Article
A recent campaign to promote the November 2021 ‘Oral Cancer Action Month’, highlighted the importance of a thorough extra-oral examination in early detection of pathology.1
A 55-year-old male was called up for a routine dental check-up with the University of Plymouth's Peninsula Dental School. Fifth-year student, and now qualified dentist, Jasleen Batra, examined the patient, and carried out a full extra-oral examination, detecting a palpable lymph node in the right submandibular region. The 2-week urgent referral stated: ‘Submandibular node (suspected) on RHS is hard, fixed and palpable’. Subsequent investigation revealed a squamous cell carcinoma of the right tonsil, and right neck P16 positive (T1N1M0).
With the patient's consent, the story was reported nationally with the patient describing his journey from early detection to treatment, and sharing his opinion that this early detection may have saved his life:
‘I hadn't been in pain at all, but Jasleen found a hard lump under my jaw, which I then felt with my hand. She calmly explained the need for an urgent referral and less than 2 weeks later, I went for an examination and then a biopsy. The consultant informed me that I had malignant and aggressive cancer of the tonsils that had spread to the lymph gland and surroundings.’
‘I underwent surgery to have as much of the cancer as possible removed and the surgeon told me that the cancerous lymph gland had grown by 12 mm in just 10 days between my appointments, so it was very fortunate and of great importance to my future health that Jasleen discovered it when she did.’
‘I do not wish to contemplate the possible ramifications had Jasleen not recognized the potential problem early’
Jasleen Batra commented: ‘Oral cancer screenings are essential, and are now routine every time you see a dentist. However, checking at home is so simple and should be promoted more. Having a good look around your mouth, including your lips, cheek, tongue, under your tongue, the back of your throat and the top of your mouth with a mirror takes less than a minute a day, but means you would catch any changes early before they become more serious.’
‘I am so glad Mr Sanders came to see me when he did and glad to hear he is doing well. I was just doing my job and what the staff at Peninsula Dental School have taught me over the years. I hope his story creates awareness that may save lives in the future.’
The patient journey emphasizes the crucial importance of thorough extra- and intra-oral examination, and the importance of early detection in improving outcomes is highlighted in this case.