Oral Cancer

Dr. Rodney Shainbom, West Vancouver dentist, performs regular screenings for oral cancer. Oral Cancer refers to “cancer of the mouth”, but in actuality, the term includes cancers found not only in the mouth, but also involving the lips, nose, tongue, throat and neck.  Over 42,000 new cases of oral cancer are diagnosed each year in the United States and 3,200 cases were diagnosed in Canada in 2007. However, in Canada, oral cancer now produces more cases of cancer than either cervical or ovarian cancer, and more deaths than melonoma and cervical cancer. (Canadian Dental Association).  According to the American Cancer Society, oral cancer occurs almost as frequently as leukemia and claims nearly as many lives as melanoma cancer. People 60 years and over are most at risk, but the number of cases is increasing in those under 40. Youth is no longer a protection, especially with the popularity of tanning salons and the use of smokeless tobacco.

There is no one single cause of oral cancer, but we know the most common type is squamous cell carcinoma and it spreads quickly. Only half of those diagnosed with oral cancer will be alive more than 5 years after diagnosis or from the end of treatment. Of those, 43% will die before 5 years after diagnosis.  If oral cancer is found early before it spreads to the lymph nodes or other areas, the cure rate is 90%. The sad findings are that more than 1/2 of diagnosed cases have already spread by the time the diagnosis is confirmed. One in four oral cancer patients will die specifically due to their cancers not being found early. This lack of detection is not due to the difficulty in finding oral cancer. It is due to lack of patient and health professional awareness. Dentists are the frontline experts in finding oral cancer, but only 15% of oral cancer patients said they had been screened by their dentist.

Routine, careful examination of dental patients is appropriate and necessary. This can easily be achieved during a regular dental visit.  Even upon general review of the patient’s social and medical history, possible correlative factors can be identified. Have you or someone you know had a history of smoking, using smokeless tobacco or a habit of heavy alcohol use?  Have you or a friend had Human Papilloma Virus (HPV), the same virus that causes cervical cancer? Other factors include taking immunosuppressant medications, having poor dental hygiene, suffering chronic irritation to the gingiva or mucosa  (gum and soft tissue inside the mouth) due to rough teeth, fillings and dentures. And if you are a man, you are twice as likely to acquire oral cancer compared with women.

Having Current Symptoms?

We all get the occasional mouth sore. Or we bite our tongue or our cheek.  If you have a sore, lump or ulcer in your mouth or a hoarseness that does not resolve, with or without treatment within two weeks, it may be a sign of oral cancer.  It may be a firm area of facial skin, or a hard-edged crack in the tissue on your tongue.  Although most oral cancers appear as red (erythroplastic) patches, some are white or pale-coloured (leukoplastic). They are usually painless, although they can attain a burning sensation when the tumour is advanced. Other symptoms include chewing problems, pain or difficulty in swallowing, speech difficulties, a change in your tone of voice, swollen lymph nodes in your neck, tongue problems or weight loss. If you have any of these, you need to be examined for oral cancer.

Screening Examination Entails . . . :

Dr. Shainbom will begin with a general introduction and observation, where he can assess the acuity of your vision and hearing and any other distinct variations. Recent changes in either can denote a cancer that has invaded these nerve systems.  He will also study any asymmetry of the face, lips and their contours, skin discolorations and unusual voice pitch. Once in the examination chair in the operatory, further observations will be made of your eyes, ears, face and neck under a bright light. Next he will palpate your face, ears, nose, jaws, and neck for signs of abnormal firmness, swelling or lumps. Inside your mouth, your soft tissue and your tongue will be examined for the same errant signs: discoloration, ulcers, hard-edged lesions, asymmetry. A recent study published by the Canadian Dental Association reports that although most malignant lesions are red, of cancers that were definitively diagnosed, at least 10% were white. One cannot depend on colour alone to make the diagnosis.

APRIL IS ORAL CANCER MONTH!  WHAT SHOULD YOU DO?

First:  BECOME EDUCATED ABOUT ORAL CANCER!  It’s no longer an “elderly person’s” disease. Many young people have oral cancer and are unaware until it is advanced, because they do not seek regular hygiene visits and check-ups with their dentist, and/or their dentist does not provide regular oral screenings as part of every 6-month exam. Although smoking, drinking alcohol and the use of smokeless tobacco are known factors, others have had no exposure to these risks and yet develop oral cancer because of genetic predisposition or other reasons presently unknown.

Second: GET YOUR ORAL CANCER SCREENING! And do so every year. Dr. Shainbom provides free oral cancer screenings to the public, as well as to his own patients, at his West Vancouver dental clinic, Dentistry-on-Bellevue, throughout the month of April. Give our office a call. We’d love to see you!