Research Projects

HNCF Director and surgeon Professor Mark McGurk is conducting a unique study at Guy’s Hospital in London that has not been carried out anywhere else in the world for the treatment of oral cancer. The study consists of an exclusively engineered molecule with a fluorescent tag, which is then injected in the patient’s arm so that the molecule can travel through the patient’s blood stream and then attach itself on the receptors that are expressed by the cancer cells.

The molecule has previously been used by a Dutch medical team on bowel cancer patients, with promising results. Guy’s hospital is extending the molecule’s use by carrying out 20 cases in oral cancer, to see if the results are applicable in this field of oncology also.

Mr Smith (photographed), a mouth cancer sufferer, is the second in a series of patients taking part in this trial. Essentially, the molecule is drawn to the tumour and fluoresces it, which, in turn, will allow surgeons to locate it more efficiently, thus minimising the amount of healthy tissue that is damaged in order to extract the malignant growth.

We are still unsure as to whether this molecule will fulfil its objective, but it’s the first in an array of new chemicals that can be used to minimise the surgical impact associated with conventional oral cancer surgery.

HNCF’s first goal is to introduce Sentinel Node Biopsy (SNB) to the UK for treating mouth cancer. In early mouth cancer, 30% of patients have undetectable microscopic spread of cancer to their neck by the time of diagnosis. SNB is a very accurate way of establishing when otherwise invisible microscopic clumps of cancer cells start to leave the main cancer and migrate. This is a watershed moment in the spread of the disease that completely changes treatment methods.

Currently, without SNB, all patients with mouth cancer undergo a complex 3-hour neck dissection operation, in order to protect the 30% of patients in whom the disease has spread. This means that 70% of patients have a major and unnecessary operation.

A large scale study has shown that SNB can identify the 30% of the patients whose cancer has spread, enabling them to be given the appropriate accelerated treatment that helps cure the disease. At the same time, it saves the other 70% of patients from having to undergo an unnecessary major surgery.

HNCF has already pioneered the use of SNB, but this test is only available in one centre in the UK. HNCF’s first goal is to introduce SNB to all the cancer centres in the UK, which will be made possible by the successful completion of a UK Prospective Randomised Trial performed to NHS standards.

Currently, HNCF trustees are training 15 centres in the SNB technique, in preparation for this trial. The trial will cost £2m to run: the HNCF hopes to contribute £500,000 of this, and applications are being made to national research funds for the remainder of the cost.

The introduction of SNB will revolutionise the management of mouth cancer in the UK and will set the pace for Europe and America.