Oral Cancer Pain Linked to Disease Spread

Oral cancer is more likely to spread in patients who experience high levels of pain, according to a study published in the journal Scientific Reports.

When oral cancer spreads to lymph nodes in the neck, a patient’s chance of survival is cut by half, the researchers noted. However, it’s often unclear through imaging and physical assessment if oral cancer has spread, leaving surgeons struggling with whether to preemptively perform prophylactic neck dissection to remove the cancer when research shows that up to 70% are unnecessary.

Researchers documented the pain experienced by 72 oral cancer patients before surgery by way of an oral cancer pain questionnaire developed by the investigators. While most patients reported some pain, researchers observed that patients with the most pain were more likely to have cancer that spread to lymph nodes in the neck. This observation suggests that patients with less pain are at low risk of metastasis, and will rarely benefit from a neck dissection.

“I have been investigating the underlying cause of oral cancer pain for two decades. This is the first time that we have demonstrated a correlation between a patient’s pain and the clinical behavior of the cancer,” said Brian L. Schmidt, DDS, MD, PhD, director of the NYU Oral Cancer Center and one of the study’s authors via a press release.

Aditi Bhattacharya, PhD, an assistant professor in the Department of Oral and Maxillofacial Surgery at NYU College of Dentistry added: “While we need to undertake a follow-up study, our current data reveal that a patient’s pain intensity score works as well as the current method–depth of invasion, or how deeply a tumor has invaded nearby tissue–as an index to predict metastasis.”