2/8/2006 New York, NY staff Forbes.com Adding the drug cetuximab to radiation therapy for head and neck cancer can boost patient survival rates by about 20 months without significantly increasing side effects, researchers report. Average overall survival for head and neck cancer patients was more than four years for patients treated with both radiation and the monoclonal antibody drug cetuximab (brand name Erbitux). That's a major improvement over the average 2.5 year survival seen in patients treated with radiation alone, according to the authors of the multi-national study. "This is the first targeted antibody therapy that showed a survival advantage. In this particular study, we're seeing the benefit of adding a targeted therapy to conventional therapy and not increasing toxicity," said the study's lead author, Dr. James Bonner, the head of radiation oncology at the University of Alabama in Birmingham. His team reported their findings in the Feb. 9 issue of the New England Journal of Medicine. Each year, approximately 39,000 Americans are diagnosed with head and neck cancers, according to the National Cancer Institute (NCI). These cancers include those of the tongue, the rest of the mouth, the salivary glands and inside the throat, the voice box and the lymph nodes in the upper neck. The malignancies are most common in people over 50 and tobacco users -- both smokers and those who use smokeless tobacco products. The NCI estimates that about 85 percent of head and neck cancers are tobacco-related. When surgery to remove the entire tumor isn't [...]

2/8/2006 Pittsburg, PA Amy Dockser Marcus Pittsburg Post-Gazette.com A series of clinical trials are opening this year to explore a newly discovered window of time when cancer treatments may work more effectively. While newer drugs along with chemotherapy and radiation have improved cancer survival rates in recent decades, doctors have long debated why the treatments don't work even better. Even the latest generation of medications -- so-called "smart drugs" that target a tumor or its blood supply -- often prolong life by only a few months. Now cancer researchers are investigating the idea that there is a narrow period -- following treatment with certain smart drugs -- when changes in the body allow chemotherapy or radiation to be particularly effective. If oncologists can identify and exploit this window, it could lead to improved survival rates. And because the window involves changes in blood vessels, the effort could have implications for other diseases affected by blood vessels, such as macular degeneration and heart disease. At research facilities around the country, including Dana-Farber Cancer Institute and Massachusetts General Hospital, researchers are recruiting patients with ovarian cancer, head-and-neck cancers, brain cancer and sarcoma to participate in several small trials that will explore this window. Studies will use investigational drugs from Novartis AG and AstraZeneca PLC, as well as existing smart drugs like Genentech Inc.'s Avastin, and Nexavar from Bayer Pharmaceuticals Corp. and Onyx Pharmaceuticals Inc. Some funding and drugs are being provided by the National Cancer Institute. The researchers will closely monitor the [...]

2/7/2006 Chicago, IL Shaohua Hu et al. J Am Dent Assoc, Vol 137, No 2, 170-179 Background: A U.S. Public Health Service–sponsored clinical practice guideline urges all health care providers to make tobacco-use cessation counseling a routine part of clinical practice. This study assessed practices of dentists in east Texas, their adherence to the guideline and barriers to adherence. Methods: A cross-sectional survey mailed September 2003 through January 2004 assessed demographic characteristics and knowledge, attitudes and activities of 783 dentists. The survey focused on familiarity with the guideline, adherence to the recommended steps (including the "5 A’s" for tobacco users willing to quit and the "5 R’s" for tobacco users unwilling to quit), perceived barriers and time spent counseling. Results: Most dentists were unfamiliar with the guideline and usually did not follow its recommended steps. Less than 20 percent of dentists spent three or more minutes per patient on counseling. Knowledge of and training in using the guideline were significantly associated with adherence and time spent counseling. Lack of training was cited as the greatest barrier. Conclusions: Most dentists in east Texas are unaware of the clinical practice guideline. Lack of training is a major barrier to adherence. Practice Implications: Opportunities for improving patients’ health through brief counseling interventions are missed. Measures are needed to increase dentists’ familiarity with and adherence to the guideline. Authors: Shaohua Hu, MD, DrPH, Unto Pallonen, PhD, Alfred L. McAlister, PhD, Brian Howard, MPH, Robert Kaminski, DDS, MS, EdD, Gene Stevenson, DDS, MS and Thomas [...]

2/7/2006 Douglas E. Morse, DDS, PhD & A. Ross Kerr, DD, MSD J Am Dent Assoc, Vol 137, No 2, 203-212 Background: The authors present statistics and long-term trends in oral and pharyngeal cancer (OPC) incidence, mortality and survival among U.S. blacks and whites. Methods: The authors obtained incidence, mortality and five-year relative survival rates via the Surveillance, Epidemiology and End Results (SEER) Program Web site. Current rates and time trends for 1975 through 2002 are presented. Results: From 1975 through 2002, age-adjusted incidence rates (AAIRs) and mortality rates (AAMRs) were higher among males than among females and highest for black males. By the mid-1980s, incidence and mortality rates were declining for black and white males and females; however, disparities persisted. During the period 1998–2002, AAIRs were more than 20 percent higher for black males compared with white males, while the difference in rates for black and white females was small. AAMRs were 82 percent higher for black males compared with white males, but rates were similar for black and white females. Five-year relative survival rates for patients diagnosed during the period 1995–2001 were higher for whites than for blacks and lowest for black males. Conclusions: Despite recent declines in OPC incidence and mortality rates, disparities persist. Disparities in survival also exist. Black males bear the brunt of these disparities. Practice Implications: Dentists can aid in reducing OPC incidence and mortality by assisting patients in the prevention and cessation of tobacco use and alcohol abuse. Five-year relative survival may be [...]

2/7/2006 New York, NY Gina Kolata New York Times (nytimes.com) The largest study ever to ask whether a low-fat diet keeps women from getting cancer or heart disease has found that the diet had no effect. The $415 million federal study involved nearly 49,000 women aged 50 to 79 who were followed for eight years. In the end, those assigned to a low-fat diet had the same rates of breast cancer, colon cancer heart attack and stroke as those who ate whatever they pleased, researchers are reporting today. "These are three totally negative studies," said Dr. David Freedman, a statistician at the University of California at Berkeley, who is not connected with the study but has written books on clinical trial design and analysis. And, he said, the results should be taken seriously for what they are — a rigorous attempt that failed to confirm a popular hypothesis that a low-fat diet can prevent three major diseases in women. And the studies were so large and so expensive that they are "the Rolls Royce of studies," said Dr. Michael Thun, who directs epidemiological research for the American Cancer Society. As such, he said, they are likely to be the final word. "We usually have only one shot at a very large scale trial on a particular issue," Dr. Thun said. The studies were part of the Women's Health Initiative of the National Institutes of Health, the same program that showed that hormone therapy after menopause can have more risks than [...]

2/7/2006 San Francisco, CA Steven A. Schroeder, MD J Am Dent Assoc, Vol 137, No 2, 144-148 Even though all health professionals understand how injurious smoking is, many may wonder whether the tobacco epidemic is yesterday’s news. After all, adult smoking prevalence is now at an all-time low in the United States—23.4 percent among men, compared with 57 percent in 1955, and 18.5 percent among women, compared with 34 percent in 1965.1,2 Smoking among youths is at a 28-year low. In public health terms, these are spectacular improvements. Furthermore, there is widespread speculation that obesity and physical inactivity soon may overtake tobacco as the most preventable causes of death and disability.3 But, as three articles in this issue of The Journal demonstrate, it is premature to drink a toast to tobacco’s demise, and there is good reason to believe that dentists can do more to reduce the toll from this deadly habit. Dye and colleagues4 analyze the data set for the Third National Health and Nutrition Examination Survey (conducted from 1988–1994) to assess the relationship between cigarette smoking and perceived needs for dental treatment. Compared with nonsmokers, smokers felt they needed more dental care, even when controlling for oral health status (odds ratio = 1.40), though the magnitude of this difference is much smaller than the fourfold risk smokers face of developing periodontal disease. Dye and colleagues call for greater involvement by dentists and dental hygienists in helping smokers quit, while acknowledging the barriers that must be overcome if that [...]

2/4/2006 Boston, MA press release Life Science News (news.biocompare.com) New data shows that proanthocyanidins, or PACs, found in cranberries inhibit the growth of lung tumors and colon and leukemia cells in vitro. That's according to a new study published in this month's issue of The Journal of the Science of Food and Agriculture. The study, led by University of Massachusetts Dartmouth researcher Catherine C. Neto, Ph.D., is one of the first studies to find that the cranberry's anti-cancer activity may come from the unique structure of its PACs. Cranberry's PACs contain a unique A-type structure, while most other fruit contains only the more-common B-type PACs. Researchers prepared PAC-rich fractions from whole cranberry extract and worked with scientists at the University of Wisconsin to characterize their structures. They tested the fractions against eight tumor cell lines and screened for the effect on tumor growth. The fractions inhibited the proliferation of the tumor cell lines without inhibiting the growth of normal embryonic mouse cells. "While previous studies have shown that cranberry extracts inhibit the proliferation of cancer cells, this is the first study to confirm that it's the cranberry PACs that are the active components," said Catherine C. Neto, Ph.D., Associate Professor, Department of Chemistry and Biochemistry at the University of Massachusetts Dartmouth. "This study is a significant step toward helping to establish a body of research that shows cranberry PACs may also work to prevent tumor cell growth in vivo." Cranberry's PACs have a unique "anti-adhesion" mechanism known to protect the [...]

2/4/2006 Kingsport,, NC staff Kingsport Times News (www.timesnews.net) Patients undergoing radiation treatment for cancer of the lung, head or neck often suffer severe weight loss - so much so that doctors sometimes have to suspend the potentially lifesaving therapy. New research conducted at Holston Valley Medical Center, however, has found that a drug originally used to treat breast cancer helps combat weight loss among patients receiving radiation treatment for lung and head and neck cancer. Dr. Byron May, a board-certified radiation oncologist at HVMC, is one of 12 researchers at five Southeast cancer centers who recently investigated the effectiveness of the drug megestrol acetate as an appetite stimulant for cancer patients. The results of the clinical trial were presented at a meeting of the American Society for Therapeutic Radiology and Oncology. "The average patient with head and neck cancer who has radiation and chemotherapy suffers moderate to severe problems two to three weeks into treatment," May said. "Treatment generally lasts two to three months. During the treatment, many patients lose 5 to 10 percent of their body weight, which is nutritionally horrible. "We've found that megestrol acetate stimulates appetite. It doesn't work for everyone, but it works for enough people to be valuable. It lets people go on with their radiation with no breaks, and it offers a better quality of life while people are receiving their treatments." People who receive radiation treatments for lung cancer and cancers of the head and neck often have difficulty swallowing and must take [...]

2/4/2006 New York, NY Anne Harding Reuters UK (today.reuters.co.uk) Children who survive cancer face a four-fold increased risk of developing cancers as adults, and these malignancies appear at an earlier-than-normal age, a new study shows. But careful screening -- as well as awareness of potential early symptoms -- can help ensure that disease is caught early, when it's much easier to treat, Dr. Nina S. Kadan-Lottick told Reuters Health in an interview. "Most of these subsequent cancers are amenable to screening and intervention, so knowledge is power," said Kadan-Lottick, of Yale University School of Medicine in New Haven, Connecticut. She and her colleagues report on follow-up of 13,136 people who had survived for at least five years after being diagnosed with a childhood cancer between 1970 and 1986. Seventy-one patients developed a subsequent cancer, at an average age of 27. Kadan-Lottick stressed that while childhood cancer survivors do face increased cancer risk, "the vast majority of survivors do very well and will never have one of these outcomes." Patients with neuroblastoma were 24 times more likely to develop a second cancer, and had a more than 300-fold increased risk of kidney cancer. Hodgkin's lymphoma survivors were at more than four-fold increased risk of gastrointestinal cancer. Survivors of soft tissue sarcoma, neuroblastoma or leukemia were all at about a 20-fold increased risk of head and neck cancer. Two-thirds of patients who developed a second cancer had previously received radiation therapy to that part of the body, a known cancer risk. However, [...]

2/3/2006 Iwoa City, IA staff Doctor's Guide (www.docguide.com) A limitation of current cancer care is the difficulty of quickly assessing how well a therapy is working. However, expanding the use of existing positron emission tomography (PET) technology can provide early and accurate assessment of a tumor's response to a particular therapy allowing physicians to better tailor a patient's treatment, according to Malik Juweid, MD, associate professor of radiology at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. Writing in the Feb. 2 issue of the New England Journal of Medicine, Juweid and co-author Bruce Cheson, MD, of the Lombardi Comprehensive Cancer Center at Georgetown University Hospital, outline the advantages and limitations of PET imaging in assessing cancer therapy and suggest that increasing the role of PET imaging has the potential to further improve cancer care management. PET is a non-invasive imaging technique that uses radioactivity emitted from injected tracer chemicals to measure and image biological activity. The most commonly used PET radiotracer is fluorodeoxyglucose (FDG), a radiolabeled form of glucose, which is consumed more avidly by tumors than by normal tissue. In fact, Dr. Juweid's work already has led to changes in how PET is used in cancer care. In a study published in the Journal of Clinical Oncology in July 2005, Dr. Juweid and colleagues showed that adding FDG-PET to the standard computer tomography (CT)-based assessment criteria made the predictions of treatment outcome much more accurate for aggressive non-Hodgkin's lymphoma. Based on this study, [...]