MOST people do not know that every month of the year is designated internationally as Cancer Awareness Month and that it specifically names dozens of areas of the body that develop this disease. Oral cancer is among the most fatal because more than half of the cases would have already spread at the time of diagnosis. Therefore, early detection of oral cancer is key.
As an example, one type of oral cancer, when treated while the cancer is still less than half an inch in diameter, has a survival rate of about 60 per cent. The same cancer, if not treated until it is double that size, reduces the patient’s survival rate to only 15 per cent on average. When diagnosed, surgery is usually required with follow-up radiation and chemotherapy treatments. Many times, surgery is disfiguring, and radiation and chemotherapy can cause severe complications.
The dentist, besides being involved in pulpal and periapical disease, is also very involved in the detection of oral cancer. Oral cancer is the sixth most common cancer in the world. Studies show oral cancers are more common than leukaemia, melanoma, and cancers of the brain, liver, kidney, stomach, thyroid, ovary or cervix. Each year in Guyana, it is estimated that oral cancer strikes more than 100 people. Of those diagnosed, 90 per cent are in the over-40 age group, and males are affected more frequently than females. Statistics further show that 95 per cent of all oral cancer is squamous cell carcinoma, which is related to tobacco use.
Major risk factors for oral cancer include the use of tobacco products (smoking and chewing), the use of alcohol, exposure to the sun (lip cancer), dietary factors, and exposure to carcinogens in the workplace. All parts of the oral cavity are affected by oral cancer: tongue, lips, floor of the mouth, soft palate, tonsils, back of the throat and salivary glands. Oral cancers most frequently occur on the lips (usually the lower lip). This is likely due to chronic sun exposure and is especially prevalent among people with light skin. The tongue is the second most affected site. These cancers occur most often on the sides and on the back two-thirds of the tongue. The floor of the mouth is the third most affected site. Cancers on the floor of the mouth and the tongue are the most aggressive and result in the highest death rates, because cancers here spread most frequently to the lymph nodes and then to other parts of the body.
The gingiva (gums), the roof of the mouth, and the inside of the cheeks are less frequently affected. However, oral cancer certainly can and does occur there.
It is estimated that 75 per cent of all oral and pharyngeal cancers are caused by excessive smoking and heavy consumption of alcohol, especially when the habits occur together. Most authorities feel that alcohol promotes the effects of cancer-producing agents found in tobacco.
Dental health professionals have the greatest opportunity to identify oral cancer while it is asymptomatic, innocuous, and unsuspected. Patients who smoke and drink alcohol can visit my clinic for a free cancer examination at least every six months. It only takes about two minutes to do an oral cancer exam. When examining the mouth, the dentist usually wraps gauze around the tongue and pulls it forward. He then feels and looks at the tissue under the tongue and inside the cheeks for texture or colour changes, bleeding, lesions, masses, ulcerations, and lymphadenopathy (swollen lymph nodes).
You can look for these warning signs:
- A sore on the lips, gum, or inside the mouth that bleeds easily and does not heal within two weeks.
- A lump or thickening in the cheek that can be felt with the tongue.
- Numbness or loss of feeling in any part of the mouth.
- Soreness in the mouth or a feeling that something is caught in the throat with no known cause.
- A white or red patch on the gums, tongue, or inside the cheeks.
- Difficulty in chewing or swallowing food.
The value of self-examination is strictly for screening purposes. When questions arise, your dentist is the best source of information about suspicious sores in and around the mouth and neck.
