In the U.S., oral cancer makes up 3% of all cancers and there are about 54,000 new cases diagnosed each year, according to the National Institutes of Health’s dental and craniofacial research. Since oral cancer can spread quickly, early diagnosis is important. 

Christopher Contag, the director of Michigan State University’s Institute for Quantitative Health Science and Engineering and also a professor in the College of Human Medicine, Engineering and Natural Science, explains how MSU is revealing new biology of oral cancer cells that will advance screening and treatment methods to improve patient outcomes.

What are the current limitations of oral cancer screenings?

Normally, oral cancer screenings are conducted by your dentist, who will typically look inside your mouth for any red or white patches or sores during routine dental exams. This is followed up by the dentist feeling inside your cheek and around your gums for any unusual lumps or other abnormalities. Your dentist may also examine your throat and neck for lumps that might be suspicious. 

The worst-case scenario is that you go to the doctor because you notice a sore that is not healing or you are symptomatic, experiencing difficulty swallowing or you have bleeding in your mouth without an obvious injury. 

But, looking for significant changes in the appearance of the mouth is subjective and subtle changes can be missed. This limits the detection to significant advanced lesions that may have spread and are inherently difficult to treat.

What did you discover about the difference between healthy cells and cancer cells?

It is widely known that cancer cells differ from normal cells in many ways, and large numbers of cancer cells may even look different to the naked eye in comparison to the surrounding normal tissues. These differences in appearance are what dentists look for during an examination. Determining why individual cancer cells look different from normal cells, and how this can change the way tumor tissue looks has not been fully revealed. 

Through our research, we have recently shown that a single protein called succinate dehydrogenase A, or SDHA, can change the way a cancer cell acts and looks compared to a normal cell. SDHA causes cancers of the mouth to be visible under blue light illumination. The fact that SDHA can account for changes in overall tumor appearance was a surprise. 

How could this information help with future tests or screening methods?

The use of SDHA as both a marker and potential therapeutic target for oral cancer will enable more definitive early detection and lead to more effective therapies. Being able to watch the tissue change in response to therapy using the optical properties of this single protein could have a dramatic impact on how we treat oral cancer and determine if a treatment is working. 

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