Yearly Archives: 2007

Mitochondrial Resequencing Arrays Detect Tumor-Specific Mutations in Salivary Rinses of Patients with Head and Neck Cancer

  • 12/20/2007
  • Baltimore, MD
  • Suhail K. Mithani et al.
  • Clinical Cancer Research 13, 7335-7340, December 15, 2007

Alterations of the mitochondrial genome have been identified in multiple solid tumors and in many head and neck squamous cell carcinomas (HNSCC). Identification of mitochondrial mutations in the salivary rinses of patients with HNSCC has potential application in disease detection. In this study, we used the MitoChip v2.0 mitochondrial genome resequencing array to detect minor populations of mitochondrial DNA in salivary rinses of patients with HNSCC.

Experimental Design:
Salivary rinses from 13 patients with HNSCC, whose tumors carried mitochondrial mutations, were collected before surgical resection. DNA isolated from salivary rinses and serial dilutions of DNA derived from HNSCC-derived cell lines with known mitochondrial mutations were sequenced using the MitoChip, and analyzed using a quantitative algorithm which we developed to detect minor populations of mitochondrial DNA from MitoChip probe intensity data.

We detected heteroplasmic populations of mitochondrial DNA up to a 1:200 dilution using MitoChip v2.0 and our analysis algorithm. A logarithmic relationship between the magnitude of assay intensity and concentration of minor mitochondrial populations was shown. This technique was able to identify tumor-specific mitochondrial mutations in salivary rinses from 10 of 13 (76.9%) patients with head and neck cancer.

Minor populations of mitochondrial DNA and disease-specific mitochondrial mutations in salivary rinses of patients with HNSCC can be successfully identified using the MitoChip resequencing array and the algorithm which we have developed. This technique has potential application in the surveillance of patients after resection and may have applicability in the surveillance of body fluids in other tumor types.

Suhail K. Mithani1, Ian M. Smith2, Shaoyu Zhou2, Andrew Gray2, Wayne M. Koch2, Anirban Maitra3 and Joseph A. Califano2

Authors’ affiliations:
1 Department of Surgery, Division of Plastic and Reconstructive Surgery,
2 Department of Otolaryngology-Head and Neck Surgery, and
3 Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland

December, 2007|Archive|

Prolonged Use Of Swedish Moist Snuff Increases Risk Of Fatal Cardiovascular Disease And Stroke

  • 12/18/2007
  • staff
  • Medical News Today (

A new doctoral thesis from the Department of Environmental Medicine at the Swedish medical university Karolinska Institutet demonstrates that consumers of Swedish moist snuff a smokeless tobacco called ‘snus’ run a higher risk of dying from cardiac arrest and stroke. Snus also increases the risk of high blood pressure, a known factor of cardiovascular disease.

The use of snus has increased markedly in Sweden in the past few decades, so much so that it now accounts for half of all tobacco consumption in the country. Over 20 per cent of men between the ages of 18 and 79 are daily users. Consumers of snus absorb as much nicotine as smokers but are spared many of the toxic chemicals that are formed on smoking.

Although snus does not seem to increase the risk of myocardial infarction, one of the studies reported on in this doctoral thesis shows that its consumers run a 30 per cent (approximately) higher risk of fatal heart attack than people who have never used the product. This greater risk is even higher for those who take more than 50 grams of snus a day. Amongst those who suffer non-fatal heart attacks, users of snus have a higher fatality rate in general than non-users, and from cardiovascular diseases in particular.

The studies reveal no greater risk of stroke amongst users of snus; however, users were more likely to suffer a fatal stroke. Users also ran a higher risk of developing high blood pressure, which is a known factor of cardiovascular disease.

Two major population studies were used for the research now published. The first comprised Swedish men between the ages of 45 and 70, living in the counties of Stockholm or Västernorrland between 1992 and 1994. A total of 1,432 men diagnosed with first-episode myocardial infarction were compared in terms of tobacco habits and other factors with a coeval group of men from the same regions without heart problems.

The second was a study using data from health checks of all workers in the building industry between the years of 1978 and 93. Information recorded at these checks included tobacco habits and blood pressure. Episodes of non-fatal and fatal myocardial infarction and stroke as well as blood pressure readings for over 100,000 snus users and non-users were then plotted up to 2003/4 using national health records.

In both population studies, the analyses were confined to non-smokers, as smoking is strongly associated with the use of snus and cardiovascular disease.

Thesis: ‘Swedish moist snuff and the risk of cardiovascular diseases’ by Maria-Pia Hergens, Department of Environmental Medicine, Karolinska Institutet 2007

December, 2007|Archive|

GlaxoSmithKline: FDA delays Cervarix approval

  • 12/18/2007
  • web-based article
  • Hedwig Kresse

The FDA has requested further information for GSK’s cervical cancer vaccine.

With Merck & Co’s blockbuster Gardasil currently the only approved HPV vaccine in the US, the FDA approval of Cervarix would represent a significant commercial milestone for GSK. However, the market delay now facing Cervarix is likely to restrict its impact and will enable Gardasil to retain a monopoly position in the crucial US market until the agency’s unspecified issues are resolved.

Cervical cancer, killing over 280,000 women worldwide each year, is causatively linked to the human papillomavirus (HPV), which is spread by sexual contact. Recently, both Merck and GSK have launched vaccines which could protect against infections with HPV if administered to young girls before they become sexually active. These products have a significant commercial opportunity: Datamonitor predicts annual cohort sales of $1.4 billion for the seven major markets by 2016. In addition, there is a significant catch-up opportunity in young women aged 13-26, which could be worth over $17 billion by 2016.

Comparing the two vaccines, Gardasil has numerous advantages over Cervarix: From a clinical point of view, it has a wider coverage than Cervarix, protecting against HPV subtypes 6 and 11, which cause genital warts in addition to the cervical cancer subtypes 16 and 18, which are also contained in Cervarix. Furthermore, Merck has been able to show significant cross-protection against further subtypes not included in the vaccine. In addition, data presented in November 2007 demonstrate excellent efficacy of Gardasil in women aged 24 through 45. However, unlike Gardasil, Cervarix contains a novel adjuvant, AS04, which could potentially enhance the immune response and reduce the need for booster shots.

On the commercial side, Gardasil is benefiting from its first-to-market advantage in the US market, where it was approved in June 2006 and continues to be the only available HPV vaccine until today. GSK’s vaccine, already approved in 45 countries around the world including the EU5, was filed in the US in April 2007 but has yet to receive approval.

Given the large amount of clinical data available for Cervarix, the FDA’s decision to issue a complete response letter rather than outright approval comes as a surprise. Currently, no information on the nature of the issues raised by the FDA is available. However, considering that Cervarix would be the first vaccine approved in the US containing an adjuvant other than aluminium, the questions raised could potentially be linked to AS04. Until such issues are resolved, Gardasil will retain its monopoly in the crucial US market and expand its leadership position.

December, 2007|Archive|

Public exposure gets man teeth

  • 12/11/2007
  • Winnipeg, Manitoba, Canada
  • Paul Turenne

A St. Malo man who had his case championed by a Manitoba MLA got a call for a medical appointment the day his situation was brought up during question period.

Earlier this week, Tory MLA Mavis Taillieu asked the health minister why a St. Malo man who has lived the past year without teeth has to wait for the Winnipeg Regional Health Authority to hire a new orthodontic surgeon.

The man lost his teeth as a result of oral cancer and needs to be sized for dentures, but has been denied treatment in Edmonton even though the position of Winnipeg’s only public orthodontic surgeon remains vacant.

Health Minister Theresa Oswald said she would look into the case.

“Interestingly enough he got a call that day to say his (treatment) would be on,” said Taillieu. “He thanked me for raising it in the house. I don’t believe his call was a coincidence. I think (the man) would still be waiting if I hadn’t raised it.”

Taillieu said that is not right.

“To me this is health care by crisis one case at a time,” she said. “All of a sudden (Oswald) had to take some action because this came out in public.”

“I don’t think we should have to address this in the house for people to get some service,” said Taillieu.

December, 2007|Archive|

Word of Mouth

Author: Veronica Jauriqui
Source: University of Southern California (

Oral Cancer Awareness Week begins April 16. Even though the disease has maintained a low public profile, the American Cancer Society estimates that more than 34,000 new cases will be diagnosed in 2007. Here is what you should know to reduce the risk of oral cancer.

Nearly every hour of every day, someone in the United States dies of oral cancer, according to the Oral Cancer Foundation, a national non-profit agency dedicated to prevention, education and research in oral cancers.

Oral and pharyngeal cancers (cancers of the lip, mouth, tongue and throat) account for about 7,500 deaths per year and have a higher fatality rate than cancers of the lung, breast, prostate and cervix. While it does not share the same high public profile as these other diseases, oral cancer is the eighth most common cancer in this country. And in many developing countries—like India, China and Vietnam—it is number one.

The statistics are disturbing, especially since oral cancer is highly preventable, explains Parish Sedghizadeh, D.D.S., assistant professor at the USC School of Dentistry.

In fact, the Oral Cancer Foundation says that when oral cancers are found early, patients have an estimated 80 to 90 percent survival rate.

“Like most cancers, early screening is the key,” Sedghizadeh says. “The first line of defense is knowing who is at risk and what to look for.”

What are the signs?
The majority of oral cancers—those on the lips, tongue, inside the lining of the cheeks, on the gums or in the upper throat—are squamous cell carcinomas, which are cancers found on the skin or mucous membranes. These cancers may begin as white or red patches of discolorations in the mucous membrane. As precancerous plaques tucked away in the smallest crevices within the oral cavity, they generally go unnoticed. Otherwise, symptoms can take innocuous forms, such as a sore in the mouth or on the lip that does not heal, intraoral bleeding, loose teeth, a lump in the neck or difficult or painful swallowing.

“Almost half of the cases of oral cancers are diagnosed at advanced,” Sedghizadeh says. “In the precancerous stages, there are few noticeable symptoms. By the time the symptoms are apparent, it has reached the cancerous stage and has often spread to the lymph nodes or other parts of the body.”

What are the risks?
According to the Oral Cancer Foundation, two-thirds of oral cancers are caused by tobacco use in any of its forms—cigarettes, cigars, pipes and chewing tobacco. Alcohol use, especially in conjunction with tobacco use, increases the risk.

Ultraviolet light exposure, in the form of sun bathing and tanning beds, has been linked to lip cancer. Previous studies suggest that diets lacking in fruits and vegetables may increase risk of oral cancer. In addition, scientists are also studying the link between oral cancer and certain viruses including the human papilloma virus.

Sedghizadeh cautions against lesser-known and more culturally specific risk activities—such as chewing areca nut, also known as betel nut, or drinking maté, a tea-like beverage—that are prevalent in Asian, Middle Eastern and South American countries, but that are becoming increasingly popular in the United States as the practices cross cultural borders.

“Drinking maté, for example, is becoming more common in the U.S.,” he says, “and it’s easy to find at some health-food stores.”

But in most cases, Sedghizadeh says, it is lifestyle choices that increase the risk.

“When you engage in these behaviors, whether it is alcohol or smoking, each one of these activities has a little bit of risk associated with it. These risks add up. Doctors cannot determine who will or who won’t get the disease, but the cumulative risk increases the potential,” he says.

What you can do
Prevention and early detection are key to battling oral cancer. Sedghizadeh recommends that everyone—especially those people in high-risk groups—do the following to reduce risk:

• Make oral cancer screenings part of your biannual dental checkup. Dentists and dental hygienists are on the front lines of the disease and know how to identify possible abnormalities.
• Moderate alcohol use and eliminating tobacco, areca nut and maté use reduces the risks of developing oral cancers and other cancers, including cancer of the lung, larynx and esophagus.
• Use sunscreen or lip balm with SPF 15 to reduce the risk of lip cancer. Wearing a hat with a wide brim may also reduce lip cancer risk and the risk of developing skin cancer.

For more information, visit the Oral Cancer Foundation online at

December, 2007|OCF In The News|

Light for Mucositis

  • 12/7/2007
  • Creve Coeur, IL
  • Jen Christensen
  • HOI19 (

Mucositis is an inflammation of the lining of the digestive tract. The condition is a common side effect of chemotherapy and radiation therapy for cancer. Although it can occur anywhere between the mouth and the anus, it’s most commonly seen in the mouth and throat. The organization, Cancer Supportive Care Programs, estimates oral mucositis affects up to 40 percent of chemotherapy patients and up to 50 percent of those receiving radiation and chemotherapy.

Chemotherapy and radiation therapy target rapidly-producing cells. While cancer cells rapidly reproduce, so do those lining the digestive tract. Since cancer treatments can’t differentiate between malignant and healthy cells, both types are affected. As the digestive tract cells are destroyed, the lining breaks down, causing inflammation, irritation and swelling.

Initially, the tissues inside the mouth become pale and dry. Painful red sores develop on the inside of the cheeks, gums and throat. The tongue may swell, causing problems with eating, swallowing and talking. Accompanying side effects of cancer treatment, like nausea and vomiting, may aggravate the ability to eat, leading to nutritional deficiencies, dehydration, weight loss, loss of muscle mass and increased susceptibility to infection. In addition, cancer treatments may slow the ability of the mucosal tissue to heal, compounding the problem. In some cases, the symptoms become so severe, cancer treatment may need to be stopped.

Shedding Light on a New Treatment
Currently, there are few adequate treatments for mucositis. Health care workers try to reduce the risk of developing symptoms by encouraging rigorous oral hygiene and use of mouth rinses and moisturizers.

Now, researchers are testing a new treatment for mucositis, using LED (light-emitting diode) lights. LED lights were originally developed for NASA to use in plant growth experiments in space. The light energy is absorbed by cell mitochondria and used as a source of energy. Harry T. Whelan, M.D., a Pediatric Neurologist with the Medical College of Wisconsin says, in the body, the LED lights provide extra energy to the damaged cells, helping them to regenerate and heal.

The LED device contains hundreds of tiny chips, each about the size and weight of a grain of sand. They produce light in the near infrared range, which can penetrate into the deep tissue. Thus, all equipment is kept outside the body. The treatment can be aimed from different directions to avoid over-exposing surface tissue. And since there is no heat involved, only light, patients don’t feel any pain during therapy.

LED therapy was used in an earlier study of pediatric bone marrow transplant patients undergoing ablative therapy to destroy their own bone marrow in preparation for a transplant. Normally, up to 90 percent of such patients develop mucositis. With LED therapy, the rate of mucositis was only 53 percent.

Currently, the LED light therapy is being tested at the Medical College of Wisconsin, the Children’s Hospital of Wisconsin and the University of Alabama for pediatric and adult cancer patients. Half the participants will receive treatment and half will receive a placebo. Researchers are hopeful LED therapy will reduce the rates of mucositis, improving the ability of patients to swallow, eat and drink.

LED therapy is not yet approved by the FDA for mucositis. Researchers at the Medical College of Wisconsin are also testing the treatment for other conditions caused by a cellular energy crisis, like Parkinson’s disease or bone fractures. In the future, the treatment may also be used to activate chemotherapy drugs that have been injected into the body.

December, 2007|Archive|

Chemoprevention, Naturally: Findings On Plant-derived Cancer Medicines

  • 12/7/2007
  • web-based article
  • staff
  • ScienceDaily (

The next cancer-fighting therapeutic could be growing in your garden. For example, a black raspberry-based gel might offer a means of stopping oral lesions from turning into a particularly dangerous and disfiguring form of cancer. And new studies show that cancer prevention might come in drinkable form: green tea extract, a powerful antioxidant, shows efficacy against colorectal cancer; and a new berry-rich beverage, made from a combination of known plant-based antioxidants, could prevent or slow the growth of prostate cancer.

That is, according to research presented December 6, at the American Association for Cancer Research’s Sixth Annual International Conference on Frontiers in Cancer Prevention Research, being held in Philadelphia, Pennsylvania.

Topically applied black raspberry gel applied on oral premalignant tumors

Oral squamous cell carcinoma is a deadly cancer that, even when treated successfully, often leaves patients permanently disfigured. Other than radical surgery, there are few known treatments. Researchers at Ohio State University, however, report a Phase I/II trial demonstrating that a gel made from black raspberries shows promise in preventing or slowing the malignant transformation of precancerous oral lesions.

“Black raspberries are full of anthocyanins, potent antioxidants that give the berries their rich, dark color, and our findings show these compounds have a role in silencing cancerous cells,” said Susan Mallery, D.D.S., Ph.D., professor in the Department of Oral Maxillofacial Surgery and Pathology at Ohio State University’s College of Dentistry. “This gel appears to be a valid means of delivering anthocyanins and other cancer-preventing compounds directly to precancerous cells, since it slowed or reduced lesion progression in about two-thirds of study participants.”

According to American Cancer Society statistics, oral cancer is one of the deadliest of all cancers, with about 35,000 new cases each year in the United States and 7,500 deaths annually. These cancers generally begin as small, often unnoticed, lesions inside the mouth. “More than a third of untreated precancerous oral lesions will undergo malignant transformation into squamous cell cancer, but we do not have the capability to predict which lesions will progress,” Mallery said.

The National Cancer Institute-funded trial included 30 participants, 20 of whom had identifiable precancerous lesions, and 10 normal controls. Each of the participants was instructed to gently dry the lesion sites (or a pre-selected control site for the normal participants) and rub the gel into the area four times a day, once after each meal and at bedtime.

After six weeks, about 35 percent of the trial participants’ lesions showed an improvement in their microscopic diagnosis, while another 45 percent showed that their lesions had stabilized. About 20 percent showed an increase in their lesional microscopic diagnoses. Importantly, none of the participants experienced any side effects from the gel.

“The trial was designed to test the safety of the gel and detect any possible toxicity, but the next obvious step is a multicenter, double-blind, placebo-controlled Phase II study,” Mallery said. “Such a study would enable us to determine that the black raspberries are the active factor and not just the gel base or the act of drying and rubbing the lesions.”

The researchers also collected cell samples from the lesion sites of each participant before and after treatment in order to study the genetics and biology of the lesions. The majority of patients with precancerous lesions at the start of the trial showed elevated levels of COX-2 and iNOS, two proteins closely correlated with inflammation and malignant progression. Following treatment, Mallery says, levels of those proteins in the treated lesional epithelial cells decreased dramatically.

Mallery and her colleagues also examined samples for three tumor suppressor genes in order to determine what researchers call “loss of heterozygosity,” whether or not a cancer cell has lost one of its two copies of the gene. Such loss greatly increases a cell’s chances of losing the benefit of the tumor suppressor genes due to a second mutation or gene silencing event. Following the trial, the researchers noted that many lesions returned to normal, retaining both copies of each tumor suppressor gene. “We speculate that the chemopreventive compounds in black raspberries assist in modulating cell growth by promoting programmed cell death or terminal differentiation, two mechanisms that help “reeducate” precancerous cells,” Mallery said.

“Oral cancer is a debilitating disease and there is a desperate need for early detection and management of precancerous lesions,” Mallery said. “While screening can help detect the disease early — and survival rates are definitely improved the earlier the disease is caught — many of these precancerous lesions recur despite complete surgical removal. There are currently no effective chemopreventive treatments which could conceivably serve as either adjunctive or alternative approaches to surgery.”

According to Mallery, the development of black raspberries as potential cancer-fighters is the result of decades of research into identification of naturally derived chemopreventive compounds by Ohio State researcher Gary D. Stoner, Ph.D., an emeritus professor at Ohio State University’s College of Medicine and Public Health. Clinical studies stemming from his research are currently underway for oral, esophageal and colorectal cancer.

The gel looks deceptively like black raspberry jam, but it certainly does not taste like something you would want to spread on toast, Mallery says. The bioadhesive gel, which contains 10 percent freeze dried black raspberries, is devoid of many of the tasty sugars found in native berries.

The black raspberry gel was manufactured by the University of Kentucky’s Good Manufacturing Production (GMP) facility. NanoMed Pharmaceuticals is partnering with OSU investigators Mallery, Stoner and Peter E. Larsen D.D.S. and Russell J. Mumper, Ph.D., of the University of North Carolina, in product development.

Suppressive effects of a phytochemical cocktail on prostate cancer growth in vitro and in vivo

A commercially available nutrition drink reduces the growth of tumors in a mouse model of human prostate cancer by 25 percent in two weeks, according to researchers from the University of Sydney. The drink, Blueberry Punch, is a mixture of plant-based chemicals — phytochemicals — known to have anti-cancer properties.

In particular, Blueberry Punch consists of a combination of fruit concentrates (blueberry, red grape, raspberry and elderberry), grape seed and skin extract, citrus skin extracts, green tea extract (EGCG), olive leaf and olive pulp extracts, tarragon, turmeric and ginger.

“We have undertaken efficacy studies on individual components of Blueberry Punch, such as curcumin, resveratrol and EGCG, in the same laboratory setting and found these effective in suppressing cell growth in culture,” said Jas Singh, Ph.D., research fellow at the University of Sydney.

“While individual phytochemicals are successful in killing cancer cells, we reasoned that synergistic or additive effects are likely to be achieved when they are combined.”

Singh and her colleagues studied the effect of the beverage on both cancer cell cultures and in mouse models that mimic human prostate cancer. After 72 hours of exposure to increasing concentrations of Blueberry Punch, prostate cancer cells showed a dose-dependent reduction in size and viability when compared with untreated cells, Singh says. After feeding mice a 10 percent solution of the punch for two weeks, the tumors in the test mice were 25 percent smaller than those found in mice that drank only tap water.

Because Blueberry Punch is a combination of several ingredients, it could have multiple mechanisms of action, Singh says. “Based on our initial findings, the mechanisms include, at least, the inhibition of the inflammation-related pathways, which is similar to the action of non-steroidal anti-inflammatory drugs; and inhibition of cyclin D1, which is similar to green tea action.”

Based on these results, the researchers believe Blueberry Punch is now ready for human prostate cancer trials. Because Blueberry Punch is a food product rather than a drug, it is unlikely to have adverse reactions or side effects assuming that the individual is tolerant to all ingredients, Singh says. “The evidence we have provided suggests that this product could be therapeutic, although it requires clinical validation,” Singh said.

The study was partially funded by the makers of Blueberry Punch, Dr. Red Nutraceuticals, a firm located near Brisbane, Australia, but the experiments were designed and conducted independently in the University of Sydney.

Inhibition of colorectal tumorigenesis in azoxymethane (AOM)-treated rats by green tea polyphenols

Elucidating a decade’s worth of conflicting studies of the cancer-fighting benefits of green tea, researchers at Rutgers University have conclusively demonstrated that a standardized green tea polyphenol preparation can prevent the growth of colorectal tumors in a rat model of human colorectal cancer.

Results from previous studies using different tea constituents in this particular rat cancer model, which is thought to closely mimic human cancer, had been inconsistent. The researchers believe their findings will pave the way for clinical trials with green tea polyphenols in humans.

“Our findings show that rats fed a diet containing Polyphenon E, a standardized green tea polyphenol preparation, are less than half as likely to develop colon cancer,” said Hang Xiao, Ph.D., research associate at the Department of Chemical Biology in Ernest Mario School of Pharmacy of Rutgers University.

According to Xiao, these results are consistent with previously published results by the project’s primary investigator, C.S. Yang, Ph.D., professor and chair of the Department of Chemical Biology at Rutgers, which showed that green tea consumption was associated with lower colon cancer rates in Shanghai, China.

Xiao and his colleagues treated two groups of mice with azoxymethane (AOM), a widely used agent that has been shown to generate in rats colorectal tumors that share many characteristics with colorectal cancer in humans, Xiao says. They then split the rats into two groups that were each fed a high fat diet, which the researchers believe closely resembles a Western diet; half received a 0.24 percent solution of Polyphenon E. According to Xiao, the green tea extract contains four major polyphenols, the majority of which (about 65 percent) is EGCG, thought to be the main active ingredient.

“When you account for caloric consumption, 0.24 percent Polyphenon E in diet gave the experimental rats the equivalent of about four to six cups of tea a day,” Xiao said. “While I can’t make any recommendations for how much green tea people should drink each day, it isn’t uncommon for some to drink that much tea.”

After 34 weeks, rats that received Polyphenon E developed 55 percent fewer tumors compared to the control rats that did not receive Polyphenon E. Moreover, the tumors were 45 percent smaller in rats treated with green tea extract. Histopathological analysis by his colleague, Xinpei Hao, Ph.D., also showed that the treatment group had significantly lower incidence and number of malignant colon tumors. The researchers could also detect green tea polyphenols in the blood plasma as well as the colorectal mucosa of the rats who received the extract.

Meanwhile, the test rats weighed about five percent less than their control group counterparts, a result Xiao attributes to the ability of the green tea polyphenols to block lipid absorption in the body, which the researchers had previously demonstrated in a mouse model of obesity.

Adapted from materials provided by American Association for Cancer Research.

December, 2007|Archive|

Florida nurse practitioners’ attitudes and practices regarding oral cancer prevention and early detection

  • 12/4/2007
  • Birmingham, AL
  • X Meng et al.
  • J Am Acad Nurse Pract, December 1, 2007; 19(12): 668-75

To examine Florida nurse practitioners’ (NPs’) attitudes and practices regarding oral cancer prevention and early detection.

Data source:
A statewide mail survey was conducted among Florida NPs who provided primary care. The questionnaire was adapted from an existing survey instrument used to measure NPs’ knowledge, attitudes, and practices about oral cancer prevention and early detection. A total of 448 Florida NPs (33% response rate) completed the survey.

Florida NPs reportedly were not well prepared for oral cancer prevention and early detection. Although most NPs realized the importance of annual oral cancer screening for high-risk populations and held positive attitudes toward the benefit of early detection, only 39.3% of respondents thought his or her knowledge about oral cancer was current and more than half had never provided oral cancer examinations.

Implications for practice:
Florida has among the nation’s highest oral cancer rates, but persons at highest risk are among those least likely to see a dentist. Therefore, a multidisciplinary approach involving all relevant healthcare providers, including NPs, may be more effective than relying only on dentists’ efforts in improving survival rates for oral cancer. Strategies are needed to increase the involvement of Florida’s NPs in oral cancer detection.

X Meng, RP Duncan, CK Porter, Q Li, and SL Tomar

Authors’ affiliation:
Department of Diagnostic Sciences, School of Dentistry, University of Alabama, Birmingham, Alabama, USA

December, 2007|Archive|

EGFR-Targeting Monoclonal Antibodies in Head and Neck Cancer

  • 12/4/2007
  • Philadelphia, PA
  • I Astsaturov, RB Cohen, and P Harari
  • Curr Cancer Drug Targets, November 1, 2007; 7(7): 650-65

The epidermal growth factor (EGFR) and its receptor were discovered nearly 40 years ago. Over the past decade interruption of this pathway has been exploited in the treatment of various solid tumors.

Antibodies that interfere with ligand binding to and dimerization of the EGFR (and small molecules that inhibit the EGFR tyrosine kinase) are anti-proliferative, profoundly radiosensitizing, and synergistic with DNA-damaging cytotoxic agents.

Proposed mechanisms of radio- and chemosensitization include enhanced apoptosis, interference with DNA repair and angiogenesis, receptor depletion from the cell surface and antibody-dependent cell-mediated cytotoxicity.

This article provides a reader with a comprehensive review of EGFR-targeting antibodies under development for the treatment of head and neck squamous cell cancer (HNSCC) and also summarizes relevant clinical data in this disease with small molecule EGFR inhibitors.

One of the monoclonal antibodies, cetuximab, recently received full FDA approval for the treatment of patients with locally advanced (with radiation) or metastatic HNSCC (as a single agent). Regulatory approval followed reporting of a large international study in which the addition of cetuximab to definitive radiation therapy in HNSCC resulted in statistically significant improvements in locoregional control and overall survival. Results of the pivotal trial, other clinical data supporting the regulatory approval, and a preview of the next generation of clinical trials are presented.

Considerable work remains to be done, particularly to enhance our understanding of factors that may predict for favorable response to EGFR inhibitor therapy and to evaluate the impact of integrating anti-EGFR therapies into complex chemoradiation programs delivered with curative intent.

Authors’ affiliation:
Fox Chase Cancer Center, Philadelphia, PA, USA

December, 2007|Archive|

Tobacco Smoking, Smoking Cessation, and Cumulative Risk of Upper Aerodigestive Tract Cancers

  • 12/4/2007
  • web-based article
  • Cristina Bosetti et al.
  • American Journal of Epidemiology, doi:10.1093/aje/kwm318

Upper aerodigestive tract cancers are strongly related to smoking, and their incidence is substantially lower in former smokers than in continuing smokers. To estimate the effect of smoking cessation on the cumulative incidence of these cancers by age 75 years (in the absence of competing causes of death), the authors combined odds ratios for males from a network of Italian hospital-based case-control studies (1984–2000) with 1993–1997 incidence data for Italian men.

The studies included 961 cases with oral/pharyngeal cancer, 618 cases with esophageal cancer, and 613 cases with laryngeal cancer, plus 3,781 controls. For all upper aerodigestive tract cancers, the cumulative risks by 75 years of age were 6.3% for men who continued to smoke any type of tobacco, 3.1% and 1.2% for men who stopped smoking at around 50 and 30 years of age, respectively, and 0.8% among lifelong nonsmokers. Corresponding figures were 3.3%, 1.4%, 0.5%, and 0.2% for oral/pharyngeal cancer; 1.0%, 0.5%, 0.4%, and 0.2% for esophageal cancer; and 2.1%, 1.1%, 0.2%, and 0.2% for laryngeal cancer.

In this Italian population, men who stopped smoking before age 50 years avoided more than half of the excess risk of upper aerodigestive tract cancer as men who did not, and men who stopped smoking before age 30 years avoided more than 90% of the risk.

Cristina Bosetti1, Silvano Gallus1, Richard Peto2, Eva Negri1, Renato Talamini3, Alessandra Tavani1, Silvia Franceschi4 and Carlo La Vecchia1,5

Authors’ affiliations:
1 Istituto di Ricerche Farmacologiche “Mario Negri,” Milan, Italy
2 Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom
3 Unità di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico di Aviano, Aviano, Italy
4 International Agency for Research on Cancer, Lyon, France
5 Istituto di Statistica Medica e Biometria “G. A. Maccacaro,” Università degli Studi di Milano, Milan, Italy

December, 2007|Archive|