Abstract
In this Part III Generalities, three important topics were described among clinical researches mainly focused on oral tumor and cancer so far performed during the past 38 years from 1965 to 2003 in Tokyo Medical and Dental Univ.and Oita Medical University etc.
As the first topic, the historical process of successful treatments for rpimary tongue cancer with 5-FU alone, an anti-tumor agent, and for oral mucous cancer with Bleomycin alone, an anti-tumor antbiotic were reported.
The second toipic concerned a first presentation of novel manipulations of plastic reconstruction, introduced to japanese oral surgery on the congress 1971 in Tokyo. The name of the novel manipulation was D-P skin flap, which was the simple and useful one among newly introduced plastic procedures through transplantation of skin-, muscle-flap and others. By means of these novel developed manipulations, we had succeeded to achieve adequate reconstruction after extended resection of oral cancer with resultant markedly improved outcomes. Among them, the first experience of D-P skin flap on the congress shown the death of the patient, although the result of the reconstruction could get success. On the report, it happened many discussions done and after that, because Shimizu found several important problems, then he persued the process of procedure by the operator. The anecdote had some historically interessant contents, so it was written, after listening to the related persons.
During the same period, a multi-drug conbined chemotherapy was widely performed for treating oral cancer also. The author recognized, unfortunately, that the therapeutic outcomes were rather negative and diasppointed.
The third topic was a therapeutic strategy for oral cancer patints, especially being aged and those with advanced tumor stages. By those cases, we should consider, how and where would be settled the limits and expectation for healing process and end results. The procedure and planning of their treatment must be different from those for the young or less advanced patients. Therefore the author emphasized that flexibility in selecting various combination of the therapeutic methods, according to each situation of the patients, hoping to let the patients get the better QOL and a prolonged peaceful coexistence with the tomor. This strategy was accepted on Japan Society of Clinical Oncology 2005.
The best treatment for oral cancer lies in the prophylactic procedure, removing the initiatiog and promoting factors of cancer formation. From the standing point, an important roll of smoking free has been recognized scientifically. As for oral cancer, the author had described a possible involvement of smoking in the pathogenesis of tongue cancer in his study in 1966, indicating the significance of preventing action against oral cancer by means of separated and/or abstained smoking.
As mentioned above, some criticized points still remain to be solved in the future as for how to consider the human span of life in relation to the existence of tumor, covering the life philosophy and ethics.
Finally, the author would like to conclude this article by saying that.
“only God is standing behind us and the God will follow the therapeutic course in patients with oral cancer.” likely as stated previously by a surgeon, Prof. Hans Killian, in Freiburg, German.
