Garnis Lab Graduate Student: Shevaun Hughes
Oral cancer is mainly caused by smoking or chewing tobacco or by alcohol consumption. Since these activities can be found around the world, oral tumors represent the most frequently occurring subtype of head and neck malignancies and one of the most common global causes of cancer death. Survival rates for oral cancer are particularly low because tumors are often diagnosed at late, advanced stages and because these tumors have a high rate of recurrence. A better understanding of the molecular changes that make oral cancer cells behave differently is needed in order to find new ways to treat this disease and predict patient outcomes, thus improving our treatment strategies for this disease.
For many cancer types, early detection is a key to an improved clinical outcome. While the oral cavity is easily investigated for precancerous disease, there are currently no tools that allow clinicians to determine whether a given low grade oral lesion is likely to progress to an invasive tumor. “Watchful waiting” is the standard clinical approach in these cases since only a small fraction will progress; intervention for all premalignant disease would be impractical and result in over-treatment for a majority of patients. Unfortunately, waiting means that the opportunity for early intervention in cases that will progress is lost. Tools that will allow us to determine the progression risk for each low grade precancerous lesion are urgently needed.
In order to address this clinical challenge, I have begun to investigate the molecular alterations that underlie the earliest stages of oral cancer. By doing this, I will uncover the specific gene changes that drive the initiation and progression of this disease. When we are able to associate these changes with specific clinical outcomes (for example, finding gene changes associated only with premalignant lesions that progress to tumors), we will have a biomarker we can use to identify early stage patients that require aggressive intervention. An additional benefit from this analysis is that cancer associated genes I uncover will also be useful as targets for the next generation of therapies being developed for oral cancer.
