Cigarettes Contain Radioactive Polonium

Cigarettes are known to cause cancer...

But we now know there's another reason why... they contain radioactive material, specifically polonium-210!

Tobacco companies also have known about it since 1959. As reported in ABC, historical documents reveal tobacco companies not only knew about the radioactive substance, but studied it, then refused to do anything about it!

They figured out that:

1) It caused "cancerous growths" in the lungs of smokers,
2) Calculated how much radiation a regular smoker would ingest over 20 years

Then they kept the research secret. The level of deception is breath-taking.

The radiation alone from cigarettes can account for up to 138 deaths for every 1,000 smokers over period of 25 years.

Even more disturbing, is that ALL tobacco products on the market today still contain radioactive polonium. This is in spite of washing techniques available since 1980 to remove the radioactivity but refused by tobacco companies to perform whether due to cost or the fact that washing would remove the addictive nicotine component as well.

Take home message?

STOP smoking! It's killing you through not only harmful chemicals, but also radioactivity!

Read the ABC article here.

Reference:
Cigarette Smoke Radioactivity and Lung Cancer Risk. Nicotine Tob Res (2011) doi: 10.1093/ntr/ntr145

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Oral Exam Using a Finger

For a good physical exam, physicians use their senses (eyes, ears, nose) to detect disease processes that may not necessarily be obvious to a lay person. Beyond these obvious senses, fingers and hands are also utilized to feel for unusual bumps or masses that may not be obvious to the naked eye.

Take a neck mass for example. Neck masses may not be necessarily visible, but by feeling the neck, may become obvious. To use an analogy, a bowling ball under a mattress may not necessarily be obvious, but if you lay on the bed, would become painfully obvious.

Physicians also use the hands/fingers to examine areas that may not be visible... such as the unpleasant digital rectal exam (inserting a finger up a bung-hole) which is done to detect blood in the stool, rectal/anal cancers, anal muscular incompetence, etc.

However, I find it odd that the mouth is a body area that is not often "felt" around... physicians included.

A finger can appreciate unusual mouth pathology that may not necessarily be appreciated by looking alone. Furthermore, just like the rectal exam, a finger can appreciate base of tongue pathology that cannot be visualized by having a patient go "ah".

I truly feel that actor Michael Douglas would have been diagnosed with his base of tongue cancer much earlier if only a doctor stuck a finger and swept that back area of the tongue. One can "feel" cancer as it is rock hard and very tender. True... it may cause a person to gag, but for a cancer test, it's dirt cheap, fast, and reliable.

However, it does not just have to be areas of the mouth that can not be seen. Even for those ulcerations and bumps of the mouth that one can clearly visualize (or not), it does help to touch it. Is it hard? Soft? Ulcerated? Tender? Grooved? Papillated? Fungating? Rubber-like? Blottable?

Each characteristic provides information to achieve a more accurate diagnosis.

To an ENT way of thinking, if a doctor regularly performs a digital rectal exam, than one can certainly do the same thing at the other end. It's less invasive and provides just as much information.

Say "ah"!!!

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New Webpage on Bumps or Lesions of the Mouth

Our practice has created a new webpage describing the various bumps and lesions commonly seen in the mouth that leads to a doctor's visit.

Such abnormal things seen in the mouth that's discussed include:

• aphthous ulcer
• herpetic ulcers
• pyogenic granuloma
• fibroma
• papilloma
• cancer

Click here to read more!

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Tall Women (Over 5'1") Have Higher Risk of Cancer!

Female models may be tall and beautiful, but they are also at markedly increased risk of developing cancer. The New York Times reported on a fascinating research article regarding height of a women and risk of cancer.

Specifically, for every four-inch increase in height over 5 feet 1 inch, the risk that a woman would develop cancer increased by about 16 percent, especially for:

• Colon Cancer (RR per 10 cm increase in height 1.25, 95% CI 1.19—1.30)
• Rectal Cancer (1.14, 1.07—1.22)
• Malignant Melanoma (1.32, 1.24—1.40)
• Breast Cancer (1.17, 1.15—1.19)
• Endometrial Cancer (1.19, 1.13—1.24)
• Ovarian Cancer (1.17, 1.11—1.23)
• Kidney Cancer (1.29, 1.19—1.41)
• Brain/Spine Cancer (1.20, 1.12—1.29)
• Non-Hodgkin's Lymphoma (1.21, 1.14—1.29)
• Leukaemia (1.26, 1.15—1.38)

It is hypothesized that the levels of growth hormone responsible for human height might also be involved in cancer development or because taller people are at greater risk for mutations simply because their bodies are comprised of more cells.

The increased cancer risk was found to be also true across Asia, Europe, Australia, and North America populations.

Perhaps now there's a reason why the average female is 5 feet, 3.8 inches tall! It's a balance between social preferences for being tall versus negative biological consequences for being tall.

The good news here (if there's any) is that head and neck cancer does not increase with height.

Read the NYT article here.

Read the research abstract here.

Reference:
Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk. The Lancet Oncology, Volume 12, Issue 8, Pages 785 - 794, August 2011 doi:10.1016/S1470-2045(11)70154-1

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Why Are You Looking in My Mouth When It's My Ear Hurting?

One June 20, 2011, NPR aired a great story about how a person may not "see" a person getting beat up on the side of a jogging path when they are focused on a task (pursuing another jogger)... even if they pass RIGHT BY THE FIGHT!!!

In fact, only a third of the subjects reported seeing this mock fight when the experiment was conducted at night. Even more surprisingly, broad daylight didn't improve the statistics (only 40% noticed the fight).

Though the situation and circumstances do not exactly correspond, there is a lesson to be learned here that applies to a medical visit.

As an ENT, I often see patients for a very specific complaint...

"My right ear hurts."
"I have a bad cough."

No matter what the complaint, unless it is for a specific task (there is earwax... can you remove it), I most always still do a complete ear, nose, and throat exam no matter the complaint.

Why???

Because often the symptoms are "the jogger" in the example above which is noticed to all exclusion when "the fight" is the more important event that should have been noticed.

Let's go to the examples stated above...

"My right ear hurts."

Though a patient may wonder why the heck I look in the mouth when their ear is the main complaint, it's mainly because there are other things that can cause ear pain... some of it life-threatening.

Tonsil cancer can cause ear pain (without any other symptoms) as well as a base of tongue abscess. Obviously, giving antibiotics to treat the right ear pain totally misses the fact that there was tonsil cancer that got missed or the tongue abscess which requires an emergency trip to the operating room followed by a few days in the intensive care unit.

"I have a bad cough."

This statement is pretty self-explanatory. Why bother looking in the ears??? A loose hair in the ear canal can cause a persistent dry cough. Why look in the nose if the cough is coming from the throat? Severe allergies and nasal polyps can lead to post-nasal drainage leading to a chronic cough. Why would an ENT than ask about my blood pressure medications? Because ACE inhibitors like lisinopril cause a chronic dry cough as a side effect.

The point being with these examples is that medical doctors are trained to not just focus in the exact symptom the patient is complaining of, but the entire picture. It doesn't do the patient any good if a doctor gets tunnel-visioned to the point where they don't notice what may be a very obvious thyroid mass or the large nasal polyp.

SO... next time you see a doctor for a specific complaint, humor us, and answer fully all questions about your medical history, surgical history, medications you are taking, and the physical exam we will perform on you... even if you are there for just a "simple" earache.

Read the NPR story here and the police beating that triggered this inattention experiment.

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Do Cell Phones Pose a Health Hazard? Do Cell Phone Companies Know About Them?

With all the recent news about increased glucose metabolism in the area of the brain in proximity to cell phone antennas (study abstract here), I thought it worth re-printing this blog article I wrote back in November 2010 regarding the possibility that cell phone makers may know more about health risks associated with cell phone use than they may be letting on. There's another blog article I wrote regarding what studies ARE already out there regarding risk of developing brain tumors that I felt worth re-printing below as well.

It is true that some people may find this recent research good news for some young people as it may be the only stimulation their brain gets (joking!), but it does bring some additional concerns that may merit limiting cell phone use as well as how it is used.

I quote (myself)...

Recently, there has been much speculation on whether cell phones pose a health risk.

What I find interesting is that the cell phone makers may actually know more about these risks than they are letting on or even have evidence for them.

If you look in the small print booklet that comes with your cell phone, cell phone makers state that phones should not be in contact with your body or skin and should be kept a certain distance away when in use or when carrying around. The picture of how the Verizon ad guy is using the cell phone is exactly how you are NOT supposed to use the cell phone (cell phone pressed against the face).

For example, in the iPhone 4 small print booklet that comes in the box with the phone, go to page 5 under the section "Exposure to Radio Frequency Energy." I quote:

"When using iPhone near your body for voice calls or for wireless data transmission over a cellular network, keep iPhone at least 15 mm (5/8 inch) away from the body, and only use carrying cases, belt clips, or holders that do not have metal parts and that maintain at least 15 mm (5/8 inch) separation between iPhone and the body."

Now, when I use a phone and answer a call, I have the phone right up against my ear just like the Verizon ad guy. I do not keep it 5/8 inch away from my ear/head.

Now why would a cell phone maker care whether the phone is right up against the ear (so you can hear better) or not unless there is some concern that there may be a danger due to proximity/contact?

Perhaps they are protecting themselves from any possible lawsuit that may occur in the future due to health problems that will occur with phone use over time?

Kind of reminds me of the tobacco industry who for years denied that smoking posed any health risk. Now we know better.

It would be ironic if Paul Marcarelli, the actor of the "Verizon Guy" character, develops a brain tumor due to cell phone use and sues the wireless industry just like the family of David McLean, the actor of the "Malboro Man," sued the tobacco industry for wrongful death when he developed and died from lung cancer caused by smoking.

Something to think about...

So are there studies out there suggesting that cell phones and wireless phones can lead to brain tumors like astrocytoma, malignant gliomas, and benign acoustic neuromas? Several studies published since 2009 containing long-term (10+ years) follow-up have lent support that it does.

The group at greatest risk for development of brain tumors have the following characteristics:

1) Use of cell/wireless phone younger than age 20 (the younger the age with first use, the worse the risk)
2) Use of cell/wireless phone for more than 10 years
3) The more hours of cellular phone use over time, the higher the risk of developing brain tumors
4) Risk higher with analog cell/wireless phones (instead of digital)
5) Risk higher with increased overall total exposure

By some estimates, subjects who used cell phones for at least 10 years had a 2.4-fold greater risk of developing a brain tumor.

Though unclear how exposure to a phone's microwave radiation leads to brain tumors, it is known that the cell signal is absorbed up to 2 inches into the adult skull. Even more worrisome is that the depth of penetration is even deeper in children.

The risk is not just to the brain, but even the parotid gland which sits just in front of the ear. In one study published in 2008 revealed an increased risk of parotid gland tumors with cell phone use. Also, contact allergy is another not uncommon risk with cell phone use.

Symptoms that a patient may exhibit that may suggest a brain tumor are subtle and include hearing loss or ringing of the ear on the same side the phone is used on.

It should be noted that all currently published results are based on retrospective studies and ideally, prospective studies will be required to provide more definitive results. However, that will take a long time and perseverance on both the researchers as well as the subjects since ideally, many of the study subjects should be children who are currently using cell phones (which it seems to be nearly all kids nowadays).

In any case, to be on the safe side, it is recommended to talk on speakerphone or use a wired headset (not wireless), or avoid altogether if at all possible, especially in children.

References:
Effects of cell phone radiofrequency signal exposure on brain glucose metabolism. JAMA. 2011 Feb 23;305(8):808-13.

Risk of Brain Tumors From Wireless Phone Use. Journal of Computer Assisted Tomography, 2010; 34 (6): 799 DOI: 10.1097/RCT.0b013e3181ed9b54

Cell phones and brain tumors: a review including the long-term epidemiologic data. Surg Neurol. 2009 Sep;72(3):205-14; discussion 214-5. Epub 2009 Mar 27.

Mobile phones, cordless phones and the risk for brain tumours. Int J Oncol. 2009 Jul;35(1):5-17.

Cell phone use and acoustic neuroma: the need for standardized questionnaires and access to industry data. Surg Neurol. 2009 Sep;72(3):216-22; discussion 222. Epub 2009 Mar 27.

Cellular phone use and risk of benign and malignant parotid gland tumors--a nationwide case-control study. Am J Epidemiol. 2008 Feb 15;167(4):457-67. Epub 2007 Dec 6.

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Oral Sex Causes More Oral Cancer Than Smoking!

HPV may now be overtaking tobacco as the leading cause of oral cancers in America in people under age 50.

And HPV, otherwise known as Human Papilloma Virus responsible for gential warts and cervical cancer, finds it way into the mouth via oral sex.

The latest data suggest that 64% of oral cancers are caused by HPV, which is more than tobacco causes. Furthermore, as the number of partners on whom you have performed oral sex goes up, the risk of oral cancer goes up.

These findings were presented by scientists this past Sunday at the American Association for the Advancement of Science annual meeting.

Hopefully, these results will be formally published soon, but you can read the story on CNN for now here.

Read more about oral masses in general here.

Related References:
Human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007 Sep 13;357(11):1157; author reply 1157-8

Human papillomaviruses in head and neck carcinomas. N Engl J Med. 2007 May 10;356(19):1993-5.

Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007 May 10;356(19):1944-56.

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Link Between Oral Sex and Head & Neck Cancer

USA Today published a pretty accurate article regarding the rise of certain head & neck cancers with the increased popularity of oral sex and number of sexual partners.

The factor that creates this link is the HPV virus which is associated with tonsil and tongue cancer. Alcohol and tobacco use is more highly linked with such oral cancers, but HPV does appear to be an independent risk factor.

A 2007 study in the New England Journal of Medicine found that younger people with head and neck cancers who tested positive for oral HPV infection were more likely to have had multiple vaginal and oral sex partners in their lifetime. Having six or more oral sex partners over a lifetime was associated with a 3.4 times higher risk for oropharyngeal cancer; cancers of the base of the tongue, back of the throat, or tonsils. Having 26 or more vaginal-sex partners tripled the risk. The association continued to increase as the number of partners in either category increased.

Of greater concern is that "French" kissing may also potentially be a mode of transmission.

The good news (if one is a young, non-smoker diagnosed with HPV-positive tumors) is that about 85% of non-smoking people with HPV-positive tumors survive. That number drops to 45 or 50% in people who smoke and are HPV-negative.

Th take-home message here is that even if you are a non-smoker and non-drinker, you can STILL develop head and neck cancer. Oral HPV infection is strongly associated with oropharyngeal cancer among subjects with or without the established risk factors of tobacco and alcohol use and that oral HPV infection can occur through sexual activity.

Furthermore, it is possible that the HPV vaccine (ie, gardasil) may also be protective (studies pending) for both women AND men.

Read the USA Today article here.

References:
Human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007 Sep 13;357(11):1157; author reply 1157-8

Human papillomaviruses in head and neck carcinomas. N Engl J Med. 2007 May 10;356(19):1993-5.

Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007 May 10;356(19):1944-56.

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Wireless and Cell Phones Increase Risk of Brain Tumors

In an ongoing controversy regarding whether cell phones and wireless phones can lead to brain tumors like astrocytoma, malignant gliomas, and benign acoustic neuromas, several recent studies published since 2009 containing long-term (10+ years) follow-up have lent support that it does.

The group at greatest risk for development of brain tumors have the following characteristics:

1) Use of cell/wireless phone younger than age 20 (the younger the age with first use, the worse the risk)
2) Use of cell/wireless phone for more than 10 years
3) The more hours of cellular phone use over time, the higher the risk of developing brain tumors
4) Risk higher with analog cell/wireless phones (instead of digital)
5) Risk higher with increased overall total exposure

By some estimates, subjects who used cell phones for at least 10 years had a 2.4-fold greater risk of developing a brain tumor.

Though unclear how exposure to a phone's microwave radiation leads to brain tumors, it is known that the cell signal is absorbed up to 2 inches into the adult skull. Even more worrisome is that the depth of penetration is even deeper in children.

The risk is not just to the brain, but even the parotid gland which sits just in front of the ear. In one study published in 2008 revealed an increased risk of parotid gland tumors with cell phone use. Also, contact allergy is another not uncommon risk with cell phone use.

Symptoms that a patient may exhibit that may suggest a brain tumor are subtle and include hearing loss or ringing of the ear on the same side the phone is used on.

It is interesting to note that it is just possible that the cell phone industry is aware of these risks even as it denies any risk of health problems with phone use. If you look in the small print booklet that comes with your cell phone, cell phone makers state that phones should not be in contact with your body or skin and should be kept a certain distance away when in use or when carrying around. Read more about this here.

However, all currently published results are based on retrospective studies and ideally, prospective studies will be required to provide more definitive results. However, that will take a long-time and perseverance on both the researchers as well as the subjects, since ideally, many of the study subjects should be children who are currently using cell phones.

In any case, to be on the safe side, it is recommended to talk on speakerphone or use a wired headset (not wireless), or avoid altogether if at all possible.

References:
Risk of Brain Tumors From Wireless Phone Use. Journal of Computer Assisted Tomography, 2010; 34 (6): 799 DOI: 10.1097/RCT.0b013e3181ed9b54

Cell phones and brain tumors: a review including the long-term epidemiologic data. Surg Neurol. 2009 Sep;72(3):205-14; discussion 214-5. Epub 2009 Mar 27.

Mobile phones, cordless phones and the risk for brain tumours. Int J Oncol. 2009 Jul;35(1):5-17.

Cell phone use and acoustic neuroma: the need for standardized questionnaires and access to industry data. Surg Neurol. 2009 Sep;72(3):216-22; discussion 222. Epub 2009 Mar 27.

Cellular phone use and risk of benign and malignant parotid gland tumors--a nationwide case-control study. Am J Epidemiol. 2008 Feb 15;167(4):457-67. Epub 2007 Dec 6.

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ENT Robotic Surgery

There has been increasing interest in using robots to help the surgeon perform complex surgical procedures within small spaces thereby saving the patient more invasive incisions. Especially in the world of ENT, surgery that may have required large incisions to the face and/or neck can now be accomplished without any incisions by using robotics to perform the same surgery, but entirely through the mouth.

Such robotic surgery performed through the mouth is called Trans-Oral Robotic Surgery, or simply TORS. The DaVinci system is the robotics platform that is most commonly used in TORS.

Using TORS and other approaches, head and neck surgeons have been able to remove the thyroid gland through the armpit, perform base of tongue cancer surgical excision (same cancer that Michael Douglas had), voicebox removal (laryngectomy), vocal cord surgery, etc.

In many of these and other surgeries, any procedure performed through the mouth traditionally was limited to two hands. With the DaVinci system, one technically can fit as many as FOUR "hands" inside the mouth enabling greater surgical flexibility and ease in performing fine dissections that otherwise would be impossible.

There are some downsides however... namely, use of robotic surgery is not compensated by insurance and as such, major medical centers are the only locations where such high-tech equipment is available.

At this time, the otolaryngology department at Johns Hopkins University, George Washington University, and University of Virginia are the only locations in the mid-Atlantic region with access to such robotic technology and the otolaryngology-head and neck surgeons who know how to use it that I'm aware of.

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Avoidable Pediatric Radiation Exposure

Children and teens often get diagnostic tests that expose them to radiation, increasing the risk of cancer later in life. Over just a 3 year span, 42.5% of kids got some form of ionizing radiation from a diagnostic medical procedure whether it be a chest x-ray, CT scan, dental scan, etc. Click here to calculate the cumulative risk of cancer with each type of test.

It also estimated that 1/3 of CT scans are unnecessary and that by limiting CT scans to when it is truly needed would reduce the number of cancers by 43%.

From an ENT standpoint, common diagnostic tests that expose patients to radiation include CT scans of the head, facial x-rays, and neck x-rays.

Why would kids get such scans done?

CT scans are often performed to evaluate for sinusitis as well as to figure out what is causing chronic headaches. Neck x-rays are often done to evaluate for adenoid hypertrophy while facial x-rays are done after facial trauma to look for a nasal fracture.

It is my personal bias to avoid such diagnostics tests if at all possible, ESPECIALLY because there are alternative options.

Nasal endoscopy can be performed to evaluate for sinusitis as well as adenoid hypertrophy thereby making unnecessary the need for neck x-rays as well as CT scans. X-rays to evaluate sinusitis is NEVER indicated as it is wrong 50% of the time (click here for more info on this).

Nasal fractures are easily appreciated on exam thereby making unnecessary facial x-rays. In cases of trauma, an x-ray can be considered from a purely medico-legal documentation standpoint, but is not really necessary from a medical standpoint. Read more here why.

Read a story about this in Reuters and in the LA Times.

References:
The Use of Computed Tomography in Pediatrics and the Associated Radiation Exposure and Estimated Cancer Risk. JAMA Pediatr. 2013;():1-8. doi:10.1001/jamapediatrics.2013.311.

Computed Tomography — An Increasing Source of Radiation Exposure. N Engl J Med 2007; 357:2277-2284November 29, 2007DOI: 10.1056/NEJMra072149

Children, computed tomography radiation dose, and the As Low As Reasonably Achievable (ALARA) concept. Pediatrics. 2003 Oct;112(4):971-2.

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Robotic Surgery for Oral Cancer

I encountered these amazing pictures in the Archives of Otolaryngology-Head & Neck Surgery Dec 2010 edition in an article titled "Transoral Robotic-Assisted Surgery for Head and Neck Squamous Cell Carcinoma". This surgery was performed at Mayo Clinic as well as University of Alabama.

Of note, there are also some YouTube videos of robotic surgery for thyroidectomy you can watch below or here.

Reference:
Transoral Robotic-Assisted Surgery for Head and Neck Squamous Cell Carcinoma. Archives of Otolaryngol Head Neck Surg 136(12):1248-1252; 2010

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Do Cell Phone Makers Secretly Know Cell Phones May Cause Health Problems?

Recently, there has been much speculation on whether cell phones pose a health risk. Wikipedia has a nice summary of those concerns.

What I find interesting is that the cell phone makers may actually know more about these risks than they are letting on or even have evidence for them.

If you look in the small print booklet that comes with your cell phone, cell phone makers state that phones should not be in contact with your body or skin and should be kept a certain distance away when in use or when carrying around. The picture here is exactly how you are NOT supposed to use the cell phone.

For example, in the iPhone 4 small print booklet that comes in the box with the phone, go to page 5 under the section "Exposure to Radio Frequency Energy." I quote:

"When using iPhone near your body for voice calls or for wireless data transmission over a cellular network, keep iPhone at least 15 mm (5/8 inch) away from the body, and only use carrying cases, belt clips, or holders that do not have metal parts and that maintain at least 15 mm (5/8 inch) separation between iPhone and the body."

Now, when I use a phone and answer a call, I have the phone right up against my ear as shown in the picture here. I do not keep it 5/8 inch away from my ear/head.

Now why would a cell phone maker care whether the phone is right up against the ear (so you can hear better) or not unless there is some concern that there may be a danger due to proximity/contact?

Perhaps they are protecting themselves from any possible lawsuit that may occur in the future due to health problems that will occur with phone use over time?

Kind of reminds me of the tobacco industry who for years denied that smoking posed any health risk. Now we know better.

Something to think about...

I should add that most studies to date do not show any definitive long-term harm from using cell phones, though studies following patients for more than 10 years do show an association with brain tumors. The greatest consistent risk is more from contact allergy.

BUT, to be on the safe side, it is recommended to talk on speakerphone or use a wired headset.

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Bone Drugs May Increase Risk of Throat Cancer

Well, at least that is what USA Today reported on September 3, 2010 with the title "Bone drugs may raise throat cancer risk". In actuality, bone drugs like boniva, fosamax, actonel, etc may possibly increase the risk of esophageal cancer which is actually not "throat cancer" and is in fact treated by a totally different specialty than ENT who is historically considered the throat expert.

Really, the specialty to see regarding esophageal cancer are the gastroenterology doctors or a general surgeon.

In any case, the study published in JAMA found that when taking bone drugs, the risk of developing esophageal cancer (not throat) was 2 in 1,000. Normally, the risk of developing cancer of the esophagus in people aged 60 to 79 is 1 in 1,000.

The increase is not that staggering. Not even close. I call it a "blip" of an increase.

Read the USA Today story here.

Read the JAMA research abstract here.

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Having Allergies Reduce Risk of Cancer!

Well maybe... According to a May 2010 study where questionnaire-based interviews were performed and encompassed self-reported history of prior medical diagnosis of asthma and eczema, medication use, and several covariates among 3,300 cancer cases and 512 population controls, a history of asthma was negatively associated with all cancer types combined (OR, 0.72; 95% CI, 0.5-1.1) and similarly for a history of eczema (OR, 0.66; 95% CI, 0.4-1.1).

Why would this happen? Well, allergies is due to a hyperreactive immune system that may lead to a more efficient elimination of abnormal cells, thus lowering cancer risks.

More study is needed to verify if this correlation truly exists.

What I would like to see is 3 groups (allergic group treated with meds only, allergic group on immunotherapy, and control group) followed out.

Reference:
History of asthma or eczema and cancer risk among men: a population-based case-control study in Montreal, Quebec, Canada. Ann Allergy Asthma Immunol. 2010 May;104(5):378-84.

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Should Boys Also Get Vaccinated for HPV?

NPR on Aug 20, 2010 aired a story whether boys should also get vaccinated for HPV. It is well established that vaccines like Gardasil (FDA approved for boys last year) and Cervarix protect against two of the HPV types (HPV-16 and HPV-18) that can cause cervical cancer and some other genital cancers including anal, vulvar, vaginal, and penile cancers.

However, it may potentially prevent other types of HPV related disorders (NOT mentioned in the NPR story) involving the head & neck in both men and women, including:

Respiratory Papillomas (benign)
Throat Cancer
Oral Cancer (tongue, tonsil, salivary gland)
Oral ulcers/lesions/warts (benign)

According to epidemiological studies, there has been a dramatic increase in cancer involving the salivary glands and tongue attributed to HPV and were of squamous, acinar, and mucoepidermoid morphologic types. This increase in oral cavity cancer has occurred mainly in the 10-40 years age group and suspected to be secondary to increased acceptance of oral-genital sexual practices.

What is my personal feeling on whether boys should get vaccinated? I believe the answer is yes.

In order to receive the beneficial effect of the vaccine, the vaccine needs to be given in 3 doses (at $130 per dose) ideally between ages 9-26.

Read the NPR article here.

References:
Cancer of the oral cavity and pharynx in young females: increasing incidence, role of human papilloma virus, and lack of survival improvement. Semin Oncol. 36 (5), 451-9.

Prevention of human papillomavirus infections and associated diseases by vaccination: a new hope for global public health. Public Health Genomics. 12 (5-6), 319-30.

The epidemiology behind the HPV vaccine discovery. Ann Epidemiol. 19 (4), 239-44.

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Coffee Decreases Risk of Head & Neck Cancer

Researchers at University of Utah found that regular coffee drinkers who drank more than four cups of coffee a day had a 39 percent decreased risk of two types of head and neck cancer: oral cavity and pharynx cancers. In the study published in the journal of Cancer Epidemiology, Biomarkers & Prevention, they found however, that coffee did not decrease the risk of laryngeal cancer. Coffee contains over 1,000 different chemical compounds, including cancer-fighting antioxidants, and it’s those antioxidants that may provide a “plausible explanation” for reducing the cancer risk.

However, patients should not take this study as an excuse to increase their coffee intake specifically to counteract known cancer-causing behaviors including smoking, drinking alcohol, and chewing tobacco.

Read a CNN report on this here.

Reference:
Coffee and Tea Intake and Risk of Head and Neck Cancer: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev, June 22, 2010; 1055-9965.

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Is Cancer Contagious? Well... it depends...

The literal answer to this question is YES... Cancer CAN be literally contagious, but only if you are a tasmanian devil, hamster, or a dog. I am excluding transmission of a vector that may lead to cancer like HPV. Rather cancer itself being contagious.

Fortunately, cancer has NOT been found to be contagious in humans... yet...

At this time, the only cancers I am aware of that is contagious are found in the animal world. And even in that world, there are only 3.

1) Devil facial tumour disease (DFTD) which causes a contagious cancer of the face in Tasmanian Devils ultimately resulting in death. The cancer originates in the Schwann cells and is suspected to spread when bits of cancer comes into contact with an open wound via biting (which Tasmanian Devils do a lot of to each other).

2) Canine transmissible venereal tumour (CTVT) is passed between dogs via sexual activity and has been known to science for about 100 years.

3) Contagious reticulum cell sarcoma of the Syrian hamster which can be transmitted from one Syrian hamster to another by means of the bite of the mosquito Aedes aegypti.

SO... the answer to whether cancer is contagious is YES!!! But not (so far) in humans.

Read more about how cancer may become contagious in this Harper's Magazine article published in 2008.

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CNN: Head & Neck Cancer Afflicting the Famous

CNN on 2/19/10 published a story portraying Roger Ebert (film critic) and George Karl (Denver Nuggets coach) diagnosed with head and neck cancer and the problems, suffering, disability associated with its treatment.

Read the story here.

Read an earlier story of Roger Ebert specifically here.

Here's another story in Esquire.

The picture portrays tongue cancer (stage 2 squamous cell carcinoma).

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Did you know that a few US Presidents also succumbed to head and neck cancer? Ulysses Grant had throat cancer (heavy drinker and smoker). Grover Cleveland had jaw cancer (also a heavy smoker and drinker).

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Website That Calculates Your Cancer Risk From Radiological Tests

In the last few weeks, there's been multiple media reports on the increased risk of cancer with common radiological tests due to radiation exposure, however minimal it may be.

Due to this concern, a website called "X-Ray Risk.com" was developed that calculates your increased cancer risk based on type of test, age, and gender.

For example, a CT Neck (a common CT test ordered by ENTs) on a 35 year-old male increases cancer risk by 0.046%. A chest x-ray? Only 0.001%.

Check out the website here.

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