ORAL CANCER: With regular examinations, silent killer doesn’t have to be … – Oak Ridger
Oral cancer is a silent killer in that it may not produce pain or other symptoms in the early stages. By the time a person realizes that there is a problem, the cancer has had an opportunity to spread to other areas of the body.
Consequently, the death rate for oral cancer is high -- higher than that of cervical cancer, skin cancer, Hodgkin's lymphoma, and testicular cancer. Roughly one person dies every hour of every day as the result of oral or pharyngeal cancer. Last year, approximately 37,000 Americans were diagnosed with oral cancer, and worldwide, more than 640,000 new cases were detected, according to the Oral Cancer Foundation.
Regular dental examinations can improve the odds because early detection may lead to early cancer diagnosis and treatment. Even before a person notices any warning signs, a dentist may detect tissue changes or the actual cancer while it is still very small and more easily treated.
Risk Factors
Oral cancer usually develops in one of two ways: Heavy, long-term use of tobacco and alcohol, or exposure to the human papilloma virus (HPV-16 virus). The HPV-16 virus also is responsible for the vast majority of cervical cancers in women. In rare instances, oral cancer has no known cause, although recent research suggests that genetics may be a factor.
In the past, oral cancer patients were predominantly age 40 or older at the time they were diagnosed. Most patients are still older, but a growing number of patients are young people. In the latter group, the primary causes are smoking, the use of "smokeless" tobacco, and the human papilloma virus.
Gender and race also play a role. Oral cancer has traditionally affected men by a six to one ratio over women, but in recent years, the gap between the sexes has closed to a ratio of two to one. This change may be the result of an increase in unhealthy lifestyle choices that women are making, such as smoking. Race plays a role in the development of oral cancer in that it occurs twice as often in African-Americans as in Caucasians.
Treatment
Prevention is always best, and making healthy lifestyle choices, such as steering clear of tobacco, may help. Regular dental examinations also are advisable. Anyone who develops a sore or discolored area in the mouth should see their dentist or family doctor if the place does not heal within two weeks. People also should seek medical help if they experience difficulty in swallowing, speaking, or chewing; persistent hoarseness; frequent ear aches; or numbness in the oral or facial region.
Once oral cancer has been diagnosed, a patient's other oral health needs should be addressed before radiation or chemotherapy begins. The patient should see a dentist for an examination, removal of any diseased teeth, and a thorough cleaning of the remaining teeth. The goal is to decrease the likelihood that a person will develop complications related to their cancer treatment. Complications may range from a minor infection to a serious condition called osteonecrosis, in which radiation causes bone in the area of the cancer to die.
Oral cancer is treated by a multidisciplinary team of health professionals that may include oral surgeons, radiation and medical oncologists, dentists, plastic surgeons, nutritionists, speech therapists, and others. Treatment often consists of chemotherapy and radiation, combined with surgery in some cases.
Life after Oral Cancer
Patients with cancer treated at an early stage may have little post-treatment disfigurement. When cancer is caught at a later stage, the patient may require reconstructive surgery in parts of their oral cavity and face.
Therapy to help patients with speech, chewing and swallowing, and problems associated with the lack of saliva also may be necessary. Additionally, some patients may need dental or facial prostheses.
Joshua Campbell, D.D.S., is an oral-maxillofacial surgeon on the staff of Methodist Medical Center of Oak Ridge. A graduate of the University of Iowa, he completed an oral-maxillofacial residency at the University of Tennessee Medical Center in Knoxville. Campbell is a member of the American Academy of Oral and Maxillofacial Surgeons, Tennessee Society of Oral and Maxillofacial Surgeons, and American Dental Association.
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