LEIPZIG, GERMANY (dpa) – Doctors face a battle against time when dealing with oral cancers, as many of those afflicted find their way to a specialist only after the symptoms are so advanced that they can scarcely swallow or even speak.
“By this stage, the tumours are so large that only half the patients survive five years after a surgical operation,” says Alexander Hemprich, head of the Clinic for oral, jaw and facial plastic surgery at the University of Leipzig.
A simple swab test could ascertain the presence of cancerous tumours at a much earlier stage and allow treatment of the patients with an increased hope of long-term success, he says, adding at once that the procedure is not available everywhere.
Some 4,000 people fall victim to oral cancers in Germany every year, and the number of carcinomas of the tongue and cheeks is rising.
One of the causes of the high rate of mortality is the lack of appropriate training for dentists, according to Torsten Remmerbach, a Leipzig oral surgeon.
“The professionals who look most often into the patients’ mouths are often not in a position to identify oral cancers at an early stage,” he says.
The consequences are serious, as the course of this, the fifth most common cancer in Germany, is particularly insidious.
“At first the patients think they have merely bitten themselves and don’t even consider the possibility of a malignant tumour,” Hemprich, a facial surgeon, says.
This is often a serious mistake. “In more than half the initial examinations we unfortunately find metastases in the lymph nodes in the throat,” the 49-year-old professor says.
At this stage surgical intervention is the only solution.
Ideally the patient should not be subject to this lottery, Remmerbach believes. He calls for earlier diagnosis.
Despite improved treatment in general and radiotherapy methods in particular, survival rates from these operations have not improved noticeably in recent years.
Examinations used to be painful and the procedure left visible scars behind, as suspect tissue had to be excised.
But Remmerbach now uses an abrasive swabbing technique with a brush. “This allows to us to examine the mucus membrane over a wide area without causing discomfort and detect small tumours at an early stage,” he says.
A small brush is used to scrape off cells of the mucus membrane. They are then examined for an enlarged cell nucleus using a colour technique.
Results showing whether or not the cells are malignant are ready within a week, and chances of a cure at this stage can be as high as 80 per cent.
To confirm the result, the cells are also tested for a raised DNA content, a procedure that reveals cancerous cells.
“This is a simple test, but only a few pathology departments are able to carry it out,” Remmerbach says.
Remmerbach, who at 30, is at the start of his career, learnt this technique for the early detection of cancerous cells while studying in Dusseldorf, and since 1997 he has been developing the method in Leipzig.
“We have improved its efficacy and found other indicators for malignant tumours,” Remmerbach says, adding he intends to publish his results soon.
