SURVIVE CANCER (ORTHOMOLECULAR ONCOLOGY)
Registered Charity No. 1078066

A Cancer Charity which promotes and researches orthomolecular medicine in the treatment of cancer.

Patrons

• HRH Princess Michael of Kent
• The Earl Baldwin of Bewdley
  (Co-Chairman of the Parliamentary Commitee for Alternative and Complementary Medicine)
• Dr Damien Downing, MBBS, (Editor of The Journal of Nutritional and Environmental Medicine)
• Mr Peter J Gravett, MB, MRCS, FRCPath.
• Dr P J Kingsley, MB, BS, MRCS, LRCP, FAAEM, DA, D.Obst. RCOG

Scientific Advisor

• Professor Mauro Perretti, PhD, FBPharmacolS, Deputy Director William Harvey Research Institute

Dental x-rays and cancer

Here are two interesting articles on the recent headlines in the newspapers about the possible danger of dental x-rays.

Study Examines Possible Link Between Dental X-rays and Meningioma Risk
Article date: April 10, 2012
By Stacy Simon
A new study has found that people diagnosed with meningioma, a tumor of the lining covering the brain, are more likely to report that they’ve received certain types of dental x-rays in the past.
The study does not prove that dental x-rays cause these tumors; much more research would be needed to determine that. And experts say the finding does not change the recommendation to have x-rays only when necessary.
The study was published online April 10, 2012 in the journal Cancer.
Most meningioma tumors are benign (non-cancerous), and they tend to grow slowly. In fact, small tumors that aren’t causing symptoms can often be watched rather than treated. Meningiomas can usually be cured by surgery, though some may come back after treatment.
For the current study, researchers examined answers to a health survey from a group of 1433 meningioma patients and compared them to answers from a control group of 1350 people without these tumors. The meningioma group was twice as likely as the control group to report ever having had a bitewing exam, which uses an x-ray film held in place by a tab between the teeth. The meningioma group also was more likely to report having had a panorex exam at a young age (under 10 years old) or on a yearly or more frequent basis. The panorex exam is taken outside the mouth and shows all of the teeth in one film.
X-rays are a source of ionizing radiation, which is a potential risk factor for meningioma. Some of the participants in the study received their x-rays many years ago, when radiation exposure from dental x-rays was much higher than it is with new technology today.
The study has some drawbacks that make the link between dental x-rays and meningiomas far from certain. Perhaps most importantly, it relied on participants’ memories about their history of dental x-rays (rather than on dental records themselves). Such studies are subject to a phenomenon that scientists call “recall bias,” when people with a disease may be more likely to look for a cause. This might have caused the meningioma patients in the Cancer study to over-report the number of dental x-rays they received, which could have contributed to the findings. Because of this, the study results can only be considered suggestive of a possible link, and more rigorous studies would be needed to prove it.
Otis W. Brawley, M.D., chief medical officer of the American Cancer Society said, "We need more data before we can even begin to state there is a relationship between dental x-rays and these tumors. Until that research is done, the best advice we can give people is to get dental x-rays when they are necessary and only when they are necessary. The dose of radiation given in a bitewing or panoramic x-ray is lower today than it was two decades ago. Nonetheless, x-rays should be done only when necessary. This is true of all x-ray technology, and it's the same advice experts would have given without this study.”
On its Web site, the American Dental Association responded to the study with a statement that said in part, “The ADA’s long-standing position is that dentists should order dental X-rays for patients only when necessary for diagnosis and treatment.” The statement also encouraged patients to talk to their dentists if they have questions about their dental treatment.
Lead author of the study, Elizabeth Claus, MD, PhD, of Yale University School of Medicine, said, “Don’t panic – don’t stop seeing the dentist – but do look at the (ADA) guidelines and discuss them with your dentist to see if you can reduce the number of x-rays you’re getting.”
Reviewed by: Members of the ACS Medical Content Staff

X-ray brain tumour risk is not proven
Regular dental X-rays “can double or even triple the chance of developing a common type of brain tumour,” according to The Daily Telegraph.
This news is based on a large US study comparing the dental histories of people who had a brain tumour known as intracranial meningioma with a group of similar people who did not have tumours. People with brain tumours were twice as likely to report having had a specific type of dental X-ray called a “bitewing” in their lifetime, compared with people without a brain tumour. Bitewings are a common type of X-ray, where patients bite down on a small holder containing X-ray film.
What didn’t make the headlines was that the same study showed that having a series of full-mouth X-rays was not associated with any increase in risk of brain tumour, which throws doubt on the proposed link between dental X-rays and brain tumour. Furthermore, participants reported their own history of X-rays rather than researchers checking their dental records. This means people with brain tumours may have been focusing on the potential causes of their cancer and therefore may have been more likely to recall dental X-rays than people without one, potentially biasing the results.
Most importantly though,the chance of developing a brain tumour is very small and, even if X-rays can double the risk, it would still be a very rare event. According to one academic quoted in the press, this doubling of risk actually translated into just a 0.07% increase in lifetime risk, once the overall rarity of brain tumours was taken into account
While this study suggests that dental X-rays may be linked to brain tumour, it falls short of proving an actual link. It is known that exposure to ionising radiation is linked to cancer (which is why X-ray use is kept to a minimum), but people should not be alarmed by today’s sensationalist headlines and should not be dissuaded from having dental X-rays when recommended by their dentist.

Where did the story come from?
The study was led by researchers from Yale University School of Medicine and was funded by grants from the US National Institutes of Health, the Brain Science Foundation and Meningioma Mommas (a not-for profit organisation providing support for those affected by meningioma brain tumours).
The study was published in the peer-reviewed medical journal, Cancer.
It was picked up by a variety of papers and online media. Most had attention-grabbing headlines reporting that dental X-rays “raise the risk of brain tumours” while others said they could “double brain tumour risk”. Reassuringly, once past the headlines, most coverage went on to mention that the absolute risk of getting a brain tumour was tiny even after X-rays, and that the reported doubling of the risk should not be a reason to avoid necessary dental X-rays. The Sun included a reasoned quote from Dr Paul Pharoah from Cambridge University who provided a clear message for worried readers: “People who have had dental X-rays do not need to worry about the health risks of those X-rays.”

What kind of research was this?
This research was a case-control study that aimed to examine the link between dental X-rays and the risk of a brain tumour called intracranial meningioma. A case-control study compares the histories of a group of people with a particular condition (the “cases”) with a group of similar people without that condition (the “controls”). Through this process they can identify differences between the two groups and identify factors that may have caused the condition of interest. They are particularly useful for studying rare conditions such as brain tumours, which would not be detected in sufficient numbers by many study types designed to follow a population over time.
The researchers said that intracranial meningioma brain tumours are the most frequently reported primary brain tumour in the US (a primary brain tumour means that the cancer started within the brain, as opposed to secondary tumours that start in other organs and spread to the brain). The researchers also stated that ionising radiation is consistently identified as being a potential risk factor for this type of brain tumour and that dental X-rays are the most common artificial source of this radiation.
Case-control studies cannot not prove on their own that dental X-rays cause brain tumours. However, this study type is a practical method for studying rare conditions or diseases such as brain cancers.

What did the research involve?
The study enrolled 1,433 patients with intracranial meningioma diagnosed between the ages of 20 to 79 years. This group were called the “cases”. A control group of 1,350 people without brain cancer were also selected to match the cases in age, gender and geographical location (state of residence). All participants lived in the US and were enrolled into the study between May 2006 and April 2011. People with a previous history of brain tumour were excluded from the control group.
Shortly after enrolment, both groups were contacted by telephone and interviewed by a trained interviewer. The interview included questions about the onset, frequency and type of dental care received over their lifetime. This included orthodontic work, endodontic (root canal) work, dental implants and dentures. Participants were also asked to report the number of times they had received various types of dental X-rays during four periods of life:
• Aged less than 10 years old
• between 10 and 19 years old
• 20 to 49 years old
• over 50
The researchers were interested in three types of dental X-ray:
• Bitewing – a small X-ray view used to look at several upper and lower teeth simultaneously. Bitewing takes its name from the way in which the X-ray film is held in place which involves the patient biting down on a small holder filled with the X-ray film. Bitewing X-rays are often used during routine check-ups to look for tooth decay
• Full-mouth – a series of multiple X-rays is used to build a complete picture of the mouth
• Panoramic – a single X-ray that provides a broad view of the teeth, jaw and lower-skull to check dental alignment rather than find cavities
Information was also gathered on the occurrence and timing of other treatments involving radiation (such as radiotherapy for cancer) - specifically, radiation treatments applied to the face, head, neck or chest.
The researchers then compared the information on dental X-rays between the case and control group to see if there were any significant differences.
The statistical techniques used to analyse the results were appropriate. The researchers made statistical allowances for differences in a variety of factors, including age, ethnicity and educational attainment. People who had radiation of the head, neck, chest or face to treat a condition were excluded from the statistical analysis comparing differences in dental X-rays.

What were the basic results?
Among the main results from this study the researchers found that:
• Over a lifetime, cases were more than twice as likely as controls to report having had a bitewing examination (OR 2.0, 95%CI 1.4 to 2.9).
• People who reported receiving bitewing X-rays yearly or more frequently were at a significantly higher risk of having a brain tumour across all the age-groups tested, except in the over 50s. The majority of study participants (from both groups) reported having at least one bitewing X-ray in their lifetime.
• There was no significant difference between the self-reported frequency of full mouth X-rays in those with a brain tumour and those without.
• More people in the case group reported having panoramic dental X-rays at a young age, on a yearly basis or with greater frequency compared with controls. For instance, individuals in the case group (with brain tumour) were almost five times more likely to report having received panoramic X-rays before the age of 10 than people in the control group (OR 4.9 95%CI 1.8 to 13.2).

How did the researchers interpret the results?
The researchers’ cautious conclusions were that “exposure to some dental X-rays performed in the past, when radiation exposure was greater than in the current era, appears to be associated with an increased risk of intracranial meningioma [brain cancer]”.
They added, “As with all sources of artificial ionising radiation, considered use of this modifiable risk factor may be of benefit to patients.”

Conclusion
This large case-control study shows that people with a brain tumour report having dental X-rays (specifically bitewing and panoramic types) significantly more frequently over their lifetime than similar individuals without tumour. The differences were only significant for bitewing and panoramic type dental X-rays and not for full-mouth X-rays.
These mixed results raise the possibility that dental X-rays may be associated with brain tumours but it stops short of proving this link. The study has significant limitations which should be borne in mind when interpreting the results of the research:
• This was a case-control study that looked at people with and without a brain tumour and analysed differences in their past exposure to dental X-rays. More of the people with brain tumours recalled having dental X-rays (bitewing and panoramic) in the past and so an association was identified. However, this does not prove that dental X-rays cause brain tumours, merely that the two events may be linked. There could be many other factors at play that are contributing to this association.
• It is slightly odd that full-mouth X-rays were not shown to be linked with brain tumour in this study, which you would expect to be the case if the X-rays were the indeed linked to brain tumours, particularly as they are performed using a series of X-rays. This highlights that further work is need to prove any link between dental X-rays and brain tumour. A cohort study that followed people over time to see who developed tumours and who did not would be needed to establish a causal link.
• Participants were asked to recall their own history of dental X-rays from throughout their lifetime. The accuracy of recalling this information may not be perfect and this may reduce the reliability of the results. It would have been preferable to assess the use of X-rays by examining people’s medical records.
• In particular, a specific type of bias called “recall bias” may also be at play here. There is a public perception that X-rays are linked with cancer and so people with cancer may be more likely to recall X-rays in their lifetime as it has more perceived significance to their lives than someone without cancer. This would bias the results to suggest a link between dental X-rays and cancer when there may not be one, or to show a stronger link than actually exists.
The study’s design and these limitations mean that the study cannot prove that X-rays cause brain tumours. However, even if the chance of developing brain tumours is indeed doubled by a history of regular dental X-rays (a big “if” based on this study alone) it would still be a very rare event given that the absolute risk of developing a brain tumour is very small. To put this into context, the increase in risk of meningioma over a lifetime has been estimated at 0.07% - with X-rays associated with an increase from 15 cases in every 10,000 people to 22 in 10,000.
Therefore, people should not be alarmed by the findings of this study and should not worry about brain tumour when deciding whether to have a dental X-ray, which is a useful tool for dentists to monitor and maintain oral health.
The authors note that radiation exposure from dental X-rays in the past was stronger than is currently the case and so the results gained from X-rays in the more distant past may not be relevant to contemporary dentistry. It is known that exposure to ionising radiation is linked to cancer, which is why X-ray use is minimised, but people should not be alarmed by today’s sensationalist headlines and should not be dissuaded from having dental X-rays when recommended by their dentist.
Analysis by Bazian
 

WHAT'S NEW IN CANCER TREATMENTS?

EPA derivative cures leukemia in mice

Sandeep Prabhu and colleagues at Pennsylvania State University report in the December 22, 2011 issue of the journal Blood that a compound derived from eicosapentaenoic acid (EPA), an omega 3 fatty acid that occurs in high amounts in fish, cured chronic myelogenous leukemia (CML) in two mouse models of the disease.

In recent research, cyclooxygenase-derived cyclopentenone prostaglandins (CyPGs) were identified as possible agents to target cancer stem cells. Currently available treatments for leukemia and other cancers fail to destroy stem cells, which results in relapses of the disease. "The patients must take the drugs continuously," noted study coauthor Robert F. Paulson, who is an associate professor of veterinary and biomedical sciences at Penn State. "If they stop, the disease relapses because the leukemia stem cells are resistant to the drugs."

For the current experiments, the researchers administered a CyPG compound known as delta-12-protaglandin J3 (D12-PGJ3, derived from EPA) to leukemic mice for one week. Animals that received the compound had normal spleens and blood counts, and increased survival without relapse after being treated. "This treatment completely eradicated leukemia stem cells in vivo, as demonstrated by the inability of donor cells from treated mice to cause leukemia in secondary transplantations," the authors write.

"Research in the past on fatty acids has shown the health benefits of fatty acids on cardiovascular system and brain development, particularly in infants, but we have shown that some metabolites of omega 3 have the ability to selectively kill the leukemia-causing stem cells in mice," stated Dr Prabhu, who is an associate professor of immunology and molecular toxicology at Penn State's Department of Veterinary and Medical Sciences. "The important thing is that the mice were completely cured of leukemia with no relapse."

FOXFIRE - A trial of chemotherapy with or without radioembolisation for bowel cancer that has spread to the liver

This trial is looking at a treatment called radioembolisation for bowel cancer that has spread to the liver and cannot be removed with surgery.

If bowel cancer spreads, it often goes to the liver. Sometimes it is possible to remove bowel cancer that has spread to the liver with surgery. If it cannot be completely removed with surgery, chemotherapy can shrink or control the cancer, but it does not cure it.

Doctors are looking for new treatments that will help to control bowel cancer that has spread to the liver. In this trial, they are looking at a treatment called radioembolisation. It uses very small radioactive beads called microspheres.

The doctor injects the microspheres directly into the blood vessels near the cancer in the liver. The beads give off radiation for a few days. The radiation damages the cancer cells and the cancer’s blood supply. As the microspheres only give off radiation to a small area, they cause little damage to the surrounding healthy tissue. This treatment is also called Selective Internal Radiation Therapy (SIRT).

The aims of the trial are to

• See if the combination of radioembolisation and chemotherapy works better than chemotherapy alone for bowel cancer that has spread to the liver
• Learn more about the side effects of radioembolisation when it is combined with chemotherapy

See Daily Telegraph article about someone who has already benefited from the trial: http://www.telegraph.co.uk/health/8733645/Miracle-technique-cures-grandf...

A New Vaccine for Ovarian and Breast Cancer shows promise

A new vaccine that targets ovarian and breast cancer has shown promise in early studies, giving scientists hope they may be closer to stopping the deadly diseases.
Known as PANVAC, the vaccine triggers the immune system to attack tumor cells.
"With this vaccine, we can clearly generate immune responses that lead to clinical responses in some patients," lead scientist Dr. James Gulley, director and deputy chief of the clinical trials group at the laboratory of tumor immunology and biology at the National Cancer Institute, said in a written statement.

See the full text of the article at:
http://www.cbsnews.com/8301-504763_162-57321522-10391704/vaccine-for-ova...

And the paper on which the article is based:
http://clincancerres.aacrjournals.org/content/early/2011/11/04/1078-0432...

NEW books:

Customized Cancer Treatment, Ralph W Moss, (Equinox 2010)

Customized Cancer Treatment is the first book for the layperson on chemosensitivity testing. This is a laboratory procedure by which patients and their doctors can discover which drugs are mostly like to work for them and which to avoid. Chemosensitivity testing is very effective at finding the best drugs for each individual. It is a form of personalized treatment. According to Dr. Robert Nagourney, No cancer patient should begin treatment without first reading this book.