6/23/2008 web-based article staff JNCI J Natl Cancer Inst Volume 100, Number 12 Pp. 829 The cost of cancer care incurred during the period two months prior to cancer diagnosis and 12 months following diagnosis increased substantially between 1991 and 2002 for elderly patients in the United States, according to a study published online June 10 in the Journal of the National Cancer Institute. The increases in costs for breast, lung, and colorectal cancer were due in large part to increases in the percentage of patients receiving radiation therapy and chemotherapy and the rising costs for those therapies. There have been general reports of increases in the cost of cancer care, but little research has examined the magnitude of those changes or the type of treatments that are driving them. To find out, Joan L. Warren, Ph.D., of the National Cancer Institute in Bethesda, Md., and colleagues analyzed data from the Surveillance, Epidemiology, and End-Results (SEER)-Medicare linked database. They identified 306,709 individuals aged 65 or older who were diagnosed with breast, lung, colorectal, or prostate cancer between 1991 and 2002. The researchers compared the cost of initial cancer treatment, separating cancer-related surgery, chemotherapy, radiation therapy, and other hospitalization. During the study period, the average cost per lung cancer patient rose by $7,139 to $39,891, after adjusting for inflation. Similarly, the cost per colorectal cancer patient climbed by $5,345 to an average of $41,134, and per-patient breast cancer care rose by $4,189 to an average of $20,964. The cost of per-patient [...]

6/23/2008 web-based article staff Biocompare Life Science News (www.biocomare.com) Primary tumors can encourage the growth of stray cancer cells lurking elsewhere in the body that otherwise may not have amounted to much, according to a new study in the June 13 issue of the journal Cell, a publication of Cell Press. As people age, most may have such indolent cancer cells given the sheer number of cells in the body, although their rarity makes them impossible to detect, the researchers said. The primary tumors under study, which were derived from human breast cancers, seem to "instigate" the growth of other cancers by mobilizing bone marrow cells, which then feed the secondary tumors' growth, they report. One key to the process is the secretion of a substance known as osteopontin by the instigating tumor, a finding that may have therapeutic implications. Indeed, the researchers noted that osteopontin is present at elevated levels in women with metastatic breast cancer, supporting the notion that the new findings may hold clinical significance. "If metastases depend on stimulation by primary tumors, interception of the signal through neutralizing antibodies" might block cancer spread, said Robert Weinberg of the Massachusetts Institute of Technology. "That's still speculative, but it's an interesting idea to ponder," he added, noting that treatments today don't specifically target metastases, which are responsible for the vast majority of cancer deaths. The researchers noted that while the effects of the tumor microenvironment has been much studied, much less was known about how the systemic environment [...]

6/21/2008 web-based article staff www.wqad.com Clinical trials are generally for a patient, not the people taking care of the patient. But a new study focuses on the caregiver and how support can help everyone involved. More than 50 million Americans are caregivers. Their help saves the health care system more than three-hundred billion dollars a year. That's why a new clinical trial focuses on educating the caregiver. Study manager Darlene Johnson is passionate about this research because she is a tongue cancer survivor. Her husband was her caregiver. "I went home and told him about the study, and he said, 'ah, man. I wish I had something like that when you were going through this,' because he felt very insecure himself." For the study, caregivers will have one-on-one time with a nurse and receive this home care guide book. Some of the advice: Take time to rest -- devote at least 30 minutes a day to yourself. Be open in your conversations with the patient -- talk about life and death. Watch for signs of depression, and let the sick person make as many decisions as possible. "I think this training will be invaluable." The study at Moffitt Cancer Center is open to patients and their caregivers for the next year. To qualify for the trial, patients must be older than 70 years of age and have a diagnosis of colon cancer or non-Hodgkin lymphoma.

6/18/2008 web-based article Caroline McNeil JNCI Journal of the National Cancer Institute 2008 100(12):840-842 Head and neck cancer researchers are considering clinical studies, including a proposed cooperative group treatment trial, that would investigate the link between human papillomavirus (HPV) and some oral cancers. Although the studies are still in the planning stage, they mark a new turn toward the clinic for an area that up to now has centered mostly on epidemiologic and laboratory studies. Over the past decade, population studies have established an association between HPV and some tumors in the oropharynx (tonsils, soft palate, posterior pharynx, and base of tongue). Much remains unknown about the biology and natural history of oral HPV infection, but evidence of its association with these tumors is so strong that the International Agency for Research on Cancer concluded, in a monograph published in December, that there is "sufficient evidence in humans for the carcinogenicity of HPV16 in the oral cavity and oropharynx." Now researchers are beginning to ponder the clinical implications of this link. Especially intriguing to many are data suggesting that HPV-positive oropharyngeal tumors respond better to treatment than HPV-negative tumors. That finding has given rise to important clinical questions, including the one to be addressed in the proposed trial: Can HPV-positive tumors be treated less aggressively than HPV-negative tumors because of their increased sensitivity to chemotherapy and radiotherapy? "That's the fundamental question," said Arlene Forastiere, M.D., a professor at the Johns Hopkins Kimmel Cancer Center in Baltimore and a leader in [...]

6/16/2008 Chicago, IL staff Newsday.com For five grueling months in 2006 and 2007, Carol Kanga suffered through treatment for a life-threatening case of throat cancer linked to an unlikely source: a sexually transmitted viral infection. Unable to swallow food or water during chemotherapy and radiation treatment, Kanga was fed through a stomach tube. Her one respite came on Thanksgiving, when she savored a single spoonful of weak broth. "The radiation basically burns the skin off the outside and inside of your throat," said Kanga, 52, a Rockville, Md., artist. "It's like there's a fire inside your neck." Kanga's treatment was successful, but the virus that struck her is causing increasing concern among some researchers who think it is causing a small-scale epidemic of throat cancer. That virus, scientists have proved only in the last two years, is human papillomavirus, or HPV -- the same virus that's behind most cases of cervical cancer. With 6,000 cases per year and an annual increase of up to 10 percent in men younger than 60, some researchers say the HPV-linked throat cancers could overtake cervical cancer in the next decade. "It's almost a new disease, in a sense," said Dr. Ezra Cohen, an oncologist at the University of Chicago Medical Center. "It's now becoming a dominant sub-type of the disease that we see in our clinic." The HPV infections likely took root decades ago as the Baby Boomers were reaching adulthood, and only now are spurring a rise in throat cancer cases, mostly among [...]

6/16/2008 Washington, D.C. Dennis Thompson US News & World Report (health.usnews.com) More than half of all people will have a sexually transmitted disease or infection at some point in their life, the American Social Health Association reports. Most HPV carriers are never diagnosed and never realize they carry the virus. "It's never detected, they are never aware of it, and their immune system suppresses it before they ever know about it in the vast majority of cases," said Fred Wyand, spokesman for the American Social Health Association. In this way, HPV is a silent killer. It's the leading cause of cervical cancer and has become the second-leading cause of cancer death for women around the globe. Doctors have responded to the threat of HPV by fighting it in a way unusual among sexually transmitted diseases -- through a vaccine. The vaccine, Gardasil, is proven to prevent infection from four particularly dangerous strains of HPV in women. The U.S. Centers for Disease Control and Prevention has recommended that 11- and 12-year-old girls begin receiving the vaccine as part of school vaccination efforts. Now researchers are looking into whether the vaccine should be given to boys as well, both to prevent the transmission of HPV, and to prevent the rarer, but no less deadly, cancers that can occur in men from the virus. "There is probably no reason to think it would not be effective in boys, and because HPV is passed back and forth, immunizing a large part of the population [...]

6/13/2008 Newport, PA press release PharmaLive.com President George W. Bush today appointed world-renowned medical oncologist Waun Ki Hong, M.D., professor and head of the Division of Cancer Medicine at The University of Texas M. D. Anderson Cancer Center, to the National Cancer Advisory Board. Hong will serve a six-year term through March 9, 2014. The function of the NCAB is to advise, assist and make recommendations to the secretary of the Department of Health and Human Services and the director of the National Cancer Institute. The NCAB may make recommendations regarding support grants and cooperative agreements, technical and scientific peer review, and functions pertaining to the NCI. “I am delighted to be selected to serve on the National Cancer Advisory Board by President Bush. This new opportunity will allow me to share my expertise in translational and clinical research, to learn from and collaborate with so many of my distinguished colleagues around the country, and to continue to do my part to shape cancer policy,” said Hong. “My ultimate challenge, both at M. D. Anderson and soon with my work with the NCAB, is very simple: raising the bar in cancer care for all those with this disease.” Since joining M. D. Anderson faculty in 1984, Hong has made seminal contributions to cancer medicine through his pioneering research in larynx preservation and chemoprevention in head and neck cancer. Hong, author or co-author of more than 660 scientific publications, has successfully translated numerous key research findings into effective clinical care during [...]

6/13/2008 web-based article Joel B. Epstein et al. Can Fam Physician Vol. 54, No. 6, June 2008, pp.870 - 8 Objective: To describe the role that primary care physicians can play in early recognition of oral and oropharyngeal squamous cell carcinomas (OOSCCs) and to review the risk factors for OOSCCs, the nature of oral premalignant lesions, and the technique and aids for clinical examination. Quality of Evidence: Medline and Cancerlit literature searches were conducted using the following terms: oral cancer and risk factors, pre-malignant oral lesions, clinical evaluation of abnormal oral lesions, and cancer screening. Additional articles were identified from key references within articles. The articles contained level I, II, and III evidence and included controlled trials and systematic reviews. Main Message: Most OOSCCs are in advanced stages at diagnosis, and treatment does not improve survival rates. Early recognition and diagnosis of OOSCCs might improve patient survival and reduce treatment-related morbidity. Comprehensive head and neck examinations should be part of all medical and dental examinations. The head and neck should be inspected and palpated to evaluate for OOSCCs, particularly in high-risk patients and when symptoms are identified. A neck mass or mouth lesion combined with regional pain might suggest a malignant or premalignant process. Conclusion: Primary care physicians are well suited to providing head and neck examinations, and to screening for the presence of suspicious oral lesions. Referral for biopsy might be indicated, depending on the experience of examining physicians. Authors: Joel B. Epstein, DMD MSD FRCDC FDS Professor in [...]

6/10/2008 Fairfax, VA press release NewsReleaseWire.com Adding radiation therapy to surgery significantly improves overall survival in patients diagnosed with node-positive head and neck cancer when compared to treating with surgery alone, according to a study in the June issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Therapeutic Radiology and Oncology. Radiation therapy is commonly used after surgery to treat some head and neck cancers, but very few studies have been conducted to determine its impact on survival. Researchers at the Mount Sinai School of Medicine departments of Radiation Oncology and Otolaryngology and Head and Neck Surgery in New York sought to determine with this study the impact of radiation and surgery on a head and neck cancer patients’ overall survival. Between 1988 and 2001, 5,297 patients with a median age of 59 who were diagnosed with node-positive head and neck squamous cell carcinoma were treated with surgery and/or adjuvant radiation therapy. The patients were surveyed approximately 4.4 years after treatment, and the researchers found that adding radiation to surgery improved patients’ chance of survival by 25 percent in all nodal stages (N1-N3), including N1 stage patients, even though radiation is typically recommended only for N2 and N3 stage patients. “This study provides evidence that radiation should be considered after surgery for most head and neck cancer patients with positive lymph nodes,” said Johnny Kao, M.D., assistant professor of radiation oncology at the Mount Sinai School of Medicine and lead author of the [...]

6/9/2008 Houston, TX staff CancerWise (www.cancerwise.org) Whether people have had their tonsils removed or not, they still might develop tonsil cancer and should be educated about the disease. Answering questions about tonsil cancer is Ann Gillenwater, M. D., associate professor in M. D. Anderson's Department of Head and Neck Surgery and director of the cancer center's Oral Cancer Prevention Clinic. What are tonsils? The tonsils are a collection of lymph tissue, or white blood cells, at the back of your mouth that gather there to help fight infection. What raises the risk of tonsil cancer? Traditionally, the known risk factors for tonsil cancer are tobacco and alcohol use, but now there seems to be an increased rate of tonsil cancer in patients who don't smoke or drink. There is some evidence that it's related to the human papillomavirus (HPV). Can you have tonsil cancer and no tonsils? Even if you have had your tonsils removed (tonsillectomy), you can still get tonsil cancer because during the procedure, some tonsil tissue is left behind. What are the symptoms of tonsil cancer? The number one symptom is asymmetrical tonsils, having one tonsil larger than the other. Another symptom is a persistent sore throat. At later stages, there are enlarged lymph nodes or cysts in the neck and maybe ear pain. As a general rule, any time someone is thought to have a tonsil infection and antibiotics don't work, doctors should consider tonsil cancer. Many times tonsil cancer that has metastasized or spread to [...]