Investigation Analyzes How Oral Cancer Causes Pain

When patients with oral cancer experience pain that affects their ability to speak, eat, and drink, healthcare professionals can offer only a limited number of aggressive treatments to help alleviate the discomfort. A team at New York University (NYU) is working to better understand the cellular and molecular mechanisms of how oral cancer cells invade nerves to help researchers identify new targets for treating patients with oral cancer and associated pain.

“When cancer spreads along or invades the nerve, more aggressive treatment—such as radiation or chemotherapies—is often required. Even with aggressive treatment, recurrence is common and the prognosis poor,” says Yi Ye, PhD, MBA, an assistant professor in the Department of Oral and Maxillofacial Surgery, and associate director of clinical research operations at the Bluestone Center for Clinical Research at NYU College of Dentistry. “There is no targeted treatment for perineural invasion, as we don’t know why certain cancers do this.”

Ye is working under a 5-year $2.2 million grant from the National Institue of Dental and Craniofacial Research to study the role of Schwann cells in oral cancer progression and pain. These cells are the most prevalent type of cell in supporting neurons in the peripheral nervous system, Ye explains.  

The team will attempt to answer the following questions in their study: What is the molecule signal that converts Schwann cells into the “repair” cell in oral cancer? Can blocking this signal switch off Schwann cell activation, reduce oral cancer growth and cancer pain?

Early detection is key in the prevention and treatment of oral cancers, as the American Cancer Society estimates about 53,260 people in the United States will be diagnosed with oral cavity or oropharyngeal cancer in 2020.1 Dentists and dental hygienists should provide oral cancer screenings to identify abnormalities and early signs of oral cancer.

“We do know that there is an intricate interplay between cancer and nerves that can drive cancer growth and progression. Increased nerve growth into the tumor supports cancer progression, while decreased nerve innervation could reduce tumor growth and metastasis, which has been shown in experimental conditions of certain cancer,” she says. “To address the molecular and cellular events that occur during the nerve and cancer interplay holds the key to develop targeted therapies to prevent or treat perineural invasion.”

Ye, whose previous studies on the neurobiology of pain have focused on the interaction between oral cancer cells and Schwann cells, will use a combination of genetic, molecular, electrophysiological, anatomical, and behavioral approaches to understand how Schwann cells are activated by oral cancer cells. They will also identify pain-causing mediators released by activated Schwann cells, according to the college. 

“Controlling Schwann cell activation or the production of pain-causing mediators could be used as novel strategies for oral cancer pain,” explains Ye. “Our study will explore the potential of shutting down Schwann cell activation to prevent oral cancer from invading the nerve and causing pain.”

REFERENCE

1.  American Cancer Society. Key Statistics for Oral Cavity and Oropharyngeal Cancers. Available at: https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/about/key-statistics.html. Accessed May 1, 2020.