Challenges in the Management of Oral Cancers: An Audit of Cases Treated in a Teaching Hospital North-West Nigeria

Abstract

Background: Oral cancer is a disease in which malignant cells form in the mouth.  It is a subset of head and neck cancer. The effective management of these cancers has been a challenge to the clinician due to high mortality rate that result from these tumours. Despite several approaches to its treatments, the prognosis has been poor.

Objectives: To evaluate various challenges encountered in the management of oral cancers in our Centre

Materials and Methods: This study was retrospective in design. We audited patients with oral cavity malignancies that presented in the Maxillofacial Unit of Barau Dikko Teaching Hospital, Kaduna, from January, 2009 to July 2022. Information was collected from patients’ record which includes: age, gender, site of occurrence, duration of the tumour, treatment giving, recurrence rate, challenges in the management and prognosis.

Results: One hundred and sixty-three patients were included in the study. The mean age was 37.64 years and males were more affected than females in the ratio of 2.32: 1.51. The mandible was the site most affected (n=52, 31.90%), then maxillae (n=40, 24.54%), tongue (n=28, 17.19%), cheek (n=15, 9.20%), Gingivae (n=10, 6.14%), floor of the mouth (n=8, 4.90%), lip (n=7, 4.29%) and least affected oropharynx (n=3, 1.84%).  Late presentation in the hospital, ignorance of the nature of the tumour by the patient, cultural belief that cancer cannot be treated, high cost of treatments, poverty, and tumour recurrence were our challenges.

 Conclusion: The challenges in the management of oral cancers can be mitigated by creating awareness among the people on how to detect early onset of the cancer and various preventive measures such as avoidance of tobacco and alcohol use. There is need for urgent establishment of more cancer treatment centers in the North western part of Nigeria where access to treatment at an affordable fee will be possible. The accurate mortality rate of these oral cancers cannot be determined in this study because many patients that were treated refused to come for review appointments.