By Anna M Avola DMD, MS
Maybe you are not at risk at developing oral cancer… but wouldn’t it be nice to know!
Unfortunately, the American public has a low degree of awareness for this disease, but the fact is that 53,000 people in the U.S. will be newly diagnosed with oral and oropharyngeal cancer this year. Sadly, almost 10,000 of those diagnosed will die from the disease, that is, one person, every hour, every day.
Unlike other cancers of the body, oral and throat cancers have one of the poorest survival rates, even worse than cervical and testicular cancer. Only 57% of those diagnosed will survive 5 years or more. Why? Because oral and throat cancers are one of the least diagnosed cancers of the body. This type of cancer is often painless and hidden until it metastasizes to secondary organs such as lymph nodes where it can be readily detected. Knowing your risk factors and early detection by a dentist or a physician is key to your survival.
What do famous people such as Michael Douglas (actor and producer), Roger Ebert (American film critic), Sammy Davis Jr (entertainer), Lana Turner (one of the most beautiful actresses of the silver screen) and George Harrison (lead guitarist for the Beatles) have in common? They all had oral or throat cancer! Some of them smoked. Some of them did not. While smoking, alcohol and age were the major risk factors for developing oral cancer in the past, the fastest growing segment of oral cancer patients today are young, healthy, nonsmoking individuals who have had contact with the Human papillomavirus 16 (HPV16). Michael Douglas made headlines with his diagnosis of throat cancer, stage four, caused by HPV16.
According to the National Cancer Institute, at least three of every four cancers of the head and neck are caused by tobacco products and alcohol use. Combined these two risk factors increase by 15 times. Additional risk factors include poor diets that lack fruits and vegetables, poor oral hygiene and poor dental care, and a personal or family history of these cancers.
Cancer is defined as the uncontrollable growth of cells that invade and cause damage to surrounding tissues. Oral cancers include areas around the lips, tongue, cheeks, gums, floor to the mouth and hard and soft palate. These are anterior to the throat and often caused by smoking and alcohol. The area posterior to these structures include the pharynx (throat) and the larynx. Cancers in this area are usually caused by HPV16. The dentist or physician has two issues to consider: discovery and diagnosis. Discovery is the result of a thorough visual and manual examination of all soft tissues of the mouth and throat. During the screening, the doctor will examine your face, neck, lips, tongue, oral cavity and the back of your throat for abnormalities. The screening is quick and painless. Once the suspect tissues have been detected, the only definitive diagnosis of oral cancer is made through biopsy.
Oral cancer and throat cancer symptoms vary, depending on the region in which the cancer originates. Symptoms of oral cavity and oropharyngeal may include a sore in the mouth that won’t heal, a lump in the cheek, difficulty chewing or swallowing or a numbness within the mouth. Any lesion or sore that does not heal in 14 days needs to examined by a professional.
Increased public awareness and early detection are the best ways to reduce the occurrence of this deadly disease. The first and best line of defense is an oral cancer screening by a dentist. This should be done annually by your dentist or hygienist. They can determine which areas in the mouth are worthy of concern. The average person often has conditions existing in their mouths that mimic the appearance of pre-cancerous changes and very early cancers of the soft tissues. Even the simplest things such as apthous ulcers, herpes simplex, herpes labialis, the wound left by accidentally biting the inside of your cheek or sore spots from a poorly fitting prosthetic appliance or denture can share similarities with dangerous lesions. The question is which ones deserve action and which ones bear watching and waiting?
The most important way to prevent oral cancer is to be aware of the risk factors. Men are twice more likely to get oral cancer especially as they get older. If you smoke, drink excessive amounts of alcohol or have a poor diet, changing these habits can decrease the chances of developing oral or oropharyngeal cancer. Since the HPV16 virus is on the rise, protected sexual activity is a must. In addition, it is very important to visit with a dentist at least twice a year in order to determine early discovery. Today there is so much more health related advice your dentist can provide in addition to maintaining your teeth with restorations, crowns and bridges. Dental exams, prophylaxis (hygienist cleanings) and oral cancer screening can be life saving!
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