It is estimated that this year alone nearly 10,000 people will die from oral cancer in the United States, and around 50,000 new oral cancer patients will be diagnosed. In the fight against this disease, early detection is one of the most crucial components.
If oral cancer is diagnosed before it spreads, the five-year survival rate is higher than 80 percent. Unfortunately, only 30 percent of patients are diagnosed during the early stages. That is because diagnosing oral cancer is not always easy, in spite of the fact that oral lesions are fairly accessible for clinical evaluations.
Dentists and physicians typically rely on the naked eye to look for problematic areas in a patient’s mouth that warrant a biopsy, but identifying these areas can be difficult because a patient’s mouth can manifest lesions that may be benign, precancerous or cancerous. As a result, many early stage cancerous oral lesions are missed, while many unnecessary and painful biopsies of benign lesions are prescribed. Diagnosing oral cancer is somewhat of an educated guessing game that Dr. Javier Jo, associate professor in the Department of Biomedical Engineering at Texas A&M University, is hoping to improve upon through the use of advanced endoscopes that he and his team are developing.
These potentially lifesaving endoscopes make use of a technology known as fluorescence lifetime imaging (FLIM) to detect subtle metabolic changes that occur in the epithelial tissue covering the oral cavity as it turns cancerous. Preliminary results from more than 80 patients already suggest the potential of FLIM imaging for distinguishing, noninvasively and in real time, a variety of benign lesions from precancerous and cancerous lesions in the human oral cavity.
Recognizing the potential of this technology for significantly facilitating the early detection of oral cancer, the National Cancer Institute (NCI), part of the National Institutes of Health (NIH), awarded Jo and his team a $2.5 million grant that will help support research focused on further developing their FLIM endoscopy technologies for noninvasive and accurate detection of oral dysplasia and early stage cancer. This grant will also help support clinical studies at different medical centers in Houston and Dallas before moving to in-depth clinical trials and licensing of the technology.
“We are extremely excited that NCI recognized the potential of our technology for enabling early detection of oral cancer and decided to award our research proposal, especially considering that only around 10 percent of these major grant proposals are recommended for funding,” Jo said. “We strongly believe that our technology could potentially be used to assist at every stage of the clinical management of oral cancer patients, not only for screening and early diagnosis, but also for guiding treatment and monitoring for cancer recurrence, which happens in 30 percent of patients who survive a first incidence.”
This five-year NCI/NIH grant was awarded in February to Jo and his colleagues Dr. Brian Applegate, associate professor in the Department of Biomedical Engineering at Texas A&M; Dr. Yi-Shing Lisa Cheng and Dr. John Wright, professors in the College of Dentistry at Texas A&M; Dr. Maryellen Giger, faculty fellow from the Hagler Institute for Advanced Study at Texas A&M; Dr. Carlos Busso, associate professor in the Department of Electrical Engineering at The University of Texas at Dallas; Dr. Nadarajah Vigneswarab, professor in the School of Dentistry at The University of Texas Health Science Center in Houston; and Dr. Thomas Schlieve, assistant professor in the Department of Surgery at The University of Texas Southwestern Medical Center.