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Oral rinse could detect head and neck cancer

A swish with an oral rinse may be the newest diagnostic tool for detecting head and neck squamous cell carcinoma in its early stages, say researchers at the University of Miami's Sylvester Comprehensive Cancer Center.

Head and neck cancers can affect the lips, teeth, gums, cheeks, floor of the mouth, tongue, soft palate, tonsils, back of the throat and larynx. If detected early, patient cure rates exceed 80 percent. Unfortunately, only 50 percent of head and neck cancers are currently detected early and cured.

The new oral rinse detects a specific protein biomarker of head and neck squamous cell carcinomas — CD44. Although the protein is contained in healthy tissue, it is found at levels at least seven times higher in patients with head and neck cancer.

Researchers collected oral rinse samples from 102 head and neck cancer patients and 69 control patients with a history of tobacco or alcohol use. The oral rinse detected oral cancer or precancer in two patients in the control group before their cancer was clinically evident, but only detected elevated CD44 levels in 62 percent of cancer patients.

Researches then used the rinse to determine if patients' DNA was chemically modified due to cancer, a condition called hypermethylated DNA. A subsequent pilot study showed hypermethylation in the oral rinse samples of nine of 11 head and neck cancer patients who had low levels of CD44 in the original study.

"Many lives could be saved through a test that is no more invasive than gargling," said Elizabeth Franzmann, M.D., assistant professor of otolaryngology at Miami. "Our study has shown that an oral rinse test simple enough to be administered at any community health center is likely to detect cancer about 90 percent of the time."

Risk factors for head and neck cancer can include tobacco and alcohol use, prolonged sun exposure, chronic oral irritation, poor nutrition, using alcohol-containing mouthwash, infection with human papiloma virus, gastroesophageal reflux disease and gender — men are affected twice as often as women.

The American Dental Association offers special oral care instructions for patients with head and neck cancer at "www.ada.org/public/topics/cancer_treatment.asp".

Please contact the ADA if you have questions about this article.

©2010 American Dental Association. All rights reserved. Reproduction or republication is strictly prohibited without the prior written permission from the American Dental Association.

4/23/2007

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