11/26/2004 London, England Madeleine Brettingham British Medical Journal.com The National Institute for Clinical Excellence (NICE) has issued guidelines on the treatment of patients with rare cancers of the head and neck. The guidelines, based on research conducted by the Centre for Reviews and Dissemination, advise that treatment should be centred at specialised cancer centres serving populations of over a million, where multidisciplinary teams will be responsible for all stages of the treatment process, including diagnosis and rehabilitation. Head and neck cancers are not common and encompasses a range of conditions located at some 30 sites around the head and neck. Some, such as mouth and lip cancer, are more common; others, such as cancer of the salivary glands, result in only a few hundred registrations per year. Nevertheless, together these cancers are responsible for 2700 deaths a year in England and Wales—and as Professor Peter Littlejohns, clinical director at NICE, pointed out, the effects of treatment can be severe. "Head and neck cancers can have devastating effects on the lives of patients," said Professor Littlejohns. "The treatment can be disfiguring and often makes normal speech and eating impossible. For health services, head and neck cancers present particular challenges because of the variety of professional disciplines involved in caring for patients and the relatively sparse geographical distribution of patients requiring specialised forms of therapy or support." Cancer centres, it is hoped, will be able to bring together carers with the requisite range of expertise. Speech therapists, counsellors, and dietitians, as well [...]

11/25/2004 no attribution www.news-medical.net Cancers of the head and neck cause over 2,700 deaths per year in England and Wales. Smoking and drinking cause most cancers of the mouth, lip and tongue (oral cavity), throat and voice box. Heavy drinkers who are also heavy smokers have over 35 times the risk of developing oral cancer than non-smokers and drinkers. Early detection and appropriate treatment improve survival, however there are variations in performance across the UK. Effective Health Care summarises the research evidence behind new guidance issued today on the management of head and neck cancers. The evidence shows that: Patients whose cancers are detected earlier and who are managed by multidisciplinary teams experience better outcomes. Dentists may detect oral cancer and therefore regular check-ups are important. Arrangements for referral at each stage of the patient’s cancer journey should be streamlined. Diagnostic clinics should be established for patients with neck lumps. Research in this area is generally inadequate. Further research using appropriate methods is urgently required. Ros Collins, one of the authors of the research, states, ‘Most head and neck cancers are preventable and better outcomes could be achieved when managing the cases that do arise. We hope that the research we have undertaken leads to real improvements in the treatment of patients suffering from these diseases.’

11/25/2004 West Linton, UK no attribution BBC News A man who lost his 22-year-old son to mouth cancer will speak to Scottish dental students about the importance of spotting the disease at an early stage. Mike Walton lost his son Ben to oral cancer in 1995 and will speak at the University of Dundee on Wednesday. Dentists are the most likely to spot the condition when checking teeth. Students at the dental school donated £1,000 raised at an auction for the Ben Walton Trust, established by his father after his death. Mr Walton, from West Linton, Peeblesshire, first contacted the university when he spotted a paper by its resident Professor Graham Ogden on oral cancer. Cancer awareness The pair now work together on the Scottish Oral Cancer Action Group. The fifth-year students he will be speaking to are currently studying oral cancer. After the students' auction, Mr Walton decided to give the money back to the dental school for a discretionary fund used to support patients with mouth cancer. He said: "I am delighted to have this working relationship with the dental students in Dundee. "It is great that these young people are raising awareness of mouth cancer and are studying to help others that may be affected by the disease. "Mouth cancer is a very difficult area to raise funding for. "The disease is not well-known despite the numbers affected by it." Mr Walton said survival rates for the cancer were not as good as for other forms of [...]

11/25/2004 Andreas Gutzeit et al. Radiology 2004, 10.1148/radiol.2341031554 PURPOSE: To retrospectively evaluate fused positron emission tomography (PET)/computed tomography (CT) in depicting the primary lesion in cancer of an unknown primary tumor, compared with PET, CT, and PET and CT side-by-side evaluation. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. Forty-five patients (26 men and 19 women) with metastatic cervical adenopathy (n = 18) or extracervical metastases (n = 27) of unknown primary tumor were included. The mean age of the patients was 57 years (range, 29–95 years). PET/CT imaging was performed in all patients 1 hour after administration of 350 MBq of fluorodeoxyglucose with a whole-body field of view. Contrast agents were administered orally and intravenously in all patients to ensure diagnostic CT data. PET/CT data sets were evaluated for the primary tumor, and imaging results were compared with those of CT, PET, and PET and CT side-by-side evaluation. Differences in diagnostic performance were assessed by using the McNemar test with Bonferroni correction, which accounts for multiple comparisons. RESULTS: PET/CT depicted the primary tumor in 15 (33%) of 45 patients. In 30 (67%) patients, the primary tumor site remained occult (P > .05). PET and CT side-by-side evaluation depicted 13 (29%) of 45 tumors (P > .05). PET alone revealed the primary tumor in 11 (24%) of 45 patients (P > .05), while CT alone helped in the correct diagnosis in eight (18%) of 45 patients (P > .05). There were no significant differences between the [...]

11/10/2004 Edgar R. Miller, III, et al. Journal of Internal Medicine, 4 January 2005 | Volume 142 Issue 1 Background: Experimental models and observational studies suggest that vitamin E supplementation may prevent cardiovascular disease and cancer. However, several trials of high-dosage vitamin E supplementation showed non–statistically significant increases in total mortality. Purpose: To perform a meta-analysis of the dose–response relationship between vitamin E supplementation and total mortality by using data from randomized, controlled trials. Patients: 135 967 participants in 19 clinical trials. Of these trials, 9 tested vitamin E alone and 10 tested vitamin E combined with other vitamins or minerals. The dosages of vitamin E ranged from 16.5 to 2000 IU/d (median, 400 IU/d). Data Sources: PubMed search from 1966 through August 2004, complemented by a search of the Cochrane Clinical Trials Database and review of citations of published reviews and meta-analyses. No language restrictions were applied. Data Extraction: 3 investigators independently abstracted study reports. The investigators of the original publications were contacted if required information was not available. Data Synthesis: 9 of 11 trials testing high-dosage vitamin E (400 IU/d) showed increased risk (risk difference > 0) for all-cause mortality in comparisons of vitamin E versus control. The pooled all-cause mortality risk difference in high-dosage vitamin E trials was 39 per 10 000 persons (95% CI, 3 to 74 per 10 000 persons; P = 0.035). For low-dosage vitamin E trials, the risk difference was –16 per 10 000 persons (CI, –41 to 10 per 10 000 persons; [...]

11/23/2004 Norfolk, VA Warren Warsaw The Virginian-Pilot For 12 young dancers, with their glittered faces and glitzy costumes, Saturday's performance at the Jeanne & George Roper Performing Arts Center will be like any other. On the surface. For all their outward smiles and athletic routines, they will dance with heavy hearts for someone who's missing from the stage. Pappou. That's Greek for "grandfather" and that's the only name some of the dancers knew for Arthur Kotarides who died in August 2003 from oral cancer. Kotarides was the real father of Hero "Ro" Kotarides Barker, a 40-year-old Wards Corner resident who owns the 7Movements in Dance studio at 7930-C Chesapeake Blvd. But "Pappou" was the surrogate grandfather for many of the girls at the 7Movements in dance since the studio opened in 1995. The fun-loving prankster who attended every performance and competition built more than just the sets and props. He built relationships. So when Pappou died on a Saturday - a day before a dance competition -several of the girls panicked. "I didn't know what to say to anyone," said Kayla Lovett, a 14-year-old dancer from Bayview who knew Pappou since she was r. "I just performed and stayed away from everyone." When words faild to express their sorrow and love, these teens who knew Pappou since they were toddlers, turned to dance. And over the past year, the core group of 12 dancers known as the Smooth Movers Performing Company, has worked 6 to 12 hours a week choreographing [...]

11/23/2004 R&D Directions Staff Pharmalive (www.pharmalive.com) A new term has entered the pharmaceutical developer’s glossary: theranostics. This word, created by the diagnostics company Pharma­Netics, defines the development of diagnostic tests that can identify which patients are most suited for a drug and provide feedback on how well the drug is working. The demand for theranostics is substantial, and the companies that produce these tests are reporting high-growth revenue rates. These companies tout the benefits of theranostic products: Patients get optimal treatment and excessive health-care expenditures can be reduced. These products will become more important in the coming years as health-care resources become even more limited, experts predict. Theranostics are a rapidly evolving group of specialized molecular diagnostic tests that are viewed as improving the real-time treatment of disease, making treatment more cost-effective, and adding value to the drug-development process. The concept of combining a drug with a diagnostic is also known as predictive medicine, personalized medicine, integrated medicine, pharmacodiagnostics, and Dx/Rx partnering. Theranostics go beyond traditional diagnostic products that only screen or confirm the presence of a disease. Theranostics can predict risks of disease, diagnose disease, stratify patients, and monitor therapeutic response. Theranostic products can provide physicians with information that enables them to individualize and optimize the therapeutic regimen of the patient. The physician may make better-informed decisions on timing, quantity, type of drugs, and choice of treatment procedure based on the relevant information provided by these tests. Recent advances in the understanding of the molecular pathways of disease have [...]

11/22/2004 Sapa www.iol.co.za Blood used in hospitals should be screened for the human herpes virus 8, a recently discovered virus which leads to Kaposi's sarcoma, particularly in HIV and Aids patients, the Medical Research Council has recommended. Kaposi's sarcoma was the leading cancer in many central, east and southern African countries, with rates "rapidly increasing" in South Africa, the MRC warned in its 2004 annual report. Other data from the MRC's cancer epidemiology research group showed that the percentage of lung cancer cases that could be ascribed to occupational environments (about 40 percent) was higher in a South African study than had been previously found in developed countries. About 3 500 patients were studied to measure the association of lung cancer and occupation, with increased risks found among miners and workers in chemical industries. In addition, 2 910 patients were examined to measure the association between HIV-infection and a number of socio-demographic characteristics. Alcohol consumption was found to be an important risk factor for HIV infection, probably due to its promotion of sexual risk-taking behaviour. "HIV-positive individuals were 3,5 times more likely to develop cancer of the vulva than HIV-negative individuals," read the report. Data from a case-control study were also analysed to determine the risk factors for cervical cancer among black women, with the results yet to be published. The association between hormonal contraceptive use and breast cancer was also investigated, with risks associated with the use of injectable progesterone contraceptives - widely used among black women since the [...]

11/22/2004 Chris Birk Scrantontimes.com "I didn't accept it as much as Mary (his wife) did," he said. "I had a tough time." "With me and our children, he managed to pull through," said Mrs. McHale. "Especially you, Mary," said her husband. Science says he may be right. Male cancer patients with wives or live-in partners have significantly higher survival rates than those who don't, according to a national study -- analyzing 1,822 people with head and neck cancer -- that included patients treated at Mercy Hospital in Scranton by local physician and cancer specialist Dr. Harmar D. Brereton. The intriguing, if intuitive, results were culled by a national team of physicians and coordinated through the Radiation Therapy Oncology Group, a cancer research base in Philadelphia. But the study, presented at a June conference, posits a rather one-sided worldview: Female patients with partners don't live any longer than those without. Explaining the absence of a supportive quid pro quo invites a host of social speculation. But Dr. Brereton is hopeful the new information will eventually help improve the lives of all cancer patients, regardless of gender. "The wonderful thing that came up, and it's something that all doctors know, is if you're married, you can't imagine how valuable that asset is in going through your treatment," said Dr. Brereton, of the Northeast Radiation Oncology Center in Dunmore. "Now that we're showing there's a real statistically significant survival advantage to that circumstance, how can we arrange for something that is a facsimile [...]

11/22/2004 Dale Chenoweth In recent years, knowledgeable biomedical researchers have sometimes wondered aloud whether the first approved gene therapy would come from a U.S. company, or instead from one in Europe or maybe even Britain. The answer, apparently, is none of the above. China Steps Out Ahead In March of this year the Chinese company Shenzhen SiBiono GeneTech Company, Ltd. began marketing in China a cancer gene therapy called Gendicine. The therapy was approved in October 2003 by China’s State Food and Drug Administration (SFDA) for use against squamous cell carcinoma of the head and neck (SCCHN), a category of solid tumors originating in such sites as the pharynx, larynx, oral cavity, and nose. In a self-interview published online last May, the company’s founder and chair, Zhouhui Peng, MD, said several Phase II and III trials among 135 patients with advanced SCCHN showed 64 percent had a complete response (CR) to the adenovirus-p53 drug used in combination with radiotherapy, and 29 percent had a partial response (PR). That’s significantly better than the response to chemotherapy and radiotherapy regimens that are now standard treatment in the U.S. and elsewhere. Additional trials involving another 240 patients also were positive, said SiBiono, but their data was not released. In all the trials, the drug was given by direct injection into accessible tumors. The easy accessibility of head and neck tumors for direct injection and their high incidence in China made SCCHN a good target disease, the company said. Over 1.6 million people worldwide [...]