Most of us have experienced oral ulcers, very commonly, due to vitamin B12 deficiency or during periods of stress. Yes, those are a frequent finding in the general population and are called aphthous ulcers.
Some might appear due to chronic trauma from the sharp adjacent teeth and are termed as traumatic ulcers
The reassuring part? Such lesions are harmless and self heal, uneventfully.
So, what does a typical harmless ulcer look like?
- They present as a well defined lesion, typically 0.5 cm X 0.5cm in dimensions.
- Associated with severe pain
- Heal within 7–10 days and have a tendency to re-appear
Have a yellowish center with a red halo.
But, there are certain warning signs that indicate towards a suspicious lesion or malignancy, which when ignored could worsen the consequences, as we all are aware of.
Those could be stated as:
- Any mouth ulcer that does not heal within 2 weeks must be evaluated by a specialist.
- Painless ulcer that does not self heal, decrease in size or shows any sign of remission.
- Hard or raised edges around the ulcer and irregular borders.
- Associated white patch or red patch, indicative of what we call as a premalignant lesion, a stage before cancer sets in.
- Neck swelling or lump, though this is clinically seen after further progression of the disease.
These features are typically the warning signs, which we should be aware of and educate the patients about the same.
Also, patients presenting with a habit history of tobacco chewing, areca nut/gutkha/pan masala use, smoking or giving a history of chronic sharp tooth irritation should carefully be examined.
Why early diagnosis matters?
When oral cancer is detected early:
- Treatment is easier, more tissues are preserved. Hence, function and appearance are better
- Survival rates are significantly higher, in the early stages.
- Surgery is the curative option, which is the most dependent unlike radiotherapy or chemotherapy. They are just a form of supportive treatment and have been associated with major complications.
- And yes, if treated in the early stages, the patient can have a modest life though with some amount of morbidity. But still enjoy the beautiful gift of life.
Unfortunately, delayed consultation owing to ignorance or lack awareness is one of the biggest challenges we see in clinical practice.
Morever, acceptance of the condition, owing to the fear and stigma associated and delay in taking a prompt action is a major setback.
Abiding by the saying “Prevention is better than cure” as health care professionals we should propagate the idea of Habit Cessation, early diagnosis, and prompt action once diagnosed, should be the realms of patient education in terms of awareness regarding oral cancer.
A habit addressed early, a lesion identified sooner and an intervention initiated without delay can be the difference between cure and compromise.
As healthcare professionals, our responsibility goes beyond treatment anddiagnosis.
We must appreciate and understand the respoonsibilty, vested on our shoulders.
MBH/PS