6/1/2007 Hyannis, MA Robin Lord Cape Cod Times (www.capecodonline.com) In one photograph, the patient's gums look pink and smooth, a sign to a dentist that, at first glance, all is well. But in the second photo, taken with a new oral screening tool, two dark round spots are revealed on the same patient's gums. They may be a sign of malignancy. The Velscope, a machine on the market only since November, consists of a thin wandlike device with a high-intensity blue light and magnifier at the end. It offers health care professionals a way to see, through the gums, whether cancer is lurking below the surface. Normal tissue will reflect the scope's light and glow. Abnormal tissue absorbs it and shows a dark opaque image. On Cape Cod, at least two dentists, Dr. William Sheier of Orleans and Dr. Stephen McGrail of Yarmouth, already have installed the $6,000 machine in their offices. McGrail says he planned to look at new dental chairs when he went to the annual dental show in Boston in January. The Velscope caught his eye, and within a half-hour of seeing it demonstrated, he had bought one. "I usually let new technology prove itself before I buy it, but this is the most exciting thing out there," he says. "It shows you things you normally would miss and puts them in the forefront." Finding ways to better detect oral cancer is important because about 90 percent of people who contract the disease die within five years, [...]

6/1/2007 web-based article Arlene A. Forastiere et al. Journal of Clinical Oncology, Vol 25, No 16 (June 1), 2007 Squamous cell cancer of the head and neck (HNSCC) would seem to be the ideal malignancy for epidermal growth factor receptor (EGFR) inhibition either with antibodies or small molecule tyrosine kinase (TK) inhibitors. EGFR protein is overexpressed in more than 90% of tumors relative to normal tissue, and high expression is associated with poor disease control.1-3 Data from preclinical models show at least additive effects of the two classes of EGFR inhibitors when combined with cisplatin,4,5 providing rationale for combination therapy. To date, cetuximab has been studied in recurrent HNSCC in combination with cisplatin6 and platinum plus fluorouracil (FU)7 as first-line treatment for recurrence and in the setting of platinum refractory disease,8,9 whereas the small molecule TK inhibitors have been tested as single agents in the second- or third-line setting.10-12 The optimal timing of EGFR inhibitors in the palliation of patients with disease recurrence has not been well defined. HNSCC has the theoretical advantage of providing easily accessible tumor for biopsy, which could facilitate study of the putative effects of molecularly targeted therapies on the complex signaling pathways downstream of the EGFR. Such correlative tissue studies are needed to elucidate EGFR pathway tumor biology and identify predictive markers for better patient selection for these costly therapies. This issue of the Journal of Clinical Oncology contains five articles that provide some insights into these questions and the results of an analysis of [...]

6/1/2007 Bethesda, MD staff Doctor's Guide (www.docguide.com) A blood test that detects proteins commonly released by a growing tumor could one day become a useful tool for monitoring the effectiveness of chemotherapy and radiation treatment in people with advanced throat cancer, according to a study published in the June 1, 2007, issue of Clinical Cancer Research. Scientists in the National Institute on Deafness and Other Communication Disorders (NIDCD) and National Cancer Institute (NCI), two of the National Institutes of Health (NIH), in collaboration with researchers of the University of Michigan, found that throat cancer patients who showed a decline in several cancer-related proteins following chemotherapy and radiation treatment were more likely to remain in remission, while those who experienced a large rise over time in those proteins frequently exhibited a return of throat cancer. The findings could help lead to the development of a blood test that enables doctors to detect the recurrence of throat cancer early on, when there is still time to pursue a second line of treatment, such as surgery or drug therapy. "Cancers of the head and neck are insidious because surgical removal of the tumor can severely impair a person's ability to talk and to swallow," said NIDCD Director, James F. Battey, Jr., MD, PhD. "A blood test that enables doctors to closely monitor a patient's rehabilitation while sparing the patient's voice, speech, and swallowing ability is an excellent example of the predictive, preemptive, and personalized approach to medicine that the NIH strives for." Roughly [...]

5/30/2007 Singapore Margie Mason apnews.myway.com Asia is bracing for a dramatic surge in cancer rates over the next decade as people in the developing world live longer and adopt bad Western habits that greatly increase the risk of the disease. Smoking, drinking and eating unhealthy foods - all linked to various cancers - will combine with larger populations and fewer deaths from infectious diseases to drive Asian cancer rates up 60 percent by 2020, some experts predict. But unlike in wealthy countries where the world's top medical care is found, there will likely be no prevention or treatment for many living in poor countries. "What happened in the Western world in the '60s or '70s will happen here in the next 10 to 20 years as life expectancy gets longer and we get better control on more common causes of deaths," said Dr. Jatin P. Shah, a professor of surgery at Memorial Sloan-Kettering Cancer Center in New York, who attended a cancer conference last month in Singapore. "The habit of alcohol consumption, smoking and dietary changes will increase the risk of Western world cancers to the Eastern world," Shah said. An estimated 40 percent of cancers worldwide can be prevented by exercise, eating healthy foods and not using tobacco, according to the World Health Organization. But more people in Asia are moving into cities and becoming overweight and obese from inactivity. They are replacing fruits and vegetables with fatty meals full of meat and salt, which is leading to increases [...]

5/30/2007 San Francisco, CA CH Shiboski et al Community Dent Oral Epidemiol, June 1, 2007; 35(3): 233-40 Objectives: To explore distribution of stage at diagnosis and relative survival rates among US adults with oral cavity cancer in relation to race, and over time. Methods: We obtained 1973-2002 oral cancer incidence data from the Surveillance, Epidemiology, and End Results (SEER) Program, and computed proportions for each oral cavity site by stage at diagnosis, tumor size, and 5-year relative survival rates among Whites and Blacks. Results: A total of 46 855 cases of oral cavity cancer were reported to the SEER registry among adults >/=20 years between 1973 and 2002. African-Americans had a significantly higher proportion of cancer, mainly in the tongue, that had spread to a regional node or to a distant site at diagnosis than Whites: 67% versus 49% of tongue cancers reported from 1973 to 1987 (P < 0.001), and 70% versus 53% of those reported from 1988 to 2002 (P < 0.001). They had a significantly higher proportion of tongue cancer that were >4 cm in diameter at time of diagnosis (59% versus 44%; P < 0.001), and black men in particular experienced lower 5-year relative survival rates than white men, in particular, for tongue cancer (25% versus 43% from 1973 to 1987, and 31% versus 53% from 1988 to 2002). Conclusion: There are significant racial disparities with respect to stage at diagnosis and survival among adults with oral cancer reported to the SEER registry from 1973 to [...]

5/28/2007 web-based article David Holmes Nature Reviews Cancer 7, 406 (June 2007) An oral smokeless tobacco known as snus is continuing to stir up controversy, after two new articles published in the Lancet found that although snus users did not experience an increased risk of lung or mouth cancer compared with people who had never smoked, they were twice as likely to develop pancreatic cancer. The first study, led by Coral Gartner of the University of Queensland in Australia, modelled the potential effect of snus if it were to be introduced in Australia, and found that there would be little difference in health-adjusted life expectancy between smokers who gave up all tobacco and those who switched to snus, concluding that, "Snus could produce a net benefit to health at the population level if it is adopted in sufficient numbers by inveterate smokers" (http://www.medicalnewstoday.com, 10 May 2007). The second study, led by Olaf Nyrén of the Karolinska Institutet in Sweden, was more cautionary. Snus is widely used in Sweden, so the authors surveyed around 280,000 Swedish construction workers on their tobacco consumption from 1978 to 1992, and then followed them until 2004. They found that although snus use did not increase the risk of lung or mouth cancer, those who used snus had double the risk of developing pancreatic cancer. Whether or not the net effect of snus is positive or negative has been a contentious issue for some time. Nyrén stresses that, "We don't only need reliable and accurate measures [...]

5/28/2007 New York, NY Wendy Anne Epstein, M.D new York News (www.nynews.com) In a May 22 Community View ("HPV vaccine: Pressure leaves parents confused"), Bob Moffitt gives merit to the argument that mandatory vaccination with the HPV vaccine will encourage "reckless behavior such as sexual promiscuity." Implicit in this argument is that once vaccinated an individual would feel freer to engage in sexual behavior because they felt immune to contracting cancer-causing HPV. However, human papilloma virus is only one sexually transmitted disease. There is no vaccine for herpes, Hepatitis C, HIV. Implicit in this argument is that sexual contact is necessary to become infected with the cancer-causing strains of HPV, and by avoiding sexual contact one is guaranteed not to contract HPV. Unfortunately, sexual contact is not necessary for the transmission of cancer-causing HPV. Abstinence will not guarantee that your children are protected against developing cervical cancer. Hand-to-hand contact can transmit cancer-causing HPV. After all, that's how most people get ordinary warts caused by HPV. Most warts do not cause cancer, because most warts on the hands and fingers are caused by non-cancer-associated HPVs. However, cancer-causing strains of HPV, including strains 16 and 18, can also be found on the hands and fingers. Squamous cell carcinoma of the finger is almost exclusively caused by HPV strains 16 and 18, the same cause of 70 percent of cervical cancer. These cancers are potentially very aggressive and can reoccur or even metastasize if not adequately treated. I have treated several patients that [...]

5/28/2007 London, England Mark Henderson and Lewis Smith The Times (www.timesonline.co.uk) A revolution in cancer screening and treatment within 15 years is heralded today with the announcement of a leap in the ability to identify genes that cause the disease. Researchers are confident that their findings will allow a screening programme, in which the inherited risk of developing cancer can be assessed for every patient, to be in place in an estimated 12-15 years. Four common genes were identified and a fifth is on the verge of being pinpointed by researchers investigating the causes of breast cancer, almost doubling the number of known rogue genes. One of the new genes, when found in a mutated form, increases the risk of developing the cancer by up to 60 per cent — giving a woman a one in six chance of the disease. Its most damaging variant is carried by one in six women, making it much more common than previously identified genes that contribute to breast cancer. The success of a new “trawling technique” to assess 200,000 blocks of DNA simultaneously instead of one by one is expected to transform the search for treatments for all common cancers. While the research concentrated on identifying genes linked to breast cancer, the same technique can equally well be used for other types of the disease and work has already started on applying it to prostate, bowel and lung cancer. One scientist described the findings as the most important in breast cancer genetics since [...]

5/26/2007 Paolo Boscolo-Rizzo, MD et al Annals of Surgical Oncology 14:1575-1582 (2007) Background: The aim of this retrospective analysis was to analyze the results of treatment of patients with cervical node metastases from carcinoma of occult primary with a policy including neck dissection and postoperative comprehensive radiotherapy. Methods: Ninety patients were treated with curative intent from 1990 to 2002. Results: The actuarial rate of neck disease control was 68.8% at 5 years (95% confidence interval [CI], 58.9%–78.7%). On multivariate analysis, the rate of neck disease control was significantly related to lymph nodal metastatic level (P = .006). The actuarial rate of developing head and neck primary tumors at 5 years was 8.9% (95% CI, 2.6%–15.2%). The 5-year actuarial rate of distant metastases was 19.1% (95% CI, 9.4%–28.9%). In multivariate analysis, a statistically significant difference in the rate of distant metastasis was obtained when patients were stratified according to the level of nodal involvement (P = .01) and the presence of extracapsular extension (P = .013). At the time of analysis, 50 of the 90 patients were alive. A total of 32 (35.6%) had died from causes related to their primary disease. Actuarial disease-specific survival at 2 and 5 years was 73.6% (95% CI, 64.3%–82.9%) and 62.8% (95% CI, 51.9%–73.7%), respectively. In multivariate analysis, a statistically significant difference in disease-specific survival was obtained when patients were stratified according to the level of nodal involvement and the presence of extracapsular extension. Conclusions: Our study seems to support the use of combined-modality therapy [...]

5/23/2007 web-based article Amy Dockser Marcus Checkbiotech.org In 2004, Marnie Kaufman was diagnosed with a rare, little-understood cancer. There was no effective chemotherapy. Her husband Jeffrey's first thoughts turned to how to jump-start research. "Jeff wanted to raise money and give it to anyone walking down the hall of the hospital," Mrs. Kaufman recounts. But after meeting with David Sidransky, director of head-and-neck-cancer research at Johns Hopkins University, and asking him to work on the organization they started, Dr. Sidransky told them to think about an issue they never anticipated: What if no one wanted their cash? Budgets are tight at the National Institutes of Health, labs are scrambling to find funding, and many private foundations and pharmaceutical companies don't invest in research for rare cancers. But for many patient advocates, there is a further obstacle. Sometimes they raise money and get no takers. A friend of the Kaufmans who started his own rare-cancer advocacy group gave the phenomenon a name: the doom loop. Some researchers -- tired of getting turned down for grants and fearing there will be no funding to sustain long-term research -- don't bother applying even when money becomes available. To avoid that trap, the Kaufmans tried something different. They raised more than $700,000 for Mrs. Kaufman's disease, a salivary-gland tumor called adenoid cystic carcinoma, or ACC, and then, instead of sending out a call for proposals and waiting for responses that might never arrive, they took matters into their own hands. Working with a small, [...]