Author: Courtney Friedman – VJ, Reporter
Oral cancer is a scary diagnosis. Sixty percent of people are diagnosed in a late stage of the disease, meaning their survival rate is below 50 percent.
“These statistics have not changed in over 40 years, because there’s not been any new therapies that target oral cancers,” said Dr. Cara Gonzales, a professor of dentistry, with the UT Health Science Center of San Antonio.
A full year after single mom Paige Lewis found a small painful spot on her tongue, she was finally diagnosed with oral cancer. By that time, it was almost at stage three.
“It was a 12-hour surgery just to remove part of my tongue. They took half my tongue,” Lewis said.
The cancer, thankfully, had not spread to her lymph nodes, but the tumor was very big, meaning an invasive surgery was needed.
“They had to take so much of my mouth itself. They couldn’t get a large enough margin around the tumor itself to be sure that they got all of the cancer,” Lewis said.
That’s why she had to undergo radiation to kill the rest of the cancer cells. It worked and she’s now in remission, but radiation leaves behind lifelong complications.
“Now I have no saliva because my salivary glands were damaged from radiation,” Lewis said, with her water bottle in hand. She needs to take sips constantly to keep her mouth moist. “I have high-risk for dental infections and problems because my jaw is weaker and deteriorated.”
Lewis said her quality of life could be better if there had been other treatments available when she was diagnosed. The problem is when patients are diagnosed with late stage oral cancer, it’s typically too late for chemotherapy. Some late stage oral cancers are even inoperable.
Thanks to a new study recently released by Gonzales, new treatment for these tumors could be around the corner. The study was published in the August edition of Oral Oncology. In the study, Gonzales combined two different FDA approved treatments that have never been used together to attack oral cancer tumors.
“Our study tested whether anaplastic lymphoma kinase (ALK) inhibitors can decrease tumor growth and progression using a mouse model. There’s another pathway called epidermal growth factor receptor that lots of pre-clinical and clinical trials have been done with inhibitors targeting it,” Gonzales explained.
Each treatment individually has not affected late stage tumors. However, when Gonzales used them together, there was huge success in mice.
“In the mouse model, we did a combination treatment and that resulted in a 50 percent reduction in tumor volume within 14 days,” she said.
This treatment could be used to shrink the tumor if it’s inoperable or shrink it before surgery. It can also be used to kill remaining cancer cells after surgery. That’s an option Lewis would have chosen.
“I might not have ever needed radiation,” Lewis said.
Lewis hopes in the future, this type of treatment can be available for patients going through what she’s been through.
Though the treatment will need to face more trials before it could be approved, researchers say it’s an enormous step, and the first of its kind in four decades. Gonzales and Lewis both emphasized prevention is key. Catching oral cancer early gives someone a 90 percent survival rate.
The National Institute of Dental and Craniofacial Research lists several warning signs of oral cancer. The first is a lesion in the mouth. There are two types. Two lesions that could be precursors to cancer are leukoplakia (white lesions) and erythroplakia (red lesions). Although less common than leukoplakia, erythroplakia and lesions with erythroplakic components have a much greater potential for becoming cancerous. Any white or red lesion that does not resolve itself in 2 weeks should be reevaluated and considered for biopsy to obtain a definitive diagnosis.
The NIDCR lists other possible signs and symptoms as: a lump or thickening in the oral soft tissues, soreness or a feeling that something is caught in the throat, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue or other areas of the mouth, or swelling of the jaw that causes dentures to fit poorly or become uncomfortable. If these problems persist for more than two weeks, a thorough clinical examination and laboratory tests, as necessary, should be performed to obtain a definitive diagnosis. If a diagnosis cannot be obtained, referral to the appropriate specialist is indicated.