“Necessity is the mother of all invention Management of Oral Cancer” have revolutionized the field of medical profession for long time and now all set to blaze a new trail in maxillofacial malignancy. Cancer being the second most frequent cause of mortality after cardiovascular disease, many patients do survive cancer treatment. With newer treatment regimens and the use of novel biological agents, more and more patients survive for longer periods of time, and many leads airily normal active lives. These patients are seen by general dentists and dental specialists in hospital and private dental clinic setting. The dental professional may be involved in preparing the patient for cancer therapy by screening for treating odontogenic infections. He / She may be involved in the management of oral complications during and after cancer therapy, since with improved techniques for delivering chemotherapy, many patients who have cancer are being treated in their community rather than travelling to cancer centres. More often, such patients are seen by general dentist for routine dental care after cancer therapy.
Chemotherapy, Radiotherapy and Newer treatment of cancer were introduce and recognize as a chief treatment. These treatment modality have been involved in medical and dental field more than ninety years. Chemotherapy typically involves the use of several antineoplastic (anticancer) drugs to treat cancer, though some people are treated with single medications. While the drugs in this family are toxic to cancer cells, many are also toxic to healthy cells, which give rise to numerous side effects. A few drugs used in chemotherapy enhance immune function, while some alter hormonal activity. Chemotherapy aims to eliminate the clonogenic cells completely. The inevitable damage to normal cells from cytotoxic therapy is tolerated by prompt and efficient repair of normal cells, as opposed to that of tumour cells. Chemotherapy and radiotherapy target actively dividing cells and the two most susceptible stages are the M-phase and S-phase of the cell cycle. Ionizing radiation is used for both therapeutic and diagnostic purposes. For therapy high energy radiation in megavoltage range is preferred where as for diagnosis kilovolt age energy is used. The radiotherapy is based on the principle that rapidly proliferating cells are more sensitive to ionizing radiation compared to normal cells. This differential cell kill is used for the treatment of tumors. A dose of radiation that is sufficient to kill cancer cells will produce considerable if not permanent damage to the normal tissues. The malignant cells which have a high rate of mitosis are highly susceptible to the action of radiation. However, the normal cells recover but not the malignant tissues. Thus the aim of radiotherapy is to deliver a homogenous dose of radiation to an accurately localized tissue target volume in order to produce tumor control with minimal effect on the surrounding normal structures. Radiotherapy is a specialty which took birth at the end of the 19th century with the discovery of x rays by Sir Wilhelm Conrad Roentgen on Friday, the 8th November 1895.
This book updates the oral health care professional on how to prepare a patient for cancer therapy and identify and manage short term and long term complications of cancer therapy. Book range from the use of new therapeutic agents, such as keratinocyte growth factor that reduces the incidence of mucositis during chemotherapy and radiotherapy to learning how to recognize infections in patients who are immunocomromised, to understanding the socio – economic costs of oral complications. We hope that that these practical and evidence – based guidelines will be readily accessible and useful to cancer specialist in the management of patient who develop oral complications of cancer therapy.
Dr. Pradeep Kumar Jha
Reader cum HOD
Oral Medicine & Radiology
Patna Dental College (GDC)
Patna Bihar, India.
