Cerebrovascular disease risk in older head and neck cancer patients after radiotherapy

Source: Journal of Clinical Oncology, Vol 26, No 31 (November 1), 2008: pp. 5119-5125 Authors: Grace L. Smith et al. Purpose: Cerebrovascular disease is common in head and neck cancer patients, but it is unknown whether radiotherapy increases the cerebrovascular disease risk in this population. Patients and Methods: We identified 6,862 patients (age > 65 years) from the Surveillance, Epidemiology, and End Results (SEER) –Medicare cohort diagnosed with nonmetastatic head and neck cancer between 1992 and 2002. Using proportional hazards regression, we compared risk of cerebrovascular events (stroke, carotid revascularization, or stroke death) after treatment with radiotherapy alone, surgery plus radiotherapy, or surgery alone. To further validate whether treatment groups had equivalent baseline risk of vascular disease, we compared the risks of developing a control diagnosis, cardiac events (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, or cardiac death). Unlike cerebrovascular risk, no difference in cardiac risk was hypothesized. Results: Mean age was 76 ± 7 years. Ten-year incidence of cerebrovascular events was 34% in patients treated with radiotherapy alone compared with 25% in patients treated with surgery plus radiotherapy and 26% in patients treated with surgery alone (P

Oral rinses used for tracking HPV-positive head and neck cancers holds promise for cancer screening

Source: www.eurekalert.com Author: staff A study published in the journal Clinical Cancer Research, a journal of the American Association for Cancer Research, validates a non-invasive screening method with future potential for detection of human papillomavirus (HPV)-positive head and neck cancers. In the study, researchers at Johns Hopkins University used oral rinses and targeted DNA amplification to track and identify oral HPV infections in patients with HPV16-positive and negative head and neck carcinomas (HNSCC) before and after therapy. Findings showed detection of high-risk HPV infections in patients with HPV16-positive HNSCC for up to five years after therapy, indicating a high rate of persistent infection and reaffirming the connection between high-risk types of HPV and HPV-positive head and neck cancer. "There is no question of cause," said the study's co-author Maura Gillison, M.D., Ph.D. associate professor of oncology. "It has now become a question of tracking the infection over time to identify those at risk of developing HPV-positive cancer, and for those who have had it, the risk of recurrence and risk of transmission. This is the first study in which we have been able to track the disease and related oral infections for an extended period of time." Researchers obtained oral rinse samples from a group of 135 patients with head and neck carcinomas. Tissue analysis showed that 44 of these patients had HPV16-positive tumors. Both the tissue and oral rinse samples were genetically sequenced to specify the HPV variants in each. Patients with HPV16-positive tumors were significantly more likely to [...]

Coffee consumption and the risk of oral, pharyngeal and esophageal cancers in Japan

Source: American Journal of Epidemiology, doi:10.1093/aje/kwn282 Authors: Toru Naganuma et al. An inverse association between coffee consumption and the risk of oral, pharyngeal, and esophageal cancers has been suggested in case-control studies, but few results from prospective studies are available. Data from the Miyagi Cohort Study in Japan were used to clarify the association between coffee consumption and the risk of these cancers. Information about coffee consumption was obtained from self-administered food frequency questionnaires in 1990. Among 38,679 subjects aged 40–64 years with no previous history of cancer, 157 cases of oral, pharyngeal, and esophageal cancers were identified during 13.6 years of follow-up. Hazard ratios were estimated by the Cox proportional hazards regression model. The risk of oral, pharyngeal, and esophageal cancers was inversely associated with coffee consumption. The multivariate-adjusted hazard ratio of these cancers for ≥1 cups of coffee per day compared with no consumption was 0.51 (95% confidence interval: 0.33, 0.77). This inverse association was consistent regardless of sex and cancer site and was observed both for subjects who did not drink or smoke and for those who currently drank or smoked at baseline. In conclusion, coffee consumption was associated with a lower risk of oral, pharyngeal, and esophageal cancers, even in the group at high risk of these cancers. Authors: Toru Naganuma, Shinichi Kuriyama, Masako Kakizaki, Toshimasa Sone, Naoki Nakaya, Kaori Ohmori-Matsuda, Yoshikazu Nishino, Akira Fukao and Ichiro Tsuji Authors' affiliation: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University School of Medicine, 2-1 [...]

Nobel laureate calls for HPV vaccine for boys

Source: ww.xtra.ca Author: Andrew Innis The Nobel Prize winning pioneer of human papilloma virus (HPV) research is calling for the vaccination of boys against HPV. Speaking at the MaRS Centre in Toronto on Oct 21, Dr Harald zur Hausen argued that vaccination against the viruses, which can lead to cervical cancer in women, is also important to men since they too are susceptible to developing cancers related to HPV. Zur Hausen said men, like women, need to be protected from the more dangerous strains of the virus, HPV-16 and -18, which can contribute to the development of anal and penile cancer. The announcement came hours before the release of a report by the US Centers for Disease Control and Prevention (CDC), which confirmed that after two years of clinical usage Gardasil remains safe for human use, citing no elevated risk for neurological complications. The vaccine was approved for use in both Canada and the United States two years ago. Philippe Brideau, media relations officer for Public Health Agency Canada, said Gardasil has been found to be, “effective and the vaccine is safe, and should be used.” He said there have been no major reactions reported. Health Canada estimates nearly 75 percent of sexually active men and women will be infected with HPV at least once in their lifetime. While most strains of the virus are of little danger, mainly producing genital warts, it can lead to the development of cancer in both males and females. Men who have sex with [...]

Periodic CT detects pulmonary metastases among head and neck cancer patients

Source: CancerConsultants.com Author: staff Among patients with head and neck cancer who are at a high risk for metastases, periodic computed tomography (CT) scans can be highly effective for detecting pulmonary metastases. Head and neck cancers originate in the oral cavity (lip, mouth, tongue), salivary glands, paranasal sinuses, nasal cavity, pharynx (upper back part of the throat), larynx (voice box), and lymph nodes in the upper part of the neck. Worldwide, head and neck cancer is diagnosed in approximately 640,000 people annually and is responsible for approximately 350,000 deaths each year. Some patients with head and neck cancer are at a higher risk of developing cancer spread (metastasis). One of the common places of metastasis is to the lung, referred to as pulmonary metastasis. Researchers continue to evaluate ways in which to detect metastasis so that detection and treatment may occur in its earliest phases. Researchers from Taiwan recently conducted a clinical study to evaluate the effectiveness of chest CT scans in early detection of pulmonary metastases among patients with head and neck cancer. This trial included 192 patients over nearly 4 years, during which time CT scans of the chest were intermittently performed. Approximately one-third of patients had abnormal chest CT scans. Nearly 70% of patients with an abnormal scan ultimately demonstrated disease progression. The researchers concluded that patients with head and neck cancer who are at a high risk of developing pulmonary metastases may benefit from intermittent chest CT scans for early detection of pulmonary metastases. Patients with [...]

How eating fruit and vegetables can improve cancer patients’ response to chemotherapy

Source: www.biocompare.com Author: staff UC Riverside study describes how naturally occurring apigenin facilitates the death of cancer cells The leading cause of death in all cancer patients continues to be the resistance of tumor cells to chemotherapy, a form of treatment in which chemicals are used to kill cells. Now a study by UC Riverside biochemists that focuses on cancer cells reports that ingesting apigenin – a naturally occurring dietary agent found in vegetables and fruit – improves cancer cells' response to chemotherapy. Xuan Liu, a professor of biochemistry, and Xin Cai, a postdoctoral researcher working in her lab, found that apigenin localizes tumor suppressor p53, a protein, in the cell nucleus – a necessary step for killing the cell that results in some tumor cells responding to chemotherapy. The study, published this week in the online early edition of the Proceedings of the National Academy of Sciences, provides a novel approach to conquer tumor resistance to chemotherapy, and suggests an avenue for developing safe chemotherapy via naturally occurring agents. Normally, cells have low levels of p53 diffused in their cytoplasm and nucleus. When DNA in the nucleus is damaged, p53 moves to the nucleus where it activates genes that stop cell growth and cause cell death. In this way, p53 ensures that cells with damaged DNA are killed. In many cancers, p53 is rendered inactive by a process called cytoplasmic sequestration. Apigenin is able to activate p53 and transport it into the nucleus, resulting in a stop to cell [...]

Bevacizumab better than gold standard imaging at detecting tumors

Source: www.biocompare.com Author: staff Scientists have developed a new imaging agent that can be used in scanning for tumours, and which gives a much clearer and more precise image than existing methods. The discovery has the potential to revolutionise pre-clinical cancer research and clinical diagnostic practice, and it makes use of compounds that have already been approved for treating patients: the anti-cancer drug bevacizumab (Avastin) and Copper-64, a radioactive copper nuclide, which is approved by the US Food and Drug Administration (FDA) for some clinical trials. Dr Zheng Jim Wang told the 20th EORTC-NCI-AACR [1] Symposium on Molecular Targets and Cancer Therapeutics in Geneva today (Wednesday 22 October) that he and his colleagues had attached bevacizumab to a molecule called DOTA (a cyclic compound) and tagged it with a radioactive tracer, Copper-64 (64Cu). Bevacizumab is an antibody that targets vascular endothelial growth factor (VEGF), a signalling protein released by tumour cells and which plays an important role in angiogenesis (the process by which a growing tumour creates its own blood supply). Currently, bevacizumab is being used to treat patients with advanced colorectal cancer and is being tested in several other metastatic cancers. When the researchers injected the compound (64Cu-bevacizumab) into mice with breast, lung and pancreatic cancers and then used PET/CT imaging to scan the animals, they found that it successfully targeted the cancer cells, accumulating in high concentrations in the tumours, and that it enabled clear and well-defined images of the tumours to be detected during scanning. When compared [...]

‘A second opinion saved our lives’ say the patients who refused to accept their GP’s diagnosis

Source: www.dailymail.co.uk Author: Marianne Power We all trust our GPs to give the correct diagnosis. But doctors CAN get it wrong - with potentially disastrous consequences. These patients prove you should never be too embarrassed to ask for a second opinion. We all want to believe what doctors tell us, especially when they're assuring us that nothing is wrong. But sometimes there remains that niggling doubt - something tells you all is not right. 'Trusting your instinct is important. Doctors do make mistakes and sometimes you know your body better than anyone else,' says Dr Graham Archard, vice chairman of the Royal College of GPs. 'I can remember a patient who was convinced he had bowel cancer, but all the tests came back clear. He wanted a second opinion so we referred him to another consultant for more tests, which showed that he did have cancer. 'I don't know if the cancer developed between the first and second appointment or if the first consultant missed it, but the patient's instincts were right. As a GP I don't take it personally if someone asks for a second opinion. If any doctor does take offence, they are too full of themselves, and it's time to stop practising. 'If you are concerned, first talk to your GP, and allow them to explain how they came to their diagnosis. Sometimes this alone can make you feel better. 'If it doesn't, ask to see another GP in the practice or to be referred to a [...]

Prevention vs. prosecution

Source: www.rdhmag.com Author: Dianne Glasscoe-Waterson Malpractice. The very word strikes fear in the hearts and minds of all health-care providers. In fact, according to risk management statistics, every dentist can expect at least one malpractice lawsuit in his or her practice lifetime. What about dental hygienists? Are they at risk? Should dental hygienists invest in their own malpractice insurance? Read on to learn of the unpleasant circumstances surrounding four dental hygienists. Limits of Malpractice Coverage Carol practiced dental hygiene for 25 years without carrying malpractice insurance. She reasoned that there was no need since the doctor's malpractice insurance covered her. When Carol's employer was sued for failure to diagnose oral cancer, Carol was named as a codefendant in the suit, as she had seen the patient for a preventive care appointment within the past year. While being named in any lawsuit was unsettling, Carol figured she really had nothing to worry about. She knew the doctor had malpractice insurance. What Carol did not know was that lawsuits can actually exceed the limits of the doctor's malpractice coverage. According to Jeff Tonner, JD, monetary awards for failure to diagnose oral cancer are the most common lawsuits to exceed the limits of coverage. If a lawsuit is successful and the limits of coverage are exceeded, codefendants can be saddled with monetary damages, because the doctor is the primary defendant. False Security Jan chose not to carry malpractice insurance. She felt it was really a waste of money, since she knew her employer's [...]

Public knowledge and attitudes towards Human Papilloma Virus (HPV) vaccination

Source: 7th Space (Johns Hopkins Medical Letter) Author: Charlotte Devereaux et al. Human Papilloma Virus (HPV) vaccine has undergone successful trials and has recently been approved for use for the primary prevention of cervical cancer. The aim of this study was to determine knowledge and attitudes towards HPV vaccination. Method: Semi-structured interview and questionnaire delivered in a street survey. Standardised HPV-related statements used to measure HPV knowledge and attitudes to vaccination. The setting was three different areas of Birmingham, to target a mix of social class and ethnicity. The sample population was composed of 16-54 year olds. Results: A total of 420 participants were recruited. Poor knowledge of HPV and its links with cervical cancer were observed. 81% had a knowledge score of zero. Knowledge about HPV was associated with different ethnic group and socio-economic group. The majority (88%) of participants were in favour of vaccination, with 83.6% indicating that they would allow a child under their care to be vaccinated. Conclusion: Initial responses to the proposed HPV vaccination within the UK public are favourable. However, knowledge levels are poor and media and health professional promotion are required to raise awareness. Authors: Charlotte Devereaux Walsh, Aradhana Gera, Meeraj Shah, Amit Sharma, Judy E Powell and Sue Wilson Source: BMC Public Health 2008, 8:368

Go to Top