Keeping an eye on oral cancer

Texas A&M, MD Anderson seek to promote early detection in oral cancer

Kelsey Kaustinen
COLLEGE STATION, Texas—While there is no shortage ofcompanies involved in cancer research these days, the amount of attention paidto oral cancer has been fairly sparing comparatively. In Texas, however, it'san issue that's drawing attention from several organizations, including TexasA&M University and the MD Anderson Cancer Center.
 
 
Dr. Kristen Maitland, an assistant professor in TexasA&M's Department of Biomedical Engineering, is working on the developmentof a new imaging system that uses confocal microscopy and fluorescence lifetimeimaging in order to detect precancerous and cancerous cells in the mouth. Thismethod was developed in earlier studies on hamsters, and is now being tested onhuman tissue. Maitland is serving as principal investigator, with Dr. JavierJo, an associate professor of Biomedical Engineering, serving as co-investigator.
 
 
There are imaging options available for monitoring oralcancer sites currently, such as the VELscope from LED Dental Inc., anadjunctive device that has been approved by the U.S. Food and DrugAdministration to aid clinicians in detecting pre-cancerous and cancerouslesions that are difficult to spot. The blue light excites "fluorophores" inmucosal tissue, which then emit their own light. The device's filter enablesfluorescence visualization by blocking the reflected blue light and enhancingthe contrast between normal and abnormal tissue.
 
 
In the new imaging system, the lifetime fluorescence systemwill send out a bluish light to make precancerous or cancerous sites light up,while the camera can zoom in on spots of interest. This approach has beentested in hamster studies, with the results published in the paper"Fluorescence lifetime imaging and reflectance confocal microscopy formultiscale imaging of oral precancer," which appeared in the Journal of Biomedical Optics. Maitlandand Jo helped to author the paper, which reported that "while [fluorescencelifetime imaging] is sensitive to biochemical and macroscopic architecturalchanges in tissue, [reflectance confocal microscopy] provides images of cellnuclear morphology, all key indicators of precancer progression."
 
 
As development of this imaging system moves forward,researchers from Texas A&M will partner with the Baylor College ofDentistry, where dentists often perform biopsies. Tissue samples taken frompatients can be sent directly to the lab to be scanned with the imaging system,then sent to another lab for official diagnosis.
 
 
This is not the first step the organizations have made inseeking better options for oral cancer patients. A dental clinic wasestablished in 2011 at Baylor University Medical Center's Charles A. SammonsCancer Center in Dallas, a move supported by the Texas A&M UniversityBaylor College of Dentistry. The Texas A&M Health Science Center noted in aJuly press release that prior to the clinic's opening, MD Anderson was the onlyTexas cancer center that offered a full-range facility that included dentistry.
 
 
Dr. Ann Gillenwater, a professor in the Department of Headand Neck Surgery at MD Anderson, considers early detection to be key in thefight against oral cancer. In a 2011 podcast in MD Anderson's Cancer Newslineseries, Gillenwater called herself "a strong advocate for early detection,"citing a high survival rate if oral cancers are caught in their early stages.She added that "we need to improve education of people into the early signs andsymptoms of oral cancer. I also like to improve the ability of the firstresponders, the people in the front line to diagnose and recognize thesecancers at their earlier stages."
 
The American Cancer Society reports than roughly 2.5 percentof all cancers diagnosed in 2013 will involve the mouth, with the Oral CancerFoundation (OCF) forecasting approximately 42,000 people in the United Statesfacing oral cancer diagnoses. The foundation notes that this is the fifth consecutiveyear in which the rate of occurrence in oral cancer has seen an increase.
 
 
"Worldwide, the problem is far greater, with new casesannually exceeding 640,000," the OCF notes on its website.
 
 
According to the OCF, if oral cancers are caught in the earlystages of development, they have an 80 percent to 90 percent survival rate.Unfortunately, due to lack of public awareness, most cases are discovered inthe late stages, leading to a 43-percent death rate at five years fromdiagnosis and "high treatment-related morbidity in survivors." 
 
 

Kelsey Kaustinen

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