1/13/2006 England staff EurekAlert (www.eurekalert.org) Many radiotherapy departments in UK hospitals are heavily overstretched, resulting in long waits for cancer patients which may be jeopardising treatment, says a paper in this week's BMJ. Radiotherapy treatment can be as successful at tackling some cancers as radical surgery, and often has the advantage of organ preservation. But waiting lists are severe in many radiotherapy departments, and although radiotherapy services in the UK offer high quality treatment, say the authors, they are often less able to cope with the volume of patients needing radiotherapy than other developed countries, and indeed many poorer countries. For patients with a realistic chance of beating cancer, studies show that delaying treatment hampers doctors' ability to tackle the disease, report the authors. With cervical cancer, for instance, a longer waiting time for radiotherapy reduces the chance of the patient's survival. And for head and neck cancer, patients waiting more than six weeks for post-operative radiotherapy are three times as likely to have the cancer recur. For breast cancer, patients are at a 60% increased risk of the disease returning if the delay between surgery and radiotherapy goes beyond eight weeks. Despite considerable investment in radiotherapy equipment in recent years, a shortage of specialist staff - radiographers, physicists, and dosimetrists (specialists in radiation dosage) - means that hospitals cannot cope with the rising demand for radiotherapy treatment. More training places are being created, but that does nothing to remedy current staff shortages. Many hospitals have already done all they [...]

1/11/2006 Bethesda, MD staff CancerConsultants (patient.cancerconsultants.com) In a study published in the journal Cancer, oral mucositis developed in over 80% of patients undergoing radiation therapy for head and neck cancer. Patients who developed oral mucositis were more likely to have unplanned breaks in radiation therapy and were also more likely to be hospitalized. Approximately 40,000 people in the U.S. are diagnosed with head and neck cancer every year. Cancers of the head and neck comprise several types of cancer affecting the nasal cavity, sinuses, oral cavity, nasopharynx, oropharynx, and other sites throughout the head and neck. The American Cancer Society estimates that 11,000 people will die from head and neck cancer in 2005. Oral mucositis refers to inflammation of the oral mucosa (lining of the mouth) that results from chemotherapy or radiation therapy. Symptoms may include redness, swelling, and ulceration. When oral mucositis is severe, patients cannot swallow food or liquid and often have to be given nutrients through a vein. In addition, oral mucositis can cause severe pain, increase the risk of infection, and may limit a patient’s ability to tolerate further treatment. Oral mucositis is known to be a common side-effect of radiation therapy for head and neck cancer, but relatively little is known about factors that increase or decrease the risk of developing oral mucositis. In order to explore the frequency, predictors, and consequences of oral mucositis in patients with head and neck cancer, researchers conducted a study among 450 head and neck cancer patients who had [...]

1/11/2006 London, England press release PR Newswire (www.prnewswire.com) New technological advances in diagnostic imaging have resulted in a highly sophisticated technique called fusion imaging that uses special software to combine both anatomical and functional images. This novel technique provides previously unattainable levels of precision in detecting numerous conditions such as tumours, Alzheimer's disease and neural disorders. "Hybrid imaging modalities such as positron emission tomography/computed tomography (PET/CT) and single photon emission computed tomography/CT (SPECT/CT) are revolutionising the field of diagnostic imaging," notes Technical Insights (http://technicalinsights.frost.com) Research Analyst Preethi Vaidyanathan. "Several PET/CT devices with different features have already been introduced and are available commercially." Combined PET/CT delivers better results than PET or CT, because it offers more accurate localisation of flurodeoxyglucose (FDG) uptake, distinguishes pathological from physical uptake and enables improved monitoring treatment. Other significant advantages of PET/CT imaging include better diagnostic accuracy, treatment planning and response evaluation as well as enhanced guided biopsy methods. This imaging modality is particularly useful for new indications and applications that cannot be satisfactorily performed with individual PET or CT and retrospective image alignment. Combined SPECT with high-powered CT scanners are finding application in multiple new research and clinical arenas such as in vivo small animal studies and CT angiography in the emergency department. Researchers are already investigating several new tracers specifically to target cancers of the brain, thyroid, prostate, breast, lung, ovaries, kidneys, and liver as well as diseases of the heart and bones. "By combining high-speed CT scanners with SPECT's highly accurate definition of [...]

1/11/2006 India staff MedIndia.com Oral and pharyngeal cancers are by far the leading cancers in the world today. The problem is that these are not discovered until too late and thus the treatment, which includes radiation and surgery, involves sacrificing a large amount of tissue leading to disfigurement. Now two Virginia Tech researchers are collaborating with the American Dental Association (ADA) to build "a tissue engineered composite material for oral reconstruction." Brian Love, Virginia Tech professor of materials science and engineering, and principal investigator in this project stresses that they could provide "substantially better clinical outcomes for all oral constructions could result if a more viable scaffold material were used that was capable of faster and higher quality bone formation." His team is monitoring how amorphous calcium phosphates (ACPs) can play a role in the rebuilding of the lost tissue. "By constructing tissue engineered composites containing ACPs, living osteoblasts, and donor materials," Love said. The Paffenbarger Research Center of the ADA is providing the ACP required for this study. Aaron Goldstein of Virginia Tech's chemical engineering department, Drago Skrtic of the ADA Paffenbarger Research Center and Peter Shires of Virginia-Maryland Regional College of Veterinary Medicine are collaborating with Love in this particular venture. The details of this study are appearing in the forthcoming issues of the Journal of Biomaterials Science, Polymers Edition, and the Journal of Biomedical Materials Research. Contact: Lynn Nystrom [email protected] 540-231-4371 Virginia Tech

1/11/2006 Gaylord, MI Mary Jergenson Gaylord Herald Times (www.gaylordheraldtimes.com) Having a dental exam every six months is not just a good idea, it can save your life, according the Dr. Margo Forsyth of Forsyth Family Dentistry in Gaylord. Dentists are able to diagnose more than gingivitis and tooth decay when they look into your mouth because periodontal disease may be an indicator of hormonal changes, diabetes, cardiovascular problems and even cancer. “When we see bleeding gums, we look for an underlying cause, such as a change of habits, or medications,” Forsyth explained. “A hormone change such as puberty, pregnancy or menopause can cause gums to bleed.” Conditions such as bulimia, acid reflux and meth amphetamine use cause breakdown in tooth enamel leading to tooth decay. Another leading cause of decay is regular pop consumption. “Mountain Dew is the worst, but all soft drinks can lead to tooth decay,” Forsyth said. Certain conditions such as sore throats, mononucleosis, and even HIV have certain telltale symptoms which can be discovered during an oral exam, according to Forsyth, who noted the presence of white or red spots (lesions) on the tongue, lip or gum, or a cold sore that won't heal often indicate a more serious health condition. “During a routine check-up I noticed a small white lesion on the throat of a patient who I knew to be a smoker. We immediately sent him to his doctor for a biopsy,” related Forsyth. Though, in this case the biopsy showed no sign of [...]

1/10/2006 Tasmania, Australia Linda Smith The Mercury News (www.themercury.news.com.au) A few months ago, Ron Fazackerley had a gaping hole under his chin as a result of tongue and mouth cancer. But using a new microscope -- which helps connect tiny blood vessels half a millimetre in diameter -- doctors at the Royal Hobart Hospital were able to rebuild Mr Fazackerley's face and give him a chance at a normal life. Mr Fazackerley, who is now recovering well from surgery he underwent in November, was the first elective patient to be treated using the $152,000 machine. The 57-year-old smoker was diagnosed with a large, inoperable tongue cancer in 1999 and although radiotherapy killed the cancer, complications led to part of his chin becoming dead and infected. A hole then formed in the bottom of his chin. Using skin from his leg, part of his fibula bone and some chunks of his tissue, doctors rebuilt Mr Fazackerley's face in a 10-hour operation, re-attaching the blood vessels and tissue using the delicate microscope. Associate Prof Frank Kimble, who undertook the plastic microsurgery, said without such surgery a large section of Mr Fazackerley's jawbone would have had to be cut out of his face leaving him severely deformed. The machine is also used in trauma cases to repair small vessels and nerves which wouldn't be able to be repaired with the naked eye and to move large blocks of tissue from one part of the body to another Associate Prof Kimble said the microscope, [...]

1/10/2006 New Haven, CT Paul M. Weinberger et al. Journal of Clinical Oncology, 10.1200/JCO.2004.00.3335 Purpose: We sought to determine the prevalence of biologically relevant human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OSCC). Retinoblastoma (Rb) downregulation by HPV E7 results in p16 upregulation. We hypothesized that p16 overexpression in OSCC defines HPV-induced tumors with favorable prognosis. Methods: Using real-time polymerase chain reaction for HPV16, we determined HPV16 viral load in a cohort of 79 OSCCs annotated with long-term patient follow-up. A tissue microarray including these cases was also analyzed for p53, p16, and Rb utilizing in situ quantitative protein expression analysis. Seventy-seven tumors were classified into a three-class model on the basis of p16 expression and HPV-DNA presence: class I, HPV-, p16 low; class II, HPV+, p16 low; and class III, HPV+, p16 high. Results: Sixty-one percent of OSCCs were HPV16+; HPV status alone was of no prognostic value for local recurrence and was barely significant for survival times. Overall survival was improved in class III (79%) compared with the other two classes (20% and 18%; P = .0095). Disease-free survival for the same class was 75% versus 15% and 13% (P = .0025). The 5-year local recurrence was 14% in class III versus 45% and 74% (P = .03). Only patients in class III had significantly lower p53 and Rb expression (P = .017 and .001, respectively). Multivariable survival analysis confirmed the prognostic value of the three-class model. Conclusion: Using this system for classification, we define the molecular profile [...]

1/10/2006 Tallahassee, FL Cliff Rapp, LHRM First Professionals Insurance Co. Every year, oral cancer kills more people in the United States than cervical cancer, malignant melanoma or Hodgkin’s disease. Ninety percent of all oral cancers are squamous cell carcinoma, and oral cancer has one of the lowest five-year survival rates of all major cancers. Malpractice claims alleging “failure to diagnose oral cancer” often are the most difficult to defend and are the most expensive of all dental claims. An analysis of Physician Insurer’s Association of America (PIAA) closed-claim data reveals oral cancer claims are on the rise nationwide. Indefensible cases fall into three categories: failure to follow up on a lesion with marginal clinical suspicion (most often a failure to biopsy); failure to re-examine a lesion and the patient’s medical history; and office-systems failure, allowing a patient or diagnostic reports to slip through the cracks. Dentists should view all lesions, lumps and bumps as possible cancer. Although most lesions are benign, squamous cell carcinoma often is found on the mucosa – facilitating the argument that diagnostic measures are readily available. Closely monitor patients who have suspicious lesions until a definitive diagnosis is made. Thoroughly document possible traumatic origin of a lesion. When patients explain a suspicious clinical sign or symptom, get “ proof” and consider a biopsy. Institute a fail-safe follow-up system. Refer patients to a specialist for further diagnostic workup or care, and send a consultation request to promptly facilitate the referral. Include the referral process in your follow-up [...]

1/8/2006 Annapolis, MD Wendi Winters The Capital Online (www.hometownannapolis.com) Hopping into the chair in the dentist's office might be a less-than-thrilling way to spend an afternoon, but for some it could be the difference between life and death. That message struck uncomfortably close to home for Dr. Vernon Sheen the day he found a lump inside a patient's mouth.The patient was his own 74-year-old father, Shuh-ji Sheen. Mr. Sheen had dropped by Annapolis Center for Dental Health and Wellness for a quick checkup from his son while in town on vacation. Some vacation. "The lump was bigger than a grape, and he didn't even know it was there," says Dr. Sheen in amazement. "It was something he'd gotten used to. It was a benign tumor in that soft spot right under the tongue. I sent him to an oral surgeon right away." He may have saved his dad's life. Turns out, dentists are looking for more than cavities these days when they say, "Open wide!" "Nick Petrinko, my dental hygienist, and I are so careful to look inside people's mouths, especially those of smokers or people who might drink to excess," says Dr. Sheen. He recalls another patient who, when asked to open up, exposed an inner check "so eroded it looked like a 'Blooming Onion' from the Outback Restaurant. It was a really bad case of mouth cancer. We sent him to an oncologist immediately. He'd either gotten used to it or thought it would just go away. He'd [...]

1/5/2006 Alexandria, VA RF Ozols et al. J. Clin. Oncol., January 1, 2007; 25(1): 146-62 A Message from the ASCO's President: For the second consecutive year, the American Society of Clinical Oncology (ASCO) is publishing Clinical Cancer Advances: Major Research Advances in Cancer Treatment, Prevention, and Screening, an annual review of the most significant cancer research presented or published over the past year. ASCO developed this report to demonstrate the enormous progress being made on the front lines of cancer research today. The report is intended to give all those with an interest in cancer care-the general public, cancer patients and physicians, policymakers, oncologists, and other medical professionals-an accessible summary of the year's most important cancer research advances. These pages report on new targeted therapies that are improving survival and response rates in hard-to-treat cancers such as kidney cancer, HER-2-positive breast cancer, head and neck cancer, and chronic myelogenous leukemia; the FDA's approval of the world's first preventive vaccine for human papillomavirus (HPV), which has the potential to dramatically reduce the global burden of cervical cancer; and advances in the fast-growing field of personalized medicine, including a new lung cancer test that could help physicians better target treatments and predict prognosis. These advances are only part of the landscape. Survival rates are on the rise, the number of cancer deaths in the United States began declining for the first time since 1930, and new research is showing that the rates of certain common cancers, such as those of the breast [...]