What is Adjunctive Oral Cancer Screening?

What Exactly is Adjunctive Oral Cancer Screening?

With the rise of oral cancer cases in North America, largely attributed to a strain of the human papillomavirus (HPV), oral cancer screening is more important than ever before. In fact, the American Dental Association recommends a visual and tactile comprehensive oral examination (COE) to be routinely performed to support early discovery and diagnosis of oral cancer and/or pre-cancer in patients of dental practices[1]. This visual and tactile examination is the absolute minimum dental practices should do for their patients concerning oral cancer screening. Adjunctive oral cancer screening technologies are used in conjunction with the COE to help detect abnormalities and provide additional information to be utilized in the clinical decision-making process.

The Purpose of Adjunctive Oral Cancer Screening

It is essential to understand that adjunctive screening should never be performed without a thorough physical examination of the oral cavity under white light accompanied with a tactile assessment of the head, neck and oral cavity.

The majority of adjunctive screening methodologies are non-diagnostic, meaning they will not give a positive or negative result in relation to whether a patient has oral cancer. Because oral cancer can often go unnoticed to the naked eye, many adjunctive technologies aim to enhance the visualization of these areas of concern so that they will be more noticeable and, hopefully, reduce the likelihood that abnormal mucosa is overlooked. The information provided by adjunctive screening together with the information from the COE is then used to contribute to the clinician’s decision-making process for referring patients to a specialist for biopsy.

Types of Adjunctive Oral Cancer Screenings Technologies

There are several different adjunctive screening technologies that can be utilized to aid in visualizing oral abnormalities, including:

  • Vital tissue staining
  • Chemiluminescence
  • Autofluorescence
  • Cytopathology

Vital Tissue Staining 

Vital tissue staining utilizes a chemical called Toluidine Blue (ToB), which is a dye that is absorbed by unhealthy mucosa, giving areas of concern a dark blue color. These dark areas are then considered to be areas of concern that warrant further investigation.

Chemiluminescence 

Chemiluminescence, marketed under the brand Vizilite, is considered the first adjunctive device for oral screening that hit the market around 15 years ago. This technology combines application of an acetic acid solution with the use of a blue-white light to help identify abnormal mucosa. The acetic acid solution is swished in the mouth for 1-2 minutes, dehydrating the mucosa to accentuate keratinized tissue. A chemiluminescent light is then utilized to accentuate oral mucosal abnormalities.

Autofluorescence 

Autofluorescence relies on the use of specific wavelengths of light interacting with fluorophores that are naturally present in most human tissues. When exposed to certain light wavelengths, fluorophores become excited and re-emit light of varying colors. Abnormal mucosa impacts the spectral properties of the tissue, allowing detection through special optical filters. The VELscope is an example of an autofluorescence technology, in addition to the Vizilite Pro and Oral ID systems.

Cytopathology

Another adjunct to the traditional COE is cytopathology, which involves the collection of cells from a suspected lesion and viewing them under a microscope to inspect for abnormalities. One example of a cytopathology system is the Oral CDx Brush Test, which uses a special brush to remove cells from a suspected lesion which are then sent to a lab for microscopic review.

Role of Biopsy

Biopsy is the gold-standard for histopathologic diagnosis of lesions . It involves physical sampling of the suspect tissue, samples of which are then examined by a pathologist under a microscope who produces the histopathologic diagnosis.  This diagnosis and consideration of patient history is then used to plan appropriate treatment for the patient.

Effectiveness of Adjunctive Screening Technologies

The COE is certainly aided by the incorporation of adjunctive technologies with regard to identifying oral mucosal abnormalities. While the COE is often efficient in locating areas of concern that are obvious to the naked eye, there is increased difficulty observing less obvious lesions or abnormalities. The addition of an adjunctive technology helps make visualization of abnormal tissues more apparent.

A study in the Journal of the American Dental Association[2] argues that the comprehensive visual and tactile examination performs poorly in locating oral squamous cell carcinomas in their earliest stages, where treatment and outcomes are more favorable. The researchers conclude that the comprehensive oral examination could be improved with the implementation of adjunctive technologies, which can subsequently contribute to the visualization of dysplastic lesions.

Again, neither the COE nor adjunctive screening technologies provide a definitive diagnosis as to the exact nature of the abnormality but can assist in providing information that can be utilized in the referral decision-making process.

So What is Adjunctive Oral Cancer Screening?

To conclude, adjunctive oral screening is an additional process that provides supplemental information to be used in conjunction with a COE. Adjunctive technologies can also help ensure that areas of concern do not go unnoticed and are visualized in early stages. By taking a holistic view of all information obtained through acquisition of patient medical history, the COE and adjunctive screening, clinicians can make more informed decisions regarding patient referral and treatment.

Want to learn more about oral screening and adjunctive technologies, including the VELscope? Contact our team below or give us a call at 877.278.3799.

1https://www.ada.org/en/member-center/oral-health-topics/cancer-head-and-neck

2 Epstein, et al. The limitations of the clinical oral examination in detecting dysplastic oral lesions and oral squamous cell carcinoma. JADA. 2012; 143. 1332-1342

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How Do I Know if It’s Oral Cancer? 5 Simple Steps

The headline news in today’s world is daunting to say the least. “The Startling Rise in Oral Cancer in Men”, “Oral Cancer Rates Rise by Two-Thirds”, “What’s Behind the Huge Rise in Oral Cancers?’ just to quote a few. What if we do find something unusual or different inside our mouth? How do I know if it’s oral cancer?

  1. The finding resolves on its own.  First rule of thumb is persistence. Anything unusual that persists beyond 14 days should always be investigated. A trip to your dentist to further evaluate a finding is critical. At that time the dentist may be able to identify the cause or may choose to evaluate further through the means of a small sampling of tissue or a biopsy. Either way, this needs to be addressed. Don’t wait!
  2. The finding is on both sides of the mouth. If the identifying lesion is present on both sides of the mouth, it is most likely part of the normal anatomical makeup. Asymmetry or presence on only one side raises more of a concern.
  3. The finding is initiated by trauma. An unusual finding may be caused by trauma; something as simple as biting your cheek or burning the palatal tissue with a slice of hot pizza can bring an area of the mouth to our attention. Again something of this nature should resolve within 7 – 10 days on its own and if it persists for more than 14 days, seek further evaluation.   
  4. The finding recurs and subsequently resolves on its own. A recurring sore that repeatedly resolves on its own is most likely initiated by trauma, stress or sometimes dietary aspects and is referred to as an aphthous ulcer or canker sore.  Typically a canker sore will last 7 – 10 days with the acute pain occurring when the lesion ulcerates. This happens in the middle of the duration of the canker sore and usually lasts 3 – 4 days.   
  5. The finding accompanies an illness and resolves on its own. There are a number of different illnesses that are accompanied by oral lesions or sores that may be found throughout the mouth. Typically the patient is experiencing general malaise, fever and would be directed to see a physician. The lesions once again resolve on their own.

Chances are if a finding meets the criteria above it is not oral cancer however there is only one way to know for sure and that is through further professional investigation. 

The point here is that in today’s world with oral, tonsillar and throat cancer on the rise, it is prudent to be knowledgeable and aware. Self examination between dental visits is vitally important as it allows for earlier discovery of anything abnormal. An oral cancer screening examination which includes checking the lymph nodes of the neck should be done on an annual basis.

Additional screening with a device such as VELscope which enables the dentist or dental hygienist to see beneath the surface where abnormal cells begin to develop provides an enhanced opportunity to again discover oral cancer in its earliest possible stage. To find a practice near you that offers the VELscope Vx examination, visit our Find a Practice Tool and enter your postal or zip code.   

Author: Jo-Anne Jones

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Is the COE Part of Your Routine?

The conventional intra and extra oral head and neck examination is taught in dental and hygiene schools to screen patients for oral cancer and other oral mucosal disease. It normally consists of a visual inspection of oral tissue, or oral mucosa, under incandescent or halogen light using the naked eye to look for suspicious lesions, as well as extra oral palpation of the face and neck to feel for suspicious lumps and intra oral palpation of the mucosa.

So why is it important? A 3-4 minute visual and palpation exam is crucial in the early detection of oral diseases. It is quick to perform, painless for the patient, and enhances the patient experience with the dental practice.

According to the Oral Cancer Foundation nearly 42,000 Americans will be diagnosed with oral or pharyngeal cancer this year. The percentage of oral cancer patients who ultimately die of the disease is higher than that of many other cancers. The key to reducing the number of lives lost to oral cancer is earlier detection of the disease, and the key to earlier detection is more frequent and more thorough intra and extra oral head and neck exams. Currently, the majority of oral cancers are detected in the later stages, when the five-year survival rate is only about 50 percent. What’s the good news? When discovered early, the survival rate leaps to around 82 percent.

There is a growing body of research available on the importance of the Clinical Oral Exam (COE) and the increased demand for comprehensive COE’s. The results from a recent independent survey have indicated that the majority of patients say they have never had an oral cancer exam. A recent UK survey found that “92% percent of respondents would like their Dentist to tell them if they were being screened for signs of oral cancer and 97% would like help from their Dentists to reduce their risk.” (1)

The take away from this study is that the majority of people are in favor of COE’s and place value in the dental health professional being involved in the oral cancer screening process. Learn how you can improve your COE. Stay ahead of the curve by screening for oral disease and oral cancer using an adjunctive device and help patient outcomes through early detection.

(1)   Oluwatunmise Awojobi*, Suzanne E Scott and Tim Newton, ‘Patients’ Perceptions of Oral Cancer Screening in Dental Practice: a Cross-sectional Study’, (BMC Oral Health 2012), http://www.biomedcentral.com/1472-6831/12/55

 * Tissue Fluorescence Image Courtesy of Dr. Samson Ng.

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Early Detection Can Equal Higher Survival Rates

It is a disease that we give very little thought to, but oral cancer continues to be prevalent with approximately 42,000 Americans being diagnosed with oral cancer or oral pharyngeal cancer this year. It will cause over 8,000 deaths, killing roughly 1 person every hour. Of those 42,000 newly diagnosed individuals, only slightly more than half will be alive in 5 years (Approximately 57%). This is a number which has not significantly improved in decades. Increasing oral cancer screenings can decrease the mortality rates from oral cancer. Early Detection is the key to better treatment, better outcomes and higher survival rates.

With early detection and timely treatment, deaths from oral cancer could be dramatically reduced. The 5-year survival rate for those with localized disease at diagnosis is 83 percent compared with only 32 percent for those whose cancer has spread to other parts of the body. It is important to open this discussion with patients and even if it’s not causing any pain, any discoloration, swelling, spots, ulcers or lumps that have been there for longer than two weeks should be checked out more thoroughly.

Oral cancer does not discriminate and an oral or oropharyngeal cancer can appear anywhere throughout the oral cavity, including the lips, the lining of the mouth, both under and on top of the tongue, in the back of the throat, tonsils, roof of the mouth and also within the gums, including the area behind the wisdom teeth. Regular screening and thorough documentation performs a key role in the early stages of detection and diagnosis.

The death rate from this type of cancer is high because it is often discovered late in its development, generally when it has spread to another location like the lymph nodes of the neck. At this stage the prognosis can be significantly worse. The good news is oral cancer can be readily diagnosed. In many cases cancer screening can be invasive, but unlike other forms of cancer, the oral cancer screening process is much easier and less invasive. With a comprehensive COE and good documentation it is easy to be diligent about any “area of concern” in the oral cavity.

The healthcare professional best positioned to screen for oral disease and cancer, are dentists and/or dental hygienists. Incorporating the COE into the routine dental visit seems to be the most effective way to tackle the early detection of oral disease and oral cancer. Nurse Practitioners, Physician Assistants, Primary Care or Family Physicians, Urgent Care Physicians, Otolaryngologists (ENT), Head and Neck Surgeon and Gastroenterologists are also professionals engaging in the fight against oral cancer. Make the COE discussion part of the patient relationship, it’s a great way to show that we as health care professionals truly care about our patients.

[1] National Institute of Dental and Craniofacial Research ‘Detecting Oral Cancer: A Guide for Health Care   Professionals’, (nidcr.nih.gov, Bethesda, MD), http://www.nidcr.nih.gov/oralhealth/topics/oralcancer/detectingoralcancer.htm


Dr. John Roberson
 is  a committed professional when it comes to early detection of oral mucosal disease and oral cancer. He is an award winning Board Certified Oral & Maxillofacial Surgeon, and also has Board Certification from the National Dental Board of Anesthesiology.  He is a member of the American Association of Oral & Maxillofacial Surgeons, American College of Oral & Maxillofacial Surgeons, American Dental Association, Mississippi Dental Association, and the South Mississippi Dental Association. Learn more about his practice and dedication at www.drjohnroberson.com

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Clinical Study Concludes That VELscope™ Technology Improves Clinical Decision Making

Independent clinical study by seven researchers from the University of British Columbia, British Columbia Cancer Agency and Simon Fraser University, is the latest report to document the benefits of adjunctive oral examination technology. The lead researcher for the study was Denise M. Laronde RDH MSc, of the Department of Oral Biological and Medical Sciences, Faculty of Dentistry, at the University of British Columbia. The study concluded that integrating fluorescence visualization technology, as delivered by the VELscope® Vx, significantly improves the protocol for screening, assessing and reassessing oral lesions.

The goal of the study was to determine whether the VELscope’s fluorescence visualization (FV) technology added any value to the traditional intraoral and extraoral examination for oral cancer screening. The researchers’ questions were focused on whether positive FV results were associated with persisting lesions detected through a step-by-step procedure that included both a conventional oral examination and an adjunctive examination using VELscope® Vx technology.  The study concluded the following:  “A protocol for screening (assess risk, reassess, and refer) is recommended for the screening of abnormal intraoral lesions. Integrating FV into a process of assessing and reassessing lesions significantly improved this model.”(1)

The full article, “Influence of Fluorescence on Screening Decisions for Oral Mucosal Lesions in Community Dental Practices,” was published in the Journal of Oral Pathology & Medicine and is also available through the LED Dental website by visiting the Downloads Center.

Peter Whitehead, founder of LED Medical Diagnostics and its subsidiary, LED Dental is encouraged by the study, “Many clinicians are unaware of the significant benefits that the adjunctive use of VELscope™ can bring to the table. It is nice to see independent confirmation that the use of VELscope™ technology not only enhances early detection but also supports clinical decision making as well.”

(1)   DM Laronde, PM Williams, TG Hislop, C Poh, S Ng, C Bajdik, L Zhang, C Macaulay, MP Rosin, Influence of fluorescence on screening decisions for oral mucosal lesions in community dental practices, (Vancouver, Canada, University of British Columbia, September, 2013)

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Increases in HPV-linked cancers in parts of US with high smoking rates

A new paper in JNCI Cancer Spectrum, published by Oxford University Press, finds increases in both men and women for several HPV-related cancers in low-income counties or those with high smoking rates. Increases were slower in the highest-income US counties or those with low smoking rates.

In the era of collective decline in cancer rates, human papillomavirus (HPV)-associated anal, oropharyngeal, and vulvar cancer is still rising. Risk factors for HPV-associated cancers include smoking and risky sexual activities, both behaviors likely more common in poorer parts of the United States.

Researchers here used the Surveillance, Epidemiology, and End Results database, a National Cancer Institute database that provides nationwide information on cancer statistics, to investigate HPV-associated cancers by US county-level income and smoking prevalence between 2000 and 2018.

They found that anal and vulvar cancer among women and anal cancer incidence among men increased significantly in the lowest-income counties and counties with high smoking rates, while the increases were slower in their counterparts.

Cervical cancer incidence plateaued, rising not at all in the highest income counties, but increasing 1.6% a year in the lowest income counties. Oropharyngeal cancer rates among women increased by 1.3% a year in low-income counties and only by .1% in high-income areas. Anal cancer rates among women increased by 3.2% in low-income counties but by only 2.6% in high-income areas. For vulvar cancer, rates increased 1.9% a year in the lowest-income counties but only vs. 0.8% a year in the highest-income counties. Vaginal cancer rates increased by 2% a year in low-income counties and declined by .3% in wealthier areas.

Among men, oropharyngeal cancer rates increased by 2.1% a year in low-income counties and by 1.7% per year in high-income counties. Anal cancer rates increased by 3.9% in low-income areas but increased by only 1.5% in high-income counties.

Counties with high smoking prevalence, which are also often low-income counties, had marked increases in cancer rates compared to their counterparts. Anal cancer among women increased by 5% a year for those living in high-smoking counties and only 1.9% a year for those living in lower smoking-rate counties. Vulvar cancer increased by 3.8% a year a year for those living in high-smoking counties and only .6% for those living in lower smoking-rate counties.

Oropharyngeal cancer rates among men increased by 2.7% a year in high-smoking areas, but only by 1.5% in low-smoking counties. Anal cancer incidence rates among men increased by 4.4% in high smoking-rate counties, but only by 1.2% in lower smoking-rate counties.

“HPV vaccination and cervical cancer screening are the cornerstone interventions to prevent avoidable suffering caused by six cancers,” said the study’s senior investigator, Ashish Deshmukh. “Unfortunately, cervical cancer screening rates declined in recent years and HPV vaccination rates remains 15% points lower in rural low-income counties. The COVID-19 pandemic has further disrupted the delivery of preventative care. Urgent and collective efforts are needed to prevent growing disparities from worsening.”

The paper, “Trends in the Incidence of Human Papillomavirus-Associated Cancers by County-Level Income and Smoking Prevalence in the United States, 2000-2018,” is available (at midnight on March 3, 2022) at https://academic.oup.com/jncics/article-lookup/doi/10.1093/jncics/pkac004.

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Increases in HPV-linked cancers in parts of US with high smoking rates

A new paper in JNCI Cancer Spectrum, published by Oxford University Press, finds increases in both men and women for several HPV-related cancers in low-income counties or those with high smoking rates. Increases were slower in the highest-income US counties or those with low smoking rates.

In the era of collective decline in cancer rates, human papillomavirus (HPV)-associated anal, oropharyngeal, and vulvar cancer is still rising. Risk factors for HPV-associated cancers include smoking and risky sexual activities, both behaviors likely more common in poorer parts of the United States.

Researchers here used the Surveillance, Epidemiology, and End Results database, a National Cancer Institute database that provides nationwide information on cancer statistics, to investigate HPV-associated cancers by US county-level income and smoking prevalence between 2000 and 2018.

They found that anal and vulvar cancer among women and anal cancer incidence among men increased significantly in the lowest-income counties and counties with high smoking rates, while the increases were slower in their counterparts.

Cervical cancer incidence plateaued, rising not at all in the highest income counties, but increasing 1.6% a year in the lowest income counties. Oropharyngeal cancer rates among women increased by 1.3% a year in low-income counties and only by .1% in high-income areas. Anal cancer rates among women increased by 3.2% in low-income counties but by only 2.6% in high-income areas. For vulvar cancer, rates increased 1.9% a year in the lowest-income counties but only vs. 0.8% a year in the highest-income counties. Vaginal cancer rates increased by 2% a year in low-income counties and declined by .3% in wealthier areas.

Among men, oropharyngeal cancer rates increased by 2.1% a year in low-income counties and by 1.7% per year in high-income counties. Anal cancer rates increased by 3.9% in low-income areas but increased by only 1.5% in high-income counties.

Counties with high smoking prevalence, which are also often low-income counties, had marked increases in cancer rates compared to their counterparts. Anal cancer among women increased by 5% a year for those living in high-smoking counties and only 1.9% a year for those living in lower smoking-rate counties. Vulvar cancer increased by 3.8% a year a year for those living in high-smoking counties and only .6% for those living in lower smoking-rate counties.

Oropharyngeal cancer rates among men increased by 2.7% a year in high-smoking areas, but only by 1.5% in low-smoking counties. Anal cancer incidence rates among men increased by 4.4% in high smoking-rate counties, but only by 1.2% in lower smoking-rate counties.

“HPV vaccination and cervical cancer screening are the cornerstone interventions to prevent avoidable suffering caused by six cancers,” said the study’s senior investigator, Ashish Deshmukh. “Unfortunately, cervical cancer screening rates declined in recent years and HPV vaccination rates remains 15% points lower in rural low-income counties. The COVID-19 pandemic has further disrupted the delivery of preventative care. Urgent and collective efforts are needed to prevent growing disparities from worsening.”

The paper, “Trends in the Incidence of Human Papillomavirus-Associated Cancers by County-Level Income and Smoking Prevalence in the United States, 2000-2018,” is available (at midnight on March 3, 2022) at https://academic.oup.com/jncics/article-lookup/doi/10.1093/jncics/pkac004.

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Biggest Misconceptions about HPV

Every year, around 3,000 new cases of cervical cancer are reported in the UK. Despite approximately 99.8 per cent of cases being preventable, there are still many misconceptions surrounding cervical cancer. Human papillomavirus (HPV) is the cause of the majority of cases of cervical cancer. HPV is a group of viruses that are spread during sexual activity, some of which do not cause any noticeable symptoms, the NHS explains.

Due to the way in which HPV is spread, some believe that it is similar to other sexually transmitted infections.

However, considering the fact that most women are likely to get HPV at some point in their lives and that it cannot be fully prevented, this isn’t necessarily the case. On Thursday, a new study found that the HPV vaccine cuts cervical cancer by almost 90 per cent. Rebecca Shoosmith, head of support services at Jo’s Cervical Cancer Trust, has spoken with The Independent to help dispel 11 of the biggest misconceptions that continue to perpetuate conversations about HPV.

1. Only women get HPV

While cervical cancer is seen as a cancer that affects women, as it can afflict any person with a cervix, HPV can affect anybody.

The majority people are likely to contract HPV in their lifetime if they are sexually active “regardless of gender”, Ms Shoosmith explains.

“HPV doesn’t discriminate!” she adds.

2. HPV is rare

Because HPV is known as the primary cause of cervical cancer, this may lead to the assumption that it is only contracted by a small number of people.

“HPV is actually really common with around four in five of us getting it at some point,” Ms Shoosmith says.

3. HPV is an STI

While it is typically transmitted through sexual contact, Jo’s Cervical Cancer Trust is trying to encourage people not to call it a sexually transmitted infection.

“Unlike many STIs, it can’t be fully prevented nor can it be treated,” Ms Shoosmith explains.

“Also due to how common it is, it is really unhelpful to call it an STI. It’s much more rare to not get HPV.”

4. Having HPV means you will definitely be diagnosed with cervical cancer

“Having it does not at all mean you will be diagnosed with cancer,” Ms Shoosmith states.

“Infections are really common and cervical cancer is rare.”

The Jo’s Cervical Cancer Trust representative outlines that the human body typically clears itself of the HPV infection “without it doing the body any harm”. “In some cases it can cause cells to change, which is why smear tests are so important as they mean any changes can be picked up.”

5. HPV is curable

Ms Shoosmith emphasises that while it cannot be fully treated, the majority of cases of the infection – nine in 10 – are cleared by the body’s immune system.

She adds that treatment can be provided for cells that have changed.

6. A vaccination isn’t safe

“The vaccine is very safe and extremely effective,” Ms Shoosmith affirms.

“It protects against seven out of 10 cases of cervical cancer, so combined with cervical screening it offers a fantastic degree of protection.”

7. If someone’s partner has the virus, this means they have cheated

While it can be transmitted through sexual activity, it can live undetected in the body for around two decades.

This means it can be extremely difficult to pinpoint exactly when a person contracted it.

“Having the virus is no sign that someone has cheated at all,” Ms Shoosmith says.

8. People who use condoms are not at risk of contracting the virus.

While wearing a barrier-form of contraception such as a condom can reduce a person’s risk of getting the virus. It is not a 100 per cent foolproof preventative measure.

“As HPV lives on the skin, condoms won’t fully protect against it,” Ms Shoosmith explains.

“Other sexual contact like touching or oral sex can pass on too.”

9. If you don’t have sex, you won’t contract HPV

The virus lives on the skin, it is not only spread through penetrative sex.

It can pass from person to person through other forms of sexual activity, Ms Shoosmith outlines.

“If you’ve ever had any kind of sexual contact – that includes oral sex, any touching of genitals or sharing sex toys – you could have come into contact with HPV.”

10. There are HPV screenings for men

While there are currently no screenings for men, boys are now being offered the vaccine in schools, Ms Shoosmith states.

In July 2019, it was announced that boys in the UK were to be offered the jab for the first time in a bid to reduce cancer rates.

11. People with HPV always exhibit symptoms

“There are no symptoms and most people who have it will never actually know that they have it,” Ms Shoosmith explains.

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Eva Grayzel, Cancer Survivor

Eva Grayzel is an oral cancer survivor that is about increasing awareness and the need for oral cancer screening.

Eva Grayzel, a nationally recognized Master Storyteller and performance artist, was diagnosed at age 33 with stage IV oral cancer and given a 15% chance of survival. After regaining her deep vibrant voice, Eva applied her stage skills to communicate the depth of her experience in a unique and powerful way. For over a decade, Eva’s programs have captivated dental professionals worldwide. A champion for early detection, Eva founded the Six-Step Screening™ oral cancer awareness campaign for which she was recognized by the American Academy of Oral Medicine. Eva is the author of two children’s books, ‘Mr. C Plays Hide & Seek’ and ‘Mr. C the Globetrotter,’ in the Talk4Hope Family Book Series.

Part I:  Becoming a Storyteller

My life changed at the sound of a bell. I was pursuing a career as an actress in New York City while intercepting boredom with interactive stories for 8-12 year olds at an after-school program. One day, the principal came into the room furious, “Didn’t you hear the bell ring?” she demanded. “This delay has caused quite a traffic jam outside!” Students protested, “Wait! Tell us the rest of the story.” Her mouth dropped. This was unprecedented – students begging to stay after the bell. Within 5 years, ‘Story Theater’ carved out a career for me as a motivational storyteller providing value-rich assembly programs, educational keynotes at Professional Day conferences and Teacher-In-Service programs on interactive storytelling techniques. 

Part 2: Transition to Motivational Speaking

A non-healing sore on my tongue was eventually diagnosed as stage IV oral cancer. Tragically ironic for a storyteller! The radical surgery and treatment was devastating but my outcome was extraordinary.

A couple of years later, the ADA (American Dental Association) launched an awareness campaign with the message, ‘There is a painless way to know if this is serious.’ The voicemail I left on their 800 line was succinct, “You need to know my story and I want to help you.” They called back.

In 2003, for the first time, I told my very personal story in a public way, with 9K dentists in the audience at the Annual ADA Conference. My call to action motivated doctors from across the country to request a presentation for their regional dental meetings. My speaking career took off. Patient stories matter. 

Part 3: A Calling to Patient Advocacy

As I contemplated my own extraordinary recovery, silence was not an option. I couldn’t stand by and allow what happened to me, happen to others. Dental offices seemed to lack the material to educate patients about oral cancer. Committed to raising awareness, Six-Step Screening was born. More than a personal choice, I feel an obligation to be a part of the revolution, awakening healthcare providers to the urgency of detecting oral cancer in the early stages and educating the general public.

Part 4: Using Storytelling to Build Business

After a keynote presentation at a dental conference, a Henry Schein sales manager confessed, ‘If my team could tell a story like you do, we would be golden.’

I was all in, “Let me give a workshop for your team on finding and crafting the story to build rapport with clients and inspire trust.” Three weeks later, a rookie to the team claimed it was her story that scored the sale of their highest ticket item. Since then, I’m hired to do what I love, what comes naturally to me: craft stories to have a meaningful impact and create a lasting impression.

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Eva Grayzel, Master Storyteller and Visionary Survivor

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Author of: M.C. Plays Hide & Seek

Award-winning children’s book to minimize fear and promote dialogue around cancer.

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Biggest Misconceptions about HPV

Every year, around 3,000 new cases of cervical cancer are reported in the UK. Despite approximately 99.8 per cent of cases being preventable, there are still many misconceptions surrounding cervical cancer. Human papillomavirus (HPV) is the cause of the majority of cases of cervical cancer. HPV is a group of viruses that are spread during sexual activity, some of which do not cause any noticeable symptoms, the NHS explains.

Due to the way in which HPV is spread, some believe that it is similar to other sexually transmitted infections.

However, considering the fact that most women are likely to get HPV at some point in their lives and that it cannot be fully prevented, this isn’t necessarily the case. On Thursday, a new study found that the HPV vaccine cuts cervical cancer by almost 90 per cent. Rebecca Shoosmith, head of support services at Jo’s Cervical Cancer Trust, has spoken with The Independent to help dispel 11 of the biggest misconceptions that continue to perpetuate conversations about HPV.

1. Only women get HPV

While cervical cancer is seen as a cancer that affects women, as it can afflict any person with a cervix, HPV can affect anybody.

The majority people are likely to contract HPV in their lifetime if they are sexually active “regardless of gender”, Ms Shoosmith explains.

“HPV doesn’t discriminate!” she adds.

2. HPV is rare

Because HPV is known as the primary cause of cervical cancer, this may lead to the assumption that it is only contracted by a small number of people.

“HPV is actually really common with around four in five of us getting it at some point,” Ms Shoosmith says.

3. HPV is an STI

While it is typically transmitted through sexual contact, Jo’s Cervical Cancer Trust is trying to encourage people not to call it a sexually transmitted infection.

“Unlike many STIs, it can’t be fully prevented nor can it be treated,” Ms Shoosmith explains.

“Also due to how common it is, it is really unhelpful to call it an STI. It’s much more rare to not get HPV.”

4. Having HPV means you will definitely be diagnosed with cervical cancer

“Having it does not at all mean you will be diagnosed with cancer,” Ms Shoosmith states.

“Infections are really common and cervical cancer is rare.”

The Jo’s Cervical Cancer Trust representative outlines that the human body typically clears itself of the HPV infection “without it doing the body any harm”. “In some cases it can cause cells to change, which is why smear tests are so important as they mean any changes can be picked up.”

5. HPV is curable

Ms Shoosmith emphasises that while it cannot be fully treated, the majority of cases of the infection – nine in 10 – are cleared by the body’s immune system.

She adds that treatment can be provided for cells that have changed.

6. A vaccination isn’t safe

“The vaccine is very safe and extremely effective,” Ms Shoosmith affirms.

“It protects against seven out of 10 cases of cervical cancer, so combined with cervical screening it offers a fantastic degree of protection.”

7. If someone’s partner has the virus, this means they have cheated

While it can be transmitted through sexual activity, it can live undetected in the body for around two decades.

This means it can be extremely difficult to pinpoint exactly when a person contracted it.

“Having the virus is no sign that someone has cheated at all,” Ms Shoosmith says.

8. People who use condoms are not at risk of contracting the virus.

While wearing a barrier-form of contraception such as a condom can reduce a person’s risk of getting the virus. It is not a 100 per cent foolproof preventative measure.

“As HPV lives on the skin, condoms won’t fully protect against it,” Ms Shoosmith explains.

“Other sexual contact like touching or oral sex can pass on too.”

9. If you don’t have sex, you won’t contract HPV

The virus lives on the skin, it is not only spread through penetrative sex.

It can pass from person to person through other forms of sexual activity, Ms Shoosmith outlines.

“If you’ve ever had any kind of sexual contact – that includes oral sex, any touching of genitals or sharing sex toys – you could have come into contact with HPV.”

10. There are HPV screenings for men

While there are currently no screenings for men, boys are now being offered the vaccine in schools, Ms Shoosmith states.

In July 2019, it was announced that boys in the UK were to be offered the jab for the first time in a bid to reduce cancer rates.

11. People with HPV always exhibit symptoms

“There are no symptoms and most people who have it will never actually know that they have it,” Ms Shoosmith explains.

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