Diary of a TCO - Oral Cancer

Diary-of-TCO-Oral-CancerDue to the recent charity walk to raise awareness of Oral Cancer, I thought I would write about a couple of my TCO experiences of when we have come across mouth cancer. Recently, some people I know took part in the 10km walk in Hyde Park; they managed to raise almost £400 over their target amount!

There are many reasons why patients should have regular check-ups with their dentist, one being an oral cancer screening. Patients may not see any abnormalities in their mouth, or they believe that the small white patch that has appeared may be an ulcer that will clear up in time. Most of the time this is the case, but there are the unlucky few for whom it turns out to be something more sinister. There will always be the odd patients who still have the view of “I will visit the dentist when I have toothache”. There is nothing you or I can say to change their mind. I just wish they could see the effect that ignoring issues like this can have on the unlucky few.

Approximately 3 years ago, I had a patient come in for a consultation. She was wearing a lower complete denture that she was struggling with. I noticed on her medical history that she mentioned that she had suffered with cancer but had recently been given the all clear. After asking a few more questions, I established that the patient had actually suffered with Oral Cancer, and due to the stage of cancer when it was discovered, had needed surgery to remove soft tissue and bone. It was not until the dentist removed her lower denture during the examination that I realised the amount of bone that had been removed. Half of the lower denture was normal but the rest was a huge ‘ball’ of acrylic that literally filled the huge gap that used to be the patient’s mandible bone. When the denture was not in situ, the patient’s face just sank; there was nothing there to support the lower right side of her face. The dentist asked the patient if she would be happy for me to take a look. I must say that I have never seen anything like it before. Due to the amount of soft tissue that was removed, a skin graft had been required. They had grafted skin from the patient’s arm into her mouth. There was actually hair in the patient’s mouth; how fascinating is that? The dentist was realistic and explained that he wouldn’t be able to improve on the denture the patient was currently wearing and that, quite honestly, this was out of his area of expertise. We were able to refer this patient on to another dentist who was able to help.

ORAL-CANCER-TCOI still find it hard to get my head around the damage that this disease can cause, and I am amazed at what our body can withstand to fight against it. Unfortunately, patients are not as aware of signs to look for, as they would be for a breast lump or changing mole. Not so long ago, we avoided the words oral cancer in any of our recall literature, as patients see the word ‘cancer’ and panic. Now, when we are reminding patients of their exam appointments we list one of the benefits as Oral Cancer Screening. This is not to scare the patient into coming in, but to make them aware that their mouth should be checked regularly for more than decay and gum recession.

Our general dentist recently saw a patient for a 6 monthly check-up. This patient has been coming to see our dentist for years, and never misses appointments. On examination, our dentist noticed a small lesion on the left side of her tongue. She was referred to hospital on the same day. We explained the reason for her referral, and that this lesion might turn out to be nothing, but just to be careful we would recommend further inspection. Within two weeks of referring her, the hospital had written to us advising us that they had scheduled an appointment to see this patient, and after examination had carried out a biopsy the following day. The patient had early stages of oral cancer but because it was found so quickly, she required the lesion and surrounding tissue to be removed, and otherwise no further treatment. If the lesion had not been spotted when it was, it could have been left to develop and would have been a far more complicated condition to treat.

Cancer is a terrible disease, but if caught in the early stages, is curable. Knowing the signs to look for will help to get a diagnosis as quickly as possible. I saw a newspaper article about a man who had to have half of his tongue removed due to oral cancer. The only reason he realised something wasn’t right was because of a picture on a cigarette pack. The man wasn’t a smoker; he only worked for a cigarette company. Pictures, television adverts and, hopefully, this recent charity walk will raise awareness so that we are able to help patients as soon as possible.

Want to know more about mouth cancer?

Mouth Cancer Foundation

NHS 

Cancer Research UK

Diary of a TCO Series:

Week 1

Week 2

Week 3

Week 4

 

 

 

 

 

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