6/24/2006 Chicago, IL Hiroyuki Inoue, MD et al. Arch Otolaryngol Head Neck Surg. 2006;132:662-666 Objective: To assess the impact of modifications to radical neck dissection on postoperative quality of life. Design: Cross-sectional study using a self-administered neck dissection questionnaire and an arm abduction test. Setting: Department of Otolaryngology–Head and Neck Surgery, Kobe University Hospital. Patients: Seventy-four patients who had undergone neck dissection for the treatment of head and neck cancer. Main Outcome Measures: Arm abduction test results and responses to questions on quality of life related to neck dissection. Results: Forty-one patients underwent bilateral neck dissections, and 33 patients underwent unilateral neck dissection. Level V nodes were dissected in 74 necks. Among them, the spinal accessory nerve (SAN) was resected in 29 necks. Patients who had neck dissections that spared the SAN had better shoulder function. When the SAN was preserved, patients without dissection of level IV and V nodes had better scores on measures of pain and constriction of the neck. Sacrifice of the sternocleidomastoid muscle and/or the SAN had a significant effect on daily activities, work, and leisure. The arm abduction test scores and answers to questions regarding shoulder function were significantly correlated. Conclusions: Modifications to radical neck dissection contribute to improvements in the postoperative quality of life after neck dissection. A multicenter study using the arm abduction test and questionnaire used in this study is currently in progress to further evaluate the impact of modifications to radical neck dissection on quality of life after surgery. Authors: Hiroyuki [...]

6/24/2006 Iowa City, IA staff CancerConsultants.com According to the results of a phase II clinical trial conducted in Italy, supplementation with folic acid resulted in the complete disappearance of precancerous changes to the larynx in 28% of patients and partial disappearance of precancerous changes to the larynx in 44% of patients. These results were published in the journal Cancer . Approximately 40,000 people in the U.S. are diagnosed with head and neck cancer every year. Cancers of the head and neck include several types of cancers affecting the nasal cavity and sinuses, oral cavity, nasopharynx (upper part of throat, behind ear), oropharynx (middle part of throat, including soft palate, base of tongue, and tonsils), larynx, and other sites throughout the head and neck. Laryngeal leucoplakia refers to precancerous changes to the larynx. The larynx is the area of the throat that contains the vocal cords. It aids in talking, swallowing, and breathing and is sometimes referred to as the voice box. If untreated, laryngeal leucoplakia can progress to laryngeal cancer. Folate is a water-soluble B vitamin found in fresh fruits and vegetables. Folate, or supplementation with its synthetic form—folic acid—has been thought to play a role in cancer prevention. If confirmed, this would be an important finding since many people in the U.S. are folate deficient. Furthermore, folic acid supplementation is believed to be safe and non-toxic. To evaluate the potential role of folic acid supplementation in the prevention of head and neck cancers, researchers in Italy conducted a phase [...]

6/24/2006 Dallas, TX press release biz.yahoo.com Access Pharmaceuticals, today announced the clinical results of MuGard(TM) at the 18th International Symposium of the Multinational Association of Supportive Care in Cancer in Toronto, June 22-24. MuGard(TM) is Access' proprietary oral rinse product for the prevention and treatment of oral mucositis, the debilitating side-effect which afflicts more than 20% of cancer patients undergoing radiation and chemotherapy. Access plans to submit a 510(k) application for U.S. marketing approval of MuGard(TM) in the third quarter of this year. "In our clinical study of head and neck cancer patients receiving radiation therapy, 47% of patients using MuGard(TM) had no mucositis," stated Rosemary Mazanet M.D., Ph.D., CEO of Access. "Historically, patients on the same treatment without MuGard(TM) had a high rate of mucositis, with only 7% of patients experiencing no mucositis. In addition, the number of patients with mild to moderate mucositis was statistically reduced as well by the use of MuGard(TM). There is currently no well-accepted treatment for mucositis, and we believe that these results demonstrate that MuGard(TM) should be a valuable supportive care option for cancer patients." The Company is actively seeking marketing partners for this product.

6/24/2006 Menlo Park, CA staff KaiserNetwork.org The Hartford Courant on Wednesday examined how Merck's human papillomavirus vaccine Gardasil could prevent oral cancer, as at least one-quarter of oral cancer cases might be linked to HPV (Waldman, Hartford Courant, 6/21). FDA earlier this month approved Gardasil -- which is given in three injections over six months and will cost $360 -- for sale and marketing to girls and women ages nine to 26. According to Merck, Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18 -- which together cause about 70% of cervical cancer cases -- in women who do not already have HPV. In addition, the vaccine was shown to be about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases (Kaiser Daily Women's Health Policy Report, 6/19). Johns Hopkins University researchers in 2000 found that 25% of 253 people who were living with head and neck tumors were also positive for HPV strain 16. Although no firm connection between sexual practices such as kissing and oral sex has been made, some studies suggest such a connection between being positive for HPV and the tumors, according to the Courant. Cancerous tumors that are positive for strains of HPV most commonly appear in the throat and tonsils and seem to be more responsive to treatment than cancer tumors that are negative for HPV, the Courant reports. [...]

6/24/2006 Gainesville, FL P.L. Sandow et al. This Article Previous investigators have reported deficits in taste acuity in patients following radiation therapy for oropharyngeal cancer. In the present longitudinal study, 13 patients (mean age = 51.6 yrs) received conventional or hyperfractionated radiotherapy (63–76.8 Gy) for primary tumors of the oropharynx. One or both parotid glands and at least two-thirds of the tongue were included in the radiation field. Smell recognition and taste detection thresholds were determined at baseline, 1 month, 6 months, and 1 year post-radiation. Differences for smell recognition and the 4 taste qualities were assessed (independently) at the 4 time intervals, with a one-way ANOVA. Smell recognition was unaffected by radiation. There were significant elevations in thresholds for sweet (p < 0.005), salty (p < 0.005), bitter (p < 0.005), and sour (p< 0.001) during radiation therapy that were restored to baseline levels at 6 months and 1 year after radiation. This study demonstrated that radiation-induced taste deficits can be recovered by 6 months.

6/23/2006 Vancouver, British Columbia, Canada Catherine F. Poh et al. J Can Dent Assoc2006; 72(5):413–6 The first solid evidence that periodic screening of the oral cavity can reduce mortality from oral cancer was published recently in Lancet.1 The article described a large population-based study of about 168,000 participants in India, 87,655 of whom received at least one visual oral screening examination. Over a 9-year period, a 32% reduction in mortality was observed among those screened. These data, along with new advances in screening technologies, support a call to dentists to commit to oral cancer screening as part of routine daily practice. Globally, survival rates for those with oral cancer have changed little over the last 3 decades. The disease is often identified at an advanced stage, significantly reducing the probability of successful treatment. Half of oral cancer patients die within 5 years of diagnosis. Early detection of the disease (stages I and II) is associated with a vast improvement in survival rate; 80% of patients survive for 5 years compared with 20% of those with advanced disease (stages III and IV).2 The typically late diagnosis of oral cancer is ironic because the oral cavity is readily accessible for screening, and visible changes in the mucosa (in most cases) are associated with development of the disease. Oral cancer is frequently preceded by an identifiable premalignant lesion and the progression from dysplasia to cancer occurs over years.3 This should allow clinicians an opportunity to detect early changes. Nevertheless, most oral cancers are [...]

6/22/2006 Sydney, Australia Tom J Vauterin et al. Head Neck, June 16, 2006 Backbround: Among patients with cutaneous squamous cell carcinoma (SCC) of the head and neck, recent studies have shown that those with involvement of the parotid gland also have a high incidence of neck node involvement. Treatment of the neck by either surgery or radiotherapy is therefore recommended among patients with parotid SCC, even if clinical examination is negative. The aim of this study was first to analyze patterns of metastatic spread in the parotid and cervical lymph nodes and then to correlate the pattern of involved nodes with the primary cutaneous site in order to guide the appropriate extent of surgery, should neck dissection be used to treat the neck in patients with parotid SCC. Methods: A cohort of 209 patients with cutaneous SCC of the head and neck and clinically evident regional metastatic disease was reviewed retrospectively from 3 Australian institutions. The distribution of involved nodes was obtained from pathology reports; the anatomic sites of primary cutaneous cancers were then correlated with these findings. Results: Among 209 patients, 171 (82%) had clinical parotid involvement. Of these, 28 had clinical neck disease, whereas 143 had parotid disease alone. Thirty-eight (18%) patients had neck disease only. A total of 199 patients were treated surgically, whereas 10 received radiotherapy alone. Surgery included 172 parotidectomies and 151 neck dissections (93 of which were elective). Primary sites were cheek (21.7%), pinna (20.4%), temple (15.8%), forehead (15.8%), postauricular region (5.9%), neck (5.3%), [...]

6/20/2006 St. Petersburg, FL V. Upender Rao St. Petersburg Times (www.sptimes.com) Researchers at the University of Texas M.D. Anderson Cancer Center found a high risk of developing a variety of cancers among parents, siblings and children of lung cancer patients who never smoked cigarettes. Researchers at the University of Texas M.D. Anderson Cancer Center found a high risk of developing a variety of cancers (melanoma, head and neck, colorectal, prostate, lung and breast) among first-degree relatives (parents, siblings and children) of lung cancer patients who never smoked cigarettes. Olga Gorlova, PhD, an assistant professor in the department of epidemiology, studied 2,465 first-degree relatives of 316 lung cancer patients who were nonsmokers. She compared the results with 2,442 first-degree relatives of 318 controls who were nonsmokers and who did not have cancer. She found the following patterns and magnitude of increased risk among first-degree relatives of nonsmoking lung cancer patients: - Overall risk of cancer was increased by 25 percent. - First-degree relatives developed cancer 10 years earlier than the index case. - Risk of developing a cancer at a younger age among relatives was estimated at 44 percent. - Greater than a sixfold risk especially for lung cancer at a young age. - A 68 percent risk of developing lung cancer at any age. A study of patients with lung cancer, published in the Journal of the American Medical Association, showed an increased risk of lung cancer not only for the first-degree but also for the second- and third-degree relatives [...]

6/20/2006 Iowa City, IA staff CancerConsultants.com Cervarix™, GlaxoSmithKline’s cervical cancer vaccine candidate, produced an antibody response against human papillomavirus (HPV) types 16 and 18 in 100% of vaccinated women between the ages of 15 and 55 years. These results were presented at the 2006 annual meeting of the American Society of Clinical Oncology (ASCO). HPV types 16 and 18 account for roughly 70% of all cases of cervical cancer. Cervarix, a bivalent L1 virus-like particle vaccine, is intended to prevent infection with these high-risk types of HPV, and may also offer some protection against two other high-risk types of HPV – types 45 and 31. The results presented at ASCO were from a phase III clinical trial conducted among 666 women between the ages of 15 and 55 years. Three doses of vaccine were administered over a six month period, and antibody levels were assessed at 7 and 12 months. - 100% of women had detectable antibodies to HPV types 16 and 18 at month 7 and month 12. - The antibody levels at month 12 were several times higher than would be expected after natural infection - Although geometric mean antibody titers declined with age, the levels observed in the oldest group of women are still expected to provide protection. This study suggests that Cervarix may protect against infection in older as well as younger women. GlaxoSmithKline is expected to submit an application for approval of its vaccine to the U.S. Food and Drug Administration (FDA) by the end [...]

6/15/2006 Iowa City, IA staff CancerConsultants.com Results from a phase III trial indicate that the addition of Taxotere (docetaxel) to Platinol® (cisplatin) and fluorouracil (5-FU) in induction therapy for advanced head and neck cancer improves survival over cisplatin/fluorouracil. These results were presented at a special session at the 42nd annual meeting of the American Society of Clinical Oncology (ASCO). Flurouracil and cisplatin are a standard chemotherapy combination for the treatment of head and neck cancers. Recent research, however, has focused on the addition of a third agent such as a taxane to this regimen in order to improve outcomes in patients with this disease. Researchers from Harvard recently conducted a phase III trial to evaluate the addition of Taxotere to cisplatin/florouracil in the treatment of advanced head and neck cancer. This trial included 538 patients with stages III-IV squamous cell carcinomas of the larynx, pharynx or oral cavity. Patients were randomized to induction Taxotere/cisplatin/fluorouracil or cisplatin/fluorouracil (control group) as induction therapy, followed by chemoradiation and in some cases, surgery. The median follow-up time is 42 months. - Three-year survival was 62% for the Taxotere arm, compared with 48% for the control group (p=0.0058). - The median survival for patients in the Taxotere arm was 70.6 months, compared with 30.1 months for the control group. - Side effects were mainly associated with radiation therapy. The researchers stated that this three-drug regimen of Taxotere/cisplatin/fluorouracil used as induction therapy should now be considered a standard reference arm from which to compare future treatment [...]