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Year : 2015 | Volume
: 26
| Issue : 6 | Page : 559 |
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Oral squamous cell carcinoma: Advances in management |
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SM Balaji
Executive Editor, Indian Journal of Dental Research, Director and Consultant Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, Tamil Nadu, India
Click here for correspondence address and email
Date of Web Publication | 18-Feb-2016 |
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How to cite this article: Balaji S M. Oral squamous cell carcinoma: Advances in management. Indian J Dent Res 2015;26:559 |
Oral squamous cell carcinoma (OSCC) is one of the most dreaded forms of cancer, responsible for millions of death in India. Undoubtedly, use of smoking and smokeless tobacco is the main reason for this preventable loss of life. [1],[2] Rapid advances in diagnosis, early management protocols, and widespread availability of prognostic markers have not increased the 5-year survival rate. [2]
Traditionally, OSCC has been treated with surgery, chemotherapy, radiotherapy, and combination therapy depending on site, age, tumor-node-metastasis staging, and surgeon's preference and training. These therapies are nonselective and often radically remove normal tissues in the complex orofacial region. This leads to a host of associated problems and morbidities. Very recently, newer evidence have emerged that could potentially alter the way OSCC is being treated. Though in its nascent stage, they give a silver lining for all those affected by this disease.
Newer insights of OSCC process at the basic molecular level, newer levels of therapies, called targeted therapy have begun to emerge. This method of treatment attempts to identify the mutations in the genes that lead to cancer corrects the pathway through which the mutated genes act. Thus, they are often customized, depending on OSCC tumor biology. They may specifically inhibit OSCC growth, its metastasis, may target the vascularity or more specifically the deviated complex cell signaling or transduction pathways. Such tumor-specific approach helps to target the tumorous cells leaving the normal cell intact. The other treatment method involves the use of immunomodulators forming basis of OSCC immunotherapy has met with certain degrees of success. Recent Cochrane review has revealed a positive benefit. [3]
The other breakthrough is in early, rapid diagnosis of OSCC, especially in limited resource settings. Dr. Petra Wilder-Smith has partnered with several centers across the globe, notably in India too to harness a LASER based technology that can detect OSCC at a much earlier stage. The team has developed prototype testing of low-cost, portable, solar powered, screening device that fieldworkers can use to detect possible oral cancer. It relies on telecommunication with specialist interpreting the finding. This would reduce the time, fear of biopsy, and reduction in waste of valuable resources besides catching OSCC at its initial stage itself. [4]
These two pieces of information, undoubtedly, are heralding changes in OSCC diagnosis and treatment approach and hopefully reduces OSCC mortality and increases the 5-year survival rate in these patients. However, the easiest solution is avoiding the tobacco, which has a long way to go.
References | |  |
1. | Bray F, Ren JS, Masuyer E, Ferlay J. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer 2013;132:1133-45. |
2. | Yeole BB, Ramanakumar AV, Sankaranarayanan R. Survival from oral cancer in Mumbai (Bombay), India. Cancer Causes Control 2003;14:945-52. |
3. | Chan KK, Glenny AM, Weldon JC, Furness S, Worthington HV, Wakeford H. Interventions for the treatment of oral and oropharyngeal cancers: Targeted therapy and immunotherapy. Cochrane Database Syst Rev 2015;12:CD010341. |
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Correspondence Address: S M Balaji Executive Editor, Indian Journal of Dental Research, Director and Consultant Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, Tamil Nadu India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-9290.176889

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