Early detection is key for treating aggressive cancers

Dr. Harlyn Susarla, right, and 4-year-old Hunter Jones.

The importance of having routine dental checkups could never be truer for a young patient in Washington state. Last year, Dr. Harlyn Susarla, was examining 4-year-old Hunter Jones who she noticed had several loose teeth, which was early for her age. After taking bite wing X-rays, Dr. Susarla had a conversation with Hunter’s mother Kara, about doing additional testing to help determine the cause of the loose teeth.

“I told Hunter’s mother that I had seen some irregularities during her exam and after asking more questions, I decided that we should do a panoramic X-ray to see what additional insights we could obtain about her mouth,” Dr. Susarla explains.

Hunter’s mother agreed and Dr. Susarla took the X-ray, which revealed irregularities in Hunter’s jaw.

The mandible bone in Hunter’s jaw did not look how she expected, revealing a tumor-like growth, but there were no clear conclusions at that time. Dr. Susarla scheduled a follow-up appointment for a few weeks after the initial visit and shared the results from the panoramic X-ray with Hunter’s pediatrician and experts at Seattle Children’s Hospital.

When Hunter returned a few weeks later to Dr. Susarla’s, her teeth were about to fall out. Dr. Susarla also was able to see a visible mass that was not there during her visit just a few weeks prior. After additional tests were completed at Seattle Children’s Hospital, the tumor growing in the child’s jaw was eventually diagnosed as Neuroblastoma, an aggressive cancer that is often seen in young children.

“While cancer isn’t necessarily the first thing that came to mind, it’s my job as a pediatric dentist to observe and diagnose anything that is out of the ordinary. I’m not just focused on teeth, cavities and the mouth. I look for anything that might not be expected,” Dr. Susarla shares. “Even suspicious items can turn out to be benign growths.

After the diagnosis, Hunter Jones spent 140 days at Seattle Children’s Hospital. She had two tumors removed, five rounds of chemo, two stem cell transplants, 12 rounds of radiation and six rounds of immunotherapy.

Hunter is now in remission and recently went back to visit Dr. Susarla to thank her for her providing extraordinary medical care that helped her quickly get the medical care she needed.

“Patients and families need to realize that as doctors, we make sure we are providing the most comprehensive care possible. When I suggested to Hunter’s mother the appropriate course of tests, she agreed and recognized that it is my job to help keep her daughter, my patient, healthy.”

Often times, dentists see patients more frequently than other health care providers do, and are in the position to help look for abnormalities more frequently than even pediatricians or other members of the health care team.

“As a dentist, I am not going to miss cavities, so I do an overall assessment of my patient and take notice of things that may be different on my patient. I track everything, especially things that look suspicious, and then I reach out to other providers for the best possible care coordination for my young patients,” Dr. Susarla explains.

The oral health care team is an integral part of the entire medical team. Hunter Jones’ family had been taking her to the dentist for regular six month checkups. Prior checkups had shown nothing out of the ordinary.

“I am so happy that Hunter’s family did not wait to take her for her dental checkup,” says Dr. Susarla. “Dentists make recommendations that are evidence-based to treat patients. [Patients] may be afraid of the dentist or hesitate to use the products we recommend, but we are here to help optimize their health for both good oral and overall health.”

“Management of this complex disease process requires a multi-disciplinary team and early recognition of the clinical presentation by the pediatric dentist was the key to successful treatment,” said Dr. Seenu Susarla, the Seattle Children’s craniofacial surgeon, who was part of the team that provided care to Hunter. He credits Dr. Harlyn Susarla, his wife, for her thorough assessment as key to diagnosing and treating Hunter.

Neuroblastomas are a cancer that develops from immature nerve cells found in several areas of the body. While they are not usually considered oral cancer, April is Oral Cancer Awareness Month, which raises awareness on the importance of performing monthly self-exams and seeking regular medical advice. According to MouthHealthy.org, over 51,500 people are diagnosed with cancers of the mouth, throat, tonsils and tongue each year. Be sure to discuss oral cancer screenings with your dentist during your next checkup.

Harlyn Susarla, DMD, is a board-certified pediatric dentist with an interest in dental public health. After graduating with honors from Wellesley College, she obtained a Master of Public Health degree from Boston University with a concentration in maternal and child health, which encouraged her interest in caring for children. Dr. Susarla completed her dental degree at Harvard University, and her pediatric dental residency at the University of Maryland. She currently lives in Washington with her children and her husband, a craniofacial surgeon at Seattle Children’s Hospital, who also provided medical care to Hunter.

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