EVERY time I attend to a patient at my clinic and I observe a lesion which I know will most probably end the life of that person, I am prompted to write an article such as this one. The patient was already in the advanced stage (Stage 4) of the disease. Luckily, it happens on rare occasions.

It is estimated that every day more than 125,000 persons die of cancer all over the world. Of those who succumb to cancer, 16 per cent exhibit the disease in the head and neck region and alert dentists are

frequently the first to detect the condition. But this should not be the case. The victims themselves should be the first to note an incipient tumour. Therefore, it is best that the patient themselves know about the physical characteristics of the condition.

One needs to know certain important points about cancer in general and oral cancer in particular. This is especially so since despite there not being a cure for it, prevention is obviously desirable. In addition, appropriate measures taken when a tumour is being ensconced will go a far way in mitigating the result. The following notes epitomise the disease.

Cancer usually attacks persons above 40 years old. Almost every cancer that affects the mouth begins as a surface lesion. In other words, you can generally see cancer when it starts to develop in the mouth.
Twice as many men as women get cancer. It takes about five years for cancer to develop to the killing stage. At that point in time, around half the victims die. However, with the right treatment for most cancers, the patient usually survives for an additional five years. Unfortunately, the great majority of cancer patients who consult the Guyana Cancer Society do so when they are in Stages 3 and 4. The treatment there is as good as is possible in the circumstances.

The two most common areas of the mouth that acquire cancer are the sides and the upper surface of the tongue. My patient was a 64-year-old male with an advanced case of cancer of the left side of the tongue. For some reason, the gums are never attacked by cancer and I believe research should be done to know exactly why this is so.

Three broad groups of agents believed to cause cancer, namely physical, chemical and viral. But exposure to these agents (called carcinogens) does not necessarily result in the development of a tumour because a number of familial, dietary, hormonal, and sex-related factors are known to modulate the process.
Although the exact cause of oral cancer remains unknown, tobacco and alcohol have been proven to be the most important contributing factors.

Over 30 carcinogens (cancer-causing agents) exist in cigarette and marijuana smoke. In one study 97 per cent of the victims with oral cancer smoked. The risk is reduced when the cigarette carries a filter. But it increases greatly with alcohol abuse. In other words, the combined habits of smoking and drinking alcohol increase the cancer risk dramatically.

Chronic mechanical irritation to the oral tissues resulting from sharp parts of dentures, irregular or sharp teeth or fillings, food burns (hot coffee), spicy food, poor oral hygiene, and a large number of other physical agents have been implicated as possible factors in the development of oral cancer.

About 25 signs and symptoms indicate the beginning of a cancerous lesion. In general, any change in appearance or sensation not previously detected should be seriously examined. Symptoms include swellings, bleeding, a crust on the lip, a rough spot pain, taste changes, numbness, chronic cough and dry mouth. Signs include a red patch, a white patch swollen and bleeding gums (leukaemia), ulcers, and bluish/brownish- black lesion. You are strongly advised to have your dentist check out any such condition as early as possible.

A mouth rinse of toluidine blue will highlight hard-to-see cancers. It is better to suspect any abnormality than not to.
Persons should get in the habit of checking out their mouth often in front of a mirror. Only then can anything be noted.