7/26/2005 Patti DeGrangi, RDH, BS RDH September 2005 Humble beginnings often wind their way down unexpected paths toward unthink-able destinations. Ribbons we wear, rib-bons on our cars, and wristbands have become not only methods to bring aware-ness of various cancers and causes; they have become a fad of nearly epic proportions. Discovering the history of the ribbon craze is tricky, with different groups and individuals taking credit. Some give credit to the black armbands worn in Victorian times or the yellow ribbons from the Tony Orlando song. But whatever the origination, these symbols can bring attention, understanding, and most importantly, funding to organizations and individuals struggling with disease. For several years, oral cancer awareness and screening has had a part in each program I give, for some very specific and personal reasons. Using my skills and intuition as a dental hygienist, I saw a suspicious area on a client. The client denied it, saying she wasn’t a smoker. The lesion was on the palate. The client said it was from eating taco chips. There was something about it that just didn’t resonate for me. I had to talk her into allowing a brush biopsy. The biopsy came back showing atypical cells; the scalpel biopsy showed early squamous cell carcinoma. The client was my sister. The good news was that we found it so early that the very early scalpel biopsy has thus far, after six years, seemed to have removed everything and there has been no recurrence. CDx Labs (www.oralcdx.com) [...]

7/26/2005 Jennifer Warner WebMD (www.webmd.com) Male, Older, and Less-Educated Patients Less Likely to Change Lifestyle After Cancer Cancer survivors often make healthy lifestyle changes after their cancer treatment, but a new study suggests many may not go far enough in adopting healthy habits. Researchers found up to 60% of cancer survivors follow a healthier diet after diagnosis and treatment, yet less than half are eating the recommended five or more servings of fruits and vegetables per day. The study also showed that about 70% of breast and prostate cancer survivors remain overweight or obese. There are almost 10 million cancer survivors in the U.S., and that number is expected to grow thanks to improvements in cancer diagnosis and treatment. For example, only about 50% of people diagnosed with cancer in 1971 were expected to be alive after five years, compared with 64% of those diagnosed with cancer today. Researchers say adopting healthy lifestyle changes is especially important for cancer survivors because they are at increased risk for second cancers as well as other diseases, such as osteoporosis, obesity, heart disease, and diabetes. A Healthier Life After Cancer? In their study, researchers reviewed 100 studies on cancer survivors to examine the impact of cancer diagnosis and treatment on lifestyle and behavior changes. The results appear in the Aug. 20 issue of the Journal of Clinical Oncology. Overall, they found that many cancer survivors adopt healthier behaviors, such as: 30%-60% eat a healthier diet. 46%-96% of smokers with tobacco-related cancers (lung, head, [...]

7/26/2005 San Francisco, CA Steven A. Schroeder, MD JAMA. 2005;294:482-487 Despite the reality that smoking remains the most important preventable cause of death and disability, most clinicians underperform in helping smokers quit. Of the 46 million current smokers in the United States, 70% say they would like to quit, but only a small fraction are able to do so on their own because nicotine is so highly addictive. One third to one half of all smokers die prematurely. Reasons clinicians avoid helping smokers quit include time constraints, lack of expertise, lack of financial incentives, respect for a smoker’s privacy, fear that a negative message might lose customers, pessimism because most smokers are unable to quit, stigma, and clinicians being smokers. The gold standard for cessation treatment is the 5 A's (ask, advise, assess, assist, and arrange). Yet, only a minority of physicians know about these, and fewer put them to use. Acceptable shortcuts are asking, advising, and referring to a telephone "quit line" or an internal referral system. Successful treatment combines counseling with pharmacotherapy (nicotine replacement therapy with or without psychotropic medication such as bupropion). Nicotine replacement therapy comes in long-acting (patch) or short-acting (gum, lozenge, nasal spray, or inhaler) forms. Ways to counter clinicians’ pessimism about cessation include the knowledge that most smokers require multiple quit attempts before they succeed, that rigorous studies show long-term quit rates of 14% to 20%, with 1 report as high as 35%, that cessation rates for users of telephone quit lines and integrated [...]

7/26/2005 Chapel Hill, NC staff Newswise (www.newswise.com) A highly powerful scanner combining two state-of-the-art technologies – computed tomography (CT) and positron emission tomography (PET) – may detect the spread of head and neck cancer more accurately than other widely used imaging examinations. These findings, based on new research from the University of North Carolina at Chapel Hill School of Medicine, appear in the July issue of the medical journal The Laryngoscope. The whole-body PET/CT also is highly accurate for detecting head and neck cancer recurrence, the researchers said. “PET/CT is very helpful in determining where we should pinpoint our biopsies for recurrent disease,” said Dr. Carol Shores, assistant professor of otolaryngology/head and neck surgery at UNC and the report’s senior author. Shores is a member of the UNC Lineberger Comprehensive Cancer Center. “We can pick up cancer where we thought none existed. The new scans are so precise that in some cases cancer had been detected that probably would not have been through any other noninvasive imaging exam.” Since its development in 2000, PET/CT imaging has enabled collection of both anatomical and biological information during a single examination. The PET component picks up the metabolic signal of actively growing cancer cells in the body, and the CT provides a detailed picture of the internal anatomy that reveals the size and shape of abnormal cancerous growths. “Alone, each test has its limitations, but when the results of the scans are integrated they provide the most complete information on cancer location and [...]

7/25/2005 Durham, NC staff News-Mediacl.net (www.news-medical.net) An analysis of more than 100 studies of cancer survivors shows that many survivors initiate diet, exercise, and other beneficial lifestyle changes following a cancer diagnosis, but that those who are male, older, and less educated are less likely to adopt such changes. The term "cancer survivor" refers to a person who has been diagnosed with cancer. The review, which will be published online July 25 in the Journal of Clinical Oncology (JCO), says that a cancer diagnosis often prompts immediate changes in health behavior, including significant modifications in diet and physical activity. Using the MEDLINE and PubMed databases, lead author Wendy Demark-Wahnefried, PhD, RD, LDN, of Duke University Medical Center, and colleagues from the National Cancer Institute and Brown University identified and reviewed more than 100 studies of cancer survivors published since 1996. Researchers found that many survivors adopt healthier behaviors, such as following a healthier diet (30-60% of survivors), quitting smoking (46-96% of smokers with tobacco-related cancers, such as lung or head and neck), abstaining from alcohol (47-59% of those with head and neck cancers, which are closely linked to alcohol use), and regular physical activity (with up to 70% of survivors reporting 30 minutes of exercise a day, at least 5 days a week). Many of these changes should be beneficial because cancer survivors are a vulnerable population, at increased risk for second cancers, osteoporosis, obesity, cardiovascular disease, and diabetes. However, researchers noted that not all cancer patients adopted healthier behaviors, [...]

7/24/2005 Raleigh, NC staff Cancer Wire (July 2005 Edition) John, age eight, was diagnosed with an Anaplastic Astrocytoma (AA) which is an aggressive and often fatal brain tumor. He underwent brain surgery followed by high-dose chemotherapy and radiation therapy (equivalent to about 50,000 dental x-rays). These treatments are highly toxic to the developing brain of a child and, if he were to survive, his IQ and cognitive abilities would be seriously compromised. The family moved to a different state and took John to the local children’s hospital for follow-up care. There, the doctors reviewed John’s pathology slides. They discovered that John’s tumor was not an AA, but was benign. This diagnosis was subsequently confirmed by two other hospitals. John never needed chemotherapy or radiation therapy. Today, John’s IQ decreases at a rate of about 6 points a year as he suffers from the side-effects of a treatment he never needed. Pathology is the medical specialty that deals with the examination of tissues and cells under the microscope in order to arrive at a diagnosis. When it comes to cancer, a pathological diagnosis is the gold standard that indicates the presence or absence of cancer, the type of cancer, and its classification. Because therapeutic decisions are based on the presumed reliability of the pathology diagnosis, a misdiagnosis can result in unnecessary, harmful and aggressive therapy (like John’s story) or inadequate treatment. Unfortunately, medical studies over the last two decades have demonstrated that this gold standard is not consistently reliable. In fact, [...]

7/20/2005 South Bend, IN Patty Levine South Bend Tribune (www.southbendtribune.com) At your next periodic dental checkup and cleaning, your dentist might take a few extra minutes to examine your tongue, gums, the roof and floor of your mouth. This thorough mouth exam probes for oral cancer, a disease which will strike 30, 000 Americans this year and kill 8,000. But within two years, you may be able to go for your regular dental visit, spit in a cup and, before the appointment is over, find out from an analysis of your saliva whether you're at risk for oral cancer. In a small study reported last year, at the American Association for Cancer Research in Anaheim, Calif., researchers from the UCLA School of Dentistry found that genetic "biomarkers" isolated in saliva predicted oral cancer in about nine out of 10 cases. According to this team of scientists, out of about 3,000 distinct bits of genetic material called messenger RNA in saliva, the appearance of four particular "biomarkers" may signal the presence of cancer of the mouth, tongue, larynx or pharynx -- even before any symptoms appear. Although it is not yet clear whether these four RNA particles are detectable because their corresponding genes are activated, or whether their presence indicates the body's inflammatory response to the cancer, the use of saliva for predicting cancer is significant. And in a study reported this past April from Johns Hopkins Medical Institutions, scientists found that an increase of another type of genetic material found [...]

7/19/2005 Isabelle Bairati et al. Journal of Clinical Oncology, 10.1200/JCO.2005.05.514 This Article Purpose: Many cancer patients take antioxidant vitamin supplements with the hope of improving the outcome of conventional therapies and of reducing the adverse effects of these treatments. A randomized trial was conducted to determine whether supplementation with antioxidant vitamins could reduce the occurrence and severity of acute adverse effects of radiation therapy and improve quality of life without compromising treatment efficacy. Patients and Methods: We conducted a randomized, double-blind, placebo-controlled trial among 540 head and neck cancer patients treated with radiation therapy. Patients were randomly assigned into two arms. The supplementation with -tocopherol (400 IU/d) and -carotene (30 mg/d) or placebos was administered during radiation therapy and for 3 years thereafter. During the course of the trial, supplementation with -carotene was discontinued because of ethical concerns. Results: Patients randomly assigned in the supplement arm tended to have less severe acute adverse effects during radiation therapy (odds ratio [OR], 0.72; 95% CI, 0.52 to 1.02). The reduction was statistically significant when the supplementation combined -tocopherol and -carotene for adverse effects to the larynx (OR, 0.38; 95% CI, 0.21 to 0.71) and overall at any site (OR, 0.38; 95% CI, 0.20 to 0.74). Quality of life was not improved by the supplementation. The rate of local recurrence of the head and neck tumor tended to be higher in the supplement arm of the trial (hazard ratio, 1.37; 95% CI, 0.93 to 2.02). Conclusion: Supplementation with high doses of -tocopherol and [...]

7/19/2005 Ann Arbor, MI press release EurekAlert (www.eurekalert.org) University of Michigan researchers have figured out one more component in cancer cells' aggressive growth---and hope that knowledge can help kill the cells. In the July issue of Cancer Cell, the scientists explain how cancer tumor cells attach themselves to a protein on the surface of cells lining blood vessel walls. When this attachment happens, it tells the cancer cell to grow and develop blood vessels, which feed the cell. Cun-Yu Wang, senior author on the paper, said this discovery could help in the fight against cancer. "The blood supply is key for tumor growth and tumor development," said Wang, the Richard H. Kingery Endowed Collegiate Professor at the U-M School of Dentistry. "If you cut off the blood supply, you stop cancer development." Wang collaborated with researchers Qinghua Zeng, Shenglin Li, Douglas B. Chepeha, Jong Li, Honglai Zhang, Peter J. Polverini, Jacques Nor and Jan Kitajewski on the paper. Scientists have heavily studied cancer cells' secretion of proteins to form blood vessels. But Wang said when researchers tried to turn off that process, some tumors responded and some did not, which left him curious about how to develop a better treatment. Rather than simply looking for a better way to interrupt the protein secretion, Wang and colleagues looked for other ways that tumor cells might develop their blood supply, a process called angiogenesis. Wang's team has studied hepatocyte growth factor, known as HGF, to better understand its function in the formation [...]

7/19/2005 Ann Arbor, MI press release EurekAlert (www.eurekalert.org) A compound derived from cottonseed could help improve the effectiveness of chemotherapy at treating head and neck cancer, researchers at the University of Michigan Comprehensive Cancer Center have found. The findings, which appear in the July issue of the journal Molecular Cancer Therapeutics, could lead to a treatment that provides an effective option to surgically removing the cancer, helping patients preserve vital organs involved in speech and swallowing. While new treatments in head and neck cancer have allowed some patients to undergo chemotherapy and radiation therapy instead of surgery, this form of cancer is often resistant to chemotherapy. When the cancer does not respond to these powerful drugs, patients must resort to surgery. "Patients really benefit long-term by avoiding surgery because the side effects of surgery for head and neck cancer can be particularly difficult for patients. It affects how you talk, how you swallow and how you breathe," says study author Carol Bradford, M.D., professor of otolaryngology at the U-M Medical School and co-director of the Head and Neck Oncology Program at the U-M Comprehensive Cancer Center. The compound, (-)-gossypol, works to regulate a protein called Bcl-xL that's overexpressed in cancer cells and makes these cells survive when they shouldn't. Shaomeng Wang, Ph.D., co-director of the Molecular Therapeutics Program at the U-M Comprehensive Cancer Center, discovered (-)-gossypol, a compound derived from a component of Chinese medicine. Gossypol comes from cottonseed and was once used in China as a male contraceptive. More [...]