LAST month was Oral Cancer Awareness Month, and one needs to know specific points about cancer in general and oral cancer in particular. This is especially important since, despite there not being a cure, prevention is obviously desirable. In addition, appropriate measures taken when the tumour is being ensconced will go a long way in mitigating the result. The following note epitomises the disease.

• Age: Diagnosis is mostly between 40 and 60 years old.
• Prevalence: It mainly occurs in males.
• Major causes: Smoking, excessive alcohol use, spices, sharp (broken) teeth, human papillomavirus, and syphilis.
• How does it appear first: White or red patches in the mouth.
• What are the main symptoms: Mouth ulcers lasting more than 21 days, a lump in or around the mouth, pain inside the mouth (not a toothache), difficulty swallowing or speaking, hoarseness, a lump on the neck or throat, and unexplained weight loss.

It is said that every day, more than 3,000 people die of cancer globally. A significant number of cancer patients exhibit 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 the incipient tumour.

Almost every cancer that affects the mouth begins as a surface lesion. Twice as many men as women get cancer. It takes about five years for a cancer to develop to the killing stage. At that point in time, around half the victims die. The two most common areas in the mouth that acquire cancer are the sides and the upper surface of the tongue. For some reason, the gums are rarely affected.

Three broad groups of agents are believed to cause cancer: physical, chemical, and viral. However, exposure to these agents (called carcinogens) does not necessarily result in the development of a tumour because a few 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 exist in cigarette and marijuana smoke. In one study, 97% 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 many 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 lesions.

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