Collaboration moves dentists to the front lines of early cancer detection

Sandy Wexler credits a dental checkup with saving her life.

During a routine visit in 2012, Wexler’s dentist noticed one of her lymph nodes was enlarged, and recommended she have it checked out by an ear, nose and throat specialist.

A biopsy revealed the lymph node was cancerous, and Wexler immediately made an appointment with MD Anderson, where doctors discovered she had stage IV oropharyngeal cancer caused by the human papillomavirus (HPV). The cancer affects the area at the back of the throat.

Wexler endured six weeks of radiation and seven weeks of chemotherapy, lost 10% of her body weight and suffered second-degree burns on much of her neck. But five years later, she’s doing well and is the type of success story that MD Anderson hopes to tell more often through a new collaboration with the American Dental Association (ADA) – the nation’s largest dental association. Announced in May, the joint effort was created to foster better working relationships between dentists and oncologists in hopes of improving patient outcomes through educational initiatives designed for dental professionals and the public.

With more than 160,000 members, the ADA makes an ideal partner because general dentists often see their patients much more frequently than other primary care physicians, and routinely perform exams of the mouth, head and neck.

“I’m so proud that dentistry and medicine are banding together for our patients. Oral health is an important part of overall health – they’re connected,” says Gary Roberts, DDS, president of the ADA. “By working together, we can be even stronger advocates for disease prevention and help people live healthier lives.”

Initially, the collaboration will focus on HPV-related oropharyngeal cancers, found in the tonsils, throat and at the base of the tongue.

Unlike HPV-related cervical cancers, early detection of oropharyngeal cancers is quite difficult. Therefore, childhood vaccination is the best prevention strategy, explains Erich Sturgis, M.D., professor of head and neck surgery and co-lead of the HPV-Related Cancers Moon Shot™.

“If we can educate dentists much more broadly about HPV-related oropharyngeal cancer, it’s a great opportunity for earlier diagnosis,” says Sturgis. “It’s also a great opportunity to increase childhood vaccination rates, as dentists become advocates for kids to get vaccinated.”

Although the HPV vaccine could prevent the majority of these cancers, childhood vaccination rates to protect against HPV remain low in the United States.

“I can’t imagine a parent – if they’ve known what I’ve gone through – how they could turn down a vaccine to prevent the same thing in their children,” says Wexler.

Education and updated guidelines

This fall at the ADA annual meeting, MD Anderson and ADA experts will host a symposium designed to educate dentists about HPV-related oropharyngeal cancers and the importance of HPV vaccination.

MD Anderson experts also have collaborated to update oral cancer screening guidelines, due to be published by the ADA this fall. As the partnership matures, efforts will broaden to address tobacco use – the leading cause of oral cavity cancer – through a variety of prevention and cessation resources.

In addition to screening and prevention, MD Anderson experts hope to improve multidisciplinary care for cancer patients by strengthening relationships between general dentists and oncologists.

“We want to educate them about personalized cancer medicine and talk about how general dentists fit into that equation,” says Mark Chambers, D.M.D., professor of head and neck surgery and chief of the section of Oral Oncology and Maxillofacial Prosthodontics.

Chambers hopes to share information more broadly to rural dentists through mobile technology, and establish guidelines for oral interventions in cancer patients. In addition, it’s important to foster a certain level of comfort between the specialties to expedite referrals to oncologists when appropriate, he explains.

“As the first echelon of providers who see many of these patients, dentists could influence outcomes substantially by getting a patient in sooner to an oncologic setting,” says Chambers.

This was certainly the case for Sandy Wexler, who applauds the partnership and looks forward to seeing how it can help more like her in the future.

“I think it’s great that MD Anderson and the ADA are working together,” she says. “I’m living proof that dentists can make a big difference.”