Fluorescent lighting tool catches oral cancer before itís too late
by Jacquelyn SpruceA 39-year-old man positions himself in the dental chair for his routine checkup. He fears he may have a cavity but is confident that his dentist will take care of it. As he leans back and opens his mouth, the dentist spots a suspicious lump underneath his tongue. It wasnít there six months ago. After further examining the lump, the dentist gives the man unexpected news. He has oral cancer.
What is frightening is that this scenario is extremely common and can happen to almost anyone. According to the Oral Cancer Foundation, oral cancer kills one American every hour. Despite promising research, there are more deadly cases of oral cancer today than there were 30 years ago. In fact, the death rate of oral cancer is higher than that of cervical, brain, liver, kidney or skin cancer and Hodgkinís disease.
Geza Terezhalmy, D.D.S., M.A., endowed professor of clinical dentistry at the Health Science Center, says that tobacco use is most commonly associated with oral cancer. But a personís genetic predisposition plays a very significant role. If an individualís immune system is not working optimally to police the abnormal cells, the risk of oral cancer significantly increases.
"The key to treating oral cancer is to diagnose it early," Dr. Terezhalmy said. "But you canít diagnose something you canít see. By the time the cancer is visible, it has already progressed to advanced stages and has had time to invade deep into structures in the mouth."
In 2003, Zila Pharmaceuticals, Inc., a progressive company that introduces innovative products to medical professionals and consumers worldwide, asked Dr. Terezhalmy and his researchers to test a state-of-the-art, fluorescent-lighting device designed to detect oral cancer long before it can be detected using other available tools. The Health Science Center is the first institution in the nation to perform an official study on the ViziLite tool and to publish promising results, which appeared in the Quintessence International journal in 2004. Dr. Terezhalmy is the principal investigator of the study, and Michaell Huber, D.D.S., associate professor of dental diagnostic science and head of the division of oral medicine, is the co-principal investigator.
Zila Pharmaceuticals selected the Health Science Center to study ViziLite because of the schoolís excellent reputation in conducting efficacy and safety trials related to dental therapeutics and diagnostics, said Mark Bride, D.D.S., director of medical affairs at Zila Pharmaceuticals. "Zila was impressed that the Health Science Centerís Dental School also seamlessly conducted clinical trials."
ViziLite is a flexible, pen-like device that features a light at one end and contains a chemical at the other. When the dentist bends the device, breaking the inner seal that separates the light from the chemical, a fluorescent illumination occurs. The technique is called chemiluminescence. The patient then gargles with a raspberry-flavored solution that contains ingredients similar to vinegar, which allows the dentist to use ViziLite to spot cancerous lesions, or areas of concern, in the earliest stages of development.
"The solution is designed to extract water from oral tissues (cells), which, under chemiluminescence, can reflect light and appear white. The reflected light is an indication that the nuclei of the cells in the area are abnormal," Dr. Terezhalmy said. "ViziLite amplifies lesions and allows the dentist to spot the suspicious areas."
After studying a variety of patients between the ages of 18 and 70, Drs. Terezhalmy and Huber collected data that provided strong evidence that the product works.
When the researchersí published data was released two years ago, Zila was able to market ViziLite to the dental community. The device is now used in dentistsí offices across the nation to detect the early stages of oral cancer. The painless, noninvasive procedure can be performed in less than two minutes.
"Further large-scale studies are needed to refine the technique and allow dentists to recognize potential problem areas," Dr. Terezhalmy said. "ViziLite could be most beneficial to patients who are at a higher risk for oral cancer."
The major cause of oral cancer is cigarette smoking, Dr. Terezhalmy said. Other factors include drinking alcohol and the use of smokeless tobacco products.
The next best thing to behavior modifications, to behavior modifications, including smoking and drinking cessation, is early detection. "We were unable to do that until we could prove the ViziLite tool works. Now we can detect problem areas much earlier," Dr. Terezhalmy said.
Oral cancer rarely crosses the minds of most healthy, non-smoking Americans. But the truth is that the earliest stages of it could be invisibly lurking in anyoneís mouth. Thanks to the use of ViziLite, dentists can now help spot the silent killer before itís too late.
UT Health Science Center
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