Pretreatment health behaviors predict survival among patients with head and neck squamous cell carcinoma

Source: Journal of Clinical Oncology, 10.1200/JCO.2008.18.2188 Author: Sonia A. Duffy et al. Purpose: Our prior work has shown that the health behaviors of head and neck cancer patients are interrelated and are associated with quality of life; however, other than smoking, the relationship between health behaviors and survival is unclear. Patients and Methods: A prospective cohort study was conducted to determine the relationship between five pretreatment health behaviors (smoking, alcohol, diet, physical activity, and sleep) and all-cause survival among 504 head and neck cancer patients. Results: Smoking status was the strongest predictor of survival, with both current smokers (hazard ratio [HR] = 2.4; 95% CI, 1.3 to 4.4) and former smokers (HR = 2.0; 95% CI, 1.2 to 3.5) showing significant associations with poor survival. Problem drinking was associated with survival in the univariate analysis (HR = 1.4; 95% CI, 1.0 to 2.0) but lost significance when controlling for other factors. Low fruit intake was negatively associated with survival in the univariate analysis only (HR = 1.6; 95% CI, 1.1 to 2.1), whereas vegetable intake was not significant in either univariate or multivariate analyses. Although physical activity was associated with survival in the univariate analysis (HR = 0.95; 95% CI, 0.93 to 0.97), it was not significant in the multivariate model. Sleep was not significantly associated with survival in either univariate or multivariate analysis. Control variables that were also independently associated with survival in the multivariate analysis were age, education, tumor site, cancer stage, and surgical treatment. Conclusion: Variation in [...]

Prognostic Factors for Survival After Salvage Reirradiation of Head and Neck Cancer

Source: Journal of Clinical Oncology Writer: Tawee Tanvetyanon, Tapan Padhya, Judith McCaffrey, Weiwei Zhu, David Boulware, Ronald DeConti, and Andrea Trotti From the Head and Neck and Thoracic Programs, and the Statistic Core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. Purpose: Patients who develop recurrent or new primary head and neck cancer in a previously irradiated site have poor prognosis. Reirradiation is a treatment option, although it is associated with substantial toxicities. We investigated potential prognostic factors, including comorbidity and pre-existing organ dysfunction, for survival after reirradiation. Methods: Institutional electronic records of patients treated with reirradiation between January 1998 and 2008 were reviewed. Comorbidity was assessed by Charlson index and Adult Comorbidity Evaluation-27 (ACE-27) grading. Organ dysfunction was defined as feeding tube dependency, functioningtracheostomy, or soft tissue defect. Results: There were 103 patients, including 46 patients who underwent salvage surgery before reirradiation. Median progression-free and overall survivals were 12.1 months (95% CI, 9.7 to 16.6) and 19.3 months (95% CI, 13.9 to 29.9), respectively. Significant comorbidity was present in 36% of patients by Charlson index and 24% by ACE-27. Baseline organ dysfunction was present in 37% of patients. Median overall survivals were 5.5 months among those with both organ dysfunction and comorbidity per Charlson index, and 4.9 months per ACE-27, compared with 59.6 and 44.2 months, respectively, among the patients with neither organ dysfunction nor comorbidity (P) .001 and < .001). Other independent prognostic factors were interval from previous radiation, recurrent tumor stage, tumor bulk at reirradiation, [...]

2009-03-17T20:24:51-07:00March, 2009|Oral Cancer News|

Smoke signals

Source: waldo.villagesoup.com Author: Dr. Jonathan M. Goss, DDS Dr. Jonathan M. Goss and the Staff of Camden Hills Dental Care would like to provide you with the following information from the Academy of General Dentistry for the education and care of your oral health. Smoke Signals Using tobacco can harm your mouth, including your teeth and gums, in a number of ways. There is no safe form of tobacco—using it produces many problems and risk factors, from tooth discoloration and gum disease to throat, lung, and oral cancer, and ultimately, even death. It is important to understand what happens to your mouth when you use any form of tobacco, and to discuss those effects—and how to quit—with your dentist and physician. What happens to my mouth when I smoke? Smoking reduces blood flow and the supply of vital nutrients to your gums, including vitamin C. Without the proper nutrients, you can develop gum disease, bone loss, and even tooth loss. This is because smoking triggers the accumulation of bacteria in plaque. Smoking also reduces the amount of saliva that flows through your mouth. Saliva is important for cleaning your mouth and preventing tooth decay. In addition, when you smoke, the temperature in your mouth increases and the heat kills important cells in your mouth. You also can see the effects of tobacco use. Nicotine and tar, the major ingredients of cigarettes, discolor your teeth—yellow and brown stains will appear and the sticky tar deposits will adhere to crevices. The roof [...]

Snus news & other tobacco products

Source: snus-news.blogspot.com Author: blog post by tobaccowatch.org 2/28/09 Twenty-six of the United States' leading tobacco control researchers and policy experts have called for regulatory control of all tobacco products. They also called for policies that encourage current tobacco users to reduce their health risks by switching from the most to the least harmful nicotine-containing products. This group met in a two-year process they called The Strategic Dialogue on Tobacco Harm Reduction - members met four times between December 2005 and August 2007. Their vision: a world in which virtually no one uses cigarettes. But the group acknowledged that smokeless-tobacco products are an option for reducing health risks for tobacco users. They also called for policies that encourage current tobacco users to reduce their health risks by switching from the most to the least harmful nicotine-containing products. Paper: Mitch Zeller et al., The strategic dialogue on tobacco harm reduction: A vision and blueprint for action in the United States, Tob Control 2009 0: 200802731, Abstract.. We’re all for this safer alternative if distribution could be limited to inveterate tobacco smokers (smokers who are either unable or unwilling to quit). The harm reduction component envisioned by the American Association of Public Health Physicians would be part of a larger program, with "marketing" limited to satisfying the nicotine addiction of inveterate smokers at substantially less health risk than smoking. Let's be realistic it would be impossible to limit distribution of smokeless tobacco products to inveterate tobacco smokers. As Professor John Britton, Chairman of [...]

First DNA Test for Two Types of Human Papillomavirus Approved by FDA

Source: FDA News The first DNA test that identifies the two types of human papillomavirus (HPV) causing the majority of cervical cancers among women in the United States is approved by the U.S. Food and Drug Administration. The test, called Cervista HPV 16/18, detects the DNA sequences for HPV type 16 and HPV type 18 in cervical cells. Differentiating these HPV types gives health care professionals more information on a patient’s risk of subsequently developing cervical cancer.  A positive Cervista 16/18 test result indicates whether HPV type 16, 18 or both types are present in the cervical sample.  The FDA also approved yesterday the Cervista HPV HR test, which is the second DNA test that detects essentially all of the high-risk HPV types in cervical cell samples. The Cervista HPV HR test uses a method similar to the Cervista HPV 16/18 test to detect the DNA sequences of these HPV types.  In women age 30 and older or women with borderline cytology, the Cervista HPV 16/18 test can be used together with cytology and the Cervista HPV HR test to assess risk of cervical disease.  “Results from these two tests, when considered with a physician’s assessment of the patient’s history, other risk factors, and professional guidelines, can help physicians better determine risk and could lead to better patient management,” said Daniel G. Schultz, M.D., director of the FDA’s Center for Devices and Radiological Health.  HPV is the most common sexually transmitted infection in the United States. The U.S. Centers for [...]

2009-03-16T13:13:26-07:00March, 2009|Oral Cancer News|

Landmarks in the History of Cancer Epidemiology

Source: Cancer Research, 10.1158/0008-5472 Author: Peter Greenwald & Barbara K. Dunn The application of epidemiology to cancer prevention is relatively new, although observations of the potential causes of cancer have been reported for more than 2,000 years. Cancer was generally considered incurable until the late 19th century. Only with a refined understanding of the nature of cancer and strategies for cancer treatment could a systematic approach to cancer prevention emerge. The 20th century saw the elucidation of clues to cancer causation from observed associations with population exposures to tobacco, diet, environmental chemicals, and other exogenous factors. With repeated confirmation of such associations, researchers entertained for the first time the possibility that cancer, like many of the infectious diseases of the time, might be prevented. By the mid-20th century, with antibiotics successfully addressing the majority of infectious diseases and high blood pressure treatment beginning to affect the prevalence of heart disease in a favorable direction, the focus of much of epidemiology shifted to cancer. The early emphasis was on exploring, in greater depth, the environmental, dietary, hormonal, and other exogenous exposures for their potential associations with increased cancer risk. The first major breakthrough in identifying a modifiable cancer risk factor was the documentation of an association between tobacco smoking and lung cancer. During the past four decades, epidemiologic studies have generated population data identifying risk factors for cancers at almost every body site, with many cancers having multiple risk factors. The development of technologies to identify biological molecules has facilitated the [...]

Doctors pleased with robotic technique

Source: www.postbulletin.com Author: staff People heal faster with robotic throat-cancer surgery and have no major complications, Mayo Clinic research shows. The part of the throat behind the mouth can be difficult to reach for surgeons, says a Mayo statement. Surgery for throat tumor removal typically requires a hospital stay of seven to 10 days. But researchers say using a "da Vinci robotic surgical system" instead of traditional surgery led to average hospital stays of 2.3 days for 45 patients studied. Robotic surgery is now Mayo's "technique of choice" after more than 100 such procedures, Moore said. "The results of this research were even more positive than we expected. We found great advantages to using transoral robotic surgery for tonsil and base-of-the-tongue cancers," said head and neck surgeon Dr. Eric Moore.

Tarceva® and Avastin® safe and effective for patients with squamous-cell head and neck carcinoma

Source: professional.cancerconsultants.com Author: staff Researchers from the National Cancer Institute and the University of Chicago have reported that the combination of Tarceva® (erlotinib) and Avastin® (bevacizumab) is well tolerated and produces sustained responses in some patients with recurrent or metastatic squamous-cell head and neck carcinoma. The details of this study appeared in the March 2009 issue of Lancet Oncology.[1] Tarceva is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor. EGFRs are small proteins that are found on the surface of all cells. EGFR binds exclusively to small growth factor proteins circulating in the blood. The binding action between EGFR and growth factors stimulates biological processes within the cell to promote growth of a cell in a strictly controlled manner. However, in many cancer cells, EGFR is either abundantly over-expressed or the EGFR biological processes that normally stimulate cell growth are constantly active, leading to the uncontrolled and excessive growth of the cancer cell. Tarceva is approved by the U.S. Food and Drug Administration (FDA) for the treatment of non–small cell lung cancer and has significant activity in a variety of tumors, including hepatocellular carcinoma, pancreatic cancer, colorectal cancer, and renal cell cancer. Avastin is a humanized monoclonal antibody that is targeted against the vascular endothelial growth factor (VEGF). Avastin is approved by the FDA for the initial treatment of advanced colorectal cancer in combination with 5-fluorouracil-based therapy and has demonstrated an improvement in survival when combined with Camptosar® (irinotecan)-based chemotherapy in the treatment of this disease. Avastin was also [...]

Chewing tobacco use surges among boys

Source: Reuters Reporter: Will Dunham WASHINGTON (Reuters) - Use of snuff and chewing tobacco by U.S. adolescent boys, particularly in rural areas, has surged this decade, a federal agency said in a report on Thursday that raised concern among tobacco control advocates. The use of such smokeless tobacco products increases the risk of oral cancer as well as heart disease and stroke. It leads to nicotine addiction just like cigarette smoking. The report by the U.S. Substance Abuse and Mental Health Services Administration showed a 30 percent increase in the rate of smokeless tobacco use among boys aged 12 to 17 from 2002 to 2007. Use by adults remained stable. In 2007, the report estimated that 566,000 boys in that age group had used chewing tobacco or snuff. "This trend toward more smokeless tobacco use by kids is of great concern," Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids advocacy group, said in a telephone interview. "This is an industry that has a history of targeting kids because they know that's when everybody starts," he added. Among adolescent boys, the rate of use of smokeless tobacco rose from 3.4 percent in 2002 to 4.4 percent in 2007, according to the report. McGoldrick said the increase occurred as smokeless tobacco companies greatly increased their spending on marketing and introduced a new range of products. The findings reiterated the need for the U.S. Food and Drug Administration to have the power to regulate tobacco products, as legislation being considered [...]

2009-03-05T11:00:47-07:00March, 2009|Oral Cancer News|

Update FDA seeks more Erbitux data on head and neck cancer

Source: www.reuters.com Author: Ransdell Pierson U.S. regulators have declined to approve use of Erbitux as a first-line treatment for head and neck cancer until a new U.S. animal study is conducted showing how the medicine is absorbed by the body, drugmakers Eli Lilly and Bristol-Myers Squibb said on Monday. Lilly and Bristol-Myers had asked the U.S. Food and Drug Administration to approve first-line use of Erbitux based on favorable head and neck cancer data from overseas studies conducted by German drugmaker Merck KGaA. Merck sells Erbitux outside the United States. Lilly separately makes Erbitux and sells it in the United States in partnership with Bristol-Myers. The FDA wants an additional study to ascertain that both batches of Erbitux have the same pharmacokinetic profile, meaning the drug is absorbed in the bloodstream in similar fashion and amounts, said Lilly spokeswoman Judy Kay Moore. "They want an additional preclinical trial to study comparability" of Erbitux batches, Moore said. Lilly and Bristol-Myers recently withdrew their U.S. application to market Erbitux for advanced non-small cell lung cancer because of the same need to confirm comparability of batches made in different plants. "Essentially we will do one animal study and that will answer the pharmacokinetic comparability questions related to first-line treatment for both head and neck and lung cancer," Moore said. Lilly hopes to refile the lung cancer marketing application in the second half of 2009, Moore said. She said the company does not need to refile its application for first-line treatment of head and [...]

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