Clinical Tips Series - Oral Cancer

Recognizing the Oral White Lesion and Oral Cancer in Daily Clinical Routine
Dr How Kim Chuan 80S (Singapore) MSc Orthodontics (London) MORTH PCS (England) MORTH RCSEd (Edinburgh) FDS RCS (England) FDS RCSEd (Edinburgh) Cert Oral Implantology FICOI

Introduction

I was inspired to write this article after hearing the speech by the Director of Oral Health, Dato DrWan Mohd Nasir on 7 August 2004 at the Opening Ceremony of the 11th CPD Blockbuster Scientific Conference & Trade Exhibition. In his speech, Dato Dr Wan touched on smoking and its potential pre-cancerous effects. He encouraged the clinician to detect lesion early so that it could be treated with better prognosis. Incidentally, a few days after his speech, a patient came in my clinic and she was suffered from this suspicious lesion. Instantly the alarm was triggered and true enough the lesion was subsequently diagnosed as Squamous cell carcinoma after histological confirmation from the biopsy.

Etiology of Cancer and its Prevention

Cancer prevention is a diverse area that touches on subjects such as epidemiology, clinical medicine, screening, cancer biology, immunobiology, behavioral medicine, stress management and education. Cancer develops as a result of both endogenous, or host, and exogenous, or environmental factors. Endogenous factors and preconception, prenatal and postnatal exogenous factor may lead to childhood cancers; similarly, endogenous and exogenous factors interact in the natural history of adult cancers.

Genetic Identification

Identifying genes that put children and adult at risk is an important and labor-intensive task. Overall, probably few cancers are entirely due to germ line mutations. Genetic research will eventually help us identify patients who are at high risk to certain types of cancers

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