Cancer staging:
It helps the oncologist decide the treatment plan and prognosis of the disease. The typical combination of letters and numbers that appears like a code in the cancer report is usually the cancer stage. The stage refers to the extent of the tumor in the body, and it may change according to the progression of the disease. The stage is usually decided based on clinical evaluation, biopsy, and other lab tests like ultrasonography, blood counts, Ct scan, etc.
Cancer staging is used for most cancers except a few like leukemia, brain tumors, small cell lung carcinoma.
Most of the cancer is staged based on the TNM system of classification. In TNM, T refers to the size of the primary tumor, N to the involvement of cancer in the surrounding lymph nodes, and M to the spread of cancer from the primary site to other parts of the body. According to this staging system, there are five stages of cancer from 0 to IV. Oral and oropharyngeal cancers are also staged based on this system of staging. The number of stages can be four or five depending on the type of cancer (Figures 1 and 2).
Cancer staging:
It helps the oncologist decide the treatment plan and prognosis of the disease. The typical combination of letters and numbers that appears like a code in the cancer report is usually the cancer stage. The stage refers to the extent of the tumor in the body, and it may change according to the progression of the disease. The stage is usually decided based on clinical evaluation, biopsy, and other lab tests like ultrasonography, blood counts, Ct scan, etc.
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Cancer staging is used for most cancers except a few like leukaemia, brain tumors, small cell lung carcinoma.
Most of the cancer is staged based on the TNM system of classification. In TNM, T refers to the size of the primary tumor, N to the involvement of cancer in the surrounding lymph nodes and M to the spread of cancer from the primary site to other parts of the body. According to this staging system, there are five stages of cancer from 0 to IV. Oral and oropharyngeal cancers are also staged based on this system of staging. The number of stages can be four or five depending on the type of cancer (Figures 1 and 2).
Tips and instructions before and after treatment: –
There are many side effects following radiotherapy, chemotherapy and surgical cancer therapy. These treatment modalities affect malignant as well as normal cells. As with every treatment, there are specific side effects. Most of the reversible effects are completely reversed after the treatment is over, as normal cells can repair themselves. But sometimes, the consequences can hamper the patient’s quality of life and lead to severe complications (table 1). The goal of the cancer treatment is to reach the end of the treatment with maximum benefits and minimum side effects.
The patients should be prepared psychologically and physically before the treatment starts. It is the responsibility of the doctors to explain the risks of the treatment to the patients and their caregivers. Proper instructions to the patients before the treatment can help them minimize the pain and suffering during and after the treatment.
Before the treatment starts, the patient is told to:
Enter With Caution (mnemonic)
E- Encourage brushing with fluoride toothpaste and interdental cleaning (flossing) to avoid dental caries and other oral infections
W- Wash, i.e. use of mouthwash to maintain oral hygiene, drink plenty of water to counteract the xerostomia during the treatment
C- Calorie intake should be optimum, but sugar-free and balanced diet should be included to remain healthy and avoid weakness during the treatment. Xylitol and sorbitol chewing gums should be used to promote salivation and prevent dental caries.
After the treatment is completed, the patient should visit the doctor for routine examination and follow the instructions given by the doctor that can alleviate the suffering due to side effects and improve the quality of life. The doctor should thoroughly check for any primary residual or secondary tumor in other parts of the body in regular intervals. A few simple points, if kept in mind by the patient and their doctor, can make the post-treatment life of cancer treated patient less painful (Table 2)
(Wong, 2014) (Sung, 2016) (Harding, 2017)
References:
Reddy, D. V. (2020, December 14). What are the different stages of cancer?
National Cancer Institute. (2015, March 9). Cancer Staging. Retrieved from https://www.cancer.gov/about-cancer/diagnosis-staging/staging
Cancer.Net. (2021, February). Oral and Oropharyngeal Cancer: Stages and Grades. Retrieved from https://www.cancer.net/cancer-types/oral-and-oropharyngeal-cancer/stages-and-grades
Wong, H. m. (2014). Oral Complications and Management Strategies for Patients Undergoing Cancer Therapy. The Scientific World Journal, 1-14.
Sung, R. H. (2016). Managing patients with oral cancers in general dental practices. J Calif Dent Assoc. , 85-92.
Harding, J. (2017). Dental care of cancer patients before, during and after treatment. Retrieved from www.nature.com/BDJTeam
By – Dr. Mayuri Ganguly Soni
MSc Forensic Odontology, BDS
Dr Mayuri Soni was a participant of our Oral Cancer Genetics Course
