A new prognosis for oral cancer
More often than not, diagnosis of oral cancer comes too late for sufferers to have a fighting chance of survival. But this is all set to change, thanks to the work of two researchers in the UTS Faculty of Engineering and Information Technology.
“Oral cancer patients are sent for biopsy of a suspected tumour upon first diagnosis,” explained final-year PhD candidate Samantha Khoury. “The issue with this is by that point, patients are presenting so late that their prognosis is usually not good, with roughly 37 per cent survival beyond five years.”
Khoury is working with Dr Nham Tran, a leading researcher in the UTS Centre for Health Technologies, on a fast and simple blood test to diagnose oral cancers at an early stage. Dubbed miRacles, the test works with existing pathology technologies and delivers results in just 48 hours. Statistics show that when oral cancer is diagnosed at stage one or two – rather than at stage three or four, when a tumour is often noticed – a patient’s chance of survival beyond five years is dramatically transformed to 92 per cent.
Currently being trialled in Sydney hospitals in collaboration with Ear, Nose and Throat (ENT) surgeons, miRacles measures the blood for elevated concentrations of six specific molecules, known as small ribonucleic acids, the unique combination of which makes them biomarkers for oral cancer. The test works in much the same way as routine blood tests that measure cholesterol or glucose.
“At the moment, there are no routine screening tests for oral cancer,” Khoury said. “Our dream is to facilitate a national screening program where those at a certain age and with a history of heavy drinking and smoking can make a request to their GP to be nominated for testing.”
Delivering a simple, cheap and effective preventive diagnostic tool into the hands of medical practitioners is critical. More than 300,000 people across the world develop oral cancer each year, with the lives of around 2,000 Australians claimed annually by the disease. This figure continues to grow, and a genomic-based technology like miRacles has significant potential to turn this around.
“Oral cancer is on the increase and has a devastating prognosis – not because it is difficult to diagnose, but because it is diagnosed late and its link to the three preventable risk factors; tobacco, alcohol and low intake of fruits and vegetables need to be a focal point to drive change. There are barely any awareness campaigns with frontline health practitioners such as dentists to encourage them to be on the look-out for changes in the mouth, and there is no push for funding into research for diagnostic tools that provide the option of early detection.”
Khoury, whose undergraduate studies were in human biomedical research and anatomy, began working with Dr Tran as part of her honours year before focusing her PhD in biomedical engineering for cancer diagnostics. Though passion and challenge led her to the project, serendipity also played a part – while scouting for an honours project, she experienced the loss of a close family member to cancer.
“My frustration with the current healthcare approach to cancer turned rather quickly into something else,” she said. “I wanted to be active in prevention. If I had the option to change the lives of cancer patients for the better and prevent that awful roller coaster of emotion and disease progression from ever taking place then I knew without hesitation that I needed to pursue preventive research.”
Dr Tran was working at the forefront of personalised medicine and early detection at a time before the field was mainstream. The two met; before Khoury knew it she was being interviewed on the spot, and her path in biomedical engineering was set.
Khoury was awarded a competitive three-year Australian Postgraduate Award for her PhD, and last year, after a post as Visiting Researcher in Preventive Medicine at the Icahn School of Medicine at Mount Sinai, New York and collaborative work with Baylor College Texas, was nominated for the Rising Star PhD student award at the Premier’s Awards for Outstanding Cancer Research. She also won the inaugural Barbara Hale Australian Federation of Graduate Women Fellowship in 2014, awarded to exceptional young female researchers, and sees no reason why gender should influence a person’s career path or success.
“A woman should know no limits and I also think people need to be competitive with themselves, not each other.”
With a patent pending for miRacles, Khoury and Tran are exploring opportunities to commercialise the genomic test to fast-track the pace of research and development and the time within which it becomes an everyday tool for doctors and patients. They are also looking at ways the test can be used to diagnose other cancers, such as prostate or colon cancer.
“I remind myself daily that we are not elusively chasing cancer to save lives, but working towards preventing the predicament from happening in the first place,” said Khoury.
“The impact of genomic-based technology will irreversibly change the methods by which we practice medicine in the coming decade, and the amount of data that we are generating and will continue to generate is atrociously complex and inherently exponential. Biology has effectively become a domain of information technology; in the future, derivatives of IBM Watson, Google DeepMind, CyC and Baidu Minwa will unavoidably share our lab space. That’s a future I look forward to.”