How You Can Help Avoid Oral Cancer

Dental hygiene and oral cancer

We hear a lot about skin cancer, lung cancer, prostate cancer, and even pancreatic cancer, but oral cancer? Not so much. The Oral Cancer Foundation estimated that nearly 50,000 Americans would be diagnosed with oral cancer in 2017. Oral cancer has a significant mortality rate, as slightly more than half of the people diagnosed with the disease will be alive in five years.

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What is oral cancer?

Before we explore ways to help avoid oral cancer, it’s important to define it so you know what you are fighting. Oral cancers are part of a group of cancers that are often referred to a head and neck cancers, but this does not include brain cancer. If you consider oral, oropharyngeal (the oropharynx), and the larynx, the number of people diagnosed with the disease is about 54,000 per year in the United States, with 13,500 deaths.

One reason the death rate tends to be high in this type of cancer is that it is usually discovered during its latter stages. In fact, it is typically found once it has spread (metastasized) to another location in the body, which is usually the lymph nodes in the neck. The cancer is especially dangerous by this time for two reasons: it has spread, and the tumor has had time to deeply invade the affected areas.

It’s also worth noting that often there are no visible discolorations or lesions in the mouth during the early phases, which would help warn of the disease. Also, individuals with early oral cancer typically don’t experience pain as a warning sign. Therefore, because a person’s first encounter with oral cancer may not be noticed, there is a high risk (up to 20 times higher) of second tumors developing.

The most common cancer of the oral cavity (more than 95%) is called squamous cell carcinoma. These cancers arise from the oral cavity lining. The remaining types of oral cancers include sarcomas (which arise from fat, bone, cartilage, muscle, or fibrous tissue), melanomas (the most dangerous form), or cancers of the salivary glands.

What are the symptoms of oral cancer?

If you experience any of the following symptoms, make an appointment to see your dental professional or general practitioner. The most common symptoms are hoarseness, pain when swallowing, earache, a feeling like a lump in the throat, unexplainable weight loss, and swollen lymph nodes. Others can include:

• Red or red and white patches on the tongue or lining of the mouth
• Sores in the mouth that don’t heal
• Painful tongue
• Loose teeth
• Difficulty moving the tongue or jaw
• Swelling in the oral area that stays for more than three weeks
• Thickening of the lining of the mouth

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What causes oral cancer?
Approximately 70 percent of oral pharyngeal cancer cases are believed to be caused by human papillomavirus (HPV), explained oral health expert Dr. Susan Maples, author of Blabber Mouth: 77 Secrets Only Your Mouth Can Tell You to Live a Healthier, Happier, Sexier Life. The culprits for the remaining 30 percent are smoking and chewing tobacco. In addition, Maples notes that “tobacco is thought to increase the risk of sustained HPV infection also, making it a synergistic factor” in the development oral cancer from HPV.

How do you prevent oral cancer?

Since the majority of cases of oral cancer are associated with HPV, it makes sense to focus on that preventive approach. Here are few things to remember:

• If you are sexually active, you have probably been exposed to HPV.
• Exposure to HPV does not mean you will automatically contract cancer. In fact, if you practice healthy lifestyle habits and support your immune system, you have a good chance of clearing the virus from your body in one to two years. Persistent infections are the ones that can eventually develop into cancer.
• Healthy lifestyle habits that can help prevent oral cancer include avoiding any use of tobacco or tobacco products especially if combined with alcohol, practice safe sex (no unprotected sexual contact and/or multiple partners), get sufficient sleep, stay hydrated, follow a nutritious whole foods diet, exercise regularly, don’t use drugs, and use alcohol moderately if at all.
• Get vaccinated against HPV. This is a personal decision that one should make after reviewing the research and speaking with knowledgeable healthcare professionals. HPV vaccines are not a guarantee you will avoid the virus, and it only resists some of the strains, of which there are 51.

Can you screen for oral cancer?

The short answer is, yes. Dentists and hygienists are the healthcare professionals who have been taught to screen for oral cancer whereas regular medical providers have not. However, are these health providers performing these screenings?

According to Linda Miles, founder of the Oral Cancer Cause Foundation, about 50 percent of dental professionals are “simply looking around,” in patients’ mouths for signs of cancer. “But in reality those who provide the complete (9 point inspection) exam are 14-18% based on what I’ve seen in other articles and evaluating client practices.” If your dental professional is not providing this screening, you may want to ask for it.

Among the efforts that are part of the 9-point inspection for oral cancer are palpation of the neck for enlarged lymph nodes, pulling the tongue out and examining it thoroughly, palpating the floor of the mouth, and using a blue fluorescent light to help identify suspicious lesions, among other techniques. Since many HPV lesions are located deep within the tissue and out of reach of the blue light, this approach is not effective for early detection of oral cancers associated with HPV. If your dentist has not conducted an oral cancer screening, you also can ask your general practitioner to perform one for you.

Sources

American Head & Neck Society
Dr. Susan Maples, correspondence
Oral Cancer Foundation

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