Oral cancer detection should be a priority

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Baroness Gardner of Parkes calls for the inclusion of oral cancer as a recommended topic in the list of subjects for Continuing Professional Development.

My interest in oral cancer, particularly cancer of the mouth, dates from my days in general dental practice, when as a young dentist, I was fortunate enough to detect an early oral cancer and to refer the patient for the required necessary drastic treatment. The patient was the father of young children. He lived to see them become adults, so it made a huge difference to the lives of the whole family.

I had a Lords question on the subject on 29th November 2005 and followed this up in a debate on 26th November 2009 and further questions. There are excellent centres treating oral cancer in London: the Eastman Dental Hospital, the Marsden and Kings College Hospital, to name just a few.

The last government agreed that it would be valuable to have a quick oral examination carried out, even by those with limited training, to decide whether an abnormal or suspect condition in the mouth might be present.

Early detection is essential for treatment to be successful. Deciding that a referral is necessary is the first stage, and I have campaigned for a wider range of people working in the Health Service to check patients’ mouths, and when they have concerns, to refer the patient to a dentist for a further assessment.

As oral cancer is a rare condition, people tend to overlook a change in their mouth, and by the time they present to either the doctor or the dentist, it is past the treatable stage. It is a particularly unpleasant cancer, and anything we can do to improve early diagnosis is valuable.

The person who did this inspection, perhaps at a time when a patient attended hospital for A&E or some other service, would then refer any suspect case to a higher-level practitioner, usually a dentist. It is most important that the dentist or doctor then seeing the patient determines whether there is real cause for concern and an urgent need to refer the patient to cancer services.

I am tabling this question, as dentists taking part in Continuing Professional Development should be up to date on diagnosis of cancer of the mouth when other, lesser qualified people are referring cases to them. To have the latest training on the subject as a topic ‘recommended’ by the General Dental Council, would remind practitioners of the importance of the subject and assist early diagnosis.

Only last week, the reported marked increase in young patients with liver disease due to alcohol reminded me that the same causative trend was noted in the debate on oral cancer in 2009.

These cancers are rare and it is important that dentists should receive continuing training so that they are able to assess a patient referred to them and decide whether they need to be seen by a specialist in oral medicine. If dentists fail to pick up these conditions at the early and treatable stage, by the time the patient asks for further help, it is often too late.

Trixie Gardneris the former Lady Mayoress of Westminster (1987-88) and GLC councillor (1970-86). She was raised to the peerage in 1981 and sits on the Conservative benches.