More than 50,000 people in North America will be diagnosed with oral/pharyngeal cancer this year, leading to roughly 9,000 deaths. Since oral (mouth) cancer is usually discovered in a late stage, about 57% of people with oral cancer will only survive five years.
Mouth cancer includes cancer of the lips, tongue, gums, inside of the cheeks, salivary glands, and/or the roof or floor of the mouth. Although it’s not clear what causes cancer cell mutations, doctors report the following risk factors: using tobacco products, such as cigarettes, pipes, cigars, snuff, and chewing tobacco; using alcohol excessively (especially with tobacco); exposing your lips to sun without sunscreen; and contracting the sexually transmitted virus HPV (human papillomavirus).
Most oral cancers (about 90%) are squamous cell carcinomas – cancers that develop in the flat, thin, squamous cells that line the inside of your mouth and lips. Mouth cancer is particularly dangerous because it is often missed in its early stages, giving the cancer time to grow and metastasize to other locations, undetected. For this reason, patients with mouth cancer have a high risk of developing a secondary cancer within 10 years.
Since early detection is vital, be alert for these signs and symptoms: loose teeth; tongue pain; a mouth sore that won’t heal; a lump or thickening of the skin and/or lining of your mouth; a white or reddish patch inside your mouth; a change in how dentures fit; pain or stiffness in your jaw; difficultly or pain when chewing and/or swallowing; a sore throat; and/or a feeling that something is caught in your throat.
Although these signs and symptoms may simply indicate an infection, if they last longer than two weeks, visit your dentist or doctor. Get checked to see if your lips and mouth have any irritated areas, sores or unusual patches of colour.
During your check-up, any suspicious cells will be scraped or incised for a biopsy. If cancerous, your doctor will determine the stage using staging tests. Staging tests may include using a scope (endoscopy) to inspect your throat and see if cancer has spread beyond your mouth. Imaging tests may also be recommended, including: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, and positron emission tomography (PET) scans.
Based on test results, Roman numerals I through IV will be used to indicate the stage of cancer. Stage I (a lower stage) indicates a smaller cancer which is confined to one area. A higher stage, such as stage IV, indicates a larger tumor and/or that the cancer has spread to other areas of the head, neck, or even other areas of your body.
An appropriate treatment depends on the location and stage of the cancer, and your overall health and personal preferences.
Some treatment options may include surgery, radiation therapy, chemotherapy and targeted drug therapy. Your treatment may be just one of these, or a combination. Be sure to discuss the options with your doctor.
If surgery is required, a surgeon may remove the tumour and a small portion of healthy skin surrounding the tumour. Small tumors can be removed with minor surgery.
However, larger tumors may require a more extensive procedure, such as the removal of a portion of your tongue or jawbone. If your cancer has spread to the lymph nodes in your neck, they will be removed as well.
When extensive surgery is required, reconstructive surgery may be necessary to enable you to speak or eat, and/or to restore your appearance. If so, skin, muscle or bone grafts and/or dental implants may be required.
If radiation therapy is used, radiation may be enough to eliminate early-stage cancer. For more advanced stages, radiation and chemotherapy may be combined.
Radiation side-effects include tooth decay, dry mouth, mouth sores, bleeding gums, fatigue, a stiff jaw and surface burns.
Chemotherapy, another treatment option, may be used alone or in combination with radiation. Common side-effects include: nausea, vomiting and hair loss.
Targeted drugs can also be used to treat mouth cancer. Cetuximab (Erbitux) is an approved targeted therapy for treating mouth cancer.
This drug affects the cancer cell’s ability to grow by changing aspects of a protein that is denser in certain mouth cancer cells than in healthy cells.
Targeted drugs are usually used in conjunction with chemotherapy and/or radiation therapy.
If you have been diagnosed and are being treated for mouth cancer, avoid tobacco and alcohol; they reduce the effectiveness of the treatment, impede your body’s ability to heal and increase your risk of developing another cancer.
If you haven’t; reduce your risk of developing mouth cancer. Avoid tobacco. Drink alcohol moderately.
Eat a variety of fruits and vegetables rich in Vitamins A, C & E. Avoid sun-burning your lips. Have your mouth thoroughly examined during regular dental/medical check-ups.Avoid oral cancer. Sometimes it’s good to be a smartmouth.
Karen Bowen is a professional health and nutrition consultant, and she can be reached at firstname.lastname@example.org.