Cancer and a Dentist

So recently I was consulted by an Oral Cancer patient, Tongue Cancer — two of them, no, I am sorry, three of them: one woman and two men, with almost identical history. They had an ulcer on their tongue, visited their local Dentist, who treated it with some gels and creams for a few weeks. After a month or so when the ulcer would refuse to budge, or rather continue to grow, that is when the patients get referred to an Onco surgical unit where they get diagnosed with Tongue Cancer and the real management starts.

One would assume that a Dentist would be all concerned and connected to Oral Cancer, since we as Dentists have official access to everyone's Oral Cavity, a window to one's whole body. An Oral Cancer is something that we will surely not miss. Right? I am sorry to say, not right.

Diagnostic delay by 3-4 months at the level of the Dentist has been shown to be almost 46%-48%, with 14% referral delays. These delays worsen the overall 5 year survival outcomes of our patients, including patients reaching for the surgery at Stage 4. India being the highest ranking country in Oral Cancers, it is high time our Dentists, irrespective of their specialities, learn to diagnose Oral Cancer early and not lead to such delays which not only are a financial burden to the state but also have huge psychological and emotional implications for the whole family and community.

A Dentist not only has a very important role in early detection of oral cancer but also in every step of management of oral cancer patients (pre, intra, post Chemo & RT), especially if we are looking at overall quality of life after cancer treatment. Here I would like to add that it's not just oral cancer patients where a Dentist has an important role, but all Cancer patients in general need to have a good thorough evaluation by a well trained Dentist before, during and after cancer therapies, especially chemo and radio.

Dentists are very important members of the interdisciplinary team managing cancer patients since they offer after care for oral health and hygiene, which in turn forms an important component of an overall quality of life of our patients.

It's high time that we Dentists should see ourselves as game changers in the Cancer field. A very important part of the cancer team: by detecting early, by participating proactively in management of complications due to chemotherapy and radiotherapy, and by knowing that these treatments lead to changes in bones — hence when to avoid invasive procedures or what care is to be taken while performing such procedures (MRONJ and ORN are real, my friends).

"When one survives cancer, all that one feels like after that is to feel good about life — and one of the best and easiest ways to feel good is to eat what one relishes. When one is unable to do so, that's the real hell of survival."

A wake up call for every dentist, who is also a dental oncologist. #dentaloncologist #cancercare #Oralcancercare #earlydetectionawareness