DURING this time of Cancer Awareness I received an e-mail recently, the contents of which saddened me for most of the day. A school mate of mine died in the USA from oral cancer. Now, as surprising as it may sound most of the cancers we humans suffer from, directly or indirectly involves the mouth. Smoking is a typical example. You could only smoke, chew tobacco or betel nuts with your mouth and oral and lung cancer accounts for nearly a quarter of the total of the victims. This is without considering that there are numerous other instances of either ingestion, infection (such as oral sex–HPV) or irritation in which the causative agent is implicated by the oral structures.

Oral cancer is any malignant growth occurring in the oral cavity, lips or oropharynx (throat). In the early stages of oral cancer’s development, it often is painless, and the physical signs may not be obvious. This makes it a very dangerous disease. Regular screenings by a qualified dental professional, combined with a person’s knowledge of the warning signs and symptoms will allow its discovery in the earliest possible stages when cure and survival are most likely. Early indicators include red and/or white discolourations of the soft tissues of the mouth, any sore which does not heal within 14 days or hoarseness which lasts for a prolonged period of time. Whereas, advanced indicators include a sensation that something is stuck in your throat, numbness in the oral region, difficulty moving the jaw or tongue, difficulty in swallowing, ear pain which occurs on one side only, a sore under a denture, which even after adjustment of the denture, still does not heal or a lump or thickening which develops in the mouth or neck.

Most oral cancers start in squamous cells (thin, flat cells) that line the lips, oral cavity, and oropharynx. Cancer that forms in squamous cells is called squamous cell carcinoma. Lesions on the mucous membranes (the lining of the mouth and throat), including leukoplakia (an abnormal white patch of cells) and erythroplakia (an abnormal red patch of cells), may develop into squamous cell carcinoma.

Oral cancer prevention is any action taken to lower the chances of developing oral cancer. When preventing oral cancer, one needs to focus on risk factors and protective factors for oral cancer. Risk factors are anything that increases your chances of getting oral cancer, whereas protective factors are anything that decreases your chances of getting oral cancer. We should, therefore, reduce our risk factors and increase our protective factors for oral cancer prevention.

SOME RISK FACTORS FOR ORAL CANCER INCLUDE:
Tobacco use: In all its forms, tobacco is the largest contributor to the development of oral cancers. Not using tobacco is the single most important thing you can do to avoid oral cancers.

Excessive alcohol consumption: More than 15 alcoholic beverages per week may put you at greater risk. If you must drink, do so in moderation.
The combined use of alcohol and tobacco: This significantly increases the risk of oral cancer more than either by itself.

Excessive unprotected exposure to the sun: Unprotected exposure to the sun will increase the likelihood of lip cancers. Use at least SPF 30 sunblock on your lips.
Low intake of fruits and vegetables: A diet that does not contain the protective nutrients of these foods increases the risk of developing a variety of illnesses including oral cancers.
Use of Betel Nut: When chewed or smoked, these are causative agents of mouth cancers. Avoid their use.

Age: Older individuals tend to develop more disease in general, including oral cancer, as their immune system becomes less efficient.
HPV viral infection: Increasing numbers of young, non-smoking individuals are being diagnosed with oral cancer. The most likely causative factor is HPV viral infection, the same virus responsible for more than 95 per cent of all cervical cancer.

Race, ethnicity and economics: There are socio-economic factors that influence the development of cancers in different groups of people. For instance, blacks are diagnosed with oral cancer two to one over other races. In addition, people who live in areas with poor access to health care, or for economic reasons do no routinely visit a dentist or doctor, are also at increased risk.

Recurrence: Previous head and neck cancer patients have a higher risk of a cancer recurrence which may occur in the mouth or other areas of the aerodigestive tract.
Gender: Statistically males get oral cancer more often than females.

PROTECTIVE FACTORS FOR ORAL CANCER INCLUDE:
Dietary factors: Eating a diet high in fruits and fibre-rich vegetables may lower the risk of developing oral cancer.
Chemoprevention: Use of drugs, vitamins, or other agents to prevent or delay the growth of cancer.