The unusual multiplying of cells or malignancy in the ear is an indication of ear cancer. Ear cancer may be mild or sometimes malignant. Of all cancers, ear cancer is rarer. Cancers in the outer ear including the pinna and auditory canal are also considered under skin cancer. Cancers also arise in the inner ear but very few cases are found.
Carcinoma in the squamous cell and basal cell, and adenoid cystic and malignant melanoma are the most common types of ear cancer. It may spread to the facial nerve, inner ear, or the temporal bone if treatment is not carried out in the early stages.
Researchers have been looking for better treatment options for ear cancer. Some of the areas covered by research are as below.
Research on Genetics
Adenoid cystic carcinoma: Also known as AdCC, till date the definite cause of this cancer is not clear. According to research, this cancer is not inherited from mother to child.
Researchers’ analyses of the causes of this cancer state that the main cause of AdCC is genetic variation because of environmental and lifestyle changes. According to them, the cells grow abnormally. Recent surveys carried out with AdCC tumor patients have found that there is alteration in the genetic number. MYB-NFIB is the new gene formed due to the fusion of two broken chromosomes 6 and 9. It is believed that the tumors may arise from the formation of this new gene.
Malignant melanoma: Surveys and experiments are ongoing for better understanding of how UV rays play a role in destructing the DNA in normal skin cells, and also how cancer cells arise from a change in normal cells.
Research on Diagnosis
Recently, a new technique called reflectance confocal microscopy (RCM) was developed, which can diagnose cancer without the need for biopsy. RCM is another type of optical biopsy that helps to analyze thoroughly the irregular areas and other in-depth layers of skin without performing surgery.
RCM is useful for the patient who has to give skin samples during biopsy; it is also useful for those who have unusual moles on their skin. It is helpful to determine the tumor margin during surgery. This technique is available in some clinics in the USA and is also widely used in Europe. It is believed that this technique will be commonly uses in many parts of the world after a few years.
Research on Drugs
The initial stage of tumors can be cured by surgery, but in the final stage there are very few available options that can prevent them. Recently, new therapies called targeted therapies and immunotherapy have been discovered as better treatment options.
Some new drugs uses for therapy are now in use.
Pembrolizumab, nivolumab, and ipilimumab are the newly found drugs whose main function is to block the proteins. Proteins usually restrain the T-cell immune which prevents the growth of melanoma cells. This has been experimented with patients who have advanced tumors. Researchers are at work to find toward improvements in these and other similar drugs.
Further study is ongoing where drugs can be of use in the initial stage of cancers as well as prior to and post-surgery, so that the chances of reoccurringtumors may be obliterated.
Targeted drugs for BRAF gene: This gene helps in the growth of cells; mainly the BRAF gene leads to growth of melanoma cells. Drugs such as vemurafenib and dabrafenib mainly target the BRAF gene. Also drugs such as cobimetinib and trametinib are the target drugs for MEK proteins along with the BRAF gene. It is proven that these drugs possess the capability to shrink various tumors. This treatment is mainly given in the advanced stage of melanoma tumors. The research on whether these drugs can be useful before or after surgery and in the initial stage of tumors is ongoing.
The main disadvantages of these drugs are that they stop the cancer cells from growing for only for a short time. According to experiments, it is found that a combination of MEK inhibitor and BRAF inhibitor can prevent the growth of cancer cells for a longer time with fewer side effects.
Target drug for protein and other genes: Drugs such as everolimus, axitinib, pazopanib are some of the targeted drugs for proteins change and other unusual growth of genes. Study is going on these drugs as well as clinical trials are continuing. Analysts are still looking to combine targeted drugs with immunotherapy or chemotherapy during treatment.
Cetuximab: This is another newly experimented protein targeted drug used in the treatment of advanced cancers in the squamous cell. This drug mainly targets the EGFR protein, which is excessively found on the surface of squamous cell cancers; these support the cancer cells to grow. This has been proven during clinical trials.
Reviewed by Afsaneh Khetrapal BSc (Hons)