Detecting head and neck cancer early, when the odds of successful treatment are best, may be as simple as gargling with saline and spitting in a cup, according to a study conducted by a Miami, Florida-based research team.
Oral rinsing flushes out a protein called CD44 — a known biomarker for cancers of the head and neck. It also detects altered DNA related to these tumors. And the combination of these two biomarkers reliably detects head and neck tumors, the research shows.
Dr. Elizabeth J. Franzmann of the University of Miami’s Sylvester Comprehensive Cancer Center reported her team’s work at the annual American Association for Cancer Research meeting in Los Angeles.
“Cancer of the head and neck is a very debilitating and deadly disease that is often detected in late stages when cure rates are only about 30 percent,” Franzmann told Reuters Health. “If we could catch it earlier, we should be able to cure it at least 80 percent of the time but we really need an early detection test.”
The CD44 protein is involved in normal cell functions, but in cancer it is over expressed and appears in alternative forms that are also involved in tumor formation. Importantly, the protein and altered form can be found in bodily fluids.
Swish, gargle and spit
“Initially, we found that if a patient swishes and gargles for 5 seconds each with saline and spits in a cup, we can actually measure the CD44 level; and it turned out that it was high in most of our head and neck cancer patients,” Franzmann said.
The potential value of the oral rinse test was confirmed in a subsequent study of 102 head and neck cancer patients and 69 subjects with benign head and neck disease who were smokers and drinkers. “Head and neck cancer is primarily a disease of tobacco and alcohol users, although about 20 percent don’t have any such history,” Franzmann explained.
In this study, the oral rinse test detected two individuals with symptom-less cancer or precancer and it detected few ”false positives” in the comparison group. Overall, “we found CD44 in spit in the head and neck cancer patients 62 percent of the time,” Franzmann reported.
“We wondered whether some of the cancers were being missed because the CD44 gene can get turned off later on in the process of tumor formation. This turning off can be detected in the oral rinse.”
“Sure enough, we found that in 9 out of 11 head and neck cancers with low CD44, the gene had been turned off,” Franzmann said.
Looking at the two markers contained in the oral rinse distinguished head and neck cancer from benign disease almost 90 percent of the time, Franzmann. “And that’s pretty good; it’s similar to what the PSA test for prostate cancer does.”
The mouth rinse test, Franzmann added, is simple enough to be administered at any community health center for individuals at high risk of head and neck cancer.