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Nothing to Spit at: Saliva used to Detect Oral Cancer

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Saliva used to Detect Oral Cancer

Nothing to Spit at: Saliva used to Detect Oral Cancer

July 11, 2005
By: Shelagh McNally for Dental1

When is saliva more than just spit? When used to detect cancer. A new study done at the UCLA School of Dentistry and the Jonsson Comprehensive Cancer Center has shown that a simple saliva test can detect cancer of the mouth and throat before symptoms develop. The findings were presented at the annual meeting of the American Association for Cancer Research.
Take Action
Watch for these symptoms of oral cancer:

1. Be aware of any changes in your mouth.

2. Look for white or red patches of tissue that do not go away.

3. Watch any canker sore that does not go away. It may be an ulcer.

4. Note any sore or discolored areas that do not heal within 14 days.

5. Lumps or masses in the mouth should be examined.

6. If you are having pain or difficulty in swallowing, speaking, or chewing, or, continual hoarseness or numbness in the oral/facial region make an appointment with your dentist.

If your dentist or doctor decides that an area is suspicious, the only way to know for sure is to do a biopsy of the area.

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The dream has always been to develop easy, non-intrusive and reliable screening tests for cancer that can be done in a doctor’s office. In order to do develop these tests, researchers have examined tissue to detecting the proteins given off by cancer. The research team at UCLA lead by David Wong, D.M.D., D.M.Sc. had been looking at oral cancer and was on the mouth's soft tissues when Marie St. John M.D., Ph.D joined Wong’s lab. This surgery/otolaryngology resident asked a simple question: “If proteins associated with cancer are present in the mouth’s tissue can they also pass from tissue into the saliva? This raised an intriguing possibility that eventually altered the team’s research.

To explore the question the team started looking at the genetic messengers for such proteins, known as RNA or Messenger RNA (mRNA). RNA acts as a chemical record of the molecular interchange between a gene and protein. "What really interested us was the idea that mRNA analyses could be performed in a bodily fluid as easily obtained as saliva," said St. John. "If correct, a salivary test in theory would be quick, painless, and most likely less expensive than current diagnostic tests." The first step was for Wong and his ream to define all of the individual 3,000 mRNAs naturally present in saliva. The team then tested the saliva of 128 people (64 with oral cancer, 64 without) and found four distinct patterns present when there was cancer. As backup the researchers looked at the genetic profile of participants' blood and found similar patterns for oral cancer in the blood. The results were impressive; using the four patterns, the team was able to detect cancer nine times out of 10. "Although we were able to identify the head and neck cancer patients with 91 percent sensitivity and accuracy, we missed one out of 10. With a larger study, we will move that accuracy closer to 100 percent," Wong said. The team is looking to expand the research to include 200 participants.

The idea of using distinct patterns of mRNA found in saliva to catch a developing tumor is causing some excitement in the medical community. Dr Kat Arney of Cancer Research UK commented, "Early detection of cancer can greatly increase a person's chances of survival. The use of RNA to detect cancer is a potential advance in technology, particularly using a non-invasive saliva test.” Dr Nick Coleman from the Medical Research Council's Cancer Cell Unit in Cambridge, Massachusetts said: "It is a good type of approach to take.”

Wong hopes that the RNA patterns in saliva may be used to detect other cancers as well as common diseases. "Saliva is a mirror of our blood," said Wong. "We're now conducting our initial studies of saliva as a possible diagnostic fluid for other human cancers and system diseases.” Given the choice between spitting into a cup or giving blood, most patients would choose to spit.

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