A Breakthrough by Bulgarian Doctors gives hope in Laryngeal Cancer Treatment

Health | December 12, 2022, Monday // 14:02|  views

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A team of Bulgarian scientists, headed by Dr. Todor Popov, surgeon at the ENT clinic of the "Tsaritsa Joanna - ISUL" hospital, have made a breakthrough in the diagnosis of laryngeal cancer. The results were published in Scientific Reports - an edition from the portfolio of one of the most authoritative scientific journals in the world - Nature.

Bulgarian scientists have discovered biomarkers that indicate the field of cancerization in tumors of the larynx. The obtained results are the result of a project for the "Scientific Research" Fund of the Sofia University. It was developed jointly with the Center for Molecular Medicine, in which experts from various specialties participate, including genetics specialists Gergana Stancheva, Silva Kyurkchan, Veronika Petrova, Styliana Panova and others. Five years of round-the-clock work cost the young team until they reached the impressive discovery.

What is the field of cancerization?

It is that invisible part of the mucosa where the cancer is born. In surgery for laryngeal cancer, the surgeon's goal is to cut the patient's tumor "to the bone" and thus give him the best chance of survival.

Sometimes, however, despite the efforts of doctors, the cancer returns after 2, 3, 5 years and then it can be fatal. The reason for this is an invisible field, usually 4-7 cm in size, with changed daughter cells, which experts call a "field of cancerization".

Prof. Todor Popov

This is otherwise normal mucosa. If we subject her to a histological analysis, it will show that everything is normal. However, fatal mutations have already begun to accumulate in her cells. Sometimes just one more is added to turn that tissue into a cancer site. These mutations are at the micro level and remain invisible to the research we currently have. What we discovered are micro RNA molecules that allow us to delineate this field of cancerization”, explains Dr. Todor Popov, who works with patients with malignant diseases in the head and neck area at the "Tsarica Joanna - ISUL" hospital (carcinomas of the larynx, pharynx, oral cavity).

Two teams in the world are currently working on this new matter for medical science - Bulgarian and Italian scientists, who, however, have focused on cancer of the pharynx.

Bulgarian specialists have made another important discovery. They were able to isolate micro RNAs that are a prognostic marker for survival in advanced laryngeal carcinoma. Given the same tumor characteristics, the same stage, exactly the same treatment, these molecules literally divide patients into two groups.

In patients who have high levels of these molecules, survival drops to 40%, while in others, with low levels, survival is around 80%. This makes it possible for the first group to look for specific, targeted therapies to reverse the negative trend.

from left to right: Prof. Popov and Prof. Stoyanov during surgery

What next?

So far, the project is on paper. Although extremely impressive, the data is still theoretical. The next major goal of the Bulgarian scientists is to put their scientific discovery into practice by being able to visualize the field of cancerization during the operation.

"This would give us the opportunity to change the paradigm and look for new resection lines for the tumor (the boundaries in which it should be cut)," Dr. Todor Popov is convinced.

Carcinoma of the larynx is one of the most common diseases of the upper respiratory tract. It affects about 2% of the population. Men are mostly affected (10 times more often than women), and the most risky age group is 60-65 years old. The main factors for the development of the disease are smoking and alcohol use (over 80% of patients are smokers with "experience" in smoking for at least 10-20 years).

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Tags: Laryngeal, cancer, Bulgarian, mucosa

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