1/24/2005 William M. Mendenhall J. Clin. Oncol. published 1 November 2004, 10.1200/JCO.2004.09.959 The presentation of osteoradionecrosis (ORN) after radiotherapy (RT) for head and neck cancer varies from small, asymptomatic bone exposures that may remain stable for months to years or heal with conservative management, to severe necroses necessitating surgical intervention and reconstruction. The risk of developing ORN depends on a number of factors, including primary site, T stage, proximity of the tumor to bone, dentition, type of treatment (external beam RT, brachytherapy, surgery, and chemotherapy), and RT dose. Other factors that probably influence the likelihood of developing ORN include the nutritional status of the patient and continued tobacco or alcohol abuse. The mandible is the most common site of ORN, probably because it is often necessary to deliver a high RT dose to tumors near the mandible and possibly also because the blood supply may be less abundant than that of the maxilla. Although patients treated with definitive RT for oral cavity malignancies are more likely to experience minor or moderate bone complications compared with those treated with surgery and adjuvant RT, the likelihood of severe ORN is probably similar after either treatment strategy.2,3 Patients in whom the RT portals include only the angle or ramus of the mandible, such as those with laryngeal or hypopharyngeal cancers, have a very low likelihood of experiencing severe ORN. Edentulous patients probably have a lower risk of developing ORN than dentulous patients. Patients with poor dentition whose teeth will be in the high-dose [...]

1/22/2005 editorial staff Anticancer Research Journal reported by Cancer Weekly via NewsRx.com Resveratrol. It may be a mouthful to pronounce, but new research suggests the importance of choosing foods like cranberries that naturally contain this anticancer compound. Researchers have linked resveratrol to the prevention of a wide variety of types of cancer including: -Breast Cancer -Prostate Cancer -Lymphoma -Leukemia -Colon Cancer -Pancreatic Cancer -Gastric Cancer -Melanoma -Lung Cancer -Liver Cancer -Thyroid, Head and Neck Cancers -Ovarian and Endometrial Cancers A research team led by Dr. Bharat Aggarwal at the University of Texas MD Anderson Cancer Center, in conjunction with Dr. Navindra Seeram of the UCLA Center for Human Nutrition, David Geffen School of Medicine, published their review article in a recent issue of the journal Anticancer Research. According to Seeram, "We reviewed over seventy previous studies examining resveratrol's ability to cause cancer cells to stop from spreading and in fact cause cell death in existing cancer cells. Foods containing this compound - like grapes, peanuts, cranberries and other berries - belong in a healthy diet." In vitro (studies conducted in a test tube or outside a living organism) and animal studies comprised the majority of the research reviewed by Seeram and Aggarwal, though several of the leukemia studies were in vivo (inside the animal). The research points to anti-inflammatory and antioxidant effects of resveratrol as well. In addition to helping with cancer prevention, cranberries pack a powerhouse of protective properties that may prevent a number of other conditions. The antiadhesion [...]

1/22/2005 editorial staff Obesity, Fitness & Wellness Week via NewsRx.com Surgeons at Montefiore Medical Center are using a new form of treatment for cancer of the larynx that allows for quicker recovery and shorter hospital stays, and saves the voice box so patients retain the ability to speak. "We have found that our Endoscopic Laser Laryngectomy procedure is much more effective in terms of preserving a better quality of life for patients with cancer of the larynx," said Richard Smith, MD, the ear, nose and throat surgeon pioneering the new surgical procedure at Montefiore. "Because this procedure is much less invasive we can also do it on much older patients with better outcomes." "By using a laser light beam that cuts like a scalpel, we do the surgery by going in through the mouth," Smith said. "That means there's no open wound, and no tracheotomy (a breathing tube in the neck) is needed - so we can save the voice box." Before using a laser, standard procedures for treating the cancer were by radiation, chemotherapy and traditional open wound surgery. The larynx, or voice box, is located in the neck and has three important functions: it forms a portion of the air passageway through which we breathe, and it protects the lungs from food by closing when we eat, and is the source of our voice function. According to the American Cancer Society, about ten thousand new cases of cancer of the larynx are reported annually in the United States. [...]

1/22/2005 E.M. Genden Oral Oncol, 2004;40(10):979-984). The complications of free flap transfers for head and neck reconstruction after cancer surgery have been reviewed. "The reported success rate of microvascular free flap reconstruction ranges between 95% and 97%," surgeons in Italy explained. "However, when complications occur, they must be identified early and managed efficiently because there is a narrow window of opportunity to salvage potential flap failure." "While technical advances in instrumentation and magnification have improved overall success rates, the rare complication may prove devastating for the patient, his/her hospital stay, and the optimum rehabilitation," noted E.M. Genden and colleagues at the University of Udine. "Complications of microvascular free tissue transfer may occur at the recipient site or at the donor site," according to the report. "Complications occurring at the recipient site are largely a result of vessel thrombosis while complications occurring at the donor site may result from many causes, ranging from infection to those related to the harvesting of the flap." "Irrespective of the site of the complication, it is essential that complications be recognized and addressed early in their course to prevent or minimize devastating consequences," the researchers concluded. Source: as reported by Medical Devices & Surgical Technology Week via NewsRx.com

1/21/2005 Jemal, A. CA: A Cancer Journal for Clinicians, January/February 2005; vol 55: pp 10-30 2005 Prediction: 1,500 Cancer Deaths Every Day Cancer has surpassed heart disease to become the leading cause of death in the U.S., according to new statistics released today by the American Cancer Society. The group predicts that 1,372,910 Americans this year will hear the words "you've got cancer." And, the group says, in 2005 cancer will kill 570,280 Americans -- more than 1,500 a day. Despite cancer's spot as America's No. 1 cause of death, the overall U.S. cancer death rate actually has been going down. Why? More widespread cancer screening and better cancer treatment, says Elizabeth Ward, PhD, director of surveillance research for the American Cancer Society. "We can say with confidence that both are occurring," Ward tells WebMD. "The declines in the cancer mortality rate are due to earlier detection and to improvements in treatment." Lung Cancer Still Top Cancer Killer Lung cancer is still the top cause of cancer death. It's the cause of one-third of cancer deaths in men and of one-fourth of cancer deaths in women. But the U.S. campaign against tobacco use has had an effect. Lung cancer deaths among men are dropping. And after years of increases, lung cancer deaths are leveling off among women. Breast cancer causes a third of all cancers in women. It's their second leading cause of cancer death. But here, too, death rates are going down -- again largely due to more women [...]

1/21/2005 New York, NY Journal of Clinical Oncology 2005;23:88-95 reported by cancerpage.com Chemotherapy combined with chemoradiotherapy allows organ preservation in patients with advanced resectable cancer of the tongue or hypopharynx, according to a report in the January 1st issue of the Journal of Clinical Oncology. The base of the tongue and hypopharynx are good candidates for organ preservation because of the potential compromise of speech and swallowing resulting from surgery, the authors explain. Dr. Susan G. Urba from University of Michigan Medical Center, Ann Arbor, and colleagues investigated the benefits of two cycles of induction chemotherapy followed by chemoradiotherapy for responders in a phase II trial of 59 patients with advanced resectable cancer of the tongue base (n=37) or hypopharynx (n=22). Fifty-eight percent had stage IV and 42% had stage III disease. Seventy-eight percent of the patients had a 50% or greater response to induction chemotherapy at their primary tumor site, the authors report. Of the 43 patients that went on to receive concurrent chemoradiotherapy, 32 (54%) achieved a documented histologic complete response, the results indicate, and 9 additional patients achieved a complete clinical response, but did not undergo the recommended biopsies. Overall, the researchers note, 44 patients (75%) were deemed organ preservation successes; they did not require salvage surgery of the primary tumor immediately following completion of the treatment because of their excellent responses to therapy. Apart from one death attributed to the induction chemotherapy, the report indicates, the treatment was well tolerated, the researchers report. The 3-year overall [...]

1/21/2005 Andre Levchenko et al. Proceedings of the National Academy of Sciences (PNAS) as reported by medicalnewstoday.com A new study by researchers at Memorial Sloan-Kettering Cancer Center and The Johns Hopkins University provides new insight into how tumor cells can become resistant to anti-cancer therapy. The scientists observed that a protein called P-glycoprotein (P-gp), which causes resistance to chemotherapy in many tumor types, is able to physically "jump" or transfer between tumor cells and retain its functional properties, protecting otherwise sensitive cells from the effects of anti-cancer treatment in vivo and in vitro. According to the authors, the research is the first to demonstrate that a protein transferred between cells retains its function long enough to allow the recipient cells to survive potentially toxic drug concentrations and ultimately develop intrinsic resistance. In other words, cells that would normally be sensitive to treatment can develop resistance to it by receiving P-glycoprotein from other cells, making chemotherapy much less efficient. Uncovering the mechanism of this unusual "jumping" of the protein between the cells can potentially improve treatment success. The authors conclude that their findings offer a new way in which to look at how cells behave in a community of cells within a tumor mass. The results have important implications for genomic analyses within tumor samples because resistance to cancer therapy can be achieved by protein transfer alone. The new research will be published the week of January 17, 2005 in the online Early Edition of the Proceedings of the National Academy [...]

1/21/2005 Malden, MA Dr. David Leader Malden Observer on Townline.com People do not usually go to the dentist complaining that their mouth is dry or that they are always thirsty. However, many patients note the sudden appearance of stains, cavities or even thrush, a fungal infection, that herald the development of xerostomia or dry mouth. Xerostomia is the lessening or lack of saliva. It may be the side effect of medication, radiation treatment or the autoimmune disease Sjögren's syndrome. Smoking and alcohol make the effects of dryness much worse. While easy to diagnose, xerostomia is not easy to correct. Usually, the best treatment a patient can get is advice from your dentist or hygienist on how to decrease the serious and irritating side effects of dry mouth. The absence of saliva is the primary cause of the deleterious effects of xerostomia. Saliva is a complex solution of water, proteins and buffering agents that work together to fight disease and maintain the health of teeth and gums. Saliva contains components of the immune system that fight bacteria. Other proteins clean teeth and make bacteria less able to adhere to teeth. Calcium in saliva hardens teeth that are weak due to exposure to acid from food, drink and decay causing bacteria. There are even enzymes and lubricants in saliva that begin digestion of food before swallowing. Saliva does so many things; loss of saliva is very hard to treat. Often, the first noticeable symptom of xerostomia is difficulty swallowing. This is due [...]

1/20/2005 South Bend, Indiana Heidi Prescott South Bend Tribune About one year ago, Dr. Rafat Ansari participated in a cancer care roundtable conference in Chicago. The oncologist listened to discussions convincing him of the future direction of cancer treatment in the region. This direction was unveiled on Wednesday by Ansari, an oncologist at Michiana Hematology-Oncology, and administrators at Memorial Hospital. The two health groups have partnered to build and operate a regional $20 million Cancer Care Center north of Memorial in downtown South Bend. The plans call for a 70,000-square-foot, free-standing center to be built just west of the current hospital entrance. The building will extend over the existing Bartlett Street toward Madison Elementary School. It will open in late 2006. The idea is to bring every kind of physician and clinical service a patient may need in one place, said Ansari. Today, cancer patients might need to see three or four physicians in different locations. "We learned the only way to go is to have one single cancer center where all the disciplines are met," said Ansari. "We've been discussing it for over 10 years now, and finally we decided the timing is right." About 160 people will work in the Cancer Care Center. The center will comprise Michiana Hematology physicians as well as support staff members from Memorial Hospital. It also will mean the creation of new jobs, hospital officials said. The center will house multi-disciplinary clinics, including thoracic oncology, breast cancer, prostate cancer, head and neck cancer, [...]

1/19/2005 Falun, Sweden K. Ohm Oral Health Prev Dent, January 1, 2004; 2 Suppl 1: 277-81 Most dental diseases are preventable. This indicates that the main concept of dentistry could be changed to a situation in which the dental hygienist becomes the principal oral care professional. The competencies of dental hygienists focus on disease prevention and oral health promotion; thus referral to a dentist would only become necessary in the event of a failure in the preventive program where disease cannot be controlled. Future oral health care personnel need to be better educated to encourage people to implement healthy lifestyles rather than to treat teeth. In addition, the connection between oral health, general health and health-related quality of life will necessitate a multidisciplinary approach to prevention and oral health promotion. To focus strictly on oral health would too narrowly define the role of the dental hygienist in comprehensive prevention and health promotion. There is no precise boundary between the oral cavity and the rest of the body. Dietary advice to prevent dental caries and smoking cessation counseling to prevent periodontal disease and oral cancer also promote general health. Consequently the focus on prevention and health promotion makes the dental hygienist a very important person in the dental team of the future.