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Interview: “Mouth cancer is a growing problem”

From left to right: Let's Talk About Mouth Cancer's Prof. Victor Lopes; Dr Orna Ni Choileain; Dr Niall McGoldrick; Dr Stephanie Sammut; and Dr Ewan MacKessack-Leitch. (Photograph: Niall McGoldrick)
Brendan Day, DTI

Brendan Day, DTI

Tue. 11. June 2019


With oral cancer rates continuing to increase worldwide, it has become clear that more needs to be done to raise awareness and combat this issue. Dental Tribune International spoke with Dr Niall McGoldrick, Specialty Registrar in Dental Public Health with NHS Fife and the convenor of the charity Let’s Talk About Mouth Cancer, about the charity’s origins, its mission and much more.

Dr McGoldrick, how did Let’s Talk About Mouth Cancer get started, and was there anything in particular that led to its creation?
It all started in 2013, soon after my colleague Dr Orna Ni Choileain and I graduated from dental school. We were both working as dental foundation trainees at the Edinburgh Dental Institute and had a shared drive to raise awareness of oral cancer among the public. We had an initial idea and we were introduced to three other colleagues, Dr Ewan MacKessack-Leitch, Dr Stephanie Sammut and Prof. Victor Lopes, and from there the idea began to grow. We all could see first-hand the impact the disease had on people’s lives and on the people around them and wanted to do something active, different and visible to bring change at all levels.

In the early days, we thrived on putting together public campaigns with few resources and little funding. We had to think outside the box and be thrifty to get our campaign off the ground. We used lunchtimes, evenings and weekends to design leaflets, paint backdrops and peruse items in charity shops to find the things we needed. It was really fun, and we quickly began to get support from other dentists and dental care professionals as word spread about our work. All five of us went forward to found the charity in 2014 and we have grown year-on-year. We now provide training for undergraduates and continuing professional development for postgraduates, and run regular public campaigns throughout Scotland. We have partnered with national and territorial health boards across Scotland to spread our message about oral self-examinations to help promote early detection.

Today, Let’s Talk About Mouth Cancer is a multi-award-winning charity still driven by the same five volunteers, who are now close friends. We are still true to our humble beginnings, have kept our running costs low and continue to be extremely grateful to patients, colleagues, relatives, students and everyone who has donated or raised funds in any way to help us continue with our work.

What is Let’s Talk About Mouth Cancer’s mission? How do you hope to achieve this?
Our mission is to improve the prognosis of patients with oral cancer through early detection and diagnosis. We are trying to tackle this in a number of ways. Our public campaign is focused on empowering people with the skills and knowledge needed to carry out oral self-examination to identify this disease themselves and present early. We also counsel the public on reducing risk from well-known risk factors such as tobacco and alcohol. Secondly, we provide training for healthcare professionals at undergraduate and postgraduate level. This work is focused on improving the confidence of healthcare professionals when dealing with a suspicious lesion in primary care and ensuring they are up to date with signs, symptoms and urgent referral pathways.

Our third approach is through advocacy. We have lobbied the Scottish Parliament on issues related to human papillomavirus gender-neutral vaccination and our general work has been supported by a Scottish parliamentary motion.

How big of a problem is oral cancer in the UK and, more specifically, in Scotland?
Oral cancer is a growing problem in the UK, but especially in Scotland. Scotland has more cases of this disease per head of population than any of the other UK nations. Prognosis for patients remains poor, with 50 per cent of those diagnosed losing their lives within five years. Further to this, the inequalities that exist among those who develop the disease and those who do not are stark; the vast majority of people developing oral cancer come from our more deprived communities.

There are issues of social justice that need to be addressed. Improving the environment that people live in, making access to services simpler, making the healthy choice the easy choice and empowering people to care for themselves are just some of the areas that need to be addressed in order to prevent a further rise in the cases of oral cancer. Society’s current approach of mitigating the circumstances when it is too late will not solve the wider issues.

What steps can individuals take to combat oral cancer?
On an individual personal level, we should all be aware of what is going on in our mouths. Being familiar with what is normal in your own mouth is important, so that if there is a change you can pick up on it early. We want everyone to be carrying out oral self-examination to help identify what could be the early signs and symptoms of oral cancer. Our website has details on how to carry out a simple five-point check in less than a minute. In terms of reducing risk in the first instance: if you smoke, stop; if you drink alcohol, do so in moderation; do not use chewing tobacco and avoid betel quid and areca nut. It goes without saying that leading a healthy lifestyle and having a balanced diet will do wonders for your general health, but it will also reduce the risk of developing oral cancer. The last thing, of course, is to see your dentist as often as recommended.

At the health professional level, we need to be up to date, vigilant and competent in dealing with suspicious lesions. Being familiar with signs and symptoms of oral cancer is important, as is listening to the patient’s concerns and taking him or her seriously, understanding the urgent referral pathway in the area in which we work and being competent in referring appropriately. Healthcare professionals also have a role in educating patients about reducing risk and teaching them how to carry out oral self-examinations.

Let’s Talk About Mouth Cancer will be hosting the Global Oral Cancer Forum 2020 (GOCF’20) in Edinburgh in March next year. What can dentists and other health professionals look forward to at this event?
GOCF’20 takes place over two days—6 and 7 March 2020—and the theme is “Reducing risk; prevention, early diagnosis and innovative treatments”. We have lined up a selection of high-calibre international speakers and expert panellists to inform the conversation with attendees from around the world. Our aim is to develop actionable outputs in the global battle against oral cancer.

Unlike other international events, GOCF’20 invites attendees from all backgrounds: dentists, doctors, surgeons, public health practitioners, NGOs, charities, data scientists, survivors and patients to join the conversations and establish new thinking in the challenge oral cancer poses globally. Registrations for the conference will go live soon and all the info is available on the event’s website.

We want as wide and varied an audience as possible to join the conversation as we develop these ideas. Come along and be part of the action!

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