Racial gap in cancer death linked to social status

Black patients with colon cancer seem to fare just as well as their white counterparts after accounting for differences in socioeconomic status and the treatment received, according to a report in the journal Cancer.

"Few studies have addressed racial disparities in survival for colon cancer by adequately incorporating both treatment and socioeconomic factors, and the findings from those studies have been inconsistent," write Dr. Xianglin L. Du and colleagues from the University of Texas Health Science Center, Houston.

The researchers conducted an analysis of published data to determine the association between socioeconomic status and racial disparities in colon cancer survival. Of 66 articles reviewed, 56 were excluded, leaving 10 studies for the final analysis.
"All 10 studies provided estimates on racial disparities in survival for colon...cancer that adjusted for some measures of socioeconomic status, age and sex," the team found. However, only three studies adjusted for all the key variables -- socioeconomic status, treatment, the presence of other diseases, and the stage of cancer.

A total of 96,494 patients with colon cancer were included in the analysis. After accounting for socioeconomic factors and treatment differences, there was little difference in survival between black and white patients.

Du and colleagues conclude that survival differences are marginal once socioeconomic factors and treatment are taken into account.

"Attempts to modify treatment and socioeconomic factors with the objective of reducing racial disparities in health outcomes may have important clinical and public health implications," they point out.

SOURCE: Cancer, June 1, 2007.

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Mouth rinse spots early head and neck cancer

Detecting head and neck cancer early, when the odds of successful treatment are best, may be as simple as gargling with saline and spitting in a cup, according to a study conducted by a Miami, Florida-based research team.

Oral rinsing flushes out a protein called CD44 -- a known biomarker for cancers of the head and neck. It also detects altered DNA related to these tumors. And the combination of these two biomarkers reliably detects head and neck tumors, the research shows.

Dr. Elizabeth J. Franzmann of the University of Miami's Sylvester Comprehensive Cancer Center reported her team's work at the annual American Association for Cancer Research meeting in Los Angeles.
"Cancer of the head and neck is a very debilitating and deadly disease that is often detected in late stages when cure rates are only about 30 percent," Franzmann told Reuters Health. "If we could catch it earlier, we should be able to cure it at least 80 percent of the time but we really need an early detection test."

The CD44 protein is involved in normal cell functions, but in cancer it is over expressed and appears in alternative forms that are also involved in tumor formation. Importantly, the protein and altered form can be found in bodily fluids.

"Initially, we found that if a patient swishes and gargles for 5 seconds each with saline and spits in a cup, we can actually measure the CD44 level; and it turned out that it was high in most of our head and neck cancer patients," Franzmann said.

The potential value of the oral rinse test was confirmed in a subsequent study of 102 head and neck cancer patients and 69 subjects with benign head and neck disease who were smokers and drinkers. "Head and neck cancer is primarily a disease of tobacco and alcohol users, although about 20 percent don't have any such history," Franzmann explained.

In this study, the oral rinse test detected two individuals with symptom-less cancer or precancer and it detected few "false positives" in the comparison group. Overall, "we found CD44 in spit in the head and neck cancer patients 62 percent of the time," Franzmann reported.

"We wondered whether some of the cancers were being missed because the CD44 gene can get turned off later on in the process of tumor formation. This turning off can be detected in the oral rinse."

"Sure enough, we found that in 9 out of 11 head and neck cancers with low CD44, the gene had been turned off," Franzmann said.

Looking at the two markers contained in the oral rinse distinguished head and neck cancer from benign disease almost 90 percent of the time, Franzmann. "And that's pretty good; it's similar to what the PSA test for prostate cancer does."

The mouth rinse test, Franzmann added, is simple enough to be administered at any community health center for individuals at high risk of head and neck cancer.

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A hypochondriac gets cancer and writes a book

John Diamond was a British journalist who died from tongue cancer in 2001. He wrote a book called Because Cowards Get Cancer Too: A Hypochondriac Confronts his Nemesis.

This book is different than your normal cancer read. I say that because of John Diamond's wit and intelligence when writing about his cancer experience. His sarcasm when it came to things like people telling him that he was brave was right on. He didn't think he was brave for going through cancer treatments, he thought that it was his only choice, something he had to do. This book is a realistic look at things that were going on around him and within him. John, you and I are definitely on the same page!

I have already read this book twice and when I find it I'm going to read it again.

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Tips for dealing with dry mouth

Dry mouth (xerostomia), is most commonly caused by radiation therapy directed at the head and neck region of the body. Radiation may irreversibly affect the production and quality of saliva in the salivary glands. A number of medications can also induce xerostomia. Dry mouth may affect the patients speech, taste sensation and ability to swallow.

Many patients complain of a sore or burning sensation, cracked lips, and fissures in the corners of the mouth. There is also an increased risk of cavities and mouth disease due to less saliva to cleanse the teeth and gums.
There are now some means of preventing xerostomia that were not available a few years ago. Amifostine, a radiation protector of normal tissues, has been shown to protect the salivary glands when given daily with radiation therapy. Also, a treatment known as Proton therapy may allow the radiation oncologist to spare the salivary glands from getting significant radiation doses. This may prevent dry mouth in the future. If you are getting radiation therapy to the head and neck region, you should discuss these options with your radiation oncologist. If you have developed xerostomia, there are management strategies that can effectively deal with your dry mouth and prevent cavities and periodontal disease.

Try to follow these simple guidelines:

• Perform oral hygiene at least four times a day. (After each meal and before bedtime)


• The oral cavity should be rinsed and wiped immediately after meals


• Dentures need to be brushed and rinsed after meals


• Only use toothpaste with fluoride when brushing


• Keep water handy to keep the mouth moist at all times


• Apply prescription strength fluoride gel at bedtime


• Rinse with salt and baking soda solution 4-6 times a day


• Avoid liquids and foods with high sugar content


• Avoid rinses containing alcohol


• Use moisturizer regularly on lips


• Oral pilocarpine (Salagen) is the only drug approved by the FDA to stimulate saliva secretion from the remaining salivary glands.

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