11/16/2006 Philadelphia, PA Ed Susman DocGuide.com Treatment of patients with head and neck cancer -- whether with conventional radiation or with intensity-modulated radiation therapy -- leave a majority of patients with severe oral mucositis, researchers reported here at the American Society for Therapeutic Radiology and Oncology (ASTRO) 48th annual meeting. There appears to be no significant difference in the proportion of patients who require hospitalization, opioid analgesics or gastronomy tubes among patients treated with intensity-modulated radiation therapy or conventional radiology, said Linda Elting, DrPH, professor of epidemiology, University of Texas School of Public health, Houston, Texas. Dr. Elting and colleagues undertook 2 studies; a retrospective record review of 160 consecutive, newly diagnosed patients with cancers of the oral cavity and oropharynx who were clinically scored for oral mucositis. Mucositis was scored on a scale of 0 to 4 --with 0 representing no oral mucositis and 4 representing "alimentation not possible." The second study was performed prospectively at 6 centers among 75 newly diagnosed patients with cancers of the oral cavity and oropharynx who were assessed for severity of oral mucositis 5 times over 6 weeks. In the retrospective study, 69% of 29 patients who received intensity-modulated radiation therapy and chemotherapy and 84% of 50 patients who received with intensity-modulated radiotherapy and chemotherapy experienced grade 3 or grade 4 mucositis. Mucositis occurred in 70% of 48 patients given intensity-modulated radiation therapy without chemotherapy and in 76% of 34 patients who received conventional radiation without chemotherapy. In her poster presentation on November [...]

11/16/2006 Baltimore, MD D.M. Yousem et al. American Journal of Neuroradiology 27:2024-2036, November-December 2006 Summary: Head and neck surgeons often rely on imaging to determine if a neoplasm is resectable. Many of the critical issues are outlined in the American Joint Committee on Cancer Staging Manual, wherein T4a and T4b head and neck cancers are defined as resectable and unresectable, respectively. Even within the T4a advanced resectable classification, there are critical determinants that define whether the surgical option is such that major morbidity and mortality could be expected. This review article examines the imaging literature to determine the accuracy and diagnostic criteria of different modalities for evaluating these critical T4a and T4b factors, which include the following: 1) arterial encasement, 2) prevertebral fascia involvement, 3) mediastinal infiltration, 4) tracheal and esophageal extension, 5) laryngeal cartilage penetration, 6) pre-epiglottic fat involvement, 7) dural spread, 8) bone (mandible/maxilla and skull base) infiltration, 9) perineural spread, 10) orbital involvement, and 11) brachial plexus invasion. For the most part, the studies find MR imaging with higher sensitivity but lower specificity than CT. An ever-increasing role for PET/CT is suggested. Imaging is of great value in the determination of resectability issues listed previously for head and neck cancers, with the possible exception of prevertebral fascia involvement. Authors: D.M. Yousem(a), K. Gad(a) and R.P. Tufano(b) Authors' affiliations: (a) Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Johns Hopkins Medical Institution, Baltimore, MD (b) Department of Otolaryngology, Johns Hopkins Medical Institution, Baltimore, MD

11/16/2006 London, UK C C R Ragin et al. British Journal of Cancer (2006) 95, 1432-1438. Two distinct etiologies of head and neck squamous cell carcinoma (HNSCC) have been proposed, DNA damage owing to tobacco and alcohol exposure and human papillomavirus (HPV) oncogene-mediated transformation. Common genetic alterations in HNSCC include TP53 mutations, 11q13 amplification (amp) and CDKN2A/p16 mutations or promoter methlyation. However, in HPV+ HNSCC it is frequent to observe wild-type TP53 and expression of p16. The relationship of this unusual pattern with 11q13 amp has not been tested. In a retrospective study on 125 HNSCC patients, only 17% (five out of 30) of HPV+ vs 44% (39 out of 89) of HPV - tumours expressed 11q13 amp (adjusted odds ratio (OR)=0.2, 95% confidence interval (CI)=0.1-0.6). A subpopulation of tumours (n=69) were classified according to the three molecular markers, TP53, p16 and 11q13 amp. In addition to wild-type TP53, and p16 expression, HPV+ tumours were more likely not to be amplified at 11q13 (OR=6.5, 95% CI=1.8-23.9). As HPV+ HNSCC lack the genetic alterations which are common in other tumours, we hypothesise that HPV infection may represent an early event in the HNSCC carcinogenic process, thus suggesting a distinct molecular pathway. Authors: C C R Ragin1,2,3, E Taioli2,3, J L Weissfeld2,3, J S White1,2,3, K M Rossie4, F Modugno2,3 and S M Gollin1,3 Authors' affiliations: 1Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, 130 DeSoto Street, Pittsburgh, PA 15261, USA 2Department of Epidemiology, University of Pittsburgh Graduate [...]

11/16/2006 Newtown, CT William A Collins The Newtown Bee (www.newtownbee.com) Who cares how, The doctors fret; I just need, My cigarette. So who do you suppose will slaughter more of their fellow mortals in this bright-eyed new century? Can the Janjaweed sustain long enough to claim the record? Perhaps the Taliban? Muktada al-Sadr? Al Qaida? Will such ephemeral evildoers be able to top their more enduring rival, the Pentagon? And whose numbers can you trust anyway? No matter. All these killing machines are pikers compared to the tobacco industry. According to the World Health Organization (WHO), we're now on track to suffer one billion smoking deaths by 2100. That would be roughly 10 times the toll in the more benign 20th Century. This would require a hefty increase over the 1.4 million tobacco deaths a year currently reported, or the mere 11 million new cancer cases diagnosed annually. Maybe the WHO is exaggerating. Still, Asia is coming on strong. But exaggeration or not, the industry is giving the death record its best shot. The government's remarkably independent Centers for Disease Control and Prevention have detected that producers have gradually been slipping higher levels of nicotine into their product. This is making it ever harder for existing addicts, however laudable their intentions, to lay their habit aside. That's bad news for the reported 60 percent of smokers who want to quit, and the 40 percent each year who actually give it a try. More nicotine, stronger addiction. The companies have also [...]

11/14/2006 San Francisco, CA staff Life Science News (www.biocompare.com) Human papillomaviruses (HPV) are the most common sexually transmitted infections in the United States, and certain "high risk" types have been shown to cause cervical cancer. Despite recent advances in the detection and prevention of HPV, the link between the virus and cervical cancer is not well known to the public. In June 2006, the Food and Drug Administration (FDA) approved the first vaccine to prevent infection of two high risk types of HPV, and two types that cause genital warts. The Advisory Committee on Immunization Practices (ACIP) recommended it for females 9 to 26 years of age. Two studies presented today at the American Association for Cancer Research's Frontiers in Cancer Prevention Research meeting in Boston assess the public's understanding of HPV and whether discussion of the vaccine by the media and public has influenced the decision to vaccinate among women at risk. What Do U.S. Women Know About Human Papillomavirus (HPV) and Cervical Cancer? Many women with HPV show no symptoms of the virus, and infections often clear without need for treatment. Because of this, many women do not have the opportunity to speak with their physicians about HPV and therefore may not learn that some HPV infections are persistent and can develop into cervical cancer. The National Cancer Institute (NCI) created the Health Information National Trends Survey (HINTS) to monitor health communications about cancer. In 2005, one high-priority research aim was to assess, for the first time, the [...]

11/14/2006 Prague, Czech Republic Chris Berrie Doctor's Guide (www.docguide.com) The tubulin-polymerising agent ixabepilone (BMS 247550; NSC 710428) is active and tolerable in taxane-naive patients with metastatic/ recurrent squamous cell cancer of the head and neck (SCCHN), according to results of a randomised, phase 2 study. The findings were presented here on November 10th at the American Association for Cancer Research 18th Symposium on Molecular Targets and Cancer Therapeutics - National Cancer Institute - 18th European Organisation for Research and Treatment of Cancer (AACR-NCI-EORTC). The epothilones are derived from fermentation of myxobacteria and they have been shown to have broad-spectrum antitumour activity. Thus, as principal investigator Barbara Burtness, MD, attending physician, medical oncology, division of medical sciences, Fox Chase Cancer Center, Philadelphia, Pennsylvania, said of this semi-synthetic epothilone derivative, "Ixabepilone is a novel tubulin-polymerising agent, which has the same target as the taxanes, but there is preclinical evidence that ixabepilone is active even if there are tubulin mutations or if MDR is over-expressed, the basis for taxane resistance." Eligibility for study entry required measurable SCCHN, with distant metastases and locoregional recurrence/ persistence. Up to 2 prior treatment regimens for recurrent/ metastatic disease were allowed (including taxanes), accompanied by: Eastern Cooperative Oncology Group (ECOG) performance status, 0/1; absolute neutrophil count, >1,500/mm2; adequate renal/ hepatic function. "It is also important to note that the majority of the taxane-naive patients in this study had previously been exposed to chemotherapy and/or radiation therapy," added Dr. Burtness. Patients were stratified according to previous taxane exposure, then [...]

11/12/2006 Canton, OH Shane Hoover CantonRep.com Michael A. White used to smoke. He chews tobacco now, and he has his reasons. “I didn’t want lung cancer,” the 18-year-old senior said while skateboarding outside Alliance High School. He knows chewing tobacco has its own health risks — mouth and throat cancers and “holes through your lips.” He also knows he’s addicted, but he’d rather chew than smoke, he said. “In a way it’s because other people around you don’t get secondhand smoke and it doesn’t make you lose your breath as easy,” White said. White’s story is not unique — to himself or to his school. While cigarettes are the most popular tobacco product, an estimated 11 percent of high school boys use chewing tobacco or moist snuff, sometimes referred to as dip, according to federal studies. Smokeless tobacco use for adult men drops to 6 percent. It is rare among women and teenage girls. But as laws further restrict smoking in Ohio and across the country, tobacco companies are targeting smokers in hopes that they will turn to the cigarette’s smokeless cousins. It’s a move that has anti-tobacco groups concerned. $50 A MONTH White started chewing five years ago. His decision to chew was based on economic, health and social concerns. His brand of choice is Grizzly Wintergreen Long Cut. He estimated he spends about $50 a month on tobacco, but a can lasts three or four days, compared with 1 1/2 days for a pack of cigarettes. So overall, [...]

11/12/2006 Australia Marg Wenham The Courier Mail (www.news.com.au) Australians were last night presented with the most gruesome anti-smoking advertisement aired yet. The ad, depicting a female smoker whose face is severely disfigured from mouth and throat cancer, was broadcast after 9.30pm due to its graphic nature. At the ad's launch yesterday, Parliamentary Secretary to the Minister for Health, Karen Struthers, said she believed the anti-smoking commercial was the most graphic ever produced in Australia. Costing $440,000 and jointly funded by the Government and the Queensland Cancer Fund, its target was adults. "We make no apologies for the graphic nature of the ad," she said. "We must be brutally honest about the devastating consequences of smoking." Ms Struthers said smoking was a major cause of cancers of the mouth and throat. In 2003, 2052 Australians, including 211 Queenslanders, died from such cancers. Queensland Health oral health consultant Dr Arabelle Clayden said the advertisement provided an accurate depiction of the ravages of mouth and throat cancer and put a human face to the statistics. Those who developed it could lose teeth, parts of their tongue, jaw bone and larynx. They may never be able to properly eat, talk or breathe again and their appearance would be permanently disfigured. Only half of those treated, she said, survived. Queensland Cancer Fund's Dr Suzanne Steginga said the last advertising campaign run between May and July, which depicted the smoking-linked amputation of a gangrenous leg, had resulted in a 300 per cent increase in calls to [...]

11/11/2006 Memphis, TN staff CancerConsultants.com According to an article recently published in Radiation Oncology, Biology and Physics, intensity-modulated radiotherapy (IMRT) improves salivary flow and quality of life compared to conventional radiotherapy (CRT) for patients with early-stage nasopharyngeal cancer. The nasopharynx is the area above the soft palate (roof of the mouth) and behind the nose. Nasopharyngeal cancer (NPC) is a type of head and neck cancer. Approximately 40,000 people in the U.S. are diagnosed with head and neck cancer every year. Early NPC refers to cancer that has not spread from the site of origin to more distant sites in the body. Radiation therapy is often an integral part of treatment for early NPC. However, side effects from radiation therapy, such as xerostomia (dry mouth), are common. Patients may suffer from different degrees of xerostomia, which impair swallowing, chewing, eating, and speaking. Researchers continue to evaluate different ways to reduce xerostomia and other side effects from therapy. Researchers from Hong Kong recently conducted a clinical trial to evaluate the effect of IMRT on the quality of life of patients with early NPC. IMRT involves the use of higher doses of radiation therapy directed toward the cancerous cells, with lower doses of radiation directed toward surrounding tissue. This is in contrast to CRT, which directs the same doses of radiation to a specified area, meaning surrounding healthy tissue receives the same dose of radiation as cancerous tissue. This trial included 51 patients. One group was treated with CRT, and the other [...]

11/11/2006 Chicago, IL staff EarthTimes.org Rates of spit tobacco use by high school males are nothing to smile about, reports Oral Health America's National Spit Tobacco Education Program (NSTEP). Research by the independent group finds that nationally about one out of seven high school males currently use spit (or smokeless) tobacco products, and in some states that number is one out of four. Spit tobacco excise taxes, which can reduce use by children, are arguably low, also resulting in a national "D" grade. "We still have a lot of work to do to educate parents and children that spit tobacco is not harmless," said Robert Klaus, President and CEO of Oral Health America. "The tobacco industry spends millions of dollars every year to hook young people, including our armed service members, into a lifetime of addiction and health risks." Youth spit tobacco use appears to be at a stand-still, meaning that states may not continue to see declines from the past decade prompted by national and state education programs. While a number of states earning "F" grades have reduced rampant youth spit tobacco use, percentages remain unacceptably high. These states include Alabama, Arkansas, Kentucky, Montana, Tennessee, West Virginia, and Wyoming. Some of the highest-use states also lack meaningful excise taxes, notably Arkansas, Georgia, Indiana, Iowa, Kansas, Kentucky, Nebraska, New Mexico, South Carolina, South Dakota, Tennessee, West Virginia, and Wyoming. 12 Worst States: State Spit Tobacco Grades High School Male Use Spit Tobacco & Excise Tax Arkansas F D Indiana D [...]