AFRO-NETS> Toluidine Blue and Oral Cancer

[Jos Hille <jjhille@iafrica.com>]

Toluidine Blue and Oral Cancer
------------------------------

Some one recently asked for information regarding oral cancer and tol-
luidine blue. I inadvertently deleted the request and thus submit re-
sponse to AFRO-NETS.

Herewith the information as requested to be read in conjunction with 
the following product information:
http://www.oralcancer.org/bda.dir/toluidine.dir/toluidine.html

1% Toluidine Blue Mouthwash is being promoted as an adjunct to oral 
cancer diagnosis - for use on high risk individuals and groups only and 
explicitly not as a tool for population screening.

The sensitivity and specificity of Toluidine Blue as a test for early 
detection of "oral cancer" is adequate. However, the sensitivity and 
specificity are given for both overtly malignant lesions and poten-
tially malignant lesions (particularly severe epithelial dysplasia) un-
der the umbrella "oral cancer". Although 100% of cancers may stain, 
most studies show that only 50% or less of dysplasias are detected by 
this technique.

The use of Toluidine Blue in expert and experienced hands is recom-
mended: in the monitoring of suspicious lesions over time, in screening 
for oral mucosal malignancy and potentially malignant lesions in high 
risk individuals and population groups in the follow-up of patients al-
ready treated for upper aero digestive tract cancer, in helping to de-
termine an optimal site for biopsy when a suspicious lesion or condi-
tion is present; and intraoperatively during surgery of upper aero di-
gestive tract malignancy. 

For clinicians in primary care settings, specific training is required 
for correct application of the test and correct interpretation of the 
results.

1.The mouth is cleansed by rinsing with 1% acetic acid solution. 

2.Rinsing with Toluidine Blue 1% disclosing solution stains abnormal
   tissue royal blue. 

3.Rinsing again with 1% acetic acid solution to remove excess stain. 

4.Visual examination by dentist or doctor. 

Toluidine Blue shall not be considered a replacement for a detailed 
visual and digital examination, but as an extra tool for the identifi-
cation of patients who should be referred to specialists or centres ex-
perienced in the diagnosis and treatment of oral cancer and potentially 
malignant lesions or conditions. 

Please also read:
http://www.ca-journal.org/frames/articles/articles_1996/46_126-128.html


With kind regards,

Jos Hille
Dept of Oral & Maxillofacial Pathology
and WHO Collaboration Centre for Oral Cancer in Sub-Saharan Africa
Oral Health Centre
University of the Western Cape
Private Bag X08
Mitchells Plain, Cape Town
7785 South Africa
Mobile: +27-82-5560703
Fax: +27-21-323-250
mailto:jjhille@iafrica.com

Dr R Lalloo
Senior Specialist: Community Oral Health
Oral Health Centre - UWC
Faculty of Dentistry & WHO Collaborating Centre
Private Bag X08
Mitchells Plain
7785 South Africa
Tel: +27-21-328-116
Fax: +27-21-323-250
mailto:lalloo@dentistry.uwc.ac.za

--
Send mail for the `AFRO-NETS' conference to `afro-nets@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to:  `owner-afro-nets@usa.healthnet.org'.