News feature: Iceberg ahead!

Just speaking to Nicki Rowlands makes you realise how passionate she is about raising awareness of oral cancer. Perfect 32 dental practice in Beverly, East Yorkshire, has seen the number of cases locally skyrocketing. One of their patients, Jacqui Alland, lost her father to the disease after he underwent intense treatment.

Jacqui explains: ‘Dad suffered horrendous facial disfigurement from his oral cancer, losing his nose, upper jaw and a great portion of his cheeks,’ she continues, ‘By the time it was detected the damage was so debilitating, it had a major impact on the remainder of his life, as well as his family and friends.’

Under the surface
It became clear to Nicki – and the team at Perfect 32 – that some kind of early detection system was needed – ‘once a lesion is visible it generally means the cancer is fairly advanced. Early detection is key with this disease and we wanted to be able to make earlier referrals,’ said Nicki. So, Perfect 32 introduced the Velscope into the practice as an adjunct to the traditional mouth cancer exam.

According to Nicki, ‘The iceberg scenario epitomises the situation.’ She explains that what’s going undetected under the surface is potentially lethal, and that’s where the Velscope comes into play. It is a system which allows the dentist to carry out a mucosal examination using fluorescence, seeing beneath the surface to detect abnormalities which could be missed by a visual exam.

The Velscope costs around £3,500, a small sum in comparison with most dental equipment, and, as she says: ‘It’s worth every penny if we just save one life a year.’ Referrals by the practice are now up by 50%.

Alongside the well-known causes of oral cancer – smoking and alcohol consumption – recent studies show links between the human papilloma virus (HPV) and the disease. This has caused the rate of oral cancer to increase in younger patients – particularly females in their 20s – as it is transmitted by oral sex. So, how does the team at Perfect 32 broach the subject with their patients?

Nicki explains: ‘It is difficult because it is so sensitive and we don’t want to scare people. We have newspaper articles on our notice boards for patients to read as well as the official Velscope leaflets. We only use information from authentic sources or clinical advice from our dentists or the clinical health advisor.

‘People need to know oral cancer is a killer,’ she adds, which is why the practice is holding a free screening day for patients to support the cause.

Screening days
Perfect 32 ran a free oral screening day last year, which proved to be such a success that it spilt over to a second day. This year, the same popularity is anticipated, but they are more prepared. Nicki says it is better planned this year; they have told all of their NHS patients about it, sent leaflets and posters, and mentioned the screening on their appointment slips.

Alongside this, West Hull Community Radio has also helped the Perfect 32 team promote their message, so a large response is expected and the screenings may end up running across three or four days.

Jacqui said: ‘Oral cancer screening is vital and if dad had accessed this service maybe he would not have had to receive such invasive surgery. If the screening prevents just one person having to go through such a terrible experience it is well worth it.’

Patients cannot simply turn up on the day, time slots have to be booked in advance for staff to cope with the numbers. On the extra screening days patients will be offered the exam for half price, Nicki explains: ‘Due to our overheads, we can only afford to run one completely free day, after that it’s half price, which is still a big incentive.’

Perfect 32 is a mixed practice, and offers annual screening to its private patients at a cost of £40, a small price to pay for a potentially life saving examination. However, patients still seem to need that extra push, which is why the free, or half price, screening days are popular.

‘It concerns me that so many people do not understand how essential oral cancer screening is and how valuable it can be in eliminating the horrendous consequences of undetected oral cancers,’ commented Jacqui.

The dentists at Perfect 32 still carry out the traditional mouth cancer exam under normal lighting conditions.

‘This is absolutely essential’ says Nicki, but they combine this with the Velscope for a more thorough screening. Nicki stresses that it is not a diagnostic tool, it is used for detection and patients with abnormalities are referred to the Hull Royal Infirmary for a diagnosis.

The hospital knows that Perfect 32 has a Velscope and so the dentists at the practice have a good working relationship with the consultant there, Martin Cope, and patients are seen within a few weeks.

Essential in avoiding that iceberg.


Nicki Rowlands is happy to offer advice to anyone looking to run their own oral cancer screening days, she can be contacted on 01482 863 667 or at [email protected]


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