Monthly Archives: February 2009

Chinese e-cigs gain ground amid safety concerns

Author: Audra Ang

With its slim white body and glowing amber tip, it can easily pass as a regular cigarette. It even emits what look like curlicues of white smoke.

The Ruyan V8, which produces a nicotine-infused mist absorbed directly into the lungs, is just one of a rapidly growing array of electronic cigarettes attracting attention in China, the U.S. and elsewhere – and the scrutiny of world health officials.

Marketed as a healthier alternative to smoking and a potential way to kick the habit, the smokeless smokes have been distributed in swag bags at the British film awards and hawked at an international trade show.

Because no burning is involved, makers say there’s no hazardous cocktail of cancer-causing chemicals and gases like those produced by a regular cigarette. There’s no secondhand smoke, so they can be used in places where cigarettes are banned, the makers say.

Health authorities are questioning those claims.

The World Health Organization issued a statement in September warning there was no evidence to back up contentions that e-cigarettes are a safe substitute for smoking or a way to help smokers quit.

It also said companies should stop marketing them that way, especially since the product may undermine smoking prevention efforts because they look like the real thing and may lure nonsmokers, including children.

“There is not sufficient evidence that (they) are safe products for human consumption,” Timothy O’Leary, a communications officer at the WHO’s Tobacco Free Initiative in Geneva, said this week.

The laundry list of WHO’s concerns includes the lack of conclusive studies and information about e-cigarette contents and their long-term health effects, he said.

Unlike other nicotine-replacement therapies such as patches for slow delivery through the skin and some inhalers and nasal sprays, e-cigarettes have not gone through rigorous testing, O’Leary said.

Nicotine is highly addictive and causes the release of the “feel good” chemical dopamine when it goes to the brain. It also increases heart rate and blood pressure and restricts blood to the heart muscle.

Ruyan – which means “like smoking” – introduced the world’s first electronic cigarette in 2004. It has patented its ultrasonic atomizing technology, in which nicotine is dissolved in a cartridge containing propylene glycol, the liquid that is vaporized in smoke machines in nightclubs or theaters and is commonly used as a solvent in food.

When a person takes a drag on the battery-powered cigarette, the solution is pumped through the atomizer and comes out as an ultrafine spray that resembles smoke.

Hong Kong-based Ruyan contends the technology has been illegally copied by Chinese and foreign companies and is embroiled in several lawsuits. It’s also battling questions about the safety of its products.

Most sales take place over the Internet, where hundreds of retailers tout their products. Their easy availability, O’Leary warns, “has elevated this to a pressing issue given its unknown safety and efficacy.”

Prices range from about $60 to $240. Kits include battery chargers and cartridges that range in flavors (from fruit to menthol) and nicotine levels (from zero – basically a flavored mist – to 16 milligrams, higher than a regular cigarette.) The National Institutes of Health says regular cigarettes contain about 10 milligrams of nicotine.

On its Web site, Gamucci, a London-based manufacturer, features a woman provocatively displaying one of its e-cigs. “They look like, feel like and taste like traditional tobacco, yet they aren’t,” the blurb reads. “They are a truly healthier and satisfying alternative. Join the revolution today!”

Smoking Everywhere, a Florida-based company, proclaims it “a much better way to smoke!” while a clip on YouTube features an employee of the NJoy brand promoting its e-cigarettes at CES, the international consumer technology trade show.

Online sales make it even more difficult to regulate the industry, which still falls in a gray area in many countries.

In the U.S., the Food and Drug Administration has “detained and refused” several brands of electronic cigarettes because they were considered unapproved new drugs and could not be legally marketed in the country, said press officer Christopher Kelly.

He did not give more details, but said the determination of whether an e-cig is a drug is made on a case-by-case basis after the agency considers its intended use, labeling and advertising.

In Australia, the sale of electronic cigarettes containing nicotine is banned. In Britain, the products appear to be unregulated and are sold in pubs.

Smoking is tightly woven into the fabric of daily life in Ruyan’s home turf of China, the world’s largest tobacco market where about 2 trillion cigarettes are sold every year.

Tobacco sales, the biggest source of government revenue, brought in $61 billion in the first 11 months of last year, up 18 percent from 2007, the Communist Party’s People’s Daily newspaper said.

In a country where the cheapest brands of cigarettes cost about 20 cents a pack, the e-cig is far pricier. Ruyan’s V8 costs $240 and includes batteries and 20 cartridges of nicotine solution, roughly the same number of puffs as 20 packs of tobacco cigarettes. The line has expanded to include cigars and pipes crafted from agate and rosewood.

Ruyan is suing a Beijing newspaper for questioning its safety and for claiming in 2006 that its products have more nicotine than regular cigarettes.

Miu Nam, Ruyan’s executive director, blames the newspaper for a hit in sales and profits but declined to give details.

“We have to restore consumers’ confidence, we have to clean up people’s doubts,” Miu said.

An operator at the Beijing Times refused to transfer calls seeking comment Friday to managers at the newspaper. A reporter said she had heard of the case but would not give any details.

Some international experts back Ruyan’s claims its product is safe.

David Sweanor, an adjunct law professor at Ottawa University and former legal counsel of the Non Smokers Rights Association in Canada, said e-cigs have the potential to save lives.

With smoking, “it’s the delivery system that’s killing people,” Sweanor said. “Anytime you suck smoke into your lungs you’re going to do yourself a great deal of damage. Nicotine has some slight risks but they are minor compared to the risk of smoke in cigarettes.”

Dr. Murray Laugesen, a New Zealand physician involved in tobacco control for 25 years who was commissioned by Ruyan to test its e-cigs, said he found “very little wrong” with them.

“It looks more like a cigarette and feels more like a cigarette than any other device so far and yet it does not cause the harm,” he said. “It’s the best substitute so far invented for tobacco cigarettes.”

In the U.S, both Philip Morris USA and RJ Reynolds have introduced cigarettes that did not burn tobacco, but the technologies were very different from the e-cigarette. Neither has been successful.

In 2006, Philip Morris USA, test-marketed the Accord, which used a heating unit activated by puffing. RJ Reynolds introduced its cigarette, the Premier, in 1987 and still sells the Eclipse, which heats the tobacco rather than burning it. Sales are “not great,” said spokesman David Howard.

Li Honglei, a fast-talking 28-year-old public relations manager in Beijing, has been smoking since he was in his teens and desperately wants to quit. He thinks he may have found his answer in Ruyan.

“I was intrigued by this new technology,” said the pudgy, bespectacled Li as he surveyed products displayed in glass cases at Ruyan’s brightly-lit shop in the capital. “I heard acupuncture is effective as well, but this method sounds more painless.”

February, 2009|Oral Cancer News|

VELscope System Called the World’s Leading Oral Cancer Screening System

Source: LED Dental Inc

Writer: John Pohl

WHITE ROCK, British Columbia—February 27, 2009—LED Dental Inc. claimed today that its VELscope system is used for more oral cancer examinations than any other adjunctive technology in the world.

Impressive Milestones Passed

According to Dr. Ralph Green, president and CEO of LED Dental’s parent, LED Medical Diagnostics, “Since our mid-2006 launch, we have sold over 4,000 VELscope systems worldwide. Based on an independent survey of VELscope users, we estimate that these devices have been used to conduct over 4 million VELscope exams to date.” Dr. Green added, “What’s more, we estimate that over 3 million additional VELscope exams will be conducted in 2009 alone. Based on sales information reported by our leading competitor, it is clear that their product is currently being used for a much lower number of exams.”

Powerful Supporting Research

The tissue fluorescence visualization technology platform on which the VELscope system is based is the culmination of over $50 million in research funded by the National Institutes of Health and other respected institutions and conducted by such leading organizations as the British Columbia Cancer Agency and the University of Texas’s M.D. Anderson Cancer Center. Translating this highly sophisticated, breakthrough technology for use in an efficacious device to examine the oral mucosa was the brainchild of LED Dental and the British Columbia Cancer Agency. Launched in 2006 as the first tissue fluorescence device made commercially available to the dental community, the VELscope system revolutionized the dental practitioner’s ability to visualize the oral mucosal environment. A second-generation device featuring a more powerful lamp and several other advancements was introduced in 2008. The VELscope system remains the first and only device in widespread use that is cleared by the FDA and Health Canada to help dental practitioners discover tissue changes, including dysplasia and cancer, that might not be apparent to the naked eye, and to help surgeons determine the appropriate surgical margin when excising cancerous lesions.

The VELscope system’s regulatory clearances were based in part on three clinical studies conducted by researchers at the British Columbia Cancer Agency. The first, “Simple Device for the Direct Visualization of Oral Cavity Fluorescence,” was published in the Journal of Biomedical Optics in 2006. The second, “Fluorescence Visualization Detection of Field Alterations in Tumor Margins of Oral Cancer Patients,” was published in the prestigious Clinical Cancer Research journal in 2006. The third, “Direct Fluorescence Visualization of Clinically Occult High-Risk Oral Premalignant Disease Using a Simple Hand-Held Device,” was published in the equally prestigious Head & Neck journal in early 2007.

Since these original publications, the clinical research community has continued to show intense interest in clinical application of the VELscope fluorescence visualization system and its role in oral disease and oral cancer management. The British Columbia Cancer Agency has presented very exciting results on the performance of VELscope’s fluorescence visualization technology in helping detect oral cancer and pre cancer as part of a longitudinal study involving over 500 dysplasia patients. They also remain very strong proponents of the technology as a tool to help surgeons determine lesion margins and recently presented new data indicating that patients who underwent fluorescence-assisted lesion surgery have considerably fewer high risk lesions present at follow-up than a control group.

In addition, extensive clinical studies of the VELscope system are currently underway at such respected institutions as the University of Washington, the University of Chicago, Ohio State University, the Baylor College of Dentistry, Kings College in London and the University of Cologne.

Speaking about a recently completed but yet-to-be-published study at the University of Washington, Dr. Edmond Truelove, Chair of Oral Medicine at the university, disclosed to the New York Times that the VELscope system discovered 100% of the cases of moderate-to-severe dysplasia, versus only 68% for a conventional visual exam.

Outstanding Clinical Experiences Reported by Dentists

“While we are quite proud of the milestones we have achieved,” said Dr. Ralph Green, president and CEO of LED Dental’s parent, LED Medical Diagnostics, “we have just scratched the surface of the VELscope system’s potential.” Dr. Green added, “We know from user surveys that the VELscope exam is easy to administer, takes only two to three minutes, and is financially attractive for the practice. What’s more, patients find it very affordable and love the fact that no distasteful rinses or messy stains are required. Most important, clinicians are telling us that it’s helping them discover abnormal tissue that they otherwise would have missed. When you look at these simple facts, there is absolutely no reason why every dental practice should not have a VELscope system.”

Clinicians give the VELscope system high marks for the relative ease with which it can incorporated into dental practices. Said Dr. Green, “We believe that a big part of this is the fact that dentists can easily photo-document any suspect areas that need to be referred to a specialist for further observation and possible surgical biopsy.” In fact, the latest generation of the VELscope system comes with an adapter kit that makes it easy for the clinician to attach a digital camera to the VELscope hand-piece. No existing competitive products, including a new low-powered device now being introduced to the market, have this capability.

Dental Practices: The First Line of Defense

One hundred Americans develop oral cancer every day, and one American dies of the disease every hour of every day. Despite the fact that tobacco usage is declining, the rate of occurrence of oral cancer is actually increasing. This increase is widely attributed in large part to the spread of HPV-16, a strain of the sexually transmitted human papilloma virus strongly associated with oropharyngeal cancers. This has led many health experts to recommend that anyone old enough to have sex should receive an oral cancer exam at least once a year.

The need for regular exams is further supported by studies showing that the majority of oral cancers are discovered in late stages, when the five-year survival rate is 20-to-30%. When discovered in early stages, however, the survival rate leaps to 80-to-90%.

In the words of Brian Hill, founder of the widely-respected Oral Cancer Foundation, “Simply stated, early detection is the key to higher survival rates. And the only way that can possibly happen is if dental practices step up and start making opportunistic, comprehensive oral cancer exams a mandatory part of their annual and even semi-annual exams.” According to Mr. Hill, “The most essential step is a visual and tactile exam. When this exam is augmented by an adjunctive exam utilizing tissue fluorescence visualization, the opportunity for early discovery is increased. The conventional and adjunctive exams combined should take only six minutes or so, which is little to ask when you consider the potentially life-saving benefit provided to the patient.”

About LED Dental

LED Dental Inc. is a wholly-owned subsidiary of LED Medical Diagnostics Inc., which was founded in 2003 and is headquartered in White Rock, British Columbia, Canada. For more information, call +1 604 541-4614, or visit

February, 2009|OCF In The News, Oral Cancer News|

Current status and perspectives of brachytherapy for head and neck cancer

Source: Int J Clin Oncol, February 1, 2009; 14(1): 2-6
Author: H Shibuya

Brachytherapy delivers a high radiation dose to a limited volume while sparing surrounding normal tissues. In head and neck cancer, severe soft-tissue damage and bone damage to the mandible has decreased markedly since the introduction of computer dosimetry and the use of spacers during treatment. For the curative treatment of head and neck cancer, the selection of brachytherapy sources from among the several linear and small permanent implant sources available, not only according to the tumor site but also according to the patient’s physical and mental condition is important.

Following the successful treatment of early head and neck cancer by brachytherapy, two major problems and one minor problem may confront the physician. The major problems are neck node metastasis and a second primary cancer of the respiratory tract or upper digestive tract, and the minor problem is radiation-induced cancer.

Author’s affilation:
Department of Radiology, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

February, 2009|Oral Cancer News|

Drink a day increases cancer risk

Source: BBC News

A glass of wine each evening is enough to increase your risk of developing cancer, women are being warned.

Consuming just one drink a day causes an extra 7,000 cancer cases – mostly breast cancer – in UK women each year, Cancer Research UK scientists say.

The risk goes up the more you drink, whether spirits, wine or beer, the data on over a million women suggests.

Overall, alcohol is to blame for about 13% of breast, liver, rectum, mouth and throat cancers, the researchers say.

They estimate that about 5,000 cases of breast cancer in the UK – 11% of the 45,000 cases diagnosed each year – can be attributed to women’s consumption of alcohol.

The study looked specifically at women who consumed low to moderate levels of alcohol – defined as three drinks a day or fewer.

Over the seven years of the study, published in the Journal of the National Cancer Institute, a quarter of the 1.3 million women reported drinking no alcohol.

Of those who did drink, virtually all consumed fewer than 21 drinks per week, and an average of 10g of alcohol per day, which is equivalent to just over one unit of alcohol found in half a pint of lager, a 125ml glass of wine or a single measure of spirits.

Nearly 70,000 of the middle-aged women developed cancer and a pattern emerged with alcohol consumption.

One too many?

Consuming one drink a day increased the risk of all types of cancer by 6% in women up to the age of 75.

The rates for individual cancers varied, with one drink a day causing a 12% rise in the risk of breast cancer, a 10% rise in rectal cancer, a 22% rise in gullet cancer, a 29% rise in mouth cancer and a 44% rise in throat cancer. On a population scale, this would mean 15 extra cases of these cancers diagnosed for every 1,000 women – comprising 11 breast, one mouth, one rectal cancer and 0.7 each for cancers of the gullet, throat and liver.

The government says no amount of alcohol is fully safe, but recommends women should drink no more than two to three units per day on a regular basis to have a lower risk of any harm to health.

For men the recommended limit is no more than three to four units per day.

Mixed messages

Lead author Dr Naomi Allen from the University of Oxford said her work would help the government assess whether the limits should be changed, although the study did not look at men.

“The findings of this report show quite strongly that even low levels of drinking that were regarded to be safe do increase cancer risk.

“About 5% of all cancers in the UK are due to drinking something in the order of one alcoholic drink a day.”

She said there was confusion about how much people should drink. Research has shown a daily tipple can be good for the heart. And factors other than alcohol pose a bigger risk for certain cancers.

“It is up to individual people to make their own decision. All of us to some extent have to weigh up the risks and take some responsibility for our health,” said Dr Allen.

A Department of Health spokesman said: “We keep our guidance on sensible drinking under review. We currently advise on a lower risk drinking limit and that drinking above this level could be harmful.

“There is no completely safe level of drinking but this lower level reflects the known risks including breast cancer, which is partly why there is a lower drinking limit for women.

“We look forward to examining this research in more detail.”

Dr Sarah Cant of Breakthrough Breast Cancer said: “We already know that drinking alcohol can increase your risk of breast cancer.

“This study suggests that for women over 50 even drinking moderate amounts of any type of alcohol can have many health consequences, including a greater chance of developing breast cancer.

“Around 80% of breast cancer cases are diagnosed in women aged over 50, so limiting how much you drink is one step you can take to try to reduce your risk of developing the disease.”

Breast cancer is now the most common cancer in the UK. Each year almost 45,000 women are diagnosed with breast cancer. A woman’s lifetime risk for breast cancer in the UK is one in nine.

February, 2009|Oral Cancer News|

Calcium tied to lower cancer risk in older people

Author: staff

A study in nearly half a million older men and women bolsters evidence that diets rich in calcium may help protect against some cancers. The benefits were mostly associated with foods high in calcium, rather than calcium tablets.

Previous studies have produced conflicting results. The new research involved food questionnaires from participants and a follow-up check of records for cancer cases during the subsequent seven years. This research method is less rigorous than some previous but smaller studies.

But because of its huge size — 492,810 people and more than 50,000 cancers — the new study presents powerful evidence favoring the idea that calcium may somehow keep cells from becoming cancerous, said University of North Carolina nutrition expert John Anderson, who was not involved in the study.

The study was run jointly by the National Institutes of Health and AARP. The results appear in Monday’s Archives of Internal Medicine.

National Cancer Institute researcher Yikyung Park, the study’s lead author, called the results strong but said more studies are needed to confirm the findings.

Duke University nutrition researcher Denise Snyder said the results support the idea that food rather than supplements is the best source for nutrients.

Participants were AARP members aged 50 to 71 who began the study in the mid-1990s. A total of 36,965 men and 16,605 women were later diagnosed with cancer. There were more than 10 different kinds of cancer, the most common being prostate, breast, lung and colorectal.

Compared with people who got little calcium, those who consumed the most had the lowest chances of getting colon cancer. Those in that highest category got on average 1,530 milligrams a day among men and 1,881 milligrams daily among women. The recommended amount for older people is 1,200 milligrams, and getting much more than that didn’t result in any greater protection. Adults can get that amount from four cups of milk or calcium-fortified orange juice.

Men who got the most calcium from food were about 30 percent less likely to get cancer of the esophagus, about 20 percent less likely to get head and neck cancer and 16 percent less likely to get colon cancer, when compared to men who got low amounts of calcium.

Among women, those who got the most food-based calcium were 28 percent less likely to get colon cancer than low-calcium women.

In men, calcium supplements only seemed to help protect against colon cancer; for women, supplements meant a lower risk for liver cancer, which is rare.

Some previous studies have linked diets high in calcium with prostate cancer but the current study found no such risk. Adults who ate the most calcium also tended to be healthier overall than the others.

Northwestern University preventive medicine instructor Patricia Sheean called the results impressive. But she noted that all those in the study, AARP members, may have been healthier and wealthier than the general US population so it’s not clear if the results would apply to the wider population.

February, 2009|Oral Cancer News|

More evidence links alcohol, cancer in women

Author: staff

A study of nearly 1.3 million British women offers yet more evidence that moderate alcohol consumption increases the risk of a handful of cancers. British researchers surveyed middle-aged women at breast cancer screening clinics about their drinking habits, and tracked their health for seven years.

A quarter of the women reported no alcohol use. Nearly all the rest reported fewer than three drinks a day; the average was one drink a day. Researchers compared the lightest drinkers – two or fewer drinks a week – with people who drank more.

Each extra drink per day increased the risk of breast, rectal and liver cancer, University of Oxford researchers reported Tuesday in the Journal of the National Cancer Institute. The type of alcohol – wine, beer or liquor – didn’t matter.

That supports earlier research, but the new wrinkle: Alcohol consumption was linked to esophageal and oral cancers only when smokers drank.

Also, moderate drinkers actually had a lower risk of thyroid cancer, non-Hodgkin’s lymphoma and renal cell cancer.

For an individual woman, the overall alcohol risk is small. In developed countries, about 118 of every 1,000 women develop any of these cancers, and each extra daily drink added 11 breast cancers and four of the other types to that rate, the study found.

But population-wide, 13 percent of those cancers in Britain may be attributable to alcohol, the researchers concluded.

Moderate alcohol use has long been thought to be heart-healthy, something the new research doesn’t address but that prompts repeated debate about safe levels. U.S. health guidelines already recommend that women consume no more than one drink a day; two a day for men, who metabolize alcohol differently.

“You have to balance all those things out,” said Dr. Philip J. Brooks, who researches alcohol and cancer at the National Institutes of Health. “This kind of information is important for people to know and to consult with their physician about the various risk factors they have.”

February, 2009|Oral Cancer News|

Department of Defense tackles tough task in separating fact from fiction about smokeless tobacco

Author: staff

The hard truth about smokeless tobacco is hardly classified intelligence, but sorting out reality versus fantasy takes some maneuvering amid the mountain of information–and misinformation–that abounds.

In observance of the Great American Spit Out, Feb. 19, and Through With Chew Week, Feb. 15 through 21, the U.S. Department of Defense is targeting smokeless tobacco as part of its Quit Tobacco–Make Everyone Proud tobacco cessation campaign. At the campaign’s official Web site,, there’s accurate and easy-to-digest information that sets the record straight on smokeless–spit, chewing, snuff and “dip”– tobacco.

Debunking the myths

Myth: Smokeless tobacco products are a safe alternative to tobacco smoking.
Fact: Here is the bottom line–smokeless is not harmless. The list of serious illnesses connected to any form of smokeless tobacco is almost too long to print, but includes mouth cancer, cancer of the pancreas, tooth loss, and bone loss around the roots of teeth.

Myth: Smokeless tobacco contains less nicotine than cigarettes.
Fact: The amount of nicotine absorbed from a can of spit tobacco is equal to the amount delivered by three to four packs of cigarettes. Nicotine is absorbed more slowly from smokeless tobacco than from cigarettes, but more nicotine per dose is absorbed from smokeless tobacco than from cigarettes. Also, the nicotine stays in the bloodstream longer.

Myth: Nicotine and all the other poisons disappear when you spit out the tobacco.
Fact: When chewers place snuff or smokeless tobacco in their mouth, cheek, or lip, they give nicotine a free pass to do its nasty thing. A high dose of nicotine enters the bloodstream and is then carried throughout the body. It takes its toll on many parts of the body, including the heart and blood vessels, hormones, metabolism, and brain.

Myth: A little dip or chew won’t hurt–it’s a harmless habit!
Fact: Even a little smokeless tobacco has enough nicotine in it to get a user hooked, if he keeps using it. Smokeless tobacco contains nicotine, the same drug that makes cigarettes addictive. Holding an average size dip or chew in the mouth for 30 minutes delivers as much nicotine as about three cigarettes. Some smokeless tobacco users sleep with it in their mouths so they keep getting nicotine through the night. That’s an addiction, not a habit.

Myth: Smokeless tobacco use will improve your social and romantic life.
Fact: Just the opposite! Chewing and dipping carry a heavy social price, especially when it comes to dating. Bad breath, ugly gum disease, and stained teeth are universally unappealing. The bulging cheeks, gunk stuck in the mouth, and spitting required by most smokeless tobacco is hardly date-bait. Surgery for oral cancer can result in removal of parts of the face, tongue, cheek or lip, a difficult scenario for a great love connection.

Myth: Americans are getting the message that smokeless does not equal harmless.
Fact: If grades were given for this sort of thing, the Nation’s spit tobacco grade would be a barely passing grade of “D.” Rates of spit tobacco use by high school males are high. Nationally, about one in seven high school males currently use spit or smokeless tobacco products, and in some states that number is one out of four.

For the total DoD male population, the rate of smokeless tobacco use is 21.6 percent, significantly exceeding the rate in the general population.

Myth: If you spit for five years or less you won’t get cancer or heart disease.
Fact: Research reported at the Mayo Clinic and other well-respected organizations indicates that any amount of smokeless tobacco use is dangerous, regardless of whether it’s used for a few years or a decade. Smokeless tobacco users have a greater risk for oral cancer than non-users. Oral cancer can form in as little as five years of regular use.

Myth: Smokeless tobacco is easy to give up–you can quit any time you want to.
Fact: Since smokeless tobacco contains nicotine, it’s as addictive as a cigarette, and users will experience the same withdrawal symptoms. These are usually strongest the first week after quitting. The worst is over after two weeks.

Help is available for those ready to give up smokeless tobacco. The DoD has an innovative array of high-tech tools and personalized resources to assist enlisted personnel get tobacco-free at

February, 2009|Oral Cancer News|

Genetic signatures of HPV-related and unrelated oropharyngeal carcinoma and their prognostic implications

Source: Clinical Cancer Research, 10.1158/1078-0432
Authors: Jens P. K et al.

Patients with human papillomavirus (HPV)-containing oropharyngeal squamous cell carcinomas (OSCC) have a better prognosis than patients with HPV-negative OSCC. This may be attributed to different genetic pathways promoting cancer.

Experimental Design:
We used comparative genomic hybridization to identify critical genetic changes in 60 selected OSCC, 28 of which were associated with HPV-16 as determined by HPV-specific PCR and fluorescence in situ hybridization analysis and positive p16INK4A immunostaining. The results were correlated with HPV status and clinical data from patients.

Two thirds of OSCC harbored gain at 3q26.3-qter irrespective of HPV status. In HPV-negative tumors this alteration was associated with advanced tumor stage (P = 0.013). In comparison with HPV-related OSCC, the HPV-negative tumors harbored: (a) a higher number of chromosomal alterations and amplifications (P = 0.03 and 0.039, respectively); (b) significantly more losses at 3p, 5q, 9p, 15q, and 18q, and gains/amplifications at 11q13 (P = 0.002, 0.03; <0.001, 0.02, 0.004, and 0.001, respectively); and (c) less often 16q losses and Xp gains (P = 0.02 and 0.03). Survival analysis revealed a significantly better disease-free survival for HPV-related OSCC (P = 0.02), whereas chromosome amplification was an unfavorable prognostic indicator for disease-free and overall survival (P = 0.01 and 0.05, respectively). Interestingly, 16q loss, predominantly identified in HPV-related OSCC, was a strong indicator of favorable outcome (overall survival, P = 0.008; disease-free survival, P = 0.01) and none of these patients had a tumor recurrence.

Genetic signatures of HPV-related and HPV-unrelated OSCC are different and most likely underlie differences in tumor development and progression. In addition, distinct chromosomal alterations have prognostic significance.

Jens P. Klussmann 1, Jeroen J. Mooren 5, 6, Martin Lehnen 1, Sandra M.H. Claessen 5, Markus Stenner 1, Christian U. Huebbers 1, 3, Soenke J. Weissenborn 5, Inga Wedemeyer 2, Simon F. Preuss 1, Jos M.J.A.A. Straetmans 6, Johannes J. Manni 6, Anton H.N. Hopman 5, Ernst-Jan M. Speel 5

Authors affiliations:
1. Departments of Oto-Rhino-Laryngology, Head and Neck Surgery, and
2 Pathology,
3 Jean-Uhrmacher Institute,
4 Institute of Virology, University of Cologne, Cologne, Germany; and Departments of
5 Molecular Cell Biology and
6 Otorhinolaryngology, Head and Neck Surgery, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands

February, 2009|Oral Cancer News|

Deadly in pink: new report warns big tobacco has stepped up targeting of women and girls

Author: staff

The tobacco industry has unleashed its most aggressive marketing campaigns aimed at women and girls in over a decade, according to a report issued today by a coalition of public health organizations. The report warns that these new marketing campaigns are putting the health of women and girls at risk and urges Congress to regulate tobacco marketing by passing legislation granting the U.S. Food and Drug Administration (FDA) authority over tobacco products.

The report, “Deadly in Pink: Big Tobacco Steps Up Its Targeting of Women and Girls,” was issued by the American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Robert Wood Johnson Foundation and Campaign for Tobacco-Free Kids. The report and images of the tobacco marketing campaigns can be found at

In the last two years, the nation’s two largest tobacco companies—Philip Morris USA and R.J. Reynolds—have launched new marketing campaigns that depict cigarette smoking as feminine and fashionable, rather than the harmful and deadly addiction it really is:

  • In October 2008, Philip Morris USA announced a makeover of its Virginia Slims brand into “purse packs”—small, rectangular cigarette packs that contain “superslim” cigarettes. Available in mauve and teal and half the size of regular cigarette packs, the sleek “purse packs” resemble packages of cosmetics and fit easily in small purses. They come in “Superslims Lights” and “Superslims Ultra Lights” versions, continuing the tobacco industry’s history of associating smoking with weight control and of appealing to women’s health concerns with misleading claims such as “light” and “low-tar.”
  • In January 2007, R.J. Reynolds launched a new version of its Camel cigarettes, called Camel No. 9, packaged in shiny black boxes with hot pink and teal borders. The name evoked famous Chanel perfumes, and magazine advertising featured flowery imagery and vintage fashion. The ads carried slogans including “Light and luscious” and “Now available in stiletto,” the latter for a thin version of the cigarette pitched to “the most fashion forward woman.” Ads ran in magazines popular with women and girls, including Vogue, Glamour, Cosmopolitan, Marie Claire and InStyle. Promotional giveaways included flavored lip balm, cell phone jewelry, tiny purses and wristbands, all in hot pink.

These new marketing campaigns are the latest chapter in the tobacco industry’s long history of targeting women and girls, which has had a devastating impact on women’s health. The nation’s latest cancer statistics, released in December 2008, showed that while lung cancer death rates are decreasing for men—and overall cancer death rates are decreasing for both men and women—lung cancer death rates have yet to decline for women.

Lung cancer is the leading cancer killer of women, having surpassed breast cancer in 1987, and smoking puts women and girls at greater risk of a wide range of deadly diseases, including heart attacks, strokes, emphysema and numerous cancers.

“These new marketing campaigns by Philip Morris and R.J. Reynolds show contempt for the health of women and girls,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. “The tobacco industry’s aggressive marketing demands an equally aggressive response from our nation’s elected leaders. By granting the FDA authority over tobacco products, the Congress can crack down on the industry’s most harmful practices.”

Despite being the nation’s number one cause of preventable death, tobacco products currently are virtually exempt from regulation. U.S. Rep. Henry Waxman (D-CA) and U.S. Sen. Edward Kennedy (D-MA) are expected to soon reintroduce legislation granting the FDA authority over tobacco products. This legislation would:

  • Restrict tobacco marketing that appeals to children.  Among other things, the bill would restrict tobacco advertising in stores and in publications with significant teen readership to black-and-white text only. It would ban all remaining tobacco industry sponsorships of sports and entertainment events. The FDA and states would gain new authority to further restrict tobacco marketing.
  • Ban misleading health claims such as “light” and “low-tar” and strictly regulate all health claims about tobacco products. The tobacco companies often have targeted misleading health claims specifically to women.
  • Require larger, more effective health warnings on tobacco packages and advertising. In addition to better informing consumers, these warnings would reduce the effectiveness of the cigarette pack itself as a marketing tool. Pack design has been a critical part of the marketing campaigns for Camel No. 9 and the Virginia Slims “purse packs.”
  • Require tobacco companies to disclose the contents of their products, as well as changes in products and research about their health effects.
  • Grant the FDA authority to require changes in new and existing tobacco products to protect public health, such as the reduction or removal of harmful ingredients.

“Big Tobacco’s blatant targeting of women is just an extension of a decades-long campaign of fraud and deception designed to addict children and adults to its deadly products,” said John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN). “Congress must empower the FDA to regulate tobacco products to put a stop to the harmful practices of an industry that has had free reign for far too long.”

“This report is a sober reminder that the tobacco industry has become more aggressive in marketing deadly products to women,” said Nancy Brown, CEO, American Heart Association. “Hip and trendy packages cannot disguise the health hazards of smoking and the risk for heart disease and stroke. We must give the Food and Drug Administration the authority to rein in the industry’s relentless campaign to manipulate young women with products that send the wrong message.”

“These findings exemplify the urgent need for the Congress to act quickly to provide the FDA regulatory authority over tobacco products,” said Charles D. Connor, president and CEO of the American Lung Association. “Until then, we leave girls and young women vulnerable to Big Tobacco’s predatory marketing practices.”

“It is unconscionable for tobacco companies to market these lethal products to women and equate them with fashion, femininity and independence,” said Risa Lavizzo-Mourey, M.D.,M.B.A., president and CEO of the Robert Wood Johnson Foundation. “Virtually all lung cancer deaths and a large portion of heart disease, two of the leading killers of women, are caused by smoking. We must redouble all our efforts to rein in tobacco industry marketing of these deadly products to our young women and girls.”

In addition to the latest marketing campaigns, the report released today describes the tobacco industry’s long history of targeting women and girls. In the 1920s, ads for Lucky Strike cigarettes first linked smoking to weight control by urging women to “Reach for a Lucky instead of a sweet.” In the 1960s, Philip Morris introduced Virginia Slims, the first cigarette brand created specifically for women, and launched the “You’ve come a long way, baby” marketing campaign that linked smoking to women’s liberation. In the 1970s, tobacco companies responded to women’s growing concerns about the health risks of smoking by targeting with them ads implying that “light” and “low-tar” cigarettes were safer, despite knowing this was not the case.

The result is that, today, smoking is the leading cause of preventable death among women, killing more than 170,000 women in the U.S. each year. In addition to the well-known risk of lung cancer, women who smoke double their risk of coronary heart disease, which is the overall leading cause of death among both women and men. More women than men now die from chronic obstructive pulmonary disease, which is caused primarily by smoking and has become the fourth leading cause of death in the U.S.

In the U.S. as a whole, tobacco use kills more than 400,000 people and costs the nation $96 billion in health care bills each year. About 90 percent of adult smokers start in their teens or earlier. Every day, another 1,000 kids become regular smokers, and one-third of them will die prematurely as a result.

February, 2009|Oral Cancer News|

Tempest in a bottle of mouthwash

Author: staff

It’s a ritual observed by thousands of Canadians every day: brush, floss, gargle and spit. Rinsing with mouthwash doesn’t just provide a scrubbed, minty feeling; it’s good for our health, we’re told, curbing plaque and gingivitis (not to mention bad breath). Some brands even carry the Canadian Dental Association’s official seal. But this so-called healthy habit could be doing more harm than good. Australian researchers recently concluded that mouthwashes containing alcohol may contribute to oral cancer.

Tobacco use is the biggest risk factor for oral cancer, according to the Canadian Cancer Society. Combined with excessive drinking, it’s even more dangerous—a heavy smoker and drinker is up to 30 times more likely to develop it. Even so, “there’s a small group of patients who don’t seem to have any risk factors,” says Michael John McCullough, an associate professor at the Melbourne Dental School and one of the experts behind the report. “I noticed some were saying they’d used alcohol-containing mouthwashes over a long period of time.”

In the article, published in the Australian Dental Journal in December, McCullough and co-author Camile Farah conclude there is now “sufficient evidence” to suggest these mouthwashes are a contributing factor. Not only does alcohol seem to make the mouth’s cells more vulnerable to cancer-causing agents, McCullough says “its first breakdown product is acetaldehyde, a known human carcinogen.” While alcohol is mostly metabolized in the liver, they argue the breakdown process actually begins in the oral cavity. “Excessive mouthwash use, over a long period of time, will increase the amount of acetaldehyde in the mouth,” McCullough says.

His hypothesis is nothing new: experts have raised the possibility these mouthwashes could be a cancer risk for over two decades. A 2007 study in the American Journal of Epidemiology, for instance, concluded that daily mouthwash use was a risk factor for head and neck cancer, independent of tobacco or alcohol consumption (McCullough draws on this study in his paper). A 2008 study of patients in Brazil linked its daily use to oral cancer.

Many of the blue and green bottles on store shelves contain more alcohol than wine or beer. Scope Original Mint is 15 per cent alcohol, for example, while Listerine Fresh Burst—the company’s most popular mouthwash—is 22 per cent. Alcohol is included as a solvent for active ingredients and flavours, preservative, and antiseptic, says Melissa Karis of Procter & Gamble Canada. (Some, like Crest Pro-Health Rinse, do not contain alcohol.)

McCullough’s paper has been, to put it mildly, controversial. Soon after it was published, Laurence Walsh, a professor of dental science at the University of Queensland, fired back in a letter to the ADJ: “There is no doubt that the real villain in the oral cancer story is ingested alcohol from beverages.” Alcoholic drinks create “prolonged and repeated exposures,” while mouthwash is swished around the mouth for seconds only, he writes. Walsh also found several flaws in the 2007 study McCullough cites in his review, ranging from “inconsistent questionnaires” to limited data.

Sol Silverman, a professor of oral medicine at the University of California, San Francisco, believes alcohol-containing mouthwashes are safe for everyone except children and recovering alcoholics. Not only did the U.S. Food and Drug Administration take a look at them over 10 years ago; the theory that acetaldehyde is produced in the mouth is “speculation,” he says. Finally, he adds, the Australian paper was a review of previous research, and contains no new data.

Mouthwash makers have also moved to defend their product. Gerry Wright is senior director, regulatory affairs for Johnson & Johnson Inc., which manufactures Listerine, Canada’s leading brand. He calls Listerine “the most extensively tested mouthwash in the world, with over 30 well-controlled studies demonstrating its safety,” and notes that it’s been used “by over one billion people for more than 100 years.” Even the Australian Dental Association, publisher of the ADJ, quickly distanced itself from McCullough’s paper, and continues to give its Seal of Approval (which promotes oral health products to consumers) to several mouthwashes that contain alcohol. The Canadian and American Dental Associations do the same. The CDA’s committee on clinical and scientific affairs will take a closer look at the Australian review at a future meeting, says Euan Swan, the CDA’s manager of dental programs. For now, though, “if people are using an alcohol-based mouthwash, there’s no reason to stop.”

Others are not so sure. Dr. Martin Corsten is chairman of the department of otolaryngology at the Ottawa General Hospital. “I think it would be reasonable to avoid alcohol-containing mouthwashes, especially if you smoke,” he says. But Swan insists that old bathroom routine—brush, floss, gargle, spit—is perfectly safe: “I have Listerine at home, and I use it.”

February, 2009|Oral Cancer News|