VELscope is painless device that enables dentists to detect signs of oral cancer

Dr. David Stein of Schenectady is one of the first dentists in the area to use the VELscope (Visuall
Dr. David Stein, a Schenectady dentist, uses a VELscope to examine soft tissue areas in the mouth of patient Kevin Hubbley.
PHOTOGRAPHER:
Dr. David Stein, a Schenectady dentist, uses a VELscope to examine soft tissue areas in the mouth of patient Kevin Hubbley.

Kevin Hubbley, 47, is concerned about oral cancer.

“After you get past 40, you’re always looking for early detection of anything,” said the flight engineer at the Air National Guard Base who lives in Glenville.

That’s why, when Hubbley received a letter from Dr. David Stein of Union Avenue, Schenectady, saying his office was one of the first in the area to use the VELscope, (Visually Enhanced Lesion scope) a customized optical device that allows dentists to visualize whether a patient might have a developing oral cancer, Hubbley made an appointment to have the test.

Developed by researchers at the National Institutes of Health, this simple hand-held device emits a cone of blue light into the mouth that excites various molecules within the cells, causing them to absorb the light energy and re-emit it as visible pale green fluorescence if the oral tissue is normal. Tissue with potentially early tumor cells will appear dark green to black. Remove the light, and the fluorescence of tissue is no longer visible.

Color changes

Dentists look through an attached eye piece and watch for changes in color.

“It gives us an indication that something might be going on,” said Stein, who suggested that patients should have the exam once a year. “It takes two minutes literally to see beneath the surface to detect potentially dangerous growths that otherwise might be missed,” said Stein.

The test is non-invasive, meaning patients don’t feel anything.

A conventional oral screening exam includes looking inside a patient’s mouth for any lesions that might be visible to the naked eye and feeling the patient’s neck for any suspicious bumps.

Oral cancer is one of the few types of cancers that haven’t experienced a significantly reduced mortality rate in the past 30 years, said Stein. In fact, the number of North Americans developing oral cancer is three times the number who develop cervical cancer.

“The reason is because usually by the time oral cancer is found, it’s found at a later stage about 70 percent of the time, and often that’s too late,” said Stein.

If caught early, 90 percent of cases are curable.

Oral cancer has traditionally been associated with tobacco usage, and it’s true that the majority of oral cancer victims smoke, consume alcohol and are over 40.

But the group experiencing the highest growth rate of oral cancer incidence does not fit this traditional “at risk” profile. More and more oral cancer is striking younger people who don’t use tobacco or abuse alcohol.

In many cases, the cause appears to be one of two strains of the human papilloma virus (HPV-16 or HPV-18) that can be contracted during sexual intercourse and especially oral sex.

As a result, health care experts recommend annual oral cancer screenings for all adults aged 18 and older.

If you smoke or use chewing tobacco, screenings are recommended every six months.

Stein has had the device for about two months.

“Most patients want to have the test,” said Stein. “I’d estimate that about 75 percent of patients who come in have it done. Some of the other 25 percent want to research it and learn more about it. Others are nervous because they’ve been smoking a long time, and there is some denial. But we encourage the test, because obviously if you can find something earlier, people are much better off, and that’s the only way to lower the mortality rate.”

The fee is $25.

Sense of relief

Stein said most people are relieved once they find out nothing is wrong.

“We have referred a couple of patients to oral surgeons when we did find something,” said Stein. “But fortunately the problem has been infections or cold sores rather than a pre-malignancy.”

Hubbley, a smoker for 20 years before quitting about a year ago, said he was relieved to find that his mouth was healthy.

“It’s not something I think about a lot, but you always have that thought in the back of your mind,” said Hubbley. “You want to make sure everything is all right.”

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