The real impact of mouth cancer
Featured Products Promotional FeaturesPosted by: Dental Design 15th November 2024
A report by the Oral Health Foundation in 2022 showed that more than 8,800 people are diagnosed with mouth cancer in the UK annually.[i] The startling reality is that 1 in 55 men and 1 in 108 women will develop mouth cancer at some point during their lives.
As dental professionals, we are tasked with screening for early symptoms of the condition in order to facilitate rapid treatment and improve survival rates. We also spend significant time and energy on patient education in the area, aiming to help more people reduce their risk factors and prevent cancer in the first place. Most of our conversations focus on physical signs of the disease, practical lifestyle improvements and the importance of regular dental check-ups. For patients who have received a mouth cancer diagnosis, the dental practitioner’s role involves helping them manage the symptoms of the disease and the side effects of treatment. Those undergoing radiotherapy will need solutions for common issues like dry mouth or difficulty swallowing, for example.
An emotional journey
However, it is important that we also consider the psychological impact of mouth cancer on our patients. Though everyone’s experience will be entirely unique, we can tailor our care according to at least some of the common psychological events associated with oral cancer treatment.[ii]
Sadly, one of these is an increased prevalence of anxiety and depression. A study[iii] into the mental health of head and neck cancer patients found that 18% were highly distressed during their first oncology appointment, rising to 25% during a follow up appointment. Other research[iv] found that people diagnosed with oral cancer were nearly 2.2 times more likely to experience depression compared to those without the condition.
Depressive symptoms may be higher for oral cancer patients who are single,[v] likely due to the lack of access to an immediate support system at home. More serious depressive symptoms have also been reported during and up to 3-months postoperative. It is also important to note that self-esteem often decreases after surgical treatment for oral cancer, negatively influencing quality of life for patients of all ages.[vi]
Upon interviewing oral cancer patients, one study[vii] identified an array of possible cognitive and social outcomes. In addition to anxiety and depression, these included being afraid of the future, as well as feeling lonely and socially avoidant/isolated. Participants also reported on the significant impact of reduced abilities to work and the consequential financial implications. Feelings of helplessness or hopelessness have also been associated with higher rates of depression and anxiety.[viii]
Comprehensive support
Coping strategies can have a significant impact on psychological outcomes for patients with oral cancer. An Indian study[ix] found that individuals often turned to one of four possibilities – a stead-fast positive attitude, their faith, emotionally unloading on family and friends, or distraction. Other studies[x] have grouped coping strategies according to being either problem-focused or emotion-focused, both of which are important to give a patient the best experience possible.
Dental professionals may, therefore, consider speaking to patients about active coping strategies that help to reduce the stress experienced throughout the oral cancer journey. Of course, we are not psychologists or counsellors and mustn’t try to act as such, but simply giving patients an opportunity to talk about how they’re feeling is important.
As dental care providers, we will also likely witness the much wider implications of mouth cancer. The partners, family members, friends and caregivers involved with someone diagnosed with mouth cancer will require support too. It is widely acknowledged that there is a lack of understanding as to what is required for effective carer support.[xi] Dental practitioners are well-placed to ensure that these individuals have the necessary information and tools to look after both their charge’s and their own oral health. Once again, just listening to their story and showing some compassion can go a long way – especially for those who unexpectedly became carers for family members or friends.
A global fight
Despite significant advances our understanding of the aetiology, development and treatment of mouth cancer in recent years, there is still work to do. In addition to further promoting the importance of early detection for improved survival rates, we must also consider how we can enhance the quality of life for oral cancer patients, before, during and after treatment. This means supporting them with practical solutions to increase both their physical and psychological wellbeing.
For further information please call EndoCare on 020 7224 0999
Or visit www.endocare.co.uk
EndoCare, led by Dr Michael Sultan, is one of the UK’s most trusted Specialist Endodontist practices. Through the use of the latest technologies and techniques, the highly-trained team can offer exceptional standards of care – always putting the patient first. What’s more, EndoCare is a dependable referral centre, to which dentists from across the country send their patients for the best in specialist endodontic treatment.
[i] State of Mouth Cancer UK Report 2022. A report by the Oral Health Foundation. https://www.dentalhealth.org/thestateofmouthcancer [Accessed August 2024]
[ii] Moore KA, Ford PJ, Farah CS. Support needs and quality of life in oral cancer: a systematic review. Int J Dent Hyg. 2014;12:36–47. doi: 10.1111/idh.12051.
[iii] Verdonck-de Leeuw IM, de Bree R, Keizer AL, Houffelaar T, Cuijpers P, van der Linden MH, Leemans CR. Computerized prospective screening for high levels of emotional distress in head and neck cancer patients and referral rate to psychosocial care. Oral Oncol. 2009;45:e129–e133. doi: 10.1016/j.oraloncology.2009.01.012.
[iv] Kung, LY., Li, TI., Chung, CH. et al. Risk of depression in patients with oral cancer: a nationwide cohort study in Taiwan. Sci Rep 11, 23524 (2021). https://doi.org/10.1038/s41598-021-02996-4
[v] Kaminogo K et al. Predictors of anxiety and depression in patients with oral cancer undergoing radical resection with reconstructive surgery. Oral Oncology Reports. 2024; 10: 100295/ https://doi.org/10.1016/j.oor.2024.100295
[vi] Wojtyna E, Pasek M, Nowakowska A, Goździalska A, Jochymek M. Self at Risk: Self-Esteem and Quality of Life in Cancer Patients Undergoing Surgical Treatment and Experiencing Bodily Deformities. Healthcare (Basel). 2023 Aug 4;11(15):2203. doi: 10.3390/healthcare11152203. PMID: 37570443; PMCID: PMC10419055.
[vii] Saghafi, E., Andås, C.A., Bernson, J. et al. Patients’ experiences of adverse symptoms, emotions, and coping strategies in connection to treatment of head and neck cancer – an interview study. BMC Oral Health 23, 641 (2023). https://doi.org/10.1186/s12903-023-03366-4
[viii] Hassanein KAAM, Musgrove BT, Bradbury E. Psychological outcome of patients following treatment of oral cancer and its relation with functional status and coping mechanisms. J Cranio-Maxillofac Surg. 2005;33:404–409.
[ix] Jagannathan A, Juvva S. Emotions and coping of patients with head and neck cancers after diagnosis: A qualitative content analysis. J Postgrad Med. 2016 Jul-Sep;62(3):143-9. doi: 10.4103/0022-3859.184273. PMID: 27320951; PMCID: PMC4970339.
[x] Khalili N, Farajzadegan Z, Mokarian F, Bahrami F. Coping strategies, quality of life and pain in women with breast cancer. Iran J Nurs Midwifery Res. 2013 Mar;18(2):105-11. PMID: 23983738; PMCID: PMC3748564.
[xi] Røen, I., Stifoss-Hanssen, H., Grande, G. et al. Supporting carers: health care professionals in need of system improvements and education – a qualitative study. BMC Palliat Care 18, 58 (2019). https://doi.org/10.1186/s12904-019-0444-3
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