12/18/2004 Medical News Editor Medical News Today Combined positron emission tomography and computerized tomography (PET/CT) can help diagnose occult (hidden) recurrent cancer, possibly a cancer patient's greatest post-treatment fear, report a team of Israeli physicians in the December issue of the Society of Nuclear Medicine's "Journal of Nuclear Medicine." PET and CT scans are standard imaging tools that allow clinicians to pinpoint the location of cancer within the body before making treatment recommendations. PET/CT involves sequential PET and CT imaging on the same device, allowing for simultaneous acquisition of functional (PET) and anatomical (CT) data. "PET/CT was found to indicate the presence of new malignancy and also precisely localize and define the extent of disease" in patients in whom recurring cancer was suspected, explained lead author and SNM member Ora Israel, M.D. The physicians asked the question, "Is FDG-PET/CT Useful for Imaging and Management of Patients With Suspected Occult Recurrence of Cancer?" Their study points to an affirmative answer, said Israel, who also noted the need for these initial results to be confirmed in large studies with more homogenous patient populations. The research team studied 36 cancer patients for whom blood tests showed increasing levels of serum cancer markers during follow-up. "PET/CT was the only test that showed whether recurrent tumors were indeed present," and since anatomic information was obtained, the type of treatment that should be applied could be determined, she said. "This is clinically important, since no treatment could be planned in these patients without the benefit of [...]

12/17/2004 Rachael Myers Lowe www.cancerpage.com Disappointing clinical trial results lead drug maker AstraZeneca to stop promoting its targeted lung cancer drug Iressa (gefitinib). The company advised patients who are currently taking the drug to talk to their doctor as soon as possible. Those who want to continue taking Iressa will continue to get it, the company said. “It is our intention to continue to provide the product” to those who want it, Mary Lynn Carver, AstraZeneca’s director of oncology information, told cancerpage.com. The company announced today that initial analysis of a large clinical trial involving nearly 1700 patients shows that Iressa “failed to significantly prolong survival in comparison to placebo” in the overall population or in patients with cancer. “This is a huge surprise to the oncology community, to the FDA and to ourselves,” Carver said. In a letter to doctors posted on the AstraZeneca USA web site today, the company suggests physicians prescribing Iressa consider other options: “In light of positive survival data with other agents including another oral EGFR inhibitor, AstraZeneca urges you to consider other treatment options in the recurrent non-small cell lung cancer patient population.” Carver said the company was moving quickly to inform doctors about the test results because of the patients they treat. “The patients they are treating are highly refractory advanced lung cancer patients with only weeks to live in some cases,” she said. In the US, Iressa was approved as a third-line treatment for advanced non-small cell lung cancer patients only after [...]

12/17/2004 New York no attribution cancerpage.com Concomitant treatment with cisplatin improves locoregional control in patients undergoing hyperfractionated radiotherapy for advanced head and neck cancer, according to Swiss researchers report in the December 1st issue of the Journal of Clinical Oncology. For these patients, "the most effective combination of chemotherapy and radiotherapy with acceptable toxicity remains to be defined," Dr. Pia Huguenin of University Hospital Zurich and colleagues note. To investigate further, the researchers studied 224 patients with squamous cell carcinomas of the head and neck who given hyperfractionated radiotherapy at a median dose of 74.4 Gy over a course of 5 weeks. They were randomized to also receive two concomitant cycles of cisplatin or to radiotherapy alone. Median time to any treatment failure was 19 months in the combination group and 16 months in the radiotherapy group. However, this difference was not significant. There was also no significant difference in overall survival and late toxicity between the two groups. However, locoregional control and distant disease-free survival significantly improved in those given cisplatin. Although the researchers note that further investigation is required, they conclude that "two cycles of cisplatin monotherapy significantly prolongs time to local failure, time to locoregional failure, and time to distant metastatic relapse, with a tendency toward improved overall survival." In an accompanying editorial, Dr. K. Kian Ang of the M. D. Anderson Cancer Center, Houston, writes that the findings help "in defining a less toxic radiation-chemotherapy platform to which novel agents can be added." SOURCE: Journal of [...]

12/15/2004 Austin, TX no attribution news8austin.com Laryngeal and hypopharyngeal cancers start in and around the larynx, which is often known as the "voice box." The larynx contains the vocal cords, which vibrate and make sound when air is directed against them. The hypopharynx surrounds the larynx. It's part of the esophagus or food pipe. Several types of cancers can form in these two areas. About 95 percent of these cancers start from squamous cells. These are the thin, flat cells that line the larynx and hypopharynx. Squamous cell cancer does not form suddenly. It starts when the cells begin to change. Smoking and heavy alcohol drinking usually cause the changes. The cells then become pre-cancerous. Most pre-cancers will not become cancers. If the causes, such as smoking, stop, these pre-cancers usually go away. The earliest form of cancer is called carcinoma in situ. This type of cancer has not yet spread to other parts of the body. Some of these very early cancers go away on their own. Most can be cured by stripping or cutting away the lining of layers of cells. Some are destroyed by a laser beam. However, if the cancers are are not treated, they can spread. While other types of cancer can start in the glands and tissue of the larynx and hypopharynx, they are very rare. The American Cancer Society said about 10,000 people in the United States will have laryngeal cancer in 2004, and more than 3,000 will die from the disease. There [...]

12/15/2004 no attribution American Society for Therapeutic Radiology and Oncology (ASTRO) To help cancer patients and their families better understand their treatment options before making a decision, the American Society for Therapeutic Radiology and Oncology has published seven patient information brochures that explain how radiation therapy is used to safely and effectively treat various cancers. Five of the brochures cover radiation therapy options for specific types of cancer, including breast cancer, prostate cancer, lung cancer, head and neck cancer, and colorectal cancer. ASTRO has also published a lengthy booklet detailing how radiation therapy works and what patients can expect during treatment as well as a brochure explaining all the healthcare professionals that work together to treat patients with radiation therapy. Each brochure contains information patients and their families can use to talk to their cancer specialists when deciding on a course of treatment. They also include information on support groups and clinical trials. The brochures are free to cancer patients and advocacy groups by visiting http://www.astro.org/patient or calling 1-800-962-7876. “Although there are literally thousands of Web sites and patient brochures out there on cancer, we felt that the sections on radiation therapy were often inaccurate or out-of-date. We thought it would be helpful to publish our own material reflecting all the exciting changes in our specialty that are helping cure patients of their cancer,” said Louis Harrison, M.D., Chair of the ASTRO Communications Committee and a radiation oncologist at Beth Israel Medical Center in New York. “We hope that this [...]

12/15/2004 Belfast, Northern Island Nigel Gould The Belfast Telegraph Ulster health experts have pioneered a revolutionary technology that is set to transform treatment for scores of cancer sufferers, it can be revealed today. The work of the Medical Physics team at Belvoir Park Hospital represents a breakthrough in the radiotherapy treatment of head and neck cancer and is being developed with the help of cancer charity, Friends of Montgomery House. This Northern Ireland development involves digital cameras and specialist computer software and has already brought inquiries from cancer facilities in the UK and the National Cancer Institute in Washington. The revolutionary new technology pioneered by Belvoir Park in conjunction with Dimensional Imaging Ltd, Glasgow is to totally transform treatment. To have radiotherapy treatment for head and neck cancer, patients must first have a personalised facial mask constructed. The radiotherapy sessions are then delivered daily over a number of weeks and the mask ensures that the radiation targets consistently the specific area affected by the cancer. The current process involves making a mould of the patient using plaster bandages over the face and neck. This can be uncomfortable, especially for children. It can also take several days to complete. The new process - photogrammetry - produces a more accurate treatment facial mask, which is ready within a few hours removing the patient's discomfort and reducing the waiting time for treatment. Photogrammetry works with a stereo digital photograph being taken by a bank of four high-tech cameras around the head and neck [...]

12/15/2004 UCLA Jonsson Cancer Center Press Release Clinical Cancer Journal, Dec. 15, 2004 In one of the first studies using the RNA in saliva to detect cancer, researchers at UCLA’s Jonsson Cancer Center were able to differentiate head and neck cancer patients from a group of healthy subjects based on biomarkers found in their spittle. The study provides a first proof of principal that may result in new diagnostic and early detection tools and will lead to further studies using saliva to detect other cancers. Published in the Dec. 15, 2004, issue of the peer-reviewed journal Clinical Cancer Research, the study used four RNA biomarkers to detect the presence of head and neck cancer with 91 percent sensitivity and accuracy, said Dr. David Wong, professor and chairman of Oral Biology and Medicine, director of the UCLA School of Dentistry, Dental Research Institute, and a Jonsson Cancer Center researcher. “This is a new direction, using a non-invasive fluid for disease diagnostics, particularly in cancer,” said Wong. “This is our proof of principal. We now hope to demonstrate the utility of saliva for systemic diagnosis of other diseases such as breast cancer.” Typically, cancer researchers use blood serum and urine to look for cancer signatures. Saliva contains the same biomarkers for disease that are found in the blood, but they are present at much lower levels of magnitude. The emergence of nanotechnology allowing scientists to manipulate materials on an atomic or molecular scale helped researchers uncover the components of saliva, Wong said, [...]

12/14/2004 M. R. Hussein, U. M. Rashad and K. A. Hassanein3 Annals of Oncology 2005 16(1):171-172; doi:10.1093/annonc/mdi026 The diagnosis of head and neck mass lesions entails examination of initial frozen sections, followed by the evaluation of permanent histological sections. This process is worrying for the surgeon who is unsure about the tentative diagnosis of the frozen sections. Moreover, the pathologist should make a hurried diagnosis on suboptimally prepared specimens. To date, controversial reports are available about the use of touch imprint cytology (TIC) in the diagnosis of these lesions. To assess the utility of an intraoperative TIC in the diagnosis of these lesions, 30 head and neck masses (nasal, pharyngeal, laryngeal and oral lesions) were examined by TIC, permanent histological sections and immunostaining methods. Immediately after obtaining the biopsy specimens, and prior to placing them in fixative, each specimen was imprinted on several glass slides (TIC), fixed immediately and stained with hematoxylin & eosin. The cytological results were reported as: (i) malignant (the cellular findings are diagnostic of malignancy); (ii) suspicious for malignancy (suggestion of cancer but uncertain due to limited number of cells or to degree of atypia); (iii) negative for malignancy (no evidence of malignancy); or (iv) unsatisfactory specimen (scant cellularity, air drying or distortion artifact, obscuring blood or inflammation). The cytological interpretation was carried out intraoperatively. Histological examination of the permanent sections was carried several days later. The cytological evaluation of the TIC revealed 12, 16 and two cases as benign, malignant and suspicious for malignancy, respectively. [...]

12/13/2004 Toronto, Ontario, Canada Staff editor Canada Newswire (newswire.ca) Physicians, dentists and pharmacists team up to help Ontarians stop smoking. Today, three of Ontario's professional healthcare associations are promoting increased public awareness of the efforts of a growing number of physicians, dentists and pharmacists throughout Ontario who are helping their patients quit smoking through the Clinical Tobacco Intervention (CTI) Program. CTI is funded, in part, by the Government of Ontario. The Ontario Dental Association (ODA), The Ontario Medical Association (OMA) and the Ontario Pharmacists' Association (OPA) have been working together to train dentists, physicians and pharmacists in stop smoking interventions and want the public to know they can look to their family doctor, dentist or pharmacist for help. "Dentists are oral health care specialists and routinely see health problems in patients that are directly linked to tobacco use," said Dr. Steve Goren, President of the Ontario Dental Association. "We see first hand the association between tobacco use and a range of oral diseases, from gum disease to oral cancer. That's why Ontario dentists are motivated to provide patients with tobacco cessation advice and assistance." Research shows that advice from a healthcare provider can significantly increase the chance of successfully quitting smoking. Success rates increase further when combined with stop-smoking medications and/or intensive counselling. "Pharmacists are aware of how difficult it is for some people to quit smoking," said OPA Chair Jane Farnham. "Our message to people is that you can quit and we can help by providing information and advice [...]

12/11/2004 Staff editors Obesity, Fitness & Wellness Week, Dec. 18 According to recent research published in the International Journal of Oral and Maxillofacial Surgery, "sentinel node navigation surgery (SNNS) has received considerable attention for its role in deciding whether to perform neck dissection in patients with early oral cancer. However, diagnostic accuracy and its intraoperative availability of results remain important concerns. First, we shortened the examination time required for genetic diagnosis." "Second, we assessed the quality of the extracted mRNA. Third, 10 patients with early NO oral cancer underwent SNNS using our new technique for genetic diagnosis to determine whether neck dissection was required," said H. Hamakawa and colleagues, Ehime University, School of Medicine. "The examination time of our one-step reverse-transcriptase polymerase chain reaction method using a minicolumn and LightCycler was successfully shortened to 2 hours, permitting intraoperative genetic diagnosis. The extracted mRNA was of high quality. Six sentinel nodes in four patients were diagnosed to be metastatic on genetic diagnosis; these patients underwent neck dissection." "The other six patients avoided unnecessary surgery. We conclude that intraoperative genetic diagnosis of micrometastasis holds promise of being a sensitive method that can be used to support SNNS," Hamakawa and coauthors stated. Hamakawa and colleagues published their study in International Journal of Oral and Maxillofacial Surgery (Intraoperative real-time genetic diagnosis for sentinel node navigation surgery. Int J Oral Maxillofac Surg, 2004;33(7):670-675).