By: Maayan S. Heller for Dental1
Earlier this year, researchers working with the National Institute of Dental and Craniofacial Research at the National Institutes of Health (NIH) reported dramatic findings – they’d had success using an optical device to detect if a patient was developing oral cancer.
The device, called a Visually Enhanced Lesion Scope, or VELScope, offers dentists a brand new means of investigating the possibility of this type of cancer.
|Risk factors for oral cancer:|
Tobacco/Alcohol Use. Tobacco and excessive alcohol use increase the risk of oral cancer. Using both tobacco and alcohol poses a much greater risk than using either substance alone.
Sunlight. Exposure to sunlight is a risk factor for lip cancer.
Age. Oral cancer is typically a disease of older people because of their longer exposure to risk factors. Incidence of oral cancer rises steadily with age, reaching a peak in persons aged 65 to 74. For African Americans, incidence peaks about 10 years earlier.
Gender. Oral cancer strikes men twice as often as it does women.
“Oral cancer is normally detected when the patient comes to the doctor or dentist complaining of a sore in the mouth,” says Kerstin M. Stenson, MD, FACS, an associate professor of Surgery and Director of the Head and Neck Program at the University of Chicago.
Until now, determining if a suspicious sore in the mouth was benign or malignant has been difficult. Many cancers can be diagnosed based on the general appearance and staining patterns of tissue biopsy, which is slightly more problematic to do inside the mouth.
The VELScope emits a cone of blue light into the mouth, which excites molecules in the cells, causing them to absorb the light energy and visibly re-emit it as fluorescence.
According to the NIH, changes in the natural fluorescence of healthy tissue usually reflect light-scattering changes that indicate developing tumor cells. Because of this biological condition, the VELScope allows dentists to shine light directly on a suspicious sore in the mouth and watch for changes in color. Cells that are potentially linked to tumors will appear dark green to black.
Dr. Miriam Rosin, a senior author on the research and a cancer biologist at the British Columbia Cancer Research Center in Vancouver, Canada, has spelled out the potential impact of this device: “The VELScope literally brings this natural fluorescence to light, helping dentists to answer in a more informed way a common question in daily practices: to biopsy or not to biopsy.”
How common are oral cancers and what causes them?
“Head and neck cancer in general accounts for three to five percent of all malignancies of the body,” explains Dr. Stenson. “Oral cancer itself is somewhat less than that.”
Cancer of the tonsils and larynx are the more common of these head and neck cancers. There are other minor salivary gland malignancies as well.
According to Dr. Stenson, “most of [these] carcinomas are associated with long-term cigarette and alcohol use.”
What kind of prognosis do these types of cancers have?
“The prognosis depends on the stage,” explains Dr. Stenson. “If the tumor is caught and treated early, it is quite curable.”
But if the cancer is discovered at an advanced stage, it can be more difficult. Although more aggressive treatment including chemotherapy, radiation and surgery may be needed, “it is still potentially curable.”
New hope in broader education and awareness
Because developing tumors in the mouth are often easy to see, health officials have long advocated the need for and impact of early detection of oral cancer. Researchers are hopeful that the VELScope can eventually provide dentists with an aid in their early detection efforts.
“The warning signs of oral cancer are a sore in the mouth that does not heal and/or ear pain without obvious ear infection,” says Dr. Stenson. “It can be caught early enough to make a difference in prognosis through education of our patients.
“This means that patients should understand that if they have a sore in their mouth that does not heal, they should see a doctor.”