Oral cancer, detection aids on rise

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I grew up in an era that was astounded by such technological advances as the transistor radio and private phone lines — a vast improvement over the “party” line.

I recall debates among my university professors as to whether students should be allowed calculators in the classroom. Now every teenager carries a calculator-sized device that has access to more information than the Library of Congress, can play almost any song ever recorded, and takes photos so hundreds of “friends” can see them almost instantaneously.

Today’s phones also contain a mind-numbing array of games and entertainment options. But of the many uses of a smart phone, would you ever have thought of one as a cancer diagnosing aid?

Manu Prakash, a bioengineering researcher at Stanford University, has developed an ingenious device he calls an OScan. It attaches to the front of a smart phone and will help screen patients for oral cancer.

Prakash was impressed with the need to develop an aid to oral cancer detection while visiting a rural clinic in Sevegram, India, and seeing patients diagnosed after it was too late to treat them. A staggering 40 percent of cancer deaths in India are due to oral cancer, with patients sometimes developing the disease while still in their teens.

With a rate of less than one dentist per 100,000 people, most of these lesions aren’t getting diagnosed in the early, treatable stages.

The device is about the size of a business card. Illuminated by the OScan’s LED lights, abnormal cancer cells appear darker than healthy tissue long before the lesion can be seen by the naked eye.

A panoramic photograph of the mouth is taken and sent to a screening center where suspicious lesions are evaluated and follow-up can be recommended.

Why is the oral cancer rate so high in India? The culprit is called gutka, a mix of tobacco and abrasive chunks of areca nut.

The mixture accelerates the harmful effects of nicotine and cancer-causing chemicals, according to an April 17, 2012, report by Stanford School of Medicine.

“Sold as chewing tobacco, gutka, is often marketed in child-friendly packaging as mouth freshener or gum,” it states.

Here in the United States, oral cancer is typically diagnosed in older people. The most common causes are smoking, chewing tobacco and excessive alcohol consumption. Oral cancer is the sixth most common type of cancer in males, and because it is often diagnosed in its later stages it can have a survival rate lower than that of melanoma, the most serious form of skin cancer.

Recently, however, there has been a remarkable uptick in the incidence of oral cancer in men younger than 40. A report in The British Medical Journal published March 25, 2010, states that between 1999 and 2006 there was a 22 percent increase in oral cancer in the U.S., while the UK experienced a 51 percent increase between 1989 and 2006.

The sharp rise is attributed to human papilloma viruses 16 and 18, which are transmitted by oral/sexual contact. Risk factors are those with four or more such partners. A saliva test is now available which reveals whether an individual has come in contact with this virus.

Coming to the U.S. market are sophisticated devices that operate similarly to the OScan smart phone device. This fluorescing technology causes abnormal cells to “glow” under special lights, helping clinicians identify the edges of abnormal cell expansion.

These innovative instruments are expected to help identify oral cancer at earlier, more treatable stages as well as aid with biopsy and removal. Seeing your hygienist and dentist every six months for cleanings will allow a better chance of an abnormal area being spotted in its early stages.

To avoid the major causes of oral cancer, follow Grandma’s advice and avoid smoking and chewing tobacco, excessive alcohol and “tom-catting” around. If you have an area of your mouth that looks suspicious to you, I strongly urge you to see your dentist, an oral surgeon, or an ENT for an evaluation. Oral cancer should not be taken lightly.

Dr. Eric Gustavsen practices dentistry at Southpoint Dental Center, 1129 S. Second Ave. More information on his practice can be found at www.southpointdentalcenter.com.

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