Oral Cancer Screening by Velscope
 |
 |
|
|
|
|
|
|
|
|
 |
 |
Representative examples of direct visualization under both white light and VELscope examination – photos courtesy of the British Columbia Oral Cancer Prevention Program.
|
|
|
|
 |
 |
No apparent lesion. Normal fluorescence pattern. Visible leukoplakia. Irregular, dark area visible under fluorescence visualization. Biopsy-confirmed severe dysplasia. No apparent lesion. Irregular, dark area visible under fluorescence visualization. Biopsy-confirmed Carcinoma in Situ (CIS).
Our office uses the state-of-the-art oral cancer detection system called Velscope. Oral cancer is more dangerous than you might think. Its five-year mortality rate of approximately 50% is higher than that of breast cancer, cervical cancer and skin melanoma, and its incidence and mortality are rising in parts of Europe. While mouth cancer has traditionally been associated with older males who use tobacco and alcohol, an increasing number of victims of this deadly and disfiguring disease are younger females and males who do not use tobacco or alcohol. One potential reason for this trend, as reported in the May 2007 issue of The New England Journal of Medicine, is that oral cancer has been associated with a strain of the sexually-transmitted human papilloma virus (HPV). This means that anyone who is sexually active is at risk for mouth cancer.
The key to controlling mouth cancer is earlier detection. For too many victims, the cancer is not detected until late stages, when the five-year survival rate is barely over 20% according to U.S. studies. However, when detected in early stages, the survival rate can jump to 80% or higher. A related problem is the fact that once mouth cancer has been detected and surgery is indicated, too often the surgery fails to remove all of the targeted diseased tissue. Until recently, the primary method for detecting mouth cancer has been a visual screening that relies on the naked eye view of the oral cavity under white, or incandescent, light as well as palpation. Unfortunately, cancers are often apparent under these conditions only when they are at or near the surface of the mouth or tongue, which in many cases happens only in late stages. Now, however, there is new hope in the form of a breakthrough technology developed by a Canadian company in conjunction with the world-renowned British Columbia Cancer Agency. This technology, called tissue fluorescence visualization, is based on extensive tissue fluorescence research undertaken by the British Columbia Cancer Agency and other respected institutions with over $50 million of funding provided in part by the U.S. National Institutes of Health and the private sector. The company is LED Dental Inc., and the product is called the VELscope Oral Cancer Screening System.
The VELscope system has been cleared by both the U.S. Food & Drug Administration (FDA) and Health Canada for two expanded indications for use that no other product has ever received. The first indication involves the ability to help detect lesions that may not be apparent to the naked eye under traditional white light examinations, including precancerous and cancerous tissue. The second indication involves the ability to help surgeons determine the appropriate surgical margin and ensure that all targeted diseased tissue is successfully removed when excising cancerous lesions. To conduct a screening, the practitioner uses the VELscope system handpiece to shine a safe blue light into the oral cavity that excites the mucosal tissue. When viewed through the patented handpiece filters, abnormal tissue typically appears as an irregular, dark area that stands out against the otherwise green fluorescence pattern of surrounding healthy tissue. If abnormal tissue is detected and determined to be a potential cause for concern, the practitioner may ask the patient to return for a follow-up examination (typically in two weeks) or refer the patient for biopsy and diagnosis. If the diagnosis indicates that surgery is required, the VELscope system can be used by the surgeon to help determine the appropriate boundary of the area to be excised.
