Monthly Archives: August 2008

FDA control of tobacco may reshape industry

Author: Associated Press

If legislation passes to give the Food and Drug Administration the authority the regulate the tobacco industry, it could reshape the industry’s competitive landscape, Fitch Ratings said in a new report Thursday.

The U.S. House overwhelmingly passed the legislation in July, but it requires approval by the Senate and President Bush. Bush’s administration has said he will veto the bill.

The bill would empower federal public health authorities to regulate tobacco for the first time.

Fitch said it does not expect the law to be put into practice this year but said that if a Democrat is elected to the White House, the eventual passage of the bill is “highly probable.”

Analysts have said Richmond, Va.-based Philip Morris USA stands to benefit if the FDA receives the authority to regulate the tobacco industry. Experts have said the measure _ which is favored by PMUSA-owner Altria _ would benefit Altria because the greater restrictions could solidify its position as the market leader and owner of the Marlboro brand.

Fitch believes more rules on how to advertise and promote cigarettes would reduce competition and benefit the companies with bigger market shares.

The nation’s second-biggest cigarette maker, Reynolds American Inc.’s R.J. Reynolds Tobacco Co., has said it opposes the bill. Altria, Reynolds and others are already expanding the number of non-cigarette products they sell, such as cigars, pouchlike snus and snuff.

Fitch Senior Director Wesley Moultrie II said any such law could lead to further consolidation as smaller players suffer the burden of compliance. Fitch analysts further noted that new rules could lead to greater development of cigarette alternatives.

August, 2008|Oral Cancer News|

Zapping oral cancer

Author: staff

According to the Oral Cancer Foundation, this year, oral cancer will cause more than 8,000 deaths, killing roughly one person every hour. This deadly cancer often starts as a discolored area in the mouth called leukoplakia. Leukoplakia is a precancerous lesion that forms on the tongue or inside of the cheek in response to a persistent irritation. Irritation can be caused by dentures, fillings, crowns, smoking or chewing tobacco. The condition normally shows up as a white or red patch in the mouth. When leukoplakia is caused by tobacco use, it is called smoker’s keratosis. These patches also sometimes appear on female genitalia, although the cause is unknown. A condition called hairy leukoplakia sometimes affects individuals with weakened immune systems, especially those with HIV or AIDS. This form of leukoplakia shows up as fuzzy, white patches that resemble folds or ridges on the sides of the tongue.

Since leukoplakia is most often caused by smoking or chewing tobacco, avoiding these habits drastically reduces your chances of developing the condition — and the oral cancer that often follows it. Sun exposure and alcohol use also put you at a higher risk for developing oral cancer. Some studies suggest a diet high in fruits and vegetable help prevent leukoplakia.

Catching leukoplakia early is another solid defense against developing oral cancer. See your physician if you notice a red or white spot or sore inside your mouth, on your tongue, on the inside of your cheek or on your lip that persists for more than two weeks. Visit your dentist regularly so he or she can check your mouth for signs of the condition. When leukoplakia progresses to oral cancer, other symptoms occur including the following: ? Sores that bleed easily or does not heal. ? A color change of the oral tissues. ? A lump, thickening, rough spot, crust or small eroded area. ? Pain, tenderness or numbness anywhere in the mouth or on the lips. ? Difficulty chewing, swallowing, speaking or moving the jaw or tongue. ? A change in the way the teeth fit together.

Detection and Treatment:
If your dentist or doctor suspects you have oral cancer after a physical examination, he or she will probably do a biopsy to determine if cells are cancerous. Other procedures including X-ray and MRI scanning may be necessary for confirmation of the cancer. Treatment usually involves surgery supplemented by radiation treatment. Some patients may need chemotherapy as well.

Experimental treatments of leukoplakia with photodynamic therapy combined with aminolevulinic acid (ALA) are underway. ALA concentrates in cancer cells when taken orally and becomes active when exposed to a certain kind of light. During treatment, the ALA is activated by laser light and kills off abnormal cells, such as those found in leukoplakia. Doctors hope this treatment will be an effective measure against leukoplakia to prevent the onset of oral cancer.

August, 2008|Oral Cancer News|

Laser Microscalpel to Target Cancers Individually

Source: The Future of Things (
Author: Anni Shaer Levitt

A group from Texas University, Austin led by Adela Ben-Yakir, has recently patented a new technology that can be used to target one cancer cell at a time. This laser “microscalpel” would make it possible for a surgeon to weed out the cancer-effected cells without harming the healthy tissue surrounding them. This could greatly help the fight against cancer and improve the quality of life of cancer patients.

A femtosecond laser is a laser which emits optical pulses with an extremely short duration, known as of femtoseconds (1 femtosecond equals 10 in the -15 seconds). The femtosecond laser used for this treatment produces brief, high energy light pulses that cut through the target cell. The laser heat does not spread around to harm nearby healthy cells. There is hope in the medical community that this device could be used for accurate demolition of various types of unhealthy tissue. This would include small tumors of the vocal cords, cancer cells left behind after the removal of solid tumors, individual cancer cells scattered throughout the brain, or other tissue and plaque in arteries.

Femtosecond lasers have been developed by several companies around the world but until recently have been heavy and cumbersome. Ben-Yakar’s laboratory has created a microscope system that is capable of delivering femtosecond laser pulses up to 250 microns deep inside a tissue. This system has a tiny flexible probe that can focus light pulses to a spot smaller than a human cell.

Ben-Yakar hopes that in a few years the probe’s 15-millimeter diameter will shrink three fold, thus making it match endoscopes that are engaged in laparoscopic surgeries today. She also considers making the probe tip disposable so it could be used in operations on people with have infectious diseases or destroying deadly viruses and other biomaterials.

During the development of the miniature-surgery system, Ben-Yakar worked in collaboration with Olav Solgaard at Stanford University’s electrical engineering department in order to incorporate a miniaturized scanning mirror. Another addition to the system was made by Ben-Yakar and her graduate student Chris Hoy; they used a novel optic-fiber cable that can withstand the light pulses the laser sends out. While trying to make the laser intensity easier to manage, they stretched the light pulses into longer, weaker pulses that travel through the fiber. Then, the fiber’s properties were used for reconstructing the light into more intense, short light pulses before they entered the tissue.

In this study, Ben-Yakar targeted breast cancer cells in three-dimensional bio-structures that mimicked the optical properties of breast tissue. The laser has also been tested on laboratory-grown layered cell structures that mimic different tissues.

An additional line of research Ben-Yakar is currently engaging is the use of nanoparticles to focus the light energy on targeted cells. She recently demonstrated that gold nanoparticles can function as magnifying lenses, thus increasing the amount of laser light reaching the cells by at least an order of magnitude. When this technique is fully developed it would be possible to target hundreds of effected cells in a single tissue at a time without affecting the healthy cells.

TFOT has recently covered several other stories on new treatments for cancer. One such story tells of a new infrared camera developed by researchers from the Argonne National Laboratory which can take images of the head and neck and predict which patients are likely to develop severe side effects due to anti-cancer treatments and adapt the treatment accordingly. Another story tells of a personalized melanoma vaccination developed by Hadassah Medical Organization and the Hebrew University in Jerusalem.

More information on the new laser can be found on the Texas University website.

August, 2008|Oral Cancer News|

Intensity-modulated radiotherapy in postoperative treatment of oral cavity cancers

Source: Int J Radiat Oncol Biol Phys, August 14, 2008
Author: Daniel R Gomez et al.

To present our single-institution experience of intensity-modulated radiotherapy (IMRT) for oral cavity cancer.

Methods and Materials:
Between September 2000 and December 2006, 35 patients with histologically confirmed squamous cell carcinoma of the oral cavity underwent surgery followed by postoperative IMRT. The sites included were buccal mucosa in 8, oral tongue in 11, floor of the mouth in 9, gingiva in 4, hard palate in 2, and retromolar trigone in 1. Most patients had Stage III-IV disease (80%). Ten patients (29%) also received concurrent postoperative chemotherapy with IMRT. The median prescribed radiation dose was 60 Gy.

The median follow-up for surviving patients was 28.1 months (range, 11.9-85.1). Treatment failure occurred in 11 cases as follows: local in 4, regional in 2, and distant metastases in 5. Of the 5 patients with distant metastases, 2 presented with dermal metastases. The 2- and 3-year estimates of locoregional progression-free survival, distant metastasis-free survival, disease-free survival, and overall survival were 84% and 77%, 85% and 85%, 70% and 64%, and 74% and 74%, respectively. Acute Grade 2 or greater dermatitis, mucositis, and esophageal reactions were experienced by 54%, 66%, and 40% of the patients, respectively. Documented late complications included trismus (17%) and osteoradionecrosis (5%).

IMRT as an adjuvant treatment after surgical resection for oral cavity tumors is feasible and effective, with promising results and acceptable toxicity.

Daniel R Gomez, Joanne E Zhung, Jennifer Gomez, Kelvin Chan, Abraham J Wu, Suzanne L Wolden, David G Pfister, Ashok Shaha, Jatin P Shah, Dennis H Kraus, Richard J Wong, and Nancy Y Lee

Authors’ affiliation:
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY

August, 2008|Oral Cancer News|

Burning incense increases risk of respiratory tract cancers

Source: ScienceDaily (
Author: staff

Long term use of incense increases the risk of developing cancers of the respiratory tract, according to a new study. The new analysis, which the authors say is the first prospective investigation of incense and cancer risk, appears in the October 1, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

Incense is an integral part of daily life in large parts of Asia. Researchers have shown that burning incense—which is made of plant materials mixed with oils—produces a mixture of possible carcinogens, including polyaromatic hydrocarbons, carbonyls and benzene. Because incense smoke is inhaled, a number of studies have looked at the possible link between incense burning and lung cancer, but results have been inconsistent. In addition, the possible association of incense use and other respiratory tract cancers has not been analyzed. To investigate this, Dr. Jeppe Friborg of the Statens Serum Institut in Copenhagen, Denmark and colleagues in Singapore and the U.S. studied the associations between exposure to incense and the whole spectrum of respiratory tract cancers in a large population in Singapore.

The study involved 61,320 Singapore Chinese who were free of cancer and aged 45-74 years in 1993-1998. At that time, they completed a comprehensive interview on living conditions and dietary and lifestyle factors. The investigators followed these individuals through 2005, noting which participants developed cancer during that time.

Dr. Friborg’s team documented a total of 325 upper respiratory tract cancers (including nasal/sinus, tongue, mouth, laryngeal and other cancers) and 821 lung cancers during follow-up. Incense use was associated with a significantly increased risk of upper respiratory tract cancer (other than nasopharyngeal), but there was no overall effect on lung cancer.

The researchers also noted that the duration and intensity of incense use were associated with an increased risk of squamous cell carcinomas in the entire respiratory tract. Squamous cells cover the internal and external surfaces of the body.

According to the study data, incense use seemed to add to the increased risk of upper respiratory tract squamous cell carcinoma in smokers. It also considerably increased the risk in never smokers, which points to an independent effect of incense smoke.

The authors note that their study is the first prospective investigation on incense and cancer risk. They stressed that incense use extends beyond the Chinese populations—it is used on a daily basis in both temples and homes in many non-Chinese, Asian communities, including those in Southeast Asia and the Indian subcontinent. Regular use also occurs in the West.

“Given the widespread and sometimes involuntary exposure to smoke of burning incense, these findings carry significant public health implications,” they wrote. “Besides initiatives to reduce incense smoke exposure, future studies should be undertaken to identify the least harmful types of incense,” they added.

Journal reference:
1. Jeppe T. Friborg, Jian-Min Yuan, Renwei Wang, Woon-Puay Koh, Hin-Peng Lee, and Mimi C. Yu. Incense use and respiratory tract carcinomas: a prospective cohort study. CANCER, Published Online: August 25, 2008 DOI: 10.1002/cncr.23788

August, 2008|Oral Cancer News|

Vaccine controversy continues

Source: Reader’s Digest (
Author: Julie Bain

Between the relay races and table tennis triumphs last week, there was some news coverage about the HPV vaccine. A study came out last Wednesday in the New England Journal of Medicine that looked at the economic impact of vaccinating young girls and women from the types of HPV virus that can cause cervical cancer.

Newsweek ran an informative Q and A with one of the study authors about who should get the vaccine and when. The New York Times did a big story, too, which I thought displayed a bit of bias in the disapproving tone of its headline: Researchers Question Wide Use of HPV Vaccines.

I called Maura Gillison, MD, a researcher at Johns Hopkins in Baltimore and one of the top experts on HPV, for her perspective. She said, “For those of us in the field, this study is not really new information. It is known that the HPV vaccine doesn’t have an impact on young women who have already been infected by the HPV types targeted by the vaccine (HPV6, 11, 16, and 18).”

While it was possible to measure a girl’s previous exposure to HPV in the study lab, it’s not possible in a medical clinic, she says. That’s why it’s not as cost-effective to give the vaccine to women who are already sexually active.

Still, she says, “only 4% of the 16- to 26-year-old women who were enrolled in the vaccine trials had evidence of exposure to all four HPV types targeted by the vaccine. So a young woman already infected by HPV6, for example, would still benefit from vaccination to prevent HPV infection by HPV 11, 16, and 18. But the older the woman, the higher the probability that she has been exposed to more of the virus types.”

So the bottom line, according to Dr. Gillison: “You get more bang for your buck by targeting vaccination to younger girls, before the onset of sexual behavior. It makes more sense, in terms of the overall cost and the overall impact of the vaccine for cancer prevention, to spend the health-care dollars to vaccinate a higher proportion of young women, than to extend vaccination to older women.”

The vaccine needs further study before researchers will know for sure how long immunity lasts and whether a booster shot may be needed, and when. The big question of the study was: Is the cost of vaccinating millions of girls worth the number of lives saved? Economic policy is one thing, but all any individual can answer is, “If it’s my daughter whose life is saved, the answer is yes.” By the way, Dr. Gillison has two very young daughters, and she says she plans to have them vaccinated.

But What About the Boys?

Some 20 million Americans are infected with the virus, including a high percentage of teenagers. And we know that the virus is easily spread through any kind of sexual contact, including oral sex. I’ve asked it before and I’ll ask it again: Why are we only talking about girls here?

Cervical cancer is not the only life-threatening hazard of the HPV virus. Oral cancer from the virus is on the rise, as we wrote about in A Father’s Brave Battle with Throat Cancer in the August issue.

“We don’t know yet if the vaccine protects against genital infection in boys or against oral infection in boys or girls,” Dr. Gillison says. “I’m doing all I can to see that such studies are done.” In the absence of such studies, she says, we’ll only know if the vaccine helps to prevent oral infection 20 to 30 years from now, if the rapid rise in HPV-related oral cancers switches directions and starts to decline.

I don’t want to see anyone suffer the way I saw Steve Reynolds, the subject of our story, suffer during and after his treatment. Last Wednesday, the day the vaccine study came out, Steve was in the hospital having a PET scan to see if any cancer cells have returned in the year since he completed his radiation and chemo. Then he and his wife and their 4-year-old son headed to Cape Cod for their annual vacation. He won’t have the results until he returns. Waiting and worrying means more suffering for him and his family. We need to find a way to prevent this cancer, too—in all people.

August, 2008|Oral Cancer News|

Zapping oral cancer

Author: Martha Benavides

This year, more than 34,000 people in the United States will be diagnosed with oral cancer — a cancer that has a higher death rate than cervical cancer, Hodgkin’s lymphoma, or skin cancer. Survival rates are not improving; but now, a new treatment may give doctors a way to stop oral cancers before they start.

They’re often detected in a routine dental or doctor’s visit. Doctors say early detection can be crucial … red or white lesions called leukoplakia can turn into serious, even deadly oral cancers. Oral cancer has a five year survival rate of less than 50 percent.

“I do happen to know people that have died of this kind of cancer and so we watch it very closely,” said Mike Hagerman, a former smoker and a two-time oral cancer survivor.

Now, Hagerman’s leukoplakia is back. This time, he’s part of a study testing a new photodynamic laser treatment designed to eliminate precancerous cells.

“When the laser fires onto the lesion, it emits light at a very specific frequency that causes oxygen radicals that destroy the lesion, make it go away,” stated Stuart Wong, M.D., a medical oncologist at the Medical College of Wisconsin in Milwaukee.

Tested on the hand or used in the mouth on actual lesions, researchers say the laser doesn’t hurt. It’s a preventive measure that doctors say could save lives.

“There is some emerging data that the better we can kill off these early precancerous lesions, that that might translate later down the road many, many years to a decreasing in the development of cancers and that’s the goal,” Dr. Wong said.

Doctors say early detection can be crucial. Check your mouth regularly. If you see a red or white spot or feel something irregular, get it checked immediately.

“I’m going to have to be aware of it for the rest of my life,” Hagerman said; but he hopes with good medical care and a little vigilance, he can stay cancer free.

Even if you don’t smoke, you can get oral cancer.

Recent research shows the fastest growing segment of the oral cancer population are non-smokers, under the age of 50. Overall, men are at higher risk for oral cancer than women. Risk factors increase over age 40, for men and women

August, 2008|Oral Cancer News|

CMS receives FDA 510(k) clearance for Atlas-based auto-segmentation software

Author: press release

CMS, Inc., an Elekta Company, and worldwide leader in radiation treatment planning and workflow management solutions, has received FDA 510(k) clearance for its new Atlas-Based Autosegmentation (ABAS) product. This clearance allows CMS to immediately begin distributing Atlas-Based Autosegmentation for clinical use in the United States.

Significantly reducing the amount of time spent creating and editing patient contours, ABAS is a software application that produces an estimate of the anatomy boundary contours needed to create a radiation treatment plan. Image segmentation, or contouring, is a time consuming component of the treatment planning process, and ABAS helps save clinicians time by providing a good starting point from which minimal editing is required.

In addition to its time-saving benefits, ABAS distinguishes itself from competing products in several ways. A stand alone, vendor neutral product that communicates using standard DICOM file formats for both input and output, ABAS is compatible with any radiation treatment planning system that can read standard DICOM RT structure set files. ABAS also provides structure specific refinement algorithms for head and neck treatments, as well as prostate treatments, in addition to a general algorithm that allows it to be used with other treatment sites.

“We are extremely proud and very pleased to receive clearance to distribute Atlas-Based Autosegmentation to the U.S. market,” says Terry Wolf, Director of Research for CMS, an Elekta Company. “An embodiment of our core values, ABAS is an innovative solution delivered in a vendor-neutral platform aimed at improving the quality of care.”

The ABAS algorithms were developed by Dr. Xiao Han, CMS Research Scientist. Dr. Han’s work, titled, “Atlas-based Auto-segmentation of Head and Neck CT Images,” will be presented September 9 at the 11th Annual International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in New York City.

About CMS

CMS, Inc., an Elekta Company, is a worldwide market leader in radiation
treatment planning and workflow management, combining innovative software
applications and advanced technology tools to deliver comprehensive treatment
planning and workflow management solutions that integrate seamlessly in any
clinical environment.

August, 2008|Oral Cancer News|

Do cell phones cause cancer?

Author: Jana Simard

Cellular telephones are everywhere. Flip phones, sliders and even the new touch screen iPhone; in every shape and every color, they have populated our planet and become the most convenient way to keep in touch no matter where your location. A cell phone beams radiofrequency energy that can penetrate the outer edge of the brain, which posed questions about cancers of the head and neck, brain tumors or leukemia. According to the Cellular Telecommunications and Internet Association (CTIA), there are now more than 180 million subscribers to cellular telephone service in the United States. This has increased from 110 million users just 3 years ago. Experts estimate that by 2010, there will be 2.2 billion subscribers worldwide.

With all of the rumors circling around cell phones, a vast study was conducted in order to give individuals a definite, precise answer. Published in the Journal of the National Cancer Institute, the study tracked 420,000 Danish cell phone users, including 52,000 who had been using cell phones for 10 years or more, and some who started using them 21 years ago. This is the largest study so far to find no bad news about the safety of cell phones and the radio frequency energy they emit. According to the article in the Associated Press ‘among 420,000 callers tracked through 2002, there were 14,249 cancers diagnosed — fewer than the 15,001 predicted from national cancer rates. Nor did the study find increased risks for any specific tumor type.’ Yet, another French study based on Interphone research was published in 2007, and concluded that regular cell phone users had “no significant increased risk” for three major types of nervous system tumors. However it also stated that “the possibility of an increased risk among the heaviest users” for one type of brain tumor, but that needs to be verified in future research.

Other researchers and doctors, such as Dr. Ronald B. Herberman, director of the University of Pittsburgh Cancer Institute, believe there is still some risk associated with cell phone usage, stating that long-term evidence is lacking. In addition to this further research, brain specialists are investigating the risk of Electromagnetic radiation and its possible effects on children. Children and young kids should limit their use of cellular devices because their brains are still developing. Many parents are being urged to err on the side of caution because the findings are still conflicting. Some think there is no harm, others oppose.

The Food and Drug Administration (FDA) suggests that cellular telephone users should invest in a hands-free headset and or use the speaker feature, in addition to limiting the amount of time spent on the phone – if they are concerned about potential health risks from cellular telephones. When it comes down to it, there is more of a potential danger when driving and using the cell phone than there is from the radiation emitted.

August, 2008|Oral Cancer News|

Prevalence and significance of human papillomavirus in oral tongue cancer: the Mayo Clinic experience

Source: Oral and Maxillofacial Surgery, Vol. 66, Issue 9, Pages 1875-1880 (September 2008)
Authors: Xin-Hua Liang et al.

Cigarette smoking and alcohol use have markedly decreased in the past 40 years. However, there has been an increasing trend in the incidence of tongue cancer, particularly in young patients without traditional risk factors. This study sought to examine the prevalence and significance of human papillomavirus (HPV) infection and its clinical significance in patients with oral tongue cancer.

Patients and Methods
Fresh-frozen tissues from 51 patients with oral tongue cancer, treated with primary surgery from January 2004 to December 2006, were included in the study. The presence of HPV infection in tumor specimens was analyzed by polymerase chain reaction with HPV L1 consensus primers (GP 5+/GP 6+) and HPV-16-specific E6 primer pairs. Demographic and clinical data were collected to analyze patient outcomes.

The overall frequency of HPV in oral tongue cancer in our study was 1.96% (1/51). Young patients below the age of 45 years accounted for 15.7% (8/51) of the total number of patients. Eighty-seven percent of the younger age group, including a single patient with an HPV-16-positive tumor, were alive and free from disease during the follow-up period. The overall survival of the study group was 81.4%.

Our data suggest that the incidence of HPV in oral tongue cancer is low and is unlikely to play a significant role in the etiology, pathogenesis, and clinical outcomes of oral tongue cancer. In addition, HPV is unlikely to constitute a significant factor in the rising trend of oral tongue cancer in the young population.

Xin-Hua Liang, MD, PhD⁎, Jason Lewis, MD†, Robert Foote, MD‡, David Smith, PhD§, Deepak Kademani, DMD, MD

Authors’ affiliations:
⁎ Research Fellow, Department of Oral and Maxillofacial Surgery, Mayo Clinic, Rochester, MN, and Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
† Assistant Professor, Department of Anatomic Pathology, Mayo Clinic, Rochester, MN
‡ Professor of Oncology, Department of Radiation Oncology, Mayo Clinic, Rochester, MN
§ Professor of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
¶ Formerly, Assistant Professor, Department of Oral and Maxillofacial Surgery, Mayo Clinic, Rochester, MN; and Currently, Associate Professor, Department of Oral and Maxillofacial Surgery, University of Minnesota Medical Center, Minneapolis, MN

August, 2008|Oral Cancer News|