Oral Cancer – Preventing A Deadly Disease

Early oral cancer detection can happen at the dentist.

We don’t often hear about oral cancer. Roughly 53,000 new cases will be diagnosed and 10,000 lives in the United States will be lost to it this year. These numbers make it more prevalent than ovarian, cervical and testicular cancers and Hodgkin’s Lymphoma. Recently rock star Eddie Van Halen lost his life to this deadly disease. The survival rate for oral cancer is poor at 57%. This means nearly half of all people diagnosed will die within five years of detection. 

Why the poor statistics? Many oral cancers are difficult to detect. Dentists screen for signs during examinations, however as with many cancers, they can be undetectable in their early stages due to their size and location. They often start at the back of the mouth, near the base of the tongue, tonsils or pharynx. Frequently no signs are visible until lesions are larger, have invaded deeper tissue structures or lymph nodes are involved. Symptoms can include a sore such as a red, white or thickened patch of tissue or lump in or around the mouth or throat that does not heal. Difficulty chewing, swallowing or speaking and swelling or numbness in the mouth are also signs. There is currently no reliable test such as a pap smear, to detect oral cancer cells in their earliest stages. 

What causes oral cancer? In the past, tobacco and alcohol were the main risk factors and affected mainly people over age forty. While the less common causes of sunlight exposure and genetics exist, most cases were caused by exposure to the known carcinogens of cigarette, pipe and cigar smoking and frequent alcohol consumption. Men have historically had higher rates of oral cancer than women, however that has been changing in recent years.

Over the past several years, more cases of oral cancer have been caused by the Human Papilloma Virus (HPV). Oral cancer is now occurring in women and younger people more frequently. HPV is spread by human sexual contact and most people will get some variations of it in their lifetime. There are over 200 variations of the virus and while many are harmless and cleared by our immune system, some variations cause warts as well as cancer. 

How can oral cancer be prevented? Obviously, avoiding tobacco products and reducing alcohol consumption reduces risks of not only oral cancers, but also several other types of cancer, such as lung, liver and stomach cancer. Diets that are high in fruits and vegetables have also been associated with decreased risk of oral and many other cancers. Wearing lip balm with sun protection ingredients while outdoors will reduce sunlight associated risk.

One of the easiest risk reduction strategies requires virtually no behavior change at all – the HPV vaccine. Recently, the FDA approved this vaccine for prevention of oral cancers and it can reduce up to 90% of virus-related cases. The American Cancer Association recommends this vaccination for children starting at around age nine or ten. The Gardasil vaccine is has been around for fifteen years and has been well shown to prevent several other types of cancers of the reproductive system. It protects against nine different variations of the HPV, has been widely tested and is very safe. The main side effects are redness, pain or swelling at the injection site. At this time, two doses of the vaccine are recommended for the best protection.

What else? Monitor yourself for any changes in your mouth. Doing this is easy and an online guide can be found here. Many common and benign lesions such as canker sores, cold sores and lesions due to trauma can exist. These short-term conditions will usually resolve on their own within two weeks. If a suspicious area of tissue does not heal and his persistent beyond this, have your dentist evaluate it. Addditional testing may be recommended. If you have questions or have an area you’d like evaluated, give us a call. 

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