Aldon was alarmed by the redness of the mouth: the diagnosis was ruthless

In February, Oral Cancer Prevention Month, oncologists at the National Cancer Institute (IMI) recall how people can contribute to the early diagnosis of the disease and what only experienced professionals can do.

The suspicion was caused by red, fast-growing polyps.

Mr. Aldona is quite an atypical patient because, laughing, she doesn’t know anyone who has visited the dentist’s office more often than she has: “I spent so much I could have bought some unusual cars!”

The 67-year-old from Vilnius said he had constant problems with his mouth and that gradually his natural teeth were replaced by prosthetics. Upper dentures bonded to the pin inserted a couple of decades ago.

“I had those pinned teeth last summer, but I was going to spend the summer in the garden and check it again when I returned to the capital in the fall. The prosthesis, although masked, stuck, but the redness of the pin caused concern. At the end of the summer, bumps and polyps began to form at the prosthesis site. I returned to the capital, but I had problems again: my dentist was on vacation, so I only went to the doctor in December. The latter, seeing him, could not make a diagnosis, so he sent a further investigation. A biopsy was performed that initially showed nothing. In January, the polyps were removed, the sample was sent in for testing, and then the answer was cancer, ”says Mr. Aldona.

In March of last year, the woman was finally admitted to IMI, where she was reoperated along with tissue reconstruction.

“Today, I can only guess if a poor quality denture and an old tooth with a pin contributed to the formation of the disease. It would seem that I checked my oral health regularly, but in the end I am glad that it was discovered that the disease had fallen. in the hands of the best specialists. Today, almost a year later, all the research is good. I am happy and I do not intend to lower my head “, said the patient.

Responsibilities of the patient and the specialist

Otilija Kutanovaitė, a physician in the Department of Surgery for Head, Neck and Skin Tumors of the National Cancer Institute, emphasizes that both patients and primary care professionals (family doctors, dentists, oral hygienists) are responsible for early or late diagnosis of oral cancer.

“On the one hand, patients often do not see changes in the mouth like cancer because, for example, they have never heard of such a disease or they are simply very afraid, they deny that something is wrong, even though they suspect that it is a serious problem. disease. There are also cases in which the patient does not see a doctor due to social factors – living in a remote area from where going to the outpatient clinic is quite complicated, or at that time he abuses psychoactive substances. It is also rare for someone to visit a dentist or hygienist every six months as recommended to maintain oral hygiene. If we follow these recommendations, we will give the specialist the opportunity to evaluate not only the teeth, but also the oral mucosa, perhaps to discover changes against cancer, ”said O. Kutanovaitė.

On the other hand, according to the doctor, primary health care professionals do not always recognize cancerous changes in the mouth, they are considered inflammatory, allergic, they tend to initiate treatment themselves and only if they do not send a consultation to a specialist.

“Another worrying problem is that primary care professionals do not know to whom to refer a patient with a suspected oral tumor. In this way, the patient often falls into the labyrinths of the health system and the disease progresses”, emphasized the jaw and facial surgeon. Medicine has advanced so far in recent decades that a physician in a particular specialty may no longer know all the nuances, guidelines, and innovations in treating disease in his field. As a result, many subspecialties, where everyone delves into their own fields: one is interested in articulation, the other in orthognathic surgery, the third in oncology, etc. For the same reason specialized treatment centers have been created. IMI is the only accredited center in Lithuania by the Organization of European Institutes of Oncology for the treatment of patients exclusively with cancer, where such patients receive specialized care comprehensive: treatment from A to Z.

Oral cancer patients are no exception. Here the patient is examined, discussed in a multidisciplinary team, given specific treatment, treated with the disease itself and the complications derived from the treatment of the disease.

“Cancer treatment does not end with surgery, many times it requires additional radiotherapy or chemotherapy, we need to control phenomena such as pain, exhaustion and others. Therefore, it is important to start and continue treatment in a single institution, to select specialists who work in this field, applying the most modern treatment available in accordance with international standards. Otherwise, if treatment is not started correctly, it may not be as effective as it could have been. Cancer treatment in a specialized center has been shown to increase a patient’s chance of survival several times to five years! Well, it is much more convenient for the patient to find all the necessary specialists for the treatment of his disease under one roof: it is not necessary to think about how to contact one or another doctor, where to get a referral, etc. – said O. Kutanovaitė.

One of the most important outcomes of treatment is quality of life.

IMI’s Department of Head, Neck and Skin Tumor Surgery has progressed rapidly over the past three years; we can compare the scope and complexity of operations with those of Western European clinics. The principle of multidisciplinarity, fundamental and very important in modern oncology, is also observed.

“We have learned to operate on advanced cancer, to master the removed organs and their functions, mastering various reconstructive techniques, in other words, to preserve human quality of life, vital functions: breathing, swallowing, speaking, aesthetic appearance, social life. At this time, the patient, whose throat or tongue removed can speak, should eat normally. Last but not least, each patient operated on in our department is referred without problems for further treatment to radiotherapists, chemotherapists, rehabilitators, from where it then enters the outpatient chain, where it is monitored by professionals and treated according to international guidelines. It has been proven that close interdisciplinary cooperation determines the best results of treatment, the quality of life of the patient. Our goal now is not only eliminate cancer, but also give the person the opportunity to continue living normally e with herself, to see her normal image in the mirror, to be able to eat, to speak and to be a full member of society, “said Dr. O. Kutanovaitė. Rising Stars Award 2019.

What to look for

There is a world view that if a new pain, a change in the lining of the mouth (an opal, a wound, a lump, the loss of a tooth, bleeding, a bite) does not go away for two weeks, we should be alarmed and see a doctor.

Another classic option is that a previously good dental plaque has become obsolete. In this case, you should always ask your dentist to check the plaque and most importantly the oral cavity for changes in the mouth that have caused the plaque to move.

Equally important are the symptoms that do not occur in the mouth and last for two weeks: the formation of a nodule in the neck, an unexplained earache should concern us.

Education is important

In February, various campaigns for the prevention of oral cancer were carried out, initiated by Prof. of the Institute of Dentistry of Vilnius University. Alina Pūrienė – organized the first six years. According to the professor, people often do not notice precancerous and cancerous changes in the mouth, because as long as it does not hurt or interfere with eating, everything is fine:

Prof. A. Pūrienė cited research that found that the motivation of patients to take the oral cancer test is directly dependent on the level of knowledge of the respondents, and the knowledge of patients about the symptoms of oral cancer depends on the age of the subjects : younger people have more knowledge.

“Therefore, the goal of ongoing actions remains the same: increase public awareness of oral cancer issues, encourage doctors of all dental profiles, oral hygienists to inspect the patient’s mouth at all times and evaluate all changes in the tissues. ” as well as students. “A. Pūrienė.