Oral squamous cell carcinoma hits one of our own

Aug. 31, 2007
A call to action on the importance of oral cancer screenings.

Dear RDH eVillage readers:

I found this letter on amysrdhlist.com. It was originally posted by Maureen Murphy Chodaba, RDH, who discovered the text from the blog of a dentist in the Poughkeepsie, N.Y., area. The dentist was recently diagnosed with oral squamous cell carcinoma.

Please share this with your colleagues and make it a clinical priority to perform oral cancer screenings on every patient, everyday.

In support,
Kristine A. Hodsdon, RDH, BS
Director, RDH eVillage

Tonight is the second day after my third chemo session. I'm nauseous, somewhat light-headed and headachey, and haven't really eaten in the last few days. I have six more weeks of chemo and radiation ahead of me, and then aggressive surgery. I just watched a movie about football and God, and God's power, and I'm trying to figure out why I have been given the gift of cancer — and I believe it is a gift so I can change the world!

My story is not unique. About six months ago, I went to button the top button on my dress shirt and realized my collar was too tight to button. I assumed I was getting fatter, older, or both, but upon further examination I noticed a swollen gland just to the right of my Adam's apple. I diagnosed myself with "unilateral lymphadenopathy," figured I was fighting some sort of infection, and forgot about it. Despite playing tennis every Tuesday with a physician friend, and despite having many patients and staff members who could have checked my neck for me, I ignored it. You see, I've missed one day of work in 24 years of dentistry, and, like my dentist-father before me, I thought there couldn't really be anything wrong with me. Besides, we always see things on our body or beneath the surface, or feel things that we're afraid might be cancer these days, and we can't go running to our doctors every time we suspect something might be wrong.

I finally asked my hygienist during my prophy what she thought, and she suggested I get it checked right away (thank God). I still didn't run to the doctor, but when I took my nine-year-old son for his routine exam, I asked my doctor/patient/ friend to check the lump on my neck. She immediately recommended a CAT scan, during which a radiologist friend discovered two masses and stated I had a type of lymphoma. I was told I had a base of the tongue tumor about the size of a super ball, and a secondary tumor in my lymph node about the size of a baseball. The doctor said at least it's not squamous cell, and I agreed … the news could be worse. He said I'll have the worst year of my life, but I'll be playing on the beach with my kids next summer. I hope he's right!

The next day the node was biopsied, and the following day I found myself at the oncologist, who told me it was Stage IV metastatic squamous cell carcinoma, the very cancer we were taught back in dental school was the oral cancer to be the most afraid of! Needless to say, I fell on the floor crying and swearing to my wife I was ready to die if that was God's plan (I feel like I packed 100 years into my 51). But I do not to leave my two boys (my other son is only 10), who I have been accused of being obsessed with since their birth. I was also not ready to leave my young, beautiful, wife, or my friends and family. Of course, I was devastated.

But today, almost two months later, I have chosen to see this challenge as a gift. I will beat this thing, and during and after the fight I will change the world. I will dedicate myself to reaching out to all of you, my fellow dentists, and implore you to take better care of yourselves — you owe it to your patients, your loved ones, and yourself. More importantly, your first responsibility as a medical care provider is to check for life-threatening disease. Why would you worry more about finding a cavity than cancer?

We have many ways of finding not just cancerous lesions, but pre-cancerous lesions! How can we justify motivating a patient to have a crown done, but not referring him or her for a "suspicious area," or maybe not even looking for it? My hope is that I can motivate just one more dentist, or one more hygienist, to look closer than they did yesterday when they did their oral cancer screenings (which the literature suggests only 20 to 50 percent of us do in the first place). Is it because insurance doesn't pay a specific fee for the most important thing you can do in the course of your day? Don't you know early diagnosis can save a life, which is quite a bit more important than a tooth? Everyday the literature is pointing more toward how important we as dentists are to finding disease in the oral cavity before anyone else can. I have focused my career on cosmetic dentistry … so I can change people's lives. Isn't it more important to save a life?

I hope to write many future articles and give many seminars on the things I know a little about, primarily porcelain veneers, but now I consider myself a first-hand expert on oral cancer. So please, perform oral cancer screenings. Get the necessary armamentarium to find these lesions earlier, and take better care of yourself. You don't know how important, and how loved, you are until you get this kind of wake up call. You, and I, have the power to change the world — one patient at a time! But I can't do it alone. Please help me make sense out of this, and do one more exam for a friend you haven't met yet, and for your patients, and for yourself — PLEASE!

Lawrence A. Hamburg, DDS

ORAL CANCER: Strategies for Early Diagnosis,