Smoking tobacco, using a hubbly bubbly pipe and smoking dagga (marijuana), puts young people at high risk of developing oral- and oro-pharyngeal cancers. This message was highlighted by the South African Dental Association (SADA) at a press briefing in Cape Town this week.

In the past, these types of cancer mostly occurred in adults over the age of 45, but in recent years, it has become increasingly prevalent in younger people between 20 and 30 years of age.

“While part of the explanation of this can be attributed to the Human Papilloma Virus (HPV) and the changing sexual behaviours of a younger generation where multiple partners and oral sex feature strongly, many other lifestyle practices also become significant in view of recent research results that indicate causal links between oral- and oro-pharyngeal cancer and cannabis and hubbly bubbly pipe smoking,” Maretha Smit, Chief Executive Officer of SADA said in a statement.

Cancer-causing HPV is transmitted through skin-to-skin contact, usually during sexual contact. The same type of HPV that causes cervical cancer is responsible for some oral and oro-pharyngeal cancers, and are transmitted to this region of the body through oral sex.

Link between dagga and cancer

Dagga has the same risk as any smoking tobacco in that it contains carcinogens that may cause cancer. In addition, research has also identified a link between dagga-use and HPV-related oral cancers.

Professor André van Zyl from the University of Pretoria explained that, other than regular tobacco smoke, dagga modifies the immune system, thereby causing HPV to spread easier during oral sex. Once it has spread, the cannabinoids will also promote the persistence of the HPV infection, as well as promoting tumour formation by suppressing those parts of the immune system required to protect against cancer.

In comparison to non-smokers it was found that dagga users had a more than four-fold increased risk of developing HPV-positive cancer.

“In South Africa, the use of cannabis among school-going children is on the increase. Coupled with changing sexual behaviours in the same groups and where oral sex features prominently, these trends will most like lead to increases in HPV oro-pharyngeal cancers in the next 10 to 20 years,” said Van Zyl.

Water pipe not innocent fun

Water-pipe smoking, locally known as the Hubbly Bubbly or Hookah pipe, is growing in popularity among school-going children and young people worldwide. Often with the full knowledge and approval of their parents who believe it to be innocent fun.

But that is not the case at all—water-pipe smoking is just as addictive, and even more dangerous than cigarette smoking. According to Van Zyl, the idea that the water in the Hubbly Bubbly filters out harmful substances is untrue, and smoke from the water pipe contains nicotine, tar and heavy metals and exposes the user to high levels of carbon monoxide.

What makes the water pipe even more dangerous is that the cooling effect from the water, combined with the fruity flavours of the tobacco, creates a soothing effect allowing smokers to inhale the smoke more deeply than regular tobacco smoke. The water pipe is also smoked in sessions of up to 45 minutes, therefore exposing the smoker to a lot more carbon monoxide than cigarette smoke. “Participants may inhale as much as the equivalent of 100 cigarettes,” said Van Zyl.

“The bottom-line message is that water-pipe smoking can deliver carcinogenic substances directly into the mouth and upper respiratory tract as well as the lungs,” said Van Zyl. “At the very least it is as dangerous as cigarette smoking while a further worrying aspect of the water pipe is that it exposes young people to the habit of smoking, increasing the risk of addiction. Also, because it is happening under the critical age of 16, these individuals are at enormous increased risk to suffer various cancers under the age of 45 years.”

There is the additional danger that the sharing of mouthpieces may spread other infectious agents such as herpes, hepatitis and tuberculosis.

Cancers associated with HPV, dagga and hubbly bubbly pipe smoking occurs mostly in young adults. “These young people could never imagine that they might develop oral cancer, and, it is therefore imperative that regular dental check-ups are conducted to ensure an early diagnosis of cancer in either the oral cavity or in the oro-pharyngeal area,” Van Zyl concluded.

Source: South African Dental Association (http://www.sada.co.za)

A substantial number of lung and colorectal cancer patients continue to smoke after being diagnosed with cancer, according to a new report published in CANCER.

The study provides valuable information on which cancer patients may need help to quit smoking.

According the study continuing smoking after a cancer diagnosis can negatively affect a patient’s response to treatment and possible recovery, and can ultimately raise their chance of death.

The study, led by Dr Elyse Park from Harvard Medical School in the United States, looked to see how many patients quit smoking around the time of their cancer diagnosis, and which smokers were most likely to quit. The researchers determined smoking rates around the time of diagnosis and five months after diagnosis in 5338 lung and colorectal cancer patients. Colorectal cancer, commonly known as bowel cancer, is a cancer from uncontrolled cell growth in the colon, rectum, or appendix.

Substantial group

The research found that a substantial group of cancer patients continue to smoke. At the time of diagnosis, 39% of lung cancer patients and 14% of colorectal cancer patients were smoking. Five months later, 14% of lung cancer patients and 9% of colorectal cancer patients were still smoking. And although lung cancer patients generally have higher smoking rates, colorectal cancer patients were less likely to quit smoking after diagnosis.

Other shared characteristics between patients, apart from their types of cancer, were also identified to help physicians pinpoint the type of individuals more likely to continue smoking after diagnosis.

“These findings can help cancer clinicians identify patients who are at risk for smoking and guide tobacco counselling treatment development for cancer patients,” Dr Park said in a EurekAlert! report.

Source: EurekAlert!

The study was published in the American Cancer Society’s current issue of CANCER by researchers at Moffitt Cancer Center.

Please read it at http://www.medicaldaily.com/news/20111206/8114/breast-cancer-chemotherapy-study-fatigue-women-treatment-cancer.htm

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’Healthy for the Holidays’– 10 tips for cancer survivors.

Surviving the holidays with one’s waistline, bank account and sanity intact can be challenging for everyone, but the season affords specific pitfalls – and opportunities – for cancer survivors who are mindful of staying healthy throughout the season and beyond.

One in 20 adults in the U.S. is a cancer survivor, and the number of survivors is growing, many of whom have long-term health needs resulting from the disease and its treatment.

Karen Syrjala, Ph.D., co-director of the Fred Hutchinson Cancer Research Center Survivorship Program, offers these tips for survivors. Most of them apply to anyone who wants a healthier holiday and less-stressful new year.

•  Know your holiday stress points. Do certain family members put you on edge? Do you take on too much and then find you don’t have time for it all? Start by asking yourself what makes you feel most pressured or irritable, and then what choices do you have to make this stress more manageable?  If you have to see a difficult relative, can you arrange something fun afterward? This way you can remind yourself that in a few hours you’ll be doing something that you enjoy.  It will help you get through a potentially difficult time.
•  Are there holiday events or traditions you could live without? Can you gracefully bow out of gatherings or obligations you no longer enjoy? Do you really need to bake all those cookies? Can this be the year you send a Christmas email or a link to your Facebook page instead of all those cards?
•  Are there non-holiday events you could postpone for a week or two? If your holiday to-do list is longer than Santa’s, perhaps schedule your next routine CT scan or mammogram after the holidays.
•  Remember your precious people. Schedule “together time” with those who may need you the most this holiday season, or those you most want to see. By scheduling ahead you can make sure you make time for what matters most to you. Our bodies and brains respond positively in lots of ways to time spent connecting with those we are close to; consider this important for your health during the holidays.
•  Keep moving. Physical activity is the clearest step you can take to benefit your health during the holidays and any time of year. It is certain to make you feel good and help your body and brain to function better. It can even reduce your cancer-related risks. Make opportunities to walk or take stairs for at least 10 minutes at a time. If exercising alone is hard, check with your local Y to see if they have a program for cancer survivors.
•  Practice healthy nutrition. Know what foods help you feel and do your best, then focus more on giving your body what it needs (such as fruits and vegetables) and less on trying not to eat certain foods. Eat sweets in moderation and make sure you also get protein, fiber and healthful fats. Eat your healthy food before going to a party so that it is easier to indulge in moderation. Make an appointment with a nutritionist if you are unsure what is healthy for you or if you have digestion problems.
•  Know how alcohol affects your health. Alcohol use has been associated with an increased risk of certain cancers. If you drink, do so in moderation (one drink a day for women and two for men).  Before a social event, plan ahead what and how much you’ll drink. Alternate between alcoholic and non-alcoholic drinks, such as sparkling water with lime, to help pace yourself and stay hydrated. If it’s hard to say no once you’ve started drinking, then plan to stick with non-alcoholic drinks.
•  Relax your body and mind. When you are more relaxed you sometimes get more done – and feel better doing it. When you feel wound up or overwhelmed, take five minutes to breathe deeply and scan your body from head to toe. Close your eyes and breathe in through your nose to a count of four, hold your breath for a count of two, breathe out through your mouth for a count of four, and repeat. Check your forehead, jaw and tongue for tightness, relax; then check your neck and shoulders, stretch and move them to find a comfortable position, then continue with your arms, chest, abdomen and legs. You can even breathe and relax your body while driving – just don’t close your eyes!
•  Tend to your body’s needs. Notice if there are parts of your body that aren’t working well. Make a list and an appointment with your doctor for after the holidays. Talk with your doctor if you have fatigue that hasn’t improved with time; mental fog that makes it hard to work or remember things; neuropathy (numbness or pain in your feet, hands or elsewhere), incontinence or other problems that affect your quality of life. Knowing you have a plan for attending to these problems can ease your mind during the holidays and let you focus on other things.
•  Have a long-term plan for your survivorship care. Schedule an appointment to go over your survivorship needs if you aren’t sure about your risks for long-term problems or you aren’t sure what symptoms to watch for to maintain your health. Tap into a survivorship program to help you detail a follow-up care plan to share with your primary care provider. Make appointments now so you can forget about them during the holidays.

In the Northwest region, visit the website of the Fred Hutchinson Cancer Research Center Survivorship Program at www.fhcrc.org/survivorship. For information on other LIVESTRONG Survivorship Programs of Excellence visit www.livestrong.org/What-We-Do.

But the Macmillan Cancer Support data highlights a “woeful” lack of progress for some types of the disease, such as lung and stomach cancer.

To read more about this interesting study, go to  http://www.bbc.co.uk/news/health-15726810

Cancer survivors of both genders and any age will face a variety of challenges to their health long after their initial cancer diagnosis and treatment. Vigilant post-cancer follow-up care is very important to address these challenges for the most successful outcome.

“Follow-up care and long-term management of the challenges that can arise following treatment of a primary cancer are important subjects for survivors,” explains Dr. Jui-Lien “Lillian” Chou, Radiation Oncologist and breast cancer survivor. “In addition to the health issues that arise from the treatment for the primary cancer, there is the fear of local cancer recurrence and/or the spread of cancer to other areas of the body.”

When Cancer Spreads

Cancer that has developed in one area of the body can spread or metastasize beyond that site and invade other parts of the body. Cancer cells can travel through the blood stream or lymph system; and while cancer can travel to any part of the body, the bones, lungs and liver are the most common sites for cancer to metastasize. Certain cancers, including breast cancer and prostate cancer, can spawn a distant metastasis 10, 20 or even 30 years after the initial cancer treatment.

“In general, distant or systemic metastases are considered stage IV,” explains Dr. Chou. “Once cancer has spread to several places in the body it can rarely be cured, but it can often be treated. Thanks to modern diagnostic procedures and treatment options, we have the ability to locate and manage metastases. With proper management, patients who respond to therapy can feel better and live longer.”

Bone Metastases

Bones are a common place for spreading cancer cells to settle in and start growing. These bone metastases can happen anywhere in the body, but they are mostly found in the spine, pelvis, ribs and skull.

When cancer spreads to the bone, cancer cells can affect bones in two ways, explains Dr. Chou. Cancer cells often make substances that damage the bones and leave them weak and vulnerable to fracture. In other cases, cancer cells cause bones to become harder. Both types of bone metastases can cause pain. If the bone metastasis is on the spine, it can press on the spinal cord, causing nerve damage, pain, and in extreme cases paralysis.

“Pain or a bone fracture which is unrelated to trauma (like a fall) is often the first flag for the patient and the physician. High levels of calcium in the blood can also be a sign of a bone metastasis,” says Dr. Chou. “The actual symptoms will vary according to the location and the size of the metastasis.”

Sometimes bone metastases are found before they have a chance to cause any symptoms. Cancer survivors may have tests like bone scans or PET/CT to see how far the cancer has spread. This may be done before, during, and after treatment.

Treatment Options

If you or your loved one is a cancer survivor, it is important to report any new symptoms or changes in old symptoms to the doctor right away. Finding and treating these symptoms early can help reduce the chances of more problems later on.

There are a variety of treatment options available for bone metastases, including chemotherapy, anti-hormonal therapy, radiation therapy, and in certain restrictive cases, surgery.

“Each patient must remember that his or her body is unique, and so is his or her cancer. No one can predict how an individual patient’s cancer will respond to treatment,” says Dr. Chou. “Statistics can paint an overall picture, but each individual patient has unique strengths and emotional and spiritual supports which impact how they cope with cancer. Our staff understands that and presents a range of options for the best management plan to suit the patient’s needs and desires.”

Comprehensive Cancer Care

Lubbock Cancer Center provides comprehensive care for screening, diagnosing, evaluating, and treating all types of cancer. In concert with the area’s best medical specialists, Lubbock Cancer Center can answer the need for comprehensive cancer care, from assessment and early detection through treatment and follow-up care.

Three world-class facilities – Lubbock Imaging Center, Wellness Lubbock and Lubbock Cancer Center – come together as a team of medical professionals to bring patients the latest technology and treatment options for all types of adult cancers.

For more information, please contact Lubbock Cancer Center at (806) 793-1406.

By Anso Thom.

Cancer patients relying on the state health system are increasingly struggling to access timeous treatment or their diagnosis and treatment is delayed until it is too late, cancer advocacy and support organisations have warned.

Their warnings come in a week where the South African health minister addressed stakeholders on non-communicable diseases and world leaders prepare to gather under the United Nations banner in New York to make serious commitments to stem what many have warned is a “health tsunami”.

Campaigning for Cancer and People living with Cancer have confirmed that they are receiving an increasing number of reports from patients struggling to access treatment.

One of the most harrowing cases is a cancer patient who for almost a year was sent from pillar to post at Johannesburg’s Charlotte Maxeke Hospital, without being offered any treatment and sent home until there was external intervention.

Patient D’s story was first revealed by a friend at a “Voice of Cancer” meeting in Cape Town earlier this year where a number of survivor’s shared their stories of living with cancer.

Patient D is now unable to care for herself due to the cancer having spread to her brain.

“After receiving no response from the hospital we escalated Patient D’s case to the DG of health. Only then did Patient D receive appropriate treatment,” said Neil Kirby Chairperson of Campaigning for Cancer.

Patient D is currently gravely ill, partially blind and unable to take care of herself.

Health-e held off exposing Patient D’s plight after the national health department pleaded for time to investigate her case.

A report from the hospital CEO reveals that Patient D had been referred to Johannesburg hospital in October last year.

It appears as if her treatment was only started in May, almost seven months after her first visit to a hospital. The Johannesburg hospital CEO’s clinical report does not deal with any of the accusations that the hospital had failed to communicate with the patient and does not explain the delays in radiation treatment which only started once Campaigning for Cancer intervened on her behalf.

In another case Patient C was diagnosed in March this year with cervical cancer at the Port Elizabeth state hospital and was referred for radiation treatment to the Dora Nginza provincial hospital in Port Elizabeth.

Here, doctors in turn referred her to Groote Schuur hospital in Cape Town for surgery. At Groote Schuur she was told that surgery was not indicated and was sent back to Port Elizabeth for radiation treatment.

She contacted People Living with Cancer (PLWC) in July. Campaigning for Cancer as alerted and wrote to the Eastern Cape health department as well as the Director-General in the national health department.

Again, it was the DG Precious Matsoso’s intervention that led to action.

Kirby said they had been writing several letters to hospital CEOs, but that the only time they have had any response had been when they contacted Matsoso.

A case brought to the attention of People living with Cancer involved 55-year-old Patient B who was referred by her doctor to Johannesburg hospital with a lump in her neck. She was told she could not be seen at the academic hospital and was sent to Helen Joseph where she had to wait for weeks before being seen.

Subsequent surgery confirmed that the lump was cancerous. Patient B was subsequently informed that the cancer had also spread to her lungs.

Eleven weeks after being referred by her GP, but without any treatment for the diagnosed cancer, Patient B turned to People living with Cancer. She has been referred back to Johannesburg Hospital but the appointment next week is too late, according to the family doctor.

Her health has deteriorated and new lumps have appeared. She weighs 45kg and is weak.

“Obviously cost is a factor of which we feel at this stage it is a life or death situation and money is irrelevant, we just need your help and treatment,” her son pleaded in a letter.

Kirby confirmed that they were receiving increasing reports of patients who unable to access treatment.

“In many cases by the time patients are able to access treatment it is too late,” she said.

Proactive diagnosis is a problem, with many patients not being diagnosed when they first report for medical assistance. “They are sent from pillar to post and by the time they reach the point where they are diagnosed, it’s too late. The referral process from day hospitals to specialist cancer units at tertiary hospitals is not effective and is hampering all efforts made to educate people about early detection of cancer,” said Linda Greeff of People living with Cancer.

Health minister Dr Aaron Motsoaledi met with non-communicable disease (NCD) representatives this week. He is expected to accompany President Jacob Zuma to the United Nations High Level meeting on NCDs in New York on Monday and Tuesday next week.

“We are not going to let these matters pass. Many of these patients have been failed by the health system on numerous occasions and one has to ask the question whether the outcome could not have been different had they been assisted when she first went to the hospital,” said Kirby.

NCDs include cancer, cardiovascular disease, chronic respiratory diseases and diabetes.

http://www.health-e.org.za/news/article.php?uid=20033256

Childhood cancer survivors on average live 10 years less than the rest of us, mainly because being a survivor opens the door to new risks.

Tanasia Dogan knows that all too well. After sinus cancer in high school left her disfigured, she’s just starting to go out in public again.

“Embarrassed and ashamed and really depressed and I closed myself in and I didn’t talk to no one, I didn’t leave the house,” Dogan said.

A visit to the dentist’s office revealed her jaw bone had been eaten away. After undergoing intensive chemotherapy, doctors removed the plum sized tumor during a 22-hour surgery. But attempts at reconstructing her jaw have been rejected by her face. She’s had 15 surgeries and is ready for another. “He has to give me new bone and reconstruct my eye socket,” she said.

Dogan is just one of the 350,000 childhood cancer survivors in the U.S. Two-thirds of them will have another life-threatening illness at some point in their lives.

“Heart problems, lung problems, issues with their kidneys, some of them have fertility issues. Many are at high risk for second cancers,” said Dr. Tara Henderson, Medical Director of the Childhood Cancer Survivor Center at the University of Chicago.

Without proper screening, these survivors are put at risk all over again. Dr. Henderson offered Hodgkin’s Lymphoma as an example.  “Women that got chest radiation to cure that Hodgkin’s Lymphoma have extremely high rates of breast cancer,” she said.

But many doctors are unaware of these risks. A recent survey of 1,500 physicians found less than 5 percent of them knew the proper screening for pediatric cancer survivors of Hodgkin’s.

“By improving the screening and detecting long-term problems earlier will ultimately reduce the morbidity and mortality of these patients, ” Henderson said.

As for Dogan , she’s still working on the present.

“It’s like I have this thing in my head, like once I was diagnosed with the cancer that Dogan had left. And now it’s a new Dogan that I have to get to know. I don’t know her just yet,” she said.

When she does, she’d like to be a motivational speaker for others like her.

Written by Chris Bateman.