April is Oral Cancer Awareness Month and dentists around the country are raising awareness by sharing information about this disease and encouraging their patients to have an oral cancer screening performed at their next dental checkup.
According to the American Dental Association, oral and oropharyngeal cancers account for 2.9 percent of or 49,750 cancer diagnoses in the United States. Oral and oropharyngeal cancers are responsible for 1.6 percent of or 9,750 cancers deaths in the U.S. each year, killing one person every hour of the day. Oral cancer deaths number over 450,000 worldwide.
Oral cancers are grouped in the more general head and neck cancers, and makeup 85 percent of the cancers in that list.
The ADA recommends that patients have routine screenings for oral cancer that include visual and digital examinations, and discuss their risks of developing oral or oropharyngeal cancer with their dentists. Although oral cancer has a high death rate, many patients choose to skip screenings at their regular dental checkups.
“One of the myths surrounding oral and oropharyngeal cancers is that many people believe that they will be able to see a cancerous spot,” Dr. Stefania Caracioni, D.D.S., L.V.I.F, said.
Caracioni is a Topeka, Kansas, dentist.
“The reality is that by the time a patient is able to notice or visually see a cancerous spot, they may already be at Stage 3 or Stage 4 of their cancer,” she said.
Oral cancer in its early states is frequently painless, and in many cases mimic benign mouth sores, like canker sores. Forms of oral cancers that develop in the back of the mouth in areas like the base of the tongue, the oropharynx and the tonsils frequently produce no discolorations or lesions in the early stages.
Oral cancer is often only discovered in a patient when it has spread to another location, typically to the lymph nodes found in the neck. When the cancer reaches this point, the chance for survival is significantly worse than if caught early, primarily because tumors develop deep into the tissue of the neck and are harder to full eradicate with radiation or excise via surgery.
There is no current comprehensive screening program in the U.S. for dentists to screen for the disease, but many dentists combine a physical examination with a visual inspection that uses ultraviolet light to detect areas cancerous cells.
Patients who are at risk of developing oral cancer include patients who smoke and those patients who use smokeless tobacco products like snuff or chew tobacco.
Oral cancer develops more frequently in men over the age of 55, but young people of both sexes are being diagnosed with oral cancer at increased rates because of exposure to human papillomavirus, or HPV. Actor Michael Douglas was diagnosed with oral cancer as a result of his HPV diagnosis.
Alcohol consumption is also a risk factor in the development of oral cancers, according to the ADA and the American Cancer Society. Three-quarters of oral cancer patients are heavy drinkers, having two drinks a day or more for men or more than one drink per day for women according to the ACS. In many cases, heavy drinkers are also heavy smokers, thus increasing their risk of developing oral cancer.
Patients who survive oral cancer have an increased risk of recurrence compared to other cancers, and are also at a 20 times greater risk of developing another type of cancer than others. Caracioni advises individuals who are concerned about developing oral cancer should discuss their risk with their dentist and ask their dentist about oral cancer screenings at their next check up.
ADA, “Oral and Oropharyngeal Cancer”, 1 January 2017
American Cancer Society, “Alcohol Use and Cancer”