National Taiwan University Hospital (NTUH) yesterday urged people with smoking, drinking or betel nut-chewing habits who have experienced non-healing ulcers or lesions inside their mouths to seek immediate medical attention, as the symptoms could be precursors to oral cancer, which affected more than 7,000 Taiwanese in 2012.
“Oral cancer is the fourth leading cause of cancer-related deaths in the nation, of which 80 percent are associated with the use of betel nuts. Statistics show that more than 1.3 million Taiwanese chew betel nuts,” NTUH vice superintendent Ho Hong-nerng (何弘能) told a press conference in Taipei.
Ho said oral cancer has a relatively low five-year survival rate of 50 percent, and one of the most effective ways to ward off the cancer is to stop it at its precancerous state as early as possible.
Department of Dentistry director Chiang Chun-pin (江俊斌) said that while surgical removal of a premalignant oral lesion is an effective treatment option, the required skin graft could affect the patient’s appearance, lowering their willingness to seek early medical care.
“In an effort to seek alternative treatments, 14 years ago the hospital started using a non-invasive therapy called photodynamic therapy to treat patients with precancerous oral lesions,” Chiang said.
Chiang said the therapy requires the application of a 20 percent solution of 5-aminolevulinic acid (ALA) to the lesion before irradiating it with a red LED or a 635-nanometer laser.
The process helps generate free radicals and singlet oxygen, both of which can kill tumor cells and activate an immune response against them, Chiang said.
“The therapy is particularly effective in treating lesions of oral verrucous hyperplasia [OVH] and oral leukoplakia [OL],” Chiang said. “All of the 36 patients with OVH who we treated in the past 14 years saw their lesions completely disappear after an average of 3.8 treatment sessions, while 17 of the 20 patients with OL we treated during the same period also experienced the same results.”
As for another type of premalignant oral lesion, called oral erythroleukoplakia (OEL), Chiang said cryogun cryotherapy using liquid nitrogen — a common method of freezing lesions — has so far helped 60 OEL patients at the hospital.
Despite the proven efficacy against OVH and OL, NTUH oral and maxillofacial surgeon Chen Hsin-ming (陳信銘) said whether the conditions relapse lies more heavily on whether the patient is determined to stay away from risk factors that could trigger malignant transformation of oral tissue — smoking, drinking and betel nut-chewing.
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