Cancer

Howard LeWine, M.D.

HPV transmission during oral sex a growing cause of mouth and throat cancer

Actress Angelina Jolie recently went public with her double mastectomy to prevent breast cancer. Governor Chris Christie told us his reasons for gastric bypass surgery. And now actor Michael Douglas is shining the spotlight on the human papilloma virus (HPV)—the number one cause of mouth and throat cancer. In an interview published in The Guardian newspaper in London, Douglas mentioned that his own throat cancer could have been brought on by oral sex, a common way to become infected with HPV. HPV transmitted by sexual contact often doesn’t become active enough to cause symptoms. When it does become active, it tends to invade mucous membranes, such as those covering the lining of the vagina, cervix, anus, mouth, tongue, and throat. An HPV infection can cause warts in and around these tissues. Most people sexually exposed to HPV never develop symptoms or health problems, and most HPV infections go away by themselves within two years. But the infection can persist and cause long-term problems. These include cervical cancer in women, penis cancer in men, and in both sexes some cancers of the anus and oropharyngeal cancer (cancer in the back of throat, including the base of the tongue and tonsils).

Patrick J. Skerrett

Celebrating cancer survivors

Sunday, June 2, is National Cancer Survivors Day. It was started 26 years ago as a way to recognize and support people living with cancer. The foundation that organizes the yearly event defines survivor as “anyone living with a history of cancer – from the moment of diagnosis through the remainder of life.” National Cancer Survivors Day offers survivors and their family members and friends a chance to acknowledge the hard work that goes into fighting cancer and to show the world that survivors can live fulfilling lives. The day is observed in many different ways. Around the U.S. and in 18 other countries, community groups, hospitals, and other organizations hold breakfasts, picnics, walks, fun runs, and other activities.

Howard LeWine, M.D.

New sunscreen labels offer clearer sunburn, skin cancer information

With the unofficial start of summer just a few days away, many people will soon be stocking up on sunscreen. The products they’ll be seeing in stores look different than they have in the past. That’s because new rules for sunscreen labels are now in effect. The changes are good ones for consumers. The new rules, mandated by the FDA, are making sunscreen more informative with less misleading information. For example, the term “sunblock” is banned because none of these products can block all of the sun’s ultraviolet rays. “Waterproof” is also banned, replaced by “water-resistant”—which must be accompanied by a set time for reapplication. Another big change has to do with SPF, or sun protection factor. The best protection comes from a sunscreen that provides broad spectrum protection, meaning it filters out much of the UVA and UVB. Under the new FDA rules, if a label says “broad spectrum,” the product must pass tests proving that it truly protects against both UVA and UVB rays. Sunscreen products that don’t meet an SPF of 15 or higher for both UVA and UVB must now carry a warning.

Howard LeWine, M.D.

Alcohol: a heart disease-cancer balancing act

The message that drinking a little alcohol is good for the heart has gotten plenty of attention. A new study linking alcohol with increased risk of dying from various cancers may temper that message a bit. About 4% of cancer deaths worldwide are related to alcohol use. A new study shows the in the United States, alcohol causes 3.5% of cancer deaths, or about 20,000 cancer-related deaths each year. The most common alcohol-related cancers were mouth, throat, and esophageal cancer in men, and breast cancer in women. At the same time, drinking alcohol in moderation (no more than two alcoholic drinks a day for men and no more than one a day for women) has been linked to lower rates of heart disease and deaths related to it. Advances in genetics may one day let us predict more accurately who can use alcohol in moderation and who should avoid it completely. Until then, it’s best to personally weigh the benefits and risks, ideally with a trusted health care provider.

Patrick J. Skerrett

Studies explore global burden of disease and heart disease in the United States

If you like numbers and statistics, especially those about health, two reports released this week should keep you occupied for days: the massive Global Burden of Disease study was published in The Lancet, and the American Heart Association released its annual “Heart and stroke statistics” report. The Global Burden of Disease project found that average life expectancy continues to rise in most countries. It also found that infection and other communicable causes of disease no longer dominate deaths and disability. Today, so-called non-communicable causes like traffic accidents, violence and war, heart disease, cancer, and other chronic conditions account for two-thirds of world deaths and the majority of years lost to disability and death. According to the American Heart Association’s annual report, the percentage of deaths due to heart attack, stroke, and other cardiovascular diseases has fallen by nearly one-third since 1999, but don’t expect that to continue. Increases in high blood pressure, high cholesterol, diabetes, overweight, and inactivity threaten to reverse these gains.

Stephanie Watson

Fear of breast cancer recurrence prompting women to choose prophylactic mastectomy

Living through the physical and emotional toll of breast cancer is so traumatic that some women can’t bear the thought of doing it again. That’s why a growing number of women who have already been diagnosed with cancer in one breast are taking the drastic measure of having both breasts removed (a procedure called prophylactic mastectomy). Yet a University of Michigan study presented last week at the American Society of Clinical Oncology’s Quality Care Symposium showed that nearly three-quarters of women who had this procedure were actually at very low risk of developing cancer in the healthy breast. In other words, many women are unnecessarily exposing themselves to the potential risks of a double mastectomy—including pain, infection, and scarring. The new study suggests that more and better information about breast cancer recurrence—and the risks and benefits of prophylactic mastectomy—are needed as women consider this procedure.

Howard LeWine, M.D.

Gene mutation key to aspirin’s benefit in people with colorectal cancer

Back in 2009, Dr. Andrew T. Chan and his colleagues at Harvard-affiliated Massachusetts General Hospital found that people diagnosed with colorectal cancer who took aspirin on a regular basis tended to live longer than those who didn’t take aspirin. Aspirin worked only for some people, though, so Chan and a larger team of researchers set out to learn why. Their latest work, published in the New England Journal of Medicine, indicates that people with colorectal cancer who have a mutation in a gene called PIK3CA are most likely to benefit from aspirin. (About 15% to 20% of people with colorectal cancer have this gene mutation.) The mutation permits colon cancer cells to thrive. Aspirin blocks this action. If confirmed, this work could lead to routine genetic testing for people with this common cancer, and aspirin therapy for those with the PIK3CA mutation.

Patrick J. Skerrett

Daily multivitamin-multimineral may help protect against cancer

Americans’ love affair with vitamins—more than half of us take one a day—isn’t well supported by science. Trials of single vitamins, like E, C, and beta carotene, have been a bust. Whether multivitamins offer any health benefits has been something of a mystery. Now a new report indicates that taking a standard multivitamin-multimineral pill every day for more than a decade reduces the odds of developing cancer by 8%. The finding comes from the Physicians’ Health Study II, a Harvard-based trial in which nearly 15,000 male physicians took a daily pill containing 31 vitamins and minerals (Centrum Silver) or a placebo. The reduction could be due to fixing micronutrient deficiencies. It’s also possible that low doses of several vitamins and minerals might work together in other ways to prevent cancer. A daily multivitamin-multimineral supplement can provide some nutritional insurance, but it’s no replacement for vegetables, fruits, whole grains, and other healthful foods.

Howard LeWine, M.D.

Study backs mammograms for women 50 to 69

For years researchers have been trying to weigh the benefits of finding early breast cancers against the risks related to false positives (the spots that turn out to be harmless). This work has sparked some bitter public debates and confusion for women over flip-flopping recommendations. The latest salvo comes from a review of the results of mammograms among more than 12 million women in 18 European countries. The results support the idea that routine mammograms can prevent deaths from breast cancer without causing undue harm. The findings support the U.S. Preventive Services Task Force’s recommendation that women between the ages of 50 and 74 have a mammogram every other year. Women at higher risk of developing breast cancer may need mammograms earlier than age 50, or more often than every other year.

Daniel Pendick

Global cancer research database reveals what you can do to lower your risk

Based on data presented this week at the Union for International Cancer Control meeting in Montreal, a startling 40% of cancers may stem from modifiable causes, such as diet, exercise, tobacco and alcohol exposure, and appropriate screening. Although adapting a healthy lifestyle isn’t an ironclad guarantee against cancer, it can help lower a person’s individual risk.