Many mouth cancers found too late

Worldwide, more than 500,000 new cases of cancer of the mouth are diagnosed each year.

The majority of these cancers are found too late, causing many people to die within five years of finding out they have cancer. There exists much information addressing issues related to the patient who has undergone surgery or chemotherapy but little information related to early diagnosis and referral. In a new article in the Journal of Prosthodontics, researchers led by Michael A. Siegel, DDS, MS, FDS, RCSEd, describe the epidemiology of oral cancer and the diagnostic tools currently available to prosthodontists to ensure that their patients are diagnosed at the earliest possible time.

Although the need for prosthodontics was expected to decline with the promotion of preventive measures, it is actually increasing with the aging population. The highest risk of developing oral cancer is in adults over 40 who use both tobacco and alcohol. However, these cancers can develop in anyone, so annual prosthodontist visits are increasingly important.

The majority of oral, head and neck cancer are initially diagnosed in a late stage, which has a five year prognosis of less than 50 percent. If these tumors are found in their earliest stage, the five year prognosis is 95 percent.

All dentists, including prosthodontists, are specifically trained to detect these tumors in an early stage. Only 28 percent of patients reported ever having had an oral cancer examination. Patients who have lost their teeth must be specifically counseled about returning for prescribed, regular recall examinations. They may wrongly think that, as they do not have all or any of their teeth, they do not need to be regularly followed by a prosthodontist.

Recently, several companies have marketed simple tests intended to aid the dentist in the early detection and diagnosis of oral lesions even before they turn into cancer; these tests are painless and relatively inexpensive. Any sore, lump, or bump in the mouth that bleeds, is enlarging, or will not heal should be evaluated at the earliest possible time.

"If prosthodontists, and other dentists, are more vigilant in performing oral cancer screening examinations on all of their patients, the quality of life and survivability from these cancers will be greatly improved, whereby morbidity and mortality will be greatly reduced," the researchers conclude.