Oral Leukoplakia- Curcumin as Evidence-based, non-toxic therapy

David Emerson says last year

Hi Marsha-

I am sorry to read of your husband’s keratinizing grade 3 dysplasia of tongue. The good news is that this is not cancer. The bad news is that grade 3 dysplasia is the “most severe level of dysplasia” and high potential to develop cancer.

I am not thoroughly knowledgeable about oral cancers. I will link potentially useful information from the Oral Cancer Foundation website.

I hope this helps.

Hang in there,

David Emerson

Cancer Survivor
Cancer Coach
Director PeopleBeatingCancer

“Chemoprevention

If the size of the lesion, its location, or the medical status of the patient would make surgical removal difficult, use of antioxidant supplements should be considered as “chemoprevention” to try to prevent
progression to carcinoma.

Beta-carotene and the retinoids are the most commonly used antioxidant supplements for chemoprevention of oral cancer. (25) However, although antioxidant supplements have shown promise, they have an uncertain success rate and no long-term results. Still, antioxidant supplementation may be appropriate if there is recurrence after surgical excision but concern that a second excision would not prevent another recurrence.

Patients with leukoplakia involving a large area of the oral mucosa might also be candidates for antioxidants, as might patients with extensive medical problems that increase their surgical risk.

Beta-carotene is a carotenoid found primarily in dark green, orange, or yellow vegetables. Several clinical trials have found that treating oral leukoplakia solely with beta-carotene supplements is associated with clinical improvement; rates have ranged from 14.8% to 71%.26-30 No side effects have been reported in patients given beta-carotene supplements; but there is little information about
recurrence following discontinuation of this substance.

Retinoids are compounds consisting of natural forms or synthetic analogues of retinol. (31) Of the more than 1,500 synthetic analogues of vitamin A, 13-cis-retinoic acid (13-cRA), also known as isotretinoin or Accutane®, has generated the most interest. 13-cRA has been shown to cause temporary remission of oral leukoplakia, but it also causes side effects in a high percentage of
patients.

A study at M.D. Anderson Hospital in Houston followed 44 patients with oral leukoplakias who were treated with 1-2 mg/kg/day of 13-cRA for 3 months;32 nearly 67% of the patients had more than a 50% reduction in lesion size, but 79% experienced a variety of side effects. Other studies have noted that lowering the 13-cRA dose reduced the incidence and severity of side effects, but
there have been numerous reports of recurrence after discontinuation. A rise in serum triglycerides has also been reported with use of 13-cRA.

To date, no combination of antioxidants has demonstrated its clear superiority. Beta-carotene with ascorbic acid and/or alpha tocopherol is attractive because of a lack of side effects, but clinical improvement typically takes several months. 13-cRA requires a shorter time to produce a clinical response, but use of this substance necessitates baseline and periodic serologies and close monitoring
for side effects; women using it must also avoid becoming pregnant…”

What is keratinizing grade 3 dysplasia of tongue?

A “keratinizing grade 3 dysplasia of the tongue” refers to a severe precancerous lesion on the tongue where abnormal cell growth extends through a large portion of the epithelial tissue, characterized by the presence of keratinization (formation of a hard protein layer) and classified as the most severe level of dysplasia (grade 3), indicating a high potential to develop into squamous cell carcinoma if left untreated…

Key points about keratinizing grade 3 dysplasia of the tongue:
Severity:
Grade 3 dysplasia is the most severe form of dysplasia, meaning the abnormal cell changes involve a large portion of the epithelial tissue, often reaching close to the surface layer. 

Keratinization:
“Keratinizing” indicates that the abnormal cells are producing keratin, a protein typically found in the outer layer of the skin and mucous membranes. 

Potential for malignancy:
Due to the significant cellular abnormalities, grade 3 dysplasia has a higher risk of progressing to squamous cell carcinoma, the most common type of oral cancer.

Clinical presentation:

A lesion on the tongue might appear as a thickened, rough patch, although sometimes it can be asymptomatic.

Diagnosis and management:
Biopsy:
A tissue sample taken from the lesion is examined under a microscope by a pathologist to confirm the diagnosis and grade of dysplasia. 

Treatment options:
Surgical excision: The most common treatment for grade 3 dysplasia is surgical removal of the affected area on the tongue. 

Laser therapy: In some cases, laser ablation might be used to remove the lesion. 

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