Oral Cancer

On Saturday, October 6th, Dr. Steven Andreaus, a Raleigh dentist, stopped in Asheville during a 750-mile bicycle ride across North Carolina to raise awareness for oral cancer.

While there are many positive facets on the landscape of disease prevention in America and worldwide, oral cancer is not one of them. Through preventive and early detection methods, most diseases, particularly cancers, have seen declining statistics. However, many are surprised to learn that one American dies of oral cancer every hour of every day, a statistic that has remained virtually unchanged for more than forty years. In fact, recent statistics from The American Cancer Society indicate that the incidence of oral cancer has increased by 5.5% and the death rate has increased by 1.5%. Thirty-four thousand Americans will be diagnosed with oral or pharyngeal cancer this year, and only half of those will be alive in five years.

Dr. Andreaus and others are to be applauded for calling attention to these alarming statistics, because it is upon the shoulders of the profession of dentistry that the burden of this responsibility lies. Early detection of oral cancer is difficult because it occurs in an area of the body in which self-examination is not easy. Fifty percent of the population never visit a dentist except in an emergency circumstance. Even at a dental visit, if the dentist or hygienist is focusing on the patients’ most obvious physical need, incipient oral cancer can be easily missed.

Most oral cancers are completely painless. And therefore diagnosis does not occur until the disease has spread to other areas, such as the lymph nodes of the neck.

Oral cancer may begin with a white or red patch of tissue in the mouth, or a small ulcer which does not heal in a reasonable length of time. The most common areas affected are the tongue and floor of the mouth. Other common sites include the base of the tongue, back of the throat, and tonsillar pillars.

The main risk factor is, of course, tobacco use. Smokers and user of chewing tobacco or “snuff” are six times more likely to develop oral cancer than non-tobacco users. About 75 to 80% of people with oral or pharyngeal cancer consume alcohol. People who smoke and drink are at an even higher risk than those who only drink or only use tobacco products.

The Human Papilloma Virus (HPV), a proven cause of cervical cancer, has recently been implicated as a causative factor in oral cancer as well. Studies are ongoing to investigate the connection, and to search for a possible vaccine.

Even though physical oral cancer examinations have long been part of a thorough dental examination, recently some new products have been developed to aid cancer diagnosis. Vizilite and Velscope are diagnostic tools which include a rinse and a special light which reveals developing cancerous areas. The American Cancer Society recommends oral cancer exams every three years prior to age 40 and once a year thereafter.

Visit your dentist at regular intervals and be sure that an oral cancer check is part of the regimen. If your dentist recommends one of the new oral cancer detection systems, please realize we are trying to reverse an oral cancer trend that seems out of control.