News

WRAL Segment Focuses on Oral Cancer

CHAPEL HILL, N.C. - A segment discussing oral cancer aired on WRAL on March 30, 2011.

The segment featured 28-year-old UNC patient Ashley Scott and Dr. Bhisham Chera, a radiation oncologist at UNC.

Dr. Chera is lead author of a recently released study that found an increasing incidence of squamous cell carcinoma of the oral tongue in young white females in the United States over the last three decades. Read related news release.

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Tet Further Revealed! Studies Track Protein Relevant to Stem Cells, Cancer

"Tet is likely to be one of the important players for stem cell reprogramming."
CHAPEL HILL, N.C. - Last year, a research team at the University of North Carolina at Chapel Hill discovered one way the protein Tet 1 helps stem cells keep their pluripotency—the unique ability to become any cell type in the body. In two new studies, the team takes a broad look at the protein’s location in the mouse genome, revealing a surprising dual function and offering the first genome-wide location of the protein and its product, 5-hydroxymethylcytosine—dubbed the “sixth base” of DNA.

UNC biochemist Yi Zhang, PhD, whose team conducted the studies, called the findings an important step in understanding the molecular mechanisms behind cell differentiation and the development of cancer. The findings appear in two recent papers, published March 30, 2011 online in Nature and in the April 1, 2011 issue of Genes & Development.

“There is no doubt that Tet proteins are relevant to cancer,” said Zhang, Kenan distinguished professor of biochemistry and biophysics. Zhang is also an investigator of the Howard Hughes Medical Institute and a member of the UNC Lineberger Comprehensive Cancer Center. Tet proteins were initially discovered in leukemia as fusion proteins, which are commonly found in cancer cells, where they may function as oncoproteins.

In addition, Zhang said, “Tet is likely to be one of the important players for stem cell reprogramming.” Learning to “reprogram” cells in the adult body to make them behave like stem cells has long been a goal for stem cell researchers; understanding how Tet proteins operate could help advance stem-cell based treatments.

Tet proteins are known to help stem cells stay pluripotent. Zhang’s team analyzed Tet1’s occupancy across the entire mouse embryonic stem cell genome. They found that the protein works by using a two-pronged approach to maintain the mouse embryonic stem cell state.

“On one hand, it silences the genes that are important for differentiation. On the other hand, it also activates pluripotency genes,” said Zhang.

The team then focused its attention on the Tet1-catalyzed reaction product,5-hydroxymethylcytosine. 5-hydroxymethylcytosine is a modified version of cytosine—the “C” in the four main DNA bases, A, T, G, and C. 5-methylcytosine and 5-hydroxymethylcytosine have been called the fifth and sixth bases of DNA, but since 5-hydroxymethylcytosine was discovered only recently, scientists know little about it.

“Everybody is trying to understand what 5-hydroxymethylcytosine is doing,” said Zhang. “Is it an intermediate, or is it an end product? What is its biological function?” Zhang’s team mapped the distribution of 5-hydroxymethylcytosine across the genome, offering new insights to its role in development and disease.

“It’s the first time we have the whole picture of where this new modification is in embryonic stem cells,” said Zhang. “We found that its role in regulating transcription is complicated. It’s not simply activating or repressing genes—it depends on the context.”

Like much of science, the research answers some questions while raising others. “This study is just beginning,” said Zhang. Although Tet1 is known to generate 5-hydroxymethylcytosine, there are places where one exists without the other. Further investigation could reveal more about the relationship between the two and whether other enzymes may play a role. In addition, scientists need to examine how Tet1 and 5-hydroxymethylcytosine function in animal models.

Study collaborators include UNC postdoctoral researchers Ana D’Alessio, Shinsuke Ito, and Kai Xia, as well as Yi Sun and Hao Wu of the University of California, Los Angeles School of Medicine; Zhibin Wang of the Johns Hopkins School of Public Health; and Kairong Cui and Keji Zhao of the National Heart, Lung, and Blood Institute.

Media contact:
Les Lang An icon indicating that a link will launch an email program., (919) 966-9366

Ewend, Buchman Step up to the Plate to Help Baseball Player

CHAPEL HILL, N.C. - The article "Fuquay-Varina's Mitchell makes his best pitch" written by Tim Stevens and published in the March 29, 2011 issue of The News & Observer highlights the care given by Drs. Matt Ewend and Craig Buchman to Fuquay-Varina High senior baseball pitcher Craig Mitchell.

Dr. Ewend is the director of UNC Lineberger’s neuro-oncology program and chair of the department of neurosurgery at UNC. Dr. Buchman is chief of the division of otology/neurotology and skull base surgery at UNC.

The News & Observer is a daily newspaper based in Raleigh that also covers Durham, Cary, and Chapel Hill.

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UNC to Lead Study of New Option for Some Colon Cancer Patients

CHAPEL HILL, N.C. - UNC Lineberger Comprehensive Cancer Center will lead a clinical trial to test a new option for colorectal cancer patients whose cancer has not responded to first line therapies.

Almost 40 percent of patients whose cancers test positive for mutant K-RAS or BRAF genes see their cancers continue to progress on the current first line therapies. While monoclonal antibodies targeted toward epithelial growth factor receptors (EGFR) are effective for many colorectal cancer patients, those whose cancers test positive for K-RAS are not candidates for these treatments, which have been shown to be ineffective in the presence of this mutation.

“These patients run out of options faster,” said Richard M. Goldberg, MD, the clinical trial’s principal investigator and associate director for clinical research at UNC Lineberger. “This trial is exciting because it provides another option for advanced disease, the standard chemotherapy regiment plus a new agent called regorafenib.”

According to Goldberg, this is the first study with regorafenib, and the first randomized study of kinase inhibition in combination with chemotherapy to focus on patients with these genetic mutations whose options are limited after their disease progresses on initial treatment. He notes that regorafenib, a multikinase inhibitor, works through a different mechanism than EGFR-targeted treatments. Instead, regorafenib targets a pathway activated by the K-RAS mutation and has the potential to work with chemotherapy to enhance the effects of both drugs against the patient’s cancer.

The study is sponsored by UNC Lineberger and financially supported by Bayer HealthCare AG, which will provide study medication free of charge to patients enrolled on the trial.

The study will be randomized and placebo-controlled, with twice as many patients receiving the experimental treatment as the control treatment of standard chemotherapy for metastatic colorectal cancer. The trial will begin in March 2011 and will enroll a total of 240 patients at UNC and at academic and community sites throughout North Carolina.

To be accepted onto the study, patients must have confirmed K-RAS or BRAF mutations in their tumors and be eligible for second line therapy for metastatic colorectal cancer.

In addition to Goldberg, who serves as chief of the division of hematology/oncology at UNC-Chapel Hill and physician-in-chief of the N.C. Cancer Hospital, other researchers include co-principal investigator Bert O’Neil, MD, Janine Davies, FRCPC, MD, BN, MSc, Stephen Bernard, MD, Tammy Triglianos, NP, and Autumn Jackson McRee, MD.

Boggess Awarded Triangle Business Journal’s Health Care Heroes Award

CHAPEL HILL, N.C. - John Boggess, MD, associate professor of obstetrics and gynecology, was honored with a Health Care Heroes Award by the Triangle Business Journal. His Health Care Innovator/Researcher Award was given in recognition of his pioneering work with robotic surgery for gynecologic cancers. Boggess is a member of UNC Lineberger Comprehensive Cancer Center.

Due in large part to his training of other surgeons, robotic surgery is now the number one treatment for gynecologic cancer in the US, according to an executive with Intuitive Surgical, Inc. Boggess has presented the surgical techniques at national and international meetings and has hosted training visits to UNC for over 400 gynecologic oncology specialists.

The greatest significance of Boggess’ efforts is the impact robotic-assisted surgery has for patients.  He has published reports in professional journals demonstrating that robotic-assisted surgery decreases complications, blood loss, pain and recovery time without compromising short-term surgical outcomes compared with both laparoscopy and laparotomy for both cervical and endometrial cancer.  These findings, which represent the largest clinical series published to date, suggest that robotic assisted surgery is superior to current methods and is a new standard of care.

UNC Physician-Scientist Receives Grant to Study Breast Cancer Brain Metastases

Prestigious Breast Cancer Research Foundation-AACR Grant funds preclinical studies

CHAPEL HILL, N.C. - The American Association for Cancer Research (AACR) announced today that Carey Anders, MD, assistant professor of medicine and a member of UNC Lineberger Comprehensive Cancer Center will receive a Breast Cancer Research Foundation-AACR Grant for Translational Breast Cancer Research.  The $181,000 grant will be presented at the organization’s 102nd Annual Meeting, to be held in Orlando, Florida, April 2-6.

The grant will fund laboratory research to test whether a new class of drugs called PARP-inhibitors, which have successfully been used to treat other types of cancers, along with nanoparticle anti-cancer agents may be effective in treating brain metastases from triple-negative breast cancer.

Approximately 200,000 women are diagnosed worldwide each year with triple-negative breast cancer, an aggressive subset of breast cancer that lacks expression of the estrogen and progesterone receptors and the HER2 protein.  This type of breast cancer is over-represented among women with advanced breast cancer.

According to Anders, recent studies show that about half of women with advanced triple-negative breast cancer experience a recurrence in the central nervous system.

“It is very frustrating as a doctor because there is no effective chemotherapy to treat breast cancer brain metastases and women who experience a recurrence in the central nervous system are frequently excluded from promising clinical trials,” says Anders.

“We hope that our work will build the foundation to move forward to design clinical trials for these patients that combine PARP inhibitors in combination with nanoparticle chemotherapies aimed at improving survival for these patients,” she adds.

Anders points out that this type of study would not be possible at many other institutions that do not have the laboratory models in place to accurately reproduce this type of cancer for preclinical testing of therapeutic agents.  She credits the collaborative environment at UNC Lineberger and the assistance of her mentors, UNC Lineberger members Lisa Carey, MD, and Charles Perou, PhD, whose work on triple-negative breast cancer has informed the entire field.

Inspiration - Wheel Power: Pedaling 3,600 Miles in 66 Days (Cycle 20Ten profiled in Endurance magazine)

Written by Dianne Shaw and published in Endurance magazine, this article talks about Cycle 20Ten, a group of boy scouts and Chapel Hill students who biked across the country in the summer of 2009 to benefit UNC Lineberger.

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DeSimone Named a WCHL Hometown Hero

CHAPEL HILL, N.C. - Yesterday, WCHL named Lineberger member, Dr. Joseph DeSimone, a Hometown Hero. Each weekday the station selects a Hometown Hero who goes “over and above the call of duty,” exemplifying excellent service and dedication to others in the community.

DeSimone is Chancellor’s Eminent Professor of Chemistry at UNC, William R. Kenan Jr. Distinguished Professor of Chemical Engineering at NCSU, Director of the Institute for Advanced Materials and the Institute for Nanomedicine at UNC, and Co-Director of the Carolina Center of Cancer Nanotechnology Excellence. DeSimone was recently selected for the 2010 Mentor Award from the American Association for the Advancement of Science Icon indicating that a link will open an external site., recognizing his dedication to advancing the diversity of doctoral-level chemists entering the workforce.

Listen to the Hometown Hero interview with Dr. DeSimone Icon indicating that a link will open an external site., in which he talks about his focus on diversity and innovation. (Look for the March 23, 2011 segment and click “Listen.”)

Battaglini, Groff, Skyrznia Receive Susan G. Komen for the Cure® NC Triangle Grants

CHAPEL HILL, N.C. - Get Real and Heel, led by Diane Groff, EdD, and Claudio Battaglini, PhD,  received just over $71,000 from Susan G. Komen for the Cure® NC Triangle to support Get REAL & HEEL, a 5 month program that provides individualized prescriptive exercise and recreational therapy to women who have completed all chemotherapy, radiation, and surgery within 6 months.  The program reduces the impact of cancer treatment by decreasing distress and improving strength, cardiovascular fitness, flexibility, balance, coping, hopefulness, neurocognitive functioning, heart rate coherence and variability, and quality of life. The program particularly tried to address health disparities by targeting African American and Latina women and offering uninsured and underinsured women services free of charge.

L-R; Kenisha Bethea, Cecile Skyrznia, MS

Cecile Skyrznia, MS, received a second grant for $67,925 to cover the cost of genetic testing for underinsured and underserved women (and men) newly diagnosed with breast cancer.  After undergoing genetic risk assessment, those who have an at least five percent probability of carrying a BRCA1/2 gene mutation and need to know their genetic status to plan their surgery will be eligible to have the cost of genetic testing covered if they can't afford it, thanks to this support.

Tournament Definitely Sweet for UNC Women's Basketball Team

CHAPEL HILL, N.C. - March Madness is well underway, and the UNC Women's Basketball team, led by senior forward and cancer survivor Jessica Breland, is ready to play ball. After a win against the University of Kentucky in a second round game last night in the NCAA tournament, the UNC Women's Basketball team has advanced to the Sweet Sixteen.

It's all the more sweet for Jessica Breland – this is her comeback year after completing treatment for Hodgkin's lymphoma. In honor of Jessica's comeback, Coach Sylvia Hatchell and the team established the Jessica Breland Comeback Kids Fund to support pediatric cancer at UNC with a plan to give cancer a full court press.

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Supportive Care and Consult Team Makes Outpatient Cancer Treatment Easier

CHAPEL HILL, N.C. - The UNC Supportive Care and Consult Service and Clinic’s innovative model of a pharmacist as part of the care team in the outpatient setting continues to attract national attention and interest. The group published an article describing their successful program in the April 1, 2011 issue of the American Journal of Health-System Pharmacy.

The article describes how integration of a clinical pharmacist practitioner (CPP) has made a positive impact on patient care through:

1) A formal chemotherapy counseling process for the adult medical oncology clinic infusion center was established. The session (also available in Spanish) is offered to patients to inform them about the agents involved in their chemotherapy regimen, to discuss anticipated adverse effects and their management, and to answer patient question. Such counseling was previously offered by the infusion nurses. With the CPP offering the counseling, nurses are now able to devote more time to other patient care duties.

2) An infusion clinic efficiency project that targeted patients receiving the biologic agent Rituximab decreased each infusion for these patients by over 1.5 hours per visit and was equally as safe as the previous longer method of infusion.

3) The addition of pharmacy students and residents paired with supportive care CPPs in the cancer clinics where previously there was no exposure of these learners to the outpatient oncology clinics.

The article highlights the team’s future projects such as looking to get patients out of the hospital faster through using the oncology pharmacist to monitor methotrexate levels as an outpatient instead of in the hospital.

Hear a podcast Icon indicating that a link will open an external site. of John Valgus, PharmD, hematology/oncology clinical pharmacist practitioner, as he describes the program’s innovative model and how it improves patient care. Valgus is a clinical assistant professor in the UNC Eshelman School of Pharmacy.

Co-author of the journal article are:  Aimee Faso, PharmD, hematology/oncology clinical pharmacist; Sandi Jarr, RN, MSN, supportive care nurse consultant; and Steve Bernard, MD, professor of medicine, division of hematology/oncology. Co-authors from the UNC Eshelman School of Pharmacy: Kelly M Gregory, hematology/oncology postgraduate year 2 pharmacy resident; Scott Savage, PharmD, MS, clinical manager, department of pharmacy and clinical assistant professor; Stephen Caiola, MS, FRSPH, associate professor and chair, division of pharmacy practice and experiential education; Christine Walko, PharmD, assistant professor division of pharmacotherapy and experimental therapeutics; and Jiyeun Kim, pharmacy student.

The UNC Supportive Care and Consult team includes a physician, a clinical nurse specialist and a clinical pharmacist practitioner. Patients from all adult oncology services are visited by the team, including gynecologic, radiation, medical and surgical. The pharmacist first sees patients when an assessment and detailed medication history are taken. Next the nurse and physician see the patient and complete a symptom management assessment. The team then “huddles” to develop a treatment recommendation that is then shared with the patients and family. A majority, 75 percent, of the consults are for pain management. Other major symptoms addressed by the team were nausea, vomiting and constipation.

Hayes Discusses Genetic Basis of Cancer in National Institutes of Health Video

CHAPEL HILL, N.C. - Neil Hayes, MD, MPH, associate professor in UNC's Division of Hematology and Oncology, is featured in a video produced by the National Institutes of Health for The Cancer Genome Atlas (TCGA) project.

This video - The Cancer Genome Atlas: The Genetic Basis of Cancer An icon indicating that content may be viewed on YouTube (TM). is one in a series that explores TCGA's approach to determining the important genomic changes that lead to cancer.

In this video, Hayes and other researchers discuss what makes a normal cell different from a cancer cell. They also talk about why studying the changes in DNA that cause cancer can result in the development of better treatments.

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Learn more about the TCGA.

Family House Diaries: Johnny and Phyllis Deal

Written by Elizabeth Swaringen for UNC Health Care, this article tells the story of a 55-year-old Lenior, N.C. man and his medical journey.

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Written by Elizabeth Swaringen for UNC Health Care, this article tells the story of a 55-year-old Lenior, N.C. man and his medical journey.

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Pam Dixon - Giving Back in Any Way She Can

Pam is giving back in any way she can to the programs at UNC Lineberger that gave her life back to her.

UNC Lineberger donor and Board of Visitors member Pam Dixon celebrated her five year anniversary of being cancer-free in December of 2010.

At age 48, she found a lump in her breast that led to a biopsy and the discovery of two more lumps. She was told that she had three different forms of breast cancer. “Initially I was in shock,” says Pam. “Nobody on either side of my family had ever had cancer.”

Her care team – surgical oncologist, Dr. David Ollila; medical oncologist, Dr. Lisa Carey; and radiation oncologist, Dr. Jan Halle; – and all the nurses and support staff “were straightforward, knowledgeable and compassionate,” she explains. As the mother of two autistic children, Pam understands the value of physicians who are not only competent but also compassionate. “UNC does a very good job of balancing the two.”

In addition to the support offered by her medical care team, Pam also found support through a number of programs available at UNC Lineberger. “The Patient and Family Resource Center (PFRC) supplied me with educational materials about my diagnosis and treatment, and center staff also directed me to many other resources to help me through my journey to recovery,” says Pam.

She visited with the chaplain before every treatment, received her first wig from the Mary Anne Long Brighter Image Boutique and participated in such programs as Look Good, Feel Better (a beauty session for female cancer patients) and Get REAL and HEEL (an after care breast cancer program).

Thankful for these programs and all of the resources available at UNC Lineberger, Pam is giving back in any way she can to the programs at UNC Lineberger that gave her life back to her.

Pam served on the Patient and Family Advisory Board helping to plan the new N.C. Cancer Hospital, is a member of the UNC Lineberger Board of Visitors and is a donor.

Pam Dixon - Giving Back in Any Way She Can

Pam is giving back in any way she can to the programs at UNC Lineberger that gave her life back to her.

UNC Lineberger donor and Board of Visitors member Pam Dixon celebrated her five year anniversary of being cancer-free in December of 2010.

At age 48, she found a lump in her breast that led to a biopsy and the discovery of two more lumps. She was told that she had three different forms of breast cancer. “Initially I was in shock,” says Pam. “Nobody on either side of my family had ever had cancer.”

Her care team – surgical oncologist, Dr. David Ollila; medical oncologist, Dr. Lisa Carey; and radiation oncologist, Dr. Jan Halle; – and all the nurses and support staff “were straightforward, knowledgeable and compassionate,” she explains. As the mother of two autistic children, Pam understands the value of physicians who are not only competent but also compassionate. “UNC does a very good job of balancing the two.”

In addition to the support offered by her medical care team, Pam also found support through a number of programs available at UNC Lineberger. “The Patient and Family Resource Center (PFRC) supplied me with educational materials about my diagnosis and treatment, and center staff also directed me to many other resources to help me through my journey to recovery,” says Pam.

She visited with the chaplain before every treatment, received her first wig from the Mary Anne Long Brighter Image Boutique and participated in such programs as Look Good, Feel Better (a beauty session for female cancer patients) and Get REAL and HEEL (an after care breast cancer program).

Thankful for these programs and all of the resources available at UNC Lineberger, Pam is giving back in any way she can to the programs at UNC Lineberger that gave her life back to her.

Pam served on the Patient and Family Advisory Board helping to plan the new N.C. Cancer Hospital, is a member of the UNC Lineberger Board of Visitors and is a donor.

Oncology Nurses Present Grand Rounds: Beyond the Diagnosis

CHAPEL HILL, N.C. - On Friday, March 11, a group of nurses gathered for a UNC Health Care Grand Rounds presentation by Jerome Schiro, RN, MN, OCN, Pat Decator, RN, BSN, OCN, and Amy De Pue, RN, BS, OCN.

Titled "Beyond the Diagnosis . . . to listen is all that I ask", the presenters shared their stories and their patients' stories in an hour that included laughter and tears. Their theme was the importance of listening and being present in the process of treating patients, and how to ensure that patient needs – whether articulated or not articulated – are being met as much as possible.

Their presentations included instances where they failed to listen well, and what they learned; times when they were able to ask open-ended questions, listen, and discover something important; and the need to understand who their patients are, their personal circumstances, concerns and backgrounds, hopes and fears.

The UNC Health Care nurses present discussed the meaning of personal connection and relationship-based care, giving examples from their own nursing experiences.

Study Finds Shoulder Function Decreased After Breast Cancer Treatment

UNC researchers working toward a rehabilitation road map

CHAPEL HILL, N.C. - A problematic side effect for women who have undergone breast cancer treatment is loss of shoulder flexibility, strength and function.  However, past studies of the problem compared patients’ surgically affected shoulder to their unaffected shoulder, an approach which doesn’t allow researchers to determine if shoulder function is also reduced by systemic effects of other cancer treatments like radiation and chemotherapy.

A study conducted by a former UNC Human Movement Science doctoral student, Shana Harrington PhD, PT, recently published in the Journal of Cancer Survivorship, has tried to answer this question by comparing shoulder function for cancer survivors who finished their treatment in the six months prior to the study with matched control subjects with healthy/normal shoulder function.

Using standard assessments for arm, shoulder and hand disability and range of motion, these researchers found significant differences in function, range of motion and strength when breast cancer survivors who have recently completed treatment are compared to healthy, matched controls – suggesting that functional impairment is the result of multiple factors.

“As more women are living longer after surviving breast cancer, these kinds of functional deficits as a result of treatment can limit activity and affect women’s quality of life,” said Claudio Battaglini, PhD, one of the mentors for Harrington’s dissertation research and a member of UNC Lineberger Comprehensive Cancer Center.

“Our work is a first step toward a better understanding of the true differences in function between women who have not undergone treatment and those who have – that gap being a deficit,” he added.

“We hope that this and future work can provide clinicians with more information regarding shoulder impairments and guide the development of evidence-based guidelines for rehabilitation after breast cancer treatment,” said Battaglini.

In addition to Battaglini, Harrington conducted the research under the mentorship of Diane Groff, EdD (also a UNC Lineberger member), and Darin Padua, PhD (Dr. Harrington’s dissertation advisor), all faculty of UNC Department of Exercise and Sport Science.

This study was funded by UNC University Cancer Research Fund Clinical Innovation Awards 2008-09, the Petro Kulynych Foundation, and National Academy of Sports Medicine (NASM).

Shana Harrington is now a faculty member at The University of North Florida Department of Clinical and Applied Movement Sciences. Other members of the research team include Lori Michener of the Department of Physical Therapy at Virginia Commonwealth University, Carol Giuliani of the Department of Allied Health Sciences, and Joseph Myers of the Department of Exercise and Sports Science – all from the University of North Carolina at Chapel Hill.

Website Serves as New Tool for Colon Cancer Patients, Goldberg Featured

CHAPEL HILL, N.C. - My Colon Cancer Coach, a new website that launched this week, serves as a tool to help people diagnosed with colon cancer.

The website provides information about colon cancer including what it is, warning signs, detection and diagnosis and treatment options. It also includes a list of questions that might be helpful to ask when visiting the doctor.

Featured throughout the website is Richard Goldberg, MD, N.C. Cancer Hospital physician-in-chief and UNC Lineberger associate director for clinical research. He is also on the Medical Advisory Board of Fight Colorectal Cancer and is a volunteer with the organization.

My Colon Cancer Coach was created by Genomic Health Icon indicating that a link will open an external site. with support from the non-profit advocacy group Fight Colorectal Cancer Icon indicating that a link will open an external site..

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Carey Discusses Treatment for Triple-Negative and Basal-Cell Breast Cancers

CHAPEL HILL, N.C. - The article "Next Generation Treatment for Triple-Negative and Basal-Cell Breast Cancer" written by Jonathan Batchelor and published on the website cancernetwork.com on March 9, 2011 features an interview with UNC Lineberger member Lisa Carey, MD.

Dr. Carey is medical director of the UNC Breast Center and also serves as UNC Lineberger associate director of clinical science. In the interview, Dr. Carey talks about triple-negative and basal-cell breast cancers and the treatment options that exist.

Cancernetwork.com Icon indicating that a link will open an external site. is the official website of The Oncology Group, specialists in cancer information since 1982, and the companion website for the journal ONCOLOGY, Oncology NEWS International, and the Cancer Management handbook.

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UNC Study Finds Oral Tongue Cancer Increasing in Young, White Females

CHAPEL HILL, N.C. - A UNC study released this week in the Journal of Clinical Oncology finds an increasing incidence of squamous cell carcinoma of the oral tongue in young white females in the United States over the last three decades.

A team of researchers from UNC Lineberger Comprehensive Cancer Center analyzed data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database and found that, between 1975 and 2007, the overall incidence for all ages, genders, and races of the disease was decreasing.  However, the incidence of oral tongue squamous cell carcinoma rose 28 percent among individuals ages 18 to 44. Specifically, among white individuals ages 18 to 44 the incidence increased 67 percent. The increasing incidence was most dramatic for white females ages 18 to 44. They had a percentage change of 111 percent. Interestingly, the incidence decreased for African American and other racial groups.

Historically, oral tongue cancer has been strongly associated with heavy tobacco and alcohol use. Other epidemiological studies have related the decreasing incidence of oral tongue cancer in the United States to the decreased use of tobacco products. Though the UNC research team verified the known decreasing incidence of oral tongue cancer, they were surprised to observe an increasing incidence in young white individuals, specifically young white females.

“Lately we have been seeing more oral tongue cancer in young white women in our clinic. So we looked at the literature, which reported an increase in oral tongue squamous cell carcinoma in young white individuals but couldn’t find any information about gender-specific incidence rates, so we decided we should take a look at the SEER data,” said Bhisham Chera, MD, lead author on the study and assistant professor in the Department of Radiation Oncology.

Over the past decade an association between the human papilloma virus with squamous cell carcinoma of the tonsil and tongue has been observed. Patients with human papilloma virus associated oral squamous cell carcinoma are typically male, white, non-smokers, non-drinkers, younger in age and have higher socioeconomic status. The researchers at UNC have preliminarily tested the cancers of the oral tongue of their young white female patients and have not found them to be associated with the virus. Other institutions have also noted the absence of the virus in young females with oral tongue cancer. The UNC researchers have also anecdotally observed that these young white female patients are typically non-smokers and non-drinkers.

“Our findings suggest that the epidemiology of this cancer in young white females may be unique and that the causative factors may be things other than tobacco and alcohol abuse. Based on our observations and the published data, it appears that these cases may not be associated with the human papilloma virus. We are actively researching other causes of this cancer in this patient population,” he added.

Though the increasing rate of oral tongue cancer in young white females is alarming, oral tongue cancer is a rare cancer, relative to breast, lung, prostate, and colorectal cancer. “Primary care physicians and dentists should be aware of this increasing incidence and screen patients appropriately,” states Dr. Chera. Oral tongue cancer is typically treated with surgery first followed by radiation and, in some cases, chemotherapy.

Other UNC Lineberger researchers who contributed to the study include Sagar Patel, BA, of the Department of Radiation Oncology, William R. Carpenter, PhD, MHA, professor of health policy and management in the UNC Gillings School of Global Public Health, Marion Couch, MD, PhD, formerly a professor of otolaryngology/head & neck surgery at UNC (now at the University of Vermont), Mark Weissler, MD, distinguished professor of otolaryngology/head & neck surgery, Trevor Hackman, MD, assistant professor of otolaryngology/head & neck surgery, D. Neil Hayes, MD, MPH, associate professor in the division of hematology/oncology, and Carol Shores, MD, PhD, associate professor of otolaryngology/head & neck surgery.