Physicians Say Good Riddance to ‘Worst Drug in History’

Source: Medscape Today By: Allison Gandey An estimated 10 million patients have used the pain reliever propoxyphene and were sent scrambling to doctors' offices when it was recently pulled from the market. Many physicians are still dealing with the aftermath of the product, first approved by the US Food and Drug Administration (FDA) in 1957. "Propoxyphene is the worst drug in history," Ulf Jonasson, doctor of public health, from the Nordic School in Gothenburg, Sweden, told Medscape Medical News. The researcher played a role in the decision to stop the pain reliever in the United Kingdom, Sweden, and later in the entire European Union. "No single drug has ever caused so many deaths," Dr. Jonasson said. Clinicians are now prescribing analgesic alternatives to propoxyphene. Propoxyphene was banned in the United Kingdom 5 years ago because of its risk for suicide. It was taken off the market in Europe in 2009 over concerns about fatal overdoses and now in the United States for arrhythmias. "I agree that propoxyphene is among the worst drugs in history," Eduardo Fraifeld, MD, president of the American Academy of Pain Medicine, said in an interview. "I'm surprised it stayed on the market so long. It's addictive, in my experience not very effective, and toxic." "I'd probably add Demerol to the list too," Dr. Fraifeld said. "It's toxic and sedating, and my personal opinion is it should not be used at all." Also known as pethidine, Demerol was the first synthetic opioid synthesized in 1932 as a [...]

2011-02-07T12:51:33-07:00February, 2011|Oral Cancer News|

Dog Sniffing Out Cancer May Lead to Early Detection Test

Source: Medscape Today By: Zosia Chustecka The latest study demonstrating that dogs can sniff out cancer has confirmed the notion that a specific cancer smell does exist, and has added fuel to the idea of developing a test based on odor. Previous studies have reported on dogs that can detect lung and breast cancer from breath samples, and there has been anecdotal evidence suggesting that dogs can detect melanoma, bladder, and ovarian cancers. In this latest study, published online January 31 in Gut, a Labrador retriever was trained over several months to sniff out colorectal cancer in breath and watery stool samples. Hideto Sonoda, MD, and colleagues from Kyushu University in Fukuoka, Japan, report that this dog was then tested with samples obtained from colorectal cancer patients and from volunteers, some of whom had gastrointestinal problems such as ulcers and inflammatory bowel disease. The dog correctly identified cancer in 33 of 36 breath tests and in 37 of 38 stool tests. This equates to 95% accuracy overall for the breath test and 98% accuracy overall for the stool test, the researchers report. The highest detection rates were among samples taken from patients with early-stage cancer, they add. Samples taken from smokers and from people with other gastrointestinal diseases, which might be expected to mask or interfere with cancer odors, did not appear to confuse the dog. "This study shows that a specific cancer scent does indeed exist," the researchers conclude. They are not suggesting using dogs in clinical practice, however. They [...]

2011-02-07T12:28:00-07:00February, 2011|Oral Cancer News|

Quadrivalent HPV Vaccine May Be Effective in Young Men

Source: Medscape Today By: Laurie Barclay, MD February 2, 2011 — Quadrivalent human papillomavirus (HPV) vaccine may prevent infection with HPV types 6, 11, 16, and 18 and the development of related external genital lesions in young men 16 to 26 years old, according to the results of a randomized, placebo-controlled, double-blind trial reported in the February 3 issue of the New England Journal of Medicine. "Infection with ...HPV and diseases caused by HPV are common in boys and men," write Anna R. Giuliano, PhD, from the Risk Assessment, Detection, and Intervention Program, H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, and colleagues. "We report on the safety of a quadrivalent vaccine (active against HPV types 6, 11, 16, and 18) and on its efficacy in preventing the development of external genital lesions and anogenital HPV infection in boys and men." The study sample consisted of 4065 healthy boys and men, aged 16 to 26 years, enrolled from 18 countries. The primary efficacy goal was to demonstrate that use of the quadrivalent HPV vaccine was associated with a lower incidence of external genital lesions related to HPV-6, 11, 16, or 18. The investigators used a per-protocol population, in which participants received all 3 vaccinations and had tested negative for relevant HPV types at enrollment, and an intent-to-treat population, in which participants received vaccine or placebo, regardless of baseline HPV status. In the intent-to-treat population, there were 36 external genital lesions in the vaccine group and 89 in [...]

2011-02-07T12:19:31-07:00February, 2011|Oral Cancer News|

In cancer survival, ‘mind matters,’ says expert

Source: www.medscape.com Author: staff Social support and psychologic/psychiatric interventions can improve survival in cancer but are "overlooked" in the treatment of the disease, argues a psychiatrist in an essay published in the February 2 issue of the Journal of the American Medical Association. "A patient's personal mental management of the stresses associated with cancer" is a "natural ally" in the battle with this disease, writes David Spiegel, MD, from the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine in Palo Alto, California. "It is plausible that interventions providing emotional and social support at the end of life have a positive influence on physiological stress-response systems that affect survival," he writes, suggesting a mechanism of action. But another expert in the field of behavioral medicine noted that there is very little evidence of such survival benefit. "Social support almost certainly makes people feel better, which is hugely important, and I wouldn't be surprised if it did improve survival," said Richard Sloan, PhD, from the Division of Behavioral Medicine at the Columbia University Medical Center in New York City. But, he added, there is no strong body of evidence that treatments and services addressing social or emotional issues improve survival in the field of cancer. For instance, "I know of no study in cancer patients that shows that reducing depression improves survival," he said. "We should treat depression because it makes patients miserable, not because we think it may improve survival," he added. Dr. Sloan's great concern about [...]

2011-02-06T09:15:28-07:00February, 2011|Oral Cancer News|

Star Scientific – filed application with U.S. FDA for approval to market a moist-snuff product

Source: snus-news.blogspot.com Author: staff Star Scientific, Inc. filed an application yesterday, February 2nd with the U.S. Food & Administration (FDA) for approval to market a moist-snuff product, Stonewall Moist-BDL™, as a modified-risk tobacco product (MRTP). The company believes that this is the first application filed with the FDA for approval of a tobacco product in a longstanding market segment. The data submitted in the application to the Center for Tobacco Products at FDA document TSNA levels in Stonewall Moist-BDL™ that are below limits of detection, or "BDL", by current standards of measure. Recent findings in the form of test results from an independent international laboratory validate the extraordinarily low levels in recently submitted samples of Stonewall Moist-BDL™, which the company believes are the lowest found anywhere in the world. The company pointed out that this application is particularly significant in two ways. First, moist snuff product sales accounted for roughly 75% of the total smokeless tobacco market in 2009. Moist snuff sales increased from 31,500 metric tons and $3.3 billion in 2004 to 37,990 metric tons and $4.64 billion in 2009 – an average annual growth rate of roughly 4%, and a 41% overall increase in sales over the six-year period. The moist snuff market segment has been well established for many decades, and is one of the oldest tobacco product categories in the United States. Second, tobacco-specific nitrosamine (TSNA) levels among the moist snuff products with the largest sales volume in 2009 averaged over 10,000 parts per billion in [...]

2011-02-06T08:36:25-07:00February, 2011|Oral Cancer News|

Global cancer statistics

Source: caonline.amcancersoc.org Authors: Ahmedin Jemal, DVM, PhD et al. The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage [...]

2011-02-06T08:31:35-07:00February, 2011|Oral Cancer News|

Gene expression profiling predicts the development of oral cancer

Source: cancerpreventionresearch.aacrjournals.org Authors: Pierre Saintigny et al. Patients with oral premalignant lesion (OPL) have a high risk of developing oral cancer. Although certain risk factors, such as smoking status and histology, are known, our ability to predict oral cancer risk remains poor. The study objective was to determine the value of gene expression profiling in predicting oral cancer development. Gene expression profile was measured in 86 of 162 OPL patients who were enrolled in a clinical chemoprevention trial that used the incidence of oral cancer development as a prespecified endpoint. The median follow-up time was 6.08 years and 35 of the 86 patients developed oral cancer over the course. Gene expression profiles were associated with oral cancer–free survival and used to develop multivariate predictive models for oral cancer prediction. We developed a 29-transcript predictive model which showed marked improvement in terms of prediction accuracy (with 8% predicting error rate) over the models using previously known clinicopathologic risk factors. On the basis of the gene expression profile data, we also identified 2,182 transcripts significantly associated with oral cancer risk–associated genes (P value

2011-02-04T18:13:41-07:00February, 2011|Oral Cancer News|

Assessment of human papillomavirus in lung tumor tissue

By: Journal of the National Cancer Institute Affiliations of authors: Division of Cancer Epidemiology and Genetics, NCI/NIH/DHHS, Bethesda, MD (JK, MR, AKC, AMG, AH, PRT, SW, MTL, NEC); Department of Internal Medicine, Ohio State University Comprehensive Cancer Center–James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH (MLG, HS); DDL Diagnostic Laboratory, Voorburg, the Netherlands (L-JVD, WGVQ, LS); EPOCA Research Center, Department of Occupational and Environmental Health, Università degli Studi di Milano, Milan, Italy (LT, PAB); Epidemiology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy (LT, PAB) Background Lung cancer kills more than 1 million people worldwide each year. Whereas several human papillomavirus (HPV)–associated cancers have been identified, the role of HPV in lung carcinogenesis remains controversial. Methods We selected 450 lung cancer patients from an Italian population–based case–control study, the Environment and Genetics in Lung Cancer Etiology. These patients were selected from those with an adequate number of unstained tissue sections and included all those who had never smoked and a random sample of the remaining patients. We used real-time polymerase chain reaction (PCR) to test specimens from these patients for HPV DNA, specifically for E6 gene sequences from HPV16 and E7 gene sequences from HPV18. We also tested a subset of 92 specimens from all never-smokers and a random selection of smokers for additional HPV types by a PCR-based test for at least 54 mucosal HPV genotypes. DNA was extracted from ethanol- or formalin-fixed paraffin-embedded tumor tissue under strict PCR clean [...]

2011-02-04T18:07:12-07:00February, 2011|Oral Cancer News|

Does chocolate hold the key to cure HPV?

Source: Yahoo News Indulgent chocolate treats may be the best-known and most widely appreciated product of the cacao tree, but new scientific research from New York Based Cacao Biotechnologies is uncovering potential new applications for the antioxidant-rich beans which could spur an innovative approach to treating human papillomavirus (HPV), a precursor to cervical cancer. The human papillomavirus is the most common sexually transmitted infection (STI) in the United States, with an estimated 24 million active cases and 5.5 million new cases each year, according to the National Cancer Institute. HPV is the leading cause of cervical cancer in woman with more than 12,000 cases reported in the U.S. each year. HPV vaccines approved by the Food and Drug Administration are available, but they are not a cure and they can’t effectively prevent all strains of HPV infection in those who are sexually active. Existing vaccines are only proven effective against a small number of high-risk, cancer-causing HPV strains and are not free of serious side effects including convulsions and paralysis. While condoms can reduce the risk of HPV infection, the virus can still be transmitted simply through skin contact of areas not covered by the condom. Vaccination will not cure someone who is already infected with the virus, so even with massive public health education campaigns, HPV will not soon be eradicated because it is so widely spread in the adult population. According to Penny Hitchcock, Chief of the Sexually Transmitted Diseases Branch of the U.S. government’s National Division of [...]

2011-02-04T12:16:39-07:00February, 2011|Oral Cancer News|

Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial

Source: www.thelancet.com Authors: Dr Christopher M Nutting FRCR et al. Background: Xerostomia is the most common late side-effect of radiotherapy to the head and neck. Compared with conventional radiotherapy, intensity-modulated radiotherapy (IMRT) can reduce irradiation of the parotid glands. We assessed the hypothesis that parotid-sparing IMRT reduces the incidence of severe xerostomia. Methods: We undertook a randomised controlled trial between Jan 21, 2003, and Dec 7, 2007, that compared conventional radiotherapy (control) with parotid-sparing IMRT. We randomly assigned patients with histologically confirmed pharyngeal squamous-cell carcinoma (T1—4, N0—3, M0) at six UK radiotherapy centres between the two radiotherapy techniques (1:1 ratio). A dose of 60 or 65 Gy was prescribed in 30 daily fractions given Monday to Friday. Treatment was not masked. Randomisation was by computer-generated permuted blocks and was stratified by centre and tumour site. Our primary endpoint was the proportion of patients with grade 2 or worse xerostomia at 12 months, as assessed by the Late Effects of Normal Tissue (LENT SOMA) scale. Analyses were done on an intention-to-treat basis, with all patients who had assessments included. Long-term follow-up of patients is ongoing. This study is registered with the International Standard Randomised Controlled Trial register, number ISRCTN48243537. Findings: 47 patients were assigned to each treatment arm. Median follow-up was 44·0 months (IQR 30·0—59·7). Six patients from each group died before 12 months and seven patients from the conventional radiotherapy and two from the IMRT group were not assessed at 12 months. At 12 months xerostomia side-effects were reported in [...]

2011-02-04T12:18:59-07:00February, 2011|Oral Cancer News|
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