4/22/2007 web-based article Lory Laughter, RDH, BS Woman Dental Journal (rdh.pennnet.com) When I present a concept or technique to dental hygienists, more often than not someone asks for evidence. We are an evidence-based group of professionals. Every educational program that offers a degree in dental hygiene might as well have a disclaimer that states, “Gullible need not apply.” While evidence may be the universal requirement, there are varying opinions on what exactly constitutes acceptable proof. Journals, opinions of key leaders and even common sense are often accepted as viable research by many in the dental profession. But somewhere in the search we need to look for trials, systematic reviews, case studies, and our own clinical experience. In October 2006 I attended the Idaho Conference on Health Care in Pocatello, Idaho. The focus was “Quality Health Care: Sifting Through the Evidence.” Being among scientists and evidence-based decision makers brought on an excitement that is hard to explain to anyone who doesn’t share a passion for research. My anticipation was never dampened by the possibility that some of my strongly held opinions might be challenged. Mark Lingen, DDS, PhD, is an associate professor in the Department of Pathology at the University of Chicago Pritzker School of Medicine. His presentation, “Oral Cancer: New Technologies for Early Detection and Prevention” was more than enlightening, it was somewhat discouraging. Dr. Lingen provided evidence that oral cancer is often associated with the papillomavirus, the same virus found in several types of cervical cancer. Medical research has [...]

4/22/2007 Topeka, KS staff 49news (www.49abcnews.com) "This is about as good as you're gonna get on this TV," Charlie Osborne said. Osborne is grateful technology's improved over the years. But he never appreciated it more than during his recent battle with throat cancer. "They would have had to cut out my voice box. That was the only other option. If this happened four years ago, that was still the standard procedure," Osborne said. He had a tumor in his neck the size of a golf ball. Typically, doctors would perform radical surgery to remove it. "He would have had a tracheotomy, at least temporarily, an opening in the neck. And he would have ended up having a feeding tube in his stomach because he was having so much trouble with his swallowing," head and neck surgeon Dr. Miriam Lango said. Instead, Dr. Lango used a minimally invasive procedure called transoral laser surgery. "We can access tumors not through the neck, but actually through the mouth," Lango said. The carbon dioxide laser is an intense beam of energy that cuts and seals the tissue simultaneously. "You are able to cut very precisely without having blood in your field. So you can really distinguish between normal tissue and tumor tissue," Lango said. Because the laser is less invasive, patients have a lower risk of infection and a faster recovery. "Patients have much less trouble with swallowing and with speech. Often times the speech is almost normal after the surgery," Lango said. Dr. [...]

4/22/2007 Okemos, MI press release Business Wire (home.businesswire.com) Despite the fact that one American life is lost every hour and approximately 30,000 new cases will be diagnosed this year, a recent EPIC-MRA Omnibus survey of 600 Michigan adults revealed little-to-no awareness of oral cancer or its signs and symptoms. Commissioned by Delta Dental of Michigan (Delta Dental), the study showed that when respondents were asked to list three forms that cancer can take, not one person named oral cancer. Additionally, 16 percent of the study’s respondents believe oral cancer is a less serious form of the disease than other cancers. In reality, the death rate for oral cancer is higher than that of cervical cancer, Hodgkin’s disease, cancer of the brain, liver, testes, kidney, or skin cancer. The low awareness levels of oral cancer are compounded with an ironic and grim statistic pertinent to Michigan – African American men in Wayne County have one of the highest rates of oral cancer in the country. In recognition of National Oral Cancer Awareness Week (April 16-22), Delta Dental is asking Michigan residents to request an oral cancer exam during their next dental visit. Oral cancer exams are quick, painless and involve an evaluation of the mouth, gums, throat and tongue by a licensed dentist using a piece of gauze to move the tongue from side-to-side. With this exam, the dentist is able to detect suspicious mouth lesions (unexplained red or white spots), an indicator of cancerous tissues. Oral cancer falls into the [...]

4/20/2007 Cape Town, South Africa staff health24.com If you want to reduce your risk of several common types of cancer, help may be no farther away than your kitchen. A trio of new studies presented at the annual meeting of the American Association for Cancer Research found that vegetables and fruits help lower your chances of getting head and neck, breast, ovarian and pancreatic cancers. One of the studies even found that just one additional serving of vegetables or fruits could help lower the risk of head and neck cancer. Still, the more fruits and vegetables you can consume, the better. 29% reduced risk "Those who ate six servings of fruit and vegetables per 1 000 calories had a 29 percent decreased risk relative to those who had 1.5 servings," said Neal Freedman, a Cancer Prevention Fellow in the division of Cancer Prevention at the US National Cancer Institute and author of one of the studies. Freedman looked at how the fruit and vegetable intake compared to the incidence of head and neck cancer in 490 802 adults. During the five-year study period, 787 people were diagnosed with head and neck cancers. After adjusting the data to account for smoking and alcohol use - known head and neck cancer risk factors - the researchers found that those who consumed the most fruits and vegetables had the lowest risk for head and neck cancers. Vegetables appeared to offer more cancer prevention than fruits alone did. Adding just one serving of fruit [...]

4/19/2007 Princeton, NU Jason Sheltzer DailyPrincetonian.com It is quite strange to me how in this country, Republicans have always been considered to be the party of "family values" and "morality." Republicans want to end social welfare programs, criminalize homosexuality and institute a system of forced-childbirth for our nation's women. This has never struck me as particularly moral. Liberals, meanwhile, care about combating the spread of global poverty, ending climate change and raising the minimum wage. These are true moral concerns. Two recent controversies have underscored the hypocrisy in the Republican position. The first debate concerns the new HPV vaccine. It's an indisputable fact that mandating the HPV vaccine would save thousands of lives. Yet, conservatives groups like Focus on the Family have led the opposition to mandatory vaccinations, arguing that it encourages sexual promiscuity in young women. This is just stupid. First of all, there's absolutely no evidence supporting that claim. Moreover, even if the vaccine did encourage promiscuous behavior, ask yourself what's worse — a sexually active 16-year-old or an 18-year-old with cervical cancer? The second, more recent example of conservative immorality comes from the debate over human embryonic stem cells. President Bush has declared his intent to veto a bill passed by Congress that would provide federal funding for stem cell research. His justification is that it "crosses a moral line" that he finds "troubling." Bush is right about one thing — the bill does cross an important "moral line," though not the one that he's thinking of. [...]

4/18/2007 St. Petersburg, FL John Barry St. Petersburg Times (www.sptimes.com) David Hastings doesn't fit the throat cancer profile. So he looked for answers and was surprised by what he found. During the grisly battle for his life, David Hastings played medical detective. He read everything he could find on what was trying to kill him. Nothing made sense. Hastings had throat cancer, mostly known for killing old people. Imagine an elderly soul addicted to cigarettes and alcohol for 40 years. There's a likely victim. Hastings didn't fit. He was 58. He looked 48. He hadn't smoked since college, and he doesn't drink. His chief addiction is cycling. He rides his bike about 100 miles per week. He'd never have guessed where he finally did fit in. He did not have an old smoker's disease, after all. His throat had been attacked by a cancer-causing virus infamous for killing women. It was HPV, the human papilloma virus, that causes most cervical cancers. HPV is the virus at the center of a national argument over preventive vaccinations of young girls. To his great surprise, Hastings discovered that this controversial women's vaccination plan aimed at ridding the world of HPV cancers may have started with the wrong gender. One day, the answer might be found here. A thousand Tampa men are currently participating in the world's largest study of male HPV infections. The National Institutes of Health has awarded the H. Lee Moffitt Cancer Center in Tampa $10-million for the work. It involves [...]

4/18/2007 New York, NY staff Forbes.com Vaccines against deadly pancreatic and head and neck cancers are showing real promise and may one day become an important part of treatment, researchers report. Researchers are also confirming that cervical cancer vaccines are both highly effective and long-lasting, according to two other studies. All of the new findings were presented Tuesday at the American Association of Cancer Research's annual meeting in Los Angeles. In one report, a team led by Andrew Lepisto, a postdoctoral researcher in the department of immunology at the University of Pittsburgh School of Medicine, presented the results of a phase I trial of a vaccine for pancreatic cancer. In that trial, Lepisto's team gave an immune cell-based vaccine to 12 cancer patients who underwent surgery for pancreatic cancer, one of the deadliest malignancies, because it is often caught too late "Patients who are eligible for surgery represent about 20 percent of all pancreatic cancer patients," Lepisto said during a teleconference. The five-year survival rate after surgery is only about 20 percent, he added. "The goal of the vaccine was to raise a strong immune response to prevent the cancer from coming back," Lepisto explained. "We found that if we did the surgery and followed up with the vaccine, we extended patient's lives from a 20 percent five-year survival rate to over 42 percent," he said. "There are five patients who are long-term survivors." Lepisto is planning to use the five surviving patients to understand how the immune vaccine extended [...]

4/18/2007 web-based article Gabriela Studer et al. Radiat Oncol, April 12, 2007; 2(1): 16 Background: Except for early T1,2 N0 stages, the prognosis for patients with oral cavity cancer (OCC) is reported to be worse than for carcinoma in other sites of the head and neck (HNC). The aim of this work was to assess disease outcome in OCC following IMRT. Between January 2002 and January 2007, 346 HNC patients have been treated with curative intensity modulated radiation therapy (IMRT) at the Department of Radiation Oncology, University Hospital Zurich. Fifty eight of these (16%) were referred for postoperative (28) or definitive (30) radiation therapy of OCC. 40 of the 58 OCC patients (69%) presented with locally advanced T3/4 or recurred lesions. Doses between 60 and 70Gy were applied, combined with simultaneous cisplatin based chemotherapy in 78%. Outcome analyses were performed using Kaplan Meier curves. In addition, comparisons were performed between this IMRT OCC cohort and historic in-house cohorts of 33 conventionally irradiated (3DCRT) and 30 surgery only patients treated over the last 10 years. Results: OCC patients treated with postoperative IMRT showed the highest local control (LC) rate of all assessed treatment sequence subgroups (92% LC at 2 years). Historic postoperative 3DCRT patients and patients treated with surgery alone reached LC rates of ~70-80%. Definitively irradiated patients revealed poorest LC rates with ~30 and 40% following 3DCRT and IMRT, respectively. T1 stage resulted in an expectedly significantly higher LC rate (95%, n=19, p<0.05) than T2-4 and recurred stages (LC ~50-60%, [...]

4/17/2007 web-based article Daved E. Schuller, MD et al. Arch Otolaryngol Head Neck Surg. 2007;133:320-326 Objective: To determine the feasibility of, compliance with, and long-term survival with intensification treatment regimens for patients with advanced, resectable, previously untreated head and neck squamous cell carcinoma. Design: Prospective phase 2 clinical trial (3 similar, consecutively evolved trials). Setting: Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University. Patients: One hundred twenty-three patients (median age, 60 years; range, 30-78 years) with previously untreated, resectable, advanced squamous cell carcinomas of the oral cavity, oropharynx, or hypopharynx. Interventions: Perioperative cisplatin chemoradiotherapy, surgical resection with intraoperative radiotherapy, and postoperative paclitaxel and cisplatin chemoradiotherapy. Main Outcome Measures: The feasibility, compliance, and long-term survival associated with the 3 intensification regimens. Results: Compliance with all 3 intensification regimens averaged 61% (75/123). Patient-directed noncompliance occurred in 16 patients (13%). The average locoregional (112/123, 91%) and systemic (106/123, 86%) disease control rates were excellent. Overall long-term disease-specific survival was 73%. Median time at risk was 62.5 months (range, 1 day to 100.4 months). Conclusions: The intensification regimens result in excellent disease control rates and long-term survival in this particular patient population. Future evolution of these regimens will include some modifications to further decrease toxic effects followed by phase 2 multi-institutional trials to determine whether the single-institutional experience can be duplicated. The results of these studies will determine whether phase 3 trials can be proposed. Authors: David E. Schuller, MD; Enver Ozer, MD; Amit Agrawal, [...]

4/16/2007 Gloversville, NY Richard Nilsen The Leader-Herald (www.leaderherald.com) Sharlee Ringer of Mayfield said she hopes by telling her story she may be able to help someone. Ringer, a 35-year-old married mother of five who is active in the community, recently had part of her tongue removed and was having her tonsils removed today in an effort to stop the spread of the oral cancer she was diagnosed with Jan. 27. “I had noticed a lesion on my tongue last April, but I thought it was just a cold sore,” Ringer said. Ringer questioned if the cold sore was something more when it didn’t go away. But since she has never smoked or been exposed to other typical things that lead to oral cancer, she put off having the sore looked at. “When I finally got an appointment to have it removed, I had to postpone due to a respiratory infection,” she said. Each delay could worsen the condition, but at 35 and with no history of smoking, she didn’t imagine the problem could be cancer. “When the doctor called me in to a conference room to discuss the lesion he had removed, I knew it was cancer,” she said. The sore was found to be squamous cell carcinoma, the most common form of oral cancer. Ringer said she wanted to tell her story in order to make others aware. April is National Cancer Control Month. She said she’d like to get the word out because it is difficult to get [...]