4/19/2004 Stephen Engroff, M.D., D.D.S. PR Newswire What did former president Ulysses S. Grant, baseball legend Babe Ruth, actor Yul Brynner and musician George Harrison all have in common? They were all diagnosed with, and died from, cancer of the head and neck. This form of cancer often gets little attention, but it remains a significant health-care problem. This disease is often missed in its early stages and, when diagnosed in its later stages, treatment becomes extensive and survival is often compromised. Most cancers of the head and neck begin in the mucosal lining and are termed squamous cell carcinoma. They frequently involve the mouth and throat and are commonly referred to as oral cancer. It is estimated that about 28,000 cases are diagnosed in the United States every year. Of the reported cases, 1,380 occur in Pennsylvania and about 350 Pennsylvanians die of this disease every year. Symptoms associated with oral cancer include white and red patches that persist for more than two weeks, non-healing ulcers, persistent sore throat, the feeling of a lump in the throat, loosening of teeth and pain that may radiate to the ear. The most commonly associated risk factors for development of oral cancer are tobacco (smoking and smokeless tobacco) and alcohol use. When these two things are combined, the risk increases substantially. Although a majority of oral cancer patients have these risk factors, there is a growing number who do not have any known risk behaviors. Treatment options depend on the stage of [...]

4/12/2004 New York Amy Norton Journal of Nuclear Medicine A standard post-surgery routine that can leave thyroid cancer patients feeling run-down for weeks may be largely unnecessary, new research suggests. The procedure, widely used for decades, calls for patients who have had their cancerous thyroid glands removed to go off of their normal hormone replacement therapy for six to eight weeks so that they can receive follow-up care. But in the new study, researchers found that just two weeks off of thyroid replacement was sufficient for about 90 percent of the 284 patients they assessed. This shortened time frame could cut the amount of time that patients suffer the side effects of stopping their normal hormone replacement therapy, according to the study authors. The thyroid is a gland in the neck that secretes hormones that help regulate metabolism. When thyroid hormone levels drop too low, a condition called hypothyroidism, metabolism slows, and symptoms such as fatigue, poor memory, weight gain and depression set in. So when the gland is removed due to cancer, patients must take synthetic replacement hormones for life. However, doctors have to temporarily stop patients' replacement therapy to give them radioactive iodine. Because the thyroid gland absorbs nearly all of the iodine that enters the body, radioactive iodine can be used to destroy cancerous thyroid cells. Alternatively, iodine can be given in a small amount to reveal on X-rays any residual cancer remaining after surgery. When patients stop their hormone replacement, the brain produces more thyroid-stimulating hormone [...]

4/12/2004 Columbus Associated Press Health care professionals hope new education programs will prevent teenagers from getting hooked on smokeless tobacco. Dentists say they're seeing more Ohio kids _ rural and suburban _ using the chewing tobacco and snuff generally associated with farmhands and baseball players. Some doctors predict a dramatic rise in oral cancers in the next several decades unless more is done to teach young people about the risks of smokeless tobacco. "It's not (an exaggeration) to say that it represents a little bit of a sleeping-giant health risk at this point in time," said Dr. David Schuller, director of the Arthur G. James Cancer Hospital and a specialist in head and neck cancers. In many cases, users start in middle school and think smokeless tobacco poses little risk. A 2002 Ohio Department of Health study found that almost 12 percent of Ohio high school boys had dipped in the past month. About 1 percent of the girls had. In middle schools, about 5 percent of the boys and almost 2 percent of the girls had. And although 77 percent of teenagers recognize the danger of cigarettes, only 40 percent know chewing tobacco can hurt them, according to a survey by the U.S. surgeon general. To combat the problem, dentists and schools throughout the state are utilizing a new program called Operation TACTIC, for Teens Against Chewing Tobacco in the Community. It includes print materials and a video in which Tammy Smith and her son Tyler tell the sobering [...]

4/11/2004 San Francisco E. J. Mundell Health Day News New biopsy test could change how doctors treat tumors of tongue, mouth Oral cancer specialists have found a way to determine which patients are most likely to benefit from surgery and which are not. Oncologists typically recommend that all patients with pre-cancerous white patches on the tongue or mouth have surgery to remove the suspicious area. But a new biopsy technique may change all that, Norwegian researchers say. The new findings are "actually challenging things that we are currently doing," says oral cancer expert Dr. Deborah Greenspan, of the University of California, San Francisco. A study summarizing the findings appears in the April 1 issue of the New England Journal of Medicine. Oral cancers are strongly linked to smoking and to the use of snuff, chew and other forms of smokeless tobacco. The disease is much more prevalent in men than women, with more than 20,000 cases of oral cancer reported in U.S. males each year. The disease typically begins as a small, innocuous leukoplakia (literally, "white patch") on the surface of the tongue or cheek "which to the patient may actually be completely asymptomatic and can only be picked up for the most part by a dentist or dental hygienist during a good oral exam," Greenspan says. The large majority of oral leukoplakias will not turn malignant but do warrant a biopsy, especially in tobacco users. If pre-cancerous cell changes called dysplasia are spotted during a biopsy, most doctors will [...]

4/11/2004 Columbus, Ohio Associated Press Health care professionals hope new education programs will prevent teenagers from getting hooked on smokeless tobacco. Dentists say they're seeing more Ohio kids - rural and suburban - using the chewing tobacco and snuff generally associated with farmhands and baseball players. Some doctors predict a dramatic rise in oral cancers in the next several decades unless more is done to teach young people about the risks of smokeless tobacco. "It's not (an exaggeration) to say that it represents a little bit of a sleeping-giant health risk at this point in time," said Dr. David Schuller, director of the Arthur G. James Cancer Hospital and a specialist in head and neck cancers. In many cases, users start in middle school and think smokeless tobacco poses little risk. A 2002 Ohio Department of Health study found that almost 12 percent of Ohio high school boys had dipped in the past month. About 1 percent of the girls had. In middle schools, about 5 percent of the boys and almost 2 percent of the girls had. And although 77 percent of teenagers recognize the danger of cigarettes, only 40 percent know chewing tobacco can hurt them, according to a survey by the U.S. surgeon general. To combat the problem, dentists and schools throughout the state are utilizing a new program called Operation TACTIC, for Teens Against Chewing Tobacco in the Community. It includes print materials and a video in which Tammy Smith and her son Tyler tell the [...]

4/10/2004 Shari Roan LA Times Hundreds of microscopic organisms found in the oral cavity may offer clues to the causes of disease elsewhere in the body. Any first-grader can tell you that if you don't brush your teeth, creepy sugar "bugs" will take over and cause cavities. But not all of the bugs, or microbes, in the mouth actually affect oral health. And not all of them are bad. A vast and diverse community of microscopic organisms — including viruses, bacteria, fungi and protozoa — thrive in the mouth, scientists are learning. Some of them may play important roles in both preserving health and causing diseases, says Dr. David Relman, an associate professor of microbiology at Stanford University. "We already know so much about so many disease-causing agents that it tends to give you the feeling that there is no reason to be going out and trying to find others," he says. But the causes of many diseases remain unknown — and the mouth appears to be a good place to look for clues. "We are increasingly becoming aware of the connection between the oral cavity and the body," says Donna Mager, a researcher at the Forsyth Institute, an independent research center in Boston. "Whatever grows in the oral cavity could have an impact on what happens to the body." Research by Relman and Mager is helping to advance this notion. In his lab, Relman samples the region in the mouth called the subgingival crevice, the deep space between the [...]

4/6/2004 DETROIT, MI BUSINESS WIRE DaimlerChrysler (DCX) is the first major corporation in the U.S. to attack one of the deadliest forms of cancer by offering a new Delta Dental benefit, the OralCDx brush biopsy, to its 400,000 UAW employees and family members, announced Thomas J. Fleszar, D.D.S., M.S., president and chief executive officer of the affiliated Delta Dental Plans of Michigan, Ohio and Indiana. The benefit, effective immediately, is expected to prevent the development of oral cancer and improve the survival rates for those who develop the disease. Each year, approximately 30,000 Americans are diagnosed with oral cancer, and the disease claims as many lives as melanoma and more than cervical cancer. If found early, oral cancer can be cured, and if detected at the precancerous stage, oral cancer can be prevented. Delta Dental Plan of Michigan (DDPMI), with its affiliated plans in Ohio and Indiana, is one of the first dental benefits providers in the nation to include the diagnostic tool as part of its standard benefits and DaimlerChrysler is the first DDPMI employer group to incorporate the benefit in its plan design. "While our benefit programs have always covered traditional scalpel biopsies, and continue to do so, the brush biopsy represents a breakthrough in the fight against oral cancer," said Dr. Fleszar. "This simple, painless and inexpensive test will make a dramatic difference in improving the five-year survival rate for oral cancer, which has remained a dismal 57 percent for the past 40 years." He added, "Further, [...]

4/1/2004 Florida Sid Kirchheimer WebMD Medical News There's more bad news for St. John's Wort, once the darling of herbal remedies and still the world's most popular alternative to prescription antidepressants: A new study now indicates that the herbal medicine compromises a powerful cancer-fighting drug used to treat a form of blood cancer. At least six previous studies show that the reason for this effect is the same: The over-the-counter supplement causes higher levels of a particular substance to be made that the body uses to breakdown other disease-fighting medicines. This time, St. John's Wort was found to interfere with Gleevec, a powerful drug that targets only cancerous cells and is used to treat people with leukemia. The drug is currently taken daily to normalize the large numbers of abnormal white blood cell in leukemia patients. However, Gleevec is being tested -- and showing promise -- in treating other aggressive cancers. "We found that when St. John's wort is taken in combination with Gleevec, it caused the amount of Gleevec in the blood to drop by 30%," says researcher Reginald F. Frye, PhD, of the University of Florida Center of Pharmacogenomics. "That may not sound like much, but for Gleevec, a 30% reduction is very important. He says that there is a critical blood level of the drug that leukemia patients need to be above to prevent the disease from coming back, what is known as a disease relapse. "What this study shows is that if they took St. John's [...]

3/30/2004 By Jennifer Warner See sources at end of article The effects of sun exposure on women's health may be more than skin deep. A new study suggests that a woman's risk of cervical cancer may be much higher during sunny months. Researchers tracked nearly a million Pap smear results collected over 16 years in southern Holland and found that women were twice as likely to be infected with the human papilloma virus (HPV) during the sunny days of August than in the darker days of winter. HPV is the most common sexually transmitted disease. Pap smears that test for HPV infection are commonly used worldwide as a tool to screen for signs of cervical cancer. The vast majority of women with HPV infection will not develop cervical cancer, but cervical cancer is a rare complication of this common infection. About 20 of the more than 230 types of HPV are considered high risk because of their close association with the disease. HPV Risks Rise During Sunny Months? In the study, researchers looked at seasonal patterns of HPV infection among 920,359 consecutive Pap smears collected from 1983 to 1998 and compared it with differences in sunlight exposure. The results showed that the number of HPV infections was twice as high in August compared with the lowest month, and the rates of HPV infection were closely linked to available sunlight exposure. "The sunnier the year, the higher the HPV rate, and the sunnier the month, the higher the HPV rate," says [...]

3/30/2004 Honolulu, Hawaii International Association for Dental Research, Annual Meeting presentation Detailed molecular analysis of tumors is now providing molecular portraits which show the genetic basis of the different clinical presentations of disease. This technology will help identify metastasis signatures and provide logical targets for drug discovery. This moves us closer to a time when we will treat patients based on the genetic profile of the tumor rather than the clinical presentation of the disease. Finding targets that are differentially expressed in cancer and normal tissue will also provide better tests for early diagnosis. There is also increasing interest in utilizing knowledge about tumor biology to address the vexing question as to why tumors recur despite seemingly adequate treatment. A new generation of ultra-sensitive diagnostics has highlighted the problem of subcutaneous foci of residual tumors that may remain at the operative site, or be disseminated throughout the body. These approaches have also revealed that the extent of spread of a precancerous patch is often much greater than previously realized. Long-term follow-up of cases screened by these molecular diagnostics suggests that detecting these troublesome foci of disease can help to identify individuals at risk of developing local and distant recurrence. In a Keynote Address during the 82nd General Session of the International Association for Dental Research, Dr. Maxine Partridge (King's College Hospital, London, UK) reports that a host of novel therapeutic strategies is now on the horizon for management of these problems. These include gene-mediated strategies to replace defective sequences, blocking [...]