A New and Unusual Pattern of Presentation of Oral Cancers Among Young People
Dr. Firoozeh Samim
Oral Medicine and Oral Pathology Specialist
In this episode of CDA Oasis Live, Dr. John O’Keefe invites Dr. Firoozeh Samim, an oral medicine and oral pathology specialist from Montreal, to discuss a worrying recent trend in the presentation of oral cancers among young people who do not have traditional risk factors for the disease.
While investigation and research into this trend is ongoing, Dr. Samim highlights the role dentists can play in early diagnosis, and urges practitioners to be especially vigilant when presented with painful ulcers on the lateral or ventral border of the tongue.
Here are some of the key takeaways from the conversation:
- There is a recent trend of oral cancer presentation among young people without traditional risk factors. Typical presentation is an ulcer on the lateral or ventral border of the tongue with pain that radiates.
- In many cases, the lesion was mistaken for trauma associated with tongue biting and valuable time was lost in delaying investigation.
- Dentists can play an important role in the early diagnosis of suspect lesions by carrying out a biopsy or referring the patient to a pathologist for biopsy.
- More investigation and research is required to understand the recent trend in presentation of the disease.
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team
Further resources
Thank you for this all important reminder to the profession. I worked with BC Cancer for 31 years and saw squamous cell carcinoma in the tongue of two individuals who were 24 years of age or less. In both cases, the cancer was aggressive. In one instance the initial lesion was diagnosed by a dentist at the oral screening examination for entry to the BC Lions football team when the lesion measured only 0.25mm in diameter. Palpation suggested the need for biopsy which was done and the diagnosis was made. All of the appropriate referrals were made and management instituted on an urgent basis but to no avail. Despite radiation and surgery, the patient succumbed to his disease within 6 months. Another female patient was successfully treated with radium needles.
In both instances, photography of the lesion was exceptionally helpful in sharing information between the professionals involved. Information can so easily be lost when a successful excision biopsy is performed complicating decision making in future management. The photograph resolves concerns about location; changing appearance; and other characteristics. Even an image from an iPhone can be helpful!
Thank you for your contributions. Can I access data on your observation of increased scca incidence in young people?
Did any of these patients have the Gardasil-9 vaccine? Is there any way to tell if they are HPV related?
Have they looked at HPV Papilloma Virus or other virus as the possible cause? Curious.
A pictures is worth thousand words. What was the biopsy report say about those lesions? I have seen reddish patches in lateral border of the tongue but they turned out to be benign lesions.