5/14/2008 web-based article staff ScienceDaily.com Positron emission tomography with a radioactive tracer (18F-FDG PET) may not improve the detection of small metastases in patients with head and neck cancer who have no clinical evidence of disease in neighboring lymph nodes, according to a meta-analysis published online May 13 in the Journal of the National Cancer Institute. A key prognostic factor for head and neck squamous cell cancer patients is whether their disease has spread to the nearby lymph nodes. Unfortunately, some patients who appear clinically to be free of such metastases, referred to as cN0, actually have small metastases. Clinicians use magnetic resonance imaging (MRI), commuted tomography (CT), and FDG-PET to try to detect these lesions, but strong data supporting the use of FDG-PET are lacking. To systematically examine the value of FDG-PET for diagnosing clinically node-negative patients, John P. A. Ioannidis, M.D., of the University of Ioannina School of Medicine in Greece and colleagues performed a meta-analysis of 32 previously published studies that tested FDG-PET in head and neck cancer patients with one or fewer nodal metastases. FDG-PET failed to identify 50 percent of the occult lesions in clinically node-negative patients and incorrectly identified normal tissue as being cancerous 13 percent of the time. When the researchers compared the sensitivity and specificity of FDG-PET with MRI and CT, they found that there was a trend for a small improvement in detection with FDG-PET, but the differences were not statistically significant. The false positive rate was similar for all three [...]

5/13/2008 New York, NY Nicholas Bakalar New York Times (nytimes.com) Dental cavities are not good news, but when it comes to preventive oral health, they may be among the smaller problems. The advice is familiar: brush and floss regularly, use fluoride mouthwash, limit snacks and sweet drinks, visit the dentist twice a year. Good suggestions, even if not everyone follows them: by age 12, 50 percent of children have cavities. But there are two much more serious problems, common dental diseases that can lead not only to loss of teeth but also to loss of life: periodontal disease and oral cancer. Periodontal disease — a chronic bacterial infection of the gums that destroys the bone and tissues that hold the teeth — is the leading cause of tooth loss in adults. Some people are genetically susceptible, and the problem can be aggravated by smoking, taking certain medications, stress and other factors. Several studies have found that gum disease is associated with an increased risk for heart attack. “It isn’t nailed down yet,” said Dr. Martin J. Davis, professor of clinical dentistry at the College of Dental Medicine at Columbia, “but there seems to be a link between the inflammation of gums and the inflammatory markers of heart disease.” It may be that oral bacteria enter the bloodstream, attach to fatty plaques in the coronary arteries and cause clots to form. Or maybe inflammation itself increases plaque buildup. A 2007 study showed that periodontal disease increased the risk of heart disease [...]

5/13/2008 Philadelphia, PA Carolyn Vachani, RN, MSN, AOCN OncoLink.com Many survivors who have previously received or are currently undergoing chemotherapy report experiencing cognitive changes, often referred to as "chemo-brain." These changes include difficulty with short-term memory, multi-tasking, new learning, reading comprehension, and working with numbers, as well as a decrease in concentration ability. For many years, this was attributed by physicians and researchers to depression or anxiety over the diagnosis and treatment of cancer. More recently, researchers have begun to study and document what survivors have been saying all along; cognitive changes after chemotherapy are real. Although we are not yet able to pinpoint whether only certain chemotherapy drugs are responsible for these cognitive changes, it seems certain that the effects are cumulative. That is, those who receive more chemotherapy tend to experience greater deficits. Studies have found that cognitive ability can improve over time in some survivors, but deficits are still present in many survivors, even years after treatment. Two studies recently presented at the annual meeting of the American Academy of Neurology prompted health news reports to claim that “chemo-brain” may be a myth. These reports fly in the face of millions of survivors’ accounts and numerous research studies (one that was presented at the same meeting). As is often the case, these news snippets don’t report the whole story, so let’s take a look at these studies and some of the research on this topic. The two abstract presentations addressed in the recent news were both small [...]

5/9/2008 United Kingdom staff Dentistry.co.uk (www.dentistry.co.uk) A new study has found drinking just two standard alcoholic drinks a day significantly increases the risks of developing throat, mouth, breast and bowel cancer. The Australian Cancer Institute report, released by the New South Wales government, draws together the results of an international audit of recent cancer research. The report found consuming two alcoholic drinks a day increases a person's risk of mouth cancer by 75%, and women's risk of breast cancer by 22%. Cancer Institute chief executive Jim Bishop says cancer is on the increase and the institute is keen to find out why. 'We don't want to have a general scare of people but the fact of the matter is that increased alcohol, in terms of the number of average drinks per day, will increase the risk,' he said. 'The risk isn't huge – it's around 10 to 20% per average drink – but if you have two average drinks a day every day of your life then that's the increased risk you're running.'

5/8/2008 Australia staff www.abc.net.au Four standard alcoholic drinks per day increases a man's risk of developing bowel cancer by 64 per cent, a new report says. For women, just two standard drinks per day increases their risk of developing breast cancer by up to 22 per cent, according to study by the Cancer Institute NSW. For both men and women, two standard drinks a day increases the risk of developing mouth cancer by 75 per cent. NSW Assistant Health Minister Verity Firth, who will release the report today, says the alarming links to cancer have been generally ignored in community debate over alcohol consumption. "In fact, alcohol consumption is a significant risk factor for a number of cancers, including those of the breast, bowel, throat and mouth," Ms Firth said in a statement today. "(It) is one of the most well-established causes of cancer. "Worryingly, a third of NSW adults actively reject the notion that drinking too much can cause cancer." The report, entitled "Alcohol As A Cause Of Cancer", also found 12 per cent of all breast cancer cases in NSW could be directly linked to excessive consumption of alcohol. Ms Firth said the World Health Organisation now listed alcohol as a top-rated Group 1 carcinogen. The 2006 NSW Population Health Survey found 70 per cent of NSW adults drank alcohol, with 17.6 per cent drinking at risky or high-risk levels. "Ultimately, we cannot police every person's drinking habits," Ms Firth said. "But we want to make sure people [...]

5/7/2008 Germany staff LifeGen.de In both breast and head and neck cancers the risk of local recurrence increases with longer radiotherapy waiting times, finds a Canadian meta-analysis. The study, published in Radiotherapy and Oncology, concludes that delays in radiotherapy treatment should be kept to the minimum time possible. Waiting times for radiotherapy were first identified as cause for concern around 20 years ago. Treatment delays can be attributed to increasing demands for radiotherapy caused by the growing incidence of cancer due to an ageing population and the discovery and adoption of new indications for radiotherapy. “When the increasing demand is not matched by a commensurate increase in treatment capacity, waiting lists for RT become inevitable,” write the authors Zheng Chen and colleagues, from Queen’s Cancer Research Institute ( Kingston, Ontario, Canada) and Cross Cancer Institute ( Edmonton, Alta, Canada). Experimental evidence has suggested that the probability of eradicating a tumour by radiotherapy can be inversely related to the number of clonogenic cells it contains, and there is also clinical evidence that the probability of local control in many different types of human cancer can be inversely related to the volume of the cancer. Two recent studies have demonstrated clear evidence of tumour progression in a high proportion of patients waiting to start radiotherapy for head and neck cancer. In the current study, Chen and colleagues set about trying to provide direct evidence that waiting times for radiotherapy influence patient’s clinical outcomes. The study was initiated in response to a request [...]

5/6/2008 New York, NY Lawrence K. Altman M.D. New York Times (nytimes.com) For people with early cancer of the larynx, the standard treatment can be grueling: a biopsy in an operating room followed by a six-week course of radiation that may lead to permanent hoarseness or speech impairment. But a team of Harvard doctors is reporting that a new outpatient laser procedure promises to eliminate the need for radiation, preserve speech, shorten treatment time and significantly improve care in other ways for many patients whose cancer is diagnosed early. The therapy, which uses heat from the laser to destroy the tumor’s blood supply and cancer cells, damages surrounding tissue far less than radiation and different types of lasers. It has been tested in only 28 patients, all at Massachusetts General Hospital in Boston. Yet the initial findings hold promise because the laser was the patients’ only treatment and none have had a recurrence or needed surgery or radiation after a mean follow-up of 27 months, the team’s leader, Dr. Steven M. Zeitels, said in an interview. The longest is more than five years. Other experts expressed cautious optimism about the findings from the pilot study, which the Harvard team reported May 1 at a meeting of the Broncho-Esophagological Association in Orlando. The scientific report involved the first 22 of the 28 patients. The procedure “represents a radically new approach to treatment of these cancers,” said Dr. Gregory A. Grillone, an otolaryngologist at Boston University School of Medicine. Dr. Grillone, who [...]

5/6/2008 Denver, CO Katy Human The Denver Post (www.denverpost.com0 A sexually transmitted virus that causes cervical cancer has been linked to cancers of the tonsil and tongue — diseases that have been on the rise in men for the past 30 years, according to a study by a Colorado Springs doctor and researcher. Among Colorado men, such throat cancers have become 37 percent more common since 1980, compared with a national increase of 11 percent. "Nobody knows that this is going on, and it's important to understand the risk," said Joel Ernster, a professor at the University of Colorado Denver School of Medicine and principal author of the study, which appeared in the journal Laryngoscope. The trends point to oral sex as a likely mode of transmission and have prompted some to call for boys to be vaccinated against the human papilloma virus, Ernster said. Girls can already receive a vaccine to prevent cervical cancer. "Based on what they know right now, why the hell aren't they giving it to boys?" asked Jon Helander, 56, a patient of Ernster's in Colorado Springs. Helander went through radiation and chemotherapy to fight a virus-related tongue cancer earlier this year and said he's frustrated that his son, 21, can't be vaccinated against the virus, as his daughter, 23, has been. While the rate of tonsil and tongue cancer is lower in Colorado than nationally — about 3.47 cases per 100,000 people versus 4.81 — it is increasing more quickly, Ernster and his colleagues [...]

5/5/2008 Chicgo, IL Monifa Thomas Chicago Sun-Times (www.suntimes.com) Though there's now a vaccine against HPV, a sexually transmitted disease that can lead to cervical cancer, most moms aren't willing to get their daughters vaccinated at the age recommended by federal health authorities. That's according to the first national study of mothers' attitudes toward the human papillomavirus vaccine, or HPV. The vaccine is approved for females ages 9 to 26. But the Centers for Disease Control and Prevention recommend that it be given to girls at age 11 or 12, when they receive adolescent booster shots. Sex discussion seen as barrier According to a survey of more than 10,000 mothers, only 49 percent said they would vaccinate a daughter if she were 9 to 12 years old. But moms were more willing to vaccinate a daughter who was 13 to 15 years old (68 percent) or 16 to 18 (86 percent). Study author Dr. Jessica Kahn said it's not surprising that parents would feel more comfortable letting an older daughter get the vaccine. "There's sort of an underlying assumption among some parents that recommending the vaccine means that someone, either a clinician or themselves, will have to have a discussion that HPV is ... transmitted sexually," said Kahn, a pediatrician at Cincinnati Children's Hospital Medical Center. "I think that's a barrier." Parents and physicians also assume older girls have a higher risk of contracting HPV than preteens, so they may feel less urgency to vaccinate at a young age, Kahn said. [...]

5/5/2008 Dublin, Ireland M Amin et al. Irish Medical Journal Abstract Most human beings will do almost anything to prolong their existence or to relieve the suffering of disease. Others will do anything to exploit these desires by selling what they claim to be pain killing remedies or life prolongation nostrums. We present three cases of head and neck cancer patients; two used complementary and alternative medicine (CAM) prior to presenting to our service and the third declined conventional treatment to seek CAM instead. We discuss here the diagnosis, the time delay between CAM and commencement of conventional treatment, and the outcome in each case. Our aim is to define Quacks and to heighten public awareness of the potential harm they can cause. Introduction In the face of the great leveller, Death, we are like children listening fearfully for the footsteps of doom, relieved only by the whisperings of hope. Quacks are peddlers of hope. Quackery is the promotion of false or unproven remedies for profit1. There is growing interest in complementary and alternative medicine at the present time; a significant number of cancer patients use complementary and alternative medicine (CAM) as adjunct therapies to their cancer treatment2,3. Eisenberg et al4 reported that one-third of the US population used some form of unconventional medicine and seventy-five percent of patients did not inform their physicians of this practice. Alternative therapies may include any unproven therapy or cure which is promoted as cancer treatment and is used in place of conventionally accepted [...]