Dr. Elizabeth Kapral faces what she calls “complex situations” almost daily. The department she works in at the Erie County Medical Center campus in Buffalo, New York, serves patients with complicated medical conditions and cancer.
More specifically, about half of her patients with cancer have head and neck cancer, she said.
April is Oral Cancer Awareness Month and it is an apt time for dental professionals to consider their role in screening and mediating oral cancers.
The ADA has made combating oropharyngeal cancer a priority. In 2017, the Association and The University of Texas MD Anderson Cancer Center announced a collaboration to focus on increasing human papillomavirus vaccinations for cancer prevention.
Dr. Kapral, 33, who graduated in 2013 from the State University of New York at Buffalo School of Dentistry, said she talks with patients about oropharyngeal cancer on a daily basis.
They discuss risk factors — smoking, alcohol use, medical history and possible viral infections — and she sometimes motivates them to modify their habits or control their medical conditions.
While most of Dr. Kapral’s patients are adults and beyond the eligible age to receive the HPV vaccine, which the Centers for Disease Control and Prevention recommends for youth ages 11-12, she said she still discusses the vaccine with them since “they can share the information with family and friends who may then become vaccinated.”
The Erie County Medical Center saw about 11,000 general dentistry visits in 2017 and 6,000 oncology patient visits. Dr. Kapral and her mentor, Dr. Maureen Sullivan, who is chief of the Department of Dentistry’s Division of Oral Oncology and Maxillofacial Prosthetics, keep pretty busy as two of about a dozen dentists who staff the medical center clinics. Dr. Kapral said she is seeing more and more younger, healthier patients afflicted by oropharyngeal cancers.
According to the Center for Disease Control and Prevention, HPV is the cause of about 70 percent of oropharyngeal cancers in the U.S. Dr. Kapral said she sees cancer screening and prevention as “primary responsibilities” in her role, though she acknowledges that when it comes to HPV, it can be uncomfortable to discuss its mode of transmission.
“It is important to remember that the HPV vaccine is primarily cancer prevention,” she said. “This should be the key point on which to focus.”
The ADA has resources for dental professionals when it comes to this topic.
In 2017, the Council on Scientific Affairs released a clinical practice guideline on the evaluation of potentially malignant disorders in the oral cavity. To download this guideline, visit ADA.org/OralCancer.
In October, the ADA and MD Anderson hosted a first-of-its-kind oropharyngeal cancer symposium. To see presentations information from the speakers, including Erich Sturgis, M.D., professor in the department of head & neck surgery and department of epidemiology at The University of Texas MD Anderson Cancer Center, visit ADA.org/ADA17OralCancer.
The ADA Science Institute regularly updates a webpage on ADA.org about oral cancers, which includes links to ADA resources.
Dentists can also refer patients to the ADA’s consumer website, MouthHealthy.org, for information about oral head and neck cancer and HPV.