Oral cancer and extra-oral examinations

A recent campaign to promote the November 2021 ‘Oral Cancer Action Month’, highlighted the importance of a thorough extra-oral examination in early detection of pathology.¹

A 55-year-old male was called up for a routine dental check-up with the University of Plymouth's Peninsula Dental School. Fifth-year student, and now qualified dentist, Jasleen Batra, examined the patient, and carried out a full extra-oral examination, detecting a palpable lymph node in the right submandibular region. The 2-week urgent referral stated: ‘Submandibular node (suspected) on RHS is hard, fixed and palpable’. Subsequent investigation revealed a squamous cell carcinoma of the right tonsil, and right neck P16 positive (T1N1M0).

With the patient's consent, the story was reported nationally with the patient describing his journey from early detection to treatment, and sharing his opinion that this early detection may have saved his life:

‘I hadn't been in pain at all, but Jasleen found a hard lump under my jaw, which I then felt with my hand. She calmly explained the need for an urgent referral and less than 2 weeks later, I went for an examination and then a biopsy. The consultant informed me that I had malignant and aggressive cancer of the tonsils that had spread to the lymph gland and surroundings.’