Professor Giorgio Gastaldi, head of the Maxillofacial Prosthetic Rehabilitation Unit at the IRCCS San Raffaele Hospital and associate professor of Odontostomatologic Diseases at the Vita-Salute San Raffaele University, was interviewed in the Tg4 medicina - Rete 4 – Tg Com24 column on 11 May 2024, to talk about tumours affecting the oral cavity and the Studium Genetics test that San Raffaele has adopted in clinical practice.

Link to TG4 website (Italian)

[Machine-translated, unofficial audio transcription]

Like every Saturday, it's time for our medicine column.

– Good morning and welcome to the TG4 medicine column. Today we're talking about oral cancers, and a new test to detect them. We do so with Professor Giorgio Gastaldi, head of prosthetic, maxillo-facial rehabilitation at San Raffaele Hospital in Milan. Professor, first of all what are the causes of tumours of the oral cavity?

GG – The causes of cancers of the oral cavity are mainly all chronic irritative factors of the oral cavity. And of course there are risk factors that increase this, so the use of alcohol, and especially super alcohol, smoking cigarettes, maybe chewing tobacco. And to these, which are the most frequent, most common causes, today we add another important risk factor, which are viral HPV infections. They are different types of tumour, the HPV tumour is a tumour that mainly affects the pharynx and the tonsils, while the most frequent type of tumour is carcinoma of the oral cavity, therefore due more to smoking, cigarettes and alcohol, it mainly affects the floor of the mouth and the tongue, and therefore they have different localisations and histories.

– You mentioned carcinoma, is there a test to detect it? Would you tell us about it?

GG – Yes, there is something new, it's an epigenetic test that revolutionises a bit the way we diagnose oral cancer. It's a test that is very simple in its execution, so with a little brushing of the lesion it allows us to take some cells, which are then analysed, variations linked to 13 genes that are associated with oral cavity carcinoma are evaluated. It is a test that is very simple in execution, but very powerful in the result, and therefore allows us to make a diagnosis with very good precision, without being invasive. This can be one of the factors that so often delays the diagnosis of oral cavity carcinoma, so often the fear of complicated examinations or surgical sampling can frighten the patient. This is an absolutely simple examination, but very precise and very powerful in its results.

– So diagnosis, but also prevention?

GG – Absolutely yes. Early diagnosis, and prevention because healing obviously benefits greatly from earlier diagnosis. So the earlier we are in diagnosis, the greater the chance of a 100 per cent cure, whereas unfortunately when we are slow and only catch these cancers late, the prognosis certainly becomes much more complex.

– Did he talk about healing? Do you heal from these types of tumours?

GG – One heals, as I said, always very well when the diagnosis is very early. Healing definitely has somewhat more complicated aspects when diagnosed later, which then also affects other organs and can be much more difficult to achieve.

– Thank you Professor. See you next time with the TG4 medicine column. Now back to the studio.