Oral Complications of Cancer and its Management

Book Preface

Introduction

Oral problems are common in cancer patients, and are a significant cause of morbidity and impaired quality of life in this group of patients[1]. Moreover, in some patients they can prevent administration of potentially life-saving treatment, whilst in other patients they can themselves cause potentially life-threatening complications.

Oral problems are usually predictable, and may be prevented or ameliorated by appropriate interventions[1]. However, even when it is not possible to prevent the oral problem, it is usually possible to treat/palliate the oral problem (and so to prevent or ameliorate the associated complications).

This chapter aims to provide an introduction to the oral complications of cancer and its management, and particularly to highlight the importance/relevance of these problems for patients with cancer.

Epidemiology

The World Health Organization (WHO) and the International Union Against Cancer (UICC) have estimated that in 2002 there were 10.9 million new cases of cancer, 6.7 million deaths from cancer, and 24.6 million people ‘living with cancer’ worldwide[2]. Furthermore, the WHO and the UICC have predicted that over the next 10–15 years there will be a significant increase in these statistics in all countries, and particularly in newly industrialized and developing countries[2].

The statistics vary from country to country, and often vary within an individual country. For example, the Office of National Statistics (UK) reports that, at present, approximately one in three people will develop cancer during their lifetime, and approximately one in four people will die from cancer in the United Kingdom[3]. However, people living in Scotland have a higher (~15% higher) incidence of cancer, and, not surprisingly, a higher (~15% higher) mortality rate[3].

The Surveillance Epidemiology and End Results Program of the National Cancer Institute (USA) estimates that, in 2008, there will be 1.44 million new cases of cancer, and 0.57 million deaths from cancer in the United States of America (USA)[4]. However, the statistics vary depending on age, gender, and race/ethnicity. For example, older people have a much higher incidence of cancer, and thus a much higher mortality rate. Indeed, the median age at diagnosis is 67 years, and the median age at death is 73 year (Figure 1.1)[4].

The epidemiology of oral problems is discussed in the next section of this chapter, and also in the relevant sections of other chapters in the book.