Oral cancer on the increase

Oral Cancer Awareness Month just ended without much notice. It is a disease that people should be aware of year-round.

According to the Oral Cancer Foundation (OCF), oral cancer is the largest group of those cancers which fall into the head and neck cancer category.

Approximately 42,000 people in the US will be newly diagnosed with oral cancer in 2013. This includes those cancers that occur in the mouth itself, in the very back of the mouth known as the oropharynx, and on the exterior lip of the mouth.

This is the fifth year in a row in which there has been an increase in the rate of occurrence of oral cancers, in 2007 there was a major jump of over 11 percent in that single year. There are two distinct pathways by which most people come to oral cancer.

One is through the use of tobacco and alcohol, a long term historic problem and cause, and the other is through exposure to the HPV-16 virus (human papilloma virus version 16), a newly identified etiology, and the same one which is responsible for the vast majority of cervical cancers in women.

A small percentage of people (under seven percent) do get oral cancers from no currently identified cause. It is believed that these are likely related to some genetic predisposition.

Furthermore, the OCF web site states that while some think this is a rare cancer, mouth cancer will be newly diagnosed in about 100 new individuals each day in the US alone, and a person dies from oral cancer every hour of every day. If you add the sub category of laryngeal throat cancers, the rates of occurrence (about 12,000 additional new cases per year) and death are significantly higher.

When found at early stages of development, oral cancers have an 80 to 90 percent survival rate. Unfortunately at this time, the majority are found as late stage cancers, and this accounts for the high death rate of about 43 percent at five years from diagnosis (for all stages combined at time of diagnosis), and high treatment related morbidity in survivors.

Late stage diagnosis is not occurring because most of these cancers are hard to discover, it is due to the lack of public awareness coupled with the lack of a national program for opportunistic screenings which would yield early discovery by medical and dental professionals. Worldwide the problem is far greater, with new cases annually exceeding 640,000.

Signs and symptoms of oral cavity cancer include: Non-healing ulcers in the mouth, loosening of teeth, dentures that no longer fit properly, trouble opening mouth, weight loss, difficulty or pain when swallowing or ear pain.

According to the Alex Correa, M.D. and Terry Day M.D. of the Head and Neck Cancer Alliance, up to 30 percent of oral cavity cancer patients show signs of cancer in the lymph glands in the initial evaluation. This percentage excludes patients with hard palate and lip cancers. These two areas have lower chances of having the cancer spread to the lymph glands.

In contrast, the tongue has a rich blood supply and lymphatic drainage which accounts for the fact that up to 66 percent of patients with tongue lesions end up with some type of neck disease as well.

The first symptoms for laryngeal cancer depend on the sites involved, but symptoms include: Difficulty or pain when swallowing, a sensation of having a constant “lump in throat,” ear pain, chronic or bloody cough and trouble breathing.

Patients with vocal cord cancers often complain of hoarseness early on. Trouble breathing is a later finding.

Tumors below the vocal cords are very rare but the most common symptoms are shortness of breath on exertion or trouble breathing.

According to Correa and Day, the treatment of head and neck cancer is often very disabling, often leaving the patient with facial disfigurement, difficulties talking, swallowing and breathing.

Early detection of oral cancer is the key to saving lives and preventing long-term difficulties.

At Summit Dental in Sidney, an advanced oral cancer screening device is in use. Dr. Michael Neal, of Summit Dental, says “We are very pleased to be one of the first dental practices in the area to utilize the Identafi technology to provide our patients with more comprehensive and accurate oral exam. Because the signs and symptoms of oral cancer often cannot be seen by the naked eye, Identafi technology enables me to do just that – identify changes in the mouth that may be a sign of something more serious.”

Sandy Goble at Summit Dental says that free oral cancer screenings were provided during month of April, but these screenings are done with every exam. She added that routine dental exams are recommended every six months.

The Identafi system uses a revolutionary light-wave technology that can help clinicians detect abnormalities that may lead to oral cancer so that something can be done about it as soon as possible. Early detection menas early treatment and a cure rate of nearly 90 percent.

The test is simple and painless and only takes about three minutes to perform. Identafi uses multi-spectral technology to identify biochemical and morphological changes in the cells in your mouth, throat, tongue and tonsils. These changes are subtle as they are happening at the cellular level; so, therefore, they are often undetected by the naked eye.

The changes in the cells are made visible through the use of Identafi’s unique three-wavelength technology which illuminates possible areas of change that may signal the occurrence or early beginnings of oral cancer.

Again, early detection is the key to survival.