Raising awareness of childhood cancer
September is Childhood Cancer Awareness Month. It aims to help more people understand the disease for earlier detection. It is important for dental professionals to know how the disease affects sufferers so that they can deliver the appropriate dental care.
4,500 children and young people are diagnosed with cancer in the UK each year. That includes approximately 1,600 children under 14-years-old. Different types of cancer tend to affect children and teenagers, which is different again to those that affect adults.
The UK has the lowest rates of childhood cancer in Europe. However, cancer is still the most common cause of death in children aged 1-14 years. Thankfully, survival rates of childhood cancer are high in the UK – 82% of sufferers survive beyond 5 years.[i]
Common types of childhood cancer
The most common type of cancer in children is leukaemia, followed by central nervous system (CNS) tumours and lymphomas. Other types of cancer affecting young people include soft tissue tumours, neuroblastoma and renal tumours, among others. Further research into the causes of childhood cancer is vital to improve understanding.
Pre-cancer treatment dental care
Dr Jon Lightstone, an associate dentist at Cookham Dental Practice, believes raising awareness of childhood cancer amongst dental professionals is very important.
He says: “As with any medical condition, oral healthcare can drop in priority and quickly take its toll. It is especially important that children with cancer visit the dentist regularly and that the oncology team remind their parents of this.”
Wherever possible, it’s important to perform a dental assessment before cancer treatment begins. This helps to optimise the patient’s oral health and minimise potential complications during and after cancer therapy. Treatment for existing caries, periodontal disease or pathologic lesions should not impact or delay cancer therapy.[ii] Giving the patient and their parents preventive oral hygiene advice is also essential. So too is recommending suitable products and reviewing techniques.
Oral complications of cancer treatment
Treatment for cancer usually involves chemotherapy, radiotherapy, immunotherapy and/or surgery. These cause several possible oral health side effects.
“It is a good idea to increase the frequency of dental assessments to ensure early detection of any potential problems and that a good homecare regime is in place,” says Dr Lightstone. “Should the child require treatment, then their healthcare team may wish to be consulted.”
Oral mucositis affects a significant proportion of children undergoing cancer treatment. This is especially true for those requiring chemotherapy or radiation to the head or neck area. In addition, oral infections, neuropathic pain and xerostomia are also common.[ii] It’s vital to tailor dental care accordingly, aiming to minimise symptoms.
Dr Lightstone adds: “While a dental team can tailor the dental care provided depending on the health and needs of the child, it is important to try and treat the child as one would any other patient, and make the experience as normal for them as possible – not another place associated with jabs and tests that they, sadly, may have become accustomed to.”
It is also important to be aware of potential side effects that can occur later in life. Childhood cancer therapy can impact tooth development, salivary function, craniofacial development and TMJ function.[iii] As a result, childhood cancer survivors have an increased risk of poor oral health when they grow up. Therefore, it’s essential to monitor their dental condition closely as they grow up.
This year’s Childhood Cancer Awareness Month is looking to Go Gold! Get involved by simply wearing a gold ribbon. Or you could take it a step further by organising a cake sale or other fundraising activity. It’s a great way to interact with your local community too, showing your support for the campaign and increasing awareness in your area.
[ii] Ritwik P. Dental Care for Patients With Childhood Cancers. Ochsner J. 2018;18(4):351–357. doi:10.31486/toj.18.0061
[iii] Effinger KE, Migliorati CA, Hudson MM, et al. Oral and dental late effects in survivors of childhood cancer: a Children’s Oncology Group report. Support Care Cancer. 2014;22(7):2009–2019. doi:10.1007/s00520-014-2260-x