Technological Advances Aiding the Treatment of Oral Cancer

Ali Amra
Professor Shermak
Com 102-054
3rd, May 2013

Technological Advances Aiding the Treatment of Oral Cancer

Cancer is a disease in which cells divide uncontrollably, which leads to the formation of tumors. It is the most despised disease anyone would want to be diagnosed with, because it currently has no found cure. According to the National Cancer Institute at the National Institutes of Health, oral cancer forms in the oropharynx, or the oral cavity. “The ratings of oral cancer in 2013 are 41,380 cases and 7,890 deaths.” (National Cancer Institute). These stats are very high in frequency per year just for one type of cancer. “As of 2004, oral cancer is the 6th leading cause of cancer deaths.” (Osuna and Hopkins, 2008) According to the Illinois Department of Public Health, “According to the Illinois State Cancer Registry, about 1,480 new cases of oral and pharyngeal cancer will be diagnosed in Illinois in 2008.” (Illinois Department of Public Health)

“In the past 40 years, there have been tremendous improvements in oral cancer care.” (Dr. Song, 2008) According to Dr. Song, 2008, despite the advances in oral cancer care, the government and scientists are focusing and funding more for the treatment of more common cancers, such as breast and lung cancer, rather than oral cancer. “Overall, 60% of people with oral cancer survive for 5 years.” (National Institute of Dental and Craniofacial Research) Despite the lower survival rate of oral cancer, physicians like Dr. Song are trying to gain awareness about oral cancer because this disease is not being funded to go under study.

Oral cancer is one of the most fatal cancers because it has relatively low survival rates. If oral cancer is diagnosed late, the likelihood of survival is rare, which is disappointing because a diagnosed patient can do his utmost to survive, but will most likely fail to do so. Despite paying large sums of money and going through numerous medical processes to treat oral cancer, the disease continues to progress to fatal stages. Despite the extreme advances in technology, the cure for cancer has yet to have been found. However, many methods to find a cure and more effective treatments are being studied, practiced and introduced by scientists today. These methods vary in strategies, but all of them have one objective, which is to treat and cure oral cancer effectively. Some of these methods include: surgery, lab on a chip technology, molecular level approaches and radiation therapy.

Surgery for oral cancer involves, removing tumors in tissues to minimize the amount of cancerous cells. “Many oral cancer surgery patients are often concerned about disfigurement; but recent advances in reconstructive surgery mean that appearances can be restored, sometimes with little or no change.” (Cancer Treatment Centers of America) Completing these surgical processes depend on the patient’s stage of oral cancer. As stated by the Cancer Treatment Centers of America, removing tumors from oral cancer through surgery includes various surgical techniques. Some of these techniques include tumor resection and gastrostomy.

Tumor resection is “An operation to remove the entire tumor.” (Cancer Treatment Centers of America) This surgical process can lead to the maxillary defects of the affected region. The Department of Oral Maxillofacial surgery at Marma University states that, a newly introduced technology, 3D screening, can be used to help minimize the loss of normal cells during resection process. They also stated that the 3D screening can also be used to ensure the safety of reconstructive process which includes the implanting of zygoma to replace lost tissues. “In particular, before zygoma implant placement, 3D imaging and planning should be performed to ensure the safety of surgery and rehabilitation.” (Ugurlu, Yildiz, Sener, and Sertgoz, 2013)

“Gastrostomy tube is a feeding tube that can be inserted directly into the stomach.” (Cancer Treatment Centers of America) According to the Cancer Treatment Centers of America, this method should only be used if oral cancer is preventing swallowing. This process consists of a tube that can easily be inserted through the mouth into the stomach, to ensure the patient’s nutrition. The tube can also be removed easily once nutrition returns to its norm. “A camera is attached to the end of a long thin tube, allowing your doctor to see directly into the stomach.” (Cancer Treatment Centers of America) This camera allows the doctor to know that the tube is functioning correctly.

Another method that is used to improve the treatment for oral cancer is the lab on a chip technology. “The chip is based on determining a 30-gene transcription profile in cancer cells isolated from fluid samples.” (Haim, Zobier, Chen, Mauk and Thompson, 2007) This technological development is beneficial for treating oral cancer because it can prevent complex surgical procedures that lead to disfigurement. According to the article, surgical procedures are the last resort to treating oral cancer during it’s the late stages. “Early detection of OSCC (Oral squamous cell carcinoma) could greatly reduce morbidity by fostering more timely initiations of therapy and patient monitoring, and also would help avoid inappropriately aggressive surgical treatments that result in severe disfigurement.” (Haim, Zobier, Chen, Mauk and Thompson, 2007) As stated by the authors, the lab on a chip microfluidics allows dentists and doctors to easily screen oral cancer without extensive training. This method is advantageous to the patients because it is inexpensive, speedy, and its efficient ability to detect oral cancer at its early stages.

Molecular level approaches help treat oral cancer by using the method of trying to prevent it. “The genomic era has fueled a rapid emergence of new information at the molecular level with a great potential for developing innovative approaches to detection, risk assessment, and management of oral cancers and premalignant disease.” (Rosin, Poh, Guillard, Williams, Zhang and MacAulay, pg. 167) According to the authors, this method has gone through an eight year practice to finally correlate with the patient outcome. “The plan is to use step-by-step sequence to guide clinicopathological on patient risk and treatment.” (Rosin, Poh, Guillard, Williams, Zhang and MacAulay, pg. 167) Some of the technologies that are used in this procedure are, the hand held visualization which is basically used to detect abnormal lesions. Then 2 computer systems, called microscopy systems are used to the measure protein expression of the cell’s phenotype, which is the expressed trait of the cell.

According to the authors, over the past 10 years radiation therapy has evolved to efficiently treat cancer by kill cancer cells, including oral cancer. This is because of the technological advancements in radiotherapy. “Technical improvements in the application of x-rays, computed tomography scans, magnetic resonance imaging with and without spectroscopy, ultrasound, positron emission tomography scans, and electronic portal imaging—and our understanding of their limitations— have greatly improved our ability to identify tumors.” (Bucci, Bevan, and Roach pg. 117) As stated by the authors, back then radiotherapy was in 2D, which only consisted of one to four beams. More recently, the 3D radiotherapy was introduced and effectively used to approximately measure irregular shapes. “While 3D planning allowed for accurate dose calculations to such irregular shapes, we were still limited in the corrections we could make.”(Bucci, Bevan, and Roach pg. 118) Therefore, the 3D radiation therapy improved to IMRT, which is Intensity modulation radiation therapy. This therapy allows for certain beam to work under high intensity while others are at lower intensities. The reason for different intensity level beams allowed for more dosage control. Further developments of radiotherapy led to the progress of IMRT to 4D therapy. These improvements took place because 3D and IMRT therapy changes the patient’s anatomy, which meant new calculations need to be considered. “The next direction in radiation oncology is to account for this movement and is being called four-dimensional (4D) conformal radiotherapy (CRT), a logical progression from 3D CRT.” (Bucci, Bevan, and Roach pg. 118) The 4D therapy uses a megavoltage coned beam to dose the patient based on the patient’s current anatomy.

This photo portrays the 3D radiotherapy used to treat cancers including oral cancer. It shows how technology changed, by illustrating the efficient beams that target all angles of the neck and head. The new angles of beams allow radiotherapy to kill cancerous cells proficiently.

Oral Cancer Screening San Diego VELscope Provider Visual Enhanced Lesion Scope Technology:
This video advertises the new efficient technology created. This technology is used to detect oral cancer at its early stages. Detecting oral cancer early can increase the possibility of being cured. As stated in the video, the VELscope can detect oral areas that have the potential to become cancerous. According to Dr. Jen Kim, “The Velscope’s blue light “excites” molecules (called “fluorophores”) deep within the layers of oral mucosal tissues.” (Dr. Kim, Jen Kim Dentistry) This allows doctors or dentists to differentiate between normal and abnormal cells.

Over time technology has evolved to effectively aid the treatment for oral cancer. Many technologies were created over the past years which helped improve the treatment of this fatal disease. Although, the technologies differed in strategies each technology continues to play an important role in the treatment of this type of cancer. These methods included are surgery, lab on a chip technology, molecular level approaches, and radiation therapy. As technology aiding the treatment for oral cancer continues to progress, one can only imagine what types of technology will be used in the future to treat this deadly disease that has killed many people throughout the years.

References:
Bucci, M. , Bevan Alison. and Roach, Mark. “Advances in Radiation Therapy: Conventional to 3D, to IMRT, to 4D, and Beyond” Department of Radiation Oncology. San Francisco, March 2005: 117-134. Web. 2 May. 2013

Calum MacAulay, et al. “Visualization and Other Emerging Technologies as Change Makers For Oral Cancer Prevention.” Annals of the New York Academy Of Sciences 1098.(2007): 167-183. Academic Search Complete. Web. 7 Apr. 2013.

Dentist92115. “Oral Cancer Screening San Diego VELscope Provider Visual Enhanced Lesion Scope Technology” Online Video Clip. YouTube. You Tube, 24 May. 2012. Web 5 May. 2013
Haim H. Bau, et al. “Lab-On-A-Chip Technologies for Oral-Based Cancer Screening and Diagnostics” Annals of the New York Academy of Sciences 1098. (2007): 467-475. Academic Search Complete. Web. 7 Apr. 2013

Jen, Kim. “How Does the Velscope Work?” Jen Kim Dentistry FAQs. Web. 5 May. 2013

National Cancer Institute at the National Institutes of Health. “Oral Cancer.” National Cancer Institute. Web. 2 May. 2013

Osuna, Tricia and Hopkins, Suzie. “Oral Cancer Diagnostic Technologies” CDHA Journal Vol. 24 No. 1. (2008): 12-17. Web. 2 May. 2013

Song, John. “Is Oral Cancer More Deadly Than Other Cancers?” Ed Zimney. (2008.) Web. 2 May. 2013

Urglu, Faysal. , Yildiz, Coskun. , Sener. and Atilla. “Rehabilitation of Posterior Maxilla with Zygomatic and Dental Implant After Tumor Resection: A Case Report” Case Reports in Dentistry. (2013.) Web. 2 May. 2013

My Soundtrack

Songs have a significant impact on many people’s lives. In my opinion, songs help people overcome difficulties and inspire people to strive for their dreams. As an adult who listens to all types of music regularly, I find it very difficult to narrow my soundtrack down to eight songs that played and remain to play a vital role to build the person I am today. Music gives me a source of inspiration and motivation. These eight songs are uniquely significant to me in many different ways. I listen to these songs regularly for a source of motivation and to revisit the past. These songs remind me the struggles I have dealt with throughout my life, which help me to continue coping with life and its difficulties thrown at me. They also aspire me to achieve my dreams. These eight songs represent different chapters of my life, and each chapter describes certain situations I experienced throughout my life.

“Changes” by 2 pac

The first time I listened to this song was when I was in seventh grade. It was a sunny day during recess, I approached my friends and sat on the bench with them. My friend began going through his playlist on his Nokia Xpress Music cell phone and this song came up. I first heard the piano tune which caught my attention because the piano tune soothed my thoughts. The lyrics were even better than the tune. I listened to the rest of the song while eating my lunch, and as soon as the song ended I immediately asked my friend for the title of the song and the artist it was written by. From that day on this song remained one of my favorite songs, that had affected my life.

I listened to the song over and over, I simply couldn’t get enough of it. The words 2pac says throughout the song helped me overcome difficult changes throughout my life. One of the most difficult difficulties this song helped me overcome was moving. Moving overseas, meant that I had to adapt to a new society, culture and language. The process of moving isn’t a process of months, it took me years. I for example moved at the age of nine years old, I had to leave my friends and close relatives, and begin from scratch. This song helped me realize that changes are not bad because changes are what makes life interesting.

“The Kick” by XV

The tune of this song came out of my favorite movie, “Inception”. One summers day in 2011, I was on YouTube listening to the instrumental of this song. I noticed this song “The Kick” in the related video section. I clicked on the video and began to listen. As I played the song and listened to the lyrics, I got goosebumps. I still get the chills listening to this song today. I knew from that point I had to download this song to my phone.

There is something about the tune of this song that gives me goosebumps. The tune itself inspires me to do what I want in this life. When XV says, “You can never have dejavu if you don’t ever dream”, I feel that the lyricist is trying to tell the audience to strive for their dreams. Even though the odds may seem slim, we should at least try because there is never failure in trying. Another verse that is always on my mind is “Paps never showed on us”. My perspective for this verse may be irrelevant but I always interpreted this verse as, never rely on anyone in this life and get things done on your own. My favorite verse in this song is “In a game full of sharks but there ain’t no cheat codes”. I like this verse the most because life is compared to a game and sharks are the struggles of this life. We simply don’t have cheat codes to escape the struggles and difficulties of this life, so we have to face the everyday obstacles thrown at us. This song remains to inspire me to deal with the difficulties throughout my life.

“Champion freestyle” by Mike Dreams

The first time I listened to this song was in the summer of 2012. I was frustrated with the way my life was going. I couldn’t wait to leave Palestine for college. Relatives were bringing me down, they wanted me to stay and study business, while I knew I did not want to study business. They said I was immature and didn’t know what I wanted in my life, which really annoyed me. It was really frustrating dealing with them so I decided to go out with my friends when certain relatives visited. It may seem rude, but it was better than dealing with the frustration they would give me. It was one summer evening, I was in my room on my laptop surfing YouTube. I noticed this song and the name “Mike Dreams” caught my attention. I clicked on the song and noticed the little views, so I assumed that it wasn’t a good song.

However, I gave it a chance, and listened to the song. The song touched me, because all the lyrics described my situation perfectly. The verse that always runs through my mind is; “And some people they just hate to see you rise so I keep it real low til I pop up like surprise”. This verse touched me the most because it helped me realize that people don’t want to see me rise and become something. So I “kept it real low” and coped with the frustration silently. This song helped me learn to deal with criticism, which is why I chose this song on my soundtrack.

“Ya Zareef El-Tool” by Ibrahim Sbehat

This song is a traditional Palestinian Arabic song. It is usually played during weddings and engagement parties. The reason why I love this song is because it brings back so much memories of the nine years I spent in Palestine. Those nine years in Palestine were arguably the best years of my life, despite being under occupation.

While listening to this song, I remember the summers I spent in Palestine. Summer is the season in which all engagements and weddings occur. My friends and I would stay out late and go to engagement parties and get free soft drinks and sweets. We would also go to the city, smoke hookah, play cards and pool. Another memory this song brings back is driving to a nearby village in a taxi, to go visit my good friends. The taxi driver would usually have this traditional song playing. While listening to this song in the taxi I’d gaze at the beautiful mountains, trees and historic buildings.

“Ride For Me Remix” by Gabriel Antonio featuring DJ Lek

This song is one of my favorite songs because it described my life and me as a person. It also showed me that hard work pays off and leads to success. The first time I listened to this song was in the summer of 2010, my favorite summer ever. I was surfing the internet and searching for club music by Gabriel Antonio with good beats to listen to when I work out at the gym. However, I found this song, “Ride for me” in the recommended video section. The title caught my attention the most because it stood out and seemed inspiring.

I played the song, and listened to it carefully. The lyrics motivated me to not only to lose weight, but to also work hard throughout my life. This song was the catalyst, which motivated me to begin working hard to achieve my dreams. After a while, I found my self sort of a perfectionist in things I cared for. I always have striven to become better in anything I wanted. For example, this song motivated to me work hard and to become better in soccer. The chorus is my favorite part of the song because it explains it all. “I works so hard to get where I am, tell me why I feel this way, cuz everywhere I go people don’t know that I’m about to go crazy, I push so hard like everyday don’t really give a damn what they say, Ima keep my head up, Ima make it to the top, now tell me who’s gonna ride for me.” These lyrics are the most inspiring lyrics that helped me advance and strive to improve throughout my life. This song helped me put aside negativity, the reasons why I can’t do it, but constantly reminded me the reasons why I can do it.

“Up Up and Away” by Kid Cudi

I first heard this song in the eleventh grade. In eleventh grade I loved Kid Cudi’s songs and used to listen to them on YouTube. However, I stopped listening to Kid Cudi’s music except a few songs that had an impact on me. This song in particular is my favorite Kid Cudi song because it helped me break out of my shell and become a confident individual. I found this song in the beginning of eleventh grade, at home on my laptop.

In the eleventh grade, I was just starting to make new friends in a new educational system called International Baccalaureate. Throughout this educational system, there were many presentations which I did not like. This song “Up Up and Away” helped me overcome the fear of making a fool of myself. In other words, this song helped me care less of what people thought of me. This song helped to not just gain confidence in speeches, but it also helped me become confident in everything else I did. For example, before soccer games I’d be nervous to make a mistake during the game, but this song helped me put aside my nerves and perform the best I can. I look back at my anxiety fear and conclude that nerves deprived me from performing the best I was capable of.

“My Dream” by Thomas Ring

This song had a great impact on many of my decisions I made throughout my life. The first time I heard this song, “My Dream” by Thomas Ring, was around a year ago, from a Lionel Messi video on YouTube. Lionel Messi is one of my favorite soccer players, he plays for F.C Barcelona. When I first heard the lyrics and tune of this song, I fell in love with it. The lyrics of the song inspire me to strive for my dream despite the slim chances.

This song also helped me become a better person and athlete. It motivated me to better myself in all ways as an individual. It gave me the hunger to accomplish and succeed in anything I do. For instance, it helped me achieve good grades in college. It also encouraged me to continue playing soccer to become a better athlete. This song also played a role in one of my most recent major decisions in life, which was to leave my family overseas to pursue a higher education in U.S.A. I listened to this song while deciding whether to travel to U.S.A or not. It helped me decide to do what is best for me and my future, despite the significance and consequences of the decision.

“Al-Dameer Al-Arabi- The Arabic Conscience” by Wadi El Safi, Hani Shaker, Latifa, Nancy Ajram, Cheb Khaled, Sherine Abdel Wahab, Yara, Asala Nasri, Amal Hijazi, Ehab Tawfek, Waed, and Ahlam Al Shamsi.

This song is unique to me in many ways. It reminds me of who I am and my originality. The first time I heard this song was with my family in 2008 late at night, during the Gaza war. The Israeli occupying forces began bombing the Gaza strip and many people were dying, while the world remained silent. The Arabian artists made this song to show that they stand beside the Palestinian people. It was devastating seeing many people dying of any age and gender. While listening to this song, I began to think of how fragile life is. This song made me feel so useless because my brothers and sisters were being brutally killed, while I was sitting in my house just a few miles away. I felt upset that the entire world remained and continues to remain silent on certain issues, which is why I felt that I had to do something as a Palestinian.

This song taught and encouraged me to fight for what is right, and to oppose the aggression of the oppressors. My friends and I became somewhat of activists, who regularly attended demonstrations for the Palestinian cause. The song reminds me of my very first demonstration I attended and my very first time suffocating from tear gas. This song also reminds me of the sound of rifles shooting, tear gas canisters falling and bombs exploding. It was a distinctive experience that I am never going to forget because I was pleased by standing by my beliefs and living the life of a normal Palestinian.

Citations:
2pac. “Changes” SimplyRapMusic’s Channel. YouTube. 25 Jul. 2012. Web. 8 Mar. 2013

XV. “The Kick” XtotheV’s Channel. YouTube. 23 Dec. 2011. Web. 8 Mar. 2013

Mike Dreams. “Champion (Chipmunk x Chris Brown Freestyle)” mrzekeproductions’ Channel. YouTube. 9 Jun. 2011. Web. 8 Mar. 2013

Sbehat, Ibrahim. “Zareef El-Tool” A7labladifalasteen’s Channel. YouTube. 22 May. 2011. Web. 8 Mar. 2013

Antonio, Gabriel and DJ Lek “Ride For Me” DJLek18’s Channel. YouTube. 21 Feb. 2009. Web. 8 Mar. 2013

Kid Cudi “Up Up and Away” MargoServaes1996’s Channel. YouTube. 25 Dec. 2011. Web. 8 Mar. 2013

Ring, Thomas “My Dream” Islam afify’s Channel. YouTube. 7 Jun. 2012. Web. 8 Mar. 2013

Wadi El Safi, Hani Shaker, Latifa, Nancy Ajram, Cheb Khaled, Sherine Abdel Wahab, Yara, Asala Nasri, Amal Hijazi, Ehab Tawfek, Waed, and Ahlam Al Shamsi. “Al Dameer Al Arabi – The Arabic Conscience (part 2 of 4)” Rasheed Khrais’ channel. YouTube. 25 Jun . 2008. Web. 8 March.2013