2/11/2004 Tammy Dotts Hem/Onc Today The lifetime risk for lymphedema is about 20% for patients who receive treatment that interferes with lymph transport. Many oncologists and other physicians, however, know little about the condition or about available treatments, said Christine Rymal, MSN, RN, CS, AOCN, a nurse practitioner at the Karmonos Cancer Institute in Detroit. “Lymphology is a neglected field,” she told Hem/Onc Today. “There aren’t many experts around.” The lack of experts may explain why some patients feel abandoned by the medical community. Rymal mentioned a 1997 paper in the Oncology Nursing Forum that found a primary theme among women treated for lymphedema was that they received little information from their doctors. “Ideally, oncologists should know enough about the condition to counsel patients before referring them to a therapist,” she said. “But oncologists may not have the time or the knowledge to understand how lymphedema and lymphedema therapy affect the patient. Even primary doctors aren’t that knowledgeable about it.” Dorland’s Illustrated Medical Dictionary defines lymphedema as chronic accumulation of interstitial fluid as a result of stasis of lymph, which is secondary to obstruction of lymph vessels or disorders of the lymph nodes. Under normal conditions, Rymal explained, lymph does not typically flow across watersheds that are the boundaries between quadrants of the peripheral lymph transport vasculature. Surgery, radiation or both can compromise lymph transport. This can cause lymph stasis, vessel hypertension, quadrant congestion and lymphedema. Untreated lymphedema can lead to decreased or lost function in the limbs, skin breakdown, [...]

2/10/2004 John Morgan USA Today Basic Instinct scribe Joe Eszterhas is known for his dark tales populated with seductive killers. But like a character from one of his famous movies, Eszterhas was being slowly murdered by two killers he thought he loved cigarettes and alcohol. Their murder weapon was cancer of the larynx. And they almost got away with it. "I started smoking when I was 12 years old and drinking when I was 14," says Eszterhas, whose just-released novel Hollywood Animal will hit the New York Times best-seller list this week. "By 2000, I was smoking four packs of Salem lights every day and drinking a significant amount. My voice began to get hoarse." Eszterhas says he wasn't concerned. He had experienced hoarseness before on several occasions after having nasal polyps removed. So the million-dollar screen writer casually went in to see his "hot shot Beverly Hills ENT guys." "I was diagnosed with a benign polyp that was wrapped around my vocal cords," Eszterhas recalls. "They said that it was nothing alarming. It was outpatient and no rush. It was just a polyp not unlike all the other ones." But it wasn't. After moving his family back to Ohio in March of 2001, the hoarseness got worse. With the renowned Cleveland Clinic nearby, Eszterhas decided to have the polyp removed rather than wait any longer. "The Cleveland Clinic throat guy performed the same test as the Beverly Hills doctors," Eszterhas explains, describing the flexible laryngoscope, a lighted tube with [...]

2/4/2004 HELEN R. PILCHER Annals of Oncology, 15, 338 - 345, (2004) Fewer people in Europe are dying from cancer now than a generation ago, according to two recent surveys. But while survival is on the up, so too is the number of new cancer cases, prompting calls for further research funding. In Britain there are 12% fewer cancer-related deaths than there were 30 years ago, according to data from Cancer Research UK. The good news holds for a range of different cancers — the female death rate from breast cancer is down by 20%, and the male death rate from testicular cancer has fallen by 37%. Deaths from stomach cancer are down by about half in most of Europe, according to research from the Institut Universitaire de Médecine Sociale et Préventive in Lausanne, Switzerland1 — a finding echoed by the Cancer Research UK study. The reduced death rates are due to a combination of factors, says Peter Selby, director of the Cancer Research UK Unit at St James's University Hospital in Leeds. Antibiotics and better sanitation are helping to rid the world of Helicobacter pylori, a bacterium thought to cause stomach cancer. Screening programs help to catch breast and cervical cancer early, when treatments may be more effective. Therapies have also improved. Surgery, radiotherapy and chemotherapy are commonly used to remove tumors and keep re-growth at bay. People are tending to smoke less and eat more healthily. Smoking, for example, is responsible for around 90% of all lung-cancer cases. [...]

2/3/2004 Alton Josh Stockinger The Telegraph Looking at 6-year-old Morrisan Henson, you would never know she’s sick. The Alton first-grader bounces into the kitchen and slides to a sock-footed stop at the base of the refrigerator. Her tiny, 3-foot frame is cloaked in a fluffy, red sweatshirt and black pajama bottoms. Morrisan scales the monstrous appliance with her eyes. Looking up, her shoulder-length, light-blond hair falls away from her face, and a slow grin stretches from one fair cheek to the other. "Can I have some pudding?" she asks. Morrisan dances with relentless energy, scooting back and forth, anticipating a response from her grandmother. Pudding and soup are two of the only foods Morrisan can eat these days. "Yes." A smile replaces the grin. In seconds, Morrisan cradles a container of chocolate pudding in her hands. Her eyes sharpen intensely as she pulls back the tin-foil covering. Thhhwiiiikk! Morrisan scampers back to the living room to play with her sister. "She’s an eater," says Sharon Connolly, Morrisan’s grandmother and legal guardian. The refrigerator door swings back, closing the appliance -- on it, a calendar. The page reads "January." Connolly can’t help noticing the calendar out of the corner of her eye. Messages like "Surgery" and "Call Oncologist" fill the boxes, now a timeline of the family’s terrifying ordeals of the past month. "We’re going to fight," Connolly says with a catch in her throat. Finding Out In January, Morrisan became the youngest documented person to be diagnosed with a common [...]

2/1/2004 By Sid Kirchheimer , Reviewed By Michael Smith, MD WebMD Medical News (see below) But More Work Is Needed as 1,500 Americans Will Die Each Day. Although more people are being diagnosed, death rates for most major cancers continue to fall, the American Cancer Society says. Since 1930, overall cancer deaths have declined 11% among men and 14% among women. The biggest decrease has been in stomach cancers, which have dropped 86% in men and 91% in women -- largely because of improved hygiene and food storage and a lower rate of infection of the H pylori bacteria among Americans. "Cancer is not an inescapable fact of life," says Michael J. Thun, MD, an author of the report. "There are things that we do, in our culture and with social policies and practices, that make a difference in cancer occurrence." While news is good regarding deaths from cancer, there is still much work to do. The ACS estimates that cancer will kill more than 1,500 Americans each day this year -- more than 560,000 in all -- and account for one of every four deaths in the U.S. Cancer will continue to be the No. 2 killer behind heart disease. About one-third of these deaths will result from lifestyle factors such as poor diet, obesity or lack of exercise, while smoking will claim about 180,000 lives. In its new report, Cancer Facts & Figures 2004, the American Cancer Society projects that some 1.4 million Americans will be diagnosed with [...]

2/1/2004 Snyder et al Public Library of Science Biology Restoring p53 protein function in mouse cancer models eliminates tumors and increases survival of the animals, according to a new study. Because a p53 mutation is one of the most common events in the development of cancer, the results could have implications for a wide variety of tumors. Cancer often begins with mutations in tumor suppressor pathways. Tumor suppressor genes—such as p53—arrest cell growth and induce apoptosis (programmed cell death) in response to cellular stress, such as chromosomal damage. Cells with p53 mutations can escape these constraints, leading to the uncontrolled growth characteristic of "immortal" cancer cells. Nearly all types of tumors have mutations in the p53 pathway, many of them in the p53 gene itself. Steven Dowdy, of the University of California at San Diego, and colleagues introduced modified p53 peptides (parts of the protein) into cancer cells. p53 works as a "transcriptional" activator that binds to specific gene sequences and triggers apoptosis in response to DNA damage. One region of the p53 protein, the C-terminal domain, facilitates DNA binding. In cancer cells, synthesized peptides (called p53C') derived from this region can induce apoptosis by restoring function to p53 proteins with DNA-binding mutations. To get p53C' peptides into cancer cells, the scientists used a technique pioneered by Dowdy that delivers proteins into the cell interior. Testing the effectiveness of the peptide therapy on mouse strains that model human metastatic disease, the scientists found that mice treated with the p53C' peptide [...]

1/27/2004 San Francisco Edward Susman Gastrointestinal Cancer Symposium Esophageal cancer patients who are deemed poor surgical candidates may benefit from endoscopically guided brachytherapy, as administered by a team of radiation oncologists and gastroenterologists, according to a Canadian study. The multidisciplinary approach to treatment resulted in no esophageal perforations in a series of 60 patients, reported Dr. Te Vuong and colleagues at the first Gastrointestinal Cancers Symposium last week in San Francisco. The meeting was sponsored by the American Society for Therapeutic Radiology and Oncology (ASTRO), the Society of Surgical Oncology (SSO), the American Gastroenterological Association (AGA), and the American Society of Clinical Oncology (ASCO). According to the poster presentation from the McGill University Health Centre in Montreal, the elderly patients with adenocarcinoma or squamous cell carcinoma of the esophagus were treated with high-dose-rate brachytherapy prior to external-beam radiation therapy. The patients received 20-Gy doses in five fractions, prescribed at 1 cm from the source to the initial tumor bed. The tumor was identified by direct endoscopy. Radio-oblique clips were placed above and below the tumor at the time of endoscopy for quality control of tumor bed localization. Chemotherapy and/or reduced radiation doses were dependent upon the individual patients' performance status. "After a median follow-up of 18 months for all 60 patients treated between 1996 and 2003, we saw about a 25% local recurrence rate of the cancer," Vuong said. "Historically we might expect to see a 50% recurrence in these patients, so we believe that we have provided a benefit [...]

1/26/2004 Las Vegas Valerie Miller LasVegasPress.com A merger between two conglomerates could mean big rewards for the University of Nevada, Las Vegas. Science & Engineering Technology (SEA), which is headquartered in New Orleans and works with UNLV, is being acquired by Washington, D.C.-based technology firm ITS Services. The $200 million deal announced last week may help propel groundbreaking research now being conducted between SEA and UNLV. That work includes attempts to develop a new, quicker method for early detection and treatment of oral cancer. The SEA method -- which is scheduled to be tested with the help of the soon-to-open UNLV Dental School -- would involve the use of both multi-spectral imaging using light reflection and high-speed wireless data transmission. Ron Ryan, the vice president of SEA in Las Vegas says that use of multi-spectral imaging technology to diagnose oral cancer is already being tested by SEA with the U.S. Army. The military is interested in quicker methods for detecting cervical cancer in service women. The idea to study the application of the technology to detecting oral cancer actually was suggested by UNLV Provost Ray Alden a few years ago in a meeting, according to Ryan. That suggestion could really help UNLV and its dental school gain prominence as research facilities, SEA officials contend. "We will help elevate them and help them reach their goal of being research and technology intensive," Ryan says. ITS is all for the research, adds Ryan. "It was something we kind of [SEA] brought to [...]

1/25/2004 Djillali Annane et al. Journal of Clinical Oncology, 10.1200/JCO.2004.09.006 Purpose: To determine the efficacy and safety of hyperbaric oxygen therapy (HBO) for overt mandibular osteoradionecrosis. Patients and Methods: This prospective, multicenter, randomized, double-blind, placebo-controlled trial was conducted at 12 university hospitals. Ambulatory adults with overt osteoradionecrosis of the mandible were assigned to receive 30 HBO exposures preoperatively at 2.4 absolute atmosphere for 90 minutes or a placebo, and 10 additional HBO dives postoperatively or a placebo. The main outcome measure was 1-year recovery rate from osteoradionecrosis. Secondary end points included time to treatment failure, time to pain relief, 1-year mortality rate, and treatment safety. Results: At the time of the second interim analysis, based on the triangular test, the study was stopped for potentially worse outcomes in the HBO arm. A total of 68 patients were enrolled and analyzed. At 1 year, six (19%) of 31 patients had recovered in the HBO arm and 12 (32%) of 37 in the placebo arm (relative risk = 0.60; 95% CI, 0.25 to 1.41; P = .23). Time to treatment failure (hazard ratio = 1.33; 95% CI, 0.68 to 2.60; P = .41) and time to pain relief (hazard ratio = 1.00; 95% CI, 0.52 to 1.89; P = .99) were similar between the two treatment arms. Conclusion: Patients with overt mandibular osteoradionecrosis did not benefit from hyperbaric oxygenation. Authors: Djillali Annane, Joël Depondt , Philippe Aubert , Maryvonne Villart , Pierre Géhanno , Philippe Gajdos , and Sylvie Chevret Authors' Affiliation: [...]

1/23/2004 Carson, NV Maggie O'Neill Record-Courier Students at Carson Valley Middle School listened -- and listened well -- as oral cancer survivor Gruen Von Behrens relayed a message on Wednesday. "I didn't think it'd happen to me," he said. Von Behrens, once a popular 17-year-old baseball player at an Illinois high school, stood as a 26-year-old advocate before middle school students, telling how tobacco took his good looks away. "I know I'm a little hard to understand, so you're going to have to bear with me and listen," he said to the packed auditorium. "This isn't a mask I can take off and throw in the closet. I'm like this 365 days a year." "This" began for Von Behrens when he was 17 and noticed a white spot on his tongue that began to grow and cause it to split. He told his mother the drooling she noticed was from a painful wisdom tooth. "I didn't want my mom to see what was going on in my mouth," he said. At the same time, he holed up in the bathroom, asking God why this was happening to him. "This" began with chewing tobacco when he was 13, a decision he regrets 33 surgeries later. "I liked the way it tasted," he said at the assembly. "It made me feel good." Concerned about his wisdom tooth, Von Behrens' mother took him to a dentist. Von Behrens told the dentist he wasn't there due to a tooth. He had cancer. The dentist [...]