Twice weekly acupuncture treatments relieve debilitating symptoms of xerostomia - severe dry mouth - among patients treated with radiation for head and neck cancer, researchers from The University of Texas M. D. Anderson Cancer Center report in the current online issue of Head & Neck.

Xerostomia develops after the salivary glands have been exposed to repeated doses of therapeutic radiation. People who have cancers of the head and neck typically receive large cumulative doses, rendering the salivary glands incapable of producing adequate saliva, said Mark S. Chambers, M.S., D.M.D., a professor in the Department of Dental Oncology. Saliva substitutes, lozenges and chewing gum bring only temporary relief, and the commonly prescribed medication, pilocarpine, has short-lived benefits and bothersome side effects of its own.

"The quality of life in patients with radiation-induced xerostomia is profoundly impaired," said Chambers, the study's senior author. "Symptoms can include altered taste acuity, dental decay, infections of the tissues of the mouth, and difficulty with speaking, eating and swallowing. Conventional treatments have been less than optimal, providing short-term response at best."

M. Kay Garcia, LAc, Dr.P.H., a clinical nurse specialist and acupuncturist in M. D. Anderson's Integrative Medicine Program and the study's first author, noted that patients with xerostomia may also develop nutritional deficits that can become irreversible.

Garcia, Chambers and their team of researchers conducted a pilot study to determine whether acupuncture could reverse xerostomia. Acupuncture therapy is based on the ancient Chinese practice of inserting and manipulating very thin needles at precise points on the body to relieve pain or otherwise restore health. In traditional Chinese medicine, stimulating these points is believed to improve the flow of vital energy through the body. Contemporary theories about acupuncture's benefits include the suggestion that needle manipulation stimulates natural substances that dilate blood vessels and increase blood flow to different areas of the body.

The M. D. Anderson study included 19 patients with xerostomia who had completed radiation therapy at least four weeks earlier. The patients were given two acupuncture treatments each week for four weeks. The acupuncture points used in the treatment were located on the ears, chin, index finger, forearm and lateral surface of the leg. All patients were tested for saliva flow and asked to complete self-assessments and questionnaires related to their symptoms and quality of life before the first treatment, after completion of four weeks of acupuncture, and again four weeks later.

The twice weekly acupuncture treatments produced highly statistically significant improvements in symptoms. Measurement tools included: the Xerostomia Inventory, asking patients to rate the dryness of their mouth and other related symptoms; and the Patient Benefit Questionnaire, inquiring about issues such as mouth and tongue discomfort; difficulties in speaking, eating and sleeping; and use of oral comfort aids. A quality-of-life assessment conducted at weeks five and eight showed significant improvements over quality-of-life scores recorded at the outset of the study.

"In this pilot study, patients with severe xerostomia who underwent acupuncture showed improvements in physical well-being and in subjective symptoms," Dr. Chambers said. "Although the patient population was small, the positive results are encouraging and warrant a larger trial to assess patients over a longer period of time."

Garcia said that a phase III, placebo-controlled trial is planned and is currently under review. She also noted that in other studies, the M. D. Anderson researchers are examining whether acupuncture can prevent xerostomia in patients treated for head and neck cancer, not just treat it.

Dr. Hisao Asamura and his team of researchers at The National Cancer Center Hospital in Tokyo, Japan examined the records of 2,281 patients who underwent lung cancer resection surgery between 2000 and 2006. The study was published in the May issue of the Journal of Thoracic Oncology, the official journal of the International Association for the Study of Lung Cancer. Dr. Asamura and his team found that after classifying patients based on the technique used to diagnose their lung cancer, either through CT scans or x-rays, there was a marked difference in five-year survival rates. Those patients diagnosed using CT scans had a 91.2 percent 5-year survival rate while those diagnosed with x-rays demonstrated a 77.8 percent survival rate.

The researchers also divided the patients into groups based on the detection type, including screen detection, symptom detection and incidental detection. The patients that demonstrated the highest five-year survival rates were those diagnosed through screening (79.6 percent) and then those diagnosed because of symptoms (74.6 percent). The patients that were diagnosed incidentally demonstrated the lowest five-year survival rate (64.6 percent).

The study findings demonstrate the impact of lung cancer screening, particularly though CT-scans, can have on improving patient prognosis by detecting the disease at an early stage. The accuracy of CT scans allow physicians to detect cancerous growths while the tumor is at an early stage and physically smaller, making it more operable. With lung cancer prognosis and survival depending heavily on the stage of the disease upon diagnosis, it is important to keep findings such as these in mind.

The Academy of General Dentistry (AGD), the only voice exclusively for the general dentist, reminds legislators that dentistry is very different from the practice of medicine and these differences must be taken into consideration in any effort by Congress to enact an overhaul of the health care system. A critical issue for general dentistry is access to care. The AGD created a white paper on access to oral health care to provide real and workable solutions for improving access to oral health care as part of any broader health care reform undertaken by the 111th Congress.

The white paper, titled, "Increasing Access to and Utilization of Oral Health Care Services" offers more than 30 recommendations in eight broad subject areas:

-- Attracting students to careers in dentistry

-- Enhancing existing federal training programs

-- Incentives for establishing dental practices in underserved areas

-- Improvements to the Medicaid program relative to the provision of oral health care

-- Continuing education and cultural awareness training for general dentists

-- Public health enhancements and health literacy improvements

-- Support for the "dental team" concept

-- Greater collaboration between private organizations and government entities

"Adoption of the specific recommendations included in the white paper with each of these broad subject areas is likely to dramatically increase access to oral health care and reduce the incidence of dental disease and associated systemic ailments," says AGD President Paula S. Jones, DDS, FAGD. "The AGD asks Congress to seriously consider the solutions outlined in the white paper in preparing health care overhaul legislation."

"In order to bridge the gap between those who receive proper dental attention and those who do not, professional organizations, as well as local, state, and national governments and even community organizations, must all make a collaborative effort," comments Dr. Jones. She says that the AGD has put forth several well thought out solutions to bridging the gap, many of which urge greater funding for dental care through Medicaid and Title VII programs, encourage practice in underserved areas through loan forgiveness programs, grants and scholarships, as well as promote recruiting dental school applicants to commit to working in underprivileged areas upon graduation.

"The AGD white paper provides the dental profession and policy makers with 30 substantive and workable solutions to access to care that can be implemented by organizations, governmental entities, and communities of interest," says John T. Sherwin, DDS, FAGD, chairperson, AGD Task Force on Access to Care. "The AGD asks federal lawmakers and administration officials to consider and include these suggestions in any comprehensive health care reform discussions and debates."

A high salt intake has been implicated in cardiovascular disease risk for 5000 years. But salt-sensitive hypertension still remains an enigma. Now, investigators from Germany at the University of Erlangen, the Max Delbrück Center for Molecular Medicine (MDC) Berlin-Buch and Regensburg, collaborating with researchers from Finland and Austria have shed new light on the relationship between salt intake, bodily processes, and blood pressure regulation. Within the skin, they have detected a new storage area for salt in the body. They also found out that if the process behind this storage is defective, animals become hypertensive (Nature Medicine, doi 10.1038/nm.1960)*.

Salt (natrium chloride, NaCl) is required for life. Herbivores (plant-eating animals) risk their lives to go to "salt licks" and carnivores (meat-eating animals) go to salt licks to eat herbivores in order to obtain salt.

Salt is responsible for water regulation in the body. It is taken up by the gastro-intestinal (GI) tract and, in large part, excreted by the kidneys. However, salt is also stored in cells and in the interstitium, the area between cells in the body.

Dr. Jens Titze and colleages, among them Dominik N. Müller, Wolfgang Derer, and Friedrich C. Luft from the Experimental and Clinical Research Center at the MDC, could now show that a high-salt diet in rats leads to the accumulation of salt in the interstitium in the skin. This process is carefully regulated by special white blood cells, the macrophages.

In those macrophages, the scientists found a gene regulator (transcription factor) called TonEBP (tonicity-responsible enhancer binding protein). TonEBP is activated in these cells in response to high salt and turns on a gene (VEGF-C - vascular endothelial growth factor C) that controls the production of lymphatic blood vessels. With a high-salt diet the lymphatic vessels increase.

The investigators also showed that when these macrophages are depleted or if the receptor for VEGF-C is absent, the animals are not able to "store their salt" and become hypertensive. However, this process and its relevance to human disease are not yet completely understood..

Macrophages regulate salt-dependent volume and blood pressure by a vascular endothelial growth factor-C-dependent buffering mechanism

It's never too early to start protecting your children against sun damage, and if you are the parent of a young girl this message is especially important.

"Even one blistering sunburn can increase your risk of skin cancer. As few as five sunburns can double your risk of skin cancer," says Dr. Anjali Dahiya, a dermatologist at the Iris Cantor Women's Health Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Teenage girls and their parents should be particularly careful, since melanoma, a potentially fatal skin cancer, is the most common cancer in young women between the ages of 25 and 29. Much of the damage from the sun in these patients will already have occurred in their teens.

"Sun exposure plays a significant role in the development of melanoma. Although more adults are using sunscreens during outdoor activities, many are unaware of how important it is to make sure that their children are getting the necessary skin protection," says Dr. Desiree Ratner, director of dermatologic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Drs. Dahiya and Ratner recommend the following guidelines to help protect teens, tweens and infants from the harmful effects of the sun:

-- Use self-tanning creams. Tanning beds are not good for anyone. Teenagers and young adults looking to get that perfect tan should use tanning creams to get a safe summer glow.

-- Be wary of freckles. Developing freckles may be a sign that the skin has sustained early sun damage.

-- Apply sunscreen generously. Teens and tweens should apply sunscreen to the entire surface of their body about 30 minutes before going outside; if they are swimming, they should reapply once they are out of the water. Parents should apply approximately one ounce of sunscreen to their infant's body as well.

-- Make it easy. Parents of tweens should find a spray-form sunscreen that is waterproof and sweat proof. This will make it more convenient to apply sunscreen to your growing child every day, and more effective.

-- Minimize exposure to the sun. In addition to applying sunscreen, everyone should be guarding against the sun with hats, sunglasses and umbrellas when appropriate. Babies up to 6 months of age should be kept out of the sun completely.