Contrary to a clinical aphorism that early head and neck cancer is painless, we show that patients who develop head and neck cancer experience significant pain at the time of initial diagnosis. We compared orofacial pain sensitivity in groups of patients with normal oral mucosa, oral precancer, and newly diagnosed oral cancer. The University of California San Francisco Oral Cancer Pain Questionnaire was administered to these patients at their initial visit, before being prescribed analgesics for pain and before any treatment. In contrast to those with biopsy-proven normal oral mucosa and oral precancer, only oral cancer patients reported significant levels of spontaneous pain and functional restriction from pain. Moreover, oral cancer patients experienced significantly higher function-related, rather than spontaneous, pain qualities. These findings suggest an important predictor for the transition from oral precancer to cancer may be the onset of orofacial pain that is exacerbated during function. Screening patients who have new-onset orofacial pain may lead to a diagnosis of early resectable head and neck cancer and may improve quality of life and survival for head and neck cancer patients.
An important predictor for the transition from oral precancer to oral cancer may be the onset of orofacial pain that is exacerbated during function.
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
aDepartment of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, CA, USA
bBluestone Center for Clinical Research, New York University, New York, NY, USA
cDepartment of Oral and Maxillofacial Surgery, New York University, New York, NY, USA
*Corresponding author. Address: Bluestone Center for Clinical Research, New York University, 345 E 24th St., Clinic 2W, New York, NY 10010, USA. Tel.: +1 212 998 9543.
Article history: Received 19 May 2010; Received in revised form 11 January 2011; Accepted 2 February 2011.