Ranked as the 13th most widespread cancer in the world, oral cancer casts a gloomy shadow over countless lives. It finds its roots in the misuse of tobacco—through smoking, chewing, snuffing, or pouching. This tumour evolves through different stages, commencing from precancerous phases to culminating in the advanced stages. Fortunately, a pivotal opportunity emerges to recognise and address the affliction during these initial phases, holding the potential to halt its ominous advance into more critical territory.
Read more about how smoking affects your health here
New diagnostic tool
The recent developments in the diagnostic tools have paved the way for early oral cancer diagnosis. One such diagnostic aid is Oral Potentially Malignant Disorders (OPMD) Atlas Project by Dr Praveen Birur, professor and head of oral medicine and radiology, KLE society’s Institute of Dental Sciences, Bengaluru and lead of oral cancer programme, Biocon foundation, Bengaluru.
The OPMD project is based on the study, ‘Oral Potentially Malignant Lesion Atlas Project: Validating the Efficacy of a Novel, Point-of-Care Diagnostics and Developing an Integrated Multidimensional, Prognostic Nomogram.’
The project, which is a work-in-progress, utilises data science and artificial intelligence to interpret clinical information, images of lesions, cell studies, genetic information, and protein analysis to diagnose oral cancer.
This specifically helps oral cancer diagnosis in India which has its own unique peculiarities. “In India, the characteristic of oral cancer becomes unique in terms of its genomic, ethnic, cellular and molecular features,” says Dr Kiran Mazumdar-Shaw, founder and managing trustee, Biocon Foundation.
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Need for early oral cancer diagnosis
“Unfortunately, in our country two third of people are at an advanced stage (III or IV). This is because awareness is low and often symptoms [of oral cancer] are mistaken for infections, dental trouble, gastric reflux or similar problems,” says Dr Narayana Subramaniam, consultant and HOD from head and neck surgical oncology department, Sri Shankara Cancer Hospital and Research Centre, Bengaluru.
Conventional diagnostic techniques for oral cancer
Currently, healthcare professionals use conventional oral examination and biopsy (removal of tissue for examination) to diagnose oral cancer. “Additionally, CT scan (computed tomography), MRI scan (magnetic resonance imaging) and PET scan (positron emission tomography) can help to identify the extent of spread and stage of the cancer,” says Dr Subramaniam.
The new approaches
“Biopsy is invasive and not feasible in a limited resource setting,” says Dr G K Rath, former chief, DBRA Institute Rotary Cancer Hospital & former head – NCI and professor, AIIMS, Delhi. He adds that the OPMD atlas project has aided in oral cancer screening, which has upscaled community-based screening and efficiency at a larger scale.
Saliva testing is a novel tool to detect oral cancer as it is non-invasive and painless, adds Dr Subramaniam. However, it requires more investigations.
Another non-invasive diagnostic tool is velscope (a handheld device that helps in early diagnosis of oral cancer). A 2021 study published in the Journal of Oral and Maxillofacial Pathology explains that this technique uses fluorescent light to observe the changes in the cells and tissues of oral cavity.
Benefits of early diagnosis
Early diagnosis and intervention become highly beneficial when it comes to managing oral cancer, says Dr Ishwarya P, consultant oral and maxillofacial surgeon, Coimbatore, Tamil Nadu. She points out the following advantages:
- Prevent the spread of oral cancer to other parts of the body
- Minimise the recurrence rate
- Provide better treatment outcomes
- Increase survival rate
“Cancer at the tip of the tongue requires minimal intervention when identified at early stages. But it becomes challenging when it extends to the back of the mouth,” she says.
Early preventive measure
Since the primary cause of oral cancer is linked to habits, it can be addressed through counselling, behavioural therapies from rehabilitation centre, and pharmacological approach with nicotine replacement therapies (nicotine gums and nicotine patches).
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