Squamous cell carcinomas of the head and neck

Editor—I had hoped to see a mention of the need for oral care for patients with cancer in the review article by Sanderson et al on squamous cell carcinomas of the head and neck, but I was again disappointed.1 Patients with head and neck cancers must receive a dental assessment and oral care before and after their treatment to ensure minimisation of oral complications for an improved quality of life. The clinical guidelines published by the Royal College of Surgeons of England in 2000 state that a clear pathway of care is necessary to prevent or minimise oral complications.2 However, many patients with cancer still receive no proper dental assessment or preventive treatment to minimise or avert the known and common oral complications of radiation treatment. This may be due, in part, to the lack of resources and recognised local standards of dental care for such patients, as well as to lack of information and apathy. The Restorative Dentistry Oncology website (www.rdoc.org.uk) was created to increase awareness of the oral complications of cancer treatments and to help patients, dentists, and doctors to find free information on oral cancer easily. The website includes first hand accounts of patients' experiences. A discussion forum offers patients, carers, and interested members of the public the opportunity to ask questions, help others, share ideas and opinions, and learn about other people's experiences in dealing with head and neck cancers. The guides for patients and professionals link to other websites dealing with basic aspects of oral cancer such as treatment and complications. Links cover other concerns that doctors rarely address but that are just as important, such as the financial implications of cancer, financial planning and support, and personal care and support. A section on tobacco risks includes links on the connection between chewing Gutkha or paan and developing mouth cancer. Although this is mainly a problem on the Indian subcontinent, the United Kingdom has a sizeable immigrant population that continues with these habits. Other sections cover treatment, complications, and spiritual help. A daily dental cartoon helps to bring humour. I hope that doctors will find the website useful and recommend it to patients and their carers should they ask for information. Oral care for patients with cancer needs more than lip service.