The Dundee Dental School is internationally recognized for its work in the area of oral cancer – in terms of research and public engagement. And this expertise is in demand like never before – in order to thwart an epidemic.
Over the past 25 years, cancer of the mouth cases in Britain have soared 300 percent – and three quarters of today’s 6,000 oral tumours are linked to tobacco and alcohol abuse.
“The number of smokers has dropped in recent years but not the intensity of tobacco consumption among smokers” says Graham Ogden, Professor of Oral Surgery, School of Dentistry at the University of Dundee. “Add to that alcohol consumption, where per head of population, every adult drinks the equivalent of nine litres of alcohol per year.”
And Scotland has Britain’s worst tobacco and alcohol problems.
Professor Ogden’s has worked on oral cancer research since 1985 when he arrived in Dundee. His earlier award winning studies focused on developing new techniques for recognizing the disease – such as refining the role of oral exfoliative cytology in early diagnosis – aspects which were later adopted by the Canadian oral cancer surveillance programme.
Much of his department’s effort now is targeted at raising public and professional awareness of the lifestyle risks associated with oral cancer and recognizing early signs of tumours. This culminates, every November, in Mouth Cancer Awareness Week which Graham Ogden coordinates in Tayside, Scotland – where a key focus is the student population.
“Scotland has the highest incidence rate for mouth cancer in the UK and is increasing particularly in younger people,” explains Professor Ogden. “We feel it is important to communicate our findings to those who might not necessarily come across our work in any other context.”
The sum of oral cancer cases in the UK is greater than testicular and cervical cancer combined. There are more mouth cancers in men than cervical cancers in women.
Recognising Professor Ogden’s work in raising awareness of oral cancer led to an invitation for him to join the medical advisory panel of Drinkaware – a nationwide organisation that advocates for more sensible and healthier drinking habits.
Early diagnosis is vital to improve survival rates. Up to 90% of those treated during the early stages of the illness will survive for at least five years. But a wait until the cancer the has spread to surrounding tissue cuts the five-year survival rate to at least 50% and sometimes lower.
Mouth cancer symptoms include red or red-and-white patches on the lining of the mouth or on the tongue; one or more mouth ulcers that do not heal; and a swelling in the mouth that lasts for more than three weeks.
Patients from this region of Scotland are treated by maxillofacial surgeons at Dundee’s Ninewells Hospital and Medical School. A biopsy is essential to confirm the disease. Early excision, particularly of small lesions, can be curative.
Dundee is also seriously engaged in cell and molecular biology, biochemistry, tissue culture and immunohistochemistry research.
Programmes include the Human Papilloma Virus (HPV) and its possible implications for oral cancer. Other studies focus on diagnostic and prognostic indicators, while researchers are investigating the effect of anti- cancer therapy on taste perception.
In terms of a patient’s overall general health, Professor Ogden believes primary care doctors should be better engaged with dentists, as screening mouths can provide much more information than merely the condition of the teeth and gums.
“The inside of a mouth can tell us a lot about systemic health. We should be encouraging professionals to recognize each other’s expertise – and get dentists talking with General Practitioners and doctors talking to the patient’s dentist,” he argues.
And this sums up the way we tackle the big healthcare challenges in Dundee. We don’t operate in specialised silos. You’ll find surgeons working with biologist, who consult with public health researchers. What distinguishes us is the interdisciplinary nature of our teaching and research – with collaborations across the professional disciplines in the professional Schools of our College of Medicine, Dentistry and Nursing.