8/3/2005 Singapore K-C Soo et al. British Journal of Cancer (2005) 93, 279-286. The majority of the patients with squamous cell head and neck cancer (SCHNC) present with locally and/or regionally advanced disease and the use of radical surgery and/or radiotherapy in this setting yield low locoregional control rates and 5-year survival rates not exceeding 40%. The administration of chemotherapy and radiotherapy concurrently makes use of the resultant synergistic activity to improve tumour cell kill. This strategy has found success in anal canal carcinoma, allowing high cure rates while obviating the need for radical surgery. Studies carried out in the 1990s using combination chemotherapy with concurrent radiation in SCHNC have shown this treatment approach to be feasible despite the significantly higher toxicity and have produced encouraging results. Adelstein et al in a phase II trial using cisplatin (CDDP) and 5-fluorouracil (5FU) combination with concurrent split-course radiotherapy have reported a 4-year relapse-free survival of 45% and an overall survival of 49% (Adelstein et al, 1993). This when compared retrospectively with a similar patient population treated with radiation alone was shown to be improved. Adelstein next investigated the use of the same combination regimen concurrently with a continuous course of radiotherapy (Adelstein et al, 1994). In 19 patients treated in this fashion, despite significant toxicity, there were no treatment-related deaths. At a median follow-up of 20 months, the projected Kaplan-Meier estimate of locoregional disease control was 92%, with the projected relapse-free survival of 86%. Of significance was that primary-site resection was not [...]

8/2/2005 Newark, NJ Vicki Hyman The Star Ledger (www.nj.com) Robert O'Brien was staring at the mirror when he saw it -- a small crease forming in the corner of his mouth -- on the side of his face that had collapsed three months before. O'Brien, a retired Montclair police officer who now is security director at Ramapo College, had developed Ramsay Hunt Syndrome, a neurological complication of shingles that paralyzed the right side of his face. He drooled, slurred his speech, had difficulty moving food around in his mouth and had to tape his drooping eye shut at night. Some patients recover spontaneously; O'Brien was told there was nothing that could be done to help him. His wife, Jane, had studied speech therapy in college and knew that it could maximize his recovery, so she contacted a speech language pathologist at Mountainside Hospital in Montclair. Janet Kalina-Suarez had just been trained on VitalStim, a new device that uses electrical currents to stimulate inactive or atrophied muscles in the neck to facilitate swallowing. Therapists using VitalStim have reported promising results with stroke patients, those with neurological disorders such as ALS, Parkinson's Disease and multiple sclerosis, and those who had been treated for mouth or throat cancer. The device reportedly helped people when traditional treatment and therapy had failed; it even helped patients who had trouble swallowing their own saliva. As Jane O'Brien described her husband's symptoms over the phone, Kalina-Suarez thought he could benefit from the therapy, as well. It took [...]

7/29/2005 Thousand Oaks, CA press release Business Wire (www.businesswire.com) Amgen today announced that the European Committee for Medicinal Products for Human Use (CHMP), which is the scientific advisory panel to the European Medicines Agency (EMEA), has issued a positive opinion to approve marketing authorization for Kepivance(TM) (palifermin) in the European Union (EU). The CHMP opinion recommends authorization of palifermin to decrease the incidence, duration and severity of oral mucositis (mouth sores) in patients with hematologic (blood) cancers undergoing myeloablative therapy associated with a high incidence of severe oral mucositis, and requiring autologus bone marrow transplant. "Before palifermin, the best we could hope for in managing oral mucositis was to control the patient's pain with narcotics and oral rinses," said Jean-Luc Harousseau, M.D., head of the department of clinical hematology in the University Hospital of Nantes and former palifermin investigator. "With the potential approval of palifermin, physicians may be able to help protect transplant patients with hematologic malignancies from severe oral mucositis and may decrease their pain and discomfort." In patients with oral mucositis, the cells lining the mouth and throat are damaged by the chemotherapy drugs and/or radiation used in cancer treatment. Oral mucositis can be extremely painful and can have a devastating impact on patients. In fact, oral mucositis has been rated as the most debilitating side effect by patients with blood cancers undergoing bone marrow transplantation. Patients suffering from these debilitating mouth sores may require longer hospitalization, high doses of narcotics, such as morphine, and intravenous feeding to [...]

7/29/2005 Seattle, WA Mary L. Disis Journal of Clinical Oncology, Vol 23, No 22 (August 1), 2005: pp. 4840-4841 The last decade has resulted in the identification of a multitude of tumor-associated antigens and the initiation of clinical trials to determine whether cancer patients can be vaccinated. In this issue of the Journal of Clinical Oncology, Carbone et al1 present an extensive analysis of the immunogenicity and potential clinical efficacy of vaccinating advanced-stage cancer patients against specific K-ras and p53 mutations present in their tumors. This report provides long-term follow-up after vaccination over a period of several years, so the length of time between initiation and publication of the trial allows evaluation of the data in the context of the evolution of more refined methods of vaccination. The authors also present data detailing the pitfalls of the clinical application of targeted therapy, which includes the need to evaluate large numbers of patients to find the few patients who may derive therapeutic benefit. Finally, the authors demonstrate an intriguing association between the development of an antigen-specific immune response and prolonged survival. The vaccination strategy used in the trial was to incubate mutated K-ras and p53 peptide sequences with peripheral-blood mononuclear cells obtained from each patient. Presumably, antigen-presenting cells present in the peripheral blood would uptake K-ras and p53 peptides, process the peptides, and present the fragments in the context of class I major histocompatibility complex molecules, resulting in the stimulation of antigen-specific cytotoxic CD8+ T cells. It has only been in [...]

7/27/2005 Tampa, FL Tania Hershman Business 2.0 (www.business2.com) What do you get when you cross a dentist with an engineer? A high-tech remedy for dry mouth. Granted, it's not much of a punch line, but it's also no joke. In fact, the dental implant developed by Saliwell Medical Systems -- an Israeli startup founded by dentist Andy Wolff and engineer Benzi Beiski -- could unlock a $2 billion market. Triggered by radiation therapy, blood-pressure medication, and autoimmune diseases, dry mouth, or xerostomia, interferes with swallowing, sleeping, and speech. But drugs to treat it often have debilitating side effects. Saliwell's implant, the Crown, is equipped with electrodes, sensors, and a 16-bit microprocessor. If the sensors detect dryness, the electrodes stimulate the lingual nerve to jump-start saliva flow. The company hopes to have the Crown on the market by 2006. If it does, Wolff and Beiski will pocket nearly all of the profits, thanks to the clever strategy they used to launch the company. Rather than relying on venture funding, the duo landed a $2 million European Union grant for medical R&D, which meant they didn't have to give up any equity -- a deal sweet enough to make any entrepreneur salivate.

7/26/2005 Patti DeGrangi, RDH, BS RDH September 2005 Humble beginnings often wind their way down unexpected paths toward unthink-able destinations. Ribbons we wear, rib-bons on our cars, and wristbands have become not only methods to bring aware-ness of various cancers and causes; they have become a fad of nearly epic proportions. Discovering the history of the ribbon craze is tricky, with different groups and individuals taking credit. Some give credit to the black armbands worn in Victorian times or the yellow ribbons from the Tony Orlando song. But whatever the origination, these symbols can bring attention, understanding, and most importantly, funding to organizations and individuals struggling with disease. For several years, oral cancer awareness and screening has had a part in each program I give, for some very specific and personal reasons. Using my skills and intuition as a dental hygienist, I saw a suspicious area on a client. The client denied it, saying she wasn’t a smoker. The lesion was on the palate. The client said it was from eating taco chips. There was something about it that just didn’t resonate for me. I had to talk her into allowing a brush biopsy. The biopsy came back showing atypical cells; the scalpel biopsy showed early squamous cell carcinoma. The client was my sister. The good news was that we found it so early that the very early scalpel biopsy has thus far, after six years, seemed to have removed everything and there has been no recurrence. CDx Labs (www.oralcdx.com) [...]

7/26/2005 Jennifer Warner WebMD (www.webmd.com) Male, Older, and Less-Educated Patients Less Likely to Change Lifestyle After Cancer Cancer survivors often make healthy lifestyle changes after their cancer treatment, but a new study suggests many may not go far enough in adopting healthy habits. Researchers found up to 60% of cancer survivors follow a healthier diet after diagnosis and treatment, yet less than half are eating the recommended five or more servings of fruits and vegetables per day. The study also showed that about 70% of breast and prostate cancer survivors remain overweight or obese. There are almost 10 million cancer survivors in the U.S., and that number is expected to grow thanks to improvements in cancer diagnosis and treatment. For example, only about 50% of people diagnosed with cancer in 1971 were expected to be alive after five years, compared with 64% of those diagnosed with cancer today. Researchers say adopting healthy lifestyle changes is especially important for cancer survivors because they are at increased risk for second cancers as well as other diseases, such as osteoporosis, obesity, heart disease, and diabetes. A Healthier Life After Cancer? In their study, researchers reviewed 100 studies on cancer survivors to examine the impact of cancer diagnosis and treatment on lifestyle and behavior changes. The results appear in the Aug. 20 issue of the Journal of Clinical Oncology. Overall, they found that many cancer survivors adopt healthier behaviors, such as: 30%-60% eat a healthier diet. 46%-96% of smokers with tobacco-related cancers (lung, head, [...]

7/26/2005 San Francisco, CA Steven A. Schroeder, MD JAMA. 2005;294:482-487 Despite the reality that smoking remains the most important preventable cause of death and disability, most clinicians underperform in helping smokers quit. Of the 46 million current smokers in the United States, 70% say they would like to quit, but only a small fraction are able to do so on their own because nicotine is so highly addictive. One third to one half of all smokers die prematurely. Reasons clinicians avoid helping smokers quit include time constraints, lack of expertise, lack of financial incentives, respect for a smoker’s privacy, fear that a negative message might lose customers, pessimism because most smokers are unable to quit, stigma, and clinicians being smokers. The gold standard for cessation treatment is the 5 A's (ask, advise, assess, assist, and arrange). Yet, only a minority of physicians know about these, and fewer put them to use. Acceptable shortcuts are asking, advising, and referring to a telephone "quit line" or an internal referral system. Successful treatment combines counseling with pharmacotherapy (nicotine replacement therapy with or without psychotropic medication such as bupropion). Nicotine replacement therapy comes in long-acting (patch) or short-acting (gum, lozenge, nasal spray, or inhaler) forms. Ways to counter clinicians’ pessimism about cessation include the knowledge that most smokers require multiple quit attempts before they succeed, that rigorous studies show long-term quit rates of 14% to 20%, with 1 report as high as 35%, that cessation rates for users of telephone quit lines and integrated [...]

7/26/2005 Chapel Hill, NC staff Newswise (www.newswise.com) A highly powerful scanner combining two state-of-the-art technologies – computed tomography (CT) and positron emission tomography (PET) – may detect the spread of head and neck cancer more accurately than other widely used imaging examinations. These findings, based on new research from the University of North Carolina at Chapel Hill School of Medicine, appear in the July issue of the medical journal The Laryngoscope. The whole-body PET/CT also is highly accurate for detecting head and neck cancer recurrence, the researchers said. “PET/CT is very helpful in determining where we should pinpoint our biopsies for recurrent disease,” said Dr. Carol Shores, assistant professor of otolaryngology/head and neck surgery at UNC and the report’s senior author. Shores is a member of the UNC Lineberger Comprehensive Cancer Center. “We can pick up cancer where we thought none existed. The new scans are so precise that in some cases cancer had been detected that probably would not have been through any other noninvasive imaging exam.” Since its development in 2000, PET/CT imaging has enabled collection of both anatomical and biological information during a single examination. The PET component picks up the metabolic signal of actively growing cancer cells in the body, and the CT provides a detailed picture of the internal anatomy that reveals the size and shape of abnormal cancerous growths. “Alone, each test has its limitations, but when the results of the scans are integrated they provide the most complete information on cancer location and [...]

7/25/2005 Durham, NC staff News-Mediacl.net (www.news-medical.net) An analysis of more than 100 studies of cancer survivors shows that many survivors initiate diet, exercise, and other beneficial lifestyle changes following a cancer diagnosis, but that those who are male, older, and less educated are less likely to adopt such changes. The term "cancer survivor" refers to a person who has been diagnosed with cancer. The review, which will be published online July 25 in the Journal of Clinical Oncology (JCO), says that a cancer diagnosis often prompts immediate changes in health behavior, including significant modifications in diet and physical activity. Using the MEDLINE and PubMed databases, lead author Wendy Demark-Wahnefried, PhD, RD, LDN, of Duke University Medical Center, and colleagues from the National Cancer Institute and Brown University identified and reviewed more than 100 studies of cancer survivors published since 1996. Researchers found that many survivors adopt healthier behaviors, such as following a healthier diet (30-60% of survivors), quitting smoking (46-96% of smokers with tobacco-related cancers, such as lung or head and neck), abstaining from alcohol (47-59% of those with head and neck cancers, which are closely linked to alcohol use), and regular physical activity (with up to 70% of survivors reporting 30 minutes of exercise a day, at least 5 days a week). Many of these changes should be beneficial because cancer survivors are a vulnerable population, at increased risk for second cancers, osteoporosis, obesity, cardiovascular disease, and diabetes. However, researchers noted that not all cancer patients adopted healthier behaviors, [...]