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Every hour, 24-hours-a-day, 365-days-a-year, someone dies of oral or oropharyngeal cancer (cancer of the mouth and upper throat).

This year an estimated 54,000 new cases of oral cancer will be diagnosed. Of those individuals, 43 percent will not survive longer than five years, and many who do survive, suffer long-term problems such as severe facial disfigurement or difficulties with eating and speaking.

The mortality rate associated with oral and oropharyngeal cancers remains particularly high because the cancers routinely are discovered late in their development. Yet, if oral cancer is detected and treated early, treatment-related health problems are reduced and survival rates may increase.

THIS APRIL…

We commemorate the Annual Oral Cancer Awareness Month – the American Academy of Oral and Maxillofacial Pathology, American Academy of Oral and Maxillofacial Radiology, the American Association of Oral and Maxillofacial Surgeons, the American Academy of Oral Medicine, the American Academy of Periodontology (perio.org), the American College of Prosthodontics and others are collaborating to raise awareness of oral cancer screenings and the importance of early detection.

Regular oral cancer examinations performed by your oral health professional remain the best method for detecting oral cancer in its early stages.

While smoking and tobacco use are still major risk factors, the fastest-growing segment of oral cancer patients is young, healthy, non-smoking individuals due to the connection to the HPV virus.

What do you need to know about HPV?

According to the Centers for Disease Control and Prevention (CDC), “HPV is the most common sexually transmitted infection in the US. Of the more than 100 types of HPV, about 40 types can spread through direct sexual contact to genital areas, as well as the mouth and throat. Oral HPV is transmitted to the mouth by oral sex, or possibly in other ways. Many people are exposed to oral HPV in their life. About 10% of men and 3.6% of women have oral HPV, and oral HPV infection is more common with older age. Most people clear HPV within one to two years, but HPV infection persists in some people.”

HPV can infect the mouth and throat and cause cancers of the oropharynx (back of the throat, including the base of the tongue and tonsils). This is called oropharyngeal cancer. HPV is thought to cause 70% of oropharyngeal cancers in the United States. It usually takes years after being infected with HPV for cancer to develop. HPV is not known to cause other head and neck cancers, including those in the mouth, larynx, lip, nose, or salivary glands.

What are the red flags?

Signs and symptoms of oral cancer which is predominantly caused by tobacco usage and/or excessive alcohol usage may include one or more of the following:

– Any sore or ulceration that does not heal within 14 days.

– A red, white, or black discolouration of the soft tissues of the mouth.

– Any abnormality that bleeds easily when touched (friable).

– A lump or hard spot in the tissue, usually border of the tongue (induration).

– Tissue raised above that which surrounds it; a growth (exophytic).

– A sore under a denture, which even after adjustment of the denture, does not heal.

– A lump or thickening that develops in the mouth.

– A painless, firm, fixated lump felt on the outside of the neck, which has been there for at least two weeks.

– All the above symptoms have the commonality of being persistent and not resolving.

Signs and symptoms of HPV-caused oropharyngeal cancer may include one or more of the following (which may persist longer than two-three weeks):

– Hoarseness or sore throat that does not resolve within a few weeks.

– A swollen tonsil on just one side. This is usually painless.

– A painless, firm, fixated lump felt on the outside of the neck, which has been there for at least two weeks.

– A persistent cough that does not resolve after many days.

– Difficulty swallowing; a sensation that food is getting caught in your throat.

– An earache on one side (unilateral) persists for more than a few days.

– All the above symptoms have the commonality of being persistent and not resolving.

How do we diagnose oral cancer?

Physical exam – Your oral health professional will examine your lips and mouth to look for abnormalities — areas of irritation, such as sores and white patches (leukoplakia).

Removal of tissue for testing (biopsy) – If a suspicious area is found, your oral health team may remove a sample of cells for laboratory testing in a procedure called a biopsy. The doctor might use a cutting tool to cut away a sample of tissue or use a needle to remove a sample. In the laboratory, the cells are analysed for cancer or precancerous changes that indicate a risk of future cancer.

Determining the extent of the cancer

Using a small camera to inspect your throat. During a procedure called endoscopy, your doctor may pass a small, flexible camera equipped with a light down your throat to look for signs that cancer has spread beyond your mouth.

Imaging tests – A variety of imaging tests may help determine whether cancer has spread beyond your mouth. Imaging tests may include X-ray, CT, MRI and positron emission tomography (PET) scans, among others. Not everyone needs each test. Your doctor will determine which tests are appropriate based on your condition.

Is Oral cancer preventable?

Oral cancer is not completely preventable, but there are certain steps that a person can take to lower their risk and identify warning signs in the cancer’s early stages. Trusted oral health professionals recommend that you schedule regular oral cancer screenings to keep an eye on your oral health and quickly identify any suspicious changes.

Always call your oral health professional right away if there are any immediate concerns. If you have never had an oral cancer examination, there is no better time to schedule one than during Oral Cancer Awareness Month in April. While COVID-19 has been a barrier to Oral Health Care, do not allow the red flags you may notice to go unchecked!