9/24/2007 Chicago, IL Caroline Helwick International Medicine World Report (www.imwr.com) Infection with human papillomavirus (HPV) is emerging as a significant factor in head and neck squamous-cell carcinoma—with medical and perhaps social implications. "HPV-related oropharynx carcinoma is beginning to constitute a significant portion of the oncologist's practice in head and neck cancer," said Marshall Posner, MD, medical director, Head and Neck Oncology Program, Dana-Farber Cancer Institute, Boston, who presented new study results at the annual meeting of the American Society of Clinical Oncology (ASCO). "HPV-related cancers are seen in as many as 25% of patients in community practice. At Dana-Farber, a referral cancer center, almost 50% of the oropharynx cancers we see are HPV-positive." HPV Infection Improves Prognosis But the presence of HPV infection actually heralds a better prognosis in patients with these types of cancer, according to data from a new phase 2 prospective study conducted by the Eastern Cooperative Oncology Group (ECOG 2399). This multicenter study confirmed retrospective, single-institution reports showing improved survival for patients with HPV-positive head and neck squamous-cell cancer compared with their HPV-negative counterparts. At ASCO, Carole Fakhry, MD, of the Johns Hopkins Medical Institutions, Baltimore, reported that a positive HPV infection status conferred a 79% lower risk of death in this population. HPV status should now be considered a biomarker for prognosis in head and neck cancer, Dr Fakhry maintained. Moreover, these findings have implications for current treatment practices, as they may necessitate a reinterpretation of survival rates found in previous phase 2 trials to [...]

9/23/2007 Bethesda, MD staff sciencedaily.com A U.S. pathologist says some anti-cancer treatments may shrink tumors but increase the cancer stem cells that drive the disease. Dr. Vasyl Vasko of the Uniformed Services University of the Health Sciences said his research suggests that some treatments could be producing more cancer stem cells, which then metastasize as a way to survive the therapy. "This may help explain why the expression of stem-cell markers has been associated with resistance to chemotherapy and radiation treatments and poor outcome for patients with cancers including prostate, breast and lung cancers," Vasko said Friday in a release. The research was presented at the American Association for Cancer Research's second International Conference on Molecular Diagnostics in Cancer Therapeutic Development. The report said the cancer stem-cell markers include Nanog and BMI1, both of which contribute to stem cells' defining ability to renew themselves and differentiate into different cell types. Vasko said these same molecules are found in embryonic stem cells.

9/21/2007 United Kingdom Dr Thomas Stuttaford: Times Online (www.timesonline.co.uk) The Health Protection Agency’s study confirms that a significant proportion of young women are having sex between the ages of 14 and 16. The finding of positive antibodies to HPV, the human papillomavirus, which can infect anyone, man or woman, who has sexual intercourse, is a good marker for sexual activity. Although 80 per cent of women become HPV positive during their lives, in only a small minority of cases does it give rise to either premalignant or malignant changes in the cervix. Most people are unaware when they are infected with HPV because the obvious genital wart is not of the type that turns malignant. It takes between ten and twenty years for cervical cancer to develop after infection. Well over 99 per cent of cases of cervical cancer can be shown to have been caused by infection with HPV. Different strains of HPV from those that cause cervical cancer result in the unsightly and troublesome genital warts. HPV is also certainly responsible for many cases of anal and penile cancer and it is thought by many doctors to account for the marked upsurge in cases of oral cancer over the past 30 years that has coincided with an increase in oral sex. It has been known for many years that far more young girls, from all walks of life, are having sex when still under age than their mentors liked to assume. For this reason it is important that [...]

9/19/2007 United Kingdom Nic Fleming Telegraph.co.uk US researchers have been given the go-ahead to give patients transfusions of “super strength” cancer-killing cells from donors. Dr Zheng Cui, of the Wake Forest University School of Medicine, has shown in laboratory experiments that immune cells from some people can be almost 50 times more effective in fighting cancer than in others. Dr Cui, whose work is highlighted in this week’s New Scientist magazine, has previously shown cells from mice found to be immune to cancer can be used to cure ordinary mice with tumours. The work raises the prospect of using cancer-killing immune system cells called granulocytes from donors to significantly boost a cancer patient’s ability to fight their disease, and potentially cure them. The US Food and Drug Administration (FDA) last week gave Dr Cui permission to inject super-strength granulocytes into 22 patients. Dr Cui said: “Our hope is that this could be a cure. Our pre-clinical tests have been exceptionally successful. “If this is half as effective in humans as it is in mice it could be that half of patients could be cured or at least given one to two years extra of high quality life. “The technology needed to do this already exists, so if it works in humans we could save a lot of lives, and we could be doing so within two years.” Dr Cui is confident patients could benefit from the technique quickly because the technology used to extract granulocytes is the same as that [...]

9/19/2007 Tulsa, OK Cindy Kleiman, CDA, RDH, BS RDH Magazine (www.rdhmag.com) I met Sandy Boody, a fellow dental hygienist, in San Antonio, Texas. We were both consulting for Biotene/Laclede at a national oncology nursing convention. Ironically, the nurses attending the meeting on “Oral Care for Cancer Patients” could be the same RNs who would be caring for my colleague in her upcoming battle to survive head and neck cancer. Sandy and I are both college faculty and are both experienced working with the medically compromised patient. We enjoy our times together and have many similarities, not only in our careers but in our personal lives as well. Sandy lives in the Pittsburgh area, and I live in the Phoenix area. The story of Sandy Boody is one I’ve wanted to share. It is her own private journey, yet it is one that, if shared, could save a patient’s life or even your own. I am grateful to be allowed to tell you this story. Sandy Boody, CDA, RDH, MEd, graduated from the University of Pittsburgh. She spent two decades of her career as an educator at Allegheny Community College/Northern Area Special Purpose Schools. She has taught many courses, including head and neck anatomy, which has given her knowledge that ended up being her lifeboat. Besides teaching, treating the medically compromised patient remains her passion. Hospital dentistry and nursing home care were interests that Sandy participated in for many years during her summer teaching breaks. She also was passionate about xerostomia [...]

9/17/2007 Washington, DC press release money.cnn.com Vision-Sciences, Inc. ("Vision-Sciences" or the "Company") announced today that it has unveiled its recently FDA-cleared, video-based flexible endoscopes at the American Academy of Otolaryngology -- Head and Neck Surgery Foundation Annual Meeting & OTO EXPO ("AAO-HNSF") September 16 - 19th in Washington D.C. The Academy includes more than 12,000 otolaryngologists, physicians and surgeons from over 75 countries and all 50 states who diagnose and treat disorders of the Ear, Nose, and Throat anatomy, as well as related structures of the head and neck. These treatments include swallowing disorders (Dysphagia), sinusitis, hoarseness, chronic cough, sleep apnea, gastroesophageal reflux disease (GERD), Barrett's disease and head and neck cancer. The ENT (Ear, Nose and Throat) and TNE (Transnasal Esophagoscopy) videoscopes are the first two in the series of uniquely advanced digital endoscopy platforms to be launched. The ENT-5000 and TNE-5000 scopes are made with a built-in LED light source, eliminating the need for a separate camera head and light cable. The ENT-5000 flexible video laryngoscope is inserted in the nose down to the throat, providing detailed, vivid images of the internal structures of the nasal cavity, vocal folds, larynx and other areas of the throat. The TNE-5000 flexible video transnasal esophagoscope allows for visualization and diagnosis further down to the esophagus and stomach. These lightweight videoscopes facilitate diagnostic and therapeutic procedures without general anesthesia or intravenous sedation. During the procedure, the patient's comfort is enhanced by the scope's use of the smallest diameter insertion tube known to [...]

9/17/2007 United Kingdom Christian Nordqvist MedicalNewsToday.com Patients with head and neck cancer may have poorer functioning in some driving proficiency compared to healthy individuals, according to a preliminary study published in Archives of Otolaryngology-Head & Neck Surgery (JAMA/Archives), September issue. The authors explain "Driving is a complex task that requires adequate cognitive, psychomotor and visuoperceptualmotor functions that work together. These functions can be compromised to a greater or lesser extent in patients with cancer in the head and neck region who have received cancer treatment." Cancer treatment is such that a patient's head and neck mobility may be impede. Cancer treatment might also produce cognitive impairments, pain and psychological distress - exposing the driver to greater risks. Hon K. Yuen, Ph.D., O.T.R./L., Medical University of South Carolina, Charleston, and team evaluated the driving skills of ten head and neck cancer patients, whose average age was 56, as well as 50 members of the community, whose average age was 48. They used a virtual reality driving simulator - the scientists monitored their average speed, break reaction times, how much their vehicles offset from the center of the driving lane (steering variability), total collisions and the Simulator Driving Performance Scale. The Simulator Driving Performance Scale assesses the driver's driving behavior and skills. The study was carried out 26.6 months after most of the patients' surgery and 20 months after cancer therapy. Here is a comparison between the two groups of people: Average break reaction time Cancer patients - 3,134.92 milliseconds General public [...]

9/17/2007 web-based article Claudia Pinto The Tennessean (Tennessean.com) Smoking and drinking alcohol aren’t the only habits that increase the risk of head and neck cancer, there is a lesser-known but just as deadly contributor: oral sex. The disease is striking an increasing number of younger adults aged 20 to 44, and the cause is attributed to a sexually transmitted disease known as human papillomavirus or HPV, according to a report in next month’s issue of Cancer, the American Cancer Society’s peer-reviewed journal. Dr. Wendell Yarbrough said he’s seeing the trend in patients he treats at Vanderbilt University Medical Center. “The rate of positive HPV tumors are increasing in the younger folks,” said Yarbrough, who is a Vanderbilt associate professor of otolaryngology and cancer biology and an Ingram professor of cancer research. “We’ve treated some people in their 20s. We used to never see it in people that young.” “Head and neck cancer used to be a disease of people in their 50s and 60s who smoked and drank a lot.” Yarbrough believes the reason for the change is an increase in HPV infection among the general public, due in part, people having more sexual partners and engaging in sexual activity earlier in life. Studies back up his views. Twenty-nine percent of American men and nine percent of American women have had 15 or more sexual partners in their lifetime, according to a study by the National Center for Health Statistics, a branch of the Centers for Disease Control and Prevention. [...]

9/15/2007 Nashville, TN staff Newswire.ascribe.org The human papillomavirus (HPV) has been implicated as a cause of cervical cancer in women, but there's another devastating form of cancer also linked to HPV infection - head and neck cancer - and almost no one is talking about it. "Right now I think the public and most physicians have no idea that HPV relates to head and neck cancer," said Dell Yarbrough, M.D., Vanderbilt-Ingram Cancer Center surgical oncologist. "In cancers of the oropharynx, which includes the tonsils, the base of the tongue, and part of the throat, about half of those tumors are HPV-positive. In the oral cavity, between 10 and 15 percent of tumors test positive for HPV, although here at Vanderbilt-Ingram we're seeing up to 20 percent." HPV is one of the most common sexually transmitted diseases in the world. The Centers for Disease Control and Prevention (CDC) estimates nearly 6.2 million new genital HPV cases occur in the United States each year. Now researchers have documented a rise in some types of head and neck cancer related to HPV, especially cancer in the tonsils. The spike in tonsillar cancer coincides with reported changes in sexual habits among young people, including earlier age of sexual activity and an increase in oral sex. "Head and neck cancer used to be a disease of people in their 50s and 60s who smoked and drank heavily," said Yarbrough. "The younger population was at very low risk until recently. But now we're seeing an increased [...]

9/15/2007 web-based article various New England Journal of Medicine, Volume 357:1156-1158 Human Papillomavirus and Oropharyngeal Cancer To the Editor: The study by D'Souza et al. (May 10 issue)1 on oropharyngeal squamous-cell carcinomas associated with human papillomavirus (HPV) provides important epidemiologic insights into a cancer that is becoming increasingly common in the United States.2 However, the molecular mechanisms of carcinogenesis in HPV-associated oropharyngeal squamous-cell carcinomas remain unclear. The integration of HPV type 16 (HPV-16) into the host genome is an important mechanism in cervical carcinogenesis,3 but there is no direct evidence that this process occurs in oropharyngeal squamous-cell carcinomas. The authors state that Southern blot, real-time polymerase-chain-reaction (PCR), and fluorescence in situ hybridization analyses4 have established integration sites but that these methods provide only indirect evidence. Direct evidence would require observation of the viral DNA sequence either flanked or attached to one end of human DNA (junction sequences). Mellin et al.5 did not observe this finding in HPV-16–positive tonsillar carcinomas. We previously used restriction-site PCR in more than 100 HPV-16 and HPV-18 cervical cancers to identify many of these junction sequences.6 However, when we used this same technique in 40 oropharyngeal squamous-cell carcinomas that were positive for HPV-16, we did not detect junction sequences (unpublished data). This finding, which suggests a mechanism of carcinogenesis that is distinct from that in cervical cancer, warrants further investigation. Odey C. Ukpo, M.S. Eric J. Moore, M.D. David I. Smith, Ph.D. Mayo Clinic Rochester, MN 55905 [email protected] References: 1.D'Souza G, Kreimer AR, Viscidi R, et [...]