2/12/2007 California, USA Daniel Borenstein ContraCosta Times (www.contracostatimes.com) (Note: this is the third of a four part series) Setting the boundaries for the next phase of my cancer therapy was all about balancing long-term risk -- weighing the chances of the disease recurring against the permanent side effects of extra radiation. No matter which way I went, there was no certainty. The data were sketchy and the doctors disagreed on the best option. They had one consistent message: I needed to pick my path. As one doctor put it: "Ultimately, you have to decide. You have to do what feels most comfortable to you." I didn't think I would ever feel comfortable with the decision. I felt totally unqualified to make it. For guidance, I visited physicians in the East Bay, as well as the UC San Francisco medical school and the Dana-Farber Cancer Institute in Boston. The East Coast doctors endorsed the cutting-edge chemotherapy I had received. That was something I needed to hear after a UCSF doctor suggested it had been a waste of time. It enabled me to put that issue behind me and move on to the big decision: Whether to irradiate one or both sides of my head and neck, and whether to include the nasal passages above my palate. I had what was broadly called head-and-neck cancer, usually found in smokers or heavy drinkers. I was never much of a drinker, and none of the doctors thought that my teenage smoking for less than [...]

2/12/2007 California, USA Daniel Borenstein ContraCosta Times (www.contracostatimes.com) (Note: This is the second of a four part series.) When I began my cancer therapy, I didn't understand the differences among the doctors who would be caring for me. I didn't appreciate that when a patient receives cutting-edge treatment, he must be ready for changes in plans along the way. And I didn't understand that, in the end, I was going to have to make the tough decisions even though I started my treatment without a basic understanding of cancer treatments. I quickly learned that a "primary" is the site where the cancer originates, and that cancer can migrate, or "metastasize," to other parts of the body. In my case, the "metastasis," the site of the migration, was obvious. There was a bulge, a cyst, on the right side of my neck. But the microscopic primary was never located. The doctors didn't know where my cancer began. As a result, they disagreed on my treatment. My wife was a doctor who could explain the medicine to me in simple terms. And my oncologist, Randy Oyer, was a good friend who wasn't put off by my flurry of inquisitive e-mails. Randy planned to hit me with a heavy dose of chemotherapy and then follow with radiation to mop up bad cells in key areas of my mouth and neck. The regimen of starting with three potent chemo drugs for head-and-neck cancers like mine was new. It had been tried only for a [...]

2/12/2007 California, USA Daniel Borenstein Contra Costa Times (www.contracostatimes.com) This is the first of a four part series. "I think you are cured," my oncologist told me April 24. It was just about a year after I had been diagnosed with cancer. I had endured chemotherapy and radiation treatment. I had traveled across the country for expert opinions to ensure I was making the right treatment decisions. I had nearly died and was hospitalized for 12 days when things went awry. But I had made it through. This story has a happy ending. I'm going to live. As I've come to fully appreciate, we all have to go someday. But the cancer probably won't kill me. I was lucky. I had a type of cancer that could be cured with intense doses of chemotherapy and radiation. I had health insurance to pay hundreds of thousands of dollars of medical bills. I was married to a doctor who could educate me and assist me in making critical decisions. And I was personal friends with one of my oncologists, who was willing to use the latest treatments. Nevertheless, it was a terrifying journey. I've never been so sick, so weak or so scared. I've never had to make so many difficult decisions. I'm hardly alone. This year, an estimated 1.4 million new cancer cases will be diagnosed in this country, according to the American Cancer Society. The five-year survival rate for all cancers diagnosed from 1996 to 2002 was 66 percent. Many [...]

2/10/2007 Washington, D.C. Aaron Lorenzo BioWorld News (www.bioworld.com) The National Cancer Institute faces a funding cut in the coming fiscal year, per President Bush's proposed budget, and oncology drug developers are in for a pinch. Cancer study cooperative groups, which include researchers, cancer centers and community doctors who evaluate investigational and approved therapies, are expected to pare back their work significantly. The Coalition of Cancer Cooperative Groups, comprised of the 10 U.S. groups whose research is sponsored by the NCI, says up to 95 of their trials may have to be closed or delayed this year. That's nearly half of the studies they conduct annually, and such cuts would affect up to 3,000 patients. That's a sizable chunk of the 20,000 enrolled in their trials each year for access to investigational drugs, newer frontline treatment modalities and quality care. Such reductions, said Richard Schilsky, chairman of a study cooperative called Cancer and Leukemia Group B, "can trickle down" to biotech companies "in a fairly negative way." Because these groups enroll nearly half the patients in the U.S. who participate in cancer trials, there will be a direct impact on drug development firms. That's especially true of smaller firms with limited finances that make their investigational products available to the NCI for use in cooperative group testing. "Oftentimes these are Phase II, but also occasionally even Phase III studies," he told BioWorld Today, though he noted that Phase II trials are most likely to absorb the cuts. That translates to less [...]

2/9/2007 web-based article Tyler Hamilton Technology Review (www.technologyreview.com) A paper-thin, biodegradable implant is proving an effective way to attack cancer cells without punishing the body with chemotherapy. The implant is a clear, flexible film that can be designed in any shape or size. A key ingredient in the film is chitosan, which is derived from a natural material extracted from algae and the exoskeletons of shellfish. Researchers at the University of Toronto have developed a way to dissolve a high concentration of various cancer-fighting drugs within the film, which is then applied directly to a site where a tumor has been removed. The drugs, which are loaded into polylactide nanoparticles, are control-released over several weeks as the implant breaks down in the body. "The formulation appears to be quite flexible," says Micheline Piquette-Miller, an assistant professor of pharmaceutical sciences at the university and codeveloper of the drug-delivery system. "We can incorporate very diverse types of chemicals into it, and that's what a lot of other systems have had trouble with." Piquette-Miller and her team are currently focusing their research on ovarian cancer, which has a high relapse rate and typically requires several rounds of chemotherapy following tumor removal. Cancer drugs administered orally or intravenously often don't reach the right organ or region of the body in strong enough doses. By applying a high concentration of cancer-fighting agents directly to a tumor site, the drugs are more likely to kill the target cells. "We're also working on an injectable formulation," says [...]

2/8/2007 Hampton Roads, VA staff DailyPress.com Here's what the Surgeon General said about smokeless tobacco: "The oral use of smokeless tobacco represents a significant health risk. It is not a safe substitute for smoking cigarettes. It can cause cancer and a number of noncancerous oral conditions and can lead to nicotine addiction and dependence." Here's what the National Cancer Institute says about smokeless tobacco: "Smokeless tobacco can cause permanent gum recession, mouth sores, precancerous lesions in the mouth, and cancers of the mouth and throat. ... Oral cancer ... is one of the most difficult cancers to treat. It can spread to other parts of the body quickly. Surgery needed to treat oral cancer is often extensive and disfiguring. On average, only half of those with the disease will survive more than five years." Here's what Philip Morris says about smokeless tobacco: "Smokeless tobacco products are addictive, cause serious diseases such as cancer, cardiovascular disease and other diseases of the mouth, gums, teeth; may increase the risk of serious diseases when used in combination with smoking; cause adverse reproductive effects and should not be used during pregnancy; and are not a safe alternative to smoking." Here's what Gov. Tim Kaine and the York County Board of Supervisors say about smokeless tobacco: Let's give Philip Morris hundreds of thousands of taxpayers' dollars to make the stuff. In fact, Walter Zaremba, chairman of the county board, is quoted in the governor's press release as saying this of Philip Morris: "They have been [...]

2/7/2007 web-based article staff Science Daily (www.sciencedaily.com) A tattoo can be more than just a fashion statement -- it has potential medical value, according to an article published in the online open access journal, Genetic Vaccines and Therapy. Martin Müller and his team at the Deutsches Krebsforschungszentrum (German Cancer Research Center), Heidelberg, Germany, have shown that tattooing is a more effective way of delivering DNA vaccines than intramuscular injection. Using a coat protein from the human papillomavirus (HPV, the cause of cervical cancer) as a model DNA vaccine antigen, they compared delivery by tattooing the skin of mice with standard intramuscular injection with, and without, the molecular adjuvants that are often given to boost immune response. The tattoo method gave a stronger humoral (antibody) response and cellular response than intramuscular injection, even when adjuvants were included in the latter. Three doses of DNA vaccine given by tattooing produced at least 16 times higher antibody levels than three intramuscular injections with adjuvant. The adjuvants enhanced the effect of intramuscular injection, but not of tattooing. Tattooing is an invasive procedure done with a solid vibrating needle, causing a wound and sufficient inflammation to 'prime' the immune system. It also covers a bigger area of the skin than an injection, so the DNA vaccine can enter more cells. These effects may account for the stronger immune response arising from introducing a DNA vaccine into the body by tattooing. Of course, the tattooing approach may not be to everyone's taste -- as it is [...]

2/7/2007 Hickory, NC staff www.hulliq.com A new computer-based technique could eliminate hours of manual adjustment associated with a popular cancer treatment. In a paper published in the Feb. 7 issue of Physics in Medicine and Biology, researchers from Rensselaer Polytechnic Institute and Memorial Sloan-Kettering Cancer Center describe an approach that has the potential to automatically determine acceptable radiation plans in a matter of minutes, without compromising the quality of treatment. "Intensity Modulated Radiation Therapy (IMRT) has exploded in popularity, but the technique can require hours of manual tuning to determine an effective radiation treatment for a given patient," said Richard Radke, assistant professor of electrical, computer, and systems engineering at Rensselaer. Radke is leading a team of engineers and medical physicists to develop a "machine learning" algorithm that could cut hours from the process. A subfield of artificial intelligence, machine learning is based on the development of algorithms that allow computers to learn relationships in large datasets from examples. Radke and his coworkers have tested their algorithm on 10 prostate cancer patients at Memorial Sloan-Kettering. They found that for 70 percent of the cases, the algorithm automatically determined an appropriate radiation therapy plan in about 10 minutes. "The main goal of radiation therapy is to irradiate a tumor with a very high dose, while avoiding all of the healthy organs," Radke said. He described early versions of radiation therapy as a "fire hose" approach, applying a uniform stream of particles to overwhelm cancer cells with radiation. IMRT adds nuance and [...]

2/7/2007 Wilmington, DE Kelly Bothum DelawareOnline (www.delawareonline.com) To the untrained eye, the image on Denise Mahoney's computer screen might look like a geometry problem gone awry. It's a CT scan of a patient with cancer in his head and neck. More than a dozen lines of different colors crisscross the screen. The intersection of these lines cuts the skull into geometric shapes of varying sizes and angles. But to Mahoney's skilled eyes, the picture makes plenty of sense. Each line represents a radiation beam. When administered to the patient over a series of treatments, these beams will attack the tumors in the patient's head and neck while sparing sensitive areas like the eyes and mouth glands. For a dosimetrist like Mahoney, whose job is to figure out the best way to administer radiation treatments to a cancer patient, there's a delicate dance between killing cancer cells and protecting nearby organs and tissues. Because of the expertise of a dosimetrist, patients can fight their cancer while preserving as much quality of life as possible. In the multidisciplinary world of cancer care, dosimetrists play crucial roles on oncology teams. Their job is like that of a radiation pharmacist. Relying on a prescription from a radiation oncologist, dosimetrists develop an individual plan of radiation treatment for a cancer patient. They use special software as well as MRI, CT and PET scans to map out specially measured radiation doses. Unlike oncologists, who care for patients, or radiation therapists, who administer treatment over many days, [...]

2/5/2007 London, England K A A S Warnakulasuriya and R Ralhan J Oral Pathol Med, February 1, 2007; 36(2): 63-77 While carcinogenicity of smokeless tobacco (ST) to humans is well established the oral lesions that precede development of cancer are less well characterized. The clinical appearances of ST-associated lesions are variable. Epidemiological studies show a strong significant association of risk with chronic daily use but population differences are noted because of various commercial products in use. Morphological features observed are some what different to oral lesions caused by smoking and oral dysplasia in ST-associated lesions is less common. Effects of ST on oral keratinocytes observed in vitro include alterations in cell proliferation, apoptosis and activation of inflammatory markers. Genetic aberrations caused by ST include activation of ras, uncommon in smokers but mutational hot spots in p53 encountered are similar to those in smokers. Authors' affiliation: Department of Oral Medicine and Pathology, WHO Collaborating Centre for Oral Cancer and Precancer, King's College Dental Institute at Guy's, King's and St Thomas? Hospitals, King's College London, London, UK