North Texas Dentistry Volume 8 Issue 1 NTD 2018 ISSUE 1 DE | Page 6

cover feature
A Rare Resource in
Oral Cancer Treatment is
Creating Dental Superheroes
David R. Kang, MD, DDS, MS, FACS
Head and Neck Surgery of North Texas PLLC
by Tina Cauller
ral cancer is a particularly deadly disease. In
the U.S., it kills about one person every hour,
24 hours per day, and nearly 50,000
Americans will be newly diagnosed with oral
cancer this year. 1 For decades, there has been
little improvement in oral cancer mortality. For years, about
50% of patients with oral cancer survived five years. A decade
ago, this number rose to 57%. While this seems, on the face,
like an improvement, the number is deceiving. In truth, the
increased incidence of more treatable cancers caused by
HPV-16/18 pushed the survival rate upward (even though HPV-
related cancers typically arise in the back of the mouth ― in the
oropharynx, tonsils, and base of tongue ― and can lack the visi-
ble signs that permit early detection).
O
Why is oral cancer so deadly? Most oral cancers are diagnosed
in an advanced stage of development. While the 5-year survival
rate for oral cancer diagnosed early is 75%, the survival rate for
oral cancer diagnosed late plummets to around 20%.
Greater awareness has the power to influence the numbers, and
when celebrities like Michael Douglas make the news with an
6 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
oral cancer diagnosis, there is an accompanying uptick in public
awareness. But the most critical factors influencing survival ―
early discovery and a fast path to treatment ― hinge on the
front-line defenders in dental offices across the country. More
than any other group, dentists and hygienists are in
an opportune position to be superheroes in the fight
against oral cancer.
According to Dr. David R. Kang, “It’s great that more dentists
are becoming aware of their unique position to screen patients
for oral cancer. However, in addition to promoting awareness
and increasing screening rates, we must also reduce the time
between detection and treatment to improve outcomes because
oral cancer is so highly aggressive. If an early lesion is thicker
than two millimeters, there is already a 20% chance that it has
spread into the lymph nodes in the neck. This scenario increases
the risk for local and distant metastasis, and requires much
more extensive surgery to treat.”
75% of all head and neck cancers originate in the mouth.