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Cancer is uncontrollable growth of cells that invade and cause damage to the surrounding tissue. Oral cancer appears as a growth or sore in the mouth that does not go away. This includes the lips, the tongue, the cheeks, the floor of the mouth, the hard and soft palate, the sinuses and the pharynx (the throat).
Rates of Occurrence in the U.S.
It’s estimated that over 40,000 people in the U.S. received an oral cancer diagnosis in 2014. This year, oral cancer will cause over 8,650 deaths, killing roughly 1 person per hour, 24 hours per day. Of those newly diagnosed individuals, only slightly more than half will be alive in 5 years (approx. 57%). This number has not significantly improved in decades (the survival rate at 5 years from diagnosis was for many decades about 50%, so 57% is an improvement over the last 10 years). This is due to the increase of HPV16 (a strain or type of HPV) caused cancers which are more vulnerable modalities, conferring significant survival advantage. The change in etiology is not the sole cause for improvement.
Historically oral cancer has a high death rate, not because it’s hard to discover or diagnose, but because it is routinely discovered late in its development. Another obstacle to early discovery is HPV16 oral cancer which is particularly in the posterior of the mouth (oropharynx, tonsils or base of the tongue areas) which many times does not produce visible lesions or discolorations that have historically been the early warning signs of the disease process. Oral cancer is often only discovered when the cancer metastasized to another location, most likely the lymph nodes. Prognosis at this stage is significantly worse than when caught in a localized intra oral area. The primary tumor also has had time to invade deep into local structures.
The most common symptoms of oral cancer are:
- Swelling/thickenings, lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums or other areas inside the mouth
- Development of velvety white, red or speckled (white and red) patches in the mouth
- Unexplained bleeding in the mouth
- Unexplained numbness, loss of feeling or pain/tenderness in any area of the face, mouth or neck
- Persistent sores on the face, neck or mouth that bleed easily and do not heal within 2 weeks
- A soreness or feeling that something is caught in the back of the throat
- Difficulty chewing/swallowing, speaking or moving the jaw or tongue
- Hoarseness, chronic sore throat or change in voice
- Ear pain
- Change in the way your teeth or dentures fit together
- Dramatic weight loss
**If you notice any of these changes, contact your dentist or health care professional immediately.
According to the American Cancer Society, men face twice the risk of developing oral cancer as women. Men over the age of 50 face the greatest risk.
- Smoking. Cigarettes, cigar or pipe smokers are 6x more likely than nonsmokers to develop oral cancer.
- Smokeless tobacco users. Users of dip, snuff or chewing tobacco products are 50x more likely to develop cancers of the cheek, gums and lining of the lips.
- Excessive consumption of alcohol. Oral cancers are about 6x more common in drinkers than nondrinkers.
- Family history of cancer.
- Excessive sun exposure, especially at a young age.
- Human papillomavirus (HPV). Certain HPV strains are etiologic risk factors for Oropharyngeal Squamous Cell Carcinoma (OSCC).
*It’s important to note that over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally.
As part of your routine dental exam, the dentist conducts an oral cancer screening exam. There are also a few other adjunctive methods used to screen for oral cancer. One that we use at Blue Diamond Dental is the Velscope Screening. This handheld scope is used by dentist to help detect oral tissue abnormalities, including cancer and pre-cancer, that are not apparent or sometimes not even visible with the naked eye alone. The Velscope is a supplement to the traditional intra and extra oral head and neck exam and does not diagnose oral cancer. The actual diagnosis of oral and oropharyngeal cancers can only be made by a biopsy.
Treatment of oral cancer is the same as other cancers. Surgery is done to remove the cancerous growth, followed by radiation therapy and/or chemotherapy to destroy any remaining cancer cells.
- Don’t smoke or use any tobacco products.
- Drink alcohol in moderation (and don’t binge drink).
- Eat a well-balanced diet.
- Limit your exposure to the sun. Repeated exposure increases the risk of cancer on the lip, especially the lower lip. Use UV-A/B blocking sun protective lotions on your skin as well as your lips.
- See a dentist regularly.
There is no proven way to prevent oral cancer, however, you can reduce your risk by making lifestyle changes and by visiting your dentist for regular examinations. Make an appointment with your doctor or dentist if you have signs or symptoms that worry you. If your doctor or dentist feels you may have mouth cancer, you may be referred to a dentist who specializes in diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral (mouth) and Maxillofacial (jaws and face) region (oral maxillofacial surgeon) or to a doctor who specializes in diseases that affect the ears, nose and throat (otolaryngologist).