November is Oral Cancer Awareness Month

Close to 58,500 Americans will be diagnosed with oral or oropharyngeal cancer this year. It will cause over 12,250 deaths, killing roughly 1 person per hour, 24 hours per day. Historically the death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development.

Oral cancer is hazardous because, in its early stages, it may not be noticed by the patient, as it can frequently prosper without producing pain or symptoms, and because it has a high risk of producing second primary tumors. This means that patients who survive a first encounter with the disease, have up to 20 times higher risk of developing second cancer.

Oral cancer (also known as mouth cancer or oral cavity cancer) is most often found in the tongue, the lips and the floor of the mouth. It also can begin in the gums, the salivary glands, the lining of the lips and cheeks, the roof of the mouth or the area behind the wisdom teeth. Oral cancer can also develop in the bones of the mouth.

The Top 10 Risk Factors for Oral Cancer

There are a number of factors that can increase your risk of developing oral cancer. These include:

• Tobacco Use
  Smoking tobacco products have been directly linked to causing oral cancer. Smokeless tobacco, like chew, can also lead to cancer of the cheeks, gums and lips.
• Alcohol
  Consuming more than two alcoholic beverages per day for men (one for women) has been linked to higher rates of oral cancer.
• Human Papilloma Virus (HPV)
  HPV is a sexually transmitted disease that is associated with approximately 9,000 cases of head, neck and oral cancer diagnosed each year in the United States.
• Ultraviolet light
  People who work outdoors, or spend significant amounts of time outdoors, have a higher risk of developing lip cancer. It is important to wear a lip balm with an SPF or 30or higher to protect your lips.
• Diet
  Poor nutrition has been linked to a higher risk of oral cancer. Fill your plate with a wide variety of leafy greens and a variety of colorful fruits and vegetables to help improve your health and lower your risk of oral cancer.
• Gender
  Men are twice as likely to develop oral cancer because they have a higher rate of alcohol and tobacco use.
• Age
  Cancers of the oral cavity usually take many years to develop, so they are typically uncommon in younger people.
• Weak immune system
  People with weakened or compromised immune systems are unable to fight off disease and infection and are often more susceptible to diseases like oral cancer.
• Graft-versus-host disease (GVHD)
  GVHD is a condition that occurs after a stem cell transplant. When the donor stem cells recognize the patient's cells as foreign and treat them like they would a disease or infection. This has been linked to a higher risk of oral cancer.
• Genetic syndromes
  People with certain genetic syndromes (e.g., faconi anemia or dyskeratosis congenita) have a very high risk of oral and throat cancer. These conditions often affect the health of your blood, skin, cells and genes.

Signs and Symptoms of oral cancer may include

• A lip or mouth sore that doesn't heal
• A white or reddish patch on the inside of the mouth
• Loose teeth
• A growth or lump inside the mouth
• Mouth pain
• Ear pain
• Difficult or painful swallowing
• Unexplained bleeding in the mouth
• Hoarseness or change in your voice
• Chronic bad breath
• Swelling, pain or stiffness in your jaw

How do healthcare providers diagnose oral cancer?

During your regular checkups we do a screening for oral cancer. If we see something that is concerning we may follow up with preliminary tests or refer you to an oral and maxillofacial surgeon, or head and neck surgeon. These specialists are also called ear, nose and throat (ENT) specialists.

Oral cancer tests include:

• Physical examination: We will look at the entire inside of your mouth during your routine exam and feel around your mouth. We also examine your head, face and neck for potential signs of pre-cancer or cancer.
• Brush biopsy also called scrape biopsy or exfoliative cytology: Healthcare providers use a small brush or spatula to gently scrape the area in question to obtain cells examined for cancer.
• incisional biopsy: Your healthcare provider will remove small pieces of tissue to get cells to be examined for cancer.
• indirect laryngoscopy and pharyngoscopy: Your healthcare provider uses a small mirror on a long thin handle to look at your throat, the base of your tongue and part of
  your larynx (voice box}.
• Direct (flexible) pharyngoscopy and laryngoscopy: They may use an endoscope to look at areas of your throat and mouth that can't be seen with mirrors. An endoscope is a thin, flexible tube with an attached light and viewing lens.

Treatment

Treatment depends on the size, type and location of the cancer and whether it has spread, but can include:

• Surgery - The tumor is surgically removed, if small. The lymph glands on the affected side may also be removed if the tumor extends into these.
• Radiation therapy - Small, precise doses of ionizing radiation target and destroy cancer cells. This type of treatment is often all that's needed for small, localized cancers.
• Chemotherapy - The use of cancer-killing drugs, often in combination with surgery and/or radiotherapy. Chemotherapy may sometimes be used to shrink a tumor before surgery.
• Multi-modal treatments - Surgery on larger tumors may be followed with radiation therapy. Chemo-radiotherapy may also be used.
• Long term monitoring - This may include regular oral examinations and occasional X-rays to make sure the cancer hasn't come back.
• Ongoing care - This may include speech therapy, dietary advice, regular medical follow-up and counseling.

All treatments have side effects. These will vary depending on the type of treatment you are having. Many side effects are temporary, but some may be permanent. Your doctor will explain all the possible side effects before your treatment begins.

Dentists play a critical role in detecting and preventing oral cancer. Here are some key aspects of their involvement:

• Oral Examinations: During routine dental check-ups, we will thoroughly examine the oral cavity, including the lips, tongue, cheeks, gums, and throat, for any signs of abnormalities or potential cancerous lesions. We look for changes in tissue color, texture, and shape, as well as any unusual lumps or sores.
• Risk Assessment: We will assess your risk factors for oral cancer, including tobacco and alcohol use, family history, and sun exposure. We may ask specific questions to identify potential risk factors and determine an individual's likelihood of developing oral cancer.
• Education and Counseling: We educate our patients about the risks associated with tobacco use, excessive alcohol consumption, and other lifestyle factors that contribute to oral cancer. We provide guidance on quitting tobacco, reducing alcohol intake, and adopting a healthy lifestyle. We also offer information about self-examinations and how to recognize early signs of oral cancer.
• Referrals and Collaboration: If we detect any suspicious lesions or abnormalities during an oral examination, we may refer the patient to an oral surgeon or an oncologist for further evaluation and diagnosis. We will collaborate with other healthcare professionals to ensure comprehensive care and appropriate management of oral cancer cases.
• Follow-up and Monitoring: We regularly monitor high-risk patients and those who have had a history of oral cancer or precancerous lesions. We will schedule periodic check-ups and conduct thorough examinations to detect any changes or potential recurrence of the disease.

By actively participating in oral cancer detection and prevention, we contribute to early diagnosis, timely treatment, and improved outcomes for our patients. With regular dental checkups it is possible to catch oral cancer signs early in its precancerous stage.

If you spot anything out of the ordinary in your mouth call today (414) 762-9010 to schedule an exam.