Risk of oral cancer associated with tobacco smoking, alcohol consumption and oral hygiene: a case-control study in Madrid, Spain.

Oral cancer is a disease whose principal etiological factors are tobacco and alcohol consumption, which if controlled could help avoid many tumors. However, consumption has continued to grow for years. We have studied the risk of the principal factors established in the development of oral cancer and the influence of the oral hygiene level on the appearance of these tumors. Seventy-five cases of oral cancer and 150 controls from the Madrid community were interviewed on tobacco and alcohol consumption habits and their oral hygiene level. The Odds Ratio (OR) for consumption of 6-20 cigarettes/day is 3.1 and 7.96 for more than 20 cigarettes/day. When more than 50 g of alcohol/day is consumed the risk results in an OR of 5.3. Daily brushing is a protective factor (OR, 0.41). In conclusion, the most important risk factor for developing oral cancer is tobacco consumption followed by alcohol consumption.

Intrathecal opiates for chronic pain in cancer patients.

A total of 20 cancer patients suffering chronic pain were treated with morphine chloride by intrathecal administration through a subcutaneous implanted reservoir. Pain evaluation was done using our INO scale, McGill questionnaire and the visual analogue scale. A morphine intrathecal test was done previously to disclose if this method of administration would be effective. In nearly all patients the initial dose of morphine chloride was 2 mg/day and according to the pain relief the dose was modified if necessary. In 14/20 patients the initial dose was maintained during all treatment until their death. One patient treated during 370 days required a final dose of 6 mg/day. In all patients the analgesia obtained and evaluated with the INO scale was statistically significant using the t-Student (P less than 0.001) with a pretreatment mean value of 12.4 +/- 1.81 (mean +/- sigma) and 6.85 +/- 0.99 (mean sigma) in the final evaluation. The mean period of treatment was 62.8 days (range 10-370 days). Side effects are comparable with those described by others, and respiratory depression did not occur in our series. This method of treatment can alleviate pain in cancer patients not suitable to be treated by other methods, including ablative neurosurgical procedures, permitting home care which can be more comfortable to patients and their families.