Monthly Archives: July 2007

Snuff’s popularity grows, despite cancer fears

  • 7/30/2007
  • Norway
  • staff

Three out of four Norwegians think the tobacco product known as snus, or snuff, can cause cancer. Its popularity has been soaring, though, especially among young men.

Snuff’s rise in popularity has followed Norway’s introduction of laws that ban smoking in offices, restaurants, bars and other public places.

Many smokers, denied their cigarettes, turned to snuff instead, and producers responded by boosting production of snuff in small packets that now are often found under the lips of many young Norwegian men. And women.

Studies show that around 6 percent of the Norwegian population aged 16-74 use snuff daily. Three times as many in the age group 16 to 24 are believed to use snuff daily.

Researcher think the figures will soon reach 35 percent of the population aged 16 to 24, despite cancer fears.

A new survey conducted by polling firm Norsk Respons for a state public health program in Østfold County found that 84 percent of women and 66 percent of men questioned believe snuff can cause cancer.

Medical researchers are split on the issue, with some downplaying the risk. Others subscribe to the cancer warnings.

“We have strong indications that snuff can lead to cancer, especially cancer in oral cavities and the stomach,” said Professor Tore Sanner at the leading Norwegian cancer hospital Radiumhospitalet. The World Health Organization and American health authorities have also classified snuff as cancer-causing.

July, 2007|Archive|

Anti-Smoking Program Again Flush With Cash

  • 7/29/2007
  • Tallahassee, FL
  • staff

Florida’s once-heralded youth anti-smoking program is coming back.

Lawmakers had gutted the program’s budget in recent years, but last year voters forced the program back into relevancy. Voters in November changed the constitution to require the Legislature to put 15 percent of the state’s tobacco settlement dollars into the program each year, just under $58 million in the current year.

“We have restored an effective youth tobacco prevention program, which includes a substantial appropriation for smoking cessation,” said Don Webster, CEO of the American Cancer Society’s Florida Division.

In the late 1990s Florida’s effort to convince kids that smoking wasn’t cool was widely praised, partly for its original TV ads that had lots of teens – and young adults – talking about them, and partly because it seemed to work.

The number of kids who said in surveys that they smoke dropped off fairly dramatically during the time the program was in full swing. Later, when the program was no longer being used, the decreases leveled off.

The program featured a teen-oriented ad campaign that didn’t bother with subtlety, squarely taking on the tobacco industry, and portraying industry officials as outright killers. One ad compared tobacco company executives to Hitler, Stalin and the Ku Klux Klan. Another featured a boy getting his tongue bitten off by a dog he was taunting. The ad, which targeted smokeless tobacco, asked “how attached are you to your tongue?”

The pinstripe suit-crowd wasn’t amused, and many lawmakers also didn’t particularly like the in-your-face ads, which were designed at least in part by teenagers themselves.

After putting $70 million into the campaign from the state’s settlement of a lawsuit with cigarette makers in 1998, spending dropped off steeply until lawmakers were putting a token $1 million a year into it, rendering it essentially dormant.

Voters stepped in last year, doing what lawmakers wouldn’t and forcing the state to restore money for the effort.

He didn’t have much of a choice on spending the money because of the constitutional mandate, but Gov. Charlie Crist has said he supports the boost in spending. In May he signed legislation spelling out the details of how the new program will be administered. On Wednesday, he re-enacted that bill signing in a ceremony to draw attention to the return of the program.

“By teaching our children about these risks early on, we are taking steps necessary to protect the health of future generations of our fellow Floridians,” Crist said.

While the program itself will return, it’s not clear yet exactly what it will do to try to fight teen smoking. It will include an advertising component, but the details of what that campaign will look like are yet to emerge.

The legislation created a 23-member advisory council to oversee the program, four of whom are appointed by the governor. Crist announced his choices Wednesday. They are: Steven Hougland, director of the state’s Division of Alcoholic Beverages and Tobacco; Robin Peters, prevention director in the state’s Office of Drug Control; Erin Sylvester, of Panama City, a Florida State University student; and Mae Waters of Tallahassee, a researcher at Florida State.

It likely will be at least early next year before most Floridians come into contact with the anti-smoking campaign, at least in the form of new ads, said Paul Hull, vice president of the American Cancer Society, which pushed hard for the constitutional amendment.

While they were mostly on the same page Wednesday as Crist touted the return of the anti-tobacco program, the governor and anti-smoking activists don’t quite see eye to eye on another issue.

The American Cancer Society and other groups have pushed for several years for Florida to increase its cigarette tax rate, which is one of the lowest in the nation and has been the same for almost 20 years. Florida’s 33 cent tax is well below the national average of over $1.

Crist demurred, saying he isn’t a fan of raising any taxes.

July, 2007|Archive|

Myriad Genetics Launches New Molecular Diagnostic Test

  • 7/29/2007
  • web-based article
  • press release

Myriad Genetics, Inc. announced today that it has introduced a new product, TheraGuide 5-FU(TM), to help predict which cancer patients are likely to suffer serious toxic reactions to the drug 5-Fluorouracil (5-FU) or the oral form of the drug, capecitabine. More than 500,000 Americans with breast cancer, colon cancer, skin cancer or head and neck cancer are treated with 5-FU each year. Approximately 30% of those patients experience severe toxicity.

TheraGuide 5-FU is a comprehensive analysis of the genetic variations in two genes, DPYD and TYMS, which increase a patient’s risk for toxicity to 5-FU chemotherapy. With the TheraGuide 5-FU test results, oncologists and their patients can take steps to reduce the risk of avoidable toxicity, including using alternative therapies, reducing the size of the dose and increasing patient monitoring for side effects. TheraGuide 5-FU provides the critical guidance oncologists need to personalize chemotherapy for their cancer patients who are being considered for chemotherapy regimens.

“TheraGuide 5-FU is a new personalized medicine test that has the potential to save many cancer patients from serious toxic reactions to the medicine that is supposed to help them,” said Greg Critchfield, M.D., President of Myriad Genetic Laboratories, Inc. “TheraGuide 5-FU points the way to the future promise of personalized medicine, where tests can guide the therapeutic choice for improved patient care, while limiting the side effects of otherwise efficacious drugs.”

Approximately one third of all patients given 5-FU will experience dose-limiting toxicity that can be severe to life-threatening. The majority of these toxic reactions are due to genetic variations in the DPYD and TYMS genes. The DPYD gene makes the enzyme that is primarily responsible for metabolizing or breaking down 5-FU and clearing it from the body quickly. If the DPYD enzyme activity is compromised, 5-FU will be cleared more slowly from the system resulting in a longer period of exposure to 5-FU and a subsequent increased risk for toxicity. An estimated 9 million individuals in the U.S. have low DPYD enzyme activity due to mutations in the DPYD gene.

Thymidylate synthase (TYMS) is an essential enzyme for DNA synthesis. The chemotherapy drug, 5-FU, binds to the TYMS enzyme, inhibiting its function. When the TYMS enzyme is inhibited, DNA synthesis does not go forward and the cell dies. Since cancer cells multiply rapidly, requiring a high level of DNA synthesis, they are much more sensitive to thymidine depletion than normal cells. The human TYMS gene has genetic variations that cause differential production of the TYMS enzyme. If a variation causes underproduction of TYMS, only a portion of the 5-FU dose is used to bind to, and inhibit, the TYMS enzyme, and the rest remains unbound in the body resulting in increased toxicity. Variations causing overproduction of TYMS enzyme lead to excess TYMS and insufficient 5-FU to completely inhibit the enzyme and a resulting loss of efficacy with the 5-FU chemotherapeutic.

Toxicity reactions due to reduced enzyme activity may include hand-foot syndrome, fever, mucositis, stomatitis and severe diarrhea. Nausea, vomiting, rectal bleeding and skin changes may also occur. Neurologic abnormalities include cerebellar ataxia (uncoordinated muscle movement) and changes in cognitive ability. Elimination of 5-FU from the treatment regimen is usually sufficient to prevent additional unexpected toxicities.

TheraGuide 5-FU is Myriad’s fifth molecular diagnostic product. The Company is now accepting samples for testing with TheraGuide 5-FU. The test cost is $1,100 and includes a comprehensive DNA sequence analysis of the DPYD gene and the important variations in the TYMS gene. The result is returned to the requesting physician within seven days of receipt at Myriad.

July, 2007|Archive|

The evolution of surgery in the management of neck metastases

  • 7/27/2007
  • web-based article
  • S Subramanian et al
  • Acta Otorhinolaryngol Ital, December 1, 2006; 26(6): 309-16

In spite of advancement in science, molecular medicine and target therapies, surgical treatment of metastases using different techniques, from selective neck dissection to extended radical neck dissections, form a major part in the management of neck metastases.

This is due to the fact that, so far, there is no treatment more effective for resectable neck metastases, than surgery. Since most head and neck cancer patients die due to loco-regional progression of disease, and a very large majority of them do not live long enough to develop distant metastases, the status of neck lymph nodes remains the single most important prognostic factor, in these cases.

In the 100 years since George Washington Crile described Radical Neck Dissection, we now have a much better understanding of the biological and clinical behaviour of neck metastases. This has ultimately led to the conservative approaches of selective neck dissections depending on the primary site of the tumour, type of tumour and the characteristic features of the metastases themselves.

A search of the literature on neck lymph nodes and neck dissections, on the internet and in old publications, not available in the electronic media, has been carried out. Using this as the basis, we arranged, in sequence, the dates of various landmarks in the treatment of head and neck cancer related to neck dissections to emphasize the overall process of evolution of neck dissection thereby showing how the field of head and neck surgery has travelled a long way from radical neck dissection to its modifications and further to selective neck dissections and sentinel node biopsies.

The present understanding of the patterns of neck metastases enables us not only to adequately treat the neck metastases, but also to diagnose metastases from unknown primaries. Therefore, depending on the site of the primary tumour, it is now easy to predict the most probable route of metastatic spread and vice versa. This has enabled us to adopt modified and selective neck dissections which have ultimately led to a dramatic reduction in morbidity and almost eliminated mortality due to neck dissection. In the near future, molecular diagnostics and targeted therapies for treating metastases should be able to further reduce the burden of head and neck cancer.

S Subramanian, F Chiesa, V Lyubaev, and A Aidarbekova

Authors’ affiliation:
Department of Head and Neck Surgery, N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation

July, 2007|Archive|

Woman Who Pushed for HPV Vaccine Dies

  • 7/24/2007
  • Austin, TX
  • staff

Heather Burcham, whose battle with cervical cancer led her to urge legislators to try to keep girls from sharing in her fate, has died of the disease. She was 31.

Burcham, of Houston, died Saturday.

“Her pain and suffering have forever ceased,” Gov. Rick Perry said Monday. He said she was “an inspiration to myself, my staff and others.”

Perry issued an executive order in February that would have required the newly approved human papillomavirus vaccine for girls entering the sixth grade, to help protect them from cervical cancer.

Members of the Legislature were outraged, complaining that Perry circumvented the legislative process, that the vaccine was too new and that making it mandatory could encourage young people to be sexually active. The human papillomavirus that causes cervical cancer is transmitted through sexual contact.

Burcham went to the Capitol to voice support for the vaccine in February. In April, legislators passed a bill blocking state officials from following Perry’s order.

In a May news conference to announce that he would not veto the bill, Perry closed with a video of Burcham speaking from her hospice bed.

With oxygen tubes snaking out of her nose, she spoke of the pain she had endured for four years. She also mourned for the husband she would never meet and the children she would never raise.

“If I could help one child, take this cancer away from one child, it would mean the world to me,” she said. “If they knew what I was going through, how incredibly painful that this was … then I feel like I’ve done my job as a human on this earth.”

Vaccination programs similar to the one blocked in Texas have been proposed in many states, but only Virginia has signed such a mandate into law.

Merck & Co.’s Gardasil, the only HPV vaccine on the market, was approved by the Food and Drug Administration in June 2006. The federal Advisory Committee on Immunization Practices followed with a recommendation that all girls be vaccinated at age 11 or 12.

Cervical cancer kills 10 women a day in the U.S., and one in four U.S. women ages 14 to 59 is infected with HPV, according to a recent report from the federal Centers for Disease Control and Prevention. While Gardasil is not a magic bullet, it protects against the strains of HPV that cause 70 percent of cervical cancer cases.

July, 2007|Archive|

Cancer strikes top chef in his prime

  • 7/24/2007
  • Chicago, IL
  • Phil Vettel and Robert Mitchum

Chemotherapy treatments could rob Chicago’s rising culinary star of his ability to taste.

Grant Achatz, the 33-year-old superstar chef whose Lincoln Park restaurant, Alinea, is ranked among the very best in the world, is facing a medical challenge with a painful twist.

On Monday, Achatz announced that he has been diagnosed with Stage 4 squamous cell carcinoma of the mouth.

The cancer, which doctors believe has spread to Achatz’s lymph nodes, is life-threatening. The lesions are on the chef’s tongue.

If chemotherapy is successful, there remains a possibility that Achatz will lose all sense of taste.

“It’s Shakespearean,” said Nick Kokonas, Achatz’s friend and co-owner of Alinea. “This is like a painter whose eyes are taken from him, a pianist who has his fingers cut off.”

An optimistic-sounding Achatz doesn’t quite see it that way.

“People confuse the role of the chef,” he said. “A lot of what I do is conceptualize. I’m not the guy who cooks everything every night; it’s impossible. I’ve got a really strong team (at Alinea), and their response has been amazingly positive. They’re going to rally around this.”

Achatz burst on the dining scene in 2001, when, after four years working under Thomas Keller at the acclaimed French Laundry in Yountville, Calif., he was hired as executive chef at Trio in Evanston. Not only did Achatz maintain the restaurant’s four-star status, but a year later he made Food & Wine magazine’s list of Best New Chefs in America. In 2003, he was named the Rising Star Chef of the year by the James Beard Foundation.

Alinea, the restaurant opened with Kokonas in 2005, quickly received worldwide attention and acclaim, along with four-star reviews from the Chicago Tribune and Chicago Magazine. Restaurant patrons were awed by Achatz’s innovative style, which challenged people’s notions of food and flavor. An early dish, called “PB&J,” presented a single peeled grape, covered in peanut butter and wrapped in thin-toasted brioche — a peanut-butter and jelly sandwich compressed into a single bite.

He presented a dish of ham and peas on a pillow filled with lavender-scented air, which wafted out from the weight of the plate. Trio fans clamored for his miniature ravioli squares filled with liquid truffle, which burst in the mouth on the first bite.

“I’m not dwelling on the possibility that I’ll never be able to taste again,” Achatz said. “Beethoven composed one of his greatest symphonies when he was deaf.”

While it is less common for this form of cancer to appear in people as young as Achatz, it is not unheard of, oncologists said. “More and more over the last several years, we’re seeing younger and younger patients with this kind of cancer, specifically in their mouth,” said Dr. Mark Agulnik, medical oncologist, at the Northwestern University Feinberg School of Medicine.

The most common risk factors for squamous cell carcinoma in the mouth are smoking and alcohol consumption, but these behaviors do not appear to contribute to most cases of the disease in younger people.

A Stage 4 cancer means that the cancer cells have spread to the lymph nodes, located in the neck. As long as the cancer has not traveled beyond this point to other organs of the body, it usually remains treatable, the oncologists said.

“With aggressive treatment, these cancers are highly curable in more than the majority of patients,” said Dr. Tanguy Seiwert, instructor of medicine in hematology/oncology at the University of Chicago. “But as soon as it spreads beyond lymph nodes, it’s no longer curable. You can only alleviate symptoms and prolong life.”

Treatment usually involves a combination of chemotherapy, radiation and, if necessary, surgery to remove afflicted regions. These treatments may affect Achatz’s salivary glands and ability to taste.

What might be more difficult for the chef, a notorious workaholic, than chemotherapy is staying away from the restaurant when the effects of the treatments make him too ill or tired to work.

“People close to me know that the biggest problem will be keeping me away,” Achatz said. “But it’s medically inevitable. But you go with that — you engage as much as you possibly can engage, then trust the people who you’ve been training for six years.”

“The news is just devastating, shocking,” fellow chef Charlie Trotter said. “He’s a great guy, a huge talent who has been great for the city. Our whole staff talked about it, and there were a lot of watering eyes.

“I think everybody is pulling for this guy. Not just in our little culinary community, but throughout the city.”

After consulting with specialists at Memorial Sloan-Kettering Cancer Center in New York, one of three groups with whom Achatz consulted, the chef broke the news to the kitchen staff at Alinea.

“He gave an amazing talk; he was very much the leader,” Kokonas said. “Personally, I could not have given that speech, and did it not just with dignity but with optimism. The thing we most want to do for him is ensure that absolutely nothing changes at Alinea.

“I went through my period of pessimism. He can beat this.”

July, 2007|Archive|

Laser surgery checks oral cancer spread

  • 7/20/2007
  • Bhubaneswar, India
  • staff

Laser technology has been used in surgeries since early seventies but innovations have made it an important tool today to treat superficial lesions in oral cancers.

As oral cancer is most common in Orissa due to the tobacco chewing habits, the ‘carbon dioxide laser’ is perhaps the right tool to manage the surgical requirements and a finding from 128 cases shows that it has got extremely good tumour control capabilities.

A study carried out over nearly a year at Panda Medical Centre (PMC), Telengapentha, has found that the use of carbon dioxide laser increases accuracy, improves accessibility and minimal collateral tissue damage through instantaneous tissue sealing, reduced pain, edema and minimal blood loss.

According to consultant ENT and head and neck surgeon Dr Sanjoy Panda of PMC, the most important benefit with this technique is sealing of lymphatic vessels as it demands paramount importance in cancer surgery.

“The small invisible vessels are sealed spontaneously by laser. This is necessary while dealing with tumours and preventing seeding of wounds,” he adds.

“There is recent data that compares excising tumours with knife to excision with laser, and finally, to excising with laser and vapourising the base. There is a marked decrease in the recurrence with the latter method,” he points out.

Carbon dioxide laser has an important role to play in Orissa as most of the cancer patients are tobacco chewers and the cost of therapy is less which makes it attractive for the needy, the cancer surgeon feels.

Laser advantages are many as it can be used from a distance and collateral thermal damage to adjacent tissues is less.

As it numbs nerve endings the post-operative pain is very less. The light beam generates a heat of 1,500 degree Celsius which, apart from destroying cells on its path, also sterilises the wound again leading to less infection and decreased chances of contamination.

As the pain and infections are less, hospital stay and medical expenses are drastically reduced. Also it has no effect on pacemakers or any electronic gadgets and useful to patients with bleeding disorders, Dr Panda reveals.

The laser can be used both as ‘freehand’ or through microscope. However, the safety measures are to be followed and eyes and adjacent areas are to be covered with wet cotton as the beam is absorbed by water, he adds.

Recently, Dr Panda presented his research findings at the 6th European Congress of ENT, Head and Neck Surgery, Vienna. Currently, PMC is the only centre in the State offering the ‘laser option’ for oral cancer surgery.

July, 2007|Archive|

Treatment is dying man’s last hope

  • 7/18/2007
  • Northamptonshire, UK
  • staff
  • Evening Telegraph (

A dying man will find out today if he is suitable for a revolutionary cancer treatment which experts say could save his life.

Brad Tompkins will undergo an MRI scan at University College Hospital in London which will determine whether he could benefit from the breakthrough laser therapy to treat his mouth cancer.

Mr Tompkins, of Rushden, has rejected the chance of chemotherapy and radiotherapy, as well as surgery to remove parts of his tongue and throat, because it would severely affect his quality of life. It leaves the new treatment his only hope for treatment.

Mr Tompkins, who has been told his cancer is terminal, said: “I’m so nervous. Essentially, I’ll find out whether I’ve got weeks left to live or if I’ve got the rest of my life to look forward to.

“Doctors will be carrying out an MRI scan to see if the treatment could work.

“I’m frightened and excited because this treatment could be perfect. Other options involved surgery to remove my tongue and voice box.

“That would not be an option for me because I have to talk to people –I have to communicate.”

Mr Tompkins, who was diagnosed with cancer in April, said he only found out about photodynamic therapy (PDT) as an alternative to chemotherapy and radiotherapy after Northampton Welfare Rights showed him a cutting from a newspaper a few weeks ago.

He is concerned that had he known about the procedure earlier, doctors would have been able to tackle the cancer in his mouth sooner.

The 48-year-old, who lives with his partner Nick Grant, said: “The problem is that few people know about the procedure and it’s not routinely offered”

The laser therapy was pioneered by Colin Hopper, an expert based at the London hospital, who will be working with Mr Tompkins.

Mr Hopper said: “The biggest problem is that health trusts want to know a new procedure is going to be better than the ones it is replacing. “They need to see a lot of studies and research before recommending a procedure and that costs a lot of money.”

The treatment Mr Tompkins is hoping for uses a laser, or other light sources, combined with a light-sensitive drug to destroy cancer cells. Treatment costs about £6,000 – compared with the average £17,000 it costs for chemotherapy.

However, even if he is eligible for the treatment Mr Tompkins will face another wait to see if the primary care trust in Northamptonshire will fund it.

A spokesman for Northamptonshire Teaching Primary Care Trust said: “The treatment has been approved by the National Institute for Clinical Excellence for the treatment of a small number of cancers, such as some skin cancers and cancer of the oesophagus.

“It may only be appropriate in particular cases and is not routinely offered on the NHS unless it has been approved by Nice.

“We may consider applications for funding of PDT in exceptional cases where there is clear evidence from the patient’s clinician that it is the most effective course of treatment.”

July, 2007|Archive|

B.C.-developed scope detects oral cancer

  • 7/16/2007
  • British Columbia, Canada
  • staff

Oral cancer will be diagnosed in over 3,200 Canadians this year and will prove fatal in over 1,100. That’s usually because it is caught late, when the cancer has spread and survival rates are around 20 per cent.

Now scientists in B.C. are testing a new tool they hope will shine a light on this little-recognized disease.

Researchers at the B.C. Cancer Agency have developed with LED Medical Diagnostics Inc. a tool called the VELscope, a hand-held device that usees fluorescence technology to allow dentists and hygienists to scan for abnormal tissue that may be cancerous.

B.C. is the first region in Canada to test the VELscope. They are part of a test project that they hope will lead to making the scope a standard screening device in every dentist’s office.

Balvir Dhadda’s life may have been saved by the VELscope. She had been suffering from what she thought were stubborn cold sores in her mouth. Her dentist used the experimental tool and discovered the cold sores were actually cancer.

“I was devastated,” Dhadda told CTV News. “I’d never heard of oral cancer myself.”

In Dhatta’s case, the VELscope found her cancer early, at the stage when treatment has an over 80 per cent survival rate. “Basically, they saved my life,” she said.

Oral cancer is more common that most think. It’s diagnosed more often than ovarian cancer, liver cancer or cervical cancer, but most aren’t aware of it. But it can be disfiguring, disabling, and often fatal.

It’s estimated that 65 per cent of oral cancers go undiagnosed. That’s because the tissue changes that lead to oral cancer actually start below the skin’s surface, at the basal membrane. These changes may not be visible to the naked eye until the disease progresses to the surface.

“The problem is that some of these early changes in the mouth are subtle, they’re ill-defined, and it’s difficult for the clinician to decide if this is something of concern that needs to be followed up or rather if it’s just an infection,” explains Dr. Miriam Rosin of the B.C Cancer Agency.

Cancerous oral tissue may not look abnormal under ordinary light, but under the blue light of the VELscope, cancerous tissues appear as dark brown or dark green patches. If the VELscope detects a suspicious lesion, a biopsy of the tissue can be taken for a full diagnosis.

“We want to catch the changes decades, or at least five years, before they become cancers,” says Rosin.

Vancouver dentist Dr. Meredith Moores has already discovered the benefits of using the VELscope.

“Since we started using the oral cancer screening tool, there have been lesions I have noticed that I had not picked up with an oral examination,” she says.

Doctors have long thought that those most at risk of oral cancer were smokers and heavy drinkers. But about 25 per cent of newly diagnosed cases do not fit the high-risk profile. And there’s been a 60 per cent increase in the last 30 years in young people under 40 being diagnosed with oral cancer.

Doctors speculate that environmental toxins or viruses like human papillomavirus or HPV, which causes cervical cancer, may be boosting the rates of oral cancer too. That’s why they hope the scope makes it easier for dentists to search for early cancers.

“That is definitely our hope: that this will save lives,” says Dr. Moores.

July, 2007|Archive|

Betel nut cancer link takes buzz out of Taiwan tradition

  • 7/15/2007
  • Kaohsiung, Taiwan
  • Ralph Jennings

For centuries, hundreds of millions of people across Asia, from Pakistan to Palau, have chewed the spicy date-like fruit of the betel palm for a quick buzz.

Then four years ago, a World Health Organization study found that chewing betel nuts can cause oral cancer and that the rate of these malignant mouth tumors was highest in Asia where the betel nut is a widely used stimulant.

Despite the cancer link, betel nut addicts are chewing on in many parts of Asia. But in Taiwan, the findings have spurred a government health campaign against the nut which is grown on palm trees across the sub-tropical island southeast of China.

“If you don’t want oral cancer, the most direct way is to quit chewing betel nuts,” Wu Chien-yuan, chief of cancer prevention in the Taiwan health ministry, told Reuters.

Betel nut, which contains an addictive stimulant similar to nicotine, is widely used in parts of Southeast Asia, India, Pakistan and the South Pacific as a breath freshener, a hunger antidote, a substitute for cigarettes and as a way to get high.

Users often chew it all day long, causing all sorts of unpleasant side-effects such as red-stained teeth and pavements covered with red spittle as many users spit out the betel nut’s remnants as they chew.

“Whether it harms you is an individual thing,” said Kaohsiung betel chewer Wan Chin-hsian, 35. “It’s healthy to spit it out.”

Under pressure from the government health drive, betel nut traders and growers are seeking new uses for the nut — such as soap — as the industry seeks to stay in business.

There is a lot at stake for betel nut growers as the nut is the island’s second biggest crop after rice and provides more than 20,000 jobs.

“Betel nut is in dispute, but the sellers still have to make a living,” said Lee Su-ming, an organizer of a betel nut festival in the southern Taiwan city of Kaohsiung last month.


Aware of the cancer link, some merchants are wrapping betel quids with less lime, a leaf-to-nut bonding additive that some in the industry believe to be the most noxious ingredient.

Growers in Taiwan now use almost every bit of the betel nut stick palms that grow all over the island.

They turn it into chicken soup, chicken feed and hard liquor for as much as T$12,000 ($366) per bottle. Some advocate eating betel flowers instead of chewing the kernels. Many consume a combination of betel nut and tobacco.

For those who still chew, sellers say they consistently hand out paper cups to discourage spitting the red pulp onto public streets, an act that outrages a sanitation-conscious public.

Betel controversy first hit Taiwan in the 1990s, when the government made farmers stop clearing mountains to grow betel palms and required growers to plant grass to prevent mudslides.

Then nut’s popularity in Taiwan began to wane after the WHO cancer study came out. The study prompted Taiwan government health warnings against betel nut in schools, churches and on tissue boxes at gas stations. Chewers can be fined the equivalent of US$36 for spitting.

“Oral cancer appears to be the most prevalent and serious health effect of concurrent use of (betel) nut and tobacco in the region,” said a WHO report.

Government statistics show that the oral cancer rate rose from 1,790 to 4,754 between 1994 and 2004, with deaths going from 779 to 1,593 cases over that period. Taiwan officials blame betel nuts. The WHO says 58 percent of the world’s 390,000 oral cancers come from Asia, where the betel nut is widely consumed.

“The government is always putting pressure on us,” said grower Yang Hui-hsiung. “If you see the reports on it, they’re all negative.”


The Taiwan Department of Health anti-cancer bureau says betel flowers and other parts of the palm also contain an alkaloid that causes cancer. It wants Taiwan to phase out betel completely, replacing it with healthier crops.

Betel nut chewers are 28 times more likely to get oral cancer than non-users, according to health officials.

In India, where the betel nut is sometimes used as offerings in religious ceremonies, some states have begun regulating the betel nut industry due to a growth in adolescent users. The WHO predicts a reduction in oral cancer in those regions.

Other countries are letting betel run its course. In the South Pacific, 63 percent of Micronesian high school students chew it, the WHO says, adding that about 20 percent of Micronesian users get mouth diseases such as oral cancer.

Experts doubt that health officials will be able to cut the use of betel across the region as the nut is embedded in many cultures and the industry is lucrative and provides jobs.

But in Taiwan at least, the government’s publicity campaign shows signs of paying off. About 9 percent of Taiwan’s 16.7 million adults chew betel, down from 10.9 percent in 1996.

“It’s gross, and not just in terms of sanitation,” said Tsai Chia-che, 20, a security guard at a recent betel nut festival in Kaohsiung.

July, 2007|Archive|