Screening for oral cancer with your dentist

Oral Cancer

Cancer is a scary word these days, and although treatments are improving year upon year, most people know someone who has been affected by cancer or have had it themselves. Essentially, cancer is the uncontrolled growth and division of cells within the body. Cancerous cells can invade nearby tissues through invasion of these tissues, or they can be transported to and grow in distant locations in the body through metastasis. Although the prognosis for many types of cancer is much better today than it ever has been before, a key to the best outcomes is to catch the presence of the cancer early so that immediate treatment can be undertaken. If oral cancer is detected early, the cure rate is nearly 90%. Unfortunately, many cases of oral cancer are not detected until a late stage, when the cancer is advanced. Because of this, survival rates for oral cancer are relatively poor, with just 58% of individuals surviving five years after treatment. This article discusses the signs and symptoms of oral cancer to promote awareness.

What is oral cancer and who is at risk?

Oral cancer includes any cancerous tissue growth that is located in the mouth. Cases of oral cancer make up about 3% of all cancers in men and 2% in women. The risk of cancer increases with age, specially in men over the age of 40. The main areas where oral cancers develop include the lips or the tongue, but it may also occur on the cheek lining, the floor or the mouth, the gums, the roof of the mouth, or the back of the mouth/throat (called the pharynx). Most oral cancers are squamous cell carcinomas that tend to spread quickly. Most cases of oral cancer are related to smoking, tobacco or heavy alcohol use, as all of these factors increase the risk of oral cancer formation. Other factors that may increase the risk of oral cancer include chronic irritation in a particular area of the mouth, taking medications that suppress the immune system, infection by the human papilloma virus (HPV), and possibly poor dental and oral hygiene.

What are the signs of oral cancer?

Early signs of cancer in the mouth are often ignored as they are thought to be canker sores, mouth ulcers or cold sores that people expect will disappear. The symptoms of oral cancer are a sore, lump or ulcer on the tongue, lip or other area of the mouth that does not heal. The lesion is usually painless at first but may become painful at later stages. There may be a deep, hard-edges crack in the tissue, and the lesion is often pale colored or white, but could be dark or discolored. Other symptoms include: difficulty chewing, pain during swallowing or difficulty swallowing, speech difficulties or tongue problems, swollen lymph nodes in the neck or weight loss.

Any changes in the mouth or throat that appear as white or red patches, ulcers or lumps, whether or not they are painful, should not be ignored. If you notice any lesions in your mouth that persist for more than two to three weeks, you should see your Victoria dentist or doctor.

Since the early signs of oral cancer often resemble harmless sores that appear in the mouth, diagnosis of oral cancer can be complicated. Your Victoria dentist will be familiar with what signs to look for and will give you an examination for oral cancer. The dentist will feel your neck for lumps and inspect your lips, tongue and all inside surfaces of your mouth, including your tonsils. If the dentist is suspicious of any lesion, he will refer you to a specialist who will take a tissue biopsy of the area and examine it under a microscope.

What if the biopsy finds malignancy?

The findings of the biopsy will determine the next step, and surgical removal of the lesion is a common treatment if the biopsy reveals cancer is present. Radiographs (“X-rays”) and CT scans can be done to help determine the extent of the cancer. Depending on the stage of the cancer, a plan will be generated by your health care team for optimal treatment.

What can you do to minimize your risk of oral cancer?

Although none of us have control over our genetic predisposition to developing cancer, there are several environmental factors that are known to increase the risk of developing oral cancer. Moderate and heavy drinkers are at three to nine times greater risk of developing oral cancer. Tobacco smokers are five to nine times more likely, and snuff and chewing tobacco users are four times more likely to develop oral cancer. Chronic exposure to the sun is associated with development of lip cancers. Chronic irritation in the mouth, such as that from dentures or a rough area on a tooth, and poor oral hygiene also increase the risk of oral cancer. By minimizing or eliminating these environmental factors, we can help protect ourselves from oral cancer.

Here’s what you can do to reduce your risk of oral cancers:

  • Reduce consumption of alcohol, especially hard alcohol, which has a higher alcohol content than beer or wine
  • Quit smoking
  • Don’t use snuff or chewing tobacco
  • Reduce chronic exposure to the sun, and use a lip balm that contains sunscreen when outdoors
  • Have any dental problems corrected and practice good oral hygiene

For more information on oral cancer or to book an oral exam, call your Victoria dentist.