8/10/2004 NEW YORK By Anthony J. Brown, MD Reuters Health New findings from a long-term study provide further evidence that leeches can be used to save head and neck free tissue flaps typically considered unsalvageable. In the study, the flaps were saved in all 15 patients treated with leeches. Although this therapy is associated with considerable blood loss and other problems, the chance to avoid a second reconstructive surgery is probably worth the risk, lead author Dr. Douglas B. Chepeha told Reuters Health. "The speech and swallowing results, as well as the cosmetic results of a second flap operation are never as good as the first."In a report published in 2002, Dr. Chepeha and colleagues, from the University of Michigan in Ann Arbor, described the outcomes of eight patients who were treated with leech therapy at their institution between 1995 and 2000. The flaps were saved in all cases, although transfusion requirements were often high and ICU psychosis and prerenal azotemia were common problems. In a study update, presented Monday at the 6th International Conference on Head and Neck Cancer in Washington, DC, Dr. Chepeha described the outcomes of the original cohort as well as seven additional patients who were treated after 2000. All of the subjects had free tissue flaps that developed venous obstruction that could not be corrected with surgery or thrombolytic therapy. Patients undergoing leech therapy were admitted to the ICU where three leeches are placed every hour until inosculation occurs. During the ICU stay, antithrombotic therapy [...]

8/8/2004 Australian Dental Association By ANDREA MAYES News.com.au Regular dental checks could save your life, according to the Australian Dental Association. West Australia branch chief executive Peter McKerracher said dental check-ups were vital in the early detection of oral cancers, which accounted for about 6.5 per cent of all cancers diagnosed in Australia. He said diseases such as diabetes and leukemia could also be seen in the mouth and gums before other parts of the body and dentists played a vital role in their early detection. "The mouth really is the mirror for the health of your body and we are only now making the connection between overall health and oral health," Dr McKerracher said. "Early detection of serious diseases like oral cancer is absolutely critical and the survival rate is infinitely higher if they are detected earlier." He said oral cancers killed more people in Australia than cervical cancer and there was a 70 per cent chance of survival in the first five years if oral cancers were detected early. The survival rate fell to 30 per cent of those diagnosed after the cancer had spread. August is Dental Awareness Month and Dr McKerracher said the ADA wanted to encourage people to view their dentist as an overall mouth doctor and not just someone who dealt with teeth. "Dentists study the mouth for five years and know what is normal in terms of lumps and bumps, so they are well placed to pick up abnormalities," he said. For example, [...]

8/7/2004 Washington DC American Head and Neck Society release Most adult Americans know how to light a cigarette and order a drink, but a great number of them are clueless about the consequence of these two destructive habits – oral and head and neck cancer. Oral and head and neck cancer (OHNC) is the term used for the group of cancers found in head and neck region, including the oral cavity (mouth, floor of mouth, lips, teeth, gums, lining of lips and cheeks), oropharynx (the back one-third of the tongue), the nasopharynx (area behind the nose), hypopharynx (lower part of the throat), and larynx (voice box). It is estimated that nearly 40,000 new cases of oral, head, and neck cancer were diagnosed in 2003; approximately 85 percent of them attributable to tobacco use and heavy alcohol consumption. The five year survival rate for OHNC is only 56 percent, a rate that has remained unchanged over several decades. Considering that most adults who smoke today started using tobacco before the age of 18 and adolescent tobacco users are three times more likely to drink alcohol than non-tobacco users, the Federal Government has included improved survival and early detection of oral and head and neck cancer as two of the nation’s health objectives. Experts believe that increased efforts to educate the public about OHNC will lead to early detection and treatment of these cancers, increasing survival. The current study endeavors to document the public’s belief about OHNC in order to raise awareness [...]

8/6/2004 Houston, TX Mark S. Chambers, DMD, MS, Merrill S. Kies, MD, Adam S. Garden, MD, Jack W. Martin, DDS, MS Head Neck 26: 796-807, 2004 Background. Xerostomia is a common, debilitating complication of radiation therapy (RT) for head and neck cancer. This article reviews the pathogenesis of radiation-induced xerostomia, its impact on quality of life (QOL), and treatment options. Methods. Virtually all patients undergoing RT for head and neck cancers have xerostomia, which causes oral discomfort and pain, increased dental caries and oral infection, and difficulty speaking and swallowing. This significantly impairs QOL and can compromise nutritional intake and continuity of cancer therapy. The literature describing pathogenesis, impact on QOL of radiation-induced xerostomia, and preventive and interventional therapies was reviewed. Results. Current management strategies include stringent dental and oral hygiene; parotid-sparing radiation techniques to prevent or minimize xerostomia; and pharmacotherapies, such as salivary substitutes and sialogogues. Future strategies may include advanced three-dimensional intensity-modulated RT techniques, salivary gland transfer, newer sialogogues, and gene therapy. Conclusions. New treatment approaches to xerostomia from RT for head and neck cancer may result in significant improvement in patient QOL. All Authors are associated with The University of Texas M. D. Anderson Cancer Center, Houston, Texas

8/4/2004 Capital News 9 Watch video Some dentists gave visitors to the Saratoga Race Course a reason to smile on Wednesday. They offered track-goers screenings for oral cancer, free of charge. Oral cancer can be fatal, but it's curable if doctors catch it in time. The problem is, the disease usually causes the patient no initial pain. So a trained eye is needed to spot the telltale signs. According to these doctors, the race course is the perfect place to raise awareness. Dr. Robert Trager of Queens said, "A number of the people in the public, such as who come to Saratoga and other outdoors events, are more susceptible to this type of problem. Why? Because they're out in the sun. Their lifestyle unfortunately of possibly drinking, especially smoking and even drugs can lend itself to oral cancers." This is the second year the screenings have been held at the track.

8/2/2004 New Delhi, India By: Upali Rupasinghe New Deli Daily News Scientists at the Indian Institute of Chemical Biology (IICB), Kolkata have identified a molecule in betel leaf which they say can be effective in killing blood cancer cells. The use of betel juice for treating diseases is a common practice in rural areas and experiments were carried out on the immuno-protection capabilities of the betel leaf. The initial results have indicated that the betel leaf could highly effective against Leukaemia, IICB Director Samir Bhattacharya said. Scientists have conduced experiments on cancer cells, obtained from USA and Europe. Tests have revealed that chlorogenic acid, code-named icb-101, was effective on blood cancer cells but did not destroy other non-cancerous cells. Elated with their initial results, scientists had referred their work to the international journal Blood which had sought several clarifications and whether the molecule could be effective in curing other forms of cancer, like oral cancer. The scientists have informed the Indian Council for Medical Research about the discovery and the drug trial on human body is expected to start soon. OCF Note: Now wouldn't this be something? The very plant that causes so many cases of oral cancer in this region of the world and in Asia could contain a compound that could be used to TREAT oral cancer.

8/1/2004 Carol G. Shores, MD, PhD; Xiaoying Yin, MD; William Funkhouser, MD; Wendell Yarbrough, MD Otolaryngology & Head Neck Surg. Objective To better detect occult cervical metastases. Design RNA from 153 cervical lymph nodes was analyzed for the presence of squamous cell carcinoma using quantitative cytokeratin (CK) 14 real-time reverse transcription polymerase chain reaction (RT-PCR). Detection of CK RNA in pathologically negative nodes was further analyzed by semi-step sectioning and CK immunohistochemistry. Subjects Thirteen consecutive patients with head and neck squamons cell carcinoma (HNSCC) presenting to the Department of Otolaryngology/Head and Neck Surgery of the University of North Carolina at Chapel Hill for neck dissection. Results Cytokeratin detection was deemed nonspecific if expressed at fewer than 50 molecules of CK 14 RNA per nanogram total RNA. Of 35 HNSCCs, 33 expressed CK 14 RNA, and 15 lymph nodes with routine pathologically positive metastasis were also positive for CK 14 RNA. Four lymph nodes that were pathologically negative nodes were positive for CK 14 RT-PCR, with 2 containing metastases detected by semi-step sectioning. Conclusions Cytokeratin 14 RT-PCR is very sensitive for detecting micrometastasis in lymph nodes that are negative by routine pathological examination, with a relatively high false-positive rate. Quantitative CK 14 RT-PCR could be used to identify nodes negative for tumor by standard pathological analysis that should be examined by step sectioning and CK immunohistochemistry. Identification of micrometastases in patients with HNSCC will allow for appropriate and aggressive treatment of patients with metastatic disease. Source: Arch Otolaryngol Head Neck Surg. [...]

8/1/2004 See end of article for authors Journal of the National Cancer Institute Background: Transcriptionally active high-risk human papilloma viruses (HPVs), particularly HPV type 16 (HPV16), are found in a subset of head and neck squamous-cell carcinomas (HNSCCs). HPV16-associated carcinogenesis is mediated by expression of the viral E6 and E7 oncoproteins, which cause deregulation of the cell cycle by inactivating p53 and pRb, respectively. We tested the hypothesis that HPV-associated HNSCCs display a pattern of genetic alterations different from those of HNSCCs without HPV DNA. Methods: Polymerase chain reaction-based assays were used to examine 143 consecutive HNSCCs (106 of the oral cavity and 37 of the oropharynx) for the presence of HPV DNA and for viral E6 and/or E7 messenger RNA (mRNA) expression. The HPV DNA-and E6 and E7 mRNA-positive HNSCCs and an equal number of HPV DNA-negative HNSCCs were further analyzed for mutations in TP53, the gene encoding p53, and for allelic loss of 28 microsatellite markers at chromosome arms 3p, 6q, 8p, 9p, 13q, 17p, and 18q, including markers located in regions of chromosome arms 9p and 17p that harbor genes involved the p53 and pRb pathways. All statistical tests were two-sided. Results: Twenty-four (16.7%) of the 143 HNSCCs were positive for HPV16 DNA, and 12 of these HNSCCs (8.4% of total number) expressed E6 and E7 mRNAs. None of the HPV DNA-and E6/E7 mRNA-positive tumors had TP53 gene mutations, whereas nine (75%) of the 12 HPV DNA-negative tumors had such mutations (P<.001). Compared with the HPV DNA-negative [...]

7/30/2004 Cody, WY By Matt Schudel Washington Post Susan Thompson Buffett, 72, the wife of billionaire investor Warren Buffett and, in her own right, the 17th richest woman in the world, died July 29 of a stroke while visiting friends in Cody, Wyo. She and Buffett, whose net worth of about $41 billion makes him the second richest man in the world after Bill Gates, were married in 1952 but had lived apart since 1977. Her primary residence was in San Francisco, while he stayed in the house they had bought together in Omaha in 1958. They remained on friendly terms and often traveled together. Warren Buffett was with his wife at a Cody hospital at the time of her death. Mrs. Buffett was a director of Berkshire Hathaway, her husband's holding company, and was president of the Buffett Foundation, which has contributed millions of dollars for education, medical research, population control and other charities. The foundation was criticized by abortion protesters in the 1990s for funding the RU-486 "abortion pill" and groups supporting abortion rights. She was known for her progressive views, had worked for civil rights and volunteered to help people in low-income housing. In evaluating organizations for possible contributions, Mrs. Buffett told the Omaha World-Herald last year in a rare interview, she sought people "who have heart and soul, the ability to organize and also to inspire -- a rare combination." Her shares in her husband's company have a current value of about $3 billion, which made [...]

7/30/2004 CHICAGO, IL Journal Abstract Journal of Hemotoogy Adding paclitaxel to a cisplatin and 5-fluorouracil (5-FU) regimen led to significantly longer survival in patients with locally advanced head and neck cancer, according to a phase-3 study presented here at the Annual Meeting of ASCO. “This new chemotherapy combination may soon become the standard treatment option for some patients with head and neck cancer,” said lead researcher Ricardo Hitt, MD, from the Hospital '12 de Octubre' in Madrid. The expanded combination also halted tumor progression more effectively than the standard regimen, and patients who received the three-drug combination were more likely to retain the ability to speak and swallow, as well as exhibit less mucocitis. The study involved 384 patients who had various types of head and neck cancer, particularly tumors of the oropharynx, larynx and oral cavity. All patients were treatment naive. In the standard arm, patients received 100 mg/m2 of cisplatin daily, and 1 gm/m2 of 5-FU on days 1 through 5 of a 21-day cycle. In the expanded regimen, patients received 100 mg/m2 of cisplatin daily, 500 mg/m2 of 5-FU on days 1 through 5, and 175 mg/m2 of paclitaxel on the first day of a 21-day cycle. The trial “appeared to demonstrate a superior outcome and far better tolerability by adding paclitaxel to 5-FU and cisplatin for head and neck cancer in a dose schedule associated with less toxicity,” said Robert Mayer, MD, the director of the Center for Gastrointestinal Oncology at Dana-Farber Cancer Institute in Boston.