The members of a UC Davis Health research team are hoping to develop a noninvasive, low-cost test to help screen for possible head and neck cancer. Their study, published in Diagnostics, found that the levels of three polyamine molecules in saliva and urine samples of head and neck cancer patients were significantly higher than those in healthy individuals.

Detecting head and neck cancer

Head and neck cancer forms in the mouth, throat, voice box, salivary glands, sinuses or nasal cavity. With over 800,000 new cases and 400,000 deaths annually, it is the seventh most common cause of cancer-related death.

Andrew Birkeland
Andrew Birkeland

Early detection is critically important for effective treatment. In most cases, head and neck cancer is not detected in its early stages.

“Around two-thirds of patients have advanced stage III or IV tumors at the time of diagnosis,” said Andrew C. Birkeland, assistant professor in the Department of Otolaryngology — Head and Neck Surgery and co-lead author of the study. “We are always looking for better ways to detect cancer early and catch signs of possible recurrence after treatment.”

Patients usually seek medical care after their cancer spreads to their lymphatic system, or they have symptoms linked to later-stage disease. These symptoms include pain, bleeding, ulcers, earache and difficulty swallowing.

Looking for signs of head and neck cancer in biofluids

Polyamines are metabolite components necessary for cellular growth and tumor progression. Higher polyamine levels have been found in breast, colon and prostate cancer patients and are linked to worse cancer results.

Using very sensitive techniques to study metabolites, the researchers analyzed 107 saliva and 124 urine samples from 39 head and neck cancer patients and 89 healthy participants. Nineteen of the patients had cancer in its early stage and 20 in its late stages. Most patients had cancer in their oral cavity or the back of their mouth.

Johnathan Anderson
Johnathon Anderson

The team measured the levels of three polyamines: N1-acetylspermine (ASP), N8-acetylspermidine (ASD), and N1,N12-diacetylspermine (DAS).

They found higher levels of ASD and DAS polyamines in the urine and ASP in the saliva of the cancer patients compared to that of healthy individuals.

“Changes in metabolite levels in biofluids such as the saliva or urine can be important indicators of abnormal cell proliferation,” said Johnathon Anderson, assistant professor in the Department of Otolaryngology and co-lead author of the study.

Saliva and urine samples can be obtained in an easy, noninvasive and inexpensive manner. Saliva testing allows patients to gather their samples at home, saving health care costs and enabling a convenient way to collect multiple samples.

“Given the noninvasive nature of saliva and urine collection and the potential cost-effective metabolite analysis options, there are opportunities for developing screening tools for at-risk patients,” Anderson said.

This is a proof-of-concept study to help assess the feasibility of using polyamines to detect early-stage cancer. Large-scale studies are needed to more definitively evaluate the preclinical and clinical development of these biomarkers for screening head and neck cancer.

“To our knowledge, this is the first study to identify elevated levels of ASP, ASD and DAS polyamines in saliva and urine samples of head and neck cancer patients,” Birkeland said. “We hope science will advance to make testing for head and neck cancer as simple and accessible as an at-home pregnancy test.”