Monthly Archives: May 2011

High risk of developing ONJ for cancer patients on bisphosphonates

Source: Dr.Bicuspid.com

Research has shown that cancer patients on bisphosphonates are at risk of developing osteonecrosis of the jaw (ONJ) and that those on the intravenous form of the drug are at a higher risk compared with those on the oral drugs.

However, a new study that looked at cancer patients on zoledronic acid (ZOL) and chemotherapy combined with the antiangiogenic agent bevacizumab (BEV) who underwent a dental exam before starting treatment found that none of them developed ONJ (JADA, May 2011, Vol. 142:5, pp. 506-513).

Researchers from the University of Siena in Italy investigated the incidence of and risk factors for ONJ in patients with metastases to the bone from solid tumors who received ZOL and BEV.

Their study included 59 patients (34 with breast cancer and 25 with non-small cell lung cancer [NSCL]) who received 4 mg of ZOL intravenously every four weeks and 15 mg per kg of BEV every three weeks. The median time the participants received ZOL therapy was 18 months, while the median time participants received BEV therapy was 16 months.

The researchers took several measures to reduce the study participants’ risk of developing ONJ, including the following:

  • Dental caries and periodontal disease were treated before starting study treatment.
  • Mouth rinses with chlorhexidine and local antibiotic agents were administered before baseline oral hygiene.
  • Recommendations were made for maintaining good oral hygiene.
  • Teeth were extracted at least four weeks before starting ZOL and BEV therapy.
  • Invasive dental procedures were avoided during treatment.
  • If invasive dental procedures were needed during treatment, ZOL and BEV were readministered after at least four weeks.

All the patients received a dental exam and panoramic x-rays before starting treatment and every three months until the patients died or were lost to follow-up. After a median follow-up period of 19 months, none of the study participants had developed ONJ.

“The number of patients investigated in this study is too low to make meaningful conclusions.”
— Tanja Fehm, MD

“Despite the fact that new and potent antiangiogenic therapies theoretically might enhance the antiangiogenic effects of ZOL on bone tissue, our findings do not indicate a trend of a higher incidence of BRONJ [bisphosphonate-related ONJ] in patients receiving ZOL and BEV,” the authors noted. “Nevertheless, evidence showing that antiangiogenesis is the main underlying mechanism of BRONJ still is lacking.”

They also noted that the preventive dental measures taken before the start of treatment could have contributed to the fact that none of the participants developed ONJ.

After the baseline dental exam, seven of the study participants needed tooth extractions, which were done before they started taking ZOL and BEV.

The participants avoided undergoing other dentoalveolar surgical procedures while they were receiving treatment, probably owing to the baseline preventive dental examination and the follow-up examinations, indicating that a dental exam prior to therapy can minimize the risk of developing ONJ, the authors noted.

“Although further research is needed, the results of our study suggest that ZOL combined with the antiangiogenic agent BEV does not predispose patients with metastases to the bone from breast and NSCL cancer to ONJ if they undergo a baseline dental examination,” they concluded. “Nevertheless, the results of the study must be considered in the context of the follow-up period used in the study and the use of the preventive dental protocol.”

Tanja Fehm, MD, from the department of obstetrics and gynecology at the University of Tübingen in Germany, has done similar research (Gynecologic Oncology, March 2009, Vol. 112:3, pp. 605-609). She told DrBicuspid.com that the incidence of ONJ is low — between 1% and 4% — in metastatic breast cancer patients receiving bisphosphonates.

“Therefore, the number of patients (59) investigated in this study is too low to make meaningful conclusions,” she added. “However, the paper summarizes the preventive measures that can help avoid ONJ.”

James Berenson, MD, from the Institute for Myeloma & Bone Cancer Research has also done similar research (American Journal of Hematology, January 2011, Vol. 86:1, pp. 25-30) and agreed that this study was too small. He also felt the follow-up period was too short for any conclusive results.

Meanwhile, the study authors hope that these results help general dentists, oral surgeons, and oncologists in their efforts to prevent ONJ and identify at-risk patients by means of careful baseline and follow-up dental examinations.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

FDA to regulate cigarette pack labeling

Source: Dr.Bicuspid

May 19, 2011 — Cigarette manufacturers have deceived consumers about the risks of their products for years, and remedial actions are needed so consumers can make informed decisions about the products they purchase, according to researchers from the Roswell Park Cancer Institute (RPCI).

The researchers evaluated the messages that cigarette pack labels convey to smokers and nonsmokers, and their findings will be published in three studies in an upcoming issue of the American Journal of Preventive Medicine (June 2011, Vol. 40:6, pp. 674-698).

“Tobacco companies have used attractive packaging and persuasive images to market their products for decades,” said lead author Maansi Bansal-Travers, PhD, a behavioral research scientist at RPCI, in a press release. “These studies support efforts by the [U.S. Food and Drug Administration] to regulate cigarette pack labeling.”

Tobacco manufacturers have effectively used cigarette pack design, colors, and descriptive terms to create the illusion that filtered and so-called light/mild cigarettes are safer than unfiltered and full-flavor cigarettes, when this is not the case.

Beginning in June 2010, regulations contained in the Family Smoking Prevention and Tobacco Control Act have prohibited tobacco companies from using descriptive terms such as “light,” “mild,” or “low” in advertising and on cigarette packaging.

“While the removal of these obviously misleading terms was a good first step, we discovered that cigarette manufacturers have circumvented the regulation by using different terms such as ‘gold’ and ‘silver’ and changing the colors on packs to continue to mislead consumers about their products,” Bansal-Travers said.

The first study, titled “What Do Cigarette Pack Colors Communicate to Smokers in the U.S.?” found that both colors and descriptors are perceived by smokers to communicate health-risk information. The authors recommend that color coding be restricted in the same way that descriptors have been to reduce consumer misperceptions.

A second study, “The Impact of Cigarette Pack Design, Descriptor, and Warning Labels on Risk Perception in the U.S.,” found that larger graphic health warnings that convey negative messages are the most effective in communicating health risks to adults and that packs with descriptors such as “smooth” or “silver,” or in specific colors, misleadingly conveyed lower health risks to consumers. Manufacturers should be barred from using any labeling that might be misperceived by consumers, and all cigarettes should be sold in standardized plain packs, the authors concluded.

The third study, “Correcting Over 50 Years of Tobacco Industry Misinformation,” analyzed proposed corrective statements required by U.S. federal court in the Department of Justice case against cigarette manufacturers. The authors found that the proposed corrective statements were effective in correcting false beliefs about smoking and health. The authors also recommend that these statements be printed on cigarette packs and at the point of sale.

“These studies reveal how consumers are likely to respond to government-mandated changes in package labeling and offer insights and recommendations about how to correct decades of misleading product marketing, so that consumers can make more informed choices about the products they purchase,” concluded K. Michael Cummings, PhD, chair of the department of health behavior at RPCI.


This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Touched by another human’s touch

Source: www.latimes.com
Author: Itzhak Brook, M.D.

I was deeply shaken to learn I had hypopharyngeal cancer. As a physician, I had access to my hospital’s laboratory results, so I took a shortcut: Rather than wait for my surgeon to call me, I looked for my name in my hospital’s pathology laboratory log book.

After my name, the log book stated in no uncertain terms: “mildly differentiated squamous cell carcinoma.”

I could not believe my eyes. Was this possible? Could it be a mistake? In spite of the hopeful questions that permeated my mind, I knew it was not a mistake: Right here, in front of me, in black and white — my own death sentence. Still, to be convinced that the diagnosis was real, I had to view the biopsy specimens under the microscope myself — and there it was.

In that very instant, my whole world changed. I had always had a sense of invulnerability. Now I was left with uncertainty about my prognosis and future.

I was in a state of desperation and disbelief when I left the pathology laboratory and walked into my internist’s office to break the news to him. He slowly got out of his chair without uttering a word and gave me a big, supportive hug.

It felt so good to know that he deeply cared for me beyond our professional relationship. His embrace moved me — made me feel that I was surrounded by those who truly appreciated my pain and distress, and who shared my personal tragedy. It meant much more at that moment than a thousand words of support or elaborate explanations.

It was the power of a caring, human touch. I knew that I was not alone in my future struggles, that he would be beside me all the way.

I had never been hugged by a medical caregiver. Nor had I given a hug to a patient: I always believed in maintaining a professional distance between them and me. Yet at that moment, I learned there may be situations in medical practice where the power of a hug eclipses everything else one can offer.

In the realm of modern medicine, where machines and tests often substitute for close patient-physician contact, this fundamental art is often forgotten. Even a simple pat on the shoulder or a warm handshake conveys genuine care and concern. In fact, there is scientific evidence that human touch can generate oxytocin and endorphins, which ameliorate pain and create a feeling of well-being.

Unfortunately, I had to undergo a total laryngectomy to have my cancer removed. The period after my surgery was very physically and emotionally trying, as I battled numerous medical problems and also struggled to regain my ability to speak. What eased those difficult months was the knowledge that my otolaryngologist’s door was always open to me and that he would act immediately to assist me in any way he could. His dedication, emotional support, sincere care and friendliness helped me overcome many of the difficulties and problems I encountered. They were indispensable on my road to recovery.

I sometimes went to his office several times a week — often just to talk with him and tell him how I was doing. I always felt welcomed. He greeted me with a big smile and hugged me every time I left. This simple act created a bond of intimacy between us and made me feel that I had a friend.

My personal experiences changed my attitude toward my own patients. I am less concerned now about maintaining a professional distance or avoiding a caring touch or hug when appropriate. I have learned that such gestures can significantly deepen the healing relationship between patient and physician.

As a laryngectomee, I have found that speaking is often difficult and challenging. So I am fortunate to have discovered that the “power of a hug” can convey so much more than the spoken word.

About the author:
Brook is a pediatric infectious disease physician at Georgetown University in Washington, D.C. He is the author of the 2010 book “My Voice: A Physician’s Personal Experience With Throat Cancer.” More at dribrook.blogspot.com.

Boys and HPV Vaccine: The Facts

Source: Forbes Magazine

CNN reports on a study that argues that boys should get vaccinated for the human papilloma virus (HPV), which causes cervical cancer in women. But it misses the main reason that boys should be getting jabs of either Merck‘s Gardasil or GlaxoSmithKline’s rival Cervarix. Cue CNN:

Men also carry the human papillomavirus, the virus that can lead to male cancers and genital warts. And they could spread HPV to their sexual partners, putting those people at risk for cervical cancer.

So the HPV vaccine, that is often recommended for girls, should extend to boys as well, say researchers from Innsbruck Medical University in Austria. Their study was presented at the meeting of the American Urological Association on Tuesday.

….

In the study, Dr. Michael Ladurner Rennau and his colleagues tested 133 men, between 7 months to 82 years old for the presence of HPV, one of the most common sexually transmitted infections. They used DNA extraction. They found 18.8% of the examined foreskins had the low-risk HPV genotypes and 9.77% had the high-risk HPV.

via Males should get HPV vaccine too, study says – The Chart – CNN.com Blogs.

Of course, the reason there’s not a big push to vaccinate men for HPV is because genital warts are treatable and penile and anal cancers are rare. And saying, “Let’s vaccinate your son so that the women he sleeps with won’t get HPV” is an uncomfortable and probably unconvincing approach for pediatricians to take with parents. Girls — the ones who might get cervical cancer — aren’t being vaccinated in overwhelming numbers.

But men are at risk for another cancer that is caused by HPV — cancer of the tonsils. The data aren’t entirely clear, but it appears that on the order of 11,400 cases of HPV-caused tonsil cancer are occurring annually, mostly in men. That compares to 12,000 cases of cervical cancer annually. These numbers are a bit fuzzy, because scientists have only just started studying the frequency of HPV infection in men, but it’s clear that HPV-caused tonsil cancer is becoming more common at a dramatic rate. Cases could double in just a few years.

The good news is that HPV-caused tonsil cancer is less deadly than traditional forms of head and neck cancer. But it can still kill. Take this patient, who I wrote about a year ago (see: The Cancer-Causing Sex Virus)

Martin Duffy, a Boston consultant and economist, thought he just had a sore throat. When it persisted for months he went to the doctor and learned there was a tumor on his tonsils.

Duffy, now 70, had none of the traditional risk factors for throat cancer. He doesn’t smoke, doesn’t drink and has run 40 Boston Marathons. Instead, his cancer was caused by the human papilloma virus (HPV), which is sexually transmitted and a common cause of throat and mouth cancer.

HPV tumors have a better prognosis than those caused by too many years of booze and cigarettes. But Duffy “is in the unlucky 20%” whose cancer comes back, despite rounds of chemotherapy and radiation that melted 20 more pounds off a lean 150-pound frame. Now the cancer has spread throughout his throat, making eating and talking difficult. “I made my living as a public speaker,” he says. “Now I sound like Daffy Duck.” Duffy believes he has only a few months left. “How do you tell the people you love you love them?” he asks.

Let’s be clear:  the most common route for HPV transmission to men’s throats is performing oral sex on women. But the virus is actually pretty easy to transmit, and other routes of transmission are possible. The reason it is increasing so fast probably is mostly due to increases in the average number of sexual partners that people have. For more on the biology of the disease, see this profile of scientist Maura Gillison, who has done the most to establish this link, that I wrote in 2009.

One argument against vaccinating boys I’ve heard pretty often is a suspicion that drug companies are pushing this research, trying to increase their bottom lines by vaccinating boys. I believe the opposite is true. Merck has so far declined to conduct a big, expensive study to establish that Gardasil can prevent HPV infection in the throat, probably because it would be difficult to use such a study to get regulatory approval from the Food and Drug Administration. Glaxo, in the past, has always told me it’s interested in focusing on HPV in cervical cancer.

But among researchers, there seems little doubt that this is a problem. And vaccines might be our best hope in preventing it from metastasizing. My worry is that the bad feelings drug companies have generated by marketing medicines too hard are preventing us from facing facts.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Clinicians support the necessity of neck dissection because of high risk of recurrence in oral cancer patients

Source: HighWire Stanford University

PURPOSE: In head and neck cancer, the most important prognostic factor is the presence or absence of neck metastasis. Although still debated in the published data regarding the “wait and see” policy for Stage T1-T2 oral cancer, a large number of clinicians support the necessity of neck dissection, especially in cases of oral tongue carcinoma, because of the poor prognosis and high risk of recurrence. The aim of the present study was to summarize and quantify the incidence of occult metastasis in oral cancer treatment at the oral and maxillofacial surgery department, Rambam Medical Center, in the past 10 years. PATIENTS AND METHODS: A total of 142 neck dissections performed at our department in the past 10 years (1998 to 2009) and a series of 68 patients (44 men and 22 women) treated for Stage T1N0 or T2N0 oral cancer were included in the present retrospective study. All patients underwent surgical resection of the oral cancer and selective neck dissection of the ipsilateral side. RESULTS: Occult lymph node metastases were detected in 11 patients (16% overall, 9 in the tongue, 1 in the buccal mucosa, and 1 in the gingiva of the mandible). The frequency of occult metastasis from tongue carcinoma was 34% (9 of 26 cases). The 5-year survival rate in the present study was 78.9%. In patients who underwent chemotherapy, radiotherapy, brachytherapy, or a combination of the 3 after surgical management, the overall survival rate decreased significantly to 22.5% (P = .006, log-rank test). CONCLUSION: The incidence of occult metastasis in patients with oral cancer in the present study was 16% overall. In those with tongue carcinoma, a much greater incidence (34%) of occult metastasis was detected. Furthermore, the need for chemoradiotherapy after initial surgical management, mainly because of occult metastasis, was a significant negative predictor of patient outcome. The results of the present study emphasize the need for prophylactic neck dissection in patients with oral cancer diagnosed with Stage T1N0 or T2N0 disease, especially when the primary lesion is localized in the tongue.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

R.J. Reynolds Tobacco Co. launches new advertising campaign

Source: The Business Journal

R.J. Reynolds Tobacco Co. has launched a new advertising campaign for its smoke-free Camel Snus that’s timed to coincide with a broader New York City smoking ban that goes into effect next week.

The ads include language such as “NYC Smokers enjoy the freedom without the flame” and “NYC smokers rise above the ban,” and are scheduled to appear next week in the Wall Street Journal, USA Today and other major daily newspapers, according to the National Association of Convenience Stores.

New York City Mayor Michael Bloomberg in February signed into a law a wider ban that would prohibit smoking in city parks, beaches, public plazas and boardwalks, and the new ban goes into effect Monday.

Greensboro is another community consider an expansion of its indoor smoking ban to include parks and outdoor recreation facilities. That push is being led by the Cone Health Foundation, and the Greensboro City Commission is in the process of getting feedback from residents. Raleigh adopted a smoking ban in city parks in February that goes into effect this summer, but exempts smokeless tobacco.

Daan Delen, the president and CEO of Reynolds American (NYSE: RAI), the parent company of RJR, has said that the company is ramping up its promotion of its products like Snus, which is a moist powder tobacco, and dissolvable tobacco products. Read an earlier Business Journal interview with Delen here.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Larynx preservation studies should consider treatment impact

Source: www.internalmedicinenews.com
Author: Sara Freeman, Internal Medicine News Digital Network

Almost one-quarter of patients who had been given induction chemotherapy before radiotherapy for head and neck cancer experienced long-term swallowing difficulties, with another 15% experiencing voice disabilities that correlated with the mobility of the vocal cords.

Long-term data from the GORTEC (Groupe Oncologie Radiothérapie Tête et Cou) 2000-01 larynx preservation trial also show that approximately two-thirds of long-term head and neck cancer survivors experienced severe problems with sticky saliva and dry mouth, which were in turn linked to nutritional problems.

These findings, reported May 9 at the European Society for Therapeutic Radiation Oncology (ESTRO) Anniversary Conference, further confirm that studies looking at the effects of chemoradiotherapy on the larynx in head and neck cancer need to consider prospective assessment of laryngeal function, rather than just looking at anatomical preservation, according to a French radiation oncologist.

Dr. Gilles Calais of the Centre Hôpitalier Régional et Universitaire de Tours (France) presented data from a prospective analysis of 61 patients who had participated in the original 213-patient GORTEC 2000-01 trial. He also presented updated results from the trial using a recently developed composite end point.

“Larynx preservation can be achieved for most of our [head and neck] patients by using three different strategies: induction chemotherapy, concomitant [chemoradiotherapy], or alternating chemoradiotherapy,” Dr. Calais observed. Indeed, larynx preservation is a possibility in approximately 80% of patients, he said.

However, anatomical preservation does not mean that laryngeal function is maintained, especially with respect to the ability to speak or to swallow normally. This realization recently resulted in the development of new end points for clinical trials that included both survival and laryngeal function. The new end points are laryngoesophageal dysfunction-free survival (LED-FS) and freedom from laryngoesophageal dysfunction (FF-LED).

“So the purpose of this study was to go back to our data of the GORTEC 2000-01 study and evaluate the results according to these new composite end points,” Dr. Calais explained. “In parallel,” he added, “we performed a prospective analysis of voice and swallowing function for long-term surviving patients.”

Published in 2009, the GORTEC 2000-01 study showed that induction chemotherapy with TPF (docetaxel, cisplatin, and 5-fluorouracil) was superior to pf (cisplatin and 5-FU) in terms of 3-year larynx preservation rates (J. Natl. Cancer Inst. 2009;101:498-506). In all, 110 patients had been treated with TPF and 103 with PF, and the published larynx preservation rates were 70.3% and 57.5%, respectively. Anatomical preservation of the larynx was a possibly in 66 patients, and these patients were assessed for voice and swallowing function.

Recalculating survival curves according to the two new end points showed much lower overall values, compared with the anatomical-only end points, Dr. Calais noted. Considering all patients, the 5-year LED-FS was just 28% and the 5-year FF-LED was 50%.

Patients who were treated with the taxane-containing regimen fared better than those who received the cisplatin and 5-FU chemotherapy. The 5-year LED-FS rates were 36% in the TPF arm vs. 21% for the PF arm (P = .007). The 5-year FF-LED rates were 60% and 39%, respectively (P = .005).

“These data can be used as a reference for comparison with future larynx preservation studies,” Dr. Calais said. He noted that it was important to bear in mind that the best treatment to preserve the larynx is not known, referring to the FF-LED rate of 60% with the TPF regimen.

“Of course, [the] patient’s quality of life measure[s used] should be conducted in every future larynx preservation study.”

Dr. Calais declared no financial conflicts of interest.

Oral Cancer Foundation breaks records in April’s Awareness and Screening Month

Source: MSNBC News
Author: staff

Oral cancer is an insidious disease that too often is not discovered until very late in its development, as it might not produce symptoms the average person may notice. By then treatments are less effective, and because of late discovery in far too many patients, it has a five year survival rate of only about 57%, much lower than cancers we commonly hear about. Oral cancer has existed outside the awareness of much of the public, yet it will take one life, every hour of every day in the U.S. This year the combination of unprecedented efforts by the relatively small, non-profit Oral Cancer Foundation, a coalition of strategic partners they formed, and a dose of celebrity power, created what might be called a perfect storm; and one that potentially will change public awareness of one of the few cancers that is actually increasing in incidence in the U.S.

For thirteen years in a row, April has been oral cancer awareness month nationally. More than 85% of all head and neck cancers are oral and oropharyngeal disease. Historically, a loose coalition of stakeholders in the disease has mustered about 200 screening events in April in facilities ranging from large institutions to individual dental offices around the country. Those participants opened their doors for at least a half-day to opportunistically screen members of the public in their communities for free, to find early stage disease, and to raise public awareness.

This year the Oral Cancer Foundation, which assumed responsibility for the logistics and promotion of the April effort, was able to create nearly 2,000 sites/events, a ten-fold increase over any previous year. In combination with 4 major walk/run awareness events the Foundation coordinated in April, tens of thousands of individual screenings for this deadly disease were conducted.

When speaking of this unprecedented success, Brian Hill, the Executive Director of the Oral Cancer Foundation, who is also a survivor of a late stage 4 oral cancer, stated, “I think that several things impacted our success. As a small organization that routinely deals with limited funding and human resources, we historically build strategic alliances to accomplish our goals. As a result, we had established relationships with large and powerful organizations to tap for help. We have a significant membership base of private practice doctors and clinical institutions that were already in place to actually accomplish the screenings, and the foundation put some of its other agendas on hold during March and April, to apply ourselves fully to the task. Combine those assets with an “A-list” celebrity who has recently come out of treatment for the disease, award-wining actor Michael Douglas, altruistically choosing to use his significant celebrity and visibility to advocate for early detection. His prime time appearances on Oprah, The Today Show and The View, discussing the need for early discovery and asking the American public to get screened for the disease, and you have an optimum environment to be successful.”

Dr. Michael Alfano, Vice Chancellor of NYU, and one of the Oral Cancer Foundation’s advisors, was particularly impressed with the metrics at the end of the month. Dr. Alfano has been an oral cancer advocate for decades, and his insightful development of the Oral Cancer Consortium, a confederacy of allied universities, and medical institutions in NY, NJ, and PA began the April screening efforts in 1998. That group continues to be involved today. “I am very pleased that OCF continues to build on their many positive credits in the world of oral cancer. To see what this idea has now become is highly gratifying. Screening has enormous potential to save lives when applied in an opportunistic manner. When the dental community, which is routinely and daily involved in the oral environment, embraces this issue, they become an important first line of defense against these cancers through early discovery of suspect tissues. OCF’s ability to organize these dental practices, and move them to active participation clearly has made a difference.”

The screenings this April were primarily visual and tactile, though many offices used some adjunctive devices in their efforts. None of these devices like the VELscope which uses a wavelength-specific beam of blue light to identify tissues with abnormalities in the oral cavity, are in any way invasive to the patients. Jamie O’Day, the Treatment Facilities Coordinator for OCF observed, “This particular cancer lends itself well to a screening methodology which is quick, painless, and even outside the realm of April’s free events, very inexpensive to accomplish. It is primarily visual and tactile, with the medical and dental professionals looking for things that a layperson may not notice, since they are often painless. Something as simple as a tissue discoloration, a hard painless lymph node in the neck, or in a patient’s verbal history taking, the statement that when swallowing they feel like something is painlessly stuck in their throat, or swallowing has become more difficult, are just a few of the signs and symptoms that professionals know are red flags. While there are more potential symptoms, I state these to illustrate how someone might easily ignore them, allowing a potentially deadly situation to prosper to a more advanced stage.”

“This is the very reason that an annual exam by a trained professional is so important,” Brian Hill added. “There is no question that annual screening and testing for potentially life threatening diseases has become the norm in the U.S. today. There are legitimate concerns about the financial impacts of some of these screenings, whether private or third party paid, and the invasiveness of them as well. Oral cancer screening is likely the least expensive or invasive cancer screening a person can have. I often joke that it is so simple that in the five-minute procedure you don’t even have to take your clothes off. As to expense, many dental offices conduct this cancer exam just as part of their normal intra and extra oral exam with no additional charges.”

Several of OCF’s partners, which the foundation credits with much of the successful turnout this year, are heavy hitters in the world of dentistry, and included both professional organizations and private sector firms.

Dr. Ross Kerr, chair of the Oral Cancer Task Force of the American Academy of Oral Medicine, said of his organizations involvement, “Oral cancer is on the rise in the U.S.. A new viral etiology, Human Papilloma Virus #16 (HPV16) is bringing a new demographic of individuals to the disease. This is the same virus which is a cause of cervical cancers in women. A decade ago, we were confident that we knew who was at high risk for oral cancers, but today that is significantly less so with this viral component as a cause. Historically those who smoked for decades, or were heavy alcohol consumers, developed these cancers after their fifth decade of life. Today we are seeing young, non-smoking individuals as the fastest growing segment of the oral cancer population. While that historic group still is a concern, this new demographic makes differentiation of those at high risk much more problematic. I think that the foundation’s approach to this through opportunistic screening is particularly important today. We may in the future have biological markers that we could test through salivary diagnostics to isolate those most at risk, but today the conventional screening protocol is the tool that we can immediately apply to the problem with tangible results. We (AAOM) were very pleased to be a partner with the Oral Cancer Foundation this year, and will continue to be involved in their future efforts. They clearly understand and can apply the mechanisms to get results.”

Two other dental professional groups also joined OCF’s efforts: The American Dental Association, and the Academy of General Dentistry. Mr. Hill commented that this commitment from these two powerful dental organizations represented a partnership that he has been working towards for some time. “The April awareness initiative was the tipping point opportunity to formalize a joint effort with these two organizations,” said Hill, “and both provided the outreach we needed to bring on private dental practices as screening sites. AGD provided the foundation with a full-page ad in the March issue of their journal Impact, which reaches the vast majority of all general dentists in the U.S. This contribution helped greatly. The ADA also through their publications, encouraged the dental community to partner with us through targeted stories. I think the partnership was made possible this year by changes inside the ADA, particularly the naming of Dr. Kathleen O’Loughlin to the Executive Director position. She is an individual who brings a significant public health background, combined with her own social consciousness to the organization, and I am optimistic that this is just the beginning of things that we can accomplish together. We could not have reached the significant level of dental participations without them.”

In the private sector, the Foundation sought to expand an existing relationship with the world’s largest dental products distribution company and a Fortune 500 member, Henry Schein Inc. Chairman of the Board and CEO Stanley Bergman created a call to action letter directed at their tens of thousands of US customers, asking them to join the effort with OCF. When combined with the messages that were already on the dental community’s radar, this direct request for their involvement was pivotal. LED Dental Inc. also reached out to thousands of customers who use their oral cancer screening tool, the VELscope, and contributed to the dental outreach as well. Outside the world of dentistry, pharmaceutical giant Bristol Meyers Squibb partially supported the costs of the effort through a dedicated grant given to OCF. “This was our first year working with BMS,” observed Megan Cannon, OCF’s Director of Operations, “and I hope that this huge leap OCF was able to facilitate in public awareness, screening sites, and numbers of individuals screened, will fuel their desire to work with OCF in a bigger way in the future. For all the donated time by screeners and volunteers, there is a significant financial component to doing this annual event well. We could not have grown this awareness month program without that generous financial support.” The balance of the funding that the Foundation needed to accomplish this year’s success came from an unrestricted grant in 2010 from The Entertainment Industry Foundation, a longtime supporter of the Oral Cancer Foundation, through the affiliated Bruce Paltrow Fund. OCF Founder Hill stated, “Many of our most important accomplishments in the last couple of years have only been possible through EIF’s generosity. They have been the strongest of all OCF’s supporters, and valuable allies in the war against cancer. They are the powerhouse behind the highly visible and effective Stand Up 2 Cancer effort, that is a catalyst for breakthrough ideas and collaborations in medicine that have not previously existed. We are proud to be official partners with them in their Stand Up 2 Cancer program, and now with their financial support of our efforts, we have developed a more complex and productive synergy.”

According to Mr. Hill, “This year’s screening and awareness events were a huge success by past standards, and I am very proud of what The Oral Cancer Foundation has accomplished. In fact, the efforts were so successful, that we have extended the events into May, and some offices are even signing up to do events in June. My only regret is that we were asked to take on the April effort so late in the game, with only about 4 weeks to pull things together. I believe that next year, with plenty of time to fine tune what we have learned, drum up additional financial support for the national screening and awareness month, and add new components to the program, that we and our partners will be able to accomplish truly amazing things.”

Oral Cancer is not a rare disease. It kills one person every hour of every day in the U.S., and 100 new individuals will be diagnosed each day with oral cancer. These staggering statistics make these free events crucial, as awareness of the disease and its risk factors in the U.S. population is so low. Oral cancer is the largest group of those cancers which fall into the head and neck cancer category. Common names for it include anatomical sites where it occurs such as mouth cancer, tongue cancer, tonsil cancer, head and neck cancer, and throat cancer. While treatments for it can be effective, survivors are often left with significant quality of life issues, including impaired speech, swallowing dysfunctions, and facial disfigurements from surgeries.

Contact for further information: Brian Hill, Executive Director OCF, bhill@oralcancerfoundation.org  (949)278-4362

Additional information can be found on the Foundation’s web site http://www.oralcancer.org

The Oral Cancer Foundation is an IRS registered 501c3 non-profit public charity.

Turmeric makes head, neck cancer treatment more effective

Source: www.dailyindia.com
Author: staff

Researchers at the University of Michigan Comprehensive Cancer Center have found that a compound derived from curcumin helps cells overcome the treatment failure of head and neck cancer. Curcumin is the principal curcuminoid of the popular Indian spice turmeric.

When researchers added a curcumin-based compound, called FLLL32, to head and neck cancer cell lines, they were able to cut the dose of the chemotherapy drug cisplatin by four while still killing tumor cells equally as well as the higher dose of cisplatin without FLLL32.

“This work opens the possibility of using lower, less toxic doses of cisplatin to achieve an equivalent or enhanced tumor kill. Typically, when cells become resistant to cisplatin, we have to give increasingly higher doses. But this drug is so toxic that patients who survive treatment often experience long-term side effects from the treatment,” said senior author Thomas Carey, professor of otolaryngology and pharmacology at the U-M Medical School.

That tumors become resistant to cisplatin is a major reason why head and neck cancer patients frequently see their cancer return or spread. It also plays a big role in why five-year survival for head and neck cancer has not improved in the past three decades.

In the current study, researchers compared varying doses of cisplatin alone with varying doses of cisplatin plus FLLL32 against two sets of head and neck cancer cells: one line that was sensitive to cisplatin and one line that was resistant.

They found that FLLL32 decreased the activation levels of STAT3, sensitizing both resistant and sensitive tumor cells to cisplatin. Further, lower doses of cisplatin with FLLL32 were equally effective at killing cancer cells as the higher doses of cisplatin alone.

The study is detailed in Archives of Otolaryngology-Head and Neck Surgery.

A compound found in a common Indian spice boosts effectiveness of head and neck cancer treatment

Source: Science Blog

A primary reason that head and neck cancer treatments fail is the tumor cells become resistant to chemotherapy drugs. Now, researchers at the University of Michigan Comprehensive Cancer Center have found that a compound derived from the Indian spice curcumin can help cells overcome that resistance.

When researchers added a curcumin-based compound, called FLLL32, to head and neck cancer cell lines, they were able to cut the dose of the chemotherapy drug cisplatin by four while still killing tumor cells equally as well as the higher dose of cisplatin without FLLL32.

The study appears this week in the Archives of Otolaryngology — Head and Neck Surgery.

“This work opens the possibility of using lower, less toxic doses of cisplatin to achieve an equivalent or enhanced tumor kill. Typically, when cells become resistant to cisplatin, we have to give increasingly higher doses. But this drug is so toxic that patients who survive treatment often experience long-term side effects from the treatment,” says senior study author Thomas Carey, Ph.D., professor of otolaryngology and pharmacology at the U-M Medical School and co-director of the Head and Neck Oncology Program at the U-M Comprehensive Cancer Center.

That tumors become resistant to cisplatin is a major reason why head and neck cancer patients frequently see their cancer return or spread. It also plays a big role in why five-year survival for head and neck cancer has not improved in the past three decades.

FLLL32 is designed to sensitize cancer cells at a molecular level to the antitumor effects of cisplatin. It targets a key type of protein called STAT3 that is seen at high levels in about 82 percent of head and neck cancers. High levels of STAT3 are linked to problems with normal cell death processes, which allow cancer cells to survive chemotherapy treatment. STAT3 activation has been associated with cisplatin resistance in head and neck cancer.

Curcumin is known to inhibit STAT3 function, but it is not well-absorbed by the body. FLLL32 was developed by researchers at Ohio State University to be more amenable to use in people. The current study used the compound only in cell lines in the laboratory.

In the current study, researchers compared varying doses of cisplatin alone with varying doses of cisplatin plus FLLL32 against two sets of head and neck cancer cells: one line that was sensitive to cisplatin and one line that was resistant.

They found that FLLL32 decreased the activation levels of STAT3, sensitizing both resistant and sensitive tumor cells to cisplatin. Further, lower doses of cisplatin with FLLL32 were equally effective at killing cancer cells as the higher doses of cisplatin alone.

Separate studies suggest FLLL32 may not be well-absorbed by the body and researchers are developing a next generation compound that they hope improves on that. The U-M team plans to further study this newer compound for its potential as part of head and neck cancer treatment. Clinical trials using this compound are not currently available.