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Sunday, November 23, 2014
A trip to the dentist can sometimes give you more than you bargained for: In some cases, it's a dentist who may be the first to discover that a nagging sore or odd-looking white patch is not merely an annoyance, but an early form of oral cancer.
Dentists are the very best when it comes to finding early lesions in the mouth that could eventually wind up being cancerous. Studies show that dentists and dental hygienists may be the most thoroughly trained and the most sensitive to early, subtle changes in the mouth that could signal trouble later on. In other words, they may be able to spot problems that other primary care providers may miss.
And when it comes to oral cancer, the earlier it's discovered and treated, the better the chances of making a full recovery.
Oral cancers make up only a small fraction of the number of new cancers in the U.S. every year, but they are some of the deadliest. Currently, about half of all oral cancers are first detected after they have already had opportunity to take root and spread. At that point, they are difficult to cure. The American Cancer Society estimates that only about half the people diagnosed with oral cancer will survive longer than five years.
New treatments are desperately needed. A variety of agents that range from targeted therapy drugs such as cetuximab, to natural products like extracts from freeze dried black raspberries are being investigated to see if they may be able to suppress the conversion of precancerous to cancerous cells. Recently a clinical trial was approved to see if the black raspberry extracts can block the progression of precancerous oral lesions in humans.
Since the risk of oral cancer increases with age, clinicians are expecting an increasing number of cases in the coming years because large numbers of baby boomers are just beginning to enter their most vulnerable, cancer-prone decades.
This is a time when increased attention to periodic screening is so important.
While oral cancer is still more prevalent among men (60%) than women (40%), dentists are seeing an increasing incidence among women, probably because more women are choosing to smoke. People at higher risk of developing oral tumors include anyone who uses tobacco products in any form and who drinks alcohol on a regular basis.
Catching oral cancer in its earliest phase is critical, as shown by the success of screening in reducing deaths from other types of cancer.
What has happened with cervical cancer in recent years is a good example. In many, less developed countries, cervical cancer still takes a terrible toll among women. But here in the United States, where there is about a 75-80 percent compliance with regular and routine screening, the incidence of cervical cancer has dropped significantly, and deaths have declined dramatically.
About 90 percent of oral malignancies are squamous cell carcinomas, meaning they originate in the lining of the mouth or tongue. And some sites in the mouth - particularly where pooling of saliva may occur - are more vulnerable than others. These include the sides and undersurface of the tongue and the floor of the mouth. Along with the tonsils and the soft palate at the back of the mouth, these areas are the most common cancer sites, representing about half of all cases.
Cancer in its earliest stages can make the lining of the mouth or the tongue look just a little bit different - maybe red or white, or with little bumps. Patients need to be on the lookout for any of the following signs or symptoms:
It is tragic that so many people develop oral cancer when it's so easy to spot during a checkup. We may not be able to catch or cure every single case, but regular screenings would help us be much more effective in controlling this terrible disease.
This article is based on information provided by The Ohio State University Medical Center Media Relations Office and was adapted for use on NetWellness with permission.
Last Reviewed: Jun 22, 2010
Enver Ozer, MD
Clinical Associate Professor of Otolaryngology
College of Medicine
The Ohio State University