Mouth cancer

Citation

(2006), "Mouth cancer", Health Education, Vol. 106 No. 2. https://doi.org/10.1108/he.2006.142106bag.001

Mouth cancer

In the UK mouth cancer is on the increase, over 25 per cent in the past ten years. The two primary contributing factors are smoking and drinking alcohol, and while smoking is showing a steady decline, the consumption of alcohol is increasing. With the advent of 24-hour licensing laws it has been predicted that alcohol consumption will rise by at least 10 per cent and with it mouth cancers can also be expected to increase. Among the many cancers that the media focuses on, mouth cancer is not one that readily springs to mind, which is a pity because it is also one of the deadliest. In the UK mouth cancer kills more people than cervical cancer and testicular cancer put together. It is also a pity because 75 per cent of mouth cancer cases are preventable by simple changes in lifestyle, in particular not smoking and only drinking alcohol in moderation. Can the internet be used to get this message across? In this review we look at the web sites that attempt to do just that.

Open Up to Mouth Cancerhttp://info.cancerresearchuk.org/healthyliving/openuptomouthcancer/

This is a relatively new web site launched by Cancer Research UK in November 2005. The home page presents the user with six areas of interest including background to the mouth cancer campaign, warning signs, and information aimed at doctors and health education professionals. The link to Warning Signs provides the user with a single page of information that briefly describes the main warning signs to look for, ulcers in the mouth, red or white patches, or unexplained pain in the mouth or neck. Unfortunately there are no illustrations of these signs, which would have been useful. The only picture used is of a rather elderly man, which, probably inadvertently, suggests that mouth cancer is only really something elderly males need bother about. It is true that mouth cancer is more common in men over 50, but it is becoming more prevalent in young men as well. Replacing this picture with something more relevant would be an improvement. What is useful on this page are the links to information on healthy living, in particular alcohol use, smoking and healthy eating.

For many people who do develop mouth cancer, there is a good chance that it might be first noticed during a trip to the dentist. But what about those people who have a real fear of the dentist? This is acknowledged by this web site and a section on how to deal with this fear is included. As well as providing useful tips and advice there are also links to other agencies that can offer help – e.g. www.beyondfear.org.uk/group/default.asp – an organisation that helps people suffering from dental anxiety.

The information for health professionals is excellent and includes leaflets that can be downloaded for patients as well as some very good photographs to help GPs, dentists and practice nurses identify the symptoms of mouth cancer. For professionals involved in health promotion there is a section of this web site devoted to campaigning. There are leaflets, posters, information sheets, and other resources that can all be freely downloaded.

Overall, for both the lay public, and for health professionals, this web site is an excellent source of information on mouth cancer.

The Mouth Cancer Foundationwww.rdoc.org.uk/

The Mouth Cancer Foundation is a registered charity and is an initiative of the Restorative Dentistry Oncology Clinic. Although this is a UK-based charity, the design of the web site is more in keeping with those we find from the USA, with sponsors’ logos, online donations, and advertising all dominating the web site. There is undoubtedly a great deal of information available from this web site, so much in fact that the home page is somewhat daunting. The basic facts about mouth cancer are found on the homepage but what makes this web site different from the previous is the content provided by sufferers themselves. Three people are featured in the donations sections, usually because of their excellent achievements in fundraising. There are also lots of case studies provided by people who have had to face the challenge of mouth cancer. These are frank accounts of how the disease was first recognized, the treatment and the outcomes, sometimes happy sometimes not. For the most part these stories are very positive and would be a great source of support for people who have recently been diagnosed with mouth cancer. Aligned to the case histories is a message board that includes survivor stories, questions about different forms of treatment, helpful tips and even a little light humour.

For health education professionals the web site has a very informative section on oral cancer and leaflets provided by the Cancer Research Fund and which can be downloaded for free.

If the details of mouth cancer and some of the tragic case studies all become a little too much, there is even a Dental Cartoon section to cheer you up.

So don’t be put off by the “in your face” homepage – take time to explore the contents in detail and you will be sure to find something of value.

The British Dental Foundationwww.dentalhealth.org.uk/mouth/

This is the web site of the British Dental Foundation, and organizes its content in terms of Public, Press and Profession. The content dealing with mouth cancer can be found in the Public section. The homepage provides details of mouth cancer and links take the user to pages dealing with prevention and other issues. Here we find amongst other things that men who drink more than 3-4 units of alcohol per day are up to 30 times more likely to develop mouth cancer (if you are unsure how many units you are consuming, try out the handy calculator that can be found at: www.nhsdirect.nhs.uk/interactivetools/alcohol/default.asp).

Another interesting feature of the content provided by this web site is the cultural dimension to mouth cancer. Some of the biggest users of tobacco products are found in ethnic minorities; for example, Bangladeshis consume more chewing tobacco than other groups, and 35 per cent of Caribbean men smoke compared with 27 per cent of the general population. In Asian communities tobacco is often added to other products, e.g. betel quid (areca nut and slaked lime) and the mixture is often held in the mouth for hours at a time. Indeed, in some cases, it is even kept in the mouth overnight! That this might constitute a significant health risk is often not appreciated within these communities, and the web site advocates the use of tailored health promotion initiatives in this respect.

This web site has a particularly wide selection of materials that can be downloaded or ordered online from the web site shop. These include books, CDs and videos, motivators and other oral health education materials. Although many of these products have to be purchased, significant discounts are available to people who become members of the Dental Health Foundation. The free materials that can be downloaded include case studies, posters, and reports on the facts and figures of mouth cancer.

This is an excellent web site not only for those with an interest in mouth cancer, but also for professionals involved in oral health education more generally.

Cancer Webhttp://cancerweb.ncl.ac.uk/cancernet/202840.html

For an example of how not to do it, look no further than this web site! Cancer Web is hosted by the National Cancer Institute, which is part of the US National Institutes for Health, the body that oversees health research in the USA. The web site looks like it was designed when the internet was in its infancy and it hasn’t been updated since! There is nothing wrong with the content but the design and presentation is minimalist to say the least. The web site is wholly text-based with a list of links at the beginning of the document. What is not clear is who this web site is aimed at. Certainly lay users will find more accessible information elsewhere on the web and shouldn’t waste their time here. The content may be of some use to doctors and nurses who have only limited experience with mouth cancer since it is presented in a form that almost resembles revision notes. Even if this is the target audience, the authors of this web site need to revise and update it – indeed it needs a thorough makeover.

NHS Directwww.nhsdirect.nhs.uk/he.asp?articleID=80&LinkID=5838

For many people seeking health education information, NHS Direct may well be their first port of call, but I wouldn’t bother. This web site is only slightly better than Cancer Web, basically a series of online leaflets providing a bare minimum of information. For a lot of users this may be all they will need, but it can be found in far more accessible formats at any of the first three web sites reviewed above. This web site has little or no interactivity, no resources for download, nothing to excite or enthuse the user. Although obviously aimed at lay people rather than professionals, the content and overall design are hardly inspiring and most users would be advised to move on to the links page as quickly as possible where they will be able to escape this dire web site for something far more interesting.