Photodynamic Way to Treat Tongue Tumors

MNM | September 16, 2014 | Discoveries, Various Cancers | No Comments

Cancers of the head and neck represent the fifth most common type of cancer worldwide. Men are about three times more likely to be diagnosed than women with these cancers, which can affect the mouth, lips, tongue, tonsils, throat, and other structures in the head and neck area. Tongue cancer rates have shown an alarming increase in recent years. A 20-year study in Europe showed that tongue cancers rose by about 3% per year among young men, as reported in the July 2014 issue of Oral Oncology.

So-called oral tongue cancer affects approximately the front two-thirds tongue. As with the gums and other parts of the mouth, the tongue is exposed to everything we eat and breathe. All of these oral structures are covered with a lining designed to withstand a high degree of chemical and mechanical insult. When the lining cannot withstand high levels of irritation, the tongue, gums and other structures within the mouth may develop cancer.

Fortunately, tongue tumors are often detected early because they can be readily noticed upon examination by a doctor or dentist. If a suspicious area or tumor is spotted, your doctor may then suggest a biopsy, a procedure in which a small piece of the suspicious area is removed and examined under a microscope. Most cases of tongue cancer can be cured with either surgery or photodynamic therapy if caught early enough; others may require more aggressive forms of treatment.

Limitations of Using Surgery for Tongue Tumors

Tongue cancers often start at the rear part of the tongue, which is technically part of the throat (pharynx). In many cases of tongue cancer, at the time of diagnosis, the cancer has already spread or metastasized to another location, such as the lymph nodes of the neck (cervical lymph nodes).

The chances of survival at this late stage of discovery are much worse than when the cancer is found in a localized part of the mouth or throat area. It stands to reason that patients diagnosed with tongue cancer have a much better chance of survival if their treatment can prevent metastasis to the cervical lymph nodes, or to other areas of the body.

Though surgery is often considered to be an adequate treatment for tongue cancer, but much of the treatment’s success depends on the size of the tumor. Wheras most of the smaller tongue tumors leave little cosmetic or functional changes once removed, the larger tumors can spread, and this can lead to difficulties with speaking and swallowing.

A Brazilian Study of PDT for Tongue Tumors

Cancer researchers in Brazil recently evaluated the effectiveness of Photodynamic Therapy (PDT) using a special liposomal form of phthalocyanine as the photosensitizer. (Liposome technology is being increasingly favored because it enables anti-cancer drugs to have much easier access to tumor cells.) The goal of the study was to determine whether PDT could prevent metastasis of tongue tumors to regional cervical lymph nodes.

What follows are the study’s three main findings:

PDT treatment increased the overall survival for lab animals with tongue tumors.
PDT was considered curative, not only because it led to complete remission of the tumors, but also because it prevented metastases.
PDT helped minimize weight loss in mice with oral cancer, and this too may be linked with better long-range survival.

Thus, the researchers concluded that “PDT should be clinically evaluated for use in the prevention of cervical lymph node metastasis in patients with oral cancer,” as researchers from the University of Brazil’s Laboratory of Nanobiotechnology report in the Journal of Biomedical Nanotechnology.

Despite these promising findings, one concern about using PDT for tongue tumors is that it results in swelling that can, in turn, narrow the airways and make breathing difficult. A recent clinical study at University College London Hospital (UK) concluded that taking steps to maintain the airways is essential when planning and performing PDT for tongue tumors. This is yet another area in need of further study.

Meanwhile, researchers from the Netherlands Cancer Institute at the Antoni van Leeuwenhoek Hospital in Amsterdam (The Netherlands) suggest that PDT for tongue tumors and certain other oral cancers “can be offered as an alternative to surgical treatment,” as reported in the March 2013 European Archives of Oto-Rhino-Laryngology.

READ MORE for additional insights into the efficacy of PDT for tongue tumors, and the optimal photosensitizer for this treatment, please see our article on the LUMC research.

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Sources

Braakhuis BJ, Leemans CR, Visser O. Incidence and survival trends of head and neck squamous cell carcinoma in the Netherlands between 1989 and 2011. Oral Oncol. 2014;50(7):670-5.

Thiagarajan S1, Nair S, Nair D, Chaturvedi P, Kane SV, Agarwal JP, D’Cruz AK. Predictors of prognosis for squamous cell carcinoma of oral tongue. J Surg Oncol. 2014;109(7):639-44.

Bicalho LS, Longo JP, Cavalcanti CE, Simioni AR, Bocca AL, Santos Mde F, Tedesco AC, Azevedo RB. Photodynamic therapy leads to complete remission of tongue tumors and inhibits metastases to regional lymph nodes. J Biomed Nanotechnol. 2013;9(5):811-8

Karakullukcu B1, Stoker SD, Wildeman AP, Copper MP, Wildeman MA, Tan IB. A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer. Eur Arch Otorhinolaryngol. 2013 Mar;270(3):1093-7.

Story W, Sultan AA, Bottini G, Vaz F, Lee G, Hopper C. Strategies of airway management for head and neck photodynamic therapy. Lasers Surg Med. 2013 Jun 15.