I may not be the right person to speak to you about early detection leading to better outcomes. My sister died of cancer two months ago. Early detection of bilateral breast cancer, in the end, did not lead to a good outcome. Like the person Jo-Anne Jones writes about in her article this month, my sister exuded great dignity throughout the course of her horrific illness and left a profound impact on those whose lives were intertwined with hers. The one cancer she did not have, was oral cancer.
Oral cancer is far too often discovered in late stage development, the primary reason for the consistently high death rate. Oral cancer treatment often results in disfiguring effects on patients, and can seriously compromise their quality of life. Early detection and diagnosis can make a tremendous difference in life expectancy; oral cancer is 90% curable when found in its early stages. Unfortunately, 70% of oral cancers are diagnosed in the late stages, III and IV, leading to a five-year survival rate of 57%.1
The mortality rate associated with oral cancer has not improved significantly in the last 40 years.
The death rate in the US for oral cancer is higher than that of cervical cancer, Hodgkin’s disease, cancer of the brain, liver testes, kidney or ovaries. By the time most oral cancers are diagnosed, they have progressed to symptomatic late-stage disease, with at least 50 percent revealing regional cervical metastases. Only 36 percent of all oral cancers are detected in their early stage — the same rate as cancer of the colon. More than 30,000 Americans will receive an oral cancer diagnosis this year and in five years, only 57 percent will still be alive.
The main reason for this situation is the fact that only in recent years has it been firmly established that examination of oral soft tissue is the responsibility of a dentist. The BC Oral Cancer Prevention Program and the College of Dental Surgeons of BC now recommend a comprehensive annual oral exam for everyone over the age of 40. With the emergence of new visualization technologies, such as Velscope (Led Dental, Vancouver, Canada) there is now even greater expectation and demand on the dental community as the frontline in the fight against oral cancer. 2
“The death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development. Often it is only discovered when the cancer has metastasized to another loca-tion, most likely the lymph nodes of the neck. Prognosis at this stage of discovery is significantly worse than when it is caught in a localized intra oral area. Besides the metastasis, at these later stages, the primary tumor has had time to invade deep into local structures. Oral cancer is particularly dangerous because in its early stages it may not be noticed by the patient, as it can frequently prosper without producing pain or symptoms they might readily recognize, and because it has a high risk of producing second, primary tumors. This means that patients who survive a first encounter with the disease, have up to a 20 times higher risk of developing a second cancer. This heightened risk factor can last for five to 10 years after the first occurrence. There are several types of oral cancers, but around 90% are squamous cell carcinomas,” according to the Oral Cancer Foundation, a California-based, non-profit agency. 3
“Creating awareness, discovery, diagnosis, and referral. When it comes to oral cancer and saving lives, these are the primary responsibilities of the dental community. The most important step in reducing the death rate from oral cancer is early discovery. No group has a better opportunity to have an impact than members of the dental community.”4
Remember, early detection can lead to better outcomes.
1. http://www.vizilite.com/oral_cancer/
