On Sunday, September 18, 2016, members of the Seidner Dental Team participated in the Oral Cancer Foundation Walk/Run for Awareness in Memory of David Nasto. This annual event takes place at Perona Farms in Andover and not only helps to raise money for the Oral Cancer Foundation but to educate the population on the symptoms and treatment options of oral cancer. The 4.1-mile walk/run is also quite inspirational as some of the participants have battled oral cancer themselves. Speakers, tricky trays, raffles, music and a fantastic barbecue are all provided in honor of this gentleman who lost his life to oral cancer. David Nasto passed away in 2006 after an incredible battle with stage IV tongue cancer. He was 47 years old. Awareness, early detection, and early action are vital for the successful treatment of oral cancer. David’s family feels that early detection would have saved his life, so along with The Cancer Foundation, this event offers oral cancer screenings by dental professionals.
The purpose of this blog is to help bring attention to the common causes and symptoms of this disease. It is an overview to help patients identify early signs of oral cancer or conditions that we recommend having evaluated professionally. This is not intended to be an all-comprehensive article about oral cancer, but a door to open for awareness, for discussion and for an understanding of what constitutes a higher or lower risk lifestyle for oral cancer.
According to The Oral Cancer Foundation, nearly 50,000 Americans “will be diagnosed with oral or pharyngeal cancer this year. It will cause over 9,575 deaths, killing one person per hour, 24 hours per day. Of those 48,250 newly diagnosed individuals, only slightly more than half will be alive in 5 years.” These are startling statistics, and there are unfortunately much more that can be found at oralcancerfoundation.org. However, with early detection and treatment, success in battling this disease is on your side!
What puts us at risk for oral cancer? Like many cancers and diseases, in general, there are some factors that we can control more than others, of which both can put someone at a greater risk of developing oral cancer.
Risk Factors that can be controlled include:
Tobacco use– Smoking AND smokeless tobacco use are one of the greatest culprits attributing to oral cancer.
Excessive alcohol consumption– Drinking in moderation is recommended to reduce risks. Consuming more than 15 alcoholic drinks per week could increase your chances of developing this disease. Some studies state that 70% of those developing oral cancer are considered heavy drinkers (cancercenter.com).
*the combined use of alcohol and tobacco greatly increases the risk than either of them alone
Betel Nut use– if chewed or smoked increases risks. Avoid use altogether.
Excessive sun exposure- increases the likelihood of lip cancers. Use of lip balm with SPF30 is recommended.
Diet low in fruit and vegetables– the antioxidative properties and the nutrients found in fresh veggies and fruit help to ward off many illnesses in general, including oral cancer. Garlic and onions, for example, are high in compounds called flavonoids which provide antioxidants and help prevent chronic disease. Additionally, dark green vegetables like broccoli, kale, spinach and Brussel sprouts all provide high fiber, antioxidants, and phytochemicals which have shown to lower the risk of chronic disease like cancer.
Factors with limited personal control include:
Age- As we get older, our risk increases for developing oral cancer. A decrease in immunity and the prolonged exposure to risk factors contribute to the diagnosis.
Socioeconomics- low income and impoverished areas have a greater risk or higher incidence. Though not completely understood why, less access to exams, regular care, healthier diets, and habits may attribute.
Recurrence-the risk of cancer developing in another location or reoccurring in the same area is higher for those with a previous history. Regular examinations are recommended for life after an initial diagnosis to help identify and treat suspicious areas of concern.
Gender- according to cancer.org, “oral cancers are more than twice as common in men as in women.”
HPV16 viral infection –The incidence of oral cancer is increasing and is linked to The Human Papillomavirus. Currently at least 25% of oral cancer diagnosis are in people that do not smoke. However, that number is on the rise due to HPV. Additionally, most oral cancers occur after 40 years of age with the average age being 67 years old. These numbers are also changing, and oral cancer is commonly being diagnosed at younger ages due to HPV16. A more detailed discussion of the Human Papillomavirus and oral cancer will be posted as a separate blog following this one.
Cancer is a result of an uncontrolled division of abnormal cells in the body. “Oral cancer” is labeled such when it affects the working parts of the mouth and pharynx, or back of the throat. These areas include lips, tongue, gum tissue, the floor of mouth (under the tongue), palate (roof of the mouth), throat and tonsils. 85% of oral cancers affect the flat cells that cover the surfaces of the mouth and develop into Squamous Cell Carcinomas. Cancers found located toward the front of the mouth, including the tongue, the tissue under the tongue, and cheeks are more associated with smoking products and smokeless tobacco use. These cancers are decreasing due to the decreasing use of tobacco products. However, tonsillar cancer and that found on the back of the tongue and throat are on the rise in younger adults and is related to the HPV16 virus. Detection is more difficult in earlier stages due to the locations in which this virus is most common.
Cancerous areas can appear as a white or red patch or spot. In many cases, there is no discomfort associated with this area, and therefore visual examinations and early detection can help improve prognosis. Oral cancer can also present itself as a sore that won’t heal or a nodule (bump) that can be felt under the tissue. More common noncancerous sores in the mouth like canker sores, cold sores, lacerations, cuts or bites will generally heal in 7 to 14 days. It is recommended to have a professional evaluation of any sore that lasts longer than this period. If no viable causes for the presence of a sore can be determined, then a simple biopsy by an oral surgeon may be recommended to rule out malignancy.
Signs and Symptoms
White or Red patch of the tissues that is newly developed
Any sore not healing within 14 days
Difficulty in eating, swallowing, speaking
Lump or thickening of the tissues
Jaw swelling or stiffness
Voice changes or prolonged hoarseness
Ear pain on one side only
A sore under a denture that will not heal even after adjustments
Oral cancer evaluations or exams are performed regularly in our dental practice. At each semi-annual dental hygiene appointment, the doctors will examine the oral tissues in the mouth, under the tongue and in the back of the throat. Additionally, the hygienist is also evaluating and looking for any abnormalities or concerns in and around the oral cavity. Any unusual or suspicious marks, spots or patches are immediately noted by a detailed description and measured. Often a referral to the oral surgeon or pathologist is recommended for further evaluation and possible biopsy. Once we have referred you to the specialist, it is their determination on whether or not a biopsy will be performed.
Early detection of any cancer leads to a better prognosis for the patient and a better chance of curing cancer altogether. 50% of diagnosed oral cancer results in a cure with no recurrence or metastasis; with the earliest detection, those numbers improve dramatically. Taking steps to live a low-risk lifestyle is the best defense against developing oral cancer. Also, good oral hygiene, regular dental visits, and oral cancer screenings will allow for early detection and higher survival rates.
By Julia Guerra, RDH, BA
Sources reviewed for the purpose of this blog include: