5/14/2007 London, England staff Telegraph.co.uk Patients suffering from head and neck cancer are to be denied a new drug on the National Health Service because it is claimed it is no more effective than existing drugs. The National Institute for Health and Clinical Excellence (Nice) has rejected Erbitux, also known as cetuximab, for cancer sufferers in England and Wales. The drug is available in Scotland. Nice said the drug, when used in conjunction with radiotherapy, did not offer "better therapeutic value" than existing treatments for locally advanced head and neck cancer. However, according to clinical trials carried out by Merck Serono UK, the drug's manufacturer, patients treated with Erbitux plus radiotherapy survive for an average of 49 months, compared with 29 months for those treated with radiotherapy alone. Campaigners said the move was a blow to patients as the drug is the first licensed in the past 40 years for treating locally advanced head and neck cancer. Andrew Dillon, the chief executive of Nice, said: "The evidence presented to the independent advisory committee did not persuade them that cetuximab works any better or offers better therapeutic value than existing treatments for head and neck cancer. "Sometimes it is possible for the committee to identify a subgroup of patients in whom a drug would be effective, for example, patients for whom other treatments are not suitable. "The committee did consider whether there are any subgroups of patients for whom cetuximab could be clinically and cost effective but they were not presented [...]

5/14/2007 Cape Town, South Africa staff Health24.com A US Food and Drug Administration advisory panel has called for new warnings and additional safety studies on anaemia drugs commonly used to treat patients undergoing kidney dialysis or chemotherapy. These medications have been the subject of controversy since some of their dangerous side effects - including the risk of heart attacks and stroke - came to light earlier this year. In March, the FDA issued stronger label warnings for the popular drugs. On Thursday, the agency's advisory panel of experts voted 15-2 in favour of new prescribing restrictions and 17-0 for new clinical trials to prove the safety of Amgen's Aranesp and Johnson & Johnson's Procrit, Bloomberg reported. "Many of us are concerned on the committee and have a lot of questions," said advisory panel chairwoman Gail Eckhardt, an oncologist at the University of Colorado in Aurora, according to Bloomberg. Insufficient evidence Eckhardt said the questions concerned the design of trials, why regulators have limited access to results from company studies, and why the drugs have been marketed for improving quality of life if there isn't sufficient evidence for the claim. Amgen, of Thousand Oaks, California, claims that 4 million patients have taken the medicines since they were introduced in 1989, and more than 9 000 people have been studied in clinical trials with cancer patients, the Bloomberg report said. "We want to consider the totality of the evidence and consider what's best for patients," Roger Perlmutter, Amgen's head of research and [...]

5/14/2007 Westchester County, NY Linda Lombroso Lower Hudson Online (www.thejournalnews.com) It was nearly five years ago that Margaret Belair received chilling news: The sensitive spot on her tongue was far more than a pizza burn or a cold sore. It was oral cancer. Belair, who'd just given birth to a baby boy, was stunned. "It didn't look or feel hard,'' says the 41-year-old mother of two, who lives in Somers. "It was just a weird irritation of the tongue, just slightly discolored, and it felt like a big canker sore.'' Despite the shock of the diagnosis, Belair was fortunate. After an operation to cut out a portion of her tongue - and the precautionary removal of several lymph nodes in her neck - all she needed was eight weeks of speech therapy (to relearn how to pronounce certain sounds) and eight weeks of physical therapy (to build up the strength in her neck). For Brian Hill, the news was not as good. By the time his oral cancer was caught in 1997, it had metastasized to his lymph nodes. Nobody expected him to survive. Although the treatment was brutal - including radiation that destroyed his salivary glands and destroyed a portion of his neck - Hill ended up beating the odds. He has since founded the Oral Cancer Foundation, a national nonprofit research and advocacy organization, and has become an outspoken champion for early detection of the disease. One of the problems in catching oral cancer early, say experts, has [...]

5/14/2007 web-based article staff CancerConsultants.com Researchers affiliated with an international study have reported that oral infection with human papilloma virus (HPV) is associated with the development of head and neck cancers. The details of this study appeared in the May 10, 2007 issue of The New England Journal of Medicine. Human papilloma viruses are probably the sole cause of cancers of the cervix and have been associated with cancers of the vulva, vagina, penis and rectum. Epidemiologic and molecular biology studies have also suggested that HPV infection may be associated with cancers of the head and neck. The relationship between HPV infection and head and neck cancer was reviewed in 1998 by researchers from the University of North Carolina (see related news). They reported that the overall frequency of HPV in benign and precancerous lesions ranged from 18.5% to 35.9%, depending upon the detection methodology. Using PCR, the overall prevalence of HPV in head and neck tumors was 34.5% (416 of 1,205 tumors). Type 16 HPV, which is associated with cervical cancer, was found in 40% of cases positive for HPV. They also reported variability in other sites including 59% positivity for oral cavity cancers, 43% for the pharynx, and 33% for the larynx. The frequency of HPV positivity in oral samples from healthy individuals ranged from 1% to 60%. Furthermore, age (<60 years) and sex (male) were associated with the presence of HPV in the tumor, whereas tobacco and alcohol use were not. In the study published in 2003, [...]

5/11/2007 web-based article staff eMaxHealth.com A visit with your dental hygienist may result in more benefits than just cleaner teeth and healthier gums -- you might even decide to stop smoking, improve your nutrition or check to see if you might be at risk for diabetes. "Most people simply don't realize just how educated and skilled their dental hygienists are," said Susan McLearan, president of the California Dental Hygienists' Association (CDHA). "The profession has evolved to the point where we actually can save lives." In keeping with its mission to raise public awareness about dental health and to promote the value of seeing a dental hygienist, the association has issued the following list of the Top Ten Things Californians Should Know About Their Dental Hygienists. "The list is intended to show how dental hygienists play such an integral role in overall public health -- in many different ways and on many different levels." That role is reflected in the following facts about Registered Dental Hygienists (RDH): 1. Highly Educated Professionals -- The minimum level of education for licensure is equivalent to a four-year degree with two years specializing in dental hygiene. 2. Committed to Expanding Access to Care -- Specially licensed hygienists can go into underserved communities and provide dental hygiene services to some of the millions of Californians who would otherwise have no access to dental care. 3. Screen for Oral Cancer -- Dental hygienists possess the skills to be the first health professional to identify potential signs of [...]

5/10/2007 web-based article Salynn Boyles WebMD.com Oral Sex Is Major Risk Factor HPV, the virus that causes cervical cancer, is also linked to throat cancer, and oral sex is a major risk factor for both men and women, new research shows. Having multiple oral sex partners topped the list of practices associated with an increased risk of developing oropharyngeal cancer, according to the study published in the May 10 issue of The New England Journal of Medicine. People in the study who reported having a history of six or more oral sex partners were three times as likely to develop the cancer as people who reported that they had never had oral sex. In looking at patients with tumors that were positive for a particular strain of HPV already well-linked to cervical cancer, six or more oral sex partners increased risk for throat cancer by eightfold. And those who showed evidence of a prior oral infection with human papillomavirus (HPV) were 32 times more likely to develop the cancer. Oral sex seemed to be the main mode of transmission for oral HPV, although the researchers note that transmission from mouth to mouth contact couldn't be excluded. The new study shows that oral HPV infection is linked to head and neck cancer regardless of two other known risk factors: heavy tobacco and alcohol use. But longtime HPV researcher Maura L. Gillison, MD, PhD, of Johns Hopkins University in Baltimore, says the findings should not be seen as cause for undue alarm. [...]

5/9/2007 Hong Kong staff msnbc.com Scientists in Hong Kong and Australia will soon test an experimental treatment for nose and throat cancer — which “trains” the patient’s own white blood cells to fight the disease. The trial will begin over the next three months and blood samples will be collected from 30 nasopharyngeal (nose) cancer patients in Hong Kong, said lead researcher Daniel Chua, associate professor of clinical oncology at the University of Hong Kong. These will be flown to the Queensland Institute of Medical Research, where scientists will isolate and “train” a certain class of white blood cells, or T-cells, to fight the disease. The battle-ready T-cells will then be cultured and the whole army of cells will be re-injected back into the cancer patients. Some classes of T-cells have “memory.” Once these T-cells have been exposed to certain invaders and fought them off, they should hopefully launch the same response when they are re-introduced back into the patient’s body. “(We expect) the T-cells (to) initiate a very aggressive inflammatory reaction and during the process, not only will the T-cells attack the cancer cells, but other immune cells in the body will be called in to eradicate the cancer cells,” Chua told Reuters this week. Nasopharyngeal cancer, most prevalent in south China, kills one in every three victims and is thought to be linked to diets rich in preserved foods, like salted fish. Its link to the common Epstein-Barr virus (EBV), from the herpes family of viruses, is well [...]

5/9/2007 web-based article Stina Syrjänen, D.D.S., Ph.D. New England Journal of Medicine Volume 356:1993-1995 Each year, almost 650,000 patients worldwide receive the diagnosis of head and neck cancer and some 350,000 die from this disease.1 Nearly 90% of these cancers are squamous-cell carcinomas. The two main causative factors in approximately 80% of oral, oropharyngeal, and laryngeal carcinomas are smoking and alcohol use. Consumption of vegetables and fruit may modulate the carcinogenic effects of tobacco and alcohol, whereas low body-mass index increases the risk of oral cancer.2 The idea that human papillomavirus (HPV) plays a role in these cancers has been under investigation for at least 20 years. It is widely accepted that HPV causes cervical cancer.3 HPV has also been associated with several other types of squamous-cell carcinoma and their precursors at different sites — skin, vulva, vagina, penis, esophagus, conjunctiva, paranasal sinuses, and bronchus — but the role of HPV in the pathogenesis of the lesions is less clear than it is in cervical cancer.4 The similarity of the morphologic features of genital and oral HPV-associated lesions was one of the early findings that raised the possibility that HPV might be involved in oral and laryngeal squamous-cell carcinomas.5,6 Until recently, however, the role of HPV in the pathogenesis of head and neck squamous-cell carcinoma has been uncertain, mainly because detection of HPV DNA has been highly variable, with rates ranging from 0 to 100%.4 New data from case–control studies suggest that HPV is an independent risk factor for oral [...]

5/9/2007 Edinburgh, Scotland, UK staff Scotsman.com A new drug treatment doctors say could help save the lives of head and neck cancer patients has been given the go-ahead. Taxotere, which is used to treat sufferers of the aggressive cancer, has been recommended for use by the Scottish Medicines Consortium (SMC). Trials found that patients taking the drug along with their regular treatment had a 30 per cent lower risk of mortality than those receiving the standard treatment alone. Dr Elizabeth Junor, consultant clinical oncologist at Edinburgh's Western General Hospital, said: "Compared with some other tumours, there are fewer treatment options for head and neck cancer. "This SMC recommendation will mean that more patients can now get this new treatment combination. "We hope it will result in many more lives being saved across Scotland." Around 760 people in the UK are diagnosed with head and neck cancer each year, which can affect the mouth, tongue and throat.

5/8/2007 Kansas City, MO Mike Hendricks KansasCity.com Fighting the disease is only half the battle, Mary Casey says. That still leaves the insurance company. At least that’s how it seems to the 57-year-old Brookside woman, a part-time admissions officer at St. Teresa’s Academy. It’s bad enough Casey had the misfortune of getting cancer. Now she finds herself on the wrong end of someone’s cost-benefit analysis. “I was stunned,” she told me. “I turned to my husband and said, ‘Now what?’ ” What floored Casey was that her oncologist prescribed one of the few drugs that work on her rare form of cancer. Yet her insurance company refuses to pay for the expensive new medicine, despite studies showing the drug’s effectiveness. “You can work all your life,” Casey says, “always pay your premiums, and then be blindsided by denial of coverage when the crisis hits.” There is no news in that. Yet if we are ever to change the system, stories such as Casey’s need telling. They remind us that all too often life or death comes down to dollars and cents. In this case, pills that cost about $3,600 for a month’s supply. Casey was diagnosed with head and neck cancer in early 2005. To excise the malignant tissue, a surgeon at the KU Cancer Center removed the roof of her mouth and replaced it with a synthetic one. He prescribed a regimen of radiation treatments but warned that the cancer was likely to return somewhere else in the body. It [...]