Ultrasound as effective as CT scans for most diagnoses, reducing the dangers of radiation

Source: www.medicalnewstoday.com Author: staff For diagnosing head and neck ailments, tests that use radiation are always less desirable than those that don't. Otolaryngologists have a wide range of techniques available to them, including CT or "CAT" scans, MRI and ultrasound. CT uses significant radiation and MRI a lower amount, but ultrasound is a non-invasive, non-radiating technique. It does not require injection of radioactive contrast material and has no side effects. Now, a new study by Tel Aviv University exploring the efficacy of expensive and invasive CT scans has found that, in some cases, they don't offer a clinical advantage over a simple, inexpensive ultrasound procedure. In his study, Dr. Michael Vaiman of Tel Aviv University's Sackler Faculty of Medicine compared the efficacy of CT versus ultrasound scans for locating vertebral arteries in the throat, an important assessment that must be completed before a surgeon operates in the neck area of the body. After comparing the outcomes of 250 CT scans with 500 ultrasound images, he concluded that there is no advantage to using CT scans for most of these procedures, especially those that are used to locate anomalies in the neck to map major arteries before surgery can take place. Dr. Vaiman's results were published in the March issue of the European Archives of Oto-Rhino-Laryngology. When scans are sound CT scans combine X-rays with highly sophisticated computers to produce a number of pictures of the interior of the body. Traditionally, doctors have relied on these scans to find neck arteries [...]

Tobacco is Estimated to Kill a Billion People in this Century

Source: San Francisco Chronicle For all the debate and pain and money expended on our ongoing "drug war' - which is too much a failing, endless one - the worst drug of all is too often unmentioned, but kills and maims more than the rest of them put together. And it's legal. Tobacco abuse is projected to cause a billion premature deaths in this century; To put it another way, until and unless we have a nuclear war, the tobacco industry will continue killing more people than any other man-made cause. This true in just about any region, but here in California, there are nearly four million smokers, and as the American Lung Association reminds us, "Tobacco-related illness remains the number one preventable cause of death in the state, responsible for more than 36,000 deaths each year - that's more people lost to tobacco than alcohol, HIV/AIDS, car crashes, illegal drugs, murders, and suicides combined." The national toll is about 438,000 deaths per year. One of them was my dad, but I hated tobacco long before it claimed him. In any event, the annual UCSF Center for Tobacco Control Research and Education symposium again keyed off on the "billion lives" estimate and showcased ongoing efforts to apply research to decreasing that daunting figure. This year, American Cancer Society CEO John Seffrin. PhD said that the 12 million cigarettes smoked each minute meant an ever-increasing morbidity and mortality, despite whatever progress, with a tripling of disease and death in the developing [...]

HPV and EGFR are hottest topics in head and neck cancer

Source: www.medscape.com Author: Zosia Chustecka The hottest topic in head and neck cancers is the role of human papillomavirus (HPV) in the disease, although there is also a lot interest in treatment with EGRF inhibitors, especially the second-generation products, according to an expert here at the European Society for Therapeutic Radiology and Oncology 11th Biennial Conference. HPV has only been associated with head and neck cancer in the last few years, but it is now clear that patients who are positive for the virus have a better prognosis, said Cai Grau, MD, DMSC, professor of oncology at Aarhus University Hospital, Denmark. He chaired a session during which both hot topics were discussed. "These patients have a better prognosis, irrespective of treatment, and their risk of a second cancer is virtually zero," added session participant Lisa Licitra, MD, medical oncologist at the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan, Italy. However, there is a difference between patients in the United States and those in Europe with regard to risk, she told meeting attendees. For American patterns, Dr. Licitra cited the analysis published last year in the New England Journal of Medicine (2010;363:24-35), which reported a risk model for death from oropharyngeal squamous cell carcinoma on the basis of HPV status, pack-years of tobacco smoking, and tumor and nodal stage. In this 266-patient cohort, 43% were low risk, 30% were intermediate risk, and 27% were high risk. Dr. Licitra reported that when she performed the same analysis [...]

High Interest in HPV and EGRF When Referring to Head and Neck Cancer

Source: MedScape Today May 12, 2011 (London, United Kingdom) — The hottest topic in head and neck cancers is the role of human papillomavirus (HPV) in the disease, although there is also a lot interest in treatment with EGRF inhibitors, especially the second-generation products, according to an expert here at the European Society for Therapeutic Radiology and Oncology 11th Biennial Conference. HPV has only been associated with head and neck cancer in the last few years, but it is now clear that patients who are positive for the virus have a better prognosis, said Cai Grau, MD, DMSC, professor of oncology at Aarhus University Hospital, Denmark. He chaired a session during which both hot topics were discussed. "These patients have a better prognosis, irrespective of treatment, and their risk of a second cancer is virtually zero," added session participant Lisa Licitra, MD, medical oncologist at the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan, Italy. However, there is a difference between patients in the United States and those in Europe with regard to risk, she told meeting attendees. For American patterns, Dr. Licitra cited the analysis published last year in the New England Journal of Medicine (2010;363:24-35), which reported a risk model for death from oropharyngeal squamous cell carcinoma on the basis of HPV status, pack-years of tobacco smoking, and tumor and nodal stage. In this 266-patient cohort, 43% were low risk, 30% were intermediate risk, and 27% were high risk. Dr. Licitra reported that when [...]

New Breath Test to Identify Head and Neck Cancer

Source: British Journal of Cancer M Hakim, S Billan, U Tisch, G Peng, I Dvrokind, O Marom, R Abdah-Bortnyak, A Kuten and H Haick Abstract Background: Head-and-neck cancer (HNC) is the eighth most common malignancy worldwide. It is often diagnosed late due to a lack of screening methods and overall cure is achieved in <50% of patients. Head-and-neck cancer sufferers often develop a second primary tumour that can affect the entire aero-digestive tract, mostly HNC or lung cancer (LC), making lifelong follow-up necessary. Methods: Alveolar breath was collected from 87 volunteers (HNC and LC patients and healthy controls) in a cross-sectional clinical trial. The discriminative power of a tailor-made Nanoscale Artificial Nose (NA-NOSE) based on an array of five gold nanoparticle sensors was tested, using 62 breath samples. The NA-NOSE signals were analysed to detect statistically significant differences between the sub-populations using (i) principal component analysis with ANOVA and Student's t-test and (ii) support vector machines and cross-validation. The identification of NA-NOSE patterns was supported by comparative analysis of the chemical composition of the breath through gas chromatography in conjunction with mass spectrometry (GC–MS), using 40 breath samples. Results: The NA-NOSE could clearly distinguish between (i) HNC patients and healthy controls, (ii) LC patients and healthy controls, and (iii) HNC and LC patients. The GC–MS analysis showed statistically significant differences in the chemical composition of the breath of the three groups. Conclusion: The presented results could lead to the development of a cost-effective, fast, and reliable method for the differential [...]

HPV Becomes a Major Topic for Researchers as a Source of Oral Cancers

By Andy Blatchford, The Canadian Press MONTREAL — Amid Michael Douglas's personal and philanthropic battle with throat cancer, the Oscar-winning actor is shedding light on a viral form of the disease lurking in a growing number of mouths. Oral cancer has long been linked to tobacco and alcohol use, but an expanding body of research suggests human papillomavirus, or HPV, is an increasing cause of the deadly disease. The culprit behind the sexually transmitted virus' emergence in mouth and throat cancers? Experts say a major factor is the prevalence of oral sex. More and more researchers have cast their microscopes on the mysteries of HPV-caused oral cancers, including McGill University, which received a big fundraising boost last week with the help of Douglas. The grateful actor, diagnosed with throat cancer last year in a Montreal hospital, volunteered to headline a charity event for the McGill Head and Neck Cancer Fund. The 66-year-old, who calls himself a "poster boy" for head-and-neck cancer, has blamed alcohol as a likely source of his illness, not HPV. Still, a portion of the $2 million amassed at the event will support HPV-caused oral cancer research. The doctor who first detected the walnut-sized tumour in Douglas's throat said the fund has supported HPV projects in the past and more are in the works. "This is an area of increasing incidence," Dr. Saul Frenkiel said of HPV-caused oral cancer at the university-affiliated hospital where he treated Douglas. Although relatively rare, the Canadian Cancer Society estimates oral cancers, [...]

New Research Shows Chemo Brain Could Last More Than 5 Years

Source: New York Times “Chemo brain,” the foggy thinking and forgetfulness that cancer patients often complain about after treatment, may last for five years or more for a sizable percentage of patients, new research shows. The findings, based on a study of 92 cancer patients at Fred Hutchinson Cancer Research Center in Seattle, suggest that the cognitive losses that seem to follow many cancer treatments are far more pronounced and longer-lasting than commonly believed. The study, published in The Journal of Clinical Oncology, is a vindication of sorts for many cancer patients, whose complaints about thinking and memory problems are often dismissed by doctors who lay blame for the symptoms on normal aging or the fatigue of illness. “It’s clearly established now that chemo brain does exist and can continue long-term,” said Karen L. Syrjala, co-director of the Survivorship Program at Fred Hutchinson and the study’s lead author. “The real issue here is that recovery from cancer treatment is not a one-year process but a two- to five-year process. People need to understand the extent to which the cells in their bodies have really been compromised by not only the cancer, but also the treatment.” The 92 patients in the study had all undergone chemotherapy as part of bone marrow or stem cell transplants to treat blood cancers. Although the range of effects of different cancers and treatments probably varies, researchers said the finding that cognitive recovery can take five years or more is likely to apply to breast cancer [...]

The End-of-Life Paradox

Source: The Huffington Post It seems that whenever Marian visits her dad, he wants to go over certain things: where his will is located, where to find his stocks and bank book, and even where to find the charcoal suit that he wants used when he is laid out in his casket. To Marian, such conversations are morbid, distressing and perplexing. At 82, her father is relatively healthy, independent and maintains an active life. Why does he always seem to focus on death -- especially when she is around? Often adult children experience what I call this end-of-life paradox. Their older parents want to speak about the logistics of death in detail. Or, maybe they want to review end-of-life care plans contained in advance directives, just at the time when it is most difficult emotionally and spiritually for their adult child to listen to such conversations. The end-of-life paradox results from the different places the generations are in their own spiritual development and how each makes sense both of life and death. Older persons recognize that even if they are active and healthy, they are nearing the end point of life. Victor Marshall, a sociologist, used the term "awareness of finitude" to describe the appreciation for the life cycle that older people may exhibit. Death is perceived as closer. This does not mean that they expect to die immediately, but rather that they realize that death is part of life. They are reluctant to plan too far into the future. [...]

Anti-Vaccine Groups Continue to Cause National Problems

The United States seems to be on track to have more measles cases than any year in more than a decade, with virtually all cases linked to other countries, including Europe where there's a big outbreak. Already there have been 89 cases reported so far. The U.S. normally sees only about 50 cases of measles in a year thanks to vaccinations. Health officials are reluctant to make predictions, but acknowledge the pace of reports is unusually hot. "It's hard to say, but we're certainly getting a lot," said Dr. Greg Wallace, who leads the measles, mumps, rubella and polio team at the U.S. Centers for Disease Control and Prevention. Europe, especially France, has been hit hard by measles, with more than 6,500 cases reported in 33 nations. International health officials are blaming it on the failure to vaccinate all children. Just about all U.S. outbreaks were sparked by people bringing it here from other countries. This week, international health officials posted an alert urging travelers everywhere to get the recommended two doses of vaccine before flying overseas. "The risk of getting infection is very high," said Dr. Cuauhtemoc Ruiz Matus, an immunization expert with the Pan American Health Organization. In the U.S., the worst year for measles in the last decade was 2008, when 140 cases were reported. There have been no measles deaths this year, but health officials warn the disease can be dangerous. Measles is highly contagious and up to 90 percent of people exposed to an infected [...]

Spouses of Head/Neck Cancer Patients More Inclined to PTSD

Source: MedScape Today Partners of patients with newly diagnosed head and neck cancer are significantly more likely to meet research criteria for post-traumatic stress disorder (PTSD) than patients themselves, according to a study presented here at the Society of Behavioral Medicine 32nd Annual Meeting and Scientific Sessions. Donna Posluszny, PhD, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, and colleagues from there and from the University of Texas, Arlington, Texas, found that 8 of 20 partners of patients with head and neck cancer (20%) had a mean score on the PTSD Checklist (also known as the PCL) of 50 or higher, compared with only 2 of 40 patients (5%). Patients who score at least 50 on the PCL meet the criteria for PTSD. "This is not a formal diagnosis of PTSD but for research purposes, a score of 50 or higher is meaningful," Dr. Posluszny told delegates. "And we were very surprised to find that partners of patients with newly diagnosed head and neck cancer experience greater amounts of traumatic stress than patients themselves do." For the study, investigators recruited 40 dyads (2 individuals regarded as a pair) where the partner was considered to be a "romantic" partner. Some 78% of the patients were male, while most partners were female; all but a small minority were married. Almost all were white, and, as a cohort, they were somewhat better educated and made more money than the majority of patients with head and neck cancer. Sixty-five percent of them also had [...]

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