Title : Oral Cancer and Precancer (Oral potentially malignant disorders) – Journey to Understand the Enemy
Speaker : WM Tilakaratne BDS, MS, FDSRCS, PhD, FRCPath
Chair Professor of Oral Pathology,
Faculty of Dental Sciences,
University of Peradeniya, Sri Lanka.
President Elect: International Association of Oral Pathologists
Oro-pharyngeal carcinoma is a major oncological problem in many regions of the world where tobacco habits are practiced in the form of chewing and/or smoking. Such habits are practiced by certain groups in Sri Lanka and other parts of South East Asia. Thus oral cancer has become the commonest cancer in Sri Lankan male patients. Large majority of oral cancers in Sri Lanka are preceded by some form of a Oral potentially malignant disorders (OPMD). Although there is a long list of oral precancers, oral submucous fibrosis (OSF) and leukoplakia, are the most important as a significant number of oral cancers arise from those two lesions in our patients. Although the disease OSF was described in 1952 its pathogenesis and mechanisms of malignant transformation are not clear to date. However, our work together with others in the last decade has shed some light to the understanding of the pathogenesis as well as malignant transformation. The other important oral precancer in Sri Lanka is leukoplakia which presents as a white patch. The malignant transformation rate varies depending on the clinical type of leukoplakia. However, the overall malignant transformation rate appears to be 5-7%. With the understanding that oral cancer and precancer as main health problem with significant morbidity and mortality we devoted most of the research time to investigate various aspects of the deadly disease.
After conducting a large series of research projects we managed to address some aspects such as pathogenesis, identification of high risk lesions and mechanisms of malignant transformation of oral precancer. We have also identified some of the prognostic indicators of oral cancer and hope that those findings would be of some help for the management of patients.