Oral Cancer and Complications of Cancer Therapies

Course #50683 -

Overview

Millions of people are diagnosed with a variety of malignant neoplastic lesions each year. Oral cancer, in which the primary malignancy arises within the oral cavity, is the 8th most common cancer in men and the 14th most common cancer in women. The common element among this diverse patient group are the problems encountered post-surgically when chemotherapy and or radiotherapy are used to destroy malignant cells, which can remain after the completion of surgery. Malignant lesions in the oral cavity are usually treated by surgical removal and several weeks of radiotherapy. The latter modality can cause severe changes in the mucosal tissues, bone, salivary glands, and the teeth, most of which are irreversible. Proper management before, during, and after both modes of therapy will have a positive impact on the quality of life and decrease the morbidity associated with these treatment regimens. This course will discuss the changes experienced within the oral environment during and after the treatment for oral and systemic cancers. Methods to mitigate these problems and to decrease the morbidity and the mortality which afflict these patients will be reviewed.

Education Category: Medical / Surgical
Release Date: 12/01/2020
Review Date: 02/01/2023
Expiration Date: 11/30/2024

Table of Contents

Audience

This course is designed for all dental professionals.

Accreditations & Approvals

NetCE Nationally Approved PACE Program Provider for FAGD/MAGD credit. Approval does not imply acceptance by any regulatory authority or AGD endorsement. 10/1/2021 to 9/30/2027 Provider ID #217994. NetCE is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at www.ada.org/cerp. NetCE is approved as a provider of continuing education by the Florida Board of Dentistry, Provider #50-2405. NetCE is a Registered Provider with the Dental Board of California. Provider Number RP3841. Completion of this course does not constitute authorization for the attendee to perform any services that he or she is not legally authorized to perform based on his or her license or permit type.

Designations of Credit

NetCE designates this activity for 5 continuing education credits. AGD Subject Code 730. This course meets the Dental Board of California's requirements for 5 unit(s) of continuing education. Dental Board of California course #05-3841-24314.

Course Objective

Problematic oral changes can affect more than oral health, and healthcare professionals should consider individuals' oral health in their overall patient care plans. The purpose of this course is to define oral cancer and briefly explain its diagnostic criteria as well as discuss the changes experienced within the oral environment after the treatments for oral and systemic cancers are initiated.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Identify the most common etiologies of oral cancer and its incidence within the population.
  2. Review the basic histology of the oral mucosa and the changes that occur with premalignant and malignant lesions and their patterns of occurrence.
  3. Compare and contrast erythroplakic lesions and leukoplakic lesions.
  4. Distinguish among the varied diagnostic procedures for suspicious oral lesions and the classification and staging of those that are found to be malignant.
  5. Review the principles of and the complications from radiotherapy utilized postsurgically for patients with oral cancer.
  6. List dental procedures that should be completed before surgery and radiotherapy that can minimize oral complications after the completion of these treatment modalities.
  7. Explain the basic principles by which chemo­therapeutic agents exert their cytotoxic effect.
  8. Discuss the serious chemotherapy-induced infections of oral origin that can be disseminated systemically.
  9. List other common oral effects of chemotherapy.

Faculty

Mark J. Szarejko, DDS, FAGD, received his dental degree from the State University of New York at Buffalo in 1985. He received fellowship from the Academy of General Dentistry in 1994.

Faculty Disclosure

Contributing faculty, Mark J. Szarejko, DDS, FAGD, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planner

William E. Frey, DDS, MS, FICD

Division Planner Disclosure

The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Director of Development and Academic Affairs

Sarah Campbell

Director Disclosure Statement

The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.

Implicit Bias in Health Care

The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.

Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.