Dentists Paul Na, left, and Nelson Krum pose for a photo at Paradise Dental Spa.
PARADISE Dental Spa’s Dr. Nelson Krum urged CNMI residents to take advantage of free oral cancer screenings that are available year round at every single private dental clinic on island as well as the Commonwealth Healthcare Corporation.
He also said that residents should quit chewing betel nut, which, along with lime and tobacco, is carcinogenic.
As April is Oral Cancer Awareness Month, the Commonwealth Cancer Association brings to light some grim statistics about the disease:
–From 2018 to 2023, 120 people in the CNMI were diagnosed with oral cancer.
–Of the 120 oral cancer patients from 2018 to 2023, 40 died within those six years.
–People between the ages of 18 and 59 make up 73% of oral cancer patients, with 62% of all diagnoses occurring in men.
Krum said until he moved to Saipan, he had never seen this rate of oral cancer cases in his 45 years of practicing dentistry. He recalled the “nightmare” first case he encountered after he arrived on island in 2013.
“I was checking a patient’s mouth for oral cancer and in the floor of his mouth under his tongue he had a lesion, and when I pulled the tongue back I could see right down into his throat,” he said. “It had eaten away at everything between the mouth and the throat.”
Krum said although he wanted the patient to immediately seek treatment at CHCC, the patient, who was not from Saipan, returned to his home off-island instead and passed away within two months.
Krum said early detection is so important that private clinics on island will take walk-ins for oral cancer screenings. The procedure is quick and painless. He said no sharp instruments are involved, and the screening is about five minutes long.
Dental staff will be looking for leukoplakia, which is a kind of white patch where the betel quid usually sits in the cheek, Krum said. Another warning sign they look out for is a “rough, almost callous” tissue of the cheek. He said healthy cheeks should be pink and smooth.
According to the Commonwealth Cancer Association, other oral cancer warning signs include white or red sores or patches that do not heal on the gums, tongue, or lining of the mouth; sores on the lips or mouth that bleed easily and do not heal within two weeks; unusual bleeding, numbness, pain, or tenderness in the mouth; difficulty chewing or swallowing, speaking, or moving your jaw or tongue; difficulty opening your mouth.
Despite the ease and comfort of the oral cancer screening procedure, just about four people come to his clinic for the screening during Oral Cancer Awareness Month, Krum said.
“Oftentimes by the time we see [them], the patients [have] dealt with sores in the mouth and issues for a while from the irritant of chewing and they don’t make a big deal about it or they’re afraid to come in,” he said. “And by the time we see it it’s so bad the treatment is worse than just letting the disease progress.”
The treatment can sometimes involve removing parts of the jaw, neck, face, or other areas where the cancer has spread.
Krum said if precancer signs are present, the patient will get referred to CHCC where a biopsy will be performed. If cancer is present, CHCC will begin a cancer treatment plan.
Krum admits that generally, people are afraid of the dentist, even when the threat of cancer isn’t present — when patients are just going in for a routine check-up. He also said that people are worried about the cost of treating any cancer that might be found.
But the long-term effects of seeking treatment are better, he added.
“It’s just nasty. Oral cancer is miserable,” Krum said. “There are a lot of people [who] stay away from us, but when all the [dental] offices on the island offer free oral cancer exams that should say ‘why not come and get checked?’ The exams are free. What if you don’t see anything? What if you just say ‘I just want to be checked.’ That didn’t cost you a thing and wouldn’t that give you peace of mind?”
He reiterated that betel nut and its paraphernalia cause cancer.
“When you take the areca nut, which is carcinogenic by itself, and add tobacco to it, and then add lime, all three are carcinogenic and you’re just asking for a time bomb,” he said. “It’s a nasty disease, it will kill you. Stop chewing if you can.”
