Post-treatment pain in head and neck cancer patients may be associated with recurrence, lower survival rate

Source: www.medicalnewstoday.com Author: staff Patients with head and neck cancer who experience a higher level of post-treatment pain appear to have a lower survival rate than those who experience little or no post-treatment pain, according to a report in the August issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals. "Pain is an important but infrequently analyzed symptom in head and neck cancer and may play a predictive role in recurrence and survivorship outcomes," according to background information in the article. "Failure to investigate substantial changes in pain symptoms or new-onset pain that develops following treatment may potentially delay the diagnosis of recurrent disease." Joseph Scharpf, M.D., and colleagues at the University of Iowa, Iowa City, examined results from 339 patients who participated in the Department of Otolaryngology's Outcomes Assessment Project, conducted between 1998 and 2001. Participants provided information about their health and quality of life at diagnosis and three, six, nine and 12 months later. Participants also rated their post-treatment pain at follow-up. Of the 339 patients, 233 were men (68.7 percent) with an average age of 60.8. "Most had primary disease (84.4 percent), advanced-stage disease (59.9 percent) and oral cavity (42.2 percent) or laryngeal (23.3 percent) tumors. Most received surgical treatment alone (37.2 percent) or combined with radiotherapy," the authors write. "Pain was associated with age, general physical and mental health conditions, depressive symptoms, survival rate and recurrence within the first year," the authors note. "The five-year survival rate was 81.8 percent for patients [...]

Screening could lead to more potent cancer drugs

Source: nytimes.com Author: Nicholas Wade Researchers have discovered a way to identify drugs that can specifically attack and kill cancer stem cells, a finding that could lead to a new generation of anticancer medicines and a new strategy of treatment. Many researchers believe that tumor growth is driven by cancerous stem cells that, for reasons not understood, are highly resistant to standard treatments. Chemotherapy agents may kill off 99 percent of cells in a tumor, but the stem cells that remain can make the cancer recur, the theory holds, or spread to other tissues to cause new cancers. Stem cells, unlike mature cells, can constantly renew themselves and are thought to be the source of cancers when, through mutations in their DNA, they throw off their natural restraints. A practical test of this theory has been difficult because cancer stem cells are hard to recognize and have proved elusive targets. But a team at the Broad Institute, a Harvard-M.I.T. collaborative for genomics research, has devised a way of screening for drugs that attack cancer stem cells but leave ordinary cells unharmed. Cancer stem cells are hard to maintain in sufficient numbers, but the Broad Institute team devised a genetic manipulation to keep breast cancer stem cells trapped in the stem cell state. The team, led by Piyush B. Gupta, screened 16,000 chemicals, including all known chemotherapeutic agents approved by the Food and Drug Administration. The team reported in the Thursday issue of Cell that 32 of the chemicals selectively went [...]

Marked inhibition of growth and invasive parameters of head and neck squamous carcinoma FaDu by a nutrient mixture

Source: ict.sagepub.com Author: M.W. Roomi, PhD et al. Head and neck squamous cell carcinomas (HNSCCs) are known for their aggressive growth and propensity to metastasize. The authors investigated the effect of a novel nutrient mixture (NM) containing ascorbic acid, lysine, proline, and green tea extract on human HNSCC cell line FaDu in vivo and in vitro. Athymic male nude mice (n = 12) were inoculated with 3 x 106 FaDu cells subcutaneously and randomly divided into 2 groups: group A was fed a regular diet and group B a regular diet supplemented with 0.5% NM. Four weeks later, the mice were sacrificed and their tumors were excised, weighted, and processed for histology. In vitro, FaDu cells were cultured in Dulbecco's modified Eagle's medium and exposed to NM at 0 to 1000 µg/mL in triplicate. Cell proliferation was assessed by MTT assay, matrix metalloproteinase (MMP) secretion by gelatinase zymography, invasion through Matrigel, apoptosis by live-green caspases, and cell morphology by hematoxylin—eosin staining. NM inhibited the growth of tumors by 55% (P = .0002) and exhibited dose-dependent toxicity on FaDu cells in vitro, with 53% (P = .0003) at 1000 µg/mL NM. Zymography revealed MMP-2 and phorbol 12-myristate 13-acetate—induced MMP-9 secretion. NM inhibited secretion of both MMPs in a dose-dependent manner, with virtual total inhibition at 1000 µg/mL. NM significantly inhibited FaDu invasion through Matrigel with total block at 1000 µg/mL. NM induced dose-dependent apoptosis. In conclusion, NM has therapeutic potential in the treatment of HNSCC by significantly suppressing tumor growth and [...]

HPV infection drives disparity in head and neck cancer survival

Source: www.cancer.gov/ncicancerbulletin Author: Carmen Phillips A new study provides what researchers are calling a “missing link” that helps to explain why black patients with head and neck cancer live significantly shorter after treatment than white patients. Unlike several other cancers, where racial disparities in outcomes have been attributed in large part to socioeconomic factors, this new study points directly at a biological difference: infection rates of human papillomavirus type 16 (HPV 16). The study, published July 29 in Cancer Prevention Research, is the latest to show that head and neck cancer patients, particularly those with cancer of the oropharynx, who are HPV 16-positive have superior outcomes with standard treatment (concurrent chemotherapy and radiation) compared with those who are HPV 16-negative. But this study is the first to show that black patients with head and neck cancer have dramatically lower rates of HPV infection than white patients and that HPV status directly correlates with the significant survival disparities between the two patient groups. The finding that so few black patients are HPV positive “in a completely statistical sense explains why historically we have seen that black patients [with head and neck cancer] do poorly,” said Dr. Kevin J. Cullen, the study’s senior author and director of the University of Maryland (UMD) Marlene and Stewart Greenebaum Cancer Center. Digging Deeper The researchers performed a retrospective analysis of data from 95 black and 106 white patients with similar stages of head and neck cancer who received similar treatments at the Greenebaum Cancer Center, [...]

Mouth cancer expert calls for booze abstinence

Source: www.dentistry.co.uk Author: staff A mouth cancer expert is calling for an abstinence from alcohol to stem the rise in mouth cancer in the UK. New figures suggest that booze is largely to blame for an ‘alarming' rise in the rate of oral cancers among men and women in their forties. The figures, released by Cancer Research UK, show that since the mid-1990s, rates of oral cancers have gone up by 28% for men in their forties and 24% for women. Alcohol consumption has doubled since the 1950s and is the most likely culprit alongside smoking, says Cancer Research UK. Now Dr Vinod Joshi, founder of the Mouth Cancer Foundation is suggesting people should 'avoid drinking alcohol altogether'. The Department of Health's current advice is that men should not regularly drink more than 3-4 units of alcohol per day, and women should not regularly drink more than 2-3 units of alcohol per day. He says: 'In view of the latest reports from Cancer Research UK, the current alcohol guidelines that we've got are actually very high. 'To reduce the risk of mouth cancer risk, the Mouth Cancer Foundation recommends that people should limit or avoid drinking alcohol altogether.' For men, the Mouth Cancer Foundation recommends no more than occasional drinking of two standard drinks a day and for women no more than one standard drink a day. Experts suggest that increased alcohol consumption is to blame as they say cancers caused by smoking often take 30 years to develop, and [...]

Your mouth can tell a lot about your health

Source: www.sfgate.com Author: Michael Birnbaum, Washington Post Your mouth can tell you a lot about your overall health. Troubled teeth and gums aren't always just a dental problem. Sometimes they indicate deeper issues, and dentists are increasingly picking up the clues. "We look around the mouth and we look for color changes. We're looking for certain smells. Spots around the gums," said Washington dentist Joseph Kravitz. The relation of oral health to the rest of the body has received increased attention in recent years, spurred by such experts as Richard Carmona, who as surgeon general urged policymakers in 2003 to "increase the understanding of how the signs and symptoms of oral infections can indicate general health status and act as a marker for other diseases." The publicity reminded a lot of dentists that their jobs weren't just about root canals and fillings, Kravitz said. Here are some conditions the possible clues dentists may be able to identify: Heart disease. Gums that have turned a "bright beefy red" or purple. Type 2 diabetes. Gums that bleed at the slightest touch although there is no plaque evident. Kidney disease. A sweet ammonia smell on a person's breath. Acid reflux. Teeth that look worn and pitted, as if they'd been "dipped in battery acid." Oral cancer. Gum tissues with white spots that last two weeks or more. Leukemia. Fiery-red swollen gums that just won't heal. Osteoporosis. Black spots on tooth X-rays that indicate air pockets and dead bone. Stress. Gums that have pulled [...]

The fog that follows chemotherapy

Source: nytimes.com Author: Jane E. Brody As more people with cancer survive and try to return to their former lives, a side effect of chemotherapy is getting more and more attention. Its name is apt, if unappealing: chemo brain. Nearly every chemotherapy patient experiences short-term problems with memory and concentration. But about 15 percent suffer prolonged effects of what is known medically as chemotherapy-induced cognitive impairment. The symptoms are remarkably consistent: a mental fogginess that may include problems with memory, word retrieval, concentration, processing numbers, following instructions, multitasking and setting priorities. In those affected — and doctors at this point have no way of predicting who might be — it is as if the cognitive portion of the brain were barely functioning. Symptoms are most apparent to high-functioning individuals used to juggling the demands of complex jobs or demanding home lives, or both. The chemo brain phenomenon was described two years ago in The New York Times by Jane Gross, who noted that after years of medical denial, “there is now widespread acknowledgment that patients with cognitive symptoms are not imagining things.” Some therapists have attributed the symptoms of chemo brain to anxiety, depression, stress, fatigue and fear rather than direct effects of chemotherapy on the brain and hormone balance. Yet when such factors dissipate, the symptoms may not. Recent studies that took other influences into account and analyzed how patients’ brains worked before and after cancer treatment have shown that cognitive effects of chemotherapy are real and, for some, [...]

Moderate lifetime marijuana use associated with reduced risk of head and neck cancer, study says

Source: www.enewspf.com Author: staff The moderate long-term use of marijuana is associated with a reduced risk of head and neck cancers, according to the results of a population-based case-control study published online by the journal Cancer Prevention Research. Investigators at Rhode Island's Brown University, along with researchers at Boston University, Louisiana State University, and the University of Minnesota assessed the lifetime marijuana use habits of 434 cases (patients diagnosed with head and neck squamous cell carcinoma from nine medical facilities) compared to 547 matched controls. Authors reported, "After adjusting for potential confounders (including smoking and alcohol drinking), 10 to 20 years of marijuana use was associated with a significantly reduced risk of head and neck squamous cell carcinoma ... [as was] moderate weekly use." Subjects who smoked marijuana and consumed alcohol and tobacco (two known high risk factors for head and neck cancers) also experienced a reduced risk of cancer, the study found. "Our study suggests that moderate marijuana use is associated with reduced risk of HNSCC," investigators concluded. "This association was consistent across different measures of marijuana use (marijuana use status, duration, and frequency of use). ... Further, we observed that marijuana use modified the interaction between alcohol and cigarette smoking, resulting in a decreased HNSCC risk among moderate smokers and light drinkers, and attenuated risk among the heaviest smokers and drinkers. ... Despite our results being consistent with the point estimates from other studies, there remains a need for this inverse association to be confirmed by further work, [...]

Medical brief: shutting down oral cancer

Source: www.bu.edu/today Author: Caleb Daniloff Maria Kukuruzinska, a professor and researcher at BU’s Henry M. Goldman School of Dental Medicine, has shown a direct relationship between the aberrant behavior of a gene known as DPAGT1 and the loss of adhesion between cells in oral cancer cell lines and oral tumor tissues, offering dramatic new insight into how the disease might be treated. Oral cancer, which affects the mouth and throat, can spread quickly and has a 50 percent survival rate beyond five years. In healthy epithelial tissues, which line body cavities and form many organs, cells are held together with the help of an adhesion receptor called E-cadherin. This molecule ensures proper cell shape and function and prevents tumor spread. In oral cancer, the DPAGT1 gene is overactive, which interferes with E-cadherin’s adhesive properties. Tumors spread when cells can’t stick to one another. “Such discohesive cells peel off the tumor and establish new tumor islands,” Kukuruzinska says. “The hallmark of malignancy is when cells break apart, migrate, and nest in inappropriate organs.” When researchers partially suppressed DPAGT1 in the oral cancer cell lines, they enhanced the E-cadherin molecule’s ability to form junctions between cells. The team’s findings suggest that diminishing DPAGT1’s activity could interrupt the growth of a tumor. “You can’t jump to the conclusion that you can stop cancer from developing,” Kukuruzinska says. “But we can perhaps stop tumors from spreading.” Researchers want to find the cause of overexpression of DPAGT1 in oral cancer. They hope to identify key [...]

Could bacteria be a throat-cancer culprit?

Source: www.forbes.com Author: Matthew Herper Could having the wrong bacteria in your throat give you cancer? That's the question raised by a new study by researchers at New York University Langone Medical Center. They found that people who have either chronic heartburn or a more serious, precancerous condition called Barrett's esophagus had completely different kinds of microbes living in their throats than those who were healthy. The research was published in the current issue of the medical journal Gastroenterology. "This is the type of thing that one hopes more people will do," says Jonathan Eisen, a professor at the UC-Davis Genome Center who was not involved in the work. He cautions that it is "way too early" to say that the bacteria are causing disease. "All they have right now is a correlation." The NYU researchers sequenced bacteria DNA samples from the throats of 12 healthy people, 12 with gastro-esophageal reflux disease (GERD) and 10 with Barrett's. In the healthy people, 82% of throat bacteria were Streptococcus. In those with esophageal disease, the bacteria in the throat were more like those in the stomach; only a quarter of them were Strep. Scientists divide bacteria into so-called "gram positive" varieties like Strep, which lack rigid cell walls and can be stained with dye, and "gram negative" ones that have cell walls and aren't dyeable. The throats of the people with GERD and Barrett's were full of gram negatives. This opens up several possibilities, says Zhiheng Pei, the paper's lead author. The [...]

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