Allelotype of head and neck squamous cell carcinoma.

To gain a better understanding of the molecular changes in head and neck squamous cell carcinoma, we tested every autosomal arm of 29 primary head and neck tumors for allelic loss. Fifty-eight microsatellite markers were used with at least two-thirds of patients informative for each chromosomal arm tested. A high frequency of allelic loss was found on chromosome 9p where 21 of 29 (72%) tumors had loss of heterozygosity for at least one polymorphic marker on this arm. Chromosomes 3, 11q, 13q, and 17p exhibited loss in over 50% of all informative cases, while chromosomes 4, 6p, 8, 14q, and 19q displayed loss in greater than 35% of all cases tested. Additionally, several other chromosomal arms exhibited loss of heterozygosity in 20 to 30% of tumors tested. This high frequency of allelic loss in these advanced stage neoplasms suggests multiple genetic steps in the progression of head and neck cancer and identifies several putative tumor suppressor loci on affected chromosomes.

Frequent loss of chromosome 9p21-22 early in head and neck cancer progression.

In order to define more clearly the role of chromosome 9 loss in head and neck squamous cell carcinoma (HNSCC), 29 invasive carcinomas and 17 preinvasive lesions were analyzed for loss of heterozygosity (LOH) on chromosome 9. We found LOH in 21 of 29 (72%) HNSCC tumors using highly polymorphic microsatellite markers. In 17 of 21, LOH was found at all informative sites on the p arm with no LOH of the q arm. Further mapping in tumors, with partial LOH of the 9p arm, localized a common region of loss between markers D9S165 and D9S156. Deletion of this region on chromosome 9 has been found in several other tumor types implying the presence of a tumor suppressor gene at this locus. The inactivation of a tumor suppressor gene on chromosome 9p may represent the most commonly described genetic alteration in HNSCC. A similar incidence of allelic loss on chromosome 9p was identified in 12 of 17 (71%) preinvasive lesions. The identical frequency of loss in preinvasive and invasive lesions suggests that loss of 9p is an early event in HNSCC progression.

The incidence of p53 mutations increases with progression of head and neck cancer.

To establish a genetic model of the progression of head and neck squamous carcinoma we have defined the incidence and timing of p53 mutations in this type of cancer. We sequenced the conserved regions of the p53 gene in 102 head and neck squamous carcinoma lesions. These included 65 primary invasive carcinomas and 37 noninvasive archival specimens consisting of 13 severe dysplasias and 24 carcinoma in situ lesions. The incidence of p53 mutations in noninvasive lesions was 19% (7/37) and increased to 43% (28/65) in invasive carcinomas. These data suggest that p53 mutations can precede invasion in primary head and neck cancer. Furthermore, the spectrum of codon hotspots is similar to that seen in squamous carcinoma of the lung and 64% of mutations are at G nucleotides, implicating carcinogens from tobacco smoke in the etiology of head and neck squamous carcinoma.

Genetic progression model for head and neck cancer: implications for field cancerization.

A genetic progression model of head and neck squamous cell carcinoma has not yet been elucidated, and the genetic basis for "field cancerization" of the aerodigestive tract has also remained obscure. Eighty-seven lesions of the head and neck, including preinvasive lesions and benign lesions associated with carcinogen exposure, were tested using microsatellite analysis for allelic loss at 10 major chromosomal loci which have been defined previously. The spectrum of chromosomal loss progressively increased at each histopathological step from benign hyperplasia to dysplasia to carcinoma in situ to invasive cancer. Adjacent areas of tissue with different histopathological appearance shared common genetic changes, but the more histopathologically advanced areas exhibited additional genetic alterations. Abnormal mucosal cells surrounding preinvasive and microinvasive lesions shared common genetic alterations with those lesions and thus appear to arise from a single progenitor clone. Based on these findings, the local clinical phenomenon of field cancerization seems to involve the expansion and migration of clonally related preneoplastic cells.

Progression of basal cell carcinoma through loss of chromosome 9q and inactivation of a single p53 allele.

Basal cell carcinoma (BCC) of the skin represents a unique group of tumors strongly associated with exposure to UV light. Unlike squamous carcinoma of the skin, BCC is generally indolent, noninvasive, and rarely metastatic. To study the involvement of tumor suppressor genes in these neoplasms, we analyzed 36 BCCs for p53 mutations and a subset of these tumors for loss of chromosomes 17p and 9q. Sixty-nine % of sporadic BCCs had lost a 9q allele, with the common area of loss surrounding the putative gene for nevoid BCC or Gorlin's syndrome. Forty-four % (16 of 36) of BCCs had a mutated p53 allele, usually opposite pyrimidine tracts, which is consistent with UV-induced mutations. Surprisingly, only one tumor had lost a 17p allele, and in all BCCs only one p53 allele was inactivated. This is in direct contrast to other epithelial tumors, which usually progress by the inactivation of both p53 alleles.

Metastatic prostate cancer presenting as an asymptomatic neck mass.

Prostate cancer often metastasizes to the regional lymph nodes, but metastases to distant supradiaphragmatic lymph nodes are uncommon. Rare case reports describe cervical lymph node metastases as the first clinical manifestation of prostate cancer, but only in the setting of widely disseminated disease. We present the unusual case of an 84-y-old male with a known history of prostate cancer and recurrent disease limited to the left supraclavicular lymph nodes.

Massage and sexuality in nursing.

This paper draws upon data from a students' massage workshop, focuses on the students' discourse as they positioned themselves as masseurs and considers relationships between nursing discourses and genderized self-hood. For some students, there was a conflation of sex and massage. Massage was more heavily laden with implicit sexual meaning for male students than for female students. The latter were able to negotiate the ambiguities of working with people's bodies in a more comfortable way. This research has implications for teaching students of nursing, particularly in relation to massage, and also nursing practice that involves care for the patient's body.

Massaged embodiment of cancer patients.

This paper analyses the massaged embodiment of cancer patients and involves a poststructural approach. Poststructuralism as a methodology is used as it provides a way of seeing and understanding cancer patients' complex experience of embodiment. Massage promotes a quality of embodiment that involves well being, comfort and relaxation. However, massage can promote vulnerability and this is evident in some of the participants' talk. For participants, massage provides a reclaiming of 'the old body' and an experience of mind and body connection. Embodiment is theorised as shifting, discursively constituted and multi layered.

Ethereal embodiment of cancer patients.

Ethereal embodiment is the attending and focusing on the body through discourses such as meditation, visualisation and massage, and the experiencing a new sense of the embodied being as balanced, connected, centred and of being made whole. This paper continues a previous article titled 'Massaged embodiment of cancer patients'. Data from my doctoral studies are analysed utilising crucial concepts of poststructuralism such as subjectivity, discourse, power and history to examine ethereal embodiment. This paper will address the advantages of visualisation and discusses the link between spirituality, embodiment, and memory.

The sexual embodiment of the cancer patient.

This paper draws upon data from my doctoral studies and uses poststructuralism as a methodology to provide a way of seeing and understanding cancer patients' complex experience of their bodies. Cancer patients were massaged for the purpose of this study and the themes addressed in this article are linked to the sexuality of the person being massaged and the masseuse (PVDR). In order to capture the richness of the cancer patients' experience, the data are presented in an unconventional way--in the form of poetry. The poems show that the damaged bodies of cancer patients are still sexual in nature. In this research, the body of the cancer patient is a discursive one inscribed with power, culture, society and history. There are also themes of managing the body, altered embodiments of femininity, altered embodiments of masculinity, intimacy, and speaking the unspeakable.

Therapeutic massage: an education program for rural and remote workers in the palliative care field.

This paper, drawing upon data from a Rural Health, Support, Education and Training (RHSET) funded project, focuses on the evaluation of a massage education program developed specifically for rural and remote palliative care workers. An 8 week pilot massage education course was run for palliative care workers in the Albury-Wodonga area and, from this course, an instructional video education package on massage has been developed. The program was evaluated by using a questionnaire, journals and focus group interviews. Feedback from participants was incorporated into both the pilot course and final education package, which was consistent with the action research framework. The major findings of the project were that skill development in the therapeutic use of massage was attained and that job satisfaction was indeed achieved by palliative care workers.

Oncogene mutations as intermediate markers.

Tumors arise through a series of genetic changes which include activation of protoocogenes and inactivation of tumor suppressor genes. It is now possible to identify rare cells containing genetic mutations in an excess background of normal cells. Theoretically, the identification of a clonal population of cells sharing an early genetic marker for malignant transformation would lead to valuable intermediate endpoints and could diagnose premalignant lesions amenable to chemoprevention. Ideally, these genetic changes would be specific point mutations that occur early in the tumor cascade, prior to the development of a clinically significant tumor. To identify these markers, precise histopathologic and genetic tumor models must be described. Early candidate markers include p53 point mutations in squamous cell carcinoma of the aerodigestive tract.