Oral Cancer

Cancer can arise in almost any part of the body.

Oral cancer occurs in, or on, the mouth.

Oral Cancer is a Common, Serious Problem

Most people have heard about lung cancer, breast cancer and cancer of the cervix, but you may be surprised to know that every year at least 12,000 Americans die from cancer of the mouth, and more than 30,000 new cases are diagnosed annually. It causes more deaths every year than malignant melanoma of the skin, or cervical cancer in women.

Oral Cancer can affect anyone

Oral cancer can affect anyone, even people with healthy life styles. People 40 and older account for 95% of the cases. Oral cancers are more common than leukemia, melanoma, and cancers of the brain, liver, kidney, thyroid, stomach, ovary or cervix.  Oral cancer represents about 5% of all cancers in men, and 2% in women. The number of people who get cancer in the mouth increases each year.

Cancers of the mouth (oral cancer) and throat (pharnygeal cancer) are responsible for about 3 - 4% of all cancer deaths in the United States.

Oral & pharyngeal cancers are the sixth most common type of cancer among American men (fourth among African Americans).  The current annual dollar cost of oral cancer treatment in the U.S. is $3.7 billion.

These cancers are among the most debilitating, disfiguring, and difficult to treat: the survival rate at 5 years is only 52%. There are 30,000 new cases and more than 8,000 deaths from these cancers each year in America. One American dies from oral cancer every hour of each year.

Can Oral Cancer be Cured?

YES !   If oral cancer is detected early, the odds of a cure are very good. It has been predicted that as many as 80% of all oral cancer deaths could be prevented by early recognition of the disease. The smaller the cancer, the better the chances of a cure. Unfortunately, too many people come forward too late: more than 60% of the tumors are first detected when disease is too advanced for treatment to be effective.

How to tell if you have oral cancer

Since the mouth is easily examined, oral cancer can be found early, treated and cured. The main problem is that people don’t visit their dentist for a regular health check often enough, or don’t have a dentist at all.  Everyone should see a dentist for an annual oral cancer examination.  It is also important to recognize the warning signs of oral cancer, and be aware of the risk factors to help prevent oral cancer.

Common signs of Oral Cancer

	A tooth socket, or sore, or that bleeds easily and/or does not heal
	A bump, lump, growth, ulcer, swelling or thickening in the soft oral tissues
	A red or white patch on the gums, tongue, tonsil, or lining of the mouth, or a browning discoloration along the border of the lip
	Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
	Loosening of the teeth or pain around the teeth or jaw
	Pain - in tongue cancer, usually the first symptom (Pain may be in the area of oral cancer, or felt elsewhere - like the ear or face).
	Numbness or discomfort of the tongue or other areas of the mouth
	A change in texture and/or unusual firmness of the tongue
	A lump or mass in the neck
	A sore throat or feeling that something is stuck in the throat
	Voice changes / hoarseness
	Difficulty in chewing, swallowing, opening the mouth or moving the tongue or jaws (often a late symptom)
	A burning sensation in the mouth or throat (more common in Asian patients who chew the areca nut)
	Unintentional weight loss

Risk Factors for Oral Cancer

	Cigarette, cigar, or pipe smoking
	Use of chewing or snuff tobacco
	Excessive consumption of alcohol
	Combining tobacco and alcohol (Tobacco use increases risk by 4- 4.5x, alcohol by 15x (up to 6 drinks per day) and the combination of tobacco and alcohol up to 100x).
	Chronic oral irritation (from poorly fitting dentures, partials, appliances, fillings or broken but unrepaired teeth
	Dental trauma or chronic dental infections
	Excessive exposure to sunlight (lip cancer) (More than 30% of patients with lip cancer have outdoor occupations associated with prolonged sunlight exposure.)
	Being male
	A prior occurrence of oral, lung or throat cancer. Also, oral cancer commonly co-exists as a second primary cancer with other upper aerodigestive cancers - larynx, esophagus and lung. - (10-40% will develop cancer of one of these organs or a 2nd oral or pharyngeal cancer in the future.)
	A compromised immune system
	Certain viral or yeast infections, particularly: Human Papilloma , Plummer Vinson Syndrome (a specific iron deficiency), any herpes group virus, adenovirus or Candida Albicans (yeast) infection
	A family or hereditary predisposition to oral or other cancers
	Dietary deficiencies of vitamins A, E, C and iron
	Exposure to the burning of fossil fuels
	Exposure/ingestion of caustic substances (particularly Asian, African and Indian populations) – slaked lime, betel nuts, some spices, or reverse smoking (placing lit end of rolled tobacco in mouth).

While many dentists provide this important care, studies show there is certainly room for improvement in the dental profession:

	More than one-third of Americans are now at least 45 years old, and 40 million are over 65 years old.  These groups are at highest risk or oral and pharyngeal cancer.
	A national survey in 1992 showed that only 14% of U.S. adults reported ever having an oral cancer examination.

[Horowitz AM, Nourjah PA. Factors associated with having oral cancer examinations among US adults 40 years of age or older. J Public Health Dent 1996; 56(6):331-5].

A more recent study of 3,200 dentists demonstrated that 81% conducted oral cancer examinations for 100% of their patients who are over 40 years of age.  While oral cancer is more common in this age group, it can occur at any age.  Only 14% of dentists provided oral cancer examinations for patients in other age groups.  Dentists who graduated from dental school in the past ten years were twice as likely to check patients for oral cancer than colleagues.

  [Horowitz et al. Oral pharyngeal cancer prevention & early detection: dentists opinions and practices. Journal of the American Dental Association, April 2000; 131(4):453-462.]

Every patient in our practice receives an examination for mouth, head, and neck cancers - both at their initial diagnostic visits and at their periodic examinations.

      This has been our standard practice since 1976.