10/23/2007 Colorado Springs, CO Brian Newsome Colorado Springs Gazette (gazette.com) Several years ago, Dr. Joel Ernster noticed something strange in his Colorado Springs ear, nose and throat practice. A man with no history of heavy smoking or drinking developed an uncommon throat cancer usually caused by such habits. Over time, there were dozens more like him. Ernster investigated the trend and after three years of research has found what appears to be the answer: a virus likely transmitted by oral sex. In a study to be published in coming months in The Laryngoscope, a leading medical journal for ear, nose and throat specialists, the physician connects a significant increase in throat-cancer cases among men to the human papilloma virus that causes cervical cancer in women. Men probably obtain the virus by performing oral sex on women who have an HPV infection of the cervix. Ernster said the cancer could develop as late as 20 years after the oral sex occurred. “Oral sex has implications that are way beyond what we first thought,” he said. Ernster’s research is the latest in a growing body of studies that have established a connection between the HPV virus and oropharyngeal (throat) cancer. A study published online in August and in print this month in the journal Cancer similarly suggests that a rise in throat cancer among men younger than 45 can be attributed to the HPV virus. Why cases among young men are increasing is unclear, but Ernster and others believe oral sex generally [...]

10/23/2007 Vancouver, British Columbia, Canada staff Canadian Press (candianpress.google.com) An increasing number of patients have a new decision to make when they go to the dentist, above and beyond choosing tooth whitening or the flavour of a fluoride rinse. When patients visit the dental office of Dr. Mark Suyama in Vancouver, they're asked if they'd like an oral cancer screening using the VELscope, a device invented at the B.C. Cancer Agency. An estimated 500 Canadian dentists and about 1,500 in other parts of the world have purchased the $5,000 piece of equipment for their practices, according to John Pohl, a spokesman for LED Dental of White Rock, B.C., which has been selling the product since the middle of last year. Suyama got his VELscope, which uses blue light aimed into the oral cavity, about three months ago. The healthy tissue glows as an apple-green colour, while a problem area that might indicate a pre-cancerous lesion shows up darker. "It's very easy. It's just like using a flashlight almost - just like shining a flashlight in someone's mouth," Suyama said. "We're offering it to everybody, but we're charging $45 and that's not always covered by dental insurance. So some people are hesitant to spend the money." Calum MacAulay, a research scientist at the cancer agency, says the agency has been involved in the study and use of tissue autofluorescence for early cancer detection in other parts of the body. "Three or four years ago I was listening to a colleague talk [...]

10/22/2007 Washingon, D.C. press release EurekAlert.com A patient’s positive or negative emotional state has no direct or indirect effect on cancer survival or disease progression, according to a large scale new study. Published in the December 1, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study found that emotional well-being was not an independent factor affecting the prognosis of head and neck cancers. The question of whether or not the mind, through psychological state and emotional status, has the ability to heal organic disease in the body continues to be reviewed and tested in human health research. A large body of evidence strongly suggests that, for life-threatening diseases such as advanced cancer, it does not. However, this debate continues in popular and scientific circles. Particular importance has been attached to the question because of the belief that if it can be shown that emotions affect the outcome of cancer, then psychotherapy might be able to aid in the fight against cancer. Dr. James Coyne and colleagues from the University of Pennsylvania say previous studies used patients with many different diseases, small sample sizes and an inadequate number of deaths to be conclusive. Dr. Coyne’s team analyzed data from two community studies of patients with head and neck cancer “to examine whether emotional well being at study entry predicted survival.” Their approach had the methodological strengths of using a homogenous population and many deaths to detect even small statistically significant effects. The sample included 1,093 patients [...]

10/21/2007 Montreal, Quebec, Canada Michael Smith, Senior Staff Writer, MedPage Today MedPageToday.com Viral testing to detect cervical cancer appears to outperform the conventional Pap smear in some respects, researchers here have concluded. In a randomized trial, a test for the human papillomavirus was significantly more likely (P=0.01) to identify cases of cervical intraepithelial neoplasia (CIN) than a Pap smear, found Marie-Hélène Mayrand, M.D., of McGill University, and colleagues. On the other hand, the viral test was significantly more likely (P<0.001) to identify a healthy woman as having CIN, the researchers reported in the Oct. 18 issue of the New England Journal of Medicine. The Canadian study is one of two in the journal comparing testing for HPV with the conventional Pap test. In the other, Swedish scientists showed that a viral test appears to detect pre-cancerous and cancerous lesions earlier than the Pap test. The study comes just a few weeks after a study in Holland produced similar results. (See: DNA Tests for HPV Improve Cervical Cancer Screening) But the findings don't mean that viral tests are ready for "prime time," said Carolyn Runowicz, M.D., of the University of Connecticut. Dr. Runowicz, who wrote an accompanying editorial in the journal, said the results are "exciting" but preliminary. Among other things, she said, their application to U.S. practice is limited: Both studies used a slide-based Pap test, while 85% of tests done in the U.S. use liquid-based cytology, and the Swedish study used a highly sensitive viral test that is not [...]

10/21/2007 Minneapolis, MN Crystal Phend, Staff Writer, MedPage Today MedPageToday.com Even devoid of smoke, tobacco remains a carcinogen hazard, found researchers here. Smokeless tobacco exposes users to at least as much of a potent carcinogen as smoking tobacco does, despite claims that it is a safer alternative, reported Stephen S. Hecht, Ph.D., of the University of Minnesota, and colleagues, in the August issue of Cancer Epidemiology, Biomarkers & Prevention. Smokeless tobacco users had 73% higher levels of a biomarker for a nitrosamine carcinogen known as NNK than did smokers in pooled analysis of six studies (P<0.0001), they found. NNK (4-[methylnitrosamino]-1-[3-pyridyl]-1-butanone) is the worst of the strong carcinogens most prevalent in smokeless tobacco, they said. In animals, it has been shown to induce tumors in the lung, pancreas, nasal mucosa, and liver. Their findings represent "an unacceptable risk" and weigh against oral snuff as a healthier substitute for smoking, they said. "Long-term use of nicotine replacement therapy may be a better option." Smokeless tobacco has been considered less toxic and carcinogenic than smoking because it has less of the harmful substances formed by burning the tobacco, they noted. Therefore, some tobacco control experts have suggested that smokers who cannot quit could switch to "low nitrosamine" smokeless tobacco to reduce their health risks, they said. To see if this claim was true, the researchers used data collected at baseline from three intervention studies of smokers and three of smokeless tobacco users. The 420 smokers (62% men) averaged 25.8 cigarettes per day. The [...]

10/21/2007 Houston, TX1 Crystal Phend, Staff Writer, MedPage Today MedPageToday.com Human papillomavirus infections are likely buoying up oropharyngeal cancer rates while other head and neck cancers decline, researchers said. Cancer-causing HPV strains have been implicated in half of oropharyngeal cancers, and 90% of HPV-related cases have been pinpointed to HPV-16 in studies, said Erich M. Sturgis, M.D., M.P.H., and Paul M. Cinciripini, M.D., both of the M.D. Anderson Cancer Center here, in a review published online in the journal Cancer. One of the reasons, the researchers suggested is the "changing sexual practices, such as more frequent oral sex in adolescents and young adults." To hasten throat cancer's decline, vaccination of boys and and men against oncogenic strains HPV-16 and HPV-18 should be considered, they suggested. "The current vaccination strategy [suggested for girls and young women ages nine to 26] will only benefit men secondarily as the cohort of vaccinated women age and the incidence of chronic oncogenic HPV infection in the sexually active female population declines," the investigators wrote. This effect may take a generation to achieve, they said. Notes: 1. Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. 2. Dr. Cinciripini reported having been a consultant for Sanofi-Aventis, Glaxo-SmithKline, Xenova, and Pfizer. To speed up the potential benefit in the prevention of HPV-related oropharyngeal cancers, Drs. Sturgis and Cinciripini recommended "the rapid study of the efficacy and safety of these vaccines in males and, if successful, the recommendation of vaccination in [...]

10/21/2007 Atlanta, GA By Peggy Peck, Managing Editor, MedPage Today MedPageToday.com Gardasil (quadrivalent human papillomavirus [Types 6, 11, 16, 18]) appears to be 100% effective against HPV-related vaginal and vulvar lesions, researchers reported here. This vaccine has won endorsement by an FDA advisory committee for cervical cancer and was expected to win agency approval for that indication this week. Meanwhile, at the American Society of Clinical Oncology meeting here, Jorma Paavonen, M.D., of the University of Helsinki in Finland, said HPV is present in about 80% of vaginal and vulvar cancers. In a pre-specified modified intention-to-treat combined analysis of data from the three randomized, placebo-controlled Gardasil clinical trials, there were 24 cases of vulvar or vaginal intraepithelial neoplasia in the placebo arm and no cases in the active treatment arm after an average of two years of follow-up, he said. "These findings support the prophylactic efficacy of Gardasil in preventing HPV-16 and HPV-18-related vulvar and vaginal cancer," Dr. Paavonen said at an ASCO press briefing here. Dr. Paavonen said the data he reported here were made available to the FDA, "but have not been previously reported or published." The analysis included data from 8,641 women ages 16 to 26 who received three doses of the vaccine and 8,667 women who received three placebo injections. The women were recruited from the U.S. as well as South America, Europe and Asia. Dr. Paavonen said that the health ministry in Finland is planning to include the HPV vaccine as a standard childhood immunization [...]

10/21/2007 Orlando, FL By Rabiya Tuma, Ph.D., MedPage Today Staff Writer MedPageToday.com A therapeutic vaccine against nicotine significantly improved smokers' ability to quit cigarettes and avoid lighting up for six months, researchers reported here. However, the vaccine was only effective in patients who achieved a strong antibody response to monthly injections of the vaccine, Swiss investigators said over the weekend at the American Society of Clinical Oncology meeting. There was no statistically significant difference between the two trial arms when all patients who were available for follow-up and stayed on protocol were evaluated. Of those patients, 64 of 159 in the vaccine arm and 25 of 80 in the placebo arm (40% versus 31%; p>0.05 but the specific number was not provided) abstained from cigarettes for five months. However, when the researchers split the participants in the vaccine arm into three equal groups, according to the intensity of their antibody response, significantly more of the individuals in the top group quit smoking compared with those in the placebo arm. Thirty of the top 53 responders (57%) abstained from cigarettes for 24 weeks, compared with 25 of the 80 patients (31%) in the placebo arm (p=0.004). Because only strong responders gained clinical benefit, the team is now looking for ways to boost the antibody responses by altering the vaccination schedule, dosing, and vaccine adjuvant preparation, said Philippe Müller, M.D., of Cytos Biotechnology AG in Zurich, the company developing the vaccine. Müller was an author on the vaccine study. When the investigators [...]

10/17/2007 Hong Kong, China Tan Ee Lyn Reuters.com Lupeol, a compound in fruits like mangoes, grapes and strawberries, appears to be effective in killing and curbing the spread of cancer cells in the head and neck, a study in Hong Kong has found. An experiment with mice showed lupeol worked most effectively with chemotherapy drugs and had almost no side effects, scientists at the University of Hong Kong said in a report published in the September issue of the journal Cancer Research. "It can suppress the movement of cancer cells and suppress their growth and it is found to be even more effective than conventional drugs (eg. cisplatin)," said Anthony Yuen, a professor at the University of Hong Kong's surgery department. "It's even more effective if we combine it with chemotherapy drugs, and has very little side effects," he said. The team plans another round of animal test and hopes to proceed eventually to human clinical trials, though it would not commit itself to a timeframe. Head and neck cancers involve cancers of the nose, oral cavity, throat, voice box, thyroid and salivary glands and they more commonly afflict Asians than Westerners. Some of the risk factors include smoking, excessive alcohol consumption, chewing betel nut and diets rich in preserved foods, like salted fish. Such cancers are difficult to treat. Fifty percent of victims are typically diagnosed in advanced stages, when cure rates would be so low they would be considered inoperable. Surgeries on the head and neck are always [...]

10/21/2007 web-based article X Huang et al. Clin. Cancer Res., October 15, 2007; 13(20): 6099-106. Purpose: Application of ultrasensitive diagnostics has shown that small numbers of p53 mutation-positive cells may signify the presence of residual tumor in histologically normal tissues after resection of squamous cell carcinomas arising in the head and neck area. To date, most studies in this area have focused on analysis of tissues at the mucosal aspect of the resection and highlighted the importance of molecular changes in the field with respect to the risk of recurrence. Experimental Design: In the present investigation, we analyzed normal tissues from mucosal and deep surgical margins, referred to as "molecular margins," for the presence of the signature p53 mutation identified for each tumor. Results: The p53 mutation status of these carcinomas did not correlate with clinical or histopathologic variables, but these mutations provided an excellent target for ultrasensitive analysis of margin status. We found that 11 of 16 (68%) of cases with histologically tumor-free (including 9 without dysplasia), but with p53 mutation-positive molecular margins, developed recurrence. The probability of developing local recurrence was significantly higher for the group with p53 mutation-positive margins when compared with the group with clear margins (P = 0.048) and more strongly associated with p53 mutation-positive deep molecular margins than mutation-positive mucosal molecular margins or positivity at both sites (P = 0.009). Conslusions: This shows that although persistent mucosal fields may contribute to recurrence, clonal p53 mutations in deep tissues are an important cause of treatment [...]