Ewan MacKessack-Leitch graduated in 2011 from Dundee Dental School. Ewan is currently a CT2 in Paediatrics at Dundee Dental Hospital.
I wrote the article to spread the word about our campaign and charity. We were set up by the enthusiasm of young dentists and hopefully we will encourage more young dentists to run a project to improve the health and well-being of the public outside the dental surgery. We also hope that a reader may wish to join the campaign and/or support our cause.
Let's Talk About Mouth CancerThis article tells the story of the first year of Let's Talk About Mouth Cancer (SC045100), a Scottish Incorporated Charitable Organisation. Set up by a team of young dentists in Edinburgh the campaign aims to improve the public's awareness of Mouth Cancer and empower them to seek early referral should a suspicious lesion be noted.
Like many good stories this starts with when a boy met a girl and something sparked. However it was not romance that burned but rather the flame of an idea. Niall McGoldrick and Orna Ni Choileain were LDFTs working in Edinburgh when the idea took hold. Armed with this and encouraged by their tutor, Jennifer Harding-Edgar, they approached Ewan MacKessack-Leitch an SHO in the Edinburgh Dental Institute; who in turn brought it to the attention of Stephanie Sammut an StR and Professor Victor Lopes of the Oral Surgery Department. What was the idea that took all them in?
The spark was the joint "Statement on Mouth Cancer Diagnosis and Prevention" from the British Society for Oral Medicine and Cancer Research UK published in October 2013. The idea, fuelled by their undergraduate experiences of a mouth cancer screening programme in Cork Dental School and student run Mouth Cancer Awareness Weeks in Dundee Dental School, was to create an Edinburgh based campaign to raise awareness of the increasing rates of mouth cancer. The campaign group Let's Talk About Mouth Cancer was born.
Once together the group dreamed a little bigger and decided that rather than just raising awareness of this horrible and nasty cancer, instead they should be more proactive and directly involve the public. Furthermore, educating the dental and other healthcare professionals, would be essential to help reach the aim of improving mouth cancer prognosis by early detection.
The first event was on 11-13th February 2014, in a marquee in Bristo Square at the heart of the University of Edinburgh campus. This 3 day mouth cancer screening and public awareness campaign was supported by NHS Lothian, the Minority Ethnic Health Inclusion Service (MEHIS), the University of Edinburgh and the Department of Oral Surgery from the Edinburgh Dental Institute. Over 600 members of the public engaged directly with the campaign and in total 455 people were screened - a rate of 1 person screened every 1 minute 20 seconds. In the evenings free CPD lectures emphasising the importance of prevention and early detection of mouth cancer were delivered to 105 local dental professionals by Professor Victor Lopes, Consultant Oral & Maxillofacial Surgeon. The campaign was hugely successful and was featured on the STV 6pm News, BBC Radio Scotland and in articles in the Scotsman, Herald, Courier and BBC News Website.
Following this success a further two events were held in 2014. A smaller mouth cancer screening and awareness stall at the Edinburgh Canal Festival where 117 people were screened in an afternoon - all in the back of a gazebo! Then a 24 hour screening and awareness marquee on the Meadows on the weekend 9/10th August during the Edinburgh Festival which was coupled with a simultaneous 24 hour fundraising tandem bicycle ride. This time 155 people were screened and the sun shone for most of the 24 hours.
The events of the first year were only possible thanks to the support of the Ben Walton Trust (SC024990), Dental Protection and other dental sector sponsors who helped to fund the costs; and the contribution of many volunteers from the EDI including the undergraduate Hygiene/Therapy students.
These campaigns won Orna & Niall the NHS Lothian Celebrating Success Awards Voluntary Service Award 2014, but this was only the beginning. In September 2015 the group gained charitable status (SC045100) and planned the next moves to further their now official aims:
- to improve the prognosis of a patient diagnosed with mouth cancer through early detection;
- to support research into improving diagnostic tools;
- to raise awareness of mouth cancer amongst the general public;
- to share knowledge and good practice amongst healthcare professionals;
Mouth Cancer screening in itself is not effective at improving early detection or prognosis. The screening performed was not just a clinical check but was used as an educational intervention to teach the participant signs, symptoms and risk factors for mouth cancer. Evolving this and trying to make it more sustainable the charity's focus changed. To remove the paternalistic element and to empower the public instead, oral self-examination for mouth cancer is now taught.
Utilising more technology this year on 10-12th March the Let's Talk About Mouth Cancer marquee returned to Bristo Square. The layout was different, there were no no "clinical" areas, instead three zones which mapped the patient's empowerment journey [See text box]: on entering the marquee a short survey to assess knowledge of mouth cancer was completed; then in the Info Zone where there were models, leaflets and interactive iPad demonstrations of the risk factors, signs & symptoms and facts about mouth cancer were discovered; the final part of the journey was to be guided through an oral self-examination at the specially constructed Mirror Zone. Follow-up questionnaires will be sent to those who took part to see if this intervention has heightened awareness of mouth cancer and if they have subsequently self-examined. The survey was completed by 304 people and these, plus a good number of others, took part either in self-examination demonstrations or came to find out more about mouth cancer.
On two evenings a free CPD lecture "Empowerment in Mouth Cancer: Your Patient, from Diagnosis to Rehabilitation" was delivered to 114 dental and healthcare professionals. This session was delivered by 4 speakers who each had a different perspective of the mouth cancer treatment journey: an Oral & Maxillofacial Consultant, a Mouth Cancer patient, a Head & Neck Cancer Nurse and a Restorative dentist. The feedback was very positive from those who attended especially the interview of the patient.
The March event cost over £3500 and was only possible thanks to support from dental sector sponsors, donations and a £2500 bursary won by Orna & Niall from Association of Dental Groups' award for the "best voluntary scheme to promote and deliver improvements in oral health 2015." Again volunteers from the School of Hygiene and Therapy and dental CTs were essential to the success [FIG 7].
Between events, Let's Talk About Mouth Cancer continue the work raising the profile of mouth cancer and its early detection online. A dedicated website, Facebook page [Fig 8], Twitter feed and YouTube channel provide information and references for the public and health professionals to use. Recently videos demonstrating how to perform professional head & neck and oral self-examinations have been released. In 4 months the videos have been viewed over 5000 times.
Looking to the future, the charity is an intellectual partner for the Global Oral Cancer Forum and hopes to spread the idea of teaching self-examination and learn from other groups around the world. More public awareness events and CPD lectures are planned as is research into the efficacy of these.
This story doesn't end here, this is only the beginning. Hopefully the charity will continue to grow; the profession and public will talk about mouth cancer; and detection and prognosis will improve.
Ewan MacKessack-Leitch
[email protected]