Tiresias Sees

Dearfriends,

Oralcancer is very common. 53,000 people were diagnosed with oral cancer in the USAalone in 2019. Oral cancer is even more common in Asia, and very common inChina.

In lastweek's post Tiresias attached the paper from Memorial Sloan-Kettering, using PARPi–Fland Optiscan ViewInVivo endomicroscope, for in-vivo imaging of malignant cellsof squamous cell cancer of the mouth. The main thrust of this paper was todemonstrate the feasibility of intraoperative detection of malignant cells atthe margin for oral cancer at the time of surgery. This is a revolutionary leapforward in treatment of this common cancer, will be the standard of care, andin quick time. In itself, this is a game changer for Optiscan, however is onlya very small part of the story as far as Optiscan is concerned.

Oralcancer incidence is on a significant increase for reasons that are not fullyunderstood. The blue sky, as far as optiscan is concerned, is in leukoplakia. Leukoplakiais the premalignant condition of oral cancer. Its incidence is between 1% and5% in the population, is increasing, and increases rapidly with age.

The current standard of practice of leukoplakia is 3 to 6 monthly reviews and repeatedbiopsies of any suspicion looking areas. When malignancy is shown then excisionis undertaken. The number of patients being followed up like this is in oralclinics enormous. This is where the in where Optiscan shareholders will “killthe pig”. In-vivo microimaging, using PARPi-Fl and Optiscan microscope, willhave to be rolled out in very quick time. Screening of all patients with leukoplakia,without the need for repeated expensive and inaccurate biopsy, will be thestandard of care. No oral surgery clinic will be able to practice without an in-vivo endoscope microscope. And then the intraoperative use in surgery itself. This is huge!