Abstract
Currently, Japan is becoming a super-aged society with the proportion of elderly people exceeding 25%. In the field of dentistry, the opportunities for treating oral cancer in elderly patients have also shown a tendency to increase. We encountered a case of gingival carcinoma in an elderly person and herein report an outline of the case, together with a literature review of the choice of and issues in the treatment of oral cancers in elderly patients.
The patient was a 96-year-old woman who was referred to our hospital and presented with an ulcer and pain from the premolar to the molar area in the left lower jaw. She had noticed maladaptation of the upper and lower dentures and visited a nearby dentist. As adjustment of the upper and lower dentures due to intrusion of the dentures into the alveolus in the molar region in the right upper jaw and from the premolar to the molar area in the left lower jaw and ulcer formation found in the same areas failed to improve her symptoms, she was referred to our hospital. Ulcers with pain were found in the molar area in the right upper jaw and from the premolar to the molar area in the left lower jaw. The imaging findings revealed marked bone destruction and infiltration of tumor lesions. The results of the biopsy performed at the time of the first visit indicated squamous cell carcinoma. Follow-up of the patient was decided in consideration of her age, body condition, and consultation with her family members.
Cancer treatment in elderly patients is not intended to cure the disease, and advanced treatments should be determined in consideration of life expectancy, physical fitness, family environment, and financial status. As oral cancers, particularly in elderly patients, require whole-body control in addition to control in the head and neck, the number of items to be considered increases and treatments become complicated. On the basis of the current situation, we suggest that the focal points should be thoroughly acquiring informed consent to encourage self-determination in patients, establishing a comprehensive treatment guideline, and introducing the concept of frailty.
