Oral Cancer - Could it happen to you?
Laura L. Matin DDS, FAGD, PC
Close to 37,000 Americans will be diagnosed with oral cancer this year, causing over 8,000 deaths and killing about 1 PERSON AN HOUR, 24 HOURS A DAY! Only slightly more than half will be alive in 5 years. This number has not improved in decades. The death rate for oral cancer is HIGHER than cervical cancer, Hodgkin's thyroid and melanoma skin cancer! The death rate is high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development. (1)
One sophisticated but easy use of screening is the VELscope - a non-invasive direct tissue fluorescence visualization technology. This device emits a particular wavelength inside the mouth and its tissues. (5). In some studies, routine incorporation of the VELscope in the exam proved useful in finding pre-malignant lesions. Some evidence suggests that diets high in fruits and vegetables reduce the risk of developing this cancer.
One of the real dangers of this cancer, is that in its early stages, it can go unnoticed. It can be painless, and little in the way of physical changes may be obvious. The good news is that your dentist or doctor can, in most cases, see or feel tissue changes or the actual cancer while it is very small, or in its earliest stages. (1)
Oral cancer is one of the most curable forms of cancer, provided it is found and diagnosed early. With appropriate intervention, success rates are greater than 90%! (5)
Oral cancer may appear as a white or red patch of tissue in the mouth, or a small ulcer which looks like a common canker sore. Because so many non-cancerous tissue changes occur normally, it is important to have any sore or discolored area of your mouth, which does not heal within 14 DAYS, looked at by a professional. Other symptoms may include a lump inside the mouth or neck, pain or difficulty swallowing, speaking or chewing, wart like masses, hoarseness which lasts a long time or any numbness. (1)
It used to be mostly people over the age of 40, but now it is occurring more frequently in those under this age. Exact causes for those younger are becoming clearer, showing a viral cause. Also links to "smokeless" chewing tobacco have been found. Chewing tobacco has not been proven to be any safer when referring to oral cancers. (1) When you combine tobacco with heavy use of alcohol, your risk is significantly increased - with a 15X greater risk of developing oral cancer than others who do not smoke or drink. It is also confirmed that in a younger age group, including those who have never used any tobacco products, have a cause which is the HPV 16 virus. HPV-positive cancer has also been reported in people who have few or no sexual partners. It may be possible for the virus to be transmitted to an infant via an infected mother's birth canal. An HPV vaccine is routinely recommended. (3)
The human papilloma virus - especially version 16 - has been implicated in the increasing incidence of young non-smoking oral cancer patients. This is the same virus that causes more than 90% of all cervical cancers. 70% of oral pharyngeal cancers in 2020 will be HPV positive. The incidence of HPV-positive oral pharyngeal cancers has increased 225% between the years 1998-2004. (3)
Patients with oral cancer treated in the early stages, may have little in the way of post treatment disfigurement. For those whose cancer is caught at a later stage, the results of surgical removal of the disease may require reconstruction of portions of their oral cavity or facial features. (1)
The dental community is the first line of defense in the early detection of this disease. There are over 100,000 dentists in the United States. The American Dental Association states that 60% of the US population sees a dentist ever year. The dental community needs to launch a public awareness of oral cancer, and to get the public aware of the need for an annual screening of this disease. Look at the impact of the annual pap smear, mammogram and prostate exam to see how effective an involved public can contribute to early detection. The dental community needs to assume this same leadership role if oral cancer is to be brought down from its high ranking as a killer. (1)
Published studies report that currently less than 15% of those who visit a dentist regularly, report having had an oral cancer screening. It is easier to get the public to comply for oral screenings, since there is no invasive technique necessary to look for it, no pain is involved, and inexpensive to have your mouth examined for the early signs. (1)
Patients need to realize that a visit to a dentist is not always about a filling, crown, or a "cleaning", but can be a matter of life and death. Dental exams, when done properly and including a screening for ORAL CANCER, will save lives. (1)
(2) National Cancer Institute - SEER program
(5) www.agd.org - General Dentistry Jan/Feb 2009
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