Lessons learned on the importance of oral cancer screening, early detection and treatment – New Dentist Blog


After I completed my oral and maxillofacial surgical procedure residency, I began out as an affiliate in a multi-doctor group apply.  I used to be stuffed with hopes and goals: I attempted to change into a greater dentist and surgeon by repeatedly attending seminars, programs and dental conventions.  I used to be planning on getting married and beginning a household and the opportunity of turning into a apply proprietor.  I wished to cross my board examination. I wished to be taught extra about how insurance coverage firms work. I wished to assist my sufferers to do higher. I had so many objectives to assist create an rebellion profession in years to come back.

Dr. Hung

All types of ideas went by my thoughts as I envisioned my future life. I continually felt a mixture of pleasure and nervousness. I used to be wanting ahead to a probably lengthy and fulfilling profession with the muse that I laid down with years of laborious work.

My story is just not distinctive. In truth, it’s a widespread story shared by many.

As new dentists step out from dental colleges into apply, there are moments that may very well be overwhelming which defaults our focus to tunnel-vision on enamel. It’s of utmost significance that as dentists, we should deal with sufferers as an entire: to carry out the dental examination and a complete head and neck examination. Examine the buccal mucosa, palate, tongue, the ground of mouth, the oropharynx, and examine the neck for asymmetry or induration of lymph nodes. Ask about your affected person’s social historical past and medical historical past. Carry out a biopsy and seek advice from an oral and maxillofacial surgeon early. Two pairs of eyes are higher than one. Many early oral cancers can’t be detected by bare eye, and a few benign lesions have transformational potentials to malignant lesions. Due to this fact, seen lesions ought to be biopsied and monitored carefully.  Malignant lesions require staging and a multidisciplinary method by specialists: oncological surgeons, medical oncologist-radiologists, and different medical specialists. Early detection and referral are prudent.

Dr. Manu Dua

The very last thing that will come to my thoughts as a brand new dentist can be: what if all that’s forward of me is stripped away? What if my very presence not existed? What if all education and laborious work simply evaporated?

All of the unimaginable turned out to be what occurred to a brand new dentist, the late Dr. Manu Dua. Dr. Dua was born within the United Arab Emirates and migrated to Calgary, Canada, together with his mother and father on the age of 13.

He was recognized with squamous carcinoma of the tongue at 33 and sadly handed at 34 in March 2021.  He was not given the prospect to additional contribute to humankind and left many family members heartbroken. Earlier than he left this world, writing turned an outlet. He wrote essays on life, sickness and loss of life through the interval of his sickness with knowledge past his age to make us rethink our priorities. After his loss of life, his essays had been compiled by his sister, Dr. Parul Dua Makkar, right into a e book “Life Interrupted: Dr. Dua’s Survival Information.”

Just lately, I had the chance to interview my buddy Dr. Parul Dua Makkar, a basic dentist training in Lengthy Island, New York, to debate her brother’s quick however unimaginable life journey, philosophies of human life and its fragility.  I wish to share these life classes with you.

Dr. Manu Dua, as a brand new dentist and an entrepreneur with a enterprise background, created a formidable award-winning dental clinic in Calgary inside a short while after graduating from College of British Columbia in Vancouver. Sooner or later, he found an ulcer on the left facet of his tongue. He and his oral surgeon mentioned the lesion, and he was positioned on steroids.

He didn’t have the biopsy achieved till months later as a result of he didn’t belong to the high-risk group. Steroids didn’t give him reduction. Biopsy was lastly carried out when the lesion turned symptomatic and had grown ominous. The biopsy outcome introduced Dr. Dua the prognosis of a stage 2 squamous cell carinoma of tongue, in a person who had no danger elements. He didn’t drink alcohol and was not a tobacco consumer of any form. He was younger and in any other case wholesome on the time of prognosis.

Dr. Parul Dua Makkar

He subsequently underwent hemiglossectomy. Inside a span of eight months, in April 2020, the most cancers recurred. He then had one other surgical procedure and acquired a complete of 33 remedies of radiation and chemotherapy. That is when he made the choice to promote his clinic within the midst of the COVID-19 pandemic in hope to heal and recuperate. Recurrences discovered within the lymph nodes in flip unfold to the lung.  The metastatic lung tumor enlarged 4 instances extra inside a interval of eight months, rendering it inoperable. PET scans confirmed lesions all the way down to pelvic bone. In December 2020, he had pulmonary pleurosis and had a chest port positioned to empty fluid. The fluid buildup made it laborious for him to breathe, to speak and to maneuver. He handed away in March 2021 resulting from metastasis.

Dr. Dua’s loss of life could also be attributed to the delay in prognosis and remedy, as the very last thing for a brand new dentist to come back to thoughts can be to be recognized with oral most cancers: if you consider oral most cancers, the imagery of an older one who smokes and drinks involves thoughts.  He didn’t match the stereotype.  He as soon as helped a feminine affected person to diagnose her oral most cancers and he or she ended up surviving.

Since I used to be the first caretaker of my late father who handed away from prostate most cancers, I used to be instantly taken by the e book “Life Interrupted.”  I didn’t know Dr. Manu Dua when he was alive. Nonetheless, as I learn by the passages, I felt that he was sitting in entrance of me, giving me life classes in essentially the most earnest method, to open my thoughts to views new to me, and to remind me of what I knew however have forgotten. As his life was peeled away layer by layer, he got here into whole peace with the scenario and himself.

Once you understand that there’s a finite time instantly in entrance of you, you achieve new views on life. The toughest factor for Dr. Parul Dua Makkar, Dr. Manu Dua’s sister, was the journey restrictions resulting from COVID-19. She was ready for the PCR testing to come back by earlier than she may journey to Canada when she discovered that her brother went into organ failure and subsequently handed. Dr. Parul Dua Makkar would by no means have her brother choosing her up from the airport once more. Their mother and father won’t ever have their son coming house asking “What’s for dinner?” As somebody who misplaced a father or mother to most cancers, and as a mom of two, I sobbed solemnly. The ache was immense.

From our telephone interview, I wish to share the excerpts of the interview quoting Dr. Parul Dua Makkar, as her messages to all of the dentists:

  • Grief could be very isolating generally. Individuals who haven’t been by it don’t get it.  Generally grief hits like a tsunami that takes my breath away. At instances in silent tears and at instances in completely satisfied recollections.
  • I wish to remind individuals, particularly our youth, that oral most cancers is on the rise. Cancers haven’t any boundaries of age, gender, training, and so on. Take note of the indicators and signs, advocate for ourselves and for our sufferers and the docs to work collectively.
  • As a younger dentist, we’re all going to make errors. That’s why it’s referred to as the apply of dentistry, though all of us don’t know every thing, we’re continually studying.  Getting that license comes with a number of privilege, a number of belief.  So if you find yourself in that chair treating that affected person, your main focus ought to be that affected person and the well-being of that affected person. Take heed to your affected person, speak to your affected person. Take that further couple of minutes to really feel round.  Don’t simply give attention to the tooth, actually give attention to the general care.
  • Be loyal to the job, be true to the job and be true to your sufferers. On the finish of the day, they’re going to go house, they’ve a household to return to.
  • You don’t know every thing. You’ll be able to’t know every thing. You might be studying. It’s the apply of dentistry. So, should you make an error, personal up, be taught and enhance your self.
  • Don’t deal with insurance coverage. Deal with individuals.

Life is gorgeous and life is tough.  To be interrupted is to say the least unfair. Nonetheless, Dr. Manu Dua’s contributions and life classes are great to me on a private degree, and I wish to share his final message from “Life Interrupted” to all of you as self-affirmations.

“One of the vital vital issues that I’ve discovered throughout these turbulent and tough instances is to just accept the lack of management, and proceed to trip the wave day-to-day … I perceive that day by day is a brand new journey, and I give attention to getting by the times having fun with little victories and having full religion that the longer term will unfold because it ought to, and my worries and anxieties are regular however fruitless, and won’t assist me outline a brand new path in life. What’s crucial is interior peace, power, and really believing that there will likely be a greater life on this world or the following.”

Dr. Cathy Hung is an AAOMS Fellow with a solo apply in New Jersey.  She is an alumna of ADA Institute for Range in Management program and an creator, speaker and coach on cultural competency and girls management. Her first e book “Pulling Knowledge: filling the gaps in cross-cultural communication” is at present accessible within the ADA bookstore as a apply administration instrument. She just lately printed her second e book, “Behind Her Scalpel: a sensible information in oral and maxillofacial surgical procedure and tales by feminine surgeons”, an IDL venture in hope to shut the gender hole. She is an authorized skilled life coach of Pulling Knowledge Teaching and Workshops, LLC to assist girls and/or minorities  professionals with struggles to realize confidence and excel within the skilled world. She was acknowledged by Benco Dental as one of many Lucy Hobb’s Venture’s “Girls who encourage” in 2020.

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