VELscope and Oral Cancer

We have been using the VELscope in our oral cancer screenings for several weeks now. It's basically a high-tech, filtered, blue LED light that makes abnormal soft tissues in the mouth look different from normal tissue even before it changes enough to be seen with the naked eye. It's quick and painless and has met with overwhelmingly positive response from our patients. The idea is that the earlier we can find a problem, the better the chance of successful treatment.

Obviously, we can see more with the VELscope that we can without it. But using it has made me realize just how much we cannot see, no matter how carefully we look. We can't see down into the throat and in most cases, we can't really see the tonsils. Unfortunately,  these are areas where oral cancer is occurring more frequently in younger people. In a way, the VELscope is a metaphor for what happens in dentistry (and medicine, for that matter) every day. No matter how hard we try, it's impossible to find everything. High-tech stuff helps, but it is not a magic bullet. And we can't overcome the damage that occurs from harmful everyday habits. Treatments like filling a cavity or surgically removing a cancerous lesion are never as good as preventing the problem in the first place. I'm glad to have the VELscope, but I would be even happier if I didn't need it. Wouldn't it be great if no one smoked, or ate refined carbohydrates, or engaged in behaviors that encourage the spread of Human Papilloma Virus (HPV), a leading cause of oral cancer in young people? The VELscope is a cool thing to have and makes a big impression with many patients. Prevention, on the other hand, is not very dramatic but it is, by far, the best tool we have. 

Necessity is the Mother of Invention

On March 29, fresh from a trip to Viet Nam, I made a post about the difficulty of crossing the street in a small country with a lot of busy people and 25 million motor scooters. There's a lot more to the motor scooter story, however. If a motor scooter is your only means of transportation and an important part of your livelihood, you can use it for things that would never occur to those of us who have the luxury of having minivans and SUV's. In Viet Nam, the lowly motor scooter is family transportation, a commercial vehicle and a beast of burden among many other things, I saw scooters carrying dozens of live baby ducks, every conceivable fruit and vegetable, chickens, a side of beef, hundreds of eggs, hay and straw, flowers, stacks of cardboard for recycling, twenty foot long bamboo poles, giant bales of stuffing for furniture and the furniture itself. As long as the kids are little, it's no problem at all for a family of four to go on an outing with the sleeping baby wedged between Dad, who is driving, and Mom on the passenger seat while big brother sits in front of Dad. All kinds of things are sold from scooters. I saw basket vendors, brooms and brushes, pizza, a toy store and lots of mobile bakeries. I watched two guys weaving their way through traffic while carrying a full length mirror. But the most amazing thing of all is in one of the attached photos. Our guide in Hanoi, Huy, needed a new refrigerator. Rather than pay extra to have it delivered in a truck, he recruited one of his buddies who balanced it on the back of his scooter and made the delivery without incident.