A portable laser device to detect oral cancer, now being tested in India, promises quick, non-invasive, early detection of cancers of the mouth and throat or oral and oropharyngeal squamous cell carcinomas (OSCC).
Development of the device, by the Beckman Laser Institute, University of California (UCI), Irvine and the Mazumdar Shaw Cancer Centre (MSCC) in Bangalore, India, is funded by the National Institute of Biomedical Imaging and Bioengineering, Bethesda, under a joint Indo-US programme.
Petra Wilder-Smith, director of dentistry at the UCI, says if “oral cancer is diagnosed before it spreads to other parts of the body, treatment options are excellent.” She says that the device is useful in developing countries where oral cancer rates are high due to cigarette smoking or the habit of chewing of cancer-causing products such as betel nuts.
The new device, the size of a loaf of bread, uses laser light to pinpoint oral lesions in what is called Optical Coherence Tomography (OCT). “Other OCT systems exist,” she says, “but, they usually are very complex, expensive and extremely fragile.”
Wilder-Smith says barriers to oral cancer prevention include poor early detection capability and the lack of predictors of risk of malignant transformation in red and white lesions that are found in the mouth and which can be the result of cold sores, infections or cancer.
India was picked for the study because it has a good public health programme where mobile field workers travel to rural areas, providing regular health services, including OSCC screenings. But the visual inspection they rely on is ineffective. “By looking at an oral lesion you cannot diagnose its nature,” Wilder-Smith says.
The device sends images of the mucosal surface and structures lying approximately two millimeters deep to the UCI laboratory where technicians use software to determine what kind of treatment the patient may need, or if he needs any at all.
Moni Abraham Kuriakose, co-principal investigator and director, department of surgical oncology, MSCC, says that the laser device can offer “non-invasive diagnosis of oral cancer through ‘optical biopsy’ of tissue that can replace incision biopsy.”
Kuriakose, who estimates that it will take more than a year to complete the development work, says the device is expected to have particular value in India where “more than 30 per cent of all cancers are oral cancers.”
“Approximately 80 per cent of patients presenting with oral cancers are seen when these cancers are in advanced stages and when the cure rate is only about 30 per cent,” Abraham tells SciDev.Net. “Early detection can increase the cure rate to about 70—80 per cent.”
He adds that because the device has the potential to detect oral cancer at an early stage in a non-invasive fashion it “will improve compliance and wider utilisation of the diagnostic procedures.”