It is estimated that about 100 new people in the USA are diagnosed with oral cancer every day and a person dies from oral cancer every hour of every day (Oral Cancer Foundation. org). In 2013 over 42,000 Americans were newly diagnosed with oral and throat cancer.
Abnormal or changes to normal cells, can result in cancer. Oral cancer can form in any part of the mouth or throat, such as:
- Inside cheeks
- Roof of the mouth (palate)
- Floor of the mouth
The tongue and floor of the mouth have the highest risk for cancer. Most at risk are males over the age of 40, and tobacco or alcohol use. Besides tobacco and alcohol, another cause has now been connected with exposure to the HPV-16 virus (human papilloma virus version 16). This is the same virus largely responsible for cervical cancers in women. Scientists believe this could be related to some genetic disposition. Unfortunately, oral cancer may not be diagnosed unless it has spread to other locations.
Mouth & Throat Cancer Risk Factors
According to studies and statistics, tobacco is the greatest risk factor for cancer of the mouth and throat. Although there are other risk factors, tobacco is the largest known cause of developing the disease. Tobacco contains DNA-damaging chemicals that increase the risk of mouth and throat cancer. According to the American Cancer Society, these chemicals damage cells in the lining of the tissues, which results in cells to grow more rapidly.
Cigarettes: It's reported that smoking cigarettes kills more people than AIDS, alcohol, drug abuse, car crashes, murders, suicides, and fires—combined! Not only are smoking cigarettes responsible for increasing the risk of lung cancer, but it also doubles the risk for heart disease.
Cigars and Pipes: You probably didn't know that some cigars contain as much tobacco as an entire pack of cigarettes. According to the Oral Cancer Foundation, cigars are a major source of secondhand smoke, which contains over 4,000 chemicals—200 are poisons, 63 of which cause cancer. Since cigars go through a long process of fermentation, more dangerous chemicals are produced.
It's a myth that if you don't inhale cigarette smoke or you only smoke pipes or cigars, you're not at risk or danger of harm. Damage occurs to living cells with any exposure to smoke. Even if not inhaled, there is a risk of harm to the lips, mouth, tongue, throat and larynx to cancer. The typical exposure to smoke is typically longer with cigar and pipe than cigarettes. Some of the harmful and toxic chemicals found in cigars include carbon monoxide, hydrocarbons, ammonia, cadmium and other substances.
Cigar and pipe smoking have been associated with males between the age of 35 and 64 with higher educational backgrounds and income. However, recent studies suggest teenagers and young adults, between ages of 18–24 have been increasingly using cigars. Women have also increased smoking cigars by five times in recent years, based on a study among California adults in 1990 and 1996.
Smokeless Tobacco: There are two types of smokeless tobacco, chewing tobacco and snuff (spit tobacco). Smokeless tobacco is sold as loose leaf, twist or plug forms. Snuff is sold in moist, dry and sachet forms. Snuff is the most popular form of smokeless tobacco.
It is estimated there are 10 million smokeless tobacco users, of which three million are under the age of 21. Rodeos, rock stars and sports heroes are motivated to be the marketing agents for the tobacco industry, which has targeted male adolescents. These same tobacco companies sponsor rock concerts, rodeos, auto racing and tractor pulls that advertise their products. It's also become popular among young women, who use it to curb appetite for weight loss.
Smokeless tobacco is not a safe substitute for smoking cigarettes. It can cause mouth and throat cancers, not to mention lead to addiction. The main ingredients in smokeless tobacco that contribute to cancer include nitrosamines, polynuclear aromatic hydrocarbons and radioactive and metallic compounds. The amount of nitrosamine content of smokeless tobacco is 1000 times the nitrosamine content allowed by the FDA in products like beer and deli meat.
Oral Cancer Symptoms
If you notice any of the following in your mouth that are not changing and last more than two weeks, make an appointment to see your physician or dentist.
- Tongue pain
- A sore on the lip or in the mouth that doesn't heal
- A lump on or under the tongue
- A lump in the neck
- Whitish patch anywhere in the mouth
- Difficult or painful swallowing
- Difficulty wearing dentures
If your doctor or dentist suspects an abnormal area following an exam, a small sample of tissue is removed (biopsy) to check for cancer cells. A biopsy is done with local anesthesia or general anesthesia. The sample is sent to a pathologist who checks for cancer cells under a microscope.
If the test is positive for cancer cells, the doctor will want to know the stage (level or extent) of the cancer. To determine the stage, lab tests may involve endoscopy, which is used by the doctor examining the throat and lungs with a thin, lighted tube (endoscope).
Dental x-rays, chest x-rays, CT scan and MRI may also be used to determine the stage of oral cancer.
Stages of Oral Cancer
Cancer of the mouth and throat is described by five stages.
At this beginning stage, the cancer is less than two centimeters (about one inch) in size. It has not spread to the lymph nodes around the mouth and neck. Lymph nodes are responsible for producing and storing infection-fighting cells.
The cancer is more than two centimeters in size, but less than four centimeters (less than two inches), and has not spread to lymph nodes in the area.
This stage may include:
- Cancer is more than four centimeters in size.
- Cancer is any size, but has spread to only one lymph node on the same side of the neck as the cancer.
- The lymph node that contains cancer measures no more than three centimeters (just over one inch).
This more advanced stage may include:
- Cancer has spread to tissues around the lip and oral cavity.
- The lymph nodes in the area may or may not contain cancer.
- The cancer is any size and has spread to more than one lymph node on the same side or both sides of the neck.
- The cancer has spread to other parts of the body.
Treatment for Oral Cancer
Depending on the stage of development, a combination or single forms of therapy may be used to stop the spread and treatment of oral cancer.Radiation therapy
Radiation therapy may cause dry mouth and tooth decay. Sore bleeding gums, mouth infection and delayed healing after dental care are other side effects of radiation therapy.
- External radiation comes from a machine, and may be prescribed once or twice a day, five days a week for several weeks.
- Internal radiation includes seeds, needles or thin plastic tubes put directly in the tissue. This involves hospital stay, and the implanted form of radiation remains in place for several days and removed before leaving the hospital.
Chemotherapy uses anticancer drugs to kill cancer cells. It's usually given by injection as an outpatient part of the hospital, at the doctor's office or at home.
Surgery involves removing the affected tissues. A small tumor may not result in lasting problems. Removing a large tumor may involve also removing part of the palate, tongue or jaw.
Alternative treatments may be offered for cancer cures, but they have not been tested or found to be effective in clinical trials. Complementary methods may enhance or support cancer therapy but are not considered as a cure for cancer. These may include acupuncture, meditation, prayer, and herbal medicine.
Before starting any treatment, certain preventive measures should be in order:
- Visiting a dentist before starting any cancer treatment. Any invasive dental care should be completed prior to cancer therapy.
- Eating well during cancer treatment will enhance your treatment. During treatment, you may have to change the form of food you eat, if you have side effects of sore mouth or dry mouth. Thick soups, puddings and milkshakes are easier to swallow.
It's also important for those diagnosed with oral cancer to have an active part in choosing the type of treatment with the doctor. Each treatment has possible side effects. The National Cancer Institute (http://cancer.gov) has information about supportive care (1.800.4.CANCER).