4/11/2004 San Francisco E. J. Mundell Health Day News New biopsy test could change how doctors treat tumors of tongue, mouth Oral cancer specialists have found a way to determine which patients are most likely to benefit from surgery and which are not. Oncologists typically recommend that all patients with pre-cancerous white patches on the tongue or mouth have surgery to remove the suspicious area. But a new biopsy technique may change all that, Norwegian researchers say. The new findings are "actually challenging things that we are currently doing," says oral cancer expert Dr. Deborah Greenspan, of the University of California, San Francisco. A study summarizing the findings appears in the April 1 issue of the New England Journal of Medicine. Oral cancers are strongly linked to smoking and to the use of snuff, chew and other forms of smokeless tobacco. The disease is much more prevalent in men than women, with more than 20,000 cases of oral cancer reported in U.S. males each year. The disease typically begins as a small, innocuous leukoplakia (literally, "white patch") on the surface of the tongue or cheek "which to the patient may actually be completely asymptomatic and can only be picked up for the most part by a dentist or dental hygienist during a good oral exam," Greenspan says. The large majority of oral leukoplakias will not turn malignant but do warrant a biopsy, especially in tobacco users. If pre-cancerous cell changes called dysplasia are spotted during a biopsy, most doctors will [...]

4/11/2004 Columbus, Ohio Associated Press Health care professionals hope new education programs will prevent teenagers from getting hooked on smokeless tobacco. Dentists say they're seeing more Ohio kids - rural and suburban - using the chewing tobacco and snuff generally associated with farmhands and baseball players. Some doctors predict a dramatic rise in oral cancers in the next several decades unless more is done to teach young people about the risks of smokeless tobacco. "It's not (an exaggeration) to say that it represents a little bit of a sleeping-giant health risk at this point in time," said Dr. David Schuller, director of the Arthur G. James Cancer Hospital and a specialist in head and neck cancers. In many cases, users start in middle school and think smokeless tobacco poses little risk. A 2002 Ohio Department of Health study found that almost 12 percent of Ohio high school boys had dipped in the past month. About 1 percent of the girls had. In middle schools, about 5 percent of the boys and almost 2 percent of the girls had. And although 77 percent of teenagers recognize the danger of cigarettes, only 40 percent know chewing tobacco can hurt them, according to a survey by the U.S. surgeon general. To combat the problem, dentists and schools throughout the state are utilizing a new program called Operation TACTIC, for Teens Against Chewing Tobacco in the Community. It includes print materials and a video in which Tammy Smith and her son Tyler tell the [...]

4/10/2004 Shari Roan LA Times Hundreds of microscopic organisms found in the oral cavity may offer clues to the causes of disease elsewhere in the body. Any first-grader can tell you that if you don't brush your teeth, creepy sugar "bugs" will take over and cause cavities. But not all of the bugs, or microbes, in the mouth actually affect oral health. And not all of them are bad. A vast and diverse community of microscopic organisms — including viruses, bacteria, fungi and protozoa — thrive in the mouth, scientists are learning. Some of them may play important roles in both preserving health and causing diseases, says Dr. David Relman, an associate professor of microbiology at Stanford University. "We already know so much about so many disease-causing agents that it tends to give you the feeling that there is no reason to be going out and trying to find others," he says. But the causes of many diseases remain unknown — and the mouth appears to be a good place to look for clues. "We are increasingly becoming aware of the connection between the oral cavity and the body," says Donna Mager, a researcher at the Forsyth Institute, an independent research center in Boston. "Whatever grows in the oral cavity could have an impact on what happens to the body." Research by Relman and Mager is helping to advance this notion. In his lab, Relman samples the region in the mouth called the subgingival crevice, the deep space between the [...]

4/6/2004 DETROIT, MI BUSINESS WIRE DaimlerChrysler (DCX) is the first major corporation in the U.S. to attack one of the deadliest forms of cancer by offering a new Delta Dental benefit, the OralCDx brush biopsy, to its 400,000 UAW employees and family members, announced Thomas J. Fleszar, D.D.S., M.S., president and chief executive officer of the affiliated Delta Dental Plans of Michigan, Ohio and Indiana. The benefit, effective immediately, is expected to prevent the development of oral cancer and improve the survival rates for those who develop the disease. Each year, approximately 30,000 Americans are diagnosed with oral cancer, and the disease claims as many lives as melanoma and more than cervical cancer. If found early, oral cancer can be cured, and if detected at the precancerous stage, oral cancer can be prevented. Delta Dental Plan of Michigan (DDPMI), with its affiliated plans in Ohio and Indiana, is one of the first dental benefits providers in the nation to include the diagnostic tool as part of its standard benefits and DaimlerChrysler is the first DDPMI employer group to incorporate the benefit in its plan design. "While our benefit programs have always covered traditional scalpel biopsies, and continue to do so, the brush biopsy represents a breakthrough in the fight against oral cancer," said Dr. Fleszar. "This simple, painless and inexpensive test will make a dramatic difference in improving the five-year survival rate for oral cancer, which has remained a dismal 57 percent for the past 40 years." He added, "Further, [...]

4/1/2004 Florida Sid Kirchheimer WebMD Medical News There's more bad news for St. John's Wort, once the darling of herbal remedies and still the world's most popular alternative to prescription antidepressants: A new study now indicates that the herbal medicine compromises a powerful cancer-fighting drug used to treat a form of blood cancer. At least six previous studies show that the reason for this effect is the same: The over-the-counter supplement causes higher levels of a particular substance to be made that the body uses to breakdown other disease-fighting medicines. This time, St. John's Wort was found to interfere with Gleevec, a powerful drug that targets only cancerous cells and is used to treat people with leukemia. The drug is currently taken daily to normalize the large numbers of abnormal white blood cell in leukemia patients. However, Gleevec is being tested -- and showing promise -- in treating other aggressive cancers. "We found that when St. John's wort is taken in combination with Gleevec, it caused the amount of Gleevec in the blood to drop by 30%," says researcher Reginald F. Frye, PhD, of the University of Florida Center of Pharmacogenomics. "That may not sound like much, but for Gleevec, a 30% reduction is very important. He says that there is a critical blood level of the drug that leukemia patients need to be above to prevent the disease from coming back, what is known as a disease relapse. "What this study shows is that if they took St. John's [...]

3/30/2004 By Jennifer Warner See sources at end of article The effects of sun exposure on women's health may be more than skin deep. A new study suggests that a woman's risk of cervical cancer may be much higher during sunny months. Researchers tracked nearly a million Pap smear results collected over 16 years in southern Holland and found that women were twice as likely to be infected with the human papilloma virus (HPV) during the sunny days of August than in the darker days of winter. HPV is the most common sexually transmitted disease. Pap smears that test for HPV infection are commonly used worldwide as a tool to screen for signs of cervical cancer. The vast majority of women with HPV infection will not develop cervical cancer, but cervical cancer is a rare complication of this common infection. About 20 of the more than 230 types of HPV are considered high risk because of their close association with the disease. HPV Risks Rise During Sunny Months? In the study, researchers looked at seasonal patterns of HPV infection among 920,359 consecutive Pap smears collected from 1983 to 1998 and compared it with differences in sunlight exposure. The results showed that the number of HPV infections was twice as high in August compared with the lowest month, and the rates of HPV infection were closely linked to available sunlight exposure. "The sunnier the year, the higher the HPV rate, and the sunnier the month, the higher the HPV rate," says [...]

3/30/2004 Honolulu, Hawaii International Association for Dental Research, Annual Meeting presentation Detailed molecular analysis of tumors is now providing molecular portraits which show the genetic basis of the different clinical presentations of disease. This technology will help identify metastasis signatures and provide logical targets for drug discovery. This moves us closer to a time when we will treat patients based on the genetic profile of the tumor rather than the clinical presentation of the disease. Finding targets that are differentially expressed in cancer and normal tissue will also provide better tests for early diagnosis. There is also increasing interest in utilizing knowledge about tumor biology to address the vexing question as to why tumors recur despite seemingly adequate treatment. A new generation of ultra-sensitive diagnostics has highlighted the problem of subcutaneous foci of residual tumors that may remain at the operative site, or be disseminated throughout the body. These approaches have also revealed that the extent of spread of a precancerous patch is often much greater than previously realized. Long-term follow-up of cases screened by these molecular diagnostics suggests that detecting these troublesome foci of disease can help to identify individuals at risk of developing local and distant recurrence. In a Keynote Address during the 82nd General Session of the International Association for Dental Research, Dr. Maxine Partridge (King's College Hospital, London, UK) reports that a host of novel therapeutic strategies is now on the horizon for management of these problems. These include gene-mediated strategies to replace defective sequences, blocking [...]

3/29/2004 Orlando, FL By Aimee Frank American Association for Cancer Research Studies show how exposure to environmental carcinogens causes dna damage in smokers, women and their unborn children. Genetic damage triggered by environmental carcinogens, including smoking, is being further defined with the aid of new technology, including microarrays, polymorphisms and DNA adducts, one of the first steps in the carcinogen pathway that ultimately leads to tumor formation. In this press briefing at the 95th Annual Meeting of the American Association for Cancer Research, scientists report their findings of specific DNA damage resulting from combustion and smoking-related carcinogens, and in the case of two studies, the impact of prenatal exposures on unborn children. Levels of Polycyclic Aromatic Hydrocarbons in Amniotic Fluid Samples from Smokers and Nonsmokers: Abstract No. 3189 The amniotic fluid of smoking women in their first trimester of pregnancy contains about 10 times the amount of a known tobacco carcinogen -- polynuclear aromatic hydrocarbons (PAHs) – than nonsmokers. Similar results were found for another established cancer-causing agent, known as benzo(a)pyrenes. "This is the first study to show the presence of carcinogens in the fetus at this early stage of development," said Steven R. Myers, Ph.D., Director of the Center for Environmental and Occupational Health Sciences at the University of Louisville School of Medicine and lead author of the study. In all, more than 500 women participated in the study, which involved routine amniocentesis performed between 16 to 20 weeks of pregnancy. The first trimester is a particularly critical period [...]

3/24/2004 San Antonio, TX News 9, San Antonio Salivary Gland Tumors There are three main pairs of salivary glands. The first and largest are the parotid glands in front and just below the ears. The second largest are the submandibular glands at the back of the mouth under the side of the jaw. The third pair is the sublingual glands. They are found in the floor of the mouth under the tongue. There are several other minor salivary glands scattered below the lining of the mouth and throat. The salivary glands secrete saliva into the mouth through ducts. Saliva moistens food, makes it easier for us to chew food and swallow, and aids in breaking down food for digestion. Saliva also washes away bacteria and food particles and keeps the mouth moist. Salivary tumors are rare, especially in children. The tumors can be benign or malignant and most commonly are located in the parotid glands. Signs of a possible tumor include: development of a painless lump or growth, swelling or gradual increase in the size of a gland, or, in rare cases, facial paralysis. Diagnosing and treating salivary tumors Sometimes salivary tumors are detected during a routine dental exam. A fine needle may be used to withdraw some cells for laboratory examination. From this information, doctors will determine if the tumor is benign or malignant and what steps need to be taken for treatment. If a tumor is malignant, surgeons need to remove the tumor and a small margin of [...]

4/23/2004 Associated Press A more definitive cervical cancer screening test that helps reduce uncertainty in diagnosing the disease is gaining support from doctors and health insurers. Aetna, the nation's largest health insurer, on Wednesday became the latest plan to cover the new DNA test that checks for the presence of a virus that studies show causes more than 99 percent of cervical cancers. The test is used when a Pap smear proves inconclusive, which happens about 5 percent of the time. Kaiser Permanente, United Healthcare and most Blue Cross and Blue Shield plans already cover the test for human papillomavirus, or HPV, according to the test's maker, Digene Corp. of Gaithersburg, Maryland. About 400,000 U.S. women had the HPV test in the past year, a Digene spokeswoman said. If the test shows no sign of HPV, a woman is assured she doesn't have cancer. If the HPV virus present, there is a greater likelihood the woman has cancer and she is sent for additional testing which most likely include a biopsy. ``Aetna is a bellwether for the adoption of HPV testing as a standard of care in cervical cancer screening,'' said Evan Jones, Chairman and CEO of Digene Corporation. About 50 million Pap smears are performed annually in the United States. Before the HPV test was approved by the Food and Drug Administration in 1999, women who had an inconclusive Pap test would have to get another Pap test or an outpatient procedure that would likely include a biopsy. The [...]