloma virus (HPV) is associated with the development of head and neck cancers. The details of this study appeared in the May 10, 2007 issue of The New England Journal of Medicine. Human papilloma viruses are probably the sole cause of cancers of the cervix and have been associated with cancers of the vulva, vagina, penis and rectum. Epidemiologic and molecular biology studies have also suggested that HPV infection may be associated with cancers of the head and neck. The relationship between HPV infection and head and neck cancer was reviewed in 1998 by researchers from the University of North Carolina (see related news). They reported that the overall frequency of HPV in benign and precancerous lesions ranged from 18.5% to 35.9%, depending upon the detection methodology. Using PCR, the overall prevalence of HPV in head and neck tumors was 34.5% (416 of 1,205 tumors). Type 16 HPV, which is associated with cervical cancer, was found in 40% of cases positive for HPV. They also reported variability in other sites including 59% positivity for oral cavity cancers, 43% for the pharynx, and 33% for the larynx. The frequency of HPV positivity in oral samples from healthy individuals ranged from 1% to 60%. Furthermore, age (<60 years) and sex (male) were associated with the presence of HPV in the tumor, whereas tobacco and alcohol use were not. In the study published in 2003, [...]

5/11/2007 web-based article staff eMaxHealth.com A visit with your dental hygienist may result in more benefits than just cleaner teeth and healthier gums -- you might even decide to stop smoking, improve your nutrition or check to see if you might be at risk for diabetes. "Most people simply don't realize just how educated and skilled their dental hygienists are," said Susan McLearan, president of the California Dental Hygienists' Association (CDHA). "The profession has evolved to the point where we actually can save lives." In keeping with its mission to raise public awareness about dental health and to promote the value of seeing a dental hygienist, the association has issued the following list of the Top Ten Things Californians Should Know About Their Dental Hygienists. "The list is intended to show how dental hygienists play such an integral role in overall public health -- in many different ways and on many different levels." That role is reflected in the following facts about Registered Dental Hygienists (RDH): 1. Highly Educated Professionals -- The minimum level of education for licensure is equivalent to a four-year degree with two years specializing in dental hygiene. 2. Committed to Expanding Access to Care -- Specially licensed hygienists can go into underserved communities and provide dental hygiene services to some of the millions of Californians who would otherwise have no access to dental care. 3. Screen for Oral Cancer -- Dental hygienists possess the skills to be the first health professional to identify potential signs of [...]