HPV-Positive Head and Neck Cancer Patients May be Safely Treated with Lower Radiation Dose

A new study suggests that lowering the dose of radiation therapy for some head and neck cancer patients may improve outcomes and cause fewer long-term side effects.

The research was presented by lead author Anthony Cmelak, M.D., professor of Radiation Oncology at Vanderbilt-Ingram Cancer Center (VICC), during the 50th annual meeting of the American Society of Clinical Oncology (ASCO), held recently in Chicago.

The study focused on patients with newly-diagnosed oropharyngeal cancers related to the human papilloma virus (HPV). More than two-thirds of new head and neck cancer patients have HPV-positive tumors and the number of these patients is on the rise. Cmelak’s prior cooperative group study found that patients with HPV-positive oropharyngeal cancer have significantly longer survival rates than patients whose tumors are HPV negative.

For the new study, 80 HPV-positive patients with stage III, or IVa,b squamous cell cancer of the oropharynx received induction chemotherapy, including paclitaxel, cisplatin and cetuximab.

After chemotherapy, 62 of the patients showed no sign of cancer and were assigned to receive a 25 percent lower dose of intensity-modulated radiation therapy – an advanced technology that targets the radiation beam more accurately to treat the tumor without harming surrounding tissue. The rest of the patients received a standard IMRT dose. The drug cetuximab was also given to both groups of patients along with the IMRT treatment.

Two years after treatment, the survival for the low-dose IMRT patients was 93 percent.  Those who did not have complete resolution of cancer following induction and went on to get full-dose radiation had an 87 percent two-year survival. Eighty percent of the low-dose patients and 65 percent of standard IMRT patients also showed no evidence of tumor recurrence.  Ninety-six percent of those who had minimal or no smoking history had no evidence of tumor recurrence after two years following treatment, and long-term side effects were minimal.

The investigators concluded that patients with HPV-positive cancer who had excellent responses to induction chemotherapy followed by a reduced dose IMRT and cetuximab experienced high rates of tumor control and very low side effects particularly for those with a minimal smoking history.

Treating tumors in the delicate head and neck region often causes side effects that can be troublesome and long-lasting, including difficulty swallowing, speech impairment, dry mouth, problems with taste and thyroid issues, so any therapy option that reduces these side effects can have an impact on patient quality of life.

“Treatment for head and neck cancer can be quite grueling, so it’s very encouraging to see we can safely dial back treatment for patients with less aggressive disease and an overall good prognosis, particularly for young patients who have many years to deal with long-term side effects,” said Cmelak.

He noted that lower-dose IMRT is not recommended for patients with HPV-negative cancer or larger tumors.

The authors note that further studies of reduced-dose IMRT in HPV-positive patients are warranted.

Other investigators include Jill Gilbert, M.D., VICC; Shuli Li, Ph.D., Dana Farber Cancer Institute, Boston, Massachusetts; Shanthi Marur, M.D., William Westra, M.D., Christine Chung, M.D., The Johns Hopkins University School of Medicine, Baltimore, Maryland;  Weiqiang Zhao, M.D., Ph.D., Maura Gillison, M.D., Ph.D., The Ohio State University, Columbus, Ohio; Julie Bauman, M.D., Robert Ferris, M.D., University of Pittsburgh Cancer Institute; Lynne Wagner, Ph.D., Feinberg School of Medicine, Northwestern University, Chicago, Illinois; David Trevarthen, M.D., Colorado Cancer Research Program, Denver;  A. Demetrios Colevas, M.D., Stanford University, California; Balkrishna Jahagirdar, M.D., HealthPartners and Regions Cancer Care Center, St. Paul, Minnesota;  Barbara Burtness, M.D., Fox Chase Cancer Center, Philadelphia, Pennsylvania.

Funding was provided by The National Cancer Institute, a division of the National Institutes of Health (CDR0000665170).

 

Excerpt: Colon Cancer Screening Saves Lives

Widespread screening for colorectal cancer has helped prevent an estimated half-million cases of the disease since the mid- 1970s, a new study suggests.

At a time when screening for many kinds of cancer is being questioned, the findings underscore the importance of screening for colorectal cancer in saving lives, said the senior author of the study, Dr. James Yu, an assistant professor of therapeutic radiology at Yale School of Medicine.

Colonoscopies, beginning at age 50, are considered the gold standard in colon cancer screening, although other techniques, like fecal occult blood testing, can detect some cancers.

 To read the full article in The New York Times, please click here.

Monday, April 7th is World Health Day

Dr. Margaret Cuomo is the author of “A World Without Cancer: The Making of a New Cure and the Real Promise of Prevention.”

World Health Day, April 7th, is a great opportunity to focus our attention on what should be an American priority: cancer prevention.

Scientific evidence tells us that over 50 percent of all cancers are preventable by applying what we know right now. Attention to diet, exercise, avoiding alcohol, protecting our skin from the sun, managing stress and, of course, ending smoking all contribute to significantly reduce cancer risk. These are the “broad strokes” of cancer prevention. The devil is in the details, and people need to know which foods, what kind of exercise, how to manage stress, etc. There are highly-effective strategies to prevent cancer, but we need to learn them. We should be teaching our children about the kinds of foods that reduce cancer risk and encouraging them to stay physically active to prevent cancer and other diseases. Anti-smoking education should focus on the young as well as adults, emphasizing that “It’s not cool to smoke, because there’s nothing cool about cancer.”

Learning that whole grains, legumes, fruits and vegetables can help prevent many cancers, including cancers of the prostate, breast, mouth, throat, esophagus, lung, colon, kidney, pancreas, thyroid, gallbladder, and probably other cancer types is a powerful lesson that can have a significant impact on children’s lives. In many cases, children who have been taught about cancer-preventing strategies can become the role models and teachers for their parents.

Our fruits, vegetables and grains should be free of harmful pesticides that promote cancer. Our cattle, poultry and fish should not be exposed to antibiotics or hormones that will be harmful to their human consumers. Our personal care products, such as shampoo and deodorant and toothpaste; cosmetics, such as lipstick, mascara and eyeliner; and our household cleaning products should be free of chemicals that disrupt our hormones, and increase our cancer risk.

The scientific and medical community, including the World Health Organization and the American Association of Obstetricians and Gynecologists and the American Reproductive Society, are speaking out against the harmful chemicals in our environment.

In a joint Committee Opinion issued by the American College of Obstetricians and Gynecologists (The College) and the American Society for Reproductive Medicine in September 2013, obstetricians and gynecologists were urged to advocate for government policy changes to identify and reduce exposure to toxic environmental agents.

Among the reproductive and health problems associated with exposure to these toxic chemicals, these powerful medical groups listed childhood cancers, miscarriage and stillbirth impaired fetal growth and low birth weight, preterm birth, birth defects, cognitive/intellectual impairment and thyroid problems.

In 2010, the President’s Cancer Panel issued a scathing report entitled, Reducing Environmental Cancer Risk: What We Can Do Now,” in which it stated: “The true burden of environmentally induced cancer has been grossly underestimated.”

It takes a village to support cancer prevention. Government and the industries producing our food, personal care products and cosmetics, household and industrial cleaning products, fertilizers and pesticides should be partners in the effort to ensure that our food is pure and healthful, and that the products used on our bodies and our farms, in our homes, schools and businesses aren’t cancer-causing. Less Cancer, a not-for-profit organization founded by Bill Couzens, seeks to educate individuals and raise awareness that results in the protection of human health, the environment, and our economy. Less Cancer’s work on health and the environment spans a wide range of issues, including specific contaminants, pollution sources and also healthy lifestyle choices, such as diet, exercise, and smoking cessation. While we work to protect all communities, our approach is particularly relevant to at-risk populations, such as children, low-income communities, and workers. Less Cancer’s ultimate goal is to reduce incidences of diagnosed cancer in all people. As a Less Cancer board member, I am honored to be a part of this vital mission.

A World Without Cancer, the book I wrote in 2012, is my personal journey with cancer as a doctor, a diagnostic radiologist and experiencing cancer’s horrific effects on my patients, friends, and family. The good news is that cancer is not an inevitability for us. Whether we are adults or children, members of the media or medical community, government, industry or cancer advocacy group, we can all contribute to a healthier environment, a stronger, more vibrant society, and ultimately, to a world without cancer. If we fully dedicate ourselves to the prevention of cancer, this impossible dream will become a reality.

Margaret I. Cuomo, M.D., is a board-certified radiologist and served as an attending physician in diagnostic radiology at North Shore University Hospital in Manhasset, N.Y. for many years. Specializing in body imaging, involving CT, Ultrasound, MRI and interventional procedures, much of her practice was dedicated to the diagnosis of cancer and AIDS. She is the daughter of former New York Governor Mario Cuomo and Mrs. Matilda Cuomo and sister to Governor Andrew Cuomo and ABC’s Chris Cuomo. She resides in New York. Cuomo’s book, A World Without Cancer, was published October 2012 by Rodale.

Today is National Cancer Prevention Day!

Everyday Ways to Prevent Cancer

By Leslie Vandever

February is National and World Cancer Month—observations meant to increase public awareness of cancer, cancer prevention, and cancer research. And Tuesday, Feb. 4 is National Cancer Prevention Day.

Even today, with the incredible scientific and medical advances that have taken place over the last hundred years, cancer remains one of the most frightening—and deadly—diseases we face. Fortunately, we’ve gotten much better at treating and even curing some types of cancer, some of the time. Unfortunately, a definitive cure for all cancers remains beyond our reach.

What is cancer?

Simply, “cancer” is the word for a group of diseases in which the cells—the body’s basic unit of life—develop abnormally and do not die when they should because of a mutation in their DNA. Instead, out of control, these “malignant” cells divide and spread (metastasize) to other parts of the body through the bloodstream or lymph system.

Sometimes mutated cells may form a mass of tissue called a tumor. It’s considered “benign” if it doesn’t spread to other parts of the body, can be removed, and doesn’t come back.

There are more than 100 different types of cancer. In many cases, what starts, or triggers, cells to mutate abnormally and spread is unknown. But scientists have been able to pinpoint some possible triggers for some forms of malignant cancer—and by avoiding or controlling those triggers, you can reduce your odds of contracting the disease.

What steps can you take toward cancer prevention?

  •  Don’t use tobacco. If you do, stop. Smoking has been linked to cancers of the lung, bladder and kidneys. Chewing tobacco has been linked to cancer of the oral cavity and pancreas.
  • Eat healthy. Choose a diet rich in plant-based foods like vegetables, fruit, beans, legumes and whole grains. Limit fat, particularly fat from animal sources. Avoid sugar. Foods that are higher in fat and sugar (and calories) contribute to obesity, which can cause cancer.
  • Avoid becoming overweight or obese. Maintaining a healthy weight for your age, height and build might help to prevent cancer. Obesity has been linked to cancer of the breast, prostate, lung, colon and kidney.
  • Exercise. Regular exercise helps to maintain overall health, helps to control your weight and might protect against breast and colon cancer.
  • Protect yourself from the sun. Many types of skin cancer are linked to the harmful ultraviolet rays in the sun. Use sunscreen liberally and wear tightly woven, loose-fitting clothes in bright or dark colors to protect exposed skin. Try to stay out of the sun between 10 a.m. and 4 p.m. And avoid tanning beds and sunlamps—they’re just as damaging as natural sunlight.
  • Cancer screening. Mammograms, PAP smears, breast and skin exams, and colorectal screening can catch precancerous conditions early. By finding abnormal cells and treating or removing them, some cancers can be prevented. They include cervical cancer, breast cancer and some skin cancers.
  • Chemoprevention.  The vaccine against the human papilloma virus (HPV) and the hepatitis B vaccine can prevent certain types of cancer. There are also medications can treat some pre-cancerous conditions and keep them from developing into a malignant form.

Other steps you can take include limiting the amount of alcohol you drink, and avoiding risky behavior. HPV and HIV infections, which can make you more susceptible to liver, cervical and other cancers, can be prevented by never sharing needles and practicing safe sex: limiting the number of sexual partners you have, and using condoms. Finally, visit your doctor at least once a year for preventive screening and an overall health checkup.

For more information about cancer and other health issues, click here.

Leslie Vandever is a professional journalist and freelance writer. Under the pen-name “Wren,” she also writes a blog about living well with rheumatoid arthritis called RheumaBlog (www.rheumablog.wordpress.com). In her spare time, Vandever enjoys cooking, reading and working on the Great American Novel.

References:

  •  What is Cancer? (2013, Feb. 8) National Cancer Institute. National Institutes of Health. Retrieved on January 26, 2014 from http://www.cancer.gov/

In honor of National Cancer Prevention Day, please consider making a donation to the T.J. Martell Foundation by clicking here. The Foundation funds cutting-edge research that will lead to clinical trials and drug discoveries that will help save lives!

 

We Want YOUR BUSINESS To Get Involved!

We would like to thank Edwards Photography Studios for supporting our organization in the month of January. You can help with a simple “CLICK.” Go to their Facebook page, and click “LIKE.” For each new like in the month of January, they will donate $2 to our foundation. Please SHARE our Facebook posts and invite your friends to do the same!

Does your company have a fan page on Facebook? We’d love for you to get involved with a campaign like this which raises money for life-saving research AND gains exposure for your business, a win-win for everyone involved! Ready to make us your charity of the month? Please email Kate Fitzpatrick, our social media manager, kfitzpatrick@tjmartell.org for details.

Settings Goals: the similarities between running a half marathon and business

Laura Heatherly with Nashville’s Mayor Karl Dean. Mayor Dean started a great program called Walk 100 Miles to get people in Nashville moving!

As most of my friends know, I am an avid runner. I enjoy my daily runs as they keep me energized, relieve stress and help me sort out my business goals for the day.

This year, I am planning to run the country music half marathon in Nashville. I took the past two years off from running marathons as I felt I wasn’t focused or in the right frame of mind to go the distance. I’m really fired up about training and meeting the goal of finishing 13 miles without stopping!

Yesterday during my training run, I decided that running is actually similar to business. You set certain goals for yourself to run a certain distance, tackle tough hills, run without stopping and finishing the run.

In my business working for the T.J. Martell Foundation, I set goals for myself. I set my sights on particular projects, create lists of goals for those projects ( such as fundraising, sponsorships, donor outreach, etc. ) and then tackle those goals until I achieve them. Similar to running, there are tough areas in fundraising such as finding new donors and sponsors, keeping focused and meeting the fundraising budgets.

The great achievement that I find when I meet goals whether in running or in business is the personal satisfaction of making life better. My life is much healthier by running as I am more fit, have a great attitude, am a bit less stressed and feel fabulous. In fundraising, I’m helping to give hope and saving lives. These are great goals for 2014.

Excerpt: Tackling a Racial Gap in Breast Cancer Survival

Every day in our work with cancer patients and research doctors, we are reminded of the importance of continuing to fund life-saving advancements and consistently renew our commitment to our foundation’s mission. A recent article in The New York Times states the eye-opening fact that black women are far more likely to die of breast cancer than white women, shining new light on the urgency of funding better treatments for every woman:

The cancer divide between black women and white women in the United States is as entrenched as it is startling. In the 1980s, breast cancer survival rates for the two were nearly identical. But since 1991, as improvements in screening and treatment came into use, the gap has widened, with no signs of abating. Although breast cancer is diagnosed in far more white women, black women are far more likely to die of the disease.

And Memphis is the deadliest major American city for African-American women with breast cancer. Black women with the disease here are more than twice as likely to die of it than white women.

“The big change in the 1990s was advances in care that were widely available in early detection and treatment,” said Steven Whitman, director of the Sinai Urban Health Institute in Chicago. “White women gained access to those advances, and black women didn’t.”

Over all, black women with a breast cancer diagnosis will die three years sooner than their white counterparts. While nearly 70 percent of white women live at least five years after diagnosis, only 56 percent of black women do. And some research suggests that institutions providing mammograms mainly to black patients miss as many as half of breast cancers compared with the expected detection rates at academic hospitals.

To read the full article, please click here.

Women of Influence!

We’re excited to congratulate Randi Rahm, one of our esteemed honorees for the Women of Influence Awards coming up on May 1st, 2014. The one and only Beyonce wore one of Randi’s gorgeous dresses to the White House this weekend for Michelle Obama’s birthday!

For more information on the Women of Influence Awards and to buy your tickets, please click here.

We Want YOU To Get Involved!

Young professionals, do you feel like it’s out of your budget to attend charity events? Are you looking for a fun way to support our foundation without breaking the bank? Our new friend Danielle gathered her friends for Sunday brunch at her apartment in Manhattan, charged a small entry fee to cover costs and donated the proceeds, over $150, to our research programs. Thank you, Danielle, for your creativity and generosity! Want to host a gathering like this but not sure where to start? Contact us for support and we’ll help you along the way, supplying ideas, brochures and whatever else you may need!