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They turn to Facebook and YouTube to find a cure for cancer — and get sucked into a world of bogus medicine

Source: The Washington Post
Date: June 25th, 2019
Author: Abby Ohlheiser

Mari pressed kale leaves through the juicer, preparing the smoothie that she believed had saved her life.

“I’m a cancer-killer, girl,” Mari told her niece, who stood next to her in the kitchen. The pair were filming themselves for a YouTube video.

Mari said she was in remission from a dangerous form of cancer, and the video was meant as a testimony to what she believed was the power of the “lemon ginger blast.” In went some cucumber, some apple, some bok choy, a whole habanero pepper.

While she pressed, she preached.

“I’m telling you, it’s anti-cancer,” Mari said. “It’ll kill your cancer cells.”

The video, first uploaded in 2016, remains on YouTube, but there’s an “important update” attached to the video’s description. It was written by Liz, the niece, a year later.

Mari’s cancer had returned, the note said, and she had died.

When Mari’s cancer came back, Liz wrote, her aunt opted to do chemotherapy. Her smoothie recipe remains online, with 506,000 views and counting. “I will not take down her videos,” wrote Liz, who declined to comment for this story, in the description of a follow-up video, “as they continue to help people.”

I found Mari’s videos without looking for them last fall, when a search for a smoothie recipe opened up an algorithmic tunnel to videos that claimed to know the secret to curing cancer. These tunnels, forged by Google searches and Facebook recommendations, connect relatively staid health and nutrition advice to fringe theories, false claims and miracle juices.

But the web of false, misleading and potentially dangerous cancer “cures” and conspiracy theories isn’t just there for those who stumble into it accidentally.More often it ensnares people who are reeling from bad news and groping for answers.

“People with a new cancer diagnosis are often feeling vulnerable and scared,” said Renee DiResta, a researcher who studies disinformation. The treatments for cancer, especially chemotherapy — which targets cancerous cells but can also kill or damage healthy ones — can come with significant, unpleasant side effects. Facing the horrors of such a diagnosis and treatment, some people start searching for information and community online.

What they find can be quite disturbing to medical professionals: home remedies that purport to cure diseases with baking soda, frankincense, silver particles.

Google and Facebook have promised to crack down on health misinformation in recent months, as links between anti-vaccine conspiracy theories and measles outbreaks in the United States become major news. But bogus health information cannot be eradicated from the Web with a shock of chlorine. Health conspiracy theories and false cures have polluted social media for years, abetted by companies that have been more focused on building out the plumbing than keeping the pipes clean of misinformation.

YouTube is trying to plug the holes that lead to videos like the Coldwell interview. When I ran the “cure for cancer” search again, in May, YouTube’s search results were a completely different story. The baking soda and Coldwell videos are still online, but no longer appear among the top pages of results. Instead, most of the top results came from major cancer research centers.

I asked YouTube about the change, which occurred just before we reached out to the company for comment on this story. I was told YouTube has started to treat search results for different types of topics differently: When its algorithms decide a search query is related to news or information-gathering on a topic like cancer, they will attempt to populate the results with more authoritative sources. The company said it is working with experts on certain health-related topics to improve results.

Even as YouTube patches “cure for cancer,” medical misinformation remains available and popular in other ways. People who are susceptible to cancer misinformation aren’t just typing keywords into YouTube. They’re also turning to fellow travelers who followed the same algorithmic tunnels to the same wells, where community members who have never met in person swap folk remedies and discuss the untrustworthiness of cancer doctors and pharmaceutical companies.

It’s tempting to think of medical misinformation as a technological problem in need of a technological solution, but that’s only part of it. The social media age has made humans part of the infrastructure of the Internet. And when it comes to medical information, it’s not just algorithms that direct online seekers who are trying to figure out how to cope with a bad diagnosis. It’s also other people.

For those facing a battle with a terrifying illness, hopeful anecdotes can be powerful. Anecdotes can turn seekers into believers, who can turn other seekers into believers. And on Facebook, those anecdotes continue to attract large audiences.

Even as Facebook works to limit the reach of anti-vaccine chatter, other medical misinformation is thriving — including bogus cancer cures. The boundaries between false medical beliefs are permeable: If you believe baking soda can cure cancer, you might also believe that the measles vaccine causes autism. (It doesn’t.) Behind each “alternative” theory of cures and causes lurks a deep suspicion of doctors, drug sellers and especially chemotherapy.

On Facebook, I easily found groups devoted to sharing “natural” cures for cancer, where people who have cancer diagnoses, or care for someone who does, asked other group members for ideas for how to cure it. “Cancer Cures & Natural Healing Research Group” has just under 100,000 members. I joined the closed group in February, identifying myself as a Washington Post journalist to the administrators.

The administrator for that group initially agreed to speak with me in private messages. But then I was blocked from the group and the administrator’s personal Facebook page. (The administrator did not return a follow-up email seeking comment.)

Facebook’s algorithms then began suggesting other groups I might like to join: “Alternative Cancer Treatments” (7,000 members), “Colloidal Silver Success Stories” (9,000 members) and “Natural healing + foods” (more than 100,000 members). I requested access to some of those groups, too, and several admitted me. People in the groups would ask one another for cancer-fighting advice. Some would be told to use baking soda or frankincense.

Rather than remove the groups, Facebook’s strategy to limit health misinformation centers on making it harder to join them unknowingly. Facebook said in an emailed statement that it “will alert group members by showing Related Articles” for any post already deemed false by Facebook’s third-partyfact-checkers, for instance.

Facebook is in the process of experimenting with how to address health misinformation beyond vaccines.One possibility might be alerting users who are invited to join a groupthat ithascirculated debunked hoaxes.

To this point, it’s been up to users to steer their peers toward or away from bad health advice. In one Facebook group, in February, a parent asked for advice on how to cure a child’s strep throat without antibiotics. The responses were split; some told the parent not to mess around and go to the doctor for antibiotics; others recommended colloidal silver and hydrogen peroxide. The National Capital Poison Center notes thateven food-grade hydrogen peroxide “should never be taken internally” unless extremely diluted, and that its use as an alternative therapy is “not based on scientific evidence.”

The world of alternative medicine seekers has its own celebrities. The names are like pass phrases. Post a question about natural cancer treatments in the right Facebook group, and you’ll get the names of supposed success stories that the pharmaceutical industry doesn’t want you to know about, and the instruction to “do your own research” into their stories.

“CHRIS BEAT CANCER! Look it up,” one Facebook user advised on a discussion thread.

So I did. The first Google result, when I ran the search in mid-May, was Chris Wark’s website, where Wark sells access to his method for $147. Below that, Google also suggested a few specific videos from Wark, promoting his “cancer fighting salad” and a lecture on how he beat cancer with “diet.”

Joanna Tackett, a spokeswoman for Wark, said in an email that Wark is not a doctor and does not provide medical advice, and that he has given free access to the paid program to hundreds of thousands of people.

Misinformation experts worry about “data voids,” created by the way information gets indexed online. If the only people discussing and looking up a particular term or phrase are those advocating a certain view, people searching that phrase would be shown information that supports that view.

“You can easily dominate search results for a term when you’ve created the term and only in-groups use it,” DiResta said. As social media companies identify and crack down on one search term, she said, 20 more might be rising in interest to take its place.

A Google spokesman said the company has worked to improve the accuracy of results for general health-related queries, but for very specific searches, such as “Chris beat cancer,” the system is designed to return “results from a diverse range of sources to help you form your own opinion — some of these provide information about the book, while others provide critiques.”

Google users searching for cancer information more generally might end up being served ads that promote dubious treatments, even if those sources don’t show up in the search results. In a search for “cure for cancer,” in May under incognito mode, the first result was an ad: “Stage four cancer survivor | thanks to natural cancer cures.” The ad promoted a cancer clinic in Mexico that appears to use unconventional treatments. Another Google spokesman said that ads promoting miracle cures are against the company’s rules, and that “if we find ads that violate our policies we remove them.”The ad was removed after I flagged it in an email.

For some searches, the results will be a tug-of-war between the believers and debunkers. Searching “Chris beat cancer” did not reveal a total data void. Google did show me two results challenging Wark’s claims about beating cancer with a healthy diet — but only after links to his YouTube channel, his website, the salad video, the lecture and Wark’s book. (When I ran the search later, after asking Google about the results, the challenges appeared a bit more prominently.)

One of the challengers is David Gorski, a surgical oncologist at Wayne State University School of Medicine who runs a blog, called Science-Based Medicine, devoted to medical bunk.

Gorski dove down the cancer conspiracy theory tunnels a decade ago, armed with science and determined to stanch as much misinformation as he could. Back then, he said, “all there really was were websites, blogs and discussion boards that were privately maintained. Their reach was nowhere near what Facebook came to be.”

Now, Gorski faces not only a more forceful tide of misinformation, but also intense blowback from those who have responded to his work. Accusations of wrongdoing from holistic healing sites and a wave of negative ratings on his Vitals.com profile have tainted the results of Google searches for his name.

Gorski’s debunking of Wark’s story was simple. Wark, who says he had surgery for his Stage 3 colon cancer but refused chemotherapy after, had a 64 percent chance of surviving five years with surgery alone, Gorski said. To get that figure, the oncologist used a tool called Adjuvant Online, which helps doctors assess the risks and benefits of potential therapies designed to prevent the recurrence of cancer after it is treated. The database used clinical trial data from a wide range of studies.

“Attempts to discredit me because I had surgery give far too much weight to my personal story, and miss the larger message. . . . People have healed all types and stages of cancer holistically (against the odds),” Wark said in a statement. “As a patient advocate, I am highly critical of the cancer industry and pharmaceutical industry,” he added, before saying that “I do not tell patients not to do the treatment.”

Surgery was the recommended primary treatment for Wark’s cancer, Gorski said. Chemotherapy is a secondary measure, meant to help prevent the cancer from coming back. Wark’s decision to forgo the post-surgery chemo was a risk, but by then the odds were in his favor.

After I was kicked out of the “Cancer Cures and Natural Healing Research Group,” I joined the similarly named “Natural Healing & Cancer Cures Research Group,” a closed Facebook group with more than 40,000 members. (Again I identified myself as a journalist while joining the group.)

That’s where I saw a post by Beth Anne Rekowski, who said her sister was sick with Stage 3 lung cancer.

“She and I both agree,” Rekowski wrote, “NO chemo or radiation.”

I called Rekowski to find out why.

Cancer has haunted Rekowski for much of her adult life. She wanted to be a nurse, but when her young son got cancer, she dropped out of nursing school. When he died in 1992, at age 4, Rekowski felt like she had died with him. Grief became activism, and she started raising money for charities that helped pay for cancer research. Later, her brother-in-law and her father were diagnosed. They died, too.

Rekowski had health issues of her own, and on the advice of a friend, she visited two naturopathic doctors. When their practices closed (Rekowski blames Big Pharma), she started seeking out remedies online. She found Facebook groups full of them.

“I used Facebook health groups just full-speed ahead,” Rekowski told me in a March phone interview from her mother’s home, where she is a full-time caretaker, “and I couldn’t believe what resources were on there. People, you know, to help other people because they’ve been there.” The Facebook groups were Rekowski’s lifeline.

She came to believe that chemotherapy, not cancer, had killed her son, father and brother-in-law. “Talk about parental guilt and remorse,” Rekowski told me.

Now, every sick relative is a chance for redemption. She advised her sister against chemotherapy or radiation to treat her lung cancer. Rekowski wanted her to use “naturals” and “immunotherapy” instead. And so she turned to her lifeline: the other members of the Natural Healing & Cancer Cures Research Group.

“If you can please give me a list,” she wrote in a post on the Facebook group, “in order of urgency and priority, of what you feel is imperative for nutrition, immune boosting, cancer killing, and whatever else you feel my sister needs.”

The responses flooded in by the dozens.

Salt water baths. 4 times a day.

B17 vitamin. . .CBD Oil full spectrum.

Add Wheatgrass juice to your sister’s diet.

Rekowski’s sister trusted her doctors: She did chemotherapy. Then she got an infection in her lungs, according to Rekowski, and in March her doctors said it was time to enter hospice. But Rekowski still had hope. She said she convinced her sister to wait on hospice, and went to a health food store that evening and bought a small fortune’s worth of essential oils.

She believed she could heal her sister’s lungs with fenugreek, licorice root, peppermint oil and oregano oil. Once her sister’s lungs were better, Rekowski believed, she could get to work curing her cancer.

In May, Rekowski wanted me to know that she believed her sister was a miracle. Once the infection had subsided, she texted to say the doctors had offered to start her sister on chemotherapy again. “My sister declined,” she wrote, and decided to continue with “natural supplements and natural oils.”

When Rekowski and I talked about health, it sometimes felt like we were talking about faith. The story she tells about her sister’s illness is meant as a parable about how chemotherapy can kill. She saw me, and the readers of this article, as potential converts.

I told Rekowski that I believed the groups she depended on exploited people’s desire for hope in the face of a bleak prognosis. When there are no options left, it’s powerful to find a community that tells you otherwise, even if those options turn out to be ineffective or even harmful.

But each time I challenged her with a counterpoint, Rekowski waved it away. The government was covering up evidence that supported her views, she told me. The treatments she found on Facebook worked for her, she believed, and that was all the proof she needed.

As a surgical oncologist, Gorski sees the effect that medical misinformation can have on the body. A couple of times a year, he says, he’ll treat “patients with neglected cancers, who try to treat their cancers naturally” before turning to medicine. The tumors have become “nasty ulcerating masses.” Even for patients with terminal diagnoses, traditional medicine can offer palliative care that can manage the pain and may be covered by health insurance.

After years of allowing health misinformation to spread, social media companies are beginning to treat the problem the best they can. They didn’t create cancer conspiracy theories, but experts like Gorski have observed how they made the problem worse. “It’s just way more concentrated and effective,” he said. “You go on Facebook and type in ‘alternative cancer cures’ and you’ll find stuff real fast.”

July, 2019|Oral Cancer News|

HPV vaccine benefits ‘exceed expectations,’ may lead to elimination of cervical cancer

Source: NBC News
Date: June 27, 2019
Author: Katie Sullivan

A new study suggests that the benefits of the vaccine extend to people who aren’t vaccinated — meaning the more people who are vaccinated, the better.

The HPV vaccine is far more effective than expected, with benefits extending beyond those who receive the vaccine, a study published Wednesday finds.

The new study, published in The Lancet, suggests that the more people who receive the vaccine, the better. That’s because vaccination not only reduces rates of HPV infection and the presence of precancerous cells in the cervix in people who receive the vaccine, it also reduces rates of HPV-related diseases in people who were not vaccinated.

The findings come as a U.S. federal advisory panel recommended Wednesday that the HPV vaccine be given to both men and women up to age 26.

HPV, or human papillomavirus, is the leading cause of cervical cancer. The virus can also cause other cancers, including cancers of the penis, head and neck, as well as conditions like genital warts.

The HPV vaccine was first introduced in 2006. Since then, more than 115 countries and territories have implemented it in their vaccination programs. The World Health Organization recommends that girls ages 9 to 13 receive two doses of the vaccine.

“The impact of the HPV vaccination has actually exceeded expectations,” said Lauri Markowitz, associate director of science for HPV at the Centers for Disease Control and Prevention, who worked on the study. “The trials showed that HPV vaccines are very effective, and data from the real world has confirmed that.”

Indeed, the reductions in HPV infections and precancerous cells “are a first sign that vaccination could eventually lead to the elimination of cervical cancer as a public health problem,” the study’s lead author, Mélanie Drolet, an epidemiologist at Laval University in Canada, said in a statement.

The Lancet study expanded upon a 2015 meta-analysis that had looked at the real-world effects of the vaccine. The new analysis was updated to include a total of 65 studies, which spanned eight years and included more than 60 million people living in 14 countries. Each study measured either changes in the number of new HPV infections, genital warts diagnoses or cases of abnormal cells associated with cervical cancer in countries before and after they adopted routine HPV vaccination in girls. (Two countries included in the analysis, the U.S. and Australia, also recommend the vaccine for boys.)

The impact of the HPV vaccination has actually exceeded expectations.

The researchers found that, in these countries, there was a significant decrease in the prevalence of two strains of HPV that cause 70 percent of cervical cancers, HPV 16 and 18. (There are more than 100 strains of HPV, 14 of which are known to cause cancer. The HPV vaccine protects against up to 9 strains.) In addition, there was a decrease in the prevalence of precancerous cells in the cervix, which can develop into cancer.

What’s more, in countries where at least half the population that was targeted for vaccination had actually received the vaccine, researchers saw evidence of herd immunity, meaning there was a decrease in the prevalence of HPV-related diseases even among those who weren’t vaccinated. This is because vaccination leads to fewer HPV hosts.

These countries also saw a decrease in genital warts diagnoses among unvaccinated boys and older women. And among girls within the age groups targeted for vaccination, there were fewer diagnoses of three HPV strains that the vaccine does not specifically protect against, a phenomenon called cross-protection. Countries in which people in multiple age groups received the vaccine also saw a greater decrease in HPV-related disease.

“This paper shows that with a broader age range that’s targeted, you’ll find greater impact in your vaccination program,” Markowitz told NBC News.

Lagging vaccination rates

Despite the widespread benefits of the vaccine, however, HPV vaccination rates in the U.S. are still lagging behind those of other adolescent immunizations. The U.S. was the first country to implement HPV vaccination for both genders, but the CDC has found that many parents and health care providers don’t yet see a need to vaccinate boys. Parents have also expressed concerns about the vaccine and its costs, the CDC found.

According to Debbie Saslow, managing director of HPV and gynecological cancers at the American Cancer Society, the lagging rates are not entirely because parents are against vaccinating their kids; rather, the way some doctors are presenting the vaccine also plays a role.

Two required vaccinations, for tetanus and meningitis, are administered at the same time as HPV, around age 12. Saslow said HPV is usually presented as an optional third vaccine at that time, and one that patients can delay another year.

“Providers often think they’re recommending all three vaccines, but they’re actually making the third, the HPV vaccine, optional,” Saslow told NBC News. “They’re just suggesting it or doctors are setting it apart from the other two in some way.”

The fact that HPV is a sexually transmitted infection could also be a hard concept for parents to come to terms with. Saslow said beliefs about sex may be a factor that deters parents from opting to have their children vaccinated against HPV.

“Despite all that, vaccination rates are continuing to grow,” she said.

Indeed, the number of adolescents in the U.S. who received at least one dose of the HPV vaccine has increased by 5 percent each year since 2013. The CDC recommendseveryone receive the first dose by age 12. Though adults up to age 45 can still be vaccinated, the vaccine may be less effective. And while the WHO does recommend that girls 9 to 13 get vaccinated against HPV, it does not yet recommend that all genders receive the vaccination. That could change in response to study results that continue to show the vaccine has substantial impact on public health.

Cancer prevention

That impact on public health is cancer prevention. Ultimately, that’s the “main goal of the HPV vaccination program,” Markowitz said. “We’re seeing an impact on one of the HPV outcomes that is close to a cancer outcome.” (Because cervical cancer can take decades to develop, it’s not yet possible to study the effects of the vaccine on cervical cancer rates, Drolet noted in the statement.)

In particular, the study found the HPV vaccine led to a reduction in the rates of abnormal pap smear findings. Pap smears are used to detect abnormal cells in the cervix that can sometimes develop into cancer. Five to nine years after a population was vaccinated against HPV, the researchers found a more than 50 percent reduction in cases of these pre-cancerous cells in girls 15 to 19. In vaccinated women 20 to 24, there were one-third fewer cases of these cells.

A separate study, published in April in The BMJ, found a 90 percent reduction in cases of pre-cancerous cells in young women in Scotland within the first decade of introducing the HPV vaccine.

But vaccination is only one piece of cervical cancer prevention; screening is also necessary.

Whether or not a person has received the HPV vaccine, getting cervical cells regularly tested — through Pap tests and HPV screening — is still a crucial to reducing cases of cervical cancer and early detection, said Diane Harper, senior associate director of the Michigan Institute for Clinical and Health Research. Rates of invasive cervical cancer dropped significantly in the U.S. when cancer screening was introduced in the 1940s, and there were less than half the number of cases in 2007 that there were in 1973, largely due to screening.

“Vaccination and screening together make a program,” Harper told NBC News. “Very few HPV cases progress into cancer, but the only way we’re going to find those that do is through the screening program.”

June, 2019|Oral Cancer News|

Meet the New York couple donating millions to the anti-vax movement

Source: The Washington Post
Date: June 19th, 2019
Authors: Lana H. Sun & Amy Brittain

A wealthy Manhattan couple has emerged as significant financiers of the anti-vaccine movement, contributing more than $3 million in recent years to groups that stoke fears about immunizations online and at live events — including two forums this year at the epicenter of measles outbreaks in New York’s ultra-Orthodox Jewish community.

Hedge fund manager and philanthropist Bernard Selz and his wife, Lisa, have long donated to organizations focused on the arts, culture, education and the environment. But seven years ago, their private foundation embraced a very different cause: groups that question the safety and effectiveness of vaccines.

How the Selzes came to support anti-vaccine ideas is unknown, but their financial impact has been enormous. Their money has gone to a handful of determined individuals who have played an outsize role in spreading doubt and misinformation about vaccines and the diseases they prevent. The groups’ false claims linking vaccines to autism and other ailments, while downplaying the risks of measles, have led growing numbers of parents to shun the shots. As a result, health officials have said, the potentially deadly disease has surged to at least 1,044 cases this year, the highest number in nearly three decades.

The Selz Foundation provides roughly three-fourths of the funding for the Informed Consent Action Network, a three-year-old charity that describes its mission as promoting drug and vaccine safety and parental choice in vaccine decisions.

Lisa Selz serves as the group’s president, but its public face and chief executive is Del Bigtree, a former daytime television show producer who draws big crowds to public events. Bigtree has no medical credentials but holds himself out as an expert on vaccine safety and promotes the idea that government officials have colluded with the pharmaceutical industry to cover up grievous harms from the drugs. In recent weeks, Bigtree has headlined forums in ultra-Orthodox Jewish communities in Brooklyn and Rockland County, N.Y., both areas confronting large measles outbreaks.

“They should be allowed to have the measles if they want the measles,” Bigtree told reporters outside the Brooklyn meeting on June 4. “It’s crazy that there’s this level of intensity around a trivial childhood illness.”

Thanks largely to the Selzes’ donations, ICAN is now the best-funded among a trio of organizations that have amplified concerns about vaccines. ICAN brought in $1.4 million in revenue in 2017, with just over $1 million supplied by the Selz Foundation, according to tax filings.

The Selzes and the groups they support are hardly the only purveyors of anti-vaccine ideas. Environmental attorney Robert F. Kennedy Jr., a nephew of the late president, runs the Children’s Health Defense, a charity that promotes a similar agenda; it brought in $727,000 in 2017, according to tax filings. Barbara Loe Fisher, who says her son was injured by vaccines, runs a Virginia-based nonprofit that fights legislative efforts to tighten vaccine requirements. Her group, the National Vaccine Information Center, brings in about $1 million a year, according to its 2018 tax documents.

Though they are separately organized, the three groups reinforce one another’s efforts. Kennedy and Bigtree often appear together at public events, while ICAN’s website includes a link to Fisher’s group. Bigtree’s weekly live stream broadcast, which ICAN promotes, frequently features Kennedy.

New York City Health Commissioner Oxiris Barbot, who has battled the nation’s single worst measles outbreak since October, said she never heard of the Selzes. “But I do know the science and the science is clear — the MMR vaccine prevents measles,” she said, using the common acronym for the vaccine that prevents measles, mumps and rubella. “Any suggestion to the contrary is a threat to the health and well-being of New Yorkers.”

The Selzes did not respond to emails or phone messages. A woman who answered the telephone at the couple’s home on Manhattan’s Upper East Side declined to identify herself. “There’s nothing to say,” she said before hanging up.

Bernard Selz, 79, has more than 40 years experience in the securities industry and runs Selz Capital, a hedge fund that holds a portfolio valued at more than $500 million, according to recent filings from the Securities and Exchange Commission.

Lisa Pagliaro Selz, 68, worked for Manufacturers Hanover Trust and Tiffany and Co. Since 1993, she has helped manage the Selz Foundation “with a focus on humanitarian, educational, geriatric, homeopathic, animal causes and the arts,” according to a news release issued by LaGuardia Community College Foundation, where she was a board memberfrom 2011 to 2016.

The Selzes’ sons — both young adults — declined to comment. Friends and family members reached by The Washington Post said they were unable to shed light on the Selzes’ philanthropic choices.

“This is a topic we don’t discuss,” said Marilyn Skony Stamm, a business executive and close friend of Lisa Selz. “We have differing opinions.” Stamm declined to elaborate, except to say that she values her friendship with the Selzes, whom she called “an incredibly philanthropic family.”

Support for a key figure

Tax filings for the couple’s charitable foundation show they began supporting the movement in 2012, when they gave $200,000 to a legal fund for Andrew Wakefield, one of the most important figures in the anti-vaccine movement.

Wakefield, a former gastroenterologist, rose to fame in 1998 after publishing a paper in the Lancet, a respected British medical journal, that linked the MMR vaccine to autism in eight children. An investigation by Britain’s General Medical Council, which regulates doctors, found Wakefield guilty of professional misconduct in 2010 and revoked his license. The panel concluded that Wakefield had financial and ethical conflicts of interest, and had acted “dishonestly and irresponsibly.” Twelve years after the study’s publication, the Lancet retracted it.

Wakefield declined to comment for this report. He has repeatedly denied wrongdoing and said he was motivated by children’s suffering.

“You have probably heard in the newspapers and elsewhere that I am guilty of scientific fraud,” Wakefield said via Skype to a forum this spring in Rockland, N.Y. “And I want to reassure you that I have never been involved in scientific fraud. What happened to me is what happens to doctors who threaten the bottom line of the pharmaceutical companies.”

By 2012, Wakefield had moved to Austin, where supporters began raising money for the Dr. Wakefield Justice Fund, an effort to sue the journalists who had questioned Wakefield’s findings. The fund was “established by friends and supporters . . . to respond to false claims made against Dr. Wakefield; expose the corrupting influence of special interest groups behind these allegations and protect Dr. Wakefield’s work from both profit- and politically-motivated censorship and retribution,” an archived version of the fund’s website says.

Wakefield’s lawsuit was unsuccessful, but the Selz Foundation found other ways to support his work. After he launched two nonprofits in 2014, the Selz Foundation donated $1.6 million to the groups over the next several years, according to tax records. One, the AMC Foundation, was registered as a public charity to fund documentaries about public health issues. The other was a Texas nonprofit corporation.

Wakefield used the money to help fund a documentary film called “Vaxxed,” which details his allegations about a government coverup of vaccine dangers. After filming, he and other producers traveled the country in a black “Vaxxed” bus that stopped at churches, libraries and chiropractors’ offices to record interviews with parents who believe their children had been injured by vaccines.

“Virtually every dollar in this film to date has been donated by a handful of brave parents and philanthropists,” the “Vaxxed” website says. In the credits, the film lists the Selz Foundation first among 16 donors who financed the production.

The film also introduced a new face to the anti-vax movement: Bigtree. Once a television producer of “The Doctors,” a daytime talk show filmed in Hollywood, Bigtree signed on to co-produce the film, which was released in 2016.

Tara Smith, an infectious disease expert at Kent State University who hasresearchedthe anti-vaccine movement, called the film “an effective piece of propaganda” that uses “heart-wrenching stories of children supposedly harmed by vaccination.”

For example, one mother featured in the filmsaid her son developed autism after he was inadvertently given a double dose of the MMR vaccine. Filmmakers provided no medical documentation to support the claim, and the mother has said publiclythat her son’s medical records were stolen from her apartment.

The stories in the film “frequently fall apart when scrutinized,” Smith said.

Bigtree said the film’s critics are “spreading misinformation” unless they “have proof that the exact stories of vaccine injury by the parents that appear in ‘Vaxxed’ are false.”

Since the publication of Wakefield’s Lancet paper, 21 studies have investigated vaccines and autism. None has found evidence of a link. The latest and largest study published this spring involved 657,461 Danish childrenborn between 1999 and 2010. Experts note the first symptoms of autism often appear when children are about 12 months old — the same age they receive their first MMR shot — leading many parents to blame vaccines.

Last year, Wakefield dissolved the two nonprofits, according to Texas business filings and Wakefield’s co-founder, Polly Tommey. During its brief life, the AMC Foundation doled out grants exclusively to Autism Media Channel LLC, a private company that was also run by Wakefield, Tommey and a third partner, according to tax filings.

According to the filings, the grants supported an educational film project.

Attorney Marc Owens, a former head of the IRS division responsible for monitoring tax-exempt organizations, said the arrangement is “a very suspicious transaction.”

“They transferred all of their income, it appears — with the exception of a small amount — to, basically, themselves,” Owens said. “It is extremely unusual to see this sort of expenditure from a public charity.”

In an interview, Tommey defended the transactions.

“Everything was cleared legally, and we stuck to our mission,” she said.

Tommey said she is now focused on the upcoming release of a sequel to “Vaxxed” that will include information about Gardasil, a vaccine that protects against several strains of the human papillomavirus. Wakefield, meanwhile, has launched another public charity to fund educational film projects, according to tax filings.

The same year “Vaxxed” was released, Bigtree established the Informed Consent Action Network. The Selz Foundation donated $100,000 that first year — 83 percent of the charity’s funding, according to tax records.

June, 2019|Oral Cancer News|

Researchers zero in on new class of oral cancer drugs

Source: UT Health San Antonio
Date: June 3, 2019
Author: Rosanne Fohn

SAN ANTONIO (June 3, 2019) ― Researchers at UT Health San Antonio have identified a potent new class of anti-cancer drugs that target oral cancer cells while leaving other cells unharmed. The new drug class also has shown promise in stopping other types of cancer.

In two recent papers, a research team led by Cara Gonzales, D.D.S., Ph.D., developed a new class of drugs broadly referred to as capsazepine analogs and tested them against oral and other types of cancers in preclinical and animal studies.

Low survival rate for advanced and recurrent oral cancer

“Our main goal was to develop cancer-targeting drugs to effectively treat advanced and recurrent oral cancer,” said Dr. Gonzales, an associate professor in the School of Dentistry’sDepartment of Comprehensive Dentistry. “This is important because oral cancer is a deadly disease with a five-year survival rate of only 40 percent,” she said. “Oral cancer is rarely diagnosed in its earliest stages when it can be cured. About 75 percent of patients come to the clinic with advanced disease, dramatically lowering their chance of survival,” she said.

The team’s previous research showed that capsazepine is a potent cancer killer. Capsazepine is a synthetic cousin of capsaicin, the substance in chili peppers that gives them their heat. While studying oral cancer pain, Dr. Gonzales’ team discovered that capsazepine has significant cancer-fighting activity through a cancer-selective mechanism of action. In collaboration with the Center for Innovative Drug Discovery, a partnership of UT Health San Antonio and The University of Texas at San Antonio, more potent capsazepine analogs were developed with significantly stronger anti-cancer efficacy in mouse models of oral cancer and no adverse effects on healthy tissue.

Two papers show progress

In a paper published in Bioorganic & Medicinal Chemistry in November, Dr. Gonzales’ team describes their work synthesizing 30 new compounds whose chemical structures were based on the parent compound, capsazepine. The compounds were then screened based on their ability to kill oral cancer cells in culture. Lead compounds CIDD24, CIDD99 and CIDD111 were validated in mouse models of human cancer.

This data informed additional preclinical and animal work outlined in the second paper, published in March in the Journal of Oral Pathology & Medicine. These studies zeroed in on the most effective lead compound, CIDD99. This compound eradicated the tumors while leaving normal healthy tissue unaffected. An added benefit was that CIDD99 also sensitized oral cancer cells to traditional chemotherapies, meaning that much lower doses of chemotherapy could be used with dramatically greater effectiveness and fewer side effects.

Drugs effective against other types of cancer

CIDD99 was also effective against a panel of other cancer types and therefore may provide a new therapy for multiple cancers with fewer side effects than traditional chemotherapies. “As we got further into our research, we found that CIDD99 also is effective against non-small-cell lung cancer, triple-negative breast cancer and prostate cancer cells,” Dr. Gonzales said.

“These results are very exciting because no new drugs have been developed in over 40 years to treat oral cancer. While immunotherapy works very well, it is only effective in a small group of patients. Our compounds may provide a new class of drugs that may be effective for all oral cancer patients,” she added.

Patents filed on three drugs

UT Health San Antonio and UTSA have a patent on the three drugs through the Office of Technology Commercialization, which serves both universities as a catalyst for stimulating innovation and entrepreneurship among faculty, staff and students and industry partners through the UT System.

Researchers working toward human clinical trials

The research team is now working with venture capital companies to apply for Small Business Technology Transfer grants and an American Cancer Society Mission Boost Phase 1 grant to conduct additional preclinical studies that are required before applying to the U.S. Food and Drug Administration for an Investigational New Drug (IND) status. An IND designation authorizes the administration of an experimental agent in humans enabling future clinical trials.

“These grants will help us generate additional data regarding safety, toxicity and how they work in the body that will get us ready to submit our FDA application for human trials,” Dr. Gonzales said.

The research was supported by an Institute for Integration of Medicine and Science Clinical and Translational Science Pilot Award and a San Antonio Life Science Sciences InstituteCenter for Innovative Drug Discoveries Pilot Grant.

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The University of Texas Health Science Center at San Antonio, now called UT Health San Antonio®, is one of the country’s leading health sciences universities. With missions of teaching, research, healing and community engagement, its schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced 36,500 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit www.uthscsa.edu.

June, 2019|Oral Cancer News|

Robotic surgery for oropharyngeal cancer not better than radiation therapy, study finds

Source: News Medical
Date: June 7, 2019
Author: Reviewed by James Ives, M.Psych (Editor)

In 2012, scientists at Lawson Health Research Institute launched the world’s first clinical trial comparing robotic surgery to radiation therapy for the treatment of oropharyngeal cancer (cancer at the back of the throat). The team is now reporting findings from the seven-year study which challenges beliefs that surgery leads to better swallowing outcomes, suggesting instead that radiation results in better quality of life for patients.

For Betty Ostrander, an operating room nurse from Tillsonburg, Ontario, a throat cancer diagnosis was life-changing. Betty was 59 when she discovered a small lump on the right side of her neck. After seeking medical care and testing, she was told she had oropharyngeal cancer.

“I remember thinking ‘I’m healthy, I eat right and I exercise; this can’t be happening to me.’ But it was, and it was scary,” recalls Betty. “One of the first questions I asked was whether there were any clinical trials available.”

Betty was one of 68 research participants in the ORATOR trial. The study included six centres from across Canada and Australia, including London Health Sciences Centre’s (LHSC) London Regional Cancer Program. Participants were randomized to receive either precision radiation therapy, often combined with chemotherapy, or transoral robotic surgery (TORS).

TORS is a surgical method for treating throat cancer which uses a small 3D camera and miniature robotic instruments to remove tumors. LHSC was the first center in Canada to offer TORS in 2011.

“Early studies suggested TORS might reduce the risk of swallowing problems historically associated with radiation and it therefore rose quickly in popularity,” explains Dr. Anthony Nichols, Associate Scientist at Lawson and Head and Neck Cancer Surgeon at LHSC. “But there was no randomized trial to compare patients’ swallowing outcomes. As the first center in Canada to offer TORS, we decided to tackle this problem through the ORATOR trial.”

The research team found no difference in survival between the two groups but, surprisingly, participants in the radiation group experienced better swallowing outcomes. A mild decline in swallowing function was observed in 40 per cent of the surgery participants compared to 26 per cent of radiation participants. All participants were able eat a full diet after treatment but 16 per cent from the surgery group said they needed to specially prepare their food.

Our findings challenge the notion that TORS leads to better swallowing outcomes. While radiation was previously associated with poor swallowing outcomes, treatments have advanced considerably and are now much more precise, which may be leading to better patient outcomes.”

Dr. David Palma, Associate Scientist at Lawson and Radiation Oncologist at LHSC

Patients in the surgery group were also at risk for dangerous bleeding during surgery. One year after treatment, patients in the surgery group were more likely to experience pain (22 per cent versus eight per cent in the radiation group), use painkillers (45 per cent versus 15 per cent), have issues with their teeth (12 per cent versus one per cent), and experience shoulder impairment.

The team found that patients in the radiation group experienced more short-term constipation and a temporary drop in blood counts. They also experienced an increased risk of tinnitus (ringing in the ears) and high frequency hearing loss when receiving chemotherapy, with some needing hearing aids.

“Each therapy has its different potential side effects but our findings suggest that TORS is not superior to modern radiation,” says Dr. Nichols. “We hope this research can be used by patients and their oncologists to help inform treatment decisions.”

Cases of oropharyngeal cancer have more than doubled since the 1990s. While throat cancer was more common in elderly patients with a history of heavy smoking or drinking, physicians have seen a dramatic rise in cases caused by human papilloma virus (HPV).

There is fortunately a high survival rate in patients with HPV-related throat cancer, leading researchers to study quality of life after treatment.

Drs. Nichols and Palma recently launched the ORATOR 2 trial which will further compare TORS against radiation and chemotherapy. The goal is to reduce the intensity of radiation and chemotherapy to improve quality of life while maintaining survival rates. The team aims to recruit 140 participants.

Results from the ORATOR trial were shared by Dr. Nichols at the American Society of Clinical Oncology’s Annual Meeting on May 31, 2019. The study was funded by the Canadian Cancer Society.

June, 2019|Oral Cancer News|

Queensland scientist develops new HPV cancer vaccine

Source: 9News
Date: May 22, 2019
Author: 9News Staff

*click Source to view video*

Former Australian of the Year Professor Ian Frazer has developed a vaccine aimed at treating HPV-related cancers of the head, neck, throat and tongue.

While funding is still being finalised, a trial of the vaccine is being prepared for people with incurable oropharyngeal cancers.

Professor Frazer, the Scottish-born immunologist who developed and patented the vaccine against HPV-related cervical cancer, has been working on this vaccine for nearly 15 years.

While the cervical cancer vaccine works as a preventative, this new vaccine is a treatment therapy.

It works by teaching the patient’s immune system to target the cancer cells containing HPV. The patient will then be given immunotherapy drugs that supercharge the immune system.

“This is all about a new way to treat cancer using the body’s defence against infection,” Professor Frazer said.

“This might give a second chance at life.”

HPV-related throat cancer kills three Australians every day.

“It’s going to become a major problem in Australia, in fact in the US we’ve seen an increase in HPV-related throat cancers by 225 per cent,” head and neck radiation oncologist Sandro Porceddu said.

Professor Porceddu will conduct the trial at the Princess Alexandra Hospital. It should begin towards the end of this year if a further $700,000 in necessary funding is found.

© Nine Digital Pty Ltd 2019
May, 2019|Oral Cancer News|

Greens and Genes

Source: Harvard Medical School
Date: May 16, 2019
Author: Jacqueline Mitchell

Your mother was right: Broccoli is good for you.

Long associated with decreased risk of cancer, broccoli and other cruciferous vegetables—the family of plants that also includes cauliflower, cabbage, collard greens, Brussels sprouts and kale—have now been found to contain a molecule that inactivates a gene known to play a role in a variety of common human cancers.

In a new paper published May 16 in Science, researchers led by Pier Paolo Pandolfi, the HMS Victor J. Aresty Professor of Medicine at Beth Israel Deaconess Medical Center, demonstrate that targeting the gene, known as WWP1, with the ingredient found in broccoli suppressed tumor growth in cancer-prone lab animals.

“We found a new important player that drives a pathway critical to the development of cancer, an enzyme that can be inhibited with a natural compound found in broccoli and other cruciferous vegetables,” said Pandolfi, who is also director of the Cancer Center and Cancer Research Institute at Beth Israel Deaconess.

“This pathway emerges not only as a regulator for tumor growth control, but also as an Achilles’ heel we can target with therapeutic options,” Pandolfi said.

One of the most frequently mutated, deleted, downregulated or silenced tumor suppressor genes in human cancersis PTEN. Certain inherited PTEN mutations can cause syndromes characterized by cancer susceptibility and developmental defects.

Because complete loss of the gene triggers an irreversible and potent failsafe mechanism that halts proliferation of cancer cells, it’s rare for both copies of the gene (humans have one copy from each parent) to be affected. Instead, tumor cells exhibit lower levels of PTEN. This raises the question of whether restoring PTEN activity to normal levels in the cancer setting can unleash the gene’s tumor-suppressive activity.

To find out, Pandolfi and colleagues identified the molecules and compounds regulating PTEN function and activation.

Carrying out a series of experiments in cancer-prone mice and human cells, the team revealed that a gene called WWP1, which is also known to play a role in the development of cancer, produces an enzyme that inhibits PTEN’s tumor-suppressive activity.

How to disable this PTEN kryptonite?

By analyzing the enzyme’s physical shape, the research team’s chemists recognized that a small molecule—formally named indole-3-carbinol (I3C), an ingredient in broccoli and its relatives—could be the key to quelling the cancer-causing effects of WWP1.

When Pandolfi and colleagues tested this idea by administering I3C to cancer-prone lab animals, they found that it inactivated WWP1, releasing the brakes on PTEN’s tumor-suppressive power.

But don’t head to the farmer’s market just yet. First author Yu-Ru Lee, HMS research fellow in medicine and a member of the Pandolfi lab, notes you’d have to eat nearly six pounds of Brussels sprouts a day, and uncooked ones at that, to reap their potential anti-cancer benefit.

That’s why the Pandolfi team is seeking other ways to leverage this new knowledge. The team plans to further study the function of WWP1 with the ultimate goal of developing more potent, and practical, WWP1 inhibitors.

Genetic or pharmacological inactivation of WWP1 with either CRISPR technology or I3C could “restore PTEN function and further unleash its tumor suppressive activity,” said Pandolfi. “These findings pave the way toward a long-sought tumor suppressor reactivation approach to cancer treatment.”

This work was mainly supported by the National Institutes of Health (grants R01CA82328 and R35CA197529).

In addition to Pandolfi and Lee, authors include Ming Chen, Jonathan D. Lee, Jinfang Zhang, Tomoki Ishikawa, Jesse M. Katon, Yang Zhang, Yulia V. Shulga, Assaf C. Bester, Jacqueline Fung, Emanuele Monteleone, Lixin Wan, John G. Clohessy, and Wenyi Wei, all of Beth Israel Deaconess; Shu-Yu Lin, Shang-Yin Chiang and Ruey-Hwa Chen of the Institute of Biological Chemistry; Tian-Min Fu and Chen Shen of Harvard Medical School; Chih-Hung Hsu, Hao Chen and Hao Wu of Boston Children’s Hospital; Antonella Papa of Monash University; Julie Teruya-Feldstein of Icahn School of Medicine at Mount Sinai; Suresh Jain of Intonation Research Laboratories; and Lydia Matesic of the University of South Carolina.

Disclosures: Pandolfi, Wei and Jain are cofounders of Rekindle Pharmaceuticals, which is developing novel therapies for cancer. All other authors declare no competing interests.

May, 2019|Oral Cancer News|

The Problem With Supplements

Source: Elemental
Date: May 6, 2019
Author: Markham Heid

Earlier this year, federal authorities announced plans to strengthen oversight of the supplement industry.

“The growth in the number of adulterated and misbranded products — including those spiked with drug ingredients not declared on their labels, misleading claims, and other risks — creates new potential dangers,” said U.S. Food and Drug Administration (FDA) commissioner Dr. Scott Gottlieb in a February press release.

Heightened oversight is needed, Gottlieb argued, because expansion and change within the supplement industry has made it difficult for his agency to keep pace. “What was once a $4 billion industry comprised of about 4,000 unique products, is now an industry worth more than $40 billion, with more than 50,000 — and possibly as many as 80,000 or even more — different products available to consumers,” he said.

From multivitamins and botanicals to probiotics and protein powders, roughly three out of four Americans now take some kind of supplement on a regular basis. Since the days of palliative tonics and snake-oil salesmen, Americans have been readily lured by the promise of health or longevity in the form of a drink, pill, or powder. While the terminology has evolved — “biohacking” and “nutraceuticals” are some of the buzzwords du jour — the implied benefits of most supplements still outpace or ignore the science. And despite recent studies that find supplements are frequently contaminated or that the best way to get nutrients is through food, Americans’ interest in supplements is only growing. And experts say many supplement users don’t recognize or appreciate the risks that accompany the use of these products.

“Pill use among every age group is at an all-time high,” says Dr. Mark Moyad, the Jenkins/Pomkempner director of preventive and alternative medicine at the University of Michigan. “There isn’t a medical condition or symptom you can name that doesn’t have a supplement you can take to treat or prevent it.”

“There’s a huge disconnect between people’s perception of supplements and the reality, and that can be really destructive.”

In some respects, the growth of the supplement industry is a good thing. As America’s population has grown older, fatter, and sicker, Moyad says there’s potential for targeted supplement use to fill in some nutrient shortfalls caused by unhealthy eating habits or disease-related deficiencies. There’s also little doubt that some groups — notably pregnant women and older adults — can benefit from taking certain supplements, he says.

“But the idea that you can take 10 pills a day and fix everything or live forever is faulty,” he says. “There’s a huge disconnect between people’s perception of supplements and the reality, and that can be really destructive.”

“Most supplements on the market are not tested for either efficacy or safety,” says Dr. JoAnn Manson, chief of the Division of Preventive Medicine at Brigham and Women’s Hospital in Boston. She mentions heavy metal contamination and other concerns related to poor manufacturing practices, and compares the current regulatory environment to “the Wild West.” Just last year, a JAMA report found unapproved pharmaceutical ingredients have turned up in hundreds of products.

If you’re taking a handful of supplements without a doctor’s oversight, she says, “there’s the potential for almost anything to happen.”

In the mid-1980s, researchers at Seattle’s Fred Hutchinson Cancer Research Center, and elsewhere, were optimistic about the disease-fighting potential of antioxidants and vitamins.

Two in particular — beta-carotene and vitamin A — had shown promise in early dietary studies. “Beta-carotene is an antioxidant and a natural component of green and orange-yellow vegetables,” says Dr. Gilbert Omenn, who back then was at Fred Hutchinson and is now a professor of human genetics and molecular medicine at the University of Michigan. “Vitamin A was shown to reduce cell division and the proliferation of cancer cells.”

After gaining study approval from the National Cancer Institute, Omenn and his colleagues recruited more than 18,000 men and women who were at high risk for lung cancer. They randomly divided these volunteers into two groups; one took a placebo while the other swallowed a daily supplement containing 30 mg of beta-carotene and 25,000 IU of vitamin A.

Omenn says the goal of his government-funded study, which was known as CARET, was to lower cancer incidence. “We had beta-carotene for its antioxidant properties and vitamin A for its antiproliferative effect, and we thought it would be a nice combination,” he says.

The results of CARET were so disastrous that the trial had to be terminated almost two years early. Rather than lowering rates of lung cancer, the supplement had the opposite effect. Among the people taking it, “we saw one additional cancer case per thousand people,” Omenn says. That may not sound like a lot, but in the world of cancer statistics, an increase of one case per 100,000 people is significant.

“What we observed was maybe the most potent carcinogenic effect ever discovered,” he says. “It was truly shocking.”

What went wrong? It turns out that, when confronted with an overabundance of certain antioxidants, the human body may convert them into prooxidants, which have the potential to activate cancer pathways. “Something fundamental we didn’t understand in advance was that, in living systems, antioxidants are not antioxidants in all situations,” Omenn says.

Troublingly, another group of researchers more or less replicated Omenn and his team’s work in a later trial that looked at the effect of vitamin E and selenium supplements on prostate cancer incidence. Again, people at high risk for cancer were randomly assigned either a placebo or a daily supplement. And again, the study had to be ended early because cancer rates soared.

The lesson here isn’t that supplements give people cancer. Rather, it’s that approaching supplements as though they’re all upside is a misguided and potentially harmful operating philosophy. When you swallow a capsule packed with concentrated amounts of a vitamin, nutrient, or other substance — a practice that did not become widespread until very recently — you can get into trouble. “To this day, there remain people who believe vitamins and organic compounds are inherently safe and that our studies were flawed,” Omenn says. “But clearly, that’s not true.”

Omenn says that heavy doses of vitamin A can also promote bone pain or swelling, headaches, and skin problems among adults. Taken during pregnancy, large doses of vitamin A can cause birth defects, he says.

While individual supplements are unlikely to pack dangerous levels of vitamin A, people who take multiple supplements with overlapping ingredients may be playing with fire. “I see patients who come in with a whole bag of supplements they’re taking — an immune booster, something for hair, something for vision, something for skin — but if you look at the ingredients, you see they’re all the same,” says Dr. Zhaoping Li, a professor of medicine and director of clinical nutrition at UCLA Medical Center. “So someone is taking three or four things with vitamin A, and also a multivitamin with vitamin A, and all these can add up.”

Li explains that fat-soluble vitamins can accumulate in the body and cause liver toxicity. She says that, on rare occasions, she’s seen patients who needed liver transplants due to supplement overuse. But a more typical reaction to this sort of nutrient overdose could be elevated levels of inflammation accompanied by GI side effects like nausea and bloating, she says. “But these are nonspecific symptoms,” she adds, meaning doctors who see people with these issues probably wouldn’t associate them with supplement overuse.

While specifics vary from one product to the next, nearly all supplements come with some level of risk — including some of the most popular pills on the market today.

“When you talk about fish oil and omega-3, it’s very difficult and expensive to preserve the goodness of the fatty acids and to put it in capsules,” says Chandan Sen, associate vice president of research at the Indiana University School of Medicine. If fish oil is not properly preserved, he says, it becomes oxidized and potentially harmful. Taking such a product has “a similar impact on the body as taking over-fried cooking oil,” he explains.

Sen has written extensively on the risk and role of supplements. He says heavy-metal contamination is a common and well-documented issue associated with herbal products. He, and others, also point out that, time and again, research has shown that taking concentrated doses of food-derived or plant-derived nutrients does not confer the same benefits as eating the foods or plants themselves.

“In the cancer world, we tell people to avoid processed foods, and supplements by definition are processed foods.”

“It’s often harder for the body to metabolize an isolated vitamin or nutrient on its own,” says Lorenzo Cohen, a distinguished professor and director of the Integrative Medicine Program at the University of Texas MD Anderson Cancer Center in Houston. Cohen says that whole, unprocessed foods contain “a whole pharmacology” of different compounds and chemicals that together have a synergistic effect not found when those same chemicals are isolated and taken as supplements. It’s this synergy, he says, that seems to provide the greatest health benefit and the least amount of risk.

“Take curcumin, which is popular in the cancer world,” he says. Curcumin is found in turmeric root, and some research has found that it has antioxidant and anti-inflammatory properties. “When you consume curcumin as ground up turmeric powder and use it in cooking, you’re getting it with this rich soup of different phytochemicals and other constituents that are probably helpful,” he explains. On the other hand, taking concentrated curcumin in a capsule — even if its paired with other ingredients to boost its bioavailability — doesn’t seem to have the same effect, and it may come with risks, he says.

“In the cancer world, we tell people to avoid processed foods, and supplements by definition are processed foods,” he adds.

Sen echoes many of these warnings. “There’s evidence that berry anthocyanins may have potent anticancer chemopreventive effects,” he says. “But these anthocyanins have a very specific chemical structure.” When supplement makers try to extract these structures and put them into pills or powder, they often end up with a very different structure, he explains.

Sen says he’s interacted with many supplement companies. And his experience, by and large, has been that most of them spend far, far more of their budget on product marketing than on proper research and development. “This is clearly not in the best interest of consumers,” he says.

A common scenario, he explains, is that a small study performed in a “limited” experimental environment — for example, in cell cultures or in animals — will link a certain plant chemical with a potential health benefit. The media reports on this finding, and then a supplement maker rushes to manufacture a supplement using the relevant chemical, which they’ll claim is “science-backed.”

“The current legal landscape permits this,” he says. “To regulate everything is not the answer, but the barrier of entry into the marketplace for supplements is very low.”

In his February press release, FDA’s Gottlieb detailed plans to beef up his agency’s research efforts and product-reporting requirements. The FDA has since announced plans to heighten public awareness of adulterated products. But experts say these changes, while welcome, won’t address many of their core concerns.

“There are really no laws that make supplement companies go through the FDA in the first place,” says Joanna Sax, a professor of law at California Western School of Law who has published papers on the supplement industry.

Sax explains that, unlike prescription drugs or over-the-counter medications, nutrition and health supplements are legally categorized as food products. This makes them exempt from many forms of oversight. “Drugs have to be tested for safety and efficacy before they go to market,” she says. “But in most cases, the FDA can remove a supplement from the market only if there’s a demonstrated harm, and they don’t know if there’s a harm until that harm has already happened.”

The FDA’s authority comes from Congress, she adds, and so their power to prevent risky supplements from getting into consumers’ hands is limited. (The FDA declined to comment for this story.)

There’s a counterargument to be made that, were the FDA granted the power to demand pharmaceutical-level testing of supplements, many people would be denied affordable access to products that could provide them real and meaningful benefits.

“Pharmaceuticals need to be vetted for efficacy and safety, and approved by the FDA through a process that can take 10-plus years and many, many millions of dollars,” says Amy Brown, an associate professor in complementary and integrative medicine at the University of Hawaii at Manoa who has researched herb and dietary supplements. “This process is not possible for dietary supplements that are not patented,” she says. The costs would chase away most manufacturers.

Still, other experts say change is needed. “I absolutely do think there should be increased regulatory oversight and supplement makers should have to show that their products are safe,” says Brigham and Women’s Manson. “Many come with risks and very few benefits.”

Regardless of how supplements are regulated, experts say it’s time people started thinking of these products as akin to prescription drugs.

“There’s a lot of distrust of the drug industry, and I think some consumers trust supplements more because they see them as ‘natural’ and not made by the drug companies,” Sax says. The irony is that the recent growth in the consumer supplement industry has largely been fueled by drug companies entering the fold.

“It used to be supplements versus Big Pharma, but now they’ve merged — supplements are Big Pharma,” UM’s Moyad says. “The drug companies saw how big complementary health was getting and they wanted a piece of the action.”

“There is a desire to go from point A to point B as quickly and easily as possible, and taking pills to do that is very chic right now.”

Based on his 33 years in medicine — much of which he’s spent studying supplements — Moyad says he approaches these products with the same caution he applies to drugs. “I understand and respect the power of pills,” he says. Like prescription drugs, supplements can help people with a diagnosed medical condition or deficiency. And like pharmaceuticals, supplements come with risks and side effects, he says.

He also practices what he preaches. “My colleagues can’t believe I don’t take anything,” he says. “And I tell them I don’t take anything, first of all, because I don’t need to take anything, and also because I’m not willing to be a guinea pig in a clinical trial of one.”

Asked for examples of times when supplements are clearly beneficial, he says there’s strong evidence that some products can benefit those at high risk for macular degeneration or skin cancer. There’s also good evidence that supplements can treat some disease-related symptoms.

There’s also no question that certain patient groups — as well as adults who, by choice or by necessity, are deficient in certain vitamins or nutrients — can make up shortfalls with supplements. “I’m primarily vegan, so I take a vitamin B12 supplement,” MD Anderson’s Cohen says. But he adds that, for healthy adults looking to mitigate their disease risks, supplements offer more downside than upside. “In the best case, they’re just a waste of money and you pee them out,” he says. “The worst case is over time there’s some kind of accumulation and toxicity.”

Over and over again, he and other experts say that eating a range of healthy whole foods is a better, safer, more-effective approach than taking supplements.

“Eat at least five servings a day of fruits and vegetables, eat whole grains rather than refined grains, avoid processed foods, eat at least two servings of fish a week,” Manson says. “If you’re vegetarian, try to get fatty acids from oils and nuts and seeds.”

Moyad agrees. “I have yet to come across any product that someone could sell me that was the secret to health or longevity,” he says. “But all the boring shit — a healthy diet, a good night’s sleep, exercise — the evidence for that has only become stronger.”

“There is a desire to go from point A to point B as quickly and easily as possible, and taking pills to do that is very chic right now,” he says. “I think we’ll get to a place where some supplements could have incredible value in disease treatment, but people need to wake up to the fact that if they’re experimenting on themselves with these products today, they could wake up in a few years and have done real harm.”

May, 2019|Oral Cancer News|

Tackling side effects in head and neck cancer treatment – the end of the road for hyperbaric oxygen?

Source: Cancer Research UK
Date: May 2, 2019
Author: Katie Roberts

Some side effects appear years after cancer treatment. That’s the case for one side effect of radiotherapy for head and neck cancer, called osteoradionecrosis.

This painful condition results from damage to the jaw bone, which often doesn’t heal properly and can cause bone fractures or even bone death.

It can develop without an obvious trigger, but it’s often linked to dental work like tooth extractions or implants. And it can happen even if the dental work is carried out 20 years after radiotherapy.

Professor Richard Shaw, a Cancer Research UK-funded head and neck surgeon at the University of Liverpool, treats the difficult condition quite frequently through reconstructive surgery.

Shaw says that these procedures are often bigger and harder than patients’ original cancer surgery, because they’ve already had so much treatment in that area.

For that reason, researchers have looked for ways to prevent osteoradionecrosis from developing. And that’s where hyperbaric oxygen comes in. It started with a small trial in the 80s, which has influenced the way doctors prepare patients for dental surgery ever since.

But new Stand Up To Cancer trial data, led by Shaw and published in the International Journal of Radiation Oncology, shows the hyperbaric oxygen hype may have been a bit premature.

The trial of hyperbaric oxygen

Back in the 1980s, a small trial in the US showed that giving hyperbaric oxygen before dental surgery could reduce the risk of osteoradionecrosis developing.

What is hyperbaric oxygen therapy?

Hyperbaric oxygen treatment involves sitting in a chamber where the oxygen is at a higher pressure than the air we normally breathe. It’s thought the increase in oxygen can help to promote healing. Sessions typically last 60-90 minutes.

“Prevention is obviously a very good idea, but I think there was concern around whether hyperbaric oxygen was the answer,” says Shaw.

A big question that lingered around the treatment was how applicable the 34-year-old trial results were to patient’s today. Radiotherapy has become a lot more targeted than it was a few decades ago, which may affect the risk of someone developing osteoradionecrosis.

“There really was no recent, good evidence for hyperbaric oxygen,” says Shaw.

No one wants to take the risk with our patients who, after all, had been cured of head and neck cancer and saw themselves as long-term survivors.

– Professor Richard Shaw

The verdict’s in

Shaw and his team ran a trial testing hyperbaric oxygen treatment in 144 patients who’d had head and neck cancer and now needed dental surgery. Half the patients had a course of hyperbaric oxygen before surgery, the other half didn’t.
Patients were then monitored after dental treatment to see who developed osteoradionecrosis, as well as monitoring pain levels and quality of life.

The first thing the team learnt was that osteoradionecrosis is a lot less common now than it was in the 80s.

“We can now say that with modern radiotherapy, someone’s risk of having this jaw problem is about 1 in 20. Which is a lot lower than the previous trial, which had shown it was around 1 in 3,” says Shaw.

The other big finding was that hyperbaric oxygen had no impact on the number of people developing osteoradionecrosis – the numbers were pretty much the same in each side of the trial.

And although people who had hyperbaric oxygen reported fewer short-term side effects and less pain immediately after surgery, there was no difference in long-term pain or quality of life between the two groups.

“It’s very clear that in our health system, hyperbaric oxygen is no longer justified,” says Shaw. “In some ways it could be reported as a negative finding, because hyperbaric oxygen didn’t work. But I think it has given us a definitive change of practice.”

What’s next?

As well as changing practice, the trial leaves another legacy: patient samples. Shaw is planning to use these to understand more about who develops osteoradionecrosis.

“What you’ll deduce with 6% of patients developing osteoradionecrosis in this trial is that 94% of people didn’t, even though they were considered high risk,” he says.

Right now, risk is assessed based on where the radiotherapy was aimed, as well as the type of follow-up dental work that’s being done. But Shaw believes risk could be predicted more precisely. The team will now study the patient samples to look if there are any differences in the DNA of patients who went on to develop osteoradionecrosis.

“We’re looking for a genetic signal or a ‘fingerprint’ that identifies people at high risk of osteoradionecrosis that we could validate in future trials,” says Shaw.

For now, Shaw says doctors can help to reduce the risk of osteoradionecrosis by making sure patients’ teeth are in the best possible condition before and after radiotherapy.

This, Shaw says, could help make sure “these conditions that require surgery don’t arise in the first place.”

May, 2019|Oral Cancer News|

Oral HPV DNA Persistence After Head and Neck Cancer Treatment Linked to Disease Progression

Source: genomeweb
Date: May 2, 2019
Author: Staff Reporter

NEW YORK (GenomeWeb) – Persistent traces of human papilloma virus DNA after treatment for HPV-positive head and neck cancer is linked to an increased recurrence risk, a new study has found.

Head and neck cancers affect some 53,000 people in the US each year, according to the National Cancer Institute, and HPV has been implicated in many of those cases. In general, patients with HPV-positive tumors have higher survival rates than those with HPV-negative tumors.

A team of MD Anderson Cancer Center-led researchers collected oral rinse samples from nearly 400 patients with head and neck squamous cell carcinomas at diagnosis and as their treatments progressed. As they reported today in JAMA Oncology, the researchers found that viral load in patients’ oral samples broadly decreased as they underwent therapy. But some patients’ viral loads persisted despite treatment, which was linked to an increased risk of cancer recurrence and death, the researchers reported.

“Our data suggest that a subset of patients with HPV-positive HNSCC at high risk for locoregional recurrence can be identified by detection of persistent, oral HPV after treatment,” MD Anderson’s Maura Gillison and her colleagues write in their paper.

The researchers enrolled 396 patients with oral cavity, oropharyngeal, or unknown primary HNSCC in their study. They tested the patients’ tumors for the presence of 13 high-risk HPV types using an mRNA expression test and found 202 patients had HPV-positive tumors.

At the same time, the researchers collected oral rinse samples from patients at diagnosis, after surgery, and at six months. Additionally, patients who underwent radiotherapy provided weekly oral rinse samples. The researchers tested these samples — a total of 2,922 oral rinse samples — for the presence of HPV using a multiplex PCR-based approach.

At diagnosis, patients with HPV-positive tumors were significantly more likely to have oral rinse samples positive for HPV than were patients with HPV-negative tumors. In particular, the researchers reported that the detection of any oral HPV DNA had a sensitivity of 84 percent, a specificity of 88 percent, a positive predictive value of 88 percent, and a negative predictive value of 84 percent for the diagnosis of an HPV-positive tumor.

The prevalence of oral HPV DNA, though, went down after treatment, the researchers reported. Prior to treatment, the prevalence of HPV DNA in oral rinses that matched that of HPV in the tumor sample was 69 percent. But after primary surgical resection, it was about 14 percent. Its prevalence fell similarly for patients who underwent radiotherapy, going from 85 percent before treatment to 9 percent after radiotherapy.

As expected, overall and recurrence-free survival was higher for patients with HPV-positive tumors than with HPV-negative tumors. Patients with HPV-positive tumors had a two-year overall survival of 91 percent, as compared to 75 percent for patients with HPV-negative tumors.

But for a subset of patients with HPV-positive tumors — about 14 percent — the prevalence of oral HPV DNA didn’t decline with treatment. These patients were more likely to recurrent disease, with about 45 percent experiencing disease recurrence within two years. Additionally, this subset had a lower two-year overall survival of 68 percent.

These patients, the researchers noted, might benefit from increased surveillance or adjuvant therapy.

The researchers added that their findings suggest that oral rinses to detect HPV DNA in head and neck cancer patients might be helpful. They cautioned, though, that its clinical utility might be limited by the need to identify tumor-type infections.

“Ongoing studies will evaluate whether multiplexed detection of plasma HPV DNA can improve these limitations,” the researchers added.

NOTE: This research was paid for in part by the Oral Cancer Foundation,www.oralcancer.org

May, 2019|Oral Cancer News|