Oral Cancer and Potentially Malignant Disorders: Biology, Detection, Chemo-prevention, and Novel Control Strategies
Oral cancers are epithelial malignancies that mainly arise from tobacco (in smoke and smokeless forms), betel-quid use, and other secondary risk factors. Often, oral cancers emerge in a distinct group of clinical disorders referred to as oral potentially malignant disorders (OPMDs), each with a unique clinicopathological profile and malignant transformation rate. One of the vital strategies to prevent oral cancer is via the detection and control of OPMDs-the actual forerunners.
Although much is presumed to be known about the biology of oral cancers, there is only a limited body of evidence on the role of mechanical factors (chronic mucosal irritation), high-risk human papillomaviruses, poor oral hygiene/periodontitis. Besides the traditional risk factors, the oral cavity could be influenced by several other complex environmental factors, like dietary constituents (processed and junk foods) or other unexplored smoking, chewing, and drinking practices (e.g., Marijuana, Khat, Coca, Mate). As the oral cavity is exposed to various products, we must recognize their cumulative effect and interplay. In recent times, more knowledge is also being shed on the role of lifestyle factors, psychological factors, diet, and microbiome in cancer progression and control.
Although oral cancers and OPMDs are obvious conditions occurring in the easily accessible oral cavity, their discovery is delayed due to the asymptomatic nature of precancerous and early cancerous lesions, a lack of timely screening, and patient negligence. The development of early detection strategies, especially those that identify epithelial dysplasia, could be vital for better detection of high-risk entities. In recent times, there has been an acceleration in different technological disciplines, and as a result, different strategies are emerging which could aid in the early detection of oral cancer.
Since OPMDs are primarily superficial oral mucosal entities, they could be potentially managed with topical therapeutics, and as they transform slowly and steadily into malignancy, there is a significant therapeutic window. In this context, herbal therapeutics are noteworthy as they do not present with serious adverse effects. Furthermore, they cause a broad spectrum of beneficial effects boosting both oral and general health. Also, the oral cavity could be easily manipulated by new-generation topical therapies like nanotechnology. Nanoparticle-based therapies, which are currently explored in in-vitro and animal studies, have enormous clinical potential and are destined to be future therapies.
As psychological factors like stress, depression, and anxiety perpetuate habit-use and may accentuate the progression of oral potentially malignant disorders and oral cancers, appropriate lifestyle management could be helpful. Since there is limited knowledge in this area, attractive hypotheses and clinical studies covering the use of suitable lifestyle interventions are necessary.
In this special issue, authors can discuss either of the strategies mentioned above from early detection, biological perspectives, and potential chemotherapeutic agents (specifically herbal therapeutics) and other valuable options for mitigating OPMD and oral cancer progression. Manuscripts focusing on contemporary strategies shall be prioritized. Clinical studies, animal experiments, and in-vitro data fall within the scope of this issue.
Dr. Prashanth Panta