Martin Duffy, 70; Marathon fixture went extra mile

Source: Boston.com By: Bryan Marquard The morning he died, during what turned out to be his last hour or so of life, Martin Duffy got up and ran through his daily regimen of stretching, push-ups, and sit-ups. Several months before, cancer had kept him from adding to his extraordinary streak of 40 consecutive Boston Marathons, but he was used to forging ahead when his body said stop. Take one particular Marathon, probably his 26th. Afterward, he learned he had competed with a broken foot. Realizing at the 2-mile mark that something was amiss, “I divided that race into sections of 6 miles, with each segment a challenge to get through,’’ he told the Globe in 2000. “And somehow I did.’’ In 2009, Mr. Duffy’s string of consecutive completed Boston Marathons was recorded as the third-longest in history when he ran his 40th and final race a few months after being diagnosed with tongue cancer induced by the human papilloma virus. He was 70 when he died Nov. 29 in his Belmont home. Runners often sought advice from Mr. Duffy, given his experience, and he didn’t stop at simply offering tips on how and where to train. An economist who advised businesses and helped them develop strategies, he was still in touch with friends and clients in his final days. “He went in to work the week before he passed away,’’ said his wife, Rusty Stieff. And that was after treatment had left Mr. Duffy no longer able to speak. Instead, he [...]

Rash prediction in lung cancer?

Source: www.medscape.com Author: Maurie Markman, MD Hello. I am Dr. Maurie Markman from Cancer Treatment Centers of America in Philadelphia. I wanted to briefly discuss with you a very interesting paper[1] that appeared online in The Lancet Oncology on December 20th, 2010, and will be in print soon. The paper was entitled "First-Cycle Rash and Survival in Patients With Advanced Non-Small-Cell Lung Cancer Receiving Cetuximab in Combination With First-Line Chemotherapy: A Subgroup Analysis of Data From the FLEX Phase 3 Study." This was a very interesting subgroup analysis -- a retrospective analysis. What the group of investigators attempted to look at was the impact on a patient who received cetuximab and developed a rash compared with individuals who received cetuximab and did not develop a rash. And, of course, the other control group here would be the patients who received chemotherapy without cetuximab. What this retrospective analysis demonstrated was that overall survival in patients who received combination chemotherapy plus cetuximab and who developed a rash was significantly longer in all of the subtypes of non-small cell lung cancer that were looked at (including squamous and adenocarcinoma), compared with chemotherapy alone or chemotherapy plus cetuximab and no development of a rash. These data, which are quite provocative and need to be confirmed by others, suggest that the development of a rash may be a reasonable clinical biomarker of the potential impact of this targeted agent on cancer. That is, the development of a rash suggests that there is going to be [...]

Less xerostomia occurs with IMRT in head and neck cancer

Source: www.medscape.com Author: Roxanne Nelson Intensity-modulated radiotherapy (IMRT) might be a better treatment option for patients with squamous cell carcinoma of the head and neck. Compared with conventional radiation therapy, IMRT significantly decreases the incidence of xerostomia and improves quality of life, according to a study published online January 13 in the Lancet Oncology. British researchers report that at 12 months, grade 2 or higher xerostomia was significantly lower with IMRT than with conventional radiotherapy (38% vs 74%; P = .0027). At 2 years, the incidence of grade 2 or higher xerostomia continued to be significantly less common with IMRT than with standard radiotherapy; 9 patients (29%) reported xerostomia in the IMRT group, compared with 20 (83%) in the conventional therapy group. The authors note that there were no significant differences in locoregional control or overall survival between the 2 patient groups. Lead author Christopher M. Nutting, MD, FRCR, consultant and honorary senior lecturer in clinical oncology at the Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom, and colleagues note that their results "strongly support a role for IMRT in squamous cell carcinoma of the head and neck." Spares the Parotid Gland, Similar Outcomes Head and neck oncology expert Ted Teknos, MD, agrees. "One of the advantages of IMRT is that you can deliver radiation very accurately and you can spare normal structures to a much higher degree than conventional radiation therapy," said Dr. Teknos, director of the Division of Head and Neck Surgery at Ohio State [...]

Scientific frauds are not nearly rare enough

Source: www.torontosun.com Author: Joanne Richard Seems there’s a whole lot of misconduct going on in the world of science. The latest scandal showed that research linking measles, mumps and rubella (MMR) vaccines with autism is a sham, and it’s not alone. An investigation reports that one in seven scientists know colleagues who fake scientific findings, according the University of Edinburgh, while nearly half know of colleagues who engage in questionable practices. Only 2% of researchers polled own up to unethical misconduct – that number is probably higher, investigators report in the journal PLoS One. An Acadia Institute survey states 50% of faculty and 43% of graduate students have “direct knowledge” of scientific wrongdoing, including fraud, falsification and plagiarism, in their labs. Falsifying findings have put Dr. Andrew Wakefield into the hall of shame. His criticism of the vaccine to fight measles, mumps and rubella literally caused a global health crisis when his studies were reported in the Lancet medical journal in 1998. The journal fully retracted the published claims. A U.K. panel found Wakefield, of London’s Royal Free Hospital, to be “dishonest,” “unethical,” “irresponsible” and “callous.” Investigation by British journalist Brian Deer unearthed the damning evidence of financial and scientific misconduct. Rule breakers rule – everything from data fabrication to falsification, plagiarism to fraud to embezzlement is on the roster of rotten scientific behavior. It’s a high-stakes game where pressure is frenzied to publish positive results. Check out other famous faked scientific results that have left careers in ruins and [...]

Why parents fear the needle

Source: nytimes.com Author: Michael Willrich Despite overwhelming evidence to the contrary, roughly one in five Americans believes that vaccines cause autism — a disturbing fact that will probably hold true even after the publication this month, in a British medical journal, of a report thoroughly debunking the 1998 paper that began the vaccine-autism scare. That’s because the public’s underlying fear of vaccines goes much deeper than a single paper. Until officials realize that, and learn how to counter such deep-seated concerns, the paranoia — and the public-health risk it poses — will remain. The evidence against the original article and its author, a British medical researcher named Andrew Wakefield, is damning. Among other things, he is said to have received payment for his research from a lawyer involved in a suit against a vaccine manufacturer; in response, Britain’s General Medical Council struck him from the medical register last May. As the journal’s editor put it, the assertion that the measles-mumps-rubella vaccine caused autism “was based not on bad science but on a deliberate fraud.” But public fear of vaccines did not originate with Dr. Wakefield’s paper. Rather, his claims tapped into a reservoir of doubt and resentment toward this life-saving, but never risk-free, technology. Vaccines have had to fight against public skepticism from the beginning. In 1802, after Edward Jenner published his first results claiming that scratching cowpox pus into the arms of healthy children could protect them against smallpox, a political cartoon appeared showing newly vaccinated people with hooves [...]

Depression not an “invariable complication” of cancer

Source: www.medscape.com Author: Nick Mulcahy Depression — the most extensively studied mood complication associated with cancer — is "less common in patients with cancer than previously thought," according to the authors of a new meta-analysis. "Substantial uncertainty exists about prevalence of mood disorders in patients with cancer, including those in oncological, hematological, and palliative-care settings," write the authors, led by Alex Mitchell, MRCPsych, from the Department of Cancer Studies and Molecular Medicine at the Leicester Royal Infirmary and Leicestershire Partnership Trust, in the United Kingdom. For instance, reviews of depression in palliative-care cancer settings have shown prevalences between 1% and 69%, say the authors. However, the meta-analysis found that depression affects only about 16% of patients in oncological, hematological, and palliative-care settings. This rate is "modest," and suggests that "depression is not an invariable complication of cancer," write the authors. The analysis was published online January 19 in the Lancet Oncology. But depression is only one problem. "Some combination of mood disorders" occurs in 30% to 40% of cancer patients in these 3 hospital settings, the authors report. The study's take-away message is that clinicians should remain "vigilant for mood complications, not just depression," suggest Dr. Mitchell and colleagues. They also recommend that clinicians use simplified screening tools to look out for "distress, activities of daily living, quality of life, unmet needs, and desire for help." Herein lies the great challenge, suggested an expert not involved with the meta-analysis — namely, how to proceed in the cancer clinic with patients [...]

HPV infection may be linked to poor head and neck cancer survival rates in African Americans

Source: www.aacr.org Author: staff American Association for Cancer Research Hosts Press Conference on New Study A groundbreaking study in Cancer Prevention Research, a journal of the American Association for Cancer Research, suggests that having the human papillomavirus (HPV) improves survival in squamous cell carcinoma of the head and neck. Furthermore, African Americans had far less HPV infection than whites, which led to worse survival. "There is currently no consensus on why blacks fare worse with squamous cell carcinoma of the head and neck than whites, but this is the first clue that it may be biologic rather than related to issues of access, insurance or provider attitudes," said senior author Kevin Cullen, M.D., director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center and professor of medicine at the University of Maryland School of Medicine. Cullen's research showed that median overall survival was more than threefold higher for whites (70.6 months) than for African Americans (20.9 months) who were treated with chemotherapy and radiation. When the researchers examined patients by HPV status, they found that HPV-negative patients had a median survival of 26.6 months, while the survival rate for HPV-positive patients could not be calculated because most were still alive. Overall, 4 percent of African American patients and 34 percent of white patients were HPV positive. Cullen said the survival difference was entirely due to HPV status, as survival rates were similar among HPV-negative patients. Scott Lippman, M.D., chair of the Department of Clinical Cancer Prevention at the [...]

Menthol

Source: snus-news.blogspot.com Author: Sarah O'Connor There is a strong preference for menthol products in a number of Asian markets such as Japan and it is also growing in some Central European and Latin American markets. (Marlboro menthol cigarettes: strong preference in Asia by O'Connor Sarah, cheapweb.info, 6/24/2009) Study Abstract: Japan presents an excellent case-study of a nation with low female smoking rates and a negligible menthol market which changed after the cigarette market was opened to foreign competition. Internal tobacco industry documents demonstrate the intent of tobacco manufacturers to increase initiation among young females through development and marketing of menthol brands. Japanese menthol market share rose rapidly from less than 1% in 1980 to 20% in 2008. Menthol brand use was dominated by younger and female smokers, in contrast with non-menthol brands which were used primarily by male smokers. Nationally representative surveys confirm industry surveys of brand use and provide further evidence of the end results of the tobacco industry‘s actions—increased female smoking in Japan. These findings suggest that female populations may be encouraged to initiate into smoking, particularly in developing nations or where female smoking rates remain low, if the tobacco industry can successfully tailor brands to them. The Japanese experience provides a warning to public health officials who wish to prevent smoking initiation among young females. Surveys identified menthol as a major reason for female experimentation and use. Menthol cigarettes tended to be viewed as "a special type" of "light" cigarette and were widely considered to be an [...]

How protein made by HPV thwarts protective human protein, causing malignancy

Source: American Society for Biochemistry and Molecular Biology BETHESDA, MD., Jan. 11, 2011 – An international team of researchers is reporting that it has uncovered new information about human papilloma virus that one day may aid in the development of drugs to eliminate the cervical-cancer-causing infection. Led by researcher Per Jemth of Uppsala University in Sweden, the collaborators from four institutions detail in the Journal of Biological Chemistry how an offensive protein generated by the sexually transmitted virus handicaps a defensive protein made by the human body. Co-author Neil Ferguson, a biophysicist at University College Dublin, says: "It has proved difficult to stem the proliferation of many viruses using conventional drug discovery. Inhibitors of protein-protein interactions, as in HPV's case, are potentially potent ways to perturb viral infections." There are almost 200 strains of HPV, dozens of which are transmitted through genital contact, and about half of sexually active people have had one or more infections. The immune system eliminates the virus within two years in about 90 percent of cases, according to the Centers for Disease Control and Prevention in Atlanta, but it lingers for many years in a minority of cases. Some strains result in no visible symptoms, others cause genital warts and still others cause cancer. "Infection by high-risk human papilloma viruses is causing as many as half a million cases of cervical cancer and more than 200,000 deaths among women per year, making it one of the most common forms of cancer," Jemth emphasized. For the [...]

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

The Lancet Oncology, Early Online Publication, 13 January 2011 Dr Christopher M Nutting FRCR a b , James P Morden MSc b, Kevin J Harrington FRCR a b, Teresa Guerrero Urbano PhD c, Shreerang A Bhide FRCR a, Catharine Clark PhD d, Elizabeth A Miles MPhil e, Aisha B Miah FRCR a, Kate Newbold FRCR a, MaryAnne Tanay MSc a, Fawzi Adab FRCR f, Sarah J Jefferies FRCR g, Christopher Scrase FRCR h, Beng K Yap FRCR i, Roger P A'Hern MSc b, Mark A Sydenham BSc b, Marie Emson BSc b, Emma Hall PhD b, on behalf of the PARSPORT trial management group† Summary 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. Randomization was by computer-generated permuted blocks and was stratified by centre and tumor site. Our primary endpoint was the proportion of patients with grade 2 or worse xerostomia at 12 months, as assessed by [...]

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