How Does Oral Cancer Happen?

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Andra Mahoney BS RDH

Two weeks ago, Becky gave us some great info raising our Awareness to Oral Cancer.  She touched on the importance of screenings and mentioned the risk factors.

But How Does Oral Cancer Happen?

According to the Oral Cancer Foundation, about 48,000 people are diagnosed each year.  Of those, about 9,500 people will loose their battle with oral cancer.  Of the 48,000 people diagnosed, only 57% of them will be alive 5 years after diagnosis.  Sadly, the number of diagnosis and deaths have not decreased over the last decade.

Let’s review the risk factors in detail…

Age

Probability dictates that the older you get, the more likely you have a chance of getting cancer.  Therefore, age will be a risk factor.  Oral Cancer is more often detected in those over the age of 40.  However, this statistic is changing with the prevalence of HPV.  We will talk more about this in a following section.

Although age does play a part, around 91% of all diagnoses of Oral Cancer are linked to “lifestyle” choices.
These following risk factors will show us why.

Sun Exposure

Excessive and unprotected exposure to the sun is linked with cancer in the lip area. To reduce your risk of lip cancer, decrease your unprotected exposure to sunlight and other sources of ultraviolent (UV) radiation.  (1)

Sun exposure and other sources of UV radiation can damage lip cells.  This damage can cause them to multiple when naturally they should die.  Fast reproduction of abnormal cells is how we classify cancer.

Tobacco Use (use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others)

The report from the Institute of Medicine (2007) says that tobacco kills more Americans annually than AIDS, alcohol, cocaine, heroin, homicides, suicides, car accidents, and fires combined.

Nationally, tobacco contributes to about one-third of U.S. cancer, one-quarter of heart disease and about 490,000 premature deaths each year. Tobacco is a known cause of lung, bladder, mouth, pharyngeal, pancreatic, kidney, stomach, laryngeal, and esophageal cancer. About ten million people in the U.S. have died from causes attributed to smoking and tobacco use (including heart disease, emphysema, and other respiratory diseases) since 1964. Tobacco is the most global cause of cancer, and it is preventable. (2)

There are thousands of chemicals contained in a single cigarette, and their point of entry is the mouth.  Smoking helps to transforms saliva into a deadly cocktail that damages cells in the mouth and can turn them cancerous. (3)

If you would like help on quitting, please check out the resources on this page: http://smokefree.gov

Alcohol Use

People who consume approximately 3.5 or more alcoholic drinks per day, or 21 drinks in a week, have at least a two to three times greater risk of developing cancer than nondrinkers. (4)

Those who both smoke and drink, have a 15 times greater risk of developing oral cancer than others.

Alcohol’s effect on the mouth may be the key to understanding how it works with tobacco to increase the risk of developing cancer. The dehydrating effect of alcohol on cell walls enhances the ability of tobacco carcinogens to permeate mouth tissues; additionally, nutritional deficiencies associated with heavy drinking can lower the body’s natural ability to use antioxidants to prevent the formation of cancers. (5)

HPV Infection

The human papilloma virus (HPV) is a common, sexually transmitted virus, which infects about 40 million Americans today. There are about 200 strains of HPV, the majority of which are thought to be harmless. Most Americans will have some version of HPV in their lifetimes, and most immune systems will be able to fight off the virus.  Those who get specific strains, and lack the ability to fight those strains off, are the ones who develop cancer.

The two strains that are mainly associated with oral cancer are HPV16 and HPV18.  HPV is a double-stranded DNA virus that infects the epithelial cells of skin and mucosa.

It is likely that the changes in sexual behaviors of young adults over the last few decades, and which are continuing today, are increasing the spread of HPV, and the oncogenic versions of it.  You can get HPV by vaginal, anal, or oral sex.  Condoms can limit, but do not prevent HPV.  HPV significantly increases with multiple (especially more than four) sexual partners. (6)

How to Spot it

One of the real dangers of this cancer, is that in its early stages, it can go unnoticed. It can be painless, and little in the way of physical changes may be obvious. The good news is however, that your Physician or Dentist can, in many cases, see or feel the precursor tissue changes, or the actual cancer while it is still very small, or in its earliest stages.

It may appear as a white or red patch of tissue in the mouth, or a small ulcer which looks like a common canker sore. Because there are so many normal tissue changes that happen normally in your mouth, and some things as simple as a bite on the inside of your cheek may mimic the look of a dangerous tissue change. It is important to have any sore or discolored area of your mouth, which does not heal within 14 days, looked at by a professional. Other symptoms include; a lump or mass which can be felt inside the mouth or neck, pain or difficulty in swallowing, speaking, or chewing, any wart like masses, hoarseness which lasts for a long time, or any numbness in the oral/facial region. (7)

But like any cancer, even if you do not do these risk factors, there is still a possibility of getting it. 

The best way to detect oral cancer is to do self exams and to see your Dentist regularly.  The Dental Team is the forefront in prevention and detection as their main focus is your mouth!  Your Dentist and/or Hygienist will perform a visual and tactile screening at each appointment.  If they do not, please ask for one.  There are also additional screenings available, and they can tell you more about them during your appointment.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

(1) http://www.cancer.net/cancer-types/oral-and-oropharyngeal-cancer/risk-factors-and-prevention

(2) http://www.oralcancerfoundation.org/tobacco/

(3) http://www.mouthcancer.org/risk-factors/

(4) http://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

(5) http://www.oralcancerfoundation.org/understanding/alcohol-connection.php

(6) http://www.pureeducation.org/index.asp?N=Pure-Education-Lake-Stevens-WA-HPV-Coaching&C=577&P=7764

(7) http://oralcancerfoundation.org/facts/

http://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/dxc-20157232

http://www.oralcancerfoundation.org/hpv/

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