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 referral procedures; oral diagnosis is not always simple and a second opinion can be valuable to all concerned in cases of doubt.
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If mouth cancer has been detected early enough, it can usually be treated with a good prognosis and with minimal adverse effects. Thus the patient with any suspicious oral lesion should be referred as soon as possible for a second opinion.
Generally speaking, the earlier a cancer is found and treated, the better the outcome is likely to be with lesser adverse treatment sequelae. In general, cancer prognosis decreases with advanced disease, advanced age, low SES (Socio-Economic Status), and continuing risky lifestyles. Mouth or oropharyngeal cancer due to HPV, however, is appearing increasingly in younger patients without the ‘traditional’ mouth cancer risk factor but has a better outlook than in cancers unassociated wih HPV.
If the cancer is small, removal through surgery may be a simple procedure. In some cases the procedure can even be carried out under local anaesthetic. If the cancer is large or has spread, surgery may still be the preferred treatment option, or other treatment modalities in addition to surgery may include radiotherapy and chemotherapy. These days, for such decisions the patient will invariably benefit from the advice and expertise of the MDT (Multi-Disciplinary Team).
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