NYU researcher to study biological differences between men and women in oral cancer pain

Nicole Scheff, PhD, a postdoctoral fellow in the laboratory of Dr. Brian L. Schmidt, director of the NYU Bluestone Center for Clinical Research and the NYU Oral Cancer Center, both located at New York University College of Dentistry (NYU Dentistry), has received a two-year, $120,000-plus F32 grant from the National Institute of Dental and Craniofacial Research (NIDCR). The grant was awarded to Dr. Scheff to investigate whether immune cells in the oral cancer environment contribute to sex differences in oral cancer pain.

Dr. Scheff is currently the only researcher at NYU Dentistry to receive an F32 grant, which provides postdoctoral research training to individuals to broaden their background and extend their potential for research in specified health-related areas. Her study combines components of immunology, cancer biology, and pain neurobiology in a preclinical model of oral squamous cell carcinoma and in human patients. The F32 grant will allow her to acquire additional training in a clinical setting and to pursue a translational hypothesis that has potential for immediate clinical impact.

"The incidence of oral cancer is increasing, particularly among young people and women," says Dr. Scheff. "While most patients of both sexes, suffer from oral cancer related severe, chronic pain, research conducted at the NYU Oral Cancer Center has demonstrated that women with oral cancer experience more cancer-related pain than men."

"Complicating matters, the etiology of oral cancer pain is unknown," says Dr. Schmidt. "And opioid drugs do not effectively alleviate oral cancer pain. Based on her findings, she hypothesizes that infiltrating neutrophils in the cancer microenvironment contribute to sex difference in oral cancer pain."

Her research has two specific aims:

1. To determine if the relationship between neutrophil infiltration and cancer pain differs by sex in oral cancer patients.
2. To determine the impact of neutrophil infiltration on oral cancer pain using a preclinical model of carcinogenesis.

She will determine if the patient's sex affects the relationship between neutrophil count and reported pain score using a pain questionnaire. The study population will include more than 50 tongue cancer patients (approximately 25 patients of each sex). Dr. Scheff expects that male patients reporting less pain will have a greater number of infiltrating neutrophils in the cancer microenvironment.

Dr. Scheff's data suggest that increased neutrophil infiltration is responsible for reduced oral cancer pain. However, a direct relationship between neutrophil infiltration and oral cancer pain has not yet been demonstrated.

To measure the effect of neutrophils on oral cancer pain, Dr. Scheff will remove neutrophils from the model during oral cancer development. Then, in the absence of neutrophil infiltration, her research will assess oral cancer pain behavior and quantify and categorize inflammation in the tongue cancer microenvironment. Her expectation is that oral cancer pain behavior will increase with the loss of neutrophils.

Dr. Scheff predicts that her studies, focused on the roles of immune cells in the cancer environment in males and females, will aid in discovering a sex-specific mechanism of analgesia that has the potential to be exploited to improve pain management for both sexes.

"By employing a translational research strategy focused on the neurobiology of oral cancer pain," she says, "I expect to gain a better understanding of neuron-immune cell communication in the cancer environment. Understanding the biological differences between men and women during cancer progression will improve clinicians' ability to treat and prevent pain in all people."