The The experience of oncological disease in dentistry: the role of narrative medicine – clinical case

Abstract

Introduction: Oral cancer has a multifactorial etiology, with tobacco and alcohol identified as the main predisposing factors, often acting synergistically and increasing the disease risk. Early detection plays a decisive role in improving prognosis, reducing mortality, and minimizing the need for more aggressive treatments. Beyond its physical burden, oral cancer imposes significant emotional and psychosocial challenges, which may affect treatment adherence and the overall patient experience. Narrative Medicine has emerged as an approach that enhances healthcare professionals’ ability to listen to, interpret, and integrate patients’ narratives into clinical practice. 

Objectives: This case report aims to reflect on the importance of a patient-centred clinical approach in the management of individuals undergoing oral cancer treatment, highlighting the role of Narrative Medicine in improving patient care and professional training.

Methodology: This case study was submitted to the Ethics Committee of the Faculty of Health Sciences of Universidade Fernando Pessoa (FCS-UFP). Data were collected through a previously recorded interview conducted for academic purposes during the Jornadas de Medicina Dentária at the Faculty of Dental Medicine of the University of Lisbon. A complementary literature review was performed using databases such as PubMed, SciELO, and b-on. Inclusion criteria comprised full-text articles in Portuguese or English addressing Narrative Medicine and its application in oncological care. Articles not aligned with the topic or without full-text access were excluded. The case focuses on a patient diagnosed with oral cancer, with a clinical history of erosive oral lichen planus and tobacco use.

Results: The patient described a markedly positive experience during follow-up with a dentist who adopted a patient-centred approach, emphasizing clear communication, active listening, and emotional support. The professional demonstrated sensitivity to the patient’s concerns, providing detailed explanations about diagnosis, treatment options, and expected outcomes, which contributed to increased understanding and engagement in the therapeutic process. This approach fostered a sense of trust and security, enhancing the patient’s ability to cope with the disease and adhere to treatment recommendations. The narrative also revealed the importance of continuity of care and the establishment of a therapeutic relationship based on empathy and respect. The patient reported feeling acknowledged as an individual, rather than solely as a clinical case, which positively influenced her perception of the healthcare experience. In contrast, previous clinical encounters characterized by limited communication and lack of emotional support were associated with feelings of helplessness, anxiety, and disorientation. These experiences contributed to a perception of vulnerability and reduced confidence in healthcare providers. The comparison between these interactions highlights the impact of communication style and relational dynamics on the patient’s emotional well-being and overall experience of oncological care.

Conclusion: This case highlights that, even when technical care is adequate, the absence of a holistic and empathetic approach may negatively impact the patient’s experience and disease management. Narrative Medicine represents a valuable tool in dental education and clinical practice, promoting more humanized care. However, further research is needed to explore its application across different fields of medicine, including dentistry.