3/22/2005 New York, NY Charnicia E. Huggins Reuters News (www.reuters.com) Many student athletes, particularly football and baseball players, in Mississippi's junior and senior high schools, use tobacco -- as do their coaches -- according to the results of two new studies. Further, an oral screening conducted among student athletes in a third study, revealed that many students with a history of tobacco use had an oral lesion, which can be an early warning sign of mouth cancer. These studies, conducted by former athletes who are researchers at the University of Mississippi School of Dentistry, were presented on Thursday in Baltimore, Maryland during the 83rd General Session of the International Association for Dental Research. Based on the findings, "early intervention" by dentists and other healthcare providers is needed, to decrease the risk of oral cancer among athletes who use tobacco, Dr. Kyle Hunt, who was involved in all three studies, told Reuters Health. He warned that if signs of oral cancer are not detected early, the risk of death increases. Among the 698 seventh through twelfth graders surveyed in the first study, nearly 23 percent of boys said they had ever used tobacco in comparison to about 3 percent of girls, according to Hunt and his team. White athletes were more likely to report a history of tobacco use and were more likely to have used smokeless tobacco than were their black peers. Further, a history of tobacco use was especially common among football and baseball players, who were more likely [...]

3/21/2005 Christopher Perry et al. Arch Otolaryngol Head Neck Surg. 2005;131:198-203 Objective: To determine whether isotretinoin (or 13-cis-retinoic acid) decreases the risk of second primary cancers in patients previously treated for cure of head and neck squamous cell carcinoma. Design: Randomized, double-blind, placebo-controlled trial. Setting: Two head and neck multidisciplinary cancer clinics in university teaching hospitals taking cases from 4 to 5 million people in Queensland, Australia, combined to enter appropriate patients into this trial. Patients: One hundred fifty-one patients with their first head and neck squamous cell carcinoma treated with high expectation for cure and living close by. They were randomized into 3 arms to receive 3 years of treatment. Interventions: Patients took isotretinoin at a high dose (1.0 mg/kg per day) or a moderate dose (0.5 mg/kg per day) or placebo. Group 1 took the high dose for 1 year and then the moderate dose for 2 years. Group 2 took the moderate dose for 3 years. Group 3 took placebo for 3 years. Main Outcome Measures: The diagnosis of a second primary malignancy of the head and neck, lung, or bladder was regarded as the end point signifying failure of therapy. Issues of drug adverse effect profile and impact on survival were measured. Results: There was no significant difference in the occurrence of second primary disease (P = .90), the recurrence of primary disease (P = .70), or disease-free time (P = .80) between the treatment and nontreatment arms. Numbers were too small to find differences in [...]

3/21/2005 Yorkshire, England The Huddersfield Daily Examiner A man who overcame throat cancer is now working to raise awareness of how the disease affects people's lives. John Hodgson, 57, of Hepworth, is chairman of Communicating Head and Neck Cancer Yorkshire (Chancy), which is organising a conference for healthcare workers on Friday, May 27. Head and neck cancers are quite rare, which means that many health professionals do not regularly encounter them. The conference, at Pontefract Racecourse, aims to give health workers the chance to hear patients' views on treatments and the challenges they have faced while battling such cancers. The conference - for 80 delegates - will be followed by a race night to raise cash for the Macmillan Cancer Relief charity. Mr Hodgson was diagnosed with throat cancer in 2000, after visiting his GP about a lump in his neck. After intensive chemo- therapy, radiotherapy and an operation he has overcome the disease. But he was left with a slight hearing problem, his voice tires easily and he has just 12 teeth. All those with fillings had to be removed before radiotherapy. He said: "I am the exception among head and neck cancer patients in that I haven't got much of a speech impediment. "Some people have their voiceboxes removed or have throats or tongues rebuilt. "It affects the way you eat and we hope to help medical professionals understand that it has quite a profound after-effect. "They can then provide better support to patients." It was while Mr [...]

3/21/2005 Mark Perkiss New Jersey Times (www.nj.com) Wendy Guerra of South Brunswick says she deserves the right to go to a restaurant, bar or nightclub of her choice without having to worry that a nearby smoker might trigger a potentially fatal asthma attack. On the other hand, Larry Williams of Trenton says he and other smokers deserve the right to light up while they sit and drink in their favorite bar instead of being forced to go outside. The two typify the conflict of rights and freedoms with which lawmakers are grappling as they consider a proposed law barring smoking in indoor workplaces, including restaurants, bars, casinos and private clubs, such as American Legion or Veterans of Foreign Wars posts. "I'm an ex-smoker so I understand their point of view, but my health is more important," said Guerra, 54, who suffers from severe asthma. "I can't go to any restaurant I want to because they might allow smoking. I can't go to bars or nightclubs or shows. "I've had to leave parties of family occasions at restaurants because of smoking," she said. "Why should I have to suffer like that because someone else wants to smoke? It's not fair." Williams, 49, a regular at the Ivy Inn, a Princeton Borough bar that draws many smokers, takes the opposite view. "I have rights and this law would take those away from me," he said. "I respect people who don't smoke and I try not to smoke near them. They should respect [...]

3/21/2005 Robert L. Ferris et al. Cancer Research 65, 2147-2156, March 15, 2005 Clinical staging of cervical lymph nodes from patients with squamous cell carcinoma of the head and neck (SCCHN) has only 50% accuracy compared with definitive pathologic assessment. Consequently, both clinically positive and clinically negative patients frequently undergo neck dissections that may not be necessary. To address this potential overtreatment, sentinel lymph node (SLN) biopsy is currently being evaluated to provide better staging of the neck. However, to fully realize the potential improvement in patient care afforded by the SLN procedure, a rapid and accurate SLN analysis is necessary. We used quantitative reverse transcription–PCR (QRT-PCR) to screen 40 potential markers for their ability to detect SCCHN metastases to cervical lymph nodes. Seven markers were identified with good characteristics for identifying metastatic disease, and these were validated using a set of 26 primary tumors, 19 histologically positive lymph nodes, and 21 benign nodes from patients without cancer. Four markers discriminated between positive and benign nodes with accuracy >97% but only one marker, pemphigus vulgaris antigen (PVA), discriminated with 100% accuracy in both the observed data and a statistical bootstrap analysis. A rapid QRT-PCR assay for PVA was then developed and incorporated into a prototype instrument capable of performing fully automated RNA isolation and QRT-PCR. The automated analysis with PVA provided perfect discrimination between histologically positive and benign lymph nodes and correctly identified two lymph nodes with micrometastatic tumor deposits. These assays were completed (from tissue to result) in 30 [...]

3/21/2005 www.cancerconsultants.com Researchers from Duke University have reported that anemic patients with advanced head and neck cancers treated with radiation therapy have poorer outcomes than comparable patients without anemia. The details of this retrospective analysis were reported in the March 15, 2005 issue of the International Journal of Radiation Oncology Biology Physics.[1] Hypoxia is known to interfere with the therapeutic effectiveness of radiation therapy and chemotherapy. It has been suggested that clinical anemia can reduce responses to radiation therapy and chemotherapy. In the current study, researchers evaluated outcomes of 159 patients with head and neck cancer treated with a standardized radiation and chemotherapy regimen. Radiation was hyperfractionated and the chemotherapy drug was cisplatin. This group of patients had a median hemoglobin of 13.6 g/dL. The researchers compared outcomes of patients who had hemoglobin levels of 13.0 g/dL with those who had levels below 13.0 g/dL. The five-year failure-free survival was 75% for patients with a hemoglobin of 13.0 g/dL or higher, compared to 50% for those with a lower hemoglobin level. However, patients with anemia appeared to have on average more extensive disease at the time of treatment. These authors concluded that anemia was associated with a worse outcome, but that the cause was unknown. They proposed prospective trials of erythropoietin (Procrit® or Aranesp®) to determine if correction of anemia improves outcome. Comments: Preliminary results from a Radiation Therapy Oncology Group (RTOG) study indicated that erythropoietin improved hemoglobin levels in anemic patients with head and neck cancers receiving only radiation [...]

3/21/2005 National Cancer Institute Clinical Trial Results As reported at the American Society of Clinical Oncology annual meeting, New Orleans, LA, 2004 Background: Head and neck cancers account for three percent of all cancers in the United States. Most of these cancers begin in squamous cells found in the lining of structures in the head and neck. Initial treatment options for patients with advanced head and neck cancer include radiation therapy, chemotherapy combined with radiation treatment, or surgery followed by radiation and/or chemotherapy plus radiation for patients whose tumors can be surgically removed. Many head and neck cancer cells overexpress (make too much of) a protein called the epidermal growth factor receptor (EGFR), which may help cancer cells to grow more aggressively. Cetuximab is a monoclonal antibody that attaches to and blocks EGFRs. Early studies suggested that treatment with cetuximab would boost the effectiveness of radiation therapy in patients with head and neck cancer. The Study: A total of 424 patients in the United States and Europe were enrolled in this study. All had tumors in their tonsils, tongue, or voicebox that may have involved lymph nodes, but had not spread to other parts of the body. Patients were randomly assigned to receive either radiation therapy alone or radiation plus weekly cetuximab. Patients were followed up for a median of just over three years. The study’s principal investigator was James A. Bonner, M.D., of the University of Alabama at Birmingham. (See the protocol summary.) Results: Median survival for patients treated [...]

3/18/2005 M. Hashibe et al. Cancer Lett, April 8, 2005; 220(2): 185-95 Radiation exposure, known to cause DNA damage, may be a potential source of field cancerization of the upper aerodigestive tract. Radiotherapy for head and neck cancers has been examined as a possible risk factor for second primary cancers, but the results have been equivocal. We evaluated the impact of therapeutic radiation for oral cancer on the risk of second primary cancers with data from the Surveillance, Epidemiology, and End Results (SEER) program for 1973-1999. Among 30,221 first primary oral squamous cell carcinoma patients, 6163 (20.4%) patients developed a second primary cancer, 5042 of which were metachronous. Patients treated with radiation only (RR=1.64, 95%CI=1.18-2.29) or radiation with surgery (RR=1.49, 95%CI=1.07, 2.06) had elevated risks of developing a second primary tumor, whereas patients treated with surgery only did not appear to be at increased risk (RR=1.28, 95%CI=0.93, 1.76). Consistent with an expected latent period between radiation exposure and tumor occurrence, radiation became a risk factor after 10 years of follow-up for solid cancers of the oral cavity (RR=2.8, 95%CI=1.5, 5.2), pharynx (RR=5.9, 95%CI=1.7, 20.7), esophagus (RR=3.9, 95%CI=1.1, 13.4) and lung (RR=1.5, 95%CI=1.0, 2.4), and after 1-5 years of follow-up for second primary leukemia (RR=2.5, 95%CI=1.0, 6.7). Radiotherapy for oral cancer appears to be a risk factor for second primary tumors. Further studies that account for chemotherapy and examine frequency and duration of radiotherapy would be of interest in confirming the observed. Authors: M Hashibe, B Ritz, AD Le, G Li, [...]

3/18/2005 Jon Sudbø et al. Journal of Clinical Oncology, Vol 23, No 9 (March 20), 2005: pp. 1927-1933 Purpose: Quitting smoking may prevent oral cancer. Behavioral intervention to quit smoking may be more efficient if persons are assigned an individual risk of cancer. Patients and Methods: In this prospective study, we provided counseling and behavioral intervention toward smoking cessation, supplemented by genetic analyses in clinically normal oral mucosa of heavy smokers. Measurement of serum cotinine was used to assess changes in smoking habits. Results: In cytologic scrapings from 275 heavy smokers with clinically normal mucosa, we found tetraploidy in four and aneuploidy in 19 persons (23 of 275; 8%). Twenty one (91%) of 23 persons with aneuploidy had quit or reduced their smoking habits at the 3-month follow-up, 20 (87%) of 23 persons had done so at 12 months, and 21 (91%) of 23 persons had done so at 24 months. Fifty-one (20%) of the 252 persons without genetic changes in their mucosa had quit or reduced their tobacco habits at the 3-month follow-up, 23 (9%) had done so at 12 months, and 17 (7%) had done so at 24 months (P < .001). After 24 months, normalization of DNA content to diploidy was observed in two of four persons with tetraploid (50%), and in 11 of 19 persons (58%) with aneuploid scrapings. One patient developed an oral carcinoma in the floor of the mouth: this patient had an aneuploid scraping obtained 43 months earlier and developed a leukoplakia 28 [...]

3/18/2005 M Dimitrijevic, A Mikic, Z Petrovic, I Pendjer, S Jesic, and A Trivic Acta Chir Iugosl, January 1, 2004; 51(1): 77-81 Despite new approaches to treatment and lower mortality, malignant tumors of the head and neck, including the malignant tumors of the oral cavity, still represent significant oncological problem because long-term survival has not been significantly prolonged. The growth of tumors of this localization is fast and infiltrative, while early metastases of regional lymph nodes are rather frequent. Malignant tumors of the oral cavity account for 1.1% of population in our community (Dimitrijvic, 2001). The objective of the study was to analyze regional metastases of the cancers of the tongue and the floor of mouth in 101 patients with planocellular cancers treated in the period 1991 to 1995. Clinically positive regional lymph nodes were found in 67.3% of patients, while the most commonly involved regions were submandibular (47.4%) and upper jugular region (46.1%). They were more frequent in localization of the floor of mouth than in case of tongue cancer. Three types of neck dissections were used for surgical treatment of patients. In the group of patients with clinically negative results of the neck (N0) who underwent neck dissection, occult metastases of regional lymph nodes were verified pathohistologically in 19.2% of the time. Malignant tumors of the oral cavity are always the indication for neck dissection, even in N0 category, on account of high proportion of occult metastases. Authors' Affiliation: Institut za Otorinolaringologiju i maksilofacijalnu hirurgiju, Klinicki centar Srbije, [...]