9/25/2005 Bethesda, MD press release Journal of the National Cancer Institute, Vol. 97, No. 18, 1315, September 21, 2005 A new study of French women has found that high beta-carotene intake—through a combination of diet or supplementation—is associated with a higher risk of tobacco-related cancers in smokers, but the risk of these cancers decreases with increasing beta-carotene intake in nonsmokers. The study appears in the September 21 issue of the Journal of the National Cancer Institute. Some observational studies have found that beta-carotene consumption is associated with a decreased risk of cancer. However, some intervention studies have suggested that high doses of the antioxidant, given through supplementation, may be associated with an increased risk of lung cancer and digestive cancers in smokers. To investigate the relationships of beta-carotene intake from both diet and supplementation with the risk of tobacco-related cancers—which include colorectal, thyroid, ovarian, cervical, and lung cancers in addition to less common cancers—Marie-Christine Boutron-Ruault, M.D., Ph.D., of INSERM in Villejuif, France, and colleagues used information from questionnaires given in 1994 to nearly 60,000 women from the French Etude Epidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective study. The researchers assessed diet, supplement use, and smoking status in these women and followed them for a median of 7.4 years. During the follow-up period, 700 women developed a type of cancer known to be related to smoking. Among women who never smoked, beta-carotene intake was inversely associated with the risk of developing a tobacco-related cancer, with a [...]

9/22/2005 England Rachel Stevenson The Independent (news.independent.co.uk) Imperial Tobacco, the group behind the Regal, John Player and Superkings cigarette brands, said yesterday it was entering the market for smokeless tobacco despite a ban on the product in the EU. The company has bought a 43.2 per cent stake in Skruf, a Swedish manufacturer of smokeless tobacco known as "snus". The EU banned "snus" and most other forms of smokeless tobacco in 1992, but Sweden, where the product is hugely popular, negotiated an exemption from the ban when it joined the EU in 1995. "Snus", sold in tins, is moist, loose tobacco put in small teabag-like pouches that are placed under the lip. They produce a similar experience to smoking a cigarette. The product was banned because it was deemed attractive to children, who could become easily hooked and move on to cigarettes. There is also research to suggest the product could increase the risk of oral cancer. Imperial hopes to capture some of the huge Swedish demand for "snus". While cigarette sales have been in decline there, more than 200 million tins of "snus" are sold every year and rising. Skruf's chairman and founder, Adam Gillberg, said: "With this alliance, we will get the resources and the muscles that we need to grow." The company has 1 per cent of the Swedish market. The tobacco industry claims "snus" is far less harmful than cigarettes, containing less of the carcinogenic chemicals that are in cigarettes. It also eradicates the danger of [...]

9/22/2005 Pendleton, Oregon Rukmini Callimachi The Guardian (www.guardian.co.uk) Bryan Richardson hadn't learned algebra when he straddled his first bull at age 13. By then, he'd already been chewing tobacco for four years, starting when he was 9. The two habits - chewing and riding bulls - have long been partners on the professional rodeo circuit. But this past week, one of the nation's oldest rodeos took its best shot at that marriage. Tobacco companies were prevented from giving out free samples of snuff at the Pendleton Round-Up, where for 95 years cowboys have come to test their mettle. Now 24, Richardson goes through one tin of Copenhagen a day, relying on its familiar rush to get through each violent ride, as he did this weekend when he mounted Poison and rode the snorting brahma bull to first place. His prize included a hand-hewn saddle, a pair of trophy spurs, a fancy cowboy hat - but no free snuff, a staple that men on the rodeo circuit have come to depend on. “At $10 a can, that's $10 bucks a day and $70 bucks a week. You do the math. It's expensive,” said Richardson of Dallas, Texas. “It's just about so expensive I was thinkin' of quittin' this week, now that they're not giving us any for free.” “It should be free,” lamented Zack Oakes, a 22-year-old bull rider from Meade, Wash., who said he, too, started chewing when he was 9. “It's dang sure nice for them to help us [...]

9/21/2005 Susan T. Mayne, Scott M. Lippman Journal of the National Cancer Institute, Vol. 97, No. 18, 1319-1321, September 21, 2005 A growing body of literature indicates that chemopreventive agents may have very different effects in populations that differ by lifestyle or host factors. One such factor of paramount importance is smoking status, which has been shown to predict the effects of micronutrients such as beta-carotene or related compounds in smoking-related cancer prevention trials. Some nutrients that appear to reduce the risk of cancer in nonsmokers may actually increase the risk of cancer in smokers, whereas other preventive nutrients may work better in smokers than nonsmokers. Two landmark trials, the Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study and Carotene and Retinol Efficacy Trial (CARET), first revealed an important impact of smoking status on chemoprevention. The ATBC trial was a randomized 2 x 2 factorial prevention trial of daily -tocopherol and/or beta-carotene in more than 29 000 male smokers from Finland (1). Unexpectedly, the men who were randomly assigned to receive supplemental beta-carotene had a statistically significantly higher lung cancer risk than did men who did not receive beta-carotene. This harmful effect occurred in men who smoked 20 cigarettes or more per day but not in men who smoked less (all ATBC participants were smokers). Therefore, the ATBC suggested that smoking intensity modified the cancer preventive effect of a nutrient. Subsequently, the CARET of beta-carotene combined with retinol to prevent lung cancer in men and women smokers and/or asbestos workers found that [...]

9/20/2005 Boston, MA Lori J. Wirth et al. Journal of Clinical Oncology, 10.1200/JCO.2005.02.4182 Purpose: Effective and tolerable palliative treatments are needed for patients with incurable squamous cell carcinoma of the head and neck (SCCHN). Single-agent targeted therapies have limited activity in this setting. The feasibility of adding celecoxib to gefitinib for the treatment of incurable SCCHN is unknown. Patients and Methods: Nineteen patients with unresectable recurrent locoregional and/or distant metastatic SCCHN with progressive disease after at least one prior chemotherapy or chemoradiotherapy regimen were enrolled onto this single-institution phase I study. Three dose levels were explored: (1) celecoxib 200 mg twice daily plus gefitinib 250 mg daily; (2) celecoxib 400 mg twice daily plus gefitinib 250 mg daily; and (3) celecoxib 400 mg twice daily plus gefitinib 500 mg daily. Results: No dose-limiting toxicities were encountered at any dose level. The most common toxicities were acneiform rash, diarrhea, hand reaction, dyspepsia, and anemia. Four of 18 patients assessable for response (22%; 95% CI, 2% to 42%) achieved a confirmed partial response. Conclusion: The combination of gefitinib 500 mg daily plus celecoxib 400 mg twice daily is well-tolerated. The encouraging responses seen in this early study suggest further evaluation of epidermal growth factor receptor and cyclooxygenase-2 inhibitors in SCCHN is warranted. Authors: Lori J. Wirth, Robert I. Haddad, Neal I. Lindeman, Xiaojun Zhao, Jeffrey C. Lee, Victoria A. Joshi, Charles M. Norris Jr, and Marshall R. Posner Authors' affiliations: Department of Adult Oncology, Dana-Farber Cancer Institute; the Department of Medicine, Pathology, [...]

9/20/2005 New York, NY staff Cancerpage.com Antioxidant vitamins may reduce the severity of adverse effects of radiation therapy but may increase the risk of recurrence of the underlying tumor, according to a report by Canadian researchers. Although many patients take vitamin and mineral supplements in the hope of improving cancer treatment outcomes, the authors point out, few studies have examined the efficacy and safety of adjuvant antioxidant vitamin supplementation in this setting. Dr. Isabelle Bairati from Laval University Cancer Research Center, Quebec City and colleagues examined whether daily supplementation with alpha-tocopherol and beta-carotene could reduce the rate and severity of acute adverse effects of radiation therapy in 540 patients with head and neck cancer. Severe acute adverse effects during radiation therapy occurred in fewer patients in the supplement group (19.2%) than in the control group (24.8%), the authors report in the August 20th issue of the Journal of Clinical Oncology. There was a tendency for less severe adverse effects during radiation therapy at any site and overall among those receiving antioxidants, the results indicate. Combined treatment with alpha-tocopherol and beta-carotene was associated with a significant 62% reduction in adverse effects overall and a similar reduction among patients with cancer of the larynx. However, local recurrence of tumor was 37% more likely among patients in the supplementation group, the investigators report, and was somewhat higher among patients treated with both antioxidants. In light of these findings, the researchers observe that "randomized controlled trials should be conducted to provide clear scientific evidence [...]

9/19/2005 Mi Sun Choe et al. Mol Cancer Ther. 2005;4:1448-1455 Head and neck squamous cell carcinoma is a well-known model for chemoprevention studies because of its field cancerization effect, its multistep carcinogenesis process, and the easy accessibility of biopsies to target lesions. With new understandings of head and neck carcinogenesis and the development of molecular targeted therapy, chemoprevention trials for head and neck squamous cell carcinoma have been rapidly updated. Cyclooxygenase-2 (COX-2) and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors are gaining significant attention as potential chemopreventive agents. Both COX-2 and EGFR are involved in head and neck carcinogenesis. Targeting COX-2 and EGFR separately has shown promising antitumor activity. Recently, combinations of COX-2 and EGFR tyrosine kinase inhibitors have been reported to show synergistic/additive effects in preclinical studies. Because COX-2 and EGFR tyrosine kinase inhibitors are toxic as single agents in clinical trials, the combination of COX-2 and EGFR tyrosine kinase inhibitors used at lower doses seems more promising than monotherapy with either as a novel strategy in head and neck cancer chemoprevention. Authors: Mi Sun Choe1, Xin Zhang1, Hyung Ju C. Shin2, Dong M. Shin1 and Zhuo (Georgia) Chen1 Authors' affilitions: 1 Department of Hematology/Oncology, Winship Cancer Institute, Emory University and 2 Quest Diagnostics, Atlanta, Georgia

9/19/2005 Akihiro Terada et al. Head Neck, September 9, 2005 Background: The sentinel node concept has become one of the most interesting topics in the treatment of head and neck cancer. The aim of this article is to report the results of our feasibility study and clinical application of sentinel lymph node (SLN) radiolocalization and biopsy in patients with clinically negative neck oral cancer. Methods: Individuals with previously untreated N0 oral cancer participated in the study. The radioactive tracer used was 99m Tc phytate. Lymphoscintigrams were taken in the feasibility study, and fusion images of SPECT and CT were obtained in the clinical SLN biopsy (SLNB) group. In the feasibility study, metastases to SLNs and other nodes were analyzed in permanent specimens. In the clinical application group, we investigated the comparative effectiveness of multi-slice frozen section analysis and imprint cytology for the intraoperative diagnosis of SLNB. Results: Fifteen individuals participated in the feasibility study. Six SLNs in five patients were cancer-positive, and two thirds of the SLNs were micrometastases. The SLN concept was established, and SLNs with the highest to the third highest radioactivity reflected the patients' neck status accurately. Twelve patients participated in the clinical application group of SLNB. Intraoperative diagnosis of the three hottest SLNs correctly predicted the neck status of 10 patients. Three patients underwent modified radical neck dissection on the basis of the intraoperative diagnosis of cancer metastasis to SLNs, whereas neck dissections were spared in patients with no evidence of such metastases. There were two [...]

9/18/2005 Australia staff World News Australia (www9.sbs.com.au) Nearly all of Sydney's south Asian grocery stores are selling deadly chewing tobacco, despite an Australia-wide ban on the substance. A new study published in the Medical Journal of Australia has found 94 per cent of Indian, Sri Lankan, Pakistani, Bangladeshi and Fijian grocery shops sell products containing the tobacco. A plug of the product held in the mouth for 30 minutes delivers as much nicotine as up to four cigarettes and has been linked to oral cancer. Researchers from the University of Sydney, who surveyed 53 Asian mixed businesses in suburbs with large south Asian populations, discovered 50 of the businesses sell the dangerous smokeless tobacco. The study's co-author, Professor Simon Chapman, says of those, 31 kept it under the counter, 14 on display behind the counter and five on shelves accessible by customers. "I think the fact that they didn't have the products on open display, but if you asked for it, it was pulled out from under the counter, suggests they're aware they're not supposed to be selling it. "These products are very carcinogenic - rapid cancer can be caused in as little as seven years. "Mouth and throat and tongue cancer are a very, very disfiguring and fatal form of cancer and totally preventable if people don't use these sort of products." The manufacture and commercial supply of smokeless tobacco is banned in Australia but individuals can import up to 1.5 kilograms at a time of it for personal [...]

9/15/2005 New York, NY Gabriella M. D'Andrea, MD CA Cancer J Clin 2005; 55:319-321 The term "complementary and alternative methods" (CAM) refers to products and regimens that individuals may employ either to enhance wellness, relieve symptoms of disease and side effects of conventional treatments, or cure disease. CAM articles provide evidence-based information on promising complementary and alternative methods, and inform clinicians of methods that may harm patients. Many patients being treated for cancer use dietary supplements, particularly antioxidants, in the hope of reducing the toxicity of chemotherapy and radiotherapy. Some researchers have claimed, furthermore, that antioxidants also increase the effectiveness of cytotoxic therapy and have explicitly recommended their use. However, mechanistic considerations suggest that antioxidants might reduce the effects of conventional cytotoxic therapies. Preclinical data are currently inconclusive and a limited number of clinical studies have not found any benefit. Clinicians should advise their patients against the use of antioxidant dietary supplements during chemotherapy or radiotherapy. Such caution should be seen as the standard approach for any unproven agent that may be harmful. Author's affiliation: Assistant Clinical Member, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY