Mouth cancer referrals plummet by a third since start of pandemic
Published: 30/11/2020
A dental charity is calling for urgent action around cancer diagnosis, following new data that shows mouth cancer referrals have fallen by a third (33%) since the beginning of the pandemic.
New figures collected from seven NHS Trust Hospitals across the UK, reveals the number of people being referred for possible mouth cancer fell from 2,257 in the six months prior to March 2020, to 1,506 in the six months after March 2020.
In total, six out of the seven NHS Trusts saw mouth cancer referrals tumble during this time, with two hospitals in Wales recording a 47% drop in referrals – the most in the UK.
In Northern Ireland, mouth cancer referrals have fallen by 36% since the beginning of the pandemic while England and Scotland have seen decreases of 31% and 30%, respectively.
Many mouth cancers are spotted in the early stages by a dentist during a routine check-up. With COVID-19 limiting dental practice activity to 20% of normal activity, the Oral Health Foundation is deeply concerned that many people with early stages of mouth cancer are going undiagnosed.
In the absence of seeing health professionals face-to-face, Dr Nigel Carter, chief executive of the Oral Health Foundation highlights the importance of self-checks at home and knowing how to spot mouth cancer in the early stages.
Dr Carter saids: 'Regular dental check-ups and GP appointments are the main routes for identifying the early stages of mouth cancer. We fear that without access to dental and wider health professionals, that many mouth cancer cases will go undiagnosed.
'A person’s quality of life after being treated for mouth cancer, as well as their chances of beating the disease, is highly dependent on the time of diagnosis. By allowing so many potential mouth cancers to go untreated, there is a real danger of more people losing their life to the disease.
'While dental and GP visits remain disrupted it is important that everybody knows how to check themselves for mouth cancer. If you notice anything out of the ordinary, contact your dental practice, who will be able to see you as an emergency patient.'
Mouth cancer can appear on the tongue, tonsils, gums and lips. It can also be found on the roof and floor of the mouth, as well as the head and neck.
Mouth ulcers lasting three weeks, red or white patches in the mouth, or unusual lumps and swellings, are the typically early warning signs. Persistent hoarseness can also be a symptom.
COVID-19 has had a significant impact on dental access in the UK. Research by the Oral Health Foundation shows that more than half (56%) of UK adults claim to have had dental check-ups postponed or cancelled.
During this time, one-in-six (16%) have experienced at least one of the potential early warning signs of the disease.
Meanwhile, the British Dental Association estimate a 10 million backlog of appointments due to dental practices being forced to shut down during the pandemic.
Dr Catherine Rutland, Clinical Director at Denplan, part of Simplyhealth, believes it is crucial that dental practices remain open during the remainder of the pandemic.
Dr Rutland said: 'Dentists continue to play a vital role in identifying mouth cancer at routine check-ups. However, during the COVID-19 pandemic, access to dentistry was severely curtailed and opportunities to catch mouth cancer early will have been missed. If mouth cancer is spotted early, the chances of a complete cure are good.
'The Foundation’s recent research has revealed that nearly four in 10 people reported encountering an issue and being unable to see or get advice from their dentist because of the current limited access to dentistry caused by the pandemic. Keeping practices open from now on is vitally important to help ensure the early detection of mouth cancer. It could save thousands of lives.'
Stuart Caplan was diagnosed with tongue cancer in 2012. The husband and father-of-one from Marble Arch, lost two-thirds of his tongue to the disease but says acting quickly was key for him beating the disease.
Stuart said: 'Mouth cancer is a hidden cancer, unlike a lot of cancers where there are obvious symptoms. People think ‘oh it’s only a mouth ulcer, it’ll pass’. It’s easy to just put a mouth ulcer treatment on and ignore it, and without visiting a dentist regularly it’s likely to get missed.
'If it’s not normal for you, get it checked immediately, especially you have had something for a few weeks. Cancer symptoms don’t go away. That’s the litmus test. Go and see a dentist or hygienist.'
Figures collected by the Oral Health Foundation show that 8,722 people in the UK were diagnosed with the disease last year, increasing by 97% since 2000.
Mouth cancer cases in the UK have soared for the 11th year in a row and have more than doubled within the last generation.
It is also vital that government issues updated advice about fallow periods for dental practices. Some practices are still working to the original one-hour fallow period, while others have reduced their time between patients. More frequent communication and direction is needed.
Real-life story: 'Giving up isn't an option'
Sarah Davies (46) was set to celebrate her 40th birthday when her life took an unexpected turn that would change her life forever.
The wife and mother-of-one from Coventry began to feel some pain in the left side of her gum, just below one of her back teeth. She thought it was just a mouth ulcer, but something was odd about it.
'At first, I didn’t think much of it and carried on with my everyday life,' Sarah says. 'It didn’t feel like a normal mouth ulcer though, sometimes it would send a feeling like an electric shock through the left side of my face.'
One month later, when the pain and inflammation did not go away, Sarah booked an appointment with her dentist.
The dentist treated the tooth above the inflammation with a filling. When the problem continued, Sarah visited another dentist who suspected it was sinusitis.
It would be another nine months, after several dental visits and a last-ditch trip to A&E, that Sarah was finally given the diagnosis of mouth cancer.
Sarah says: 'The doctor told me that they had results from my biopsy back and they had found malignant cells. From what they could tell, the tumour was 20mm long and was squished up against the gum.'
Despite several knock-backs, Sarah’s persistence meant that she was able to catch her cancer in the early stages.
This gave Sarah the very best chance of beating the disease.
Sarah received both radiotherapy and chemotherapy and was given the all clear five years ago.
Despite surviving mouth cancer, Sarah continues to live with the after effects that impact her life to this day.
Sarah adds: 'Following my treatment, I developed trismus, also called lockjaw, which has impacted my life dramatically. I am only able to open my jaw a matter of millimetres so eating with a knife and fork is tricky and it takes me a long time to eat my meals.
'When going out with friends and family I usually order kids meals so that people aren’t waiting around for too long and, if I want a drink, I have to do it through a straw.'
As is common with many mouth cancer survivors, Sarah’s taste buds and salivary glands were also affected, taking some of the joy out of eating and making swallowing more difficult.
Despite the setbacks Sarah has always kept a positive attitude. She admits to still having her down days when she feels frustrated or depressed but her friends, family as well as support from Macmillan nurses keep her going.
Sarah adds: 'Some friends have commented that I’m amazing for having the attitude that I have but I don’t think of myself that way. When you’re dealt something, you’ve got to face it. I’ve got an incredible family and friends who’ve supported me through it all.
'The way I look at it is that you’ve got two choices; do what has to be done or give up. Giving up isn’t an option.'
Author: Julie Bissett