|Oral healthcare in people living with cancer|
|Thursday, 01 July 2010|
Professor Crispian Scully has led a major meeting in London highlighting that oral cancer is on the rise, particularly in younger people
Professionals from across the healthcare team gathered at Canary Wharf’s De Vere Conference Centre on 11 June to hear the latest evidence on the importance of early detection of orofacial signs and symptoms of cancers, and of cancer prevention. Much oral cancer presents late, at a stage when more radical treatment is necessary and the prognosis is less favourable.
Oral Healthcare in People Living with Cancer was a parallel session, CPD event organised by Professor Crispian Scully CBE, one of RCSEd’s Dental Council Members and Regional Advisers. At the meeting, the aetiopathogenesis of cancer (carcinoma) was outlined for the healthcare team, a broad understanding of which is crucial for prevention, diagnosis and management.
The World Health Organization (WHO), other agencies and researchers have produced a large amount of epidemiological data showing that oral cancer is increasing, and is being seen in younger patients. Tobacco, alcohol and betel remain the key risk factors, but the role of human papillomaviruses (HPV) in oropharyngeal cancer, in particular, is increasingly recognised, as is the beneficial effect of diets rich in fruit and vegetables.
Prevention is crucial if there is to be any significant progress. This involves lifestyle decisions which afford protection not only against cancers in many sites, but also against a wide range of other conditions, many of which are equally life-threatening. Controversies were also highlighted in the early diagnosis of oral cancer, which is likely to be achieved reliably only with the introduction of molecular studies. Early detection and treatment can reduce the mortality rate and morbidity from cancers and their treatment, and speakers emphasised the role of multidisciplinary teams in detection and management.
Despite medical, surgical and technological management advances improving the quality of life for patients, the five-year overall survival rate has advanced little at most treatment centres. The basic treatment modalities are still surgery, radiotherapy and chemotherapy and treatment improvements are largely directed towards reducing the complications, which remain a major issue. Patients with oral cancer may be faced with a range of untoward symptoms, from pain and anxiety, to a dry mouth, and disturbed taste, eating, swallowing and speech. A major focus of the meeting was the importance of minimising adverse effects from treatments, and of support for the patient and their family.
The meeting was delivered by a European faculty of leaders in their field and supported by the International Academy of Oral Oncology (IAOO) and the Multinational Association of Supportive Care in Cancer (MASCC).
Industry supporters included Philips Oral Healthcare, science publisher Elsevier, Healthcare Learning Company and HCA. The day attracted dentists and specialists, mainly in maxillofacial surgery, oral medicine, oral surgery, special care dentistry, and otorhinolaryngology, as well as Dental Care Professionals (DCPs) and the cancer support team.
Oral cancer: key facts
• 40% rise in incidence over last ten years in the UK.
• Oral cancer has traditionally been associated with middle age/elderly, but an increasing number of cases are seen in young people and 25% of the cases have no associated significant risk factors.
• Since 1989, oral cancer in British men has risen to 11 per 100,000 in 2006, an increase of 51%.
• Oral cancer among British women has increased at almost 3% each year since 1989.
• In the UK, mouth cancer is diagnosed in 5,000 people annually and kills almost 2,000 people each year – that’s one death every five hours.
• No improvement in long-term survival rate – overall survival at five years has remained at 50% for the last few decades except in specialised centres.
• Early detection and diagnosis improves survival chances to more than 90%.
Professor Crispian Scully CBE, UCL Eastman Dental Institute