A Story Behind the Screening: Dr. Makkar's Oral Cancer Mission After Losing Her Brother

We talk with Dr. Parul Dua Makkar about losing her brother Manu to a late oral cancer diagnosis and how that loss reshapes her mission to help dental teams catch oral cancer earlier. We share concrete ways to screen efficiently, communicate without fear, and build referral relationships that lead to timely biopsies and better outcomes.

• Manu’s story and why late diagnosis happens even for clinicians
• Turning grief into education through writing and publishing Life Interrupted
• Choosing learning, mindset, and prevention over legal action
• What a practical head and neck oral cancer screening looks like
• Making screening a whole-team process from assistant to front desk
• How to talk about lesions and biopsies without alarming patients
• Why a scapel  biopsy is required for diagnosis
• Picking referral partners who align with urgency and follow-through
• Bridging dentistry and medicine to improve survival rates

That is on April 22nd. And it is a free webinar, it’s complimentary to everyone who signs up. 4/22/26 Dr. Makkar | Dental Bun

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Transcript

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Why Oral Cancer Gets Missed

SPEAKER_02 0:00

Dr. Perul Duamakar lost her brother at the age of 34 due to a late diagnosis of oral cancer. Today, she moves forward by sharing Manu's story and educating dental professionals by bridging the gap between dentistry and medicine, fostering collaboration that enhances patient outcomes and improves survival rates.

SPEAKER_03 0:36

We each year go into April and know that we are reminded that as dental professionals, we need to provide dental screenings on all of our patients, including the head and neck oral cancer screening. Dr. McCar has gone to several organizations to spread the word on how important it is for us to do just that. And the reason behind this is because her brother, who was a dentist, passed away due to oral cancer at the age of 34 due to late diagnosis of oral cancer. She's here today to tell us her story.

Manu’s Diagnosis And What Changed

SPEAKER_00 1:19

Thank you so much for having me here today. Um I'm excited to be here. And uh yes, my journey uh was, you know, I was happily practicing as a private practitioner, not even had the concept of speaking in front of audiences. I think that's like one of the biggest fears of, you know, social fears speaking in uh in a large audience. And um, my brother was 32 and a dentist um and had a late diagnosis. Uh, part of it was denial, because you you never think that you're gonna have cancer at the age of 32 uh when you're in the prime of your life. And unfortunately, it was um pretty devastating and had metastasized and took him away from us within a year and a half of diagnosis. Losing him at the point of COVID where the world was kind of isolated. I turned to the internet for support and guidance, whether it was my channeling my grief, learning more about this, what we could do, and the steps that were missed in Manu's case. And I wanted to change the narrative to help save lives because it is a preventable form of cancer. It is one of the top 10 cancers worldwide. And we as dental professionals, it's on us to be preventing it and helping diagnose earlier cases with a better survival rate.

SPEAKER_03 2:42

So on your journey, since it's been um since what year did he pass away?

SPEAKER_00 2:47

21. So this March was five years now.

Publishing Life Interrupted

SPEAKER_03 2:52

2021. After you lost Manu, first thing that you did, because as I was going through a few of the other interviews that you've had, you helped finish a book that he was writing. Could you tell us a little bit about his book?

SPEAKER_00 3:09

Sure. So in his last stages of life, he he was a brilliant writer, and I think he found his calling in writing. He was on the cover of Dental Town magazine. He wrote an article for them. He actually wrote an article in that magazine about leaving dentistry, um, which was published the same month of his death. So uh he dies, and then two days later, when I'm there for the funeral, that article in the Dental Town uh was there, and that article is in the book. And while he was going through cancer, he lost a lot of weight. He was very sporty, um, he was full of life, he loved living. And at that point, towards the end, he was he couldn't walk, couldn't talk, uh, but he was still sharp in his, you know, his mind was fully aware. It's just he had fluid buildup and he couldn't, he had to be drained of the fluid every um, sometimes twice a a day. So it was hard for him to speak long sentences. And uh so his outlet was really writing, and he's like, I've got time, I'm gonna finish this. I and he really, really wanted to be published. He called it his uh n, you know, survival guide. And it was basically blogs about life lessons that he felt, um, you know, talking about suffering, about parents, the love of the parents, about um enduring pain, mistakes that we make, how we're not our mistakes, not losing hope, new journeys, new beginnings. And so he reflected on his own life lessons and, you know, he talks about how all the accolades in the world couldn't help him as he lay alone in a hospital bed, staring out into the world that he was no longer allowed to participate in with no fault of his own. And somewhere along the line, he never questioned his fate. Um, he never was angry at what life had dealt him, it shortened him of the things he couldn't do, but he wanted to leave something positive. And he talks about how we're all mortal beings, we're gonna all die one day, so not to fear death, not to fear our own mortality, but rather leave something positive for the world to remember you with in whichever form you feel is best. Um, so in some way he felt enlightened. Um, he accepted, and he's like, you know what? I'm not gonna give up a fight, I'm gonna keep fighting, but I'm okay, my my soul is going to be at peace. Um and I wanted to not leave this. So when he died, and I I read the article, I got onto his computer and I was like, this needs to be shared with the world. And so I wrote the article. Uh I I finished his book with all his blogs, and I I wrote uh the epilogue about him, how he was more than just the cancer that took him, how I, as an older sister, um, felt about him and where the steps were missed in his diagnosis and treatment. And recently, Dr. Hung, who's an oral surgeon, came out with a book, Guided Um Wellness, and she drew parallels about doctors being diagnosed as patients, and she drew parallels between Manu's book and the book Uh When Breath Becomes Air by Dr. Paul Kalinati. I'm not sure if people have heard about it. So they were both the parallels are they're both in their 30s, both prime of their lives, both doctors diagnosed with terminal cancer and who died, leaving positive messages in books that were published by him with his wife and you know, Manus with by myself, who were also in the same profession. So um anyway, so that that book gets published and uh it's it did very well, and I wish he was here to see it. Um, and I called it Life Interrupted, because his life was interrupted and Dr. Threw a survival guide.

SPEAKER_03 6:50

I have yet to read the book, but I have heard you talk about it. She does have a few episodes on several different podcasts on YouTube where you can hear a little bit more about that story. And of course, this is where I learned a little bit more about you and Monica.

SPEAKER_01 7:07

Yeah.

SPEAKER_03 7:07

I think the beautiful piece that I took away from a lot of the interviews that I got to to listen to or watch was that you took his the death of your brother and knowing that now you're you know a single sibling and you made it into something so very beautiful. There are some people that don't know you guys did not pursue any legal action against uh any of the you know physicians involved. That wasn't something that you wanted to to go through and relive with your family. We are human as physicians and dentists, but we are human and things do get missed.

Choosing Learning Over Lawsuits

SPEAKER_00 7:47

Right. I mean, you know, you're right. We're humans, we make mistakes. To our is human. And, you know, it's also a lot from his writings where he would say the issue is not failing. The issue is not learning from the failure, um, and repeating the same mistakes again and again. And that's kind of a sign of insanity, as for Albert Einstein, you know. So the whole, you know, we can change narratives, we can change outlooks. It is how you choose to look at life. Um, and I've been dealing or dwelling a lot in the psychology of grief, in the psychology of our choices, how our mindset really alters our perception of reality, because we can look at the same thing, like you know, the glass being half empty analogy, and we can look at it, and somebody can say, Oh my God, I'm grateful that I do have some water to drink, and thank goodness for that, and I'm going to enjoy and nourish my body. And somebody can look like, oh my God, I only have so little. What am I going to do with this? This sucks, you know, for the lack of words. But you can look at life, um, whatever life throws at you, life is unpredictable. Um, it comes with no guarantees. It doesn't go the way you plan it. We all know that. Um, but you know, something good definitely can come out of it. It is how we choose to live with it. Um, you know, and just like the book, I'm like, yeah, I don't have Manu anymore, and I don't have his kids, and I don't have a life with him in the future. But I have something tangible that I can share the world with, like, hey, we did this, we did this together, and that's my key. Um, that I'm able to people get educated on cancer and they come back and they're like, you know, I never knew this. There is no good coming out of pursuing a long lawsuit, which I may not win. You know, again, it's a lawsuit, it's not necessarily um, but that would have gotten me nowhere. So I I choose to spread the message of positivity and hope, and that yes, life may not take you down the road that you want to, but you still at the end of the day, you still have a choice in how you live it.

Chairside Screening That Fits Real Schedules

SPEAKER_03 10:08

So with that, you have now created courses and of course speak to many different audiences across the country on oral cancer. And today we're gonna talk about your oral cancer chair side course that you have.

SPEAKER_00 10:30

So, yes, I created the chair side as a shorter, abridged version of the longer course. The longer course goes into more detail about how do you do a proper screening and biopsy, um, saliva um uh testing, um, and speaking to the patients. And I and in the chair side, I created downloadables. I know everybody's busy and may not have the time for the longer version, which is 11 modules. So the chair side is about an hour or so of viewing, gives you two CEs, but it's got downloadables that you can use in the office the next day. Yes, people think that it takes a lot of time, or I don't have the time to talk, but this is a team effort between, you know, not only as a hygienist, you know, you look and you're looking around and also screening, but as a dentist, but even the person who's taking x-rays, your dental assistant, um, you know, when she's taking x-rays, she may find an area that looks a little suspicious and bring it to attention. Or the patient may complain, like, oh, that hurt because, you know, that it's uncomfortable me. My tongue's kind of I have a bump on my tongue, it hurts against, you know, anything. And even the front desk, because if a patient's been told that, hey, I need to get you need to go for a biopsy, and it's a scary B word, uh, people think immediately biopsy equals cancer, not necessarily, but they may not express that fear. We know what patients tell us as a dentist is very different than the share with the hygienist or the team member or the front desk. And so they may go up to Mary in the front and say, Hey, Mary, uh, I just got referred to Dr. So-and-so. And how is he? What's his bedside manners? Should I go now? Should I go later? And, you know, Mary needs a little bit of guidance, like, yes, biopsy doesn't mean cancer. It's a routine procedure. The doctor's great, you can talk to them. You know, um, Dr. McCarr wouldn't refer you if she didn't feel that there was confidence in them. And it's totally routine. Once we get the biopsy, then we'll go over all the next protocols and the next steps. So, you know, it's acknowledging the patient's fear that validating them. At the end of the day, people want to be seen, heard, and validated that their feelings are real. And we work in the profession of humans, and everybody comes with a different set of baggage or different set of outlook of life. They may have had somebody who's had cancer and they may have a different outlook on it, versus somebody who's super healthy and is like, uh, I'll I'll just deal with this later. And somebody who would be a little bit more proactive is like, no, no, that person had a late diagnosis. Let me go quickly and address this issue head on. So everybody comes with their own life um challenges or um outlooks. So it's just guiding the patient um with comfort and having open conversations, truthful conversations, but at the same time not alarming them that, no, I'm sending you a biopsy equals definitely we have cancer, we can't diagnose until we get a scapal biopsy in. And a large proponent of what I tell my general dentist, I'm a general dentist, is that if you are able to place an implant, if you are doing surgical extractions, if you are good with surgery and you like that, do the biopsy in your office. I know oral cancer screening is not a big practice builder in the sense of the ROI of, you know, like doing an Invisalign or doing the near cases or doing the large ticket items, but it is a life-changing because the consequences of not doing a proper screening and missing and having the cancer grow, leading to a patient losing half their face or their jaw or whatever, uh, it's more detrimental.

SPEAKER_01 14:12

The onus kind of falls on us.

SPEAKER_00 14:16

And also guiding the patient correctly, and the screening doesn't take long, you don't need fancy tools. Um, you could do it in your office, you can get lights, but nothing screens besides a scapal biopsy. And we just need to be educated. It may not bring you a practice builder in the sense of ROI, but uh in collection of dollars, but it's a different mindset. It is telling your patient, like, hey, you know, you talked about, oh, patients may uh doctors may not feel comfortable going in there and touching all these different parts of the body, you know, fat and neck. We're already in such close quarters and we're already not liked. So um, but you know, telling the patient, hey, this is what I'm doing, this is why I'm doing it, talking to them, like what's going on in your life, what's changed, you get to build a patient-doctor relationship that's beyond just being a tooth or a number or an insurance checkoff, you know. Um, it's building your practice on the human side of it, which is so lacking sometimes in this digital world. People are more lonely, people have different stuff that they're dealing with. So if somebody just sits with them and talks for five minutes while the patient's getting numb and really looking out, it's just it changes the perspective of that relationship. And that's how you build your practice on that.

SPEAKER_03 15:41

I don't think we talk about that enough. Um, the human side of connecting with our patients. I mean, once again, we all have learned how to do fillings and hygiene and our oral cancer screening and the steps of, you know, completing all of the exams and treatments, but no one really tells us how to communicate with our patient in a way that they are receptive to either saying yes to treatment or understanding what is happening without overwhelming them with dental terminology sometimes, knowing that you work really hard on getting that human element in there to help us as clinicians get that point across in a way where it doesn't burden the patient or make them fearful is what we do need because there's fear on both sides. We see something and we're like, what is that? Or what could that be? And then you don't want to scare the patient to where they leave and now they're like, I've got the big C and I'm gonna die. And Dr. Google gets in there, and you know, you know. And so then of course, you know, they get anxiety and you've created this because you you you know, you started with anxiety. And so it is nice that you're you're teaching the clinicians on how to approach that. It can help them actually calm their nerves a little bit and approach them in a way that um doesn't make make the patient fearful. Yeah.

unknown 17:14

Yeah.

SPEAKER_00 17:15

And and part of like as a grief coach and and you know, uh the proponent is also taking a grief break. And grief is not like, you know, you lost lost somebody, but even delivering something um like a bad news or having them to do a biopsy, going through those steps, it's like you need to take a break and shake it off before you go to the next patient. You don't want to carry that anxiety of the patient. Your anxiety of, hey, I don't know what that was. And it's sometimes we don't know everything. Um, we are in the profession, we're in the practice of dentistry. So we're still practicing, we're growing, we're learning on a constant basis. And so if there is something that you don't know, you can be honest and say, hey, um, I'm gonna take a picture of this. We love our phones, I'm gonna share it with my, you know, my oral surgeon friend or my pathology friend and get back to you, maybe you should follow up with them, you know, and and tell your patient, be upfront about it, uh, instead of inventing or or just shrugging it off, you know, just say, like, I'll come back to you on this and let me look into this. And I it's just something I've never seen before. So yeah.

Referrals That Actually Lead To Answers

SPEAKER_03 18:25

And I love that. Um, in and one of the videos that I did see, you did express that you don't want to tell your patient they have cancer because you can't say that unless someone physically biopsies delesion. There was one thing that you said that was interesting to me because we all partner with other dentists. We refer. And you said to be mindful of who you refer to because you think you're doing your due diligence by referring them to the neurosurgeon, and they then choose not to biopsy and go, oh, you're fine. And that wasn't what the referral was for. It was for them to, you know, dig a little deeper. Yeah. So how do how do we help our doctors and physicians that are getting these relationships to make sure that they're in alignment when something like that does occur?

SPEAKER_00 19:16

Yeah. And that's especially true with ENTs. I've had um patients refer to ENTs. I've had stories that I've heard where the ENT is like, yeah, here's a rinse, come back later. I saw a patient come back in a month. And with head and neck cancers, they spread so rapidly. You know, our neck area has the largest amount of lymph nodes than anywhere in our body, and this is how cancer spreads. So the quicker we get, it's, you know, waiting a month is a long time. I have a patient who I saw a lesion on his esophagus, you know, right at the start of the esophagus when I was doing the head and neck cancer screening, and it's bilateral. So I'm a little cautious of it because it's bilateral, usually cancer is uni. And I run to the ENT, and the ENT is like, yeah, here's a rinse. I'll see you in April. So and then it becomes a challenge because they're in their profession. That's their, you know, I'm like, go get a scope done, go get a biopsy done. The lesion hasn't improved, in my opinion, and I can't scope this. So every time I see the patient, I'm like, okay, we need to change your ENT if this doesn't get done, you know, like we need a second opinion from and that's the problem with oral surgeons. Advocate for themselves. For themselves because they don't know and they look to us to offer guidance. And same thing with oral surgeons. If you don't feel like your oral surgeon is taking you seriously, because they may, you know, say, like, oh no, it's geographic tongue. In Mato's case, his friend was an oral surgeon. We're still friends, you know.

SPEAKER_03 20:52

And it's heartbreaking. I did not have to do that.

SPEAKER_00 20:54

It's heartbreaking for him. But he was given uh prednisone without being uh diagnosed, you know, giving a immunosuppressant to a cancer patient that made the cancer grow. I mean, it's this is all in hindsight, we don't know, right? And no 30-year-old thing's gonna have cancer. So um my point is that not all lesions are non-cancerous, you know, it we cannot diagnose without a scapal biopsy, even if you do a punch biopsy or something simple, if you don't want to take out the scapel, just get the lesion, get it diagnosed. Um but having the right just like you would with any other uh specialty that you're dealing with, whether it's a periodontist or whether it's an endodontist, uh, and you build those relationships, you talk what their office policy is like or their philosophy as a practice is like, um, how soon they can they see your patients, how soon can they um especially when somebody's in pain, just like that, if you just build your relationship at the right path. Pathologist, the right oral surgeon or medical doctor, oral medicine doctor, and say, like, hey, this is what my focus is on. I really do, you know, screen properly and I know what I'm looking for. So if I send you a case, please, you know, take an extra look for at it, do the biopsy. And so what? 80% of benign uh of white lesions are going to be benign. I'd rather know what it is and have an extra charge of the biopsy because the the price of not getting it is much, much more expensive. So getting that earlier in and find and that's it. You just gotta interview like you would normally any other patient. So yeah.

SPEAKER_01 22:42

Any other any other physician, sorry, not patients.

SPEAKER_03 22:45

I just hope that you're like aligned once you they have your because you know you have patients that come back and then you're like, oh, yeah.

SPEAKER_00 22:55

That's what happened. Exactly. And just like, you know, with airway too, right? Like orthodontists, there are still orthodontists who are extracting premolar teeth. And you're like, uh, you may want somebody who's more airway focused. So it's just finding the right people who align with your philosophies and your practice.

SPEAKER_03 23:16

Because it is a circle of care. We're, I think, right now with just the topics and discussion, with trying to make us integrated into whole systemic health and getting that mindset going and knowing that those connections are being made, and we have to work a little harder with our physician friends to go, hey, the mouth is connected to the rest of the rest of the body. Yeah.

SPEAKER_00 23:42

I'm just letting you know. And the insurance is different, doesn't mean we're still connected.

SPEAKER_03 23:47

Right.

unknown 23:48

Yeah.

SPEAKER_03 23:49

So it's it's coming, and we just have to do our our due diligence as clinicians to keep pushing and going, hey, hey, yeah, to the medical industry. 100%.

Free Webinar Invite And Goodbye

SPEAKER_03 24:03

Well, I just appreciate you so much for being a guest with me today, hearing a little bit about Manu's story. And then, of course, um, you will be doing a webinar for me, and that is going to be on April 22nd. And it is a free webinar, it's complimentary to everyone that signs up. Thank you so much for being a guest on the Dental Bun podcast. I can't wait to learn from you on April 22nd. And we will see you there.

SPEAKER_01 24:35

Yes. I'm excited. Thank you.

SPEAKER_00 24:37

Thank you.