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/

Oral Cancer Awareness

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Becky Larson, RDH

Oral Cancer Awareness

It’s April again!  Which means Oral Cancer Awareness month.  I can’t even begin to tell you how critical it is to receive regular oral cancer screenings.  Your dentist and/or dental hygienist should perform a basic screening at your six month check-ups.  We also recommend having a more in depth oral cancer screening (such as the Velscope, Oral ID, or Identafi) annually.  These more in depth screenings use florescent or ultra violet lights that can detect signs of oral cancer much earlier.  The earlier cancer is caught, the sooner treatment can begin and the better the prognosis.

Oral cancer is any abnormal growth of cells in the oral cavity (mouth).  Abnormal cell growth can be benign (no cause for concern) or malignant (can be life-threatening).  The oral cavity consists of the lips, cheek lining, salivary glands, hard and soft palates, uvula, tongue, floor of the mouth (underneath the tongue), gums, and tonsils.  The tongue and the floor of the mouth are the most common areas for oral cancer to occur.  However, the cancer can spread to other areas of the oral cavity and/or other areas of the body.

Oral cancer can manifest itself in many ways including swellings, lumps or bumps, numbness, abnormal bleeding, white patches, red patches, speckled patch, sores that do not heal, sore throat, pain when chewing/speaking/etc., changes in voice, ear pain, and dramatic weight loss.  If you are experiencing any of these symptoms please visit your dentist or primary care physician.

Risk factors for oral cancer include tobacco use, alcohol use, sun exposure, having HPV (Human papillomavirus), and a history of having oral cancer previously.  Tobacco use is the reason for most oral cancers, especially in those individuals who have used tobacco for lengthy amounts of time.  The risk increases when tobacco users become heavy alcohol drinkers.  Three out of every four oral cancers occur in people who use alcohol, tobacco, or both.  The Human papillomavirus is mainly linked to oropharyngeal cancers.  Limiting sun exposure and the use of sun screen and lip balm can help reduce the risk.  Men are twice as likely to develop oral cancer than women.  It is also important to note that more than 25% of oral cancers are found in individuals with no risk factors.

Everyone is at risk!  Make sure to visit your dentist and dental hygienist for regular oral cancer screenings.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.medicinenet.com/oral_cancer/article.htm

http://www.webmd.com/oral-health/guide/oral-cancer

http://www.cdc.gov/std/hpv/STDFact-HPVandOropharyngealCancer.htm

 

April is Oral Cancer Awareness Month

Sharma RDH

Sharma Mulqueen RDH

April is Oral Cancer Awareness Month

OC Awareness

Early detection is key with oral cancer. When found early, oral cancer patients can have an 80 to 90% survival rate. Unfortunately 40% of those diagnosed with oral cancer will die within five years because the majority of these cases will be discovered as a late stage malignancy.

Oral cancer is particularly dangerous, because the patient may not notice it in its early stages. It can frequently prosper without producing pain or symptoms. As a result, Oral Cancer often goes undetected until it has already metastasized to another location.

Who does oral cancer screenings?

Most oral cancer screenings are done by a Dentist or Hygienist. It is very important at all of your dental appointments you have a screening completed.

When should I have my first oral cancer screening?

More people are being diagnosed with oral cancer than ever before. But surprisingly, research shows this increase is not due to the traditional risk factors of drinking, smoking and using chewing tobacco. Rather oral cancer is now being found in a younger population of men and women because due to their exposure to the HPV (Human Papillomavirus). That is why the Center for Disease Control recommends that all patients over the age of 17 be screened annually for oral cancer.

What types of screenings are there?

A routine “recall” exam usually includes a visual search for lesions and abnormal structures in the oral cavity with palpitations on neck, throat, tongue and cheeks.

The Identafi system uses the Identafi Multi-Spectral Fluorescence and Reflectance technology to enhance visualization of mucosal abnormalities such as oral cancer or premalignant dysplasia that may not be apparent to the naked eye. Unlike other fluorescence technologies and dye systems, the Identafi is Multi-Spectral with three distinct color wavelengths, making it easier to distinguish lesion morphology and vasculature.

Identafi System

The VELscope® Vx system is an adjunctive device which means it must be used together with and as a supplement to the traditional intra and extra oral head and neck exam. Unlike other adjunctive devices used for oral examinations, the VELscope® Vx does not require any dyes or prolonged testing procedures. In fact, a VELscope® Vx exam can be performed during a routine hygiene exam in about two minutes at your dental office.

Dentists, Hygienists, Periodontists, Oral Surgeons, Primary Care Physicians and Otolaryngologists now have the technology to detect morphological and biochemical changes which may lead to oral cancer and potentially save lives, thanks to the Identafi® and VELscope® Vx systems.

Where do I go if there is any concern with my screening?

You will be referred to an Oral and Maxillofacial Surgeons where they will check for lesions and abnormal tissue structures and perform a biopsy.

Oral Surgeons are not front-line detectors, because their patients are typically referred by dentist and other medical professionals as a primary source for cancer diagnosis and treatment.

OC Happens

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Source:

http://www.identafi.net/tools

http://www.dentalez.com/products/stardental/identafi/

http://www.velscope.com/velscope-technology/overview/

PLEASE, Stick Your Tongue Out at Your Dentist

Kim McCrady

Kim McCrady RDH, BA

Dedicated to Phil Swanson and his courageous family

     Come on, you know you have always wanted to stick your tongue out at your dentist and or your hygienist. Honestly, we invite you to be as impolite as possible. During the oral cancer-screening portion of your dental check up we need and want to see as much of your tongue, tissues, lips, and throat as we can.

Oral Cancer Risk Factors

     Unfortunately, according to The Oral Cancer Foundation, cancers of the tongue, lips, cheeks, throat and floor of the mouth are on the rise and have been for the last five years.   In fact, one person passes away every hour from oral cancer.  Those at the highest risk for oral cancer are people with past or current tobacco use habits.  Patients with a family history of oral cancer and men are at a greater risk for oral cancer than women.  The latest consideration as a causative factor for oral cancer is the human papilloma virus (warts) in the oral cavity.  Other listed risk factors include heavy alcohol consumption and over-exposure to the sun.  However, there are many people with oral cancer who will have none of the major known risks factors.

Signs and Symptoms

     There are some signs and symptoms of oral cancer, but most are not detectable until the later stages of development. The National Cancer Institute lists a few of the symptoms of possible oral cancer.  They are patches of tissue that become white or red or a combination of white and red.  Sores on the inside or outside of the lips, mobile teeth, difficulty or pain when swallowing.  If you wear dentures, pain while wearing your dentures can be a warning sign.  Lumps in your neck, along your jawline, behind your ears, pain in your ear that does not subside and lumps in the floor of the mouth are also possible symptoms of oral cancer. 

Oral Caner Screening

     Your dentist and hygienist will check your tissues by having you stick out your tongue.  We catch your tongue with a piece of gauze and will pull it from side to side. We will ask you if you have noticed any sores in your mouth that have been present for more than two weeks.  We will have you touch the roof of your mouth with the tip of your tongue so we can easily view the underside of your tongue.  We also evaluate the inside of your cheeks, lips, floor of the mouth and the back of your throat is also examined. Even the lymph nodes in your neck and along your jawbone need to be checked regularly for abnormalities.  We also check your face, neck and lips for abnormal changes.

     Luckily, new technology is available for oral cancer screenings.  Our office uses a piece of equipment called, the VELscope.  The VeELcope allows the doctor to see changes in the tissue using fluorescence.    This technology allows the doctor to detect changes in the tissue earlier than he can with the naked eye.   Like most technology, we are confident these tools will continue to evolve in accuracy and be used more and more in dental offices.  It is our office philosophy to stay aware of these changes in technology and make them available to you.

Diagnosis and Treatment

     If a suspicious area is detected during your oral cancer screening, your dentist will refer you to an oral surgeon, ear nose and throat specialist or a dermatologist for evaluation and probable biopsy of the area in question.  If you are diagnosed with an oral cancer, treatment will likely vary depending upon the stage of the cancer.  Surgery, radiation, targeted therapy and chemotherapy are often used in combination as treatments.  Early detection and immediate treatment is critical to survival.  Prognosis in a latter stage of development is poor because oral cancers spread (metastasize) quickly to the lymph nodes and other parts of the body as they grow. 

Prevention

     Decrease your risk of oral cancer by reducing your alcohol intake, commit to tobacco cessation.  If you need help quitting, contact your doctor or contact a support program like Ashline.  Be proactive, check your tongue and tissues at home regularly and report to your dentist immediately if you find any concerning areas in your mouth.  The ADA estimates 60% of the US population will see a dentist each year.  This means dental professionals are your partner providers in early detection.  When you see your dentist and your hygienist at your regular visit, insist on an oral cancer screening.  Our office takes oral cancer screening seriously and we invite you to, “PLEASE, stick your tongue out at your dentist!”

 

The Oral Cancer Foundation:  http://oralcancerfoundation.org

National Cancer Institute:  http://www.cancer.gov/cancertopics/wyntk/oral/page1

Ashline: http://www.ashline.org

Oral Surgeons and the VELscope system:  Partners in Early Detection and Diagnosis:  http://www.velscope.com/upload/VELscopeVX_Oral_Surgeons.pdf