Oral Pharyngeal Cancer Epidemiology and Prevention

Oral health professional
•Complete head and neck and oral exam
•Reinforce tobacco cessation, moderate alcohol consumption; balanced diet
Manage
•Dental status: functional occlusion, dental pain/infection, dental breakdown, pain
•Dental prevention: oral hygiene, caries prevention
•Jaw continuity: postsurgery, osteonecrosis
•Hyposalivation
•Mucosal lesions/pain/sensitivity
•Functional pain (e.g.,: TMD)
•Limitation of opening (pain, fibrosis)
•Diet recommendations:
– Balanced meal plan, adequate in vitamins, minerals, and nutrients (calories, protein, and fluid)
–Modify diet texture for specific limitations (e.g.,: dental and jaw condition, xerostomia, mucosal sensitivity)
–Instruction on limiting simple sugar intake, diet texture
•Taste
Nutrition professional
•Reinforce tobacco cessation, moderate alcohol consumption
•Balanced meal plan, adequate in vitamins, minerals, and nutrients (calories, protein, and fluid)
•Modify diet texture for specific limitations (e.g.,: dental and jaw condition, xerostomia, mucosal sensitivity)
•Encourage selecting foods from all food groups; American cancer Society Guidelines for Cancer Prevention
•Encourage 5–9 servings of fruits and vegetables; including citrus fruits, dark green, deep yellow vegetables
•Encourage whole foods, high fiber foods (e.g.,: whole grain breads and cereals)
•Encourage healthy fats, limit saturated fats
•Preparation: encourage fresh, baking or broiling
•Encourage low-fat milk and dairy options
•Limit salt-cured, smoked and pickled foods
•Limit alcohol intake, encourage moderation
•Minimize consumption of simple sugars (frequency and quantity)
•Weight maintenance, weight gain, weight loss: discuss achievable goals and give direction on achieving goals (i.e., increase activity if no limitations; discuss a new exercise with physician). If goals not met, discuss and address barriers were possible
To date, nutritional supplements in the forms of vitamin and minerals have not shown preventive effects, other than vitamin A and B-carotene that have significant adverse effects or other systemic health risks that have led to recommendations against use of systemic supplementation. Some investigations also suggest that the consumption of whole grain foods as well as a diet high in fiber intake may also be protective. Studies investigating specific dietary micronutrients in relation to OPC have suggested that vitamin C may be associated with a reduced risk. It is not clear, however, whether these micronutrients are directly responsible for the risk reduction, or whether they are markers for some other responsible factor and the adverse effects seen to date do not allow recommendations for use. Multivitamins have not emerged as protective in terms of OSCC/OPC, and while two case-control studies have suggested that vitamin E supplementation may be protective, it is too early to recommend this supplement to patients. Coffee consumption has been assessed in large population studies, with beneficial effects attributed to plant phenols and antioxidants. Finally, although various potential oral cancer chemopreventive agents have been and are being evaluated for their effectiveness and safety, the use of these agents remains experimental at this time. Although patients and consumers may self-prescribe dietary supplements for prevention of OSCC/OPC, it is up to clinicians to advise patients about the lack of supportive evidence and risks associated with some dietary supplements. Chapter 9 in this book addresses dietary supplementation in greater depth.

Sources for Additional Information

Further information regarding diet and nutrition in relation to OSCC/OPC can be obtained by accessing the websites for the National Cancer Institute and the American Cancer Society (ACS). (​www.​cancer.​org/​docroot/​PED/​content/​PED_​3_​2X_​Recommendations.​asp?​sitearea=​PED; ​www.​cancer.​org/​docroot/​MBC/​MBC_​6_​1_​things_​to_​think_​about.​asp).
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Nov 4, 2015 | Posted by in General Dentistry | Comments Off on Oral Pharyngeal Cancer Epidemiology and Prevention
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