The cost of living

Source: Author: Kathy Latour Cancer patients are living longer, but if radiation was part of their treatment, late effects may be a problem. Sam LaMonte, MD, knew he had cancer as soon as he touched the lump in his neck. It was 1991, and LaMonte, a head and neck surgeon in Pensacola, Florida, had just stepped down as the president of the Florida division of the American Cancer Society (ACS). “I told my partners I thought it was cancer, and they were in complete denial,” he recalls. “I wasn’t, because I had been feeling cancer in people’s necks my whole life.” LaMonte was right. A biopsy revealed cancer; the primary site was found at the base of his tongue. The diagnosis: stage 3 squamous cell head and neck cancer. The treatment: radiation twice a day for eight weeks. LaMonte, 50, resumed his career three months after he finished treatment. He picked up where he left off with the ACS, joining the national board and becoming the ACS poster boy for survivor issues even after he retired in 2002. Then in 2004, his doctor discovered from an X-ray that LaMonte’s left carotid artery was 100 percent blocked, and the right was 60 percent blocked. The damage, his doctor said, was the result of radiation that had saved his life 15 years earlier. LaMonte was a stroke waiting to happen. He had never had a symptom. “I was dumb as a door,” LaMonte says in retrospect. “So was my radiation oncologist about [...]

Finding survivor care

Source: www.curetoday.com Author: Kathy Latour In 2006, the Institute of Medicine and National Research Council released From Cancer Patient to Cancer Survivor: Lost in Transition. The goal of the study—the first of its kind—was to examine the range of medical and psychological issues faced by cancer survivors and to make recommendations to improve their health and quality of life. One such recommendation was to recognize that cancer survivors have unique medical needs and should have available, specialized follow-up care. Since then, clinicians and researchers have begun addressing the issues of who provides survivor care, how that care is delivered and what services should be available. Each year, an increasing number of cancer centers advertise the addition of survivorship programs. Some focus primarily on quality-of-life issues, while others offer a holistic approach of evaluation and recommendation for follow-up, says Linda Jacobs, PhD, RN, director of one of eight LIVESTRONG Survivorship Centers of Excellence, located at the University of Pennsylvania Abramson Cancer Center in Philadelphia. “Each emerging program is different,” Jacobs says. “They respond to regional needs as well as the population. Some only focus on one population of survivors, and some only provide services to their own patients.” This variation in services means survivors “have to have the knowledge to take care of themselves.” Jacobs says the first step is to document your treatment, either by calling the cancer center where you were treated or by completing a care plan using one of the available tools online, such as the LIVESTRONG [...]

Ban flavored tobacco products

Source: www.acscan.org Author: staff On 1/5/11, the Assembly introduced legislation banning the sale of flavored tobacco products. The American Cancer Society continues to be a strong advocate of this effort. Below is our memo of support: Memorandum In Support A. 288 An Act to amend the public health law, in relation to prohibiting the sale of flavored tobacco products. This measure prohibits the sale in New York of tobacco products, other than cigarettes, containing natural or artificial additives that impart to a tobacco product or its smoke flavors attractive to youth including, but not limited to, fruit, chocolate, vanilla, honey, candy, cocoa, dessert, alcoholic beverage, herb or spice flavoring. Menthol, mint and wintergreen flavors are excepted. In no event shall a tobacco product be construed as flavored based solely on the use of additives or flavorings in its manufacture, or their presence on an ingredient list. In 2009, Congress enacted the Family Smoking Prevention and Tobacco Control Act granting the federal Food and Drug Administration authority to regulate tobacco products and banning the use of flavors other than menthol in cigarettes. However, other tobacco products, including "little cigars" (cigarettes wrapped in paper containing tobacco), cigars, snuff and other smokeless tobacco products were not included in the prohibition. This bill corrects that oversight. An important function of the flavorings affected by this legislation is to mask from tobacco product users, particularly new users, the harsh, toxic properties of tobacco smoke and spit tobacco. Tobacco industry internal documents uncovered during the course [...]

Radiation aids local control of head and neck mucosal melanoma

Source: www.oncolink.org ( from Reuters Health Information) Author: staff Radiotherapy after surgery for head and neck mucosal melanoma (HNMM) can help prevent local spread of the disease, according to a retrospective study from France. The study covered 160 patients treated over 28 years at 13 centers in the Groupe d'Etude des Tumeurs de la Tete et du Cou (GETTEC). It's the largest analysis to date of this rare cancer, according to lead author Dr. Adil Benlyazid of the Claudius Regaud Institute in Toulouse and colleagues. HNMM accounts for 3% of melanoma cases and 0.4% to 10% of melanomas of the head and neck, the researchers said in the December Archives of Otolaryngology and Head and Neck Surgery. Treatment typically involves surgery with or without postoperative radiotherapy, or radiotherapy alone if surgery is not feasible. Previous studies involving fewer subjects (i.e., 59 and 69 patients) found a benefit to adjuvant radiotherapy, but "there remains great skepticism, mostly among head and neck surgeons," according to Dr. Benlyazid and colleagues. Between 1980 and 2008, 82 HNMM patients had surgery at the GETTEC hospitals, and another 78 had surgery followed by radiotherapy. There was a nonsignificant trend toward more locally advanced tumor stage in patients who had adjuvant radiation. Overall and relapse-free survival didn't differ between the two groups. But the radiotherapy patients were significantly less likely to have locoregional recurrence as a first event, with a five-year cumulative rate of 55.6% with surgery alone vs 29.9% with surgery plus radiotherapy. After adjustment for [...]

Fraudulent autism vaccine study shows the flaws in medical journal system

Source: blogs.forbes.com Author: Robert Langreth The British Medical Journal’s conclusion that the original study that led to the autism vaccine scare was “an elaborate fraud” shows how flawed the current system for reviewing high-profile medical studies is. The study, by discredited British doctor Andrew Wakefield, was originally published in 1998 by the journal The Lancet, and was retracted last year. Now the BMJ has published an investigation by British journalist Brian Deer finding that the whole thing was a fraud. According to a BMJ editorial, “not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration…and that in no single case could the medical records be fully reconciled” with Lancet publication. The editorial concludes that there is “no doubt” that Wakefield was responsible. The study, with just 12 patients, was dubious from the beginning. Why did it take 12 astonishingly long years to find out the truth? Strict British libel laws may have had something to do with it. But the bigger problem is the limitations of the medical journal system. The Food and Drug Administration often examines much of the raw data when it analyzes whether to approve or restrict a drug. But medical journals rely more on the good faith of researchers and something called peer review, outside researchers who anonymously review papers. This is good at detecting conclusions that don’t match up with the data, flawed analysis, and and obviously faulty method. But it can leave them surprisingly vulnerable [...]

Thimerosol-Autism link was a legal theory in search of science

Source: blogs.forbes.com Author: Daniel Fisher What has been obvious to skeptics for years has finally become obvious to all: The supposed link between vaccines and autism is a sham perpetrated in the name of litigation. In a scathing series of articles and editorial in the British Medical Journal, researcher Andrew Wakefield, who wrote an influential Lancet article in 1998 suggesting vaccines cause autism, has been exposed as a fraud. What’s worse, he was paid by lawyers to perpetrate his fraud, more than $675,000 over two years. Wakefield’s theories and the shoddy research performed by a British lab helped fuel a similar wave of litigation in the U.S. With total disregard for the risk of needless injury and death they were helping to cause, trial lawyers and cheerleaders like Robert Kennedy peddled the story that the preservative thimerosol, containing minute traces of mercury, was the cause of an explosion in autism diagnoses. What they never said was this was a theory tailor-made for litigation. Science designed to serve the courtroom. The lawyers had a problem, you see. Congress, recognizing that vaccines will injure and kill a predictable number of people each year while saving many more, passed a law in 1986 taking away the right to sue vaccine manufacturers in standard courts. The cases were funneled to a special vaccine court where damages would be paid out according to a schedule. Lawyers didn’t like that, preferring the potentially much larger verdicts they could get from a jury. So they began looking [...]

Fox Chase researchers find estrogen may help precancerous cells spread in oral cavity

Source: www.fccc.edu Author: staff Head and neck cancer is the sixth most common type of cancer and is on the rise in some demographic groups, including young women without any known risk factors. Now, researchers at Fox Chase Cancer Center report that estrogen may increase the movement of precancerous cells in the mouth and thus promote the spread of the disease within the oral cavity. The new results, which are reported in the January issue of Cancer Prevention Research, may lead to novel chemoprevention strategies in the future. Margie Clapper, PhD, Co-leader of the Cancer Prevention and Control Program at Fox Chase Cancer Center, and colleagues reported earlier this year that estrogen metabolism changes after smoke exposure in the lungs and may contribute to lung cancer. To find out if this female hormone influences development of head and neck cancer, Ekaterina Shatalova, PhD, a postdoctoral fellow and first author on the paper, examined the impact of estrogen on precancerous and cancerous cells. They found that estrogen induces the expression of an enzyme called cytochrome P450 1B1 (CYP1B1), which is responsible for breaking down toxins and metabolizing estrogen. Interestingly, CYP1B1 induction occurred only in precancerous cells, which are neither totally normal or cancerous. Interestingly, estrogen did not induce CYP1B1 in cancer cells. With closer investigation, the team found that depleting the expression of CYP1B1 diminished the ability of precancerous cells to move and divide, as compared to similar cells with normal levels of CYP1B1. Estrogen also reduced cell death in the [...]

Tobacco manufacturers must report ingredients to FDA

Source: www2.journalnow.com Author: Richard Craver The Food and Drug Administration is giving tobacco manufacturers less than three months to provide proof that any product introduced since February 2007 is "substantially equivalent" to products already in the marketplace. If a manufacturer does not file a report by March 22, or cannot substantiate its evidence, the FDA said Wednesday that it could remove the product from store shelves. The announcement updated the guidance provided to manufacturers in June 2009 as part of enacting the Family Smoking Prevention and Tobacco Control Act. Manufacturers of any product introduced after March 22 must submit an application and obtain a marketing order from the FDA before placing the product on the market. The emphasis of the new rules puts R.J. Reynolds Tobacco Co. in the bull's-eye because it has been the most prolific developer of tobacco products in recent years, including Camel Snus and the Camel orbs, sticks and filmlike strips for the tongue. "No known existing tobacco product is safe, and a market order issued by the FDA for these products should never be interpreted as such," said Dr. Lawrence Deyton, the director of the FDA's Center for Tobacco Products. "These products will not be safer, but we are required by this law to not allow even more dangerous products to cause further harm to those Americans who use tobacco products." The FDA defined "substantially equivalent" as "being the same in terms of ingredients, design, composition, heating source and other characteristics to an existing, single-predicate [...]

Henry Schein Dental selected as exclusive distributor of VELscope Vx System in North America

Source: www.prnewswire.com Author: press release LED Dental announced today that Henry Schein Dental will be the exclusive distributor of its revolutionary new VELscope Vx Enhanced Oral Assessment system in North America. Henry Schein Dental is the U.S. Dental business of Henry Schein, Inc. (Nasdaq: HSIC), the largest provider of health care products and services to office-based practitioners. In 2006 LED Dental introduced the first generation VELscope system, which was the first to employ fluorescence visualization to help dental practitioners detect oral cancer and other forms of oral disease. The VELscope system was also the first to receive FDA and Health Canada clearance to help clinicians detect cancerous and precancerous lesions that might not be apparent to the naked eye, and to help surgeons determine the appropriate surgical margin when excision of abnormal tissue is indicated. Since then, over 6,000 VELscope systems around the world have been used to conduct over 10 million oral health exams, which is more than any other oral disease detection technology. The VELscope Vx system is the latest and most advanced generation of VELscope technology. While retaining all of the capabilities of prior generations, its cordless design provides significantly greater portability and convenience. Moreover, a price of less than half the level of prior generations makes it feasible for many practices to have one in two or more operatories. In addition, a reimbursement code has been approved for this procedure, and is honored by many insurance companies. "As the world leader in oral disease detection, it [...]

HPV: To test or not to test

Source: www.rdhmag.com Author: Nancy W. Burkhart, RDH, EdD The dental practitioner has a responsibility to examine and assess the oral tissue status of all patients. Usually, we are happy to report that the tissue is healthy and no further treatment is necessary. Ethically, our role in assessment is both an understood practice as well as a legal one each time we interact with our patients. Within your practice, what is the expected role in assessing and relaying advice/recommendations to our patients? Do we rely strictly on scientific evidence with evidence-based protocol? Do we trust the developers/promoters of dental products to provide information to us? Do we relay personal opinion from colleagues, or do we reject opinion-based information? Do we search the scientific literature for current information, or call our colleagues and company representatives and obtain a consensus of what the best options may be for dissemination of information? We have all been in these situations. With busy practices, it is very time consuming to sit down and evaluate all the literature. Anyone who has been faced with a medical decision for a loved one or ourselves may actually feel exhausted while trying to sort through all of the options, treatments, and advice – some of which may even be at odds within specific group specialties in the way treatment is rendered. It can be very daunting, draining us both mentally and physically. So how do we approach this dilemma? For some time, we have known about the detrimental [...]

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