Dental office spit test may help find early signs of oral cancer
The earliest signs of oral cancer might one day show up in a simple spit test at your dentist’s office.
Delta Dental of Michigan has teamed up in a clinical trial with two university researchers to identify clues in saliva that could give doctors the first hint of the sixth most common cancer — one that was expected to be diagnosed an estimated 40,250 times in 2012, according to the National Cancer Institute (NCI).
“We are very concerned about oral cancer,” said Dr. Jed Jacobson, chief science officer and senior vice president at Okemos-based Delta Dental of Michigan, part of a network of national dental plan administrators. “It’s so deadly.”
Delta and the clinical trial’s cosponsor, Haverton, Pa.-based PeriRx, are seeking 100 to 120 patients with mouth lesions or a heightened risk of oral cancer to give up about a half-teaspoon worth of spit that can be analyzed for cancer markers.
About 25 patients have already participated through Michigan State University; this month, the University of Michigan is expected to begin recruiting, said Dr. Joseph Helman, who heads oral surgery at University of Michigan’s dental and medical schools.
If it works, it would be the first diagnostic salivary test for oral cancer — an important breakthrough because diagnosis is often too late, requiring radical, disfiguring surgery, Delta Dental’s Jacobson said. About 7,850 men and women were expected to die of cancer of the oral cavity and pharynx, the part of the throat at the back of the mouth in the U.S. in 2012, according to NCI.
The problem is that cancerous cells in the mouth can masquerade as a canker sore or some kind of trauma — the result of biting the inside of the cheek, for example.
“It’s not something that’s directing immediate attention. It’s not painful,” said Dr. Neil Gottehrer, founder of PeriRx.
Cancer is now confirmed after cells are removed from a patient’s mouth with a scalpel or a specialized brush that can scrape a thin layer of cells from, say, inside the cheek. They then are biopsied in a lab elsewhere.
But on a level that can’t be seen with the naked eye or even a microscope, oral squamous cell carcinoma emits specific proteins — a kind of signature picked up by specialized equipment.
Patients need only to spit in a cup during a regular dental checkup. Under the clinical trial, they also would undergo a traditional biopsy. If the clinical trial proves that the screening is effective, results one day would be available during the same visit to the dentist.
Preliminary results may be about a year away, though final results could take much longer.
In addition to refining tests to identify the biomarkers for cancer, PeriRx is finalizing tests that would identify biomarkers for Type 2 diabetes; a specific kind of lung cancer known as small cell lung cancer; Sjogren’s Syndrome, which is an immune disorder causing dry eyes and dry mouth, and other diseases, said PeriRx’s Gottehrer.
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