Danely P.Slaughters Field Cancerization Concept of Carcinogenesis: The Path Forward to Early Cancer Detection and Chemoprevention

It is over seven decades since the seminal work of the otolaryngologist, Dr. Danely Slaughter was published. In patients with oral cancer, he critically demonstrated that carcinogen exposure led to the development of “condemned mucosa”, within which multiple cancers emanated. Thus, the histologically normal cells adjacent to the primary tumor harbor invisible features of the cancer. Other workers such as Strong have confirmed Slaughter’s initial observations, and in recent times by many investigators using molecular genetic approaches. This concept of carcinogenesis is partly responsible for our failure to successfully treat some of our cancer patients. With current technological advancements, biomarkers of field cancerization can be assayed using even noninvasive samples such as body fluids such as saliva and bronchial washes. In clinical practice, such validated biomarkers should enable risk stratification, and hence close surveillance of individuals at risk for early cancer detection or the early deployment of chemopreventive strategies. Arguably, this will immensely contribute to the reduction in the socioeconomic, physical and psychological burden of cancer.