This year, nearly 50,000 people are expected to be diagnosed with oral and oropharyngeal cancer. It’s important to distinguish oral cavity cancers from oropharyngeal cancers because they often have different etiologies and prognoses. The 5-year survival rate for oral and oropharyngeal cancer is about 65%, and has improved dramatically over the last few decades. Still, the single best prognostic feature is early diagnosis with a 5-year survival rate of more than 80% if disease is localized and found early. Oral cancer can be extremely treatable if it’s caught early. Knowing the signs and symptoms as well as the risk factors are vital.
Oral cancer can affect all areas around the mouth and eventually spread to affect other parts of the body as well. The most common presentation of oral cancer in the mouth is an ulcerated lesion on the lateral tongue that does not heal. Other presentations include a sharply demarcated white and/or red area, a mass in the mouth that grows, and (less likely) swelling of the gums. Other suspicious signs include numbness in your oral or facial region, difficulty swallowing or speaking, hoarseness in your voice that lasts longer than a cold (4-6+ weeks), as well as a persistent earache.
Oral cancer is often painless in its early stages, so it is critical to maintain regular dentist appointments to ensure that any cancer is caught early. When a patient is in our chair, we do a thorough check of their lips, gums, tongue, floor of mouth, the inside of their cheeks, and their throat. We look for red or white patches, a thick or hard spot, open sores or an ulcerated area inside the mouth. One of the best things you can do to protect yourself from oral cancer is to get regular check-ups, ask questions, and alert the clinician if you have noticed any areas that haven’t healed.
Risk factors that can increase the likelihood of developing oral cancer include tobacco use and excessive consumption of alcohol (more than 15 drinks a week). It’s important to remember that the combined use of tobacco and alcohol significantly increases your risk of getting oral cancer. Unprotected exposure to the sun and UV radiation can lead to cancer of the lip, too, just like skin cancer. With that being said, 25% of oral cancer patients have no risk factors!
One risk factor for oropharyngeal cancer that might be surprising to some is the Human Papilloma Virus, or HPV. Any type of sexual contact with a person who has HPV can impact your health. HPV is contributing to oropharyngeal cancer found in the oropharynx, the tonsils, and the base of tongue. Often it does not produce visible lesions or discolorations that historically have been early warning signs of the disease. In fact, HPV-related oropharyngeal cancer frequently presents as an enlarged lymph node on the side of the face that is involved. If you note a swollen lymph node that continues to enlarge, see your physician for evaluation.
So, what can you do to prevent oral cancer? If you’re a smoker, quit now. While the risk of developing oral cancer from smokeless tobacco exists, it is much, much smaller than that of smoking tobacco. If you’re a heavy drinker, cut back on the number of alcoholic beverages you consume a week. Always practice safe sex and wear SPF lip balm (and sunscreen) if you’re in the sun. Aside from eliminating harmful substances, one of the most important ways to ensure early diagnosis of precancerous and cancerous lesions is to maintain regular appointments with your dentist. Remember, 25% of patients with oral cancer have no risk factors at all, so simple precautions like maintaining your twice yearly appointments can greatly improve your health and even save your life.