Smokeless tobacco may be on its way out of Major League Baseball parks

Source: www.latimes.com Author: Karen Kaplan, Los Angeles Times Major League Baseball begins the 2011 season in two days, and if public heath officials have their way it will be the last season during which players will be able to chew and spit smokeless tobacco on the field. The leaders of 15 public health departments in cities with professional baseball teams sent a letter Monday to MLB Commissioner Bud Selig and Michael Weiner, executive director of the union representing major league players, urging them to forbid the use of smokeless tobacco products. Tobacco has been banned in baseball’s minor leagues since 1993. “The use of smokeless tobacco endangers the health of Major League ballplayers and sets a terrible example for the millions of young people who watch baseball at the ballparks and on TV,” the health chiefs wrote. The letter continues: Tobacco use is the number one cause of preventable death in the United States, killing more than400,000 people each year. As cigarette smoking has declined, the tobacco industry has increased its marketing of smokeless products and is spending record sums to promote them. But smokeless tobacco use is itself very dangerous, causing serious diseases of the mouth, including oral cancer. In addition, there is reason to worry that smokeless tobacco use by young persons may serve as a gateway to cigarette smoking, this nation’s leading preventable cause of premature death and disease. As officials in Major League cities around the country, we know that baseball is important to civic life [...]

Jury finds no negligence by orthodontist in Annadale woman’s tongue-cancer death

Source: Silive.com Tragic teen: Stephanie Hare's cancer was too far advanced, and aspiring teacher died in November 2004. STATEN ISLAND, N.Y. -- Annadale resident Stephanie Hare was only 19 years old when a cancerous lesion was detected on her tongue in April 2004. By that time, it was too late. Despite undergoing surgery to remove most of her tongue and submitting to painful radiation and chemotherapy treatments, the vivacious young woman who aspired to be a teacher died seven months later at the age of 20. Ms. Hare’s family contends her orthodontist, Dr. Michael J. Donato of Richmond, was responsible for her death by failing to detect the lesion during a December 2003 visit. However, a jury in state Supreme Court, St. George, disagreed. The panel on Wednesday found Dr. Donato was not negligent and had followed standard dental practices and care when he examined Ms. Hare on Dec. 19, 2003. "Stephanie’s death was not anybody’s fault," Dr. Donato’s lawyer, Douglas J. Fitzmorris, told jurors in his summation. "Stephanie died of cancer. Dr. Donato’s not to blame. The whole specter of this lesion being missed by Dr. Donato is not what happened. There was no deviation from accepted practice." Jason C. Molesso, the lawyer for Ms. Hare’s family, had asked jurors to consider a $2.3 million award for her pain and suffering if they found Dr. Donato liable. "This case is about choices," Molesso told jurors in his closing argument as Ms. Hare’s family wept and hugged each other in the [...]

Oral cancer screenings a must, say malpractice attorneys

Source: Dr.Bicuspid.com By: Donna Domino March 10, 2011 -- The patient was insistent: All she wanted was to get her teeth whitened for an upcoming high school reunion. She came in for the $99 Internet special the dentist had run and mentioned a sore on her tongue, but she said it was recent, attributing it to a tongue-biting habit. The dentist did the procedure but advised the patient that she needed a follow-up oral exam. The patient eventually went to an oral surgeon who diagnosed the young mother with terminal tongue cancer. She sued the dentist who did the teeth whitening for malpractice, for missing her oral cancer. That case, Tale of the Tainted Tongue, was dramatized at the recent Chicago Dental Society Midwinter Meeting in a session highlighting the growing number of malpractice suits over missed oral cancer screenings. Anne Oldenburg, an attorney with Alholm, Monahan, Klauke, Hay & Oldenburg, which specializes in dental malpractice cases, participated in the mock trial. Ten years ago she didn't have many such cases, she told DrBicuspid.com. But that scenario has changed dramatically in recent years, she said, noting that she is currently involved in three dental malpractice cases. The mock trial was similar to a previous lawsuit she handled, in which a young man in his 40s died. "It was oral cancer that was clearly missed," Oldenburg recalled. The family settled for $750,000 because the children didn't want to go through the litigation process, but many death cases can reach $1 million [...]

Reirradiation for head-and-neck cancer: delicate balance between effectiveness and toxicity

Source: HighWire- Stanford University PURPOSE: To analyze the effectiveness and toxicity of reirradiation (re-RT) for head-and-neck cancer. METHODS AND MATERIALS: A retrospective data analysis was performed of 58 patients who underwent re-RT with curative intent. Re-RT was given as definitive treatment in 53% of patients, whereas salvage surgery preceded reirradiation in 47%. The median cumulative RT dose was 119 Gy (range, 76-140). Concurrent chemotherapy was administered with re-RT (CRT) in 57% of patients. Event-free survival was defined as survival without recurrence and without serious toxicity (?Grade 3). RESULTS: Median follow-up was 57 months (range, 9-140). Locoregional (LR) control was 50% at 2 and 5 years. The 2-year and 5-year overall survival (OS) was 42% and 34%. The following factors were associated with improved OS: postoperative re-RT (vs. primary re-RT), treatment with RT only (vs. CRT) and interval >3 years between previous RT and re-RT. For patients treated with postoperative re-RT and definitive re-RT, the 5-year OS was 49% and 20%, respectively. Patients treated with CRT had a 5-year OS of 13%. Serious (late) toxicity ?Grade 3 was observed in 20 of 47 evaluable patients (43%). Three cases of treatment-related death were recorded. The 2- and 5-year serious toxicity-free interval was 59% and 55%, respectively. Associated with increased risk of serious toxicity were CRT and higher re-RT dose. The event-free survival rates at 2 and 5 years were 34% and 31%, respectively. CONCLUSIONS: Re-RT in head-and-neck cancer is associated with poor survival rates of 13-20% in patients with inoperable disease treated [...]

New-generation radiation treatment, a first-line therapy for patients with large head and neck tumours

Source: Medical News Today Biologically targeted BNCT treatment is based on producing radiation inside a tumour using boron-10 and thermal neutrons. Boron-10 is introduced into cancer cells with the help of a special carrier substance (phenylalanine), after which the tumour is irradiated with lowenergy neutrons. The latter react with the boron to generate high-LET radiation, which may destroy the cancer cells. One to two BNCT treatment sessions may be sufficient to destroy a tumour, while keeping the impact of radiation on surrounding healthy tissue to a minimum. A research reactor is currently used as the neutron source, but dedicated neutron accelerators being designed for BNCT. Clinical trials to assess the efficacy and safety of BNCT in the treatment of locally recurrent head and neck cancer have been carried out at the Department of Oncology at Helsinki University Central Hospital (HUCH). OCF Apart from palliative chemotherapy, conventional treatment was no longer considered possible for the patients treated in the BNCT trials. A total of 30 patients referred to HUCH's Department of Oncology from hospitals around Finland took part in the trial. 76% of patients responded well to the treatment and 30% were still alive two years after treatment; although only one patient has survived 55 months. The results of the study, conducted by Professor Heikki Joensuu, have recently been published in the International Journal of Radiation Oncology, Biology, Physics. BNCT treatment is provided by Boneca Corporation, which is based at the main campus of Helsinki University Central Hospital and is the [...]

Cetuximab therapy for head and neck squamous cell carcinoma: a systematic review of the data

Source: http://oto.sagepub.com/ Authors: Travis D. Reeves, MD et al. Objective: To review the current state of the data on the use of cetuximab in head and neck squamous cell carcinoma (HNSCC). Data Sources: The National Center for Biotechnology Information’s PubMed and the Cochrane collection. Review Methods. Search terms included cetuximab and head and neck cancer. These results were reviewed, and a second search was performed using limits: meta-analysis, randomized controlled trial, and clinical trial. Results: The literature search yielded 412 articles. Fifteen were identified for analysis. For patients with recurrent/metastatic disease who received combination chemotherapy in phase I/II trials, the overall response (OR) was 18.7% (95% confidence interval [CI], 10.4%-27.0%). Phase III trial data for combination chemotherapy in recurrent/metastatic disease showed OR to be 17.0% (95% CI, 12.6%-21.4%) for platinum-based regimens and 34.2% (28.6%-39.7%) for platinum-based regimens with cetuximab. For this same group, the estimated aggregate hazard ratio comparing platinum-based therapy plus cetuximab to platinum therapy alone was 1.10 (95% CI, 0.78-1.54), indicating no significant improvement in overall survival in the aggregate analysis. Combination chemoradiation with cetuximab in both phase I/II trials and the single phase III trial shows enhanced responsiveness, but the data are difficult to interpret because it is not used with standard-of-care regimens for advanced-stage disease. Conclusion: Early evidence has shown cetuximab to be effective in the treatment of HNSCC, and it should be used to enhance, but not replace, current treatment paradigms until further phase III data are available. Note: This article was presented at the [...]

Fatal adverse events with Bevacizumab

Source: Medscape Today Treatment-Related Mortality With Bevacizumab in Cancer Patients: A Meta-analysis Study Summary Although bevacizumab has been shown to improve survival in patients with a variety of solid tumors when added to conventional chemotherapy, it has also been associated with life-threatening and fatal adverse events (FAEs), including bleeding, thromboembolism, and perforation. This improvement in survival has led to the assumption that FAEs are rare and do not significantly affect patients who are receiving treatment. In this large meta-analysis, Ranpura and colleagues identified 10,217 patients with various solid tumors from 16 randomized studies, as follows: Colorectal cancer (5 studies); Non-small cell lung cancer (4 studies); Breast cancer (3 studies); Renal cell cancer (2 studies); Pancreatic cancer (1 study); and Prostate cancer (1 study). A clear increase in FAEs was evident in patients who received bevacizumab compared with those who received standard chemotherapy alone (2.5% vs 1.7%; relative risk [RR] 1.46; P = .01). This association varied with chemotherapy agents but not with tumor type. In particular, FAEs occurred in patients receiving taxanes or platinum agents (RR 3.49; 3.3% vs 1%) but not with other specific agents. Types of FAEs included bleeding (23.5%), gastrointestinal perforation (7.1%), and pulmonary embolism and stroke (5.1% each). Most fatal bleeding events were pulmonary or gastrointestinal in origin. Viewpoint The benefit of bevacizumab is under increased scrutiny given the latest data in patients with metastatic breast cancer. In this large meta-analysis, Ranpura and colleagues documented a clear increase in the rate of FAEs (2.5%) in patients [...]

Survival and human papillomavirus in oropharynx cancer in TAX 324: a subset analysis from an international phase III trial

Source: annonc.oxfordjournals.org Authors: M. R. Posner et al. Background: The association between human papillomavirus (HPV) and overall survival (OS) in oropharynx cancer (OPC) was retrospectively examined in TAX 324, a phase III trial of sequential therapy for locally advanced head and neck cancer. Methods: Accrual for TAX 324 was completed in 2003 and data updated through 2008. Pretherapy tumor biopsies were studied by PCR for human papillomavirus type 16 and linked to OS, progression-free survival (PFS) and demographics. Results: Of 264 patients with OPC, 111 (42%) had evaluable biopsies; 56 (50%) were HPV+ and 55 (50%) were HPV−. HPV+ patients were significantly younger (54 versus 58 years, P = 0.02), had T1/T2 primary cancers (49% versus 20%, P = 0.001), and had a performance status of zero (77% versus 49%, P = 0.003). OS and PFS were better for HPV+ patients (OS, hazard ratio = 0.20, P 

2011-02-12T15:06:18-07:00February, 2011|Oral Cancer News|

Lightning rod for head and neck cancer

Source: www.physorg.com Author: staff They say lightning never strikes the same place twice—unless, of course, that place is a lightning rod. An enzyme called UROD acts like a lightning rod for cancer cells, drawing radiation and chemotherapy toward specific spots in diseased tissue, a new study in mice and humans reports in Science. The findings suggest that UROD—identified for the first time in this paper as a key player in human cancer--could help decrease treatment side effects for people with head and neck cancer, the eighth most common cancer worldwide. Despite many advances over the last few decades, the toxic side effects associated with current therapies have made for disappointing outcomes in many patients. Head and neck tumors are often found near critical organs, so destroying the diseased tissue is often a delicate challenge that could lead to life-threatening conditions. Here, Emma Ito and colleagues show that targeting UROD can selectively enhance the effects of radiation and chemotherapy in head and neck tumors, while minimizing toxicity to normal tissues. By focusing therapy toward specific parts of tissue, lower doses of radiation and chemotherapeutic drugs could potentially be administered to patients without compromising treatment efficacy. Uroporphyrinogen decarboxylase or UROD is an enzyme involved in the production of a molecule called heme, which is vital for all of the body's organs (though it is most abundant in the blood, bone marrow, and liver). Heme is an essential component of iron-containing proteins called hemoproteins, including hemoglobin, the protein that carries oxygen in the [...]

Rash prediction in lung cancer?

Source: www.medscape.com Author: Maurie Markman, MD Hello. I am Dr. Maurie Markman from Cancer Treatment Centers of America in Philadelphia. I wanted to briefly discuss with you a very interesting paper[1] that appeared online in The Lancet Oncology on December 20th, 2010, and will be in print soon. The paper was entitled "First-Cycle Rash and Survival in Patients With Advanced Non-Small-Cell Lung Cancer Receiving Cetuximab in Combination With First-Line Chemotherapy: A Subgroup Analysis of Data From the FLEX Phase 3 Study." This was a very interesting subgroup analysis -- a retrospective analysis. What the group of investigators attempted to look at was the impact on a patient who received cetuximab and developed a rash compared with individuals who received cetuximab and did not develop a rash. And, of course, the other control group here would be the patients who received chemotherapy without cetuximab. What this retrospective analysis demonstrated was that overall survival in patients who received combination chemotherapy plus cetuximab and who developed a rash was significantly longer in all of the subtypes of non-small cell lung cancer that were looked at (including squamous and adenocarcinoma), compared with chemotherapy alone or chemotherapy plus cetuximab and no development of a rash. These data, which are quite provocative and need to be confirmed by others, suggest that the development of a rash may be a reasonable clinical biomarker of the potential impact of this targeted agent on cancer. That is, the development of a rash suggests that there is going to be [...]

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