10/5/2006 Instanbul, Turkey Jill Stein Doctor's Guide (www.docguide.com) The use of either an antiseptic mouthwash containing chlorhexidine or cryotherapy can reduce the duration of oral mucositis secondary to chemotherapy, researchers reported here at the 31st European Society for Medical Oncology (ESMO) Congress. The mouthwash may be superior because cryotherapy cannot be used with infusional 5-fluorouracil or with chemotherapy that has a substantially longer half-live than 5-FU, researchers said in a presentation on October 2nd. Jens B. Sorensen, MD, chief of oncology, Finsen Centre, National University Hospital, Copenhagen, Denmark, presented results in 206 patients who had been randomized to 1 of 3 treatment arms: 1) mouth rinse containing 15 mL of chlorhexidine 0.1% for 1 minute thrice daily for 3 weeks; 2) saline mouth rinse with the same taste additive as in the chlorhexidine rinse for 1 minute thrice daily for 3 weeks; 3) cryotherapy with crushed ice for 10 minutes before to 35 minutes after chemotherapy. The trial included previously untreated patients with gastrointestinal cancer receiving bolus 5-FU 425 mg/m2 with leucovorin 20 mg/m2 daily over 5 days. Patient completed questionnaires that measured the severity and duration of mucositis after treatment. Mucositis grade III/IV was defined as impaired oral nutrition and the need for artificial nutrition. Mucositis grade 3/4 occurred in 13% of the chlorhexidine group, 33% of the placebo group, and 11% of the cryotherapy group. Median duration of mucositis was 3 days in the chlorhexidine group, 5 days in the placebo group, and 1 day in the cryotherapy [...]

10/3/2006 Web Resource, No City Listed press release TherapeuticsDaily (www.therapeuticsdaily.com) Cephalon Inc.'s Fentora (fentanyl buccal tablet) has been approved by the U.S. Food and Drug Administration to treat so called "breakthrough" pain in those who have cancer. This type of pain -- characterized by its rapid onset, intensity and short duration -- affects about 800,000 cancer patients, the American Cancer Society says. Fentora, an oral opioid, is partially absorbed through the cheek into the bloodstream, making it faster-acting than similar drugs absorbed through the gastrointestinal tract, Cephalon said in a statement. The drug was approved for people who are already tolerant of opioid therapy for persistent cancer pain. Side effects of opioids may include decreased respiration and circulation, nausea, and fatigue. Cephalon said it expects Fentora to be available in the United States during the first week of October.

10/3/2006 Scottsdale, AZ Richard Johnson Market Day (www.market-day.net) Radiation therapy (also called radiotherapy, x-ray therapy, or irradiation)is the use of a certain type of energy (called ionizing radiation) to kill cancer cells and shrink tumors. Radiation therapy injures or destroys cells in the area being treated (the "target tissue") by damaging their genetic material, making it impossible for these cells to continue to grow and divide. Although radiation damages both cancer cells and normal cells, most normal cells can recover from the effects of radiation and function properly. The goal of radiation therapy is to damage as many cancer cells as possible, while limiting harm to nearby healthy tissue. There are different types of radiation and different ways to deliver the radiation. For example, certain types of radiation can penetrate more deeply into the body than can others. In addition, some types of radiation can be very finely controlled to treat only a small area (an inch of tissue, for example) without damaging nearby tissues and organs. Other types of radiation are better for treating larger areas. In some cases, the goal of radiation treatment is the complete destruction of an entire tumor. In other cases, the aim is to shrink a tumor and relieve symptoms. In either case, doctors plan treatment to spare as much healthy tissue as possible. About half of all cancer patients receive some type of radiation therapy. Radiation therapy may be used alone or in combination with other cancer treatments, such as chemotherapy or surgery. [...]

10/3/2006 Houston, TX staff MD Anderson Cancer Center (www.cancerwise.org) Genetic Fragments Turn Off Cancer Growth Switch In experiments with mice, researchers have determined how to embed molecular “off” switches into fatty spheres and send these tiny blobs down the bloodstream into ovarian cancer cells to stop tumor growth. Significance of results The therapy reduced the size of ovarian tumors by up to 98% in mice, and it was well tolerated, say senior authors Anil Sood, M.D., associate professor in M. D. Anderson’s Department of Gynecologic Oncology and Department of Cancer Biology, and Gabriel Lopez-Berestein, M.D., professor in the Department of Experimental Therapeutics. "We hope to develop this approach for clinical use in the future," Sood says. The study, reported in the Aug. 15 issue of the scientific journal Clinical Cancer Research, uses the freshest technologies developed in cancer research laboratories. These tools include spheres of fat known as nanoparticles and bits of RNA that can target genes involved in cancer growth and “silence” them. Background RNA is produced from activated DNA (the master genetic code) and serves as a template for producing proteins, the workhorses of cells. But researchers recently discovered that special fragments of RNA can reverse the DNA-RNA-protein process and turn off selected genes so that they cannot order the production of dangerous proteins. These are called “small interfering” RNA, or siRNA. This finding was followed by the discovery that siRNA can target cancer-promoting genes. Now researchers can artificially create the siRNA they want. Scientists have shown that [...]

10/2/2006 Surrey, British Columbia, Canada Jeff Nagel The Surrey Leader (www.surreyleader.com) A doctor at Surrey Memorial Hospital is the first surgeon in the province using a new laser cutting technique to remove challenging cancerous tumours of the upper throat. Armed with a laser and microscope, Dr. Don Anderson is literally at the cutting edge of the new treatment that hospital officials say is making a major difference in the lives of patients. "It's absolutely spectacular," said Dr. Peter Doris, the head of surgery at SMH. Lasers are commonly used to burn away easy-to-access tumours, he said. But European hospitals have started to use them as a microsurgery scalpel to precisely carve out tumours in hard to reach areas like the base of the tongue and voicebox. Until now those cancers required either radiation treatment or major surgery to split open the neck - often involving a tracheostomy that could leave the patient voiceless, being fed by a stomach tube and having to slowly re-learn how to swallow. With the minimally invasive microsurgery procedure now being performed by Dr. Anderson, those patients experience very little pain, are out of hospital in some cases overnight and usually have speedy and easy recoveries. "I guess I'm kind of the pioneer in B.C.," Anderson said. He's now performed about a dozen of the tumour removals on patients this year using the laser microsurgery after undergoing training in England and Germany. "They've done well," he said. "The patients are happy. And the hospitals are happy [...]

9/30/2006 Chapel Hill, NC staff Sudbury, UK Scientists have identified a gene that controls the development of taste buds. The gene, SOX2, stimulates stem cells on the surface of the embryonic tongue and in the back of the mouth to transform into taste buds, according to the researchers. "Not only did we find that SOX2 is crucial for the development of taste buds, but we showed that the amount of SOX2 is just as important," said Brigid Hogan, Ph.D., chair of the Duke University Medical Center Department of Cell Biology and senior member of the research team. "If there isn't enough SOX2 present, or if there is too much, the stem cells will not turn into taste buds." The researchers made their discovery in mice, but they believe the same process occurs in humans. According to the researchers, the findings will help scientists better understand how the behavior of certain stem cells is controlled. The SOX2 gene is already known to be crucial in controlling whether embryonic stem cells remain undifferentiated and whether stem cells in the brain, eye and inner ear differentiate into specialized nerve cells. Taste bud cells, much like skin cells, continually slough off and are replaced by new ones. So the findings provide insights into the interactions between SOX2 and tongue stem cells during embryonic development, as well as into how stem cells continue to operate in adults, the researchers said. The researchers published the findings in the October 2006 issue of the journal Genes and [...]

9/30/2006 New Delhi, India staff The Hindu (www.hindu.com) For patients suffering from head and neck cancer, there is a new hope as a new therapy drug will be soon hitting the market. The cancer drug, Erbitux, got a clearance from the Drugs Controller General of India yesterday. "We got the clearance yesterday. It is an enormous step forward, providing more patients with the potential for a long term benefit," said Marek Dziki, the Managing Director of Merck Specialities that had also launched last month another cancer drug that treats colon cancer. He said it is the first and only monoclonal antibody to get an approval for the treatment of head and neck cancer by the US Food and Drug Administration and the European Medicines Agency. Head and neck cancer is very common in India because of the widespread habit of chewing tobacco and tobacco-related products. There are an estimated 3.5 million cancer patients in India. Every year around 8,00,000 cases are diagnosed every year, out of which 2,00,000 are head and neck cancer cases. According to Shyam Agarwal, chairperson of the medical oncology department in Sir Gangaram Hospital, the drug represents an important new option for so many patinets who are fighting head and neck cancer, a seious disease for which there is a tremendous unmet medical need. "In combination with radiotherapy, the drug provides a significant enhancemet in survival. This is a hallmark development." The drug is for all those whose cancer has not spread to other body parts. [...]

9/30/2006 New Delhi, India staff The Hindu (www.hindu.com) For patients suffering from head and neck cancer, there is a new hope as a new therapy drug will be soon hitting the market. The cancer drug, Erbitux, got a clearance from the Drugs Controller General of India yesterday. "We got the clearance yesterday. It is an enormous step forward, providing more patients with the potential for a long term benefit," said Marek Dziki, the Managing Director of Merck Specialities that had also launched last month another cancer drug that treats colon cancer. He said it is the first and only monoclonal antibody to get an approval for the treatment of head and neck cancer by the US Food and Drug Administration and the European Medicines Agency. Head and neck cancer is very common in India because of the widespread habit of chewing tobacco and tobacco-related products. There are an estimated 3.5 million cancer patients in India. Every year around 8,00,000 cases are diagnosed every year, out of which 2,00,000 are head and neck cancer cases. According to Shyam Agarwal, chairperson of the medical oncology department in Sir Gangaram Hospital, the drug represents an important new option for so many patinets who are fighting head and neck cancer, a seious disease for which there is a tremendous unmet medical need. "In combination with radiotherapy, the drug provides a significant enhancemet in survival. This is a hallmark development." The drug is for all those whose cancer has not spread to other body parts. [...]

9/30/2006 Baltimore, MD staff www.nbc4.com A Maryland doctor has helped develop a vaccine that could one day help in the fight against certain types of cancer. The vaccine, which is being tested now, is designed to target cancers of the head and neck. Doctor Scott Strome at the University of Maryland School of Medicine in Baltimore helped develop the so-called Trojan peptide vaccines. "It's given as a shot, with a couple of other drugs that are designed to turn on the immune system," said Strome. The vaccines are made of specialized peptides, which are pieces of protiens found in certain cancer cells. The idea is that when they are injected, they will rev up the patients immune cells. Those cells will then seek out the peptides in the cancer cells and kill them. Strome likens it to a Trojan horse being used in a surprise attack. "We use it to kind of sneak into the cell," said Strome. "It kind of fakes out the body's immune system to turn on against a protein that we optimistically think will be on the tumor cell itself." The survival rate of head and neck cancers is about 50 percent and it's been that way for about 30 years. Doctor Strome thinks if the vaccine is effective it may change that. "We treat the cancer and then potentially we can give an adjuvant vaccine, to boost the immune system to make sure it doesn't come back," he said. The human trials of the vaccine [...]

9/28/2006 New York, NY Alejandro Garcia et al. Ann Thorac Surg 2006;82:1240-1243 Backgoround: Completely occlusive esophageal strictures may develop after head and neck radiotherapy or esophagectomy with gastric or colonic interposition. Major surgical intervention may be required to restore alimentary tract patency when endoscopic lumen reconstitution is not feasible by routine antegrade endoscopy. Retrograde endoscopic lumen identification and dilation is a useful method to reestablish alimentary tract patency, thereby avoiding surgical intervention. Methods: Patients requiring endoscopic dilation for completely occlusive esophageal strictures were identified by the gastroenterology, thoracic, and head and neck services. Retrograde access was obtained by balloon dilation of either a jejunostomy or gastrostomy tract, and an endoscope was passed to the area of stricture. Antegrade and retrograde endoscopy were performed simultaneously. A guidewire was passed either retrograde or antegrade under direct endoscopic visualization, followed by antegrade Savary dilation under fluoroscopic guidance. Results: From 2003 to 2006, 9 patients were identified with completely occlusive esophageal strictures requiring retrograde lumen identification and dilation. Stricture developed in 6 patients after radiotherapy for head and neck cancer and in 3 after esophagectomy with either gastric or colonic interposition for esophageal cancer. Endoscopic dilation was successful in all patients, without perforation. Conclusions: Retrograde endoscopic lumen identification and dilation is an option to reestablish lumen patency of completely occlusive esophageal strictures after esophagectomy with gastric or colonic interposition or after head and neck chemoradiotherapy. Authors: Alejandro Garcia, BA1, Raja M. Flores, MD1, Mark Schattner, MD2, Dennis Kraus, MD3, Manjit S. Bains, MD1, Richard [...]