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Recently, my friend Maya and I participated in a health walk organized by a charity to increase awareness about breast cancer. As we were walking, we were talking about how science has improved in the diagnosis and treatment of cancers. I casually enquired Maya if she knew about Oral Cancer. Maya, of course, had heard about it but didn’t have much awareness about the disease, its symptoms and treatment options. We spent time talking about Oral cancer that I would like to share with Saathee readers. Oral Cancer includes the cancer of the lips, tongue, palate and the floor of the mouth inside your cheek. According to American Cancer Society, Oral Cancer strikes about 34,000 Americans each year and statistics indicates that it on the rise. Worldwide, Oral cancer strikes about half a million people and India has the highest incidence of oral cancer in the world. Oral cancer is as common as other cancers like Leukemia and claims more lives than cervical and skin cancers.

Let us look at the risk factors for Oral Cancer.

Tobacco: is one of the leading causes of cancer and about 90% of oral cancer patients have used some form of Tobacco. Cigarette, Cigars and Pipes are different forms of smoking tobacco. Smokeless tobacco includes snuff and chewing tobacco.

Alcohol: People who drink alcohol are more prone to oral cancer than non-drinkers. The combination of smoking and drinking is particularly dangerous and can significantly increase the risk of oral cancer.

Virus: HPV or Human papilloma virus is a virus that causes Warts. Recent evidence suggests that HPC seems to be involved in the cause of Oral cancer.

UV light: People who work outside and have prolonged exposure to sun can develop cancer of the lip.

Ill-fitting Dentures: Poorly fitting dentures that cause long-term irritation to the lining of the mouth has also been implicated as a risk factor for oral cancer. Hence denture wearers need to get their dentures checked by a dentist for proper fit. Dentures should not be worn at night and also need to be thoroughly cleaned.

Let us look at the symptoms.

Oral Cancer starts as a small patch seen anywhere inside your mouth or on your lips. These can be red white or a combination of white and red.  These patches do not always mean cancer but it is better for your doctor or dentist to look at it as soon as possible.  

Sores that t do not heel or bleed easily

Changes to your teeth alignment or teeth getting loose

Difficulty swallowing, chewing or speaking or wearing denture

Difficulty moving the tongue or jaw

Pain or numbness anywhere inside the mouth or lips

Lump in the neck

Thickening in the cheek

Early Detection?

Like any cancer, when oral cancer is detected early, the chances of complete recovery are much greater. Only half of all patients diagnosed with oral cancer survive more than 5 years. More than 25% of oral cancers occur in people who not smoke and have not other risk factors. Dentists have advanced tools and skills for early detection of Oral cancer & precancerous areas. On seeing a suspicious spot, a Dentist may perform a diagnostic tests like Vizilite Plus Cancer Exam or a Simple Brush OralCDX Test. It is important that all positive results from either of these tests need to be followed up with a biopsy. Hence regular dental checkups are very important.

Precancerous areas:

These are areas that are morphologically altered and have increased risk of turning into a malignancy. These areas are present as red , white or combination of red and white. These areas need to be completely removed to prevent future transformation into cancer

Diagnosis and Treatment:

Once the diagnosis of the oral cancer is established by biopsy, staging of the cancer is done to determine the size of the cancer and if it has spread to other areas of your body. Oral cancer usually spreads through the lymph nodes. Treatment of oral cancer includes surgery, radiation or chemotherapy. Some patients will receive combination of treatments, depending on the extent of the cancer. People with oral cancer may need reconstructive surgery to rebuild tissues of the mouth. Recent advances in reconstructive surgery help people with oral cancer to return to their normal activities as soon as possible. Follow up care very important after cancer treatment to prevent recurrence. In addition to regular visits to dentists, patients are advised to do self-check of their mouths for suspicious spots.

By the time, I explained my little talk on Oral Cancer, Maya and I have almost crossed the finish line of our Walk. As we were driving back home, I noticed that Maya was looking at her mouth for any suspicious spots. Should you have any questions about Oral Cancer, consult your dentist.

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Dr Meena Chelury, a long time resident of the Triangle, is a graduate of University of North Carolina Dental School and with advanced degrees in Public Health and Oral Pathology. She balances her life between two demanding but wonderful children and her family friendly practice of dentistry. You can reach her at meenac@yahoo.com or soon to open www.AmberlyFamilyDentistry.com

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