primary care and cancer

Question 1

List 6 risk factors for oral cancer

Answer 1

HPH16 (oropharyngeal)
Smoking
Alcohol
Betel quid
Poor OH
Poor nutrition

Question 2

What are some common sites for oral cancer?

Answer 2

Tongue
Labial/buccal mucosa
Gingiva
Palate
Alveolar bone

Question 3

List 4 features of oral cancer

Answer 3

Ulceration
Swelling
Erythema
Speckled red and white

Question 4

Name 6 potentially malignant lesions

Answer 4

Leukoplakia
Erythroplakia
Submucous fibrosis
Lichen planus
SCC arising in pre-existing actinic keratosis
Palatal keratosis in reverse smokers

Question 5

How can a dentist prevent further dental disease in oral cancer pts?

Answer 5

Dentally fit
Immediate tx
PMPR
Imps for fluoride trays
Start fluoride therapy for diéntate pts

Question 6

What is the role of the GDP in oral cancer?

Answer 6

Early detection of soft tissue lesions
Pre-tx and assessment
Minimal role during tx
Maintenance of oral and dental health post-tx
Palliative care
Prevention of further disease

Question 7

Why should OHI and fluoride be given pre-cancer tx?

Answer 7

Avoids unscheduled interruption of chemo
Avoids exacerbation of mucositis
Removes potential source of infection

Question 8

List 5 side effects of radiotherapy

Answer 8

Mucositis
Trismus
Dry mouth
Caries
ORN

Question 9

What is the GDPs role during cancer tx?

Answer 9

Treat oral ulceration, infection and provide emergency tx
Manage oral mucositis

Question 10

How can oral mucositis be managed?

Answer 10

Stop smoking, no spirits and avoid spicy foods
Topical lidocaine
Saline mouthwash
Benzydamine
Prevent with cryotherapy and keratinocyte growth factor
Treat with opioids

Question 11

What is the GDPs role post cancer tx?

Answer 11

Prevention
Monitoring:
- increased RVD frequency
- dry mouth management
- prosthodontics
- appropriate referrals

Question 12

What is important to remember with ORN?

Answer 12

More likely with dose over 60Gy
Prevention paramount
Any XLA at least 10 days prior to radiotherapy