Throat cancer: Sri Lankan team identifies biomarker for early detection
In a first, Dr. Rizny Sakkaff and team zero-in on diagnostic role of autoantibodies in laryngeal cancer
He saw their agony and the long wait just to get a diagnosis of cancer and felt moved to action to do something in his power to ease their plight.
This quest to help his patients has borne fruit and he and his team have come up with a first in the world – a simple blood test to point in the direction of laryngeal cancer.
Consultant Ear, Nose & Throat (ENT) Surgeon Dr. Rizny Sakkaff who is also a skilled Head & Neck Surgeon had peered closely at the larynx and pondered why there were no biomarkers or tumour-markers to get a heads up about any malignancies affecting this area.
The larynx is the section of the throat containing the vocal cords also called the voice box and is used for breathing, swallowing and talking.
Explaining what a biomarker is, Dr. Sakkaff who is now based at the Wathupitiwela Base Hospital says it is a biological molecule found in blood, other body fluids or tissues which indicates a normal or abnormal process or a condition of a disease.
A tumour-marker, meanwhile, is produced by cancer cells or other cells of the body in response to cancer which gives a pointer how aggressive it is, what kind of treatment it may respond to and whether it is responding to treatment.
Reiterating that biomarkers and tumour-markers are a “big advantage” in diagnosing, treating and getting information on recurrence of cancers, Dr. Sakkaff cites examples of thyroid anti-bodies produced when a patient is affected by thyroid cancer or the prostate-specific antigen (PSA) test used in the early detection of prostate cancer.
With laryngeal cancer, the situation was tragic until now. It was a long wait until symptoms appeared, followed by an endoscopy of the throat and CT-scan imaging just to diagnose the cancer.
Dr. Sakkaff says that many present with hoarseness and voice changes and because there is no easy detection method, the doctors they access near their homes may say it is due to sema (phlegm). This causes time loss, which is valuable in cancer treatment. Some of the risk factors for laryngeal cancer are smoking, alcohol intake and betelchewing.
“If diagnosed early, the prognosis for laryngeal cancer is excellent with 100% chances of a cure,” he stresses, lamenting that in a state hospital, patients have to wait as long as three months for an endoscopy. This was why about a year ago he set about going down the pathway of identifying tumour-markers for laryngeal cancer.
Then attached to the Chilaw General Hospital, he got all the authorizations and ethical clearance required to launch a study on throat samples of patients, co-opting two scientists from the Institute of Biochemistry, Molecular Biology and Biotechnology (IBMBB), a post-graduate training institute of the University of Colombo as well as a doctoral student and a few others.
His research partners from the IBMBB were Dr. Sameera Samarakoon and Dr. Umapriyatharshini Rajagopalan. The other team members were doctoral student Roshan Jalaldeen, Dr. Samith Herath and Thashani Gunasekera.
……And so, with dedicated work and research, Dr. Sakkaff and his team have been able to bring to the forefront auto-antibodies in laryngeal cancer which play a major role in the detection of these cancers and also as a biomarker.
Recognition has come as a publication of the paper titled ‘Autoantibodies in laryngeal cancer: detection and role as a biomarker’ on February 13, this year (last month) by the Oxford University Press based in Oxford, United Kingdom, for ‘Laboratory Medicine’, an official journal of the American Society for Clinical Pathology.
The objective of the study, in which 30 patients with laryngeal cancer (LC) and 30 healthy individuals had taken part, had been the identification of the diagnostic role of autoantibodies (AAb) as serological biomarkers in laryngeal cancer.
The conclusion was: “Significant level of AAbs could be detected among LC patients with good diagnostic performance, irrespective of stage. Thus, anti-LC AAbs reflect potential to be utilized as predictive biomarkers in early diagnostics of LC.”
Incidentally, Dr. Sakkaff was the first ENT Surgeon to be bestowed the national honour of ‘Vidya Nidhi’ "for meritorious scientific and technological achievements" in 2019. It was for the performance of a thyroidectomy through the mouth with no major cut, using 3D technology at the National Hospital of Sri Lanka (NHSL).
The Sunday Times reported this trailblazing procedure on April 29, 2018, headlined: ‘Thyroidectomy: No major cut and quicker recovery with NOTES (Natural Orifice Transluminal Endoscopic Surgery).’