Mouth cancer for clinicians part 13: life after mouth cancer treatment

From Volume 43, Issue 7, September 2016 | Pages 672-686

Authors

Nicholas Kalavrezos

FRCS, FFD RCSI, MD

Consultant in Head and Neck/Reconstructive Surgery, Head and Neck Centre, University College London Hospitals, London, UK

Articles by Nicholas Kalavrezos

Crispian Scully

CBE, DSc, DChD, DMed (HC), Dhc(multi), MD, PhD, PhD (HC), FMedSci, MDS, MRCS, BSc, FDS RCS, FDS RCPS, FFD RCSI, FDS RCSEd, FRCPath, FHEA

Bristol Dental Hospital, Lower Maudlin Street, Bristol BS1 2LY, UK

Articles by Crispian Scully

Abstract

A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team, in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family.

Clinical Relevance: This article offers the dental team an overview of prognostication, quality of life and oral and dental healthcare.

Article

The stage at which mouth cancer is diagnosed has a significant effect on overall survival and quality of life: early diagnosis reduces mortality and also minimizes:

Early diagnosis and treatment continue to be the target but, nevertheless, diagnosis is often delayed despite exhortations over the past 25 years to increase the index of suspicion. The proportion of patients with head and neck cancer presenting with advanced disease has increased. Delays in diagnosis can lead to patients having more advanced stages of cancer, especially when delay is more than a month.

The quality of life (QoL) during and after mouth cancer treatment, however, has steadily improved over the years, despite survival rates increasing at a slower pace.

Survival rates for mouth and oropharyngeal cancers have risen slightly over the last 20 years. The best outcome for overall 5-year survival rates for treated oral cancers is over 90% for lip cancer. This relates presumably to the very early diagnosis at this site. The 5-year survival rates for treated cancers of the tongue, oral cavity, oropharynx are at best around 50–60%.

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