Tissue auto fluorescence technologies have some value and as we learn to interpret what they reveal, (there is a bit of a learning curve) they are in some cases more useful than others. OCF was a funder of this technology long before there ever was a device on the market, when we recognized its potential. The work in those days as being done in cervical cancers, but I and our board saw the idea as useful in oral as well if it proved out. We funded research at MDACC, and later when devices appeared, I was a consultant to the manufacturer. Canada was the home of LED who made the first device - the VELscope, and it is also home to the BC Cancer Agency who has worked (Dr. Miriam Rosen) on the science for over a decade.

There have been wild marketing claims made by companies selling various devices these days about what it will and will not do. At the end of the day it can (not always) reveal dysplasia and cancerous cells that may be difficult to visualize with the naked eye. This is particularly useful in advanced cancers to determine/define surrounding tissues that while not yet malignant, but are dysplastic and on their way to it. Where it has not proven very useful is in HPV+ cancers, as they develop deep in the basal cells, and do not produce surface based lesions that the device can be used for (nor can they be seen by the naked eye). HPV in the tonsil very seldom ever produces a surface lesion or color change and it has metastasized through the normal lymph drainage passageways into the cervical nodes of the neck so fast, that in most cases a surface lesion never appears even in stage 4 disease.

So while it is highly useful, it is not the second coming, nor able to find everything, and it is highly non specific. It finds all tissues in which the fluorophores in the cells are non functional, indicating cellular damage, and more often that not this damage is NOT cancer. It can be benign things, even hyperkeratosis which is just the formation of a thickening of tissue from chronic low grade trauma. So this is where the "art " of interpretation of understanding what it is revealing comes into play. Everything that goes dark when you are using the light is NOT cancer, and most things are even just natural anatomical occurrences, such as any blood vessels that are close to the surface of the tissue, like under the tongue. The hemoglobin in the blood has the same reaction under the light as tissue abnormalities. Useful device/science yes, completely game changing device, no.