Nasopharyngeal carcinoma: the role of the dentist in assessment, early diagnosis and care before and after cancer therapy.
Nasopharyngeal carcinoma (NPC) may present first to the dental profession as facial pain, neck masses, difficulty in speech and swallowing, ear, nose and throat symptoms, or as symptoms of temporomandibular disorders (TMD). Recognition of the signs and symptoms are essential in order to lead to the correct diagnosis, and to avoid inappropriate intervention that may further delay diagnosis and initiation of treatment of the cancer. Differentiation between NPC and TMD may be facilitated by specific questioning of other symptoms that are not frequently associated with TMD such as neck masses, nasal obstruction, recent unilateral hearing deficit and epistaxis. The general dentist can become involved at three stages of a patient's experience with NPC: Stage 1, recognition of signs and symptoms; Stage 2, pre-treatment dental assessment; and Stage 3, post-treatment support. This paper is intended to: (1) alert the general dentist of the signs and symptoms associated with NPC, such that timely and appropriate treatment may ensue; (2) provide a basic outline for assessment, preparation, palliation and continuing care of a patient diagnosed with NPC; and (3) underline the significant role of the general dentist in achieving an optimal quality of life for these patients
Mackie
A M
AM
Department of Dentistry, British Columbia Cancer Agency, 600 West 10th Avenue, BC, V5Z 4E6, Vancouver, Canada.
Epstein
J B
JB
Wu
J S
JS
Stevenson-Moore
P
P
D000293:Adolescent; D000328:Adult; D002327:Cariostatic Agents / Q000627:therapeutic use; D003729:Dental Care / Q000379:methods*; D003731:Dental Caries / Q000517:prevention & control; D003937:Diagnosis, Differential; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000532:radiotherapy; D009910:Oral Hygiene / Q000379:methods; D010020:Osteonecrosis / Q000517:prevention & control*; D010353:Patient Education as Topic; D011788:Quality of Life; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*; D014987:Xerostomia / Q000150:complications* / Q000209:etiology
D002327:Cariostatic Agents; D005459:Fluorides